REFERENCES 1. Berdowski J, Berg RA, Tijssen JG, Koster RW. Global incidences of out-of-hospital cardiac arrest and survival rates: Systematic review of 67 prospective studies. Resuscitation, 2010; 81(11): 1479-1487. 2. Grasner JT, Lefering R, Koster RW, et al. EuReCa ONE-27 Nations, ONE Europe, ONE Registry: A prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe. Resuscitation. 2016;105: 188-195. 3. Nishiyama C, Brown SP, May S, et al. Apples to apples or apples to oranges? International variation
Jana Heczková and Alan Bulava
Chariya Hahnvajanawong, Supaluk Ketnimit, Wongwarut Boonyanugomol, Kovit Pattanapanyasat, Yaovalux Chamgramol, Banchob Sripa, Nisana Namwat, Khosit Pinmai, Wichittra Tassaneeyakul and Vichai Reutrakul
:5506-7. 20. Niles RM, McFarland M, Weimer MB, Redkar A, Fu YM, Meadows GG. Resveratrol is a potent inducer of apoptosis in human melanoma cells. Cancer Lett. 2003; 190:157-63. 21. Compton MM. A biochemical hallmark of apoptosis: internucleosomal degradation of the genome. Cancer Metastasis Rev. 1992; 11:105-19. 22. Benitez DA, Pozo-Guisado E, Alvarez-Barrientos A, Fernandez-Salguero PM, Castellon EA. Mechanisms involved in resveratrol-induced apoptosis and cell cycle arrest in prostate cancer-derived cell lines. J Androl. 2007; 28
Senol Yavuz, Cuneyt Eris, Faruk Toktas, Tugrul Goncu, Yusuf Ata and Tamer Turk
, Leelachiewchankul F. Risk factors of perioperative death at a university hospital in Thailand: a registry of 50,409 anesthetics. Asian Biomed. 2008; 2:51-8. 11. Anthi A, Tzelepis GE, Alivizatos P, Michalis A, Palatianos GM, Geroulanos S. Unexpected cardiac arrest after cardiac surgery: incidence, predisposing causes, and outcome of open chest cardiopulmonary resuscitation. Chest. 1998; 113;15-9. 12. Buschmann CT, Tsokos M. Frequent and rare complications of resuscitation attempts. Intensive Care Med. 2009; 35:397-404. 13. Krischer
Somrat Charuluxananan, Wimonrat Sriraj, Yodying Punjasawadwong, Siriporn Pitimana-aree, Varinee Lekprasert, Thewarug Werawatganon, Wirat Wasinwong, Prapa Ratanachai, Dujduen Sriramatr, Sunida Atichat, Wanna Angkasuvan, Chuthamat Somchat, Duangporn Tanutanud, Thidarat Ariyanuchitkul, Jaroonpong Choorat, Krairerk Sintavanuruk and Jeratkana Janngam
Anesthesiologists are accepted as aiming to be outstanding in patient safety and medical quality improvement. However, both preventable and inevitable adverse events still persist [ 1 , 2 ]. According to the Thai Anesthesia Incidents Study (THAI Study) database, the incidence of perioperative cardiac arrest within 24 h was 31:10,000 in 2005 with a mortality rate of 90% [ 3 , 4 ]. The Royal College of Anesthesiologists of Thailand (RCAT) initiated knowledge management tools using research to improve anesthesia processes and outcomes. Several strategies have been
Rong-Rong Zhang, Hong Wang, Ning Hui and Ping Zhang
. Cancer Res. 2009; 69:5893-900. 26. Fuke H, Shiraki K, Sugimoto K, Tanaka J, Beppu T, Yoneda K, et al. Jak inhibitor induces S phase cellcycle arrest and augments TRAIL-induced apoptosis in human hepatocellular carcinoma cells. Biochem Biophys Res Commun. 2007; 363:738-44. 27. Li H, Wang H, Wang F, Gu Q, Xu X. Snail involves in the transforming growth factor beta1-mediated epithelial-mesenchymal transition of retinal pigment epithelial cells. PLoS One. 2011; 6:e23322. 28. Huang C, Yang G, Jiang T, Huang K, Cao J, Qiu Z
Somrat Charuluxananan, Wanwimol Saengchote, Sireeluck Klanarong, Yodying Punjasawadwong, Waraporn Chau-in, Chanrit Lawthaweesawat and Thewarug Werawatganon
:1375-81. 29. Tamdee D, Charuluxananan S, Punjasawadwong Y, Tawichasri C, Kyokong O, Patumanond J, et al. Factors related to 24-hour periopeative cardiac arrest in geriatric patients in a Thai university hospital. J Med Assoc Thai. 2009; 92:198-207. 30. Charuluxananan S, Thienthong S, Rumgreungvanich M, Chanchayanon T, Chinachotti T, Kyokong O, et al. Cardiac arrest after spinal anesthesia in Thailand: a prospective multicenter registry of 40271 anesthetics. Anesth Analg. 2008; 107:1735-43.
Suwannee Suraseranivongse, Busakorn Wungpayon, Phuping Akavipat, Paron Prownpun and Sireeluck Klanarong
Background: Currently, there is a considerable variation concerning the provision of preanesthetic-risk information, especially potential detrimental adverse outcomes.
Objective: Determine the effects of printed anesthetic-risk information before surgery including patients’ anxiety, refusal of surgery, knowledge perception of adverse events and factors affecting anxiety.
Methods: Patients in a university hospital, a tertiary care hospital, a secondary care hospital, and a neurological institute in Thailand, undergoing low-to-moderate risk surgery were randomly allocated to control group (C) and study group (S), where group C received printed general information in anesthesia, and group S received printed incidences of five anesthetic adverse events as sore throat, nausea/vomiting, tooth loss, not waking up after surgery, cardiac arrest. Spielberger State-Trait Anxiety Inventory Scale (STAIS, STAIT) for anxiety and Visual Analog Scale (VAS) for knowledge perception were recorded before and after information, and after surgery. Numbers of patients who refused surgery and needed anesthetic-risk information in the next surgery were also recorded. STAIS >45 were considered “high anxiety”.
Results: Eight-hundred and twenty-four patients were analyzed (group C: 414, group S: 410). There was no difference in age, sex, ASA physical status, salary, education level, habitat, anesthetic experience and operative risk between groups. STAIS and STAIT, proportion of patients with high anxiety, proportion of patients who refused surgery were not different between groups. Patients in control group needed anesthetic-risk information in the next surgery more than study group (p <0.001). VAS for knowledge about five adverse events in study group were significantly higher than control group (p <0.001). Risk factors by the multivariate analysis included patients with high baseline trait anxiety and low income of less than 10,000 Baht/month.
Conclusion: Printed anesthetic-risk information did not increase anxiety, but increased knowledge perception of the patients.
Pongphaya Choosakulchart, Tanattha Kittisopee, Suchet Takdhada, Yoel Lubell and Janet Robinson
Background: Influenza can exacerbate chronic coronary heart diseases (CHD) and health policy recommends influenza vaccination in this population group. However, cost effectiveness of influenza vaccination in protecting CHD population has not been, to our knowledge, well studied before especially in CHD patients with different disease severities.
Objectives: To assess life-time cost utility of influenza vaccination in CHD patients either with angina and/or cardiac arrest/myocardial infarction (CA/MI) and to identify the most cost-effective influenza vaccination strategies.
Method: The Markov model of CHD progression concurrent with the influenza infection was developed to quantify life-time costs and health effects of the three influenza vaccination strategies compared with no influenza vaccination (base case): (1) influenza vaccination in all CHD patients, (2) influenza vaccination in CA/MI patients-only, and (3) influenza vaccination in angina patients-only. The cost-effectiveness analysis (CEA) was based on the societal perspective. Deterministic and probabilistic sensitivity analyses were performed to identify variables that influence the sensitivity of the results and examine the effects of model parameters uncertainty, respectively.
Results: For the base case, the expected value (EV) results of no influenza vaccination, influenza vaccination in all CHD groups, influenza vaccination in angina patients, and influenza vaccination in CA/MI are 346,437 Thai baht (THB) yielded 18.26 Quality adjusted life year (QALYs), 454,664 THB yielded 21.46 QALYs, 360,786 THB yielded 19.96 QALYs, and 437,901 THB yielded 19.72 QALYs; respectively. CEA graph comparing all influenza vaccination strategies shows that vaccination in all CHD patients groups and angina patients are in the costeffectiveness frontier, but not influenza vaccination in CA/MI patients. The cost-effectiveness rankings report shows that the willingness-to-pay (WTP) threshold (100,000 THB) is greater than the incremental cost effectiveness ratio (ICER) of vaccination in all CHD groups (ICER = 33,813 THB per QALY gained) and angina group (8,420 THB per QALY gained) and therefore the vaccination in all CHD groups, which is more expensive, but more effective would be recommended. The deterministic sensitivity analysis shows the most influential parameters driving the cost-effectiveness of vaccination strategies are the effect of influenza vaccination on CHD both for acute myocardial infarction and cardiovascular death, respectively. The probabilistic sensitivity analysis shows the same influenza strategy recommendation (vaccination in all CHD groups) as the base case analysis.
Conclusion: From a societal perspective, influenza vaccination in all CHD groups is recommended. The information from economic modeling should be confirmed by primary economic research.
Pornarun Charoenraj, Somrat Charuluxananan, Phornlert Chatrkaw, Chooksak Tunprasit, Parinya Wangdumrongwong and Vorapong Phupong
:12-6. 7. Charuluxananan S, Thienthong S, Rungreungvanich M, Chanchayanon T, Chinachoti T, Kyokong O, Punjasawadwong Y. Cardiac arrest after spinal anesthesia in Thailand: a prospective multicenter registry of 40271 anesthetics. Anesth Analg. 2008; 107: 1735-41. 8. Peel WJ. A survey of the anaesthetic management of patients presenting for Caesarean section with high risk obstetric conditions. Int J Obstet Anaesth. 1996; 5:219-20. 9. Plumer MH, Rottman R. How anesthesiologists practice obstetric anesthesia. Responses of practicing obstetric
Ngamjit Kasetsuwan, Preeyatas Sukharoch, Piyawadee Meesoupong, Usanee Reinprayoom, Vilavun Puangsricharern and Lalida Pariyakanok
. Tissue adhesive arrests stromal melting in the human cornea. Am J Ophthalmol. 1980; 89:795-802. 16. Hirst LW, Smiddy WE, Stark WJ. Corneal perforations: changing methods of treatments of treatment.1960-1980. Ophthalmology. 1982; 89:630-5. 17. Snip RC, Kenyon KR. Acute inflammatory cells in melting human corneas. Invest Ophthalmol Vis Sci [Suppl]. 1978; 17:252. 18. Cavanaugh TB, Gottsch JD. Infectious keratitis and cyanoacrylate adhesive. Am J Ophthalmol. 1991; 111: 466-72.