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OALib Journal期刊

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Psychiatric services in primary care settings: a survey of general practitioners in Thailand
Manote Lotrakul, Ratana Saipanish
BMC Family Practice , 2006, DOI: 10.1186/1471-2296-7-48
Abstract: We distributed 1,193 postal questionnaires inquiring about psychiatric practices and service problems to doctors in primary care settings throughout Thailand.Four hundred and thirty-four questionnaires (36.4%) were returned. Sixty-seven of the respondents (15.4%) who had taken further special training in various fields were excluded from the analysis, giving a total of 367 GPs in this study. Fifty-six per cent of respondents were males and they had worked for 4.6 years on average (median = 3 years). 65.6% (SD = 19.3) of the total patients examined had physical problems, 10.7% (SD = 7.9) had psychiatric problems and 23.9% (SD = 16.0) had both problems. The most common psychiatric diagnoses were anxiety disorders (37.5%), alcohol and drugs abuse (28.1%), and depressive disorders (29.2%). Commonly prescribed psychotropic drugs were anxiolytics and antidepressants. The psychotropic drugs most frequently prescribed were diazepam among anti-anxiety drugs, amitriptyline among antidepressant drugs, and haloperidol among antipsychotic drugs.Most drugs available through primary care were the same as what existed 3 decades ago. There should be adequate supply of new and appropriate psychotropic drugs in primary care. Case-finding instruments for common mental disorders might be helpful for GPs whose quality of practice was limited by large numbers of patients. However, the service delivery system should be modified in order to maintain successful care for a large number of psychiatric patients.Studies show a serious shortage of mental health professionals, particularly of psychiatrists [1-3] in developing countries. Thailand is one such country. It is a lower middle-income country with a population of 62.3 million in 2002, 65% of whom reside in rural areas. In 2000, there were 180,252 practicing medical doctors in Thailand [4]. In 2004, there were only seven psychiatrists per million inhabitants and 55% of them were concentrated in Bangkok [5]. There are no psychiatrists avail
Reliability and validity of the Thai version of the PHQ-9
Manote Lotrakul, Sutida Sumrithe, Ratana Saipanish
BMC Psychiatry , 2008, DOI: 10.1186/1471-244x-8-46
Abstract: The English language PHQ-9 was translated into Thai. The process involved back-translation, cross-cultural adaptation, field testing of the pre-final version, as well as final adjustments. The PHQ-9 was then administered among 1,000 patients in family practice clinic. Of these 1,000 patients, 300 were further assessed by the Thai version of the Mini International Neuropsychiatric Interview (MINI) and the Thai version of the Hamilton Rating Scale for Depression (HAM-D). These tools served as gold-standards for diagnosing depression and for assessing symptom severity, respectively. In the assessment, reliability and validity analyses, and receiver operating characteristic curve analysis were performed.Complete data were obtained from 924 participants and 279 interviewed respondents. The mean age of the participants was 45.0 years (SD = 14.3) and 73.7% of them were females. The mean PHQ-9 score was 4.93 (SD = 3.75). The Thai version of the PHQ-9 had satisfactory internal consistency (Cronbach's alpha = 0.79) and showed moderate convergent validity with the HAM-D (r = 0.56; P < 0.001). The categorical algorithm of the PHQ-9 had low sensitivity (0.53) but very high specificity (0.98) and positive likelihood ratio (27.37). Used as a continuous measure, the optimal cut-off score of PHQ-9 ≥ 9 revealed a sensitivity of 0.84, specificity of 0.77, positive predictive value (PPV) of 0.21, negative predictive value (NPV) of 0.99, and positive likelihood ratio of 3.71. The area under the curve (AUC) in this study was 0.89 (SD = 0.05, 95% CI 0.85 to 0.92).The Thai version of the PHQ-9 has acceptable psychometric properties for screening for major depression in general practice with a recommended cut-off score of nine or greater.Depressive illness constitutes a significant proportion of all disabilities caused by mental disorders and has significant public health and economic costs [1]. During the past two decades, health care professionals have made major progress towards the trea
Effects of silk sericin on the proliferation and apoptosis of colon cancer cells
Kaewkorn,Waraporn; Limpeanchob,Nanteetip; Tiyaboonchai,Waree; Pongcharoen,Sutatip; Sutheerawattananonda,Manote;
Biological Research , 2012, DOI: 10.4067/S0716-97602012000100006
Abstract: sericin is a silk protein woven from silkworm cocoons (bombyx mori). in animal model, sericin has been reported to have anti-tumoral action against colon cancer. the mechanisms underlying the activity of sericin against cancer cells are not fully understood. the present study investigated the effects of sericin on human colorectal cancer sw480 cells compared to normal colonic mucosal fhc cells. since the size of the sericin protein may be important for its activity, two ranges of molecular weight were tested. sericin was found to decrease sw480 and fhc cell viability. the small sericin had higher anti-proliferative effects than that of the large sericin in both cell types. increased apoptosis of sw480 cells is associated with increased caspase-3 activity and decreased bcl-2 expression. the anti-proliferative effect of sericin was accompanied by cell cycle arrest at the s phase. thus, sericin reduced sw480 cell viability by inducing cell apoptosis via caspase-3 activation and down-regulation of bcl-2 expression. the present study provides scientific data that support the protective effect of silk sericin against cancer cells of the colon and suggests that this protein may have significant health benefits and could potentially be developed as a dietary supplement for colon cancer prevention.
Hypotensive and Vasorelaxant Effects of Sericin-Derived Oligopeptides in Rats
Amnart Onsa-ard,Dawan Shimbhu,Jiraporn Tocharus,Manote Sutheerawattananonda,Rungusa Pantan,Chainarong Tocharus
ISRN Pharmacology , 2013, DOI: 10.1155/2013/717529
Abstract: Sericin-derived oligopeptides obtained from silk cocoons were investigated for the in vivo hypotensive effect and investigated for the underlying mechanism involved in vasodilation in isolated rat thoracic aorta. In normotensive anesthetized rats, oligopeptides induced an immediate and transient hypotensive activity. In rat aortic rings, oligopeptides induced a concentration-dependent vasorelaxation in vessels precontracted with both KCl and phenylephrine (PE) with endothelium-intact or endothelium-denuded rings. In endothelium-intact rings, pretreatment with Nω-Nitro-L-arginine methyl ester hydrochloride (L-NAME, 100?μM), an inhibitor of the NO synthase (NOS) or 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (ODQ, 1?μM), a selective inhibitor of the guanylyl cyclase enzyme, significantly reduced the relaxant effect of oligopeptides. However, indomethacin, an inhibitor of the cyclooxygenase, had no effect on oligopeptides-induced relaxation. In addition, pretreatment with tetraethylammonium (TEA, 5?mM) reduced the maximal relaxant effect induced by oligopeptides. By contrast, relaxation was not affected by 4-aminopyridine (4-AP, 1?mM), glibenclamide (10?μM), or barium chloride (BaCl2, 1?mM). In depolarization Ca2+-free solution, oligopeptides inhibited calcium chloride- (CaCl2-) induced contraction in endothelium-denuded rings in a concentration-dependent manner. Nevertheless, oligopeptides attenuated transient contractions in Ca2+-free medium containing EGTA (1?mM) induced by 1?μM PE, but they were not affected by 20?mM caffeine. It is obvious that potent vasodilation effect of oligopeptides is mediated through both the endothelium and the vascular smooth muscle. 1. Introduction Peptides derived from dietary proteins have been determined to modulate physiological functions. Bioactive peptides have also elicited antihypertensive and vasodilator functions [1]. The most common underlying mechanism of bioactive peptides has been studied in angiotensin-converting enzyme (ACE) inhibition [2–4]. Although the ACE inhibitor effects of bioactive peptides are most often studied, the vasorelaxant activity has also shown an important evidence for lowering blood pressure. It is well established that dietary protein found in soy protein [5], milk casein [6], and sweet potato [7] and its hydrolysates are capable of reducing blood pressure and modulating vascular activity. Recently, there are many reports that dietary-protein-derived peptides lower blood pressure and modulate vasodilation from several sources including egg white [8], soy protein [9], and κ-casein [10].
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