2006 ที่น้องแอนทำ.pmd - Mahidol University

Mahidol University Abstract of International Publications 2006
No.21
Author(s) : Ananworanich J, Hirschel B, Sirivichayakul S, Ubolyam S, Jupimai T, Prasithsirikul
W, Chetchotisakd P, Kiertiburanakul S, Munsakul W, Raksakulkarn P,
Tansuphasawadikul S, Schutz M, Snowden W, Ruxrungtham K.
Title : Absence of resistance mutations in antiretroviral – naive patients treated with ritonavir
– boosted saquinavir.
Source : Antiviral Therapy. 11 (5): 631 – 635, 2006.
Document Type : Article.
Keywords : Reverse – transcriptase inhibitors, Treatment – experienced patients, Early virological
failure, Drug susceptibility, HIV – 1, Identification, Regimens, Thailand, Therapy,
A/E.
Abstract : Background: There are few data on the selection of resistance by ritonavir – boosted
saquinavir (SQV/r), particularly in antiretroviral (ARV) – naive patients. Objective:
To assess the incidence of virological failure and evolution of resistance in ARV –
naive individuals receiving SQV/r in the induction phase of the Staccato trial. Methods:
ARV – naive subjects (n=272) received SQV/r 1,600/100 mg once daily with two
nucleoside reverse transcriptase inhibitors (NRTIs) for at least 24 weeks. Patients
were defined as having virological failure (VF) when there were two consecutive HIV
– 1 RNA measurements > 500 copies/ml after week 12. Viral genotypes (reverse
transcriptase [RT] and protease [PRO]) were determined at baseline in all patients
and as close as possible to the time of initial failure in patients experiencing VF.
Results: VF was observed in 9/272 patients receiving SQV/r 1,600/100 mg once daily
with two NRTIs (3.3%) and occurred 19 – 48 weeks after treatment initiation. Eight
of these patients were evaluable at failure. No major PRO mutations were detected,
but 2/8 displayed single new minor PRO substitutions (M36I, L10I) at VF that were
known or suspected not to have been present at baseline; both these substitutions
exist as natural polymorphisms. A third patient displayed a single new RT mutation
(M184I). Conclusions: SQV/r plus two NRTIs (1,600/100 mg once daily) is an effective
initial treatment option for ARV – naive patients, resulting in a low rate of viral
rebound (3.3%). Furthermore, no major protease mutations were detected following
VF, suggesting that future treatment options are preserved.
No.22
Author(s) : Angkoolpakdeekul T, Samlitpradit P, Warodomwichit D, Roongpisuthipong C,
Pongchailert P, Komindr S.
Title : Initial experience and result of a Swedish adjustable gastric banding by laparoscopic
approach in Thai cohorts.
Source : Journal of the Medical Association of Thailand. 89 (8): 1140 – 1145, 2006.
Document Type : Article.
Keywords : Laparoscopic gastric banding, Morbid obesity, Surgical complication, Surgical device,
Weight loss.
Abstract : Background: Morbid obesity is a growing problem in Thailand. Several surgical
procedures are available for weight reduction. The laparoscopic gastric banding has
been shown to be an effective weight loss with a low post or perioperative complication.
Objective: The aim of this report was to evaluate the early preliminary outcome of
the laparoscopic Swedish adjustable gastric banding operation in Thai cohort patients.
Material and Method: From November 2003 until March 2005, ten patients with a
median age of 31 (range, 18 – 61) underwent laparoscopic Swedish adjustable gastric
banding for morbid obesity at Ramathibodi Hospital. Demography, clinical course and
outcome including excess weight loss and peri – operative complications were reviewed
and studied. Descriptive statistics were used for data summary. Results: There were
3 men and 7 women with a median preoperative body weight of 142.5 kg (range, 98
– 164 kg), and median body mass index (BMI) of 49.2 kg/m 2 (range, 40.3 – 62.4 kg/m 2 ).
The operations were successful in 9 out of 10 patients with median operative time of
195 minutes (range, 125 – 275 minutes). One patient with a BMI of 62.4 had a failed
operation due to poor operative exposure from a very large left lobe of the liver. None
of the remaining patients required conversion to the opened technique. The mean
hospital stay was 4 days with no perioperative mortality. There was no major post
operative complication except one minor wound infection. The excess weight loss
was within the range of 33.5% to 62.1% during the short – term follow – up (range, 1
– 15 months) Conclusion: The presented early preliminary result of the laparoscopic
Swedish adjustable gastric banding showed a good technical success with a significant
short – term weight loss. The authors believe this minimally invasive operation is
appropriate for morbidly obese Thai patient. However, a longer follow – up study is
needed.
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