Sarcopenia in Asia

Panita Limpawattana,Praew Kotruchin,Chatlert Pongchaiyakul 대한골다공증학회 2015 Osteoporosis and Sarcopenia Vol.1 No.2

Sarcopenia is a progressive and generalized loss of muscle mass and either a loss of muscle strength or physical performance. Its prevalence increases with age and is associated with multiple unfavorable clinical outcomes. The operational definitions and diagnostic strategy of sarcopenia in Asia is currently based on the consensus of the Asian Working Group of Sarcopenia (AWGS) which requires measurements of muscle mass, muscle strength, and physical performance. This article reviewed the epidemiology, impact, pathophysiology, recommended tools and their cut-offs for diagnosis of sarcopenia in Asia according to the consensus of the AWGS and existing evidence in Asia. It is clear that exercise, diet and nutrition are beneficial for sarcopenic adults in the areas of prevention and treatment but no medications are currently proven. Future study in Asia should be straight forward to include intervention for prevention and treatment of sarcopenia. © 2015 The Korean Society of Osteoporosis. Production and hosting by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Burdens among Caregivers of Older Adults with Advanced Cancer and Risk Factors

Chindaprasirt, Jarin,Limpawattana, Panita,Pakkaratho, Pornvaree,Wirasorn, Kosin,Sookprasert, Aumkhae,Kongbunkiat, Kannikar,Sawanyawisuth, Kittisak Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.4

Family caregivers of older cancer patients face many challenges in managing illness. The burden impacts physical, emotional, spiritual, and social health. The objective of this study was to identify burden among caregivers of older patients with advanced cancer, and associated factors. Materials and Methods: Caregivers of older cancer patients were randomly interviewed from March-September 2012. Information on baseline characteristics and caregiver burden using the Zarit Burden Inventory (ZBI) was collected. Descriptive statistics were used to analyze baseline data, with univariate and multiple linear regression to analyze factors associated with higher burden. Results: One hundred and fifty participants were assessed. The mean ZBI was $19.2{\pm}12.9$ (95%CI, 17.1, 21.2). Two-thirds of caregivers reported no burden (63%) and the main impact variable on ZBI was guilt. High burdens were associated with single caregiver, relationship with the patient as siblings, presence of migraines, and cancer types of the patients. Conclusions: Caregiver burden of Thai cancer patients is low. This unexpected small number could be the result of the socio-cultural viewpoint. Assessment of caregivers and focusing on related factors should be incorporated into treatment plans.

Properties and bioavailability assessment of shrimp astaxanthin loaded liposomes

Anantita Sangsuriyawong,Maruj Limpawattana,Dalad Siriwan,Wanwimol Klaypradit 한국식품과학회 2019 Food Science and Biotechnology Vol.28 No.2

This study aimed to investigate the effects ofphospholipid composition on the properties and bioavailabilityof astaxanthin-loaded liposomes using cell culture. Two mixtures of phospholipids with different proportionsof phosphatidylcholine (PC, 23% and 70%) were used atvarious concentrations (0.8, 1.6, and 2.0% w/v) to prepareastaxanthin-loaded liposomes, which were investigated forentrapment efficiency (EE), antioxidant activity, morphologyand changes in astaxanthin properties during a storageperiod of 8 weeks at 4 C. Furthermore, Caco-2 humancolon adenocarcinoma cells were employed to examine thecellular uptake of astaxanthin-loaded liposomes. Thehighest EE was observed with astaxanthin-loaded liposomescontaining 70% PC, and used at the concentration of2.0% w/v. Liposomes maintained the antioxidant activityof astaxanthin. All liposomal preparations were non-toxic. Cellular uptake of astaxanthin-loaded liposomes containing70% PC was significantly higher than that of 23% PCcontainingliposomes (p\0.05).

Mortality, Length of Stay, and Cost Associated with Hospitalized Adult Cancer Patients with Febrile Neutropenia

Chindaprasirt, Jarin,Wanitpongpun, Chinadol,Limpawattana, Panita,Thepsuthammarat, Kaewjai,Sripakdee, Warunsuda,Wirasorn, Kosin,Sookprasert, Aumkhae Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.2

Background: Febrile neutropenia (FN) is a serious complication following chemotherapy and is associated with significant mortality and financial expenditure. The aim of this study was to evaluate risk factors for longer length of stay (LOS) and mortality and cost of treatment among hospitalized adults with cancer who developed febrile neutropenia in Thailand. Materials and Methods: Information on illness of inpatients and casualties came from hospitals nationwide and from hospital withdrawals from the 3 health insurance schemes in fiscal 2010. The data covered 96% of the population and were analyzed by age groups, hospital level, and insurance year schemes in patients with febrile neutropenia. Results: A total of 5,809 patients were identified in the study. The mortality rate was 14%. The median LOS was 8.67 days and 69% of patients stayed for longer than 5 days. On bivariate analysis, age, cancer type, and infectious complications (bacteremia/sepsis, hypotension, fungal infections, and pneumonia) were significantly associated with longer LOS and death. On multivariate analysis, acute leukemia and infectious complications were linked with longer LOS and death significantly. The median cost of hospitalized FN was THB 33,686 (USD 1,122) with the highest cost observed in acute leukemia patients. Conclusions: FN in adult patients results in significant mortality in hospitalized Thai patients. Factors associated with increased mortality include older age (>70), acute leukemia, comorbidity, and infectious complications.

Hospital-based Population of Elderly Cancer Cases in Northeastern Thailand

Wirasorn, K,Suwanrungruang, K,Sookprasert, A,Limpawattana, P,Sirithanaphol, W,Chindaprasirt, J Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.2

Background: The proportion of aged Thais (${\geq}65$ years old) is expected to be 30% by 2030, leading to an increased number of elderly cancer cases. Older individuals have distinct patterns of cancer and treatment needs. We therefore conducted the present study of new cancer cases and trends to get a perspective on the elderly cancer situation in Northeast Thailand. Materials and Methods: All new elderly cancer cases (${\geq}65$ years) registered in the hospital-based cancer registry at the Faculty of Medicine, Srinagarind Hospital, Khon Kaen University during 1993-2012 were included in the study. Results: Elderly patients accounted for 31.6% of all cancer patients and new cancer cases in the older age group increased 46% from the first to second decades. The absolute number of oldest old (80+ years) doubled. The top three cancers in males were liver and bile duct, lung, and colorectal. In females, the three most common cancers were liver and bile duct, oral cavity, and cervix. Cancers with the highest percentages of increase were thyroid, prostate, and colorectal. Conclusions: Elderly cancer cases are increasing. Treatment modalities and palliative care for older populations are urgently needed.

Brain Metastases from Cholangiocarcinoma: a First Case Series in Thailand

Chindaprasirt, Jarin,Sookprasert, Aumkhae,Sawanyawisuth, Kittisak,Limpawattana, Panita,Tiamkao, Somsak Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.5

Background: Brain metastasis from cholangiocarcinoma (CCA) is a rare but fatal event. To the best of our knowledge, only few cases have been reported. Herein, we report the incident rate and a first case series of brain metastases from CCA. Methods: Between January 2006 and December 2010 5,164 patients were treated at Srinagarind hospital, Khon Kaen University; of those, 8 patients developed brain metastasis. Here we reviewed clinical data and survival times. Results: The incident rate of brain metastases from CCA was 0.15%. The median age of the patients was 60 years. Tumor subtypes were intrahepatic in 6 and hilar in 2 patients. All suffered from symptoms related to brain metastasis. Three patients were treated with whole-brain radiation therapy (WBRT), one of whom also underwent surgery. The median survival after the diagnosis of brain metastasis was 9.5 weeks (1-28 weeks). The longest survival observed in a patient in RPA class I with two brain lesions and received WBRT. Conclusion: This is a first case series of brain metastases from CCA with the incident rate of 0.15%. It is rare and associated with short survival time.

Predictors for Obesity Hypoventilation Syndrome in Thai Population

sarunya saeseow,Kittisak Sawanyawisuth,Sittichai khamsai,Panita Limpawattana,Jarin Chindaprasirt,Berajit Chotmonkol,Songkwan Silaruks,Vichai Senthong,paiboon chattkul 대한수면학회 2019 sleep medicine research Vol.10 No.1

Background and ObjectiveaaObesity Hypoventilation Syndrome (OHS), is a condition with high morbidity and mortality. Body Mass Index (BMI) of more than 30 kg/m2 is used, to diagnose OHS. As BMI for obesity for Thais is 25 kg/m2, BMI more than 25 kg/m2 is used in our institution, to diagnose OHS. The purpose of this study was to evaluate if BMI of 25 kg/m2 is appropriate crite- rion for OHS in Thai patients. MethodsaaThis study was a retrospective study conducted at Khon Kaen University. Inclusion criteria were adult patients diagnosed with OHS in 2016. Patients diagnosed with obstructive sleep apnea (OSA), were randomly selected as control subjects. The ratio of OHS:OSA, was 1:4. Clinical factors associated with OHS were examined, using multivariate logistic regression analysis. ResultsaaDuring the study period, there were 25 OHS and 108 OSA patients. The OHS group had a significantly higher average BMI (48.9 kg/m2 vs. 29.2 kg/m2), than the OSA group. The OHS group also had higher proportions of patients with pulmonary hypertension (50% vs. 2%), and heart failure (76% vs. 6.5%). There were two independent predictors for OHS, including BMI and serum bicarbonate levels. Adjusted odds ratio (95% CI) for each of these factors was 1.08 (1.01, 1.17) and 1.96 (1.15, 3.34), respectively. Body mass index greater than 25 kg/m2 and serum bicar- bonate more than 25 mEq/L, yielded 100% sensitivity for OHS. ConclusionsaaAppropriate diagnostic criteria for OHS for the Thai population, may be different from those for populations in Western countries.

Clinical Manifestations of Eosinophilic Meningitis Due to Infection with Angiostrongylus cantonensis in Children

Kittisak Sawanyawisuth,Jarin Chindaprasirt,Vichai Senthong,Panita Limpawattana,Narong Auvichayapat,Sompon Tassniyom,Verajit Chotmongkol,Wanchai Maleewong,Pewpan M. Intapan 대한기생충학열대의학회 2013 The Korean Journal of Parasitology Vol.51 No.6