Ruangrong Cheepsattayakorn

Parasitic Pneumonia and Lung Involvement

Parasitic infestations demonstrated a decline in the past decade as a result of better hygiene practices and improved socioeconomic conditions. Nevertheless, global immigration, increased numbers of the immunocompromised people, international traveling, global warming, and rapid urbanization of the cities have increased the susceptibility of the world population to parasitic diseases. A number of new human parasites, such as Plasmodium knowlesi, in addition to many potential parasites, have urged the interest of scientific community. A broad spectrum of protozoal parasites frequently affects the respiratory system, particularly the lungs. The diagnosis of parasitic diseases of airway is challenging due to their wide varieties of clinical and roentgenographic presentations. So detailed interrogations of travel history to endemic areas are critical for clinicians or pulmonologists to manage this entity. The migrating adult worms can cause mechanical airway obstruction, while the larvae can cause airway inflammation. This paper provides a comprehensive review of both protozoal and helminthic infestations that affect the airway system, particularly the lungs, including clinical and roentgenographic presentations, diagnostic tests, and therapeutic approaches.

Novel compounds and drugs and recent patents in treating multidrug-resistant and extensively drug-resistant tuberculosis.

A number of recent studies revealed that successful treatment of the patients with MDR/XDR- TB was not achieved due to high resistant rates to many second-line drugs such as kanamycin and prothionamide including poor adherence of the lengthy treatment. Many new drugs and compounds such as benzothiazinones, meropenem, PA-824, isoflavonoids, rhein, PNU-100480, TMC207, SQ109, OPC-67683, AZD5847, and linezolid are currently in development pipeline. According to very few patents in new compounds and drugs against MDR/XDRMycobacterium tuberculosis bacilli have been currently introduced, so inventors must be encouraged to contribute to this area worldwide.

Breath Tests in Respiratory and Critical Care Medicine: From Research to Practice in Current Perspectives

Today, exhaled nitric oxide has been studied the most, and most researches have now focusd on asthma. More than a thousand different volatile organic compounds have been observed in low concentrations in normal human breath. Alkanes and methylalkanes, the majority of breath volatile organic compounds, have been increasingly used by physicians as a novel method to diagnose many diseases without discomforts of invasive procedures. None of the individual exhaled volatile organic compound alone is specific for disease. Exhaled breath analysis techniques may be available to diagnose and monitor the diseases in home setting when their sensitivity and specificity are improved in the future.

Malaria with Pulmonary Complications

Received date: September 30, 2014, Accepted date: October 9, 2014, Published date: October 16, 2014Copyright:

Novel Avian Flu A (H7N9): Clinical and Epidemiological Aspects, andManagement

Avian influenza A (H7N9) virus, the latest avian influenza virus strain was once considered a relatively rare cause of infection and low pathogenic. This novel virus spreading among three cases was firstly reported on 31 March 2013 in eastern China. By 31 March 2013, the number of laboratory-confirmed influenza H7N9 virus infections reached 132, with 37 deaths. There are age and gender differences between H7N9 virus-infected and H5N1 virus-infected patients. Currently, the reservoir or source of this novel virus is unknown but is most likely to be live-bird markets in eastern China. Low pathogenicity in poultry and birds and no evidence of human-to-human transmission have been noted. The incubation period of this novel virus ranges 3 to 8 days, thus the most appropriate time for contacts observation and treatment is 10 full days. The best diagnostic method for confirmation of H7N9 virus infections is real-time reversetranscriptase polymerase chain reaction. Lymphopenia and thrombocytopenia can be predictors of acute respiratory distress syndrome and death. Approximately, 20% of cases without appropriate treatment with antivirals are dead with respiratory failure and multiple organ failure. Fortunately, Oseltamivir and Zanamivir are still susceptible to this novel virus. Currently, no specific vaccines against H7N9 viruses are available. China scenario and its model against spreading of this virus can be an effective model for other countries for protection of this virus spreading.

Treatment Outcomes of Adjunctive Surgery in Multidrug-Resistant and Extensively Drug-Resistant Tuberculosis

cohort study of about 10,000 MDR-TB cases ( at least 400 cases of them being XDR-TB) demonstrated 62% of treatment success rate, 7% of failing or relapsing rate, 17% of defaulting rate, and 9% of death rate. Among XDR-TB subgroup, only 40% reached the treatment success, 22% failed treatment or relapsed, 16% defaulted, and 15% died. Among the subgroup of XDR-TB with severe drug-resistance pattern, only 19% achieved treatment success. Thoracic surgery for MDR-TB/XDR-TB is a potentially beneficial adjunctive treatment. The first surgical intervention on a patient with TB was performed by Barry E in 1726, followed by Forlannini C in 1882, who carried out an artificial pneumothorax. A favorable outcomes for 72 MDR-TB/ XDR-TB patients undergoing surgical lung resection in the country of Georgia was reported that 49(68%) were cured, 6(8%) were completed. Nevertheless, 4(5.5%) of them were treatment failure, 5(7%) were defaulters, and 4(5.5%) were dead. The surgical procedures were performed as the following : 11% of pneumonectomy, 54% of lobectomy, and 35% of segmentectomy. With utilizing a combination of personal medical treatment for MDR-TB/XDR-TB according to the WHO guidelines and adjunctive surgical treatment, a high rate of favorable treatment outcomes (82%) was obtained. Favorable treatment outcomes was included in 90% of those with MDR-TB and 67% of those with XDR-TB. Surgical treatment for drug-resistant TB has been demonstrated to be safe and effective, with operative mortality rates similar to surgery for lung cancer. Two specific indications for lung resection in drug-resistant TB are failed medical treatment with persistent sputum positivity and patients with medical treatment and negative sputum smear who have bronchiectasis or localized cavitary disease. A systematic review and meta-analysis of adjunctive pulmonary resection for MDR-TB patients that included 15 studies (a total sample size of 949) demonstrated the overall cure rate of 84%. A previous study of 5 Japanese XDR-TB cases revealed that two cases with pneumonectomy and three cases with upper lobectomy (preoperative chemotherapy with sparfloxacin+pyrazinamide+cyclos erine+ethionamide+enviomycin;gatifloxacin+cycloserine+enviomyci n+para-aminosalicylic acid; gatifloxacin+pyrazinamide+cycoserine ; gatifloxacin+pyrazinamide+enviomycin ; and kanamycin+cycoserin e+ethionamide+para-aminosalicylic acid+sultamicillin tosilate) After the surgical operation, most patients attained sputum negative status, and return to their normal daily activities. The duration of postoperative antituberculous chemotherapy ranged from 12-25months with the median of 19months and all of them remained free from disease at the time of follow-up. In conclusion, There has been lack of randomized controlled trials of surgical resections although observational studies with surgical interventions have demonstrated a high treatment success rate when used as adjunctive treatment in MDR-TB/XDR-TB patients. Adjunctive surgical interventions may [lay a significant role in improving clinical outcomes in many cases of complicated MDRTB/XDR-TB with localized and tissue destruction accompanying failure to become culture negative.

Human Herpesvirus Type 6 and 7-Associated Diseases: An Update

Humanherpesvirus type 6 (HHV 6) and 7 (HHV 7), two different herpesviruses of herpes family, particularly HHV 7 can cause roseola and several other associated diseases, such as neurological diseases, Graves’ disease, Hodgkin’s disease, Kaposi’s sarcoma, etc. The pathological association of HHV 7 with pityriasis rosea is still controversial. HHV 6 mostly infects CD4+ T cells. Genomes of both variants of HHV 6 and 7 are closely related. TP53 gene plays the major role in restricting the production of HHV 6B messenger-ribonucleic acid (mRNA). Nevertheless, the roles of both HHV 6 and 7 in various dermatological disorders and several other clinical manifestations are still to be defined. Further investigations are urgently needed.

Zika Virus Infection and Disease

The incubation period is likely to be a few days to a week. The illness is usually mild with symptoms lasting for several days to a week. The virus usually remains in the blood for a few days, but it can be identified longer in some individuals. Cases with severe disease requiring hospital admission is uncommon. There are at least 72 persons who have been diagnosed with the Zika virus infection or disease in the United States since the latest outbreak began. At least four pregnant women have been confirmed the diagnosis of Zika virus infection. All of the infected cases are believed to have been travel related except for one that was transmitted through sexual contact from an infected traveler to their partner that mentioned before. The disease has historically occurred in Africa, Southeast Asia, and islands in the Pacific Ocean. Zika virus disease is considered an emerging infectious disease with potential to spread to new areas. In May 2015, the Pan American Health Organization (PAHO) issued an alert regarding the first confirmed Zika virus infections in northeastern Brazil. The virus has since spread throughout much of the South America, Central America, and the Carribean. They had more evidence that links the Zika virus to a dangerous birth defect namely“ microcephaly ”. The genetic material of the Zika virus was identified in brain tissue from two infants with microcephaly who had finally died. The United States Centers for Disease Control and Prevention recommends that pregnant woman consider postponing travel to any area where the Zika virus transmission is ongoing. Despite these relatively mild clinical symptoms, several health officials are investigating a possible association between Zika virus infections in pregnant women and certain birth defects.The diagnosis of Zika virus infection is performed through serologic and molecular testing that includes reverse transcriptase-polymerase chain reaction (RT-PCR) for viral RNA, and immunoglobulin (Ig) M ELISA and plaque reduction neutralization test (PRNT) for Zika virus antibodies.Individuals prevent Zika virus infection by avoiding mosquito bites. Currently, there is no vaccine or medications are available to prevent or treat Zika virus infection.

World AIDS Day-1 December 2015: Global Campaigns and Challenges

In 1988, the first World AIDS Day was held after the health ministers from around the world met in London, United Kingdom to ensure universal care, treatment and support for persons living with HIV and AIDS. The theme of this year is “Getting to zero”, Zero New HIV Infections, Zero Discrimination, and Zero AIDS-related deaths. Since 2000, the world has come a long way achieving the global target of reversing the spread of HIV.

Human Immunodeficiency Virus Infection (HIV)/Acquired Immunodeficiency Syndrome (AIDS): The Frontiers and Global Challenges

HIV/AIDS continues to be a major health threat. An estimated 2.7 million new infections and an estimated 2 million deaths from HIV/AIDS-related illnesses were demonstrated in 2007. The World Health Organization (WHO) estimates that 8-10 million new cases of tuberculosis (TB) globally occur each year and accounts for 25% of AIDS deaths. Although AIDS is the same disease as HIV disease in all part of the world, this microorganism is mostly in many tropical countries. In tropical countries, TB and bacterial pneumonia represent the major pulmonary infections among the patients with HIV-infection/AIDS. Although the spectrum of HIV disease/AIDS is quite broad, the majority of the pulmonary infections in HIV-1 infected patients are similar to those observed in non-HIV infected persons. The geographical differences are primarily due to varying frequencies rather than the kinds of infections. Of all the pulmonary infections encountered in the tropics obviously Mycobacterium tuberculosis is one of the most significant pathogenic microorganisms. Great effort and resources have been invested in the improvement of diagnostic and treatment approaches for TB, and in identification of the close association between the two diseases. The developments have simultaneously benefited many living with HIV. Not all co-infections, nevertheless, have received sufficient attention. Donated funds would require paying for AIDS treatment, and funds remain insufficient for prevention strategies. Making therapy a priority could have the result of reducing fund, thus, increasing the numbers of cases which need therapy. When treatment and prevention ideals meet reality, prevention must be the highest priority. The United States Centers for Disease Control and Prevention (CDC) has recommended HIV testing of all pregnant women as part of the basic package of prenatal services for nearly two decades. Unfortunately, in the past, the focus of global mother-to-child HIV prevention efforts was on Editorial Volume 1 Issue 2 2014