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Fulltext Seroepidemiology of Klebsiella pneumoniae colonizing the intestinal tract of healthy Chinese and overseas Chinese adults in Asian countries

Lin YT, Siu LK, Lin JC, Chen TL, Tseng CP, Yeh KM, et al.

BMC Microbiol, 2012;12:13.
PMID: 22260182 DOI: 10.1186/1471-2180-12-13

Capsular serotypes K1 and K2 of Klebsiella pneumoniae are thought to the major virulence determinants responsible for liver abscess. The intestine is one of the major reservoirs of K. pneumoniae, and epidemiological studies have suggested that the majority of K. pneumoniae infections are preceded by colonization of the gastrointestinal tract. The possibility of fecal-oral transmission in liver abscess has been raised on the basis of molecular typing of isolates. Data on the serotype distribution of K. pneumoniae in stool samples from healthy individuals has not been previously reported. This study investigated the seroepidemiology of K. pneumoniae isolates from the intestinal tract of healthy Chinese in Asian countries. Stool specimens from healthy adult Chinese residents of Taiwan, Japan, Hong Kong, China, Thailand, Malaysia, Singapore, and Vietnam were collected from August 2004 to August 2010 for analysis.
Water quality variation during a strong El Niño event in 2016: a case study in Kampar River, Malaysia

Ng CK, Goh CH, Lin JC, Tan MS, Bong W, Yong CS, et al.

Environ Monit Assess, 2018 Jun 15;190(7):402.
PMID: 29904816 DOI: 10.1007/s10661-018-6784-2

El Niño and Southern Oscillation (ENSO) is a natural forcing that affects global climate patterns, thereon influencing freshwater quality and security. In the advent of a strong El Niño warming event in 2016 which induced an extreme dry weather in Malaysia, water quality variation was investigated in Kampar River which supplies potable water to a population of 92,850. Sampling points were stratified into four ecohydrological units and 144 water samples were examined from October 2015 to March 2017. The Malaysian Water Quality Index (WQI) and some supplementary parameters were analysed in the context of reduced precipitation. Data shows that prolonged dry weather, episodic and sporadic pollution incidents have caused some anomalies in dissolved oxygen (DO), total suspended solids (TSS), turbidity and ammoniacal nitrogen (AN) values recorded and the possible factors are discussed. The month of March and August 2016 recorded the lowest precipitation, but the overall resultant WQI remained acceptable. Since the occurrence of a strong El Niño event is infrequent and far between in decadal time scale, this paper gives some rare insights that may be central to monitoring and managing freshwater resource that has a crucial impact to the mass population in the region of Southeast Asia.
Patient and oncologist perceptions regarding symptoms and impact on quality-of-life of oral mucositis in cancer treatment: results from the Awareness Drives Oral Mucositis PercepTion (ADOPT) study

Kanagalingam J, Wahid MIA, Lin JC, Cupino NA, Liu E, Kang JH, et al.

Support Care Cancer, 2018 Jul;26(7):2191-2200.
PMID: 29387994 DOI: 10.1007/s00520-018-4050-3

PURPOSE: This descriptive cross-sectional survey aims to assess the level of concordance between the perspectives of oncologists and those of patients regarding oral mucositis (OM) symptoms, and the impact of OM on various aspects of daily living and concurrent cancer management.
METHODS: Oncologists involved in OM management (n = 105), and patients who developed OM during cancer treatment (n = 175), were recruited from seven Asian countries. Oncologists completed a face-to-face, quantitative interview; patients completed a face-to-face interview, and a self-reported questionnaire.
RESULTS: Oncologists and patients ranked treatment-induced OM among the three most important toxicities of cancer therapy requiring intervention. The most frequent OM symptoms reported by patients were oral ulcers (74%), dry mouth (73%), and difficulty swallowing (62%). Oncologists expected mild OM symptoms to last slightly longer than 1 week, whereas patients reported mild symptoms for more than 2 weeks. In mild-to-moderate OM, oncologists underestimated patients' pain experience. Overall, only 45% of oncologists said they would initiate OM prophylaxis when cancer therapy started. Of the 87% of patients who said they used their prescribed medications, only 16% reported using prophylactically prescribed medication. While oncologists' concerns related to the delays and interruptions of cancer treatment, patients tended to focus on the effects of OM on eating, drinking, and talking.
CONCLUSIONS: Oncologists' and patients' perceptions about treatment-induced OM differ. To overcome discordant perspectives, there is a need to raise general awareness and improve proactive management of OM. As noted in recent guidelines, supportive cancer care is critical for ensuring optimal therapy and for improving the patient's experience.
Fulltext Consensus recommendations for management of head and neck cancer in Asian countries: a review of international guidelines

D'cruz A, Lin T, Anand AK, Atmakusuma D, Calaguas MJ, Chitapanarux I, et al.

Oral Oncol, 2013 Sep;49(9):872-877.
PMID: 23830839 DOI: 10.1016/j.oraloncology.2013.05.010

Head and neck cancer (HNC) is a disease of the upper aerodigestive tract and is one of the most frequently diagnosed cancers worldwide. A high rate of cancers involving the head and neck are reported across the Asian region, with notable variations between countries. Disease prognosis is largely dependent on tumor stage and site. Patients with early stage disease have a 60-95% chance of cure with local therapy. Early diagnosis and appropriate treatment are important to increase the likelihood of cure and survival. However, the majority of patients present with locally advanced disease and require multimodality treatment. This necessitates, a multidisciplinary approach which is essential to make appropriate treatment decisions, particularly with regards to tolerability, costs, available infrastructure and quality of life issues. Unfortunately, majority of the studies that dictate current practice have been developed in the west where diseases biology, patient population and available infrastructure are very different from those in the Asian continent. With this in mind an expert panel of Head and Neck Oncologists was convened in May 2012 to review the National Comprehensive Cancer Network (NCCN) and the European Society for Medical Oncology (ESMO) clinical practice guidelines and develop practical recommendations on the applicability of these guidelines on the management of head and neck cancer for Asian patients. The objective of this review and consensus meeting was to suggest revisions, to account for potential differences in demographics and resources, to the NCCN and ESMO guidelines, to better reflect current clinical management of head and neck cancer within the Asian region for health care providers. These recommendations, which reflect best clinical practice within Asia, are expected to benefit practitioners when making decisions regarding optimal treatment strategies for their patients.
Fulltext International recommendations for plasma Epstein-Barr virus DNA measurement in nasopharyngeal carcinoma in resource-constrained settings: lessons from the COVID-19 pandemic

Lee VH, Adham M, Ben Kridis W, Bossi P, Chen MY, Chitapanarux I, et al.

Lancet Oncol, 2022 Dec;23(12):e544-e551.
PMID: 36455583 DOI: 10.1016/S1470-2045(22)00505-8

The effects of the COVID-19 pandemic continue to constrain health-care staff and resources worldwide, despite the availability of effective vaccines. Aerosol-generating procedures such as endoscopy, a common investigation tool for nasopharyngeal carcinoma, are recognised as a likely cause of SARS-CoV-2 spread in hospitals. Plasma Epstein-Barr virus (EBV) DNA is considered the most accurate biomarker for the routine management of nasopharyngeal carcinoma. A consensus statement on whether plasma EBV DNA can minimise the need for or replace aerosol-generating procedures, imaging methods, and face-to-face consultations in managing nasopharyngeal carcinoma is urgently needed amid the current pandemic and potentially for future highly contagious airborne diseases or natural disasters. We completed a modified Delphi consensus process of three rounds with 33 international experts in otorhinolaryngology or head and neck surgery, radiation oncology, medical oncology, and clinical oncology with vast experience in managing nasopharyngeal carcinoma, representing 51 international professional societies and national clinical trial groups. These consensus recommendations aim to enhance consistency in clinical practice, reduce ambiguity in delivering care, and offer advice for clinicians worldwide who work in endemic and non-endemic regions of nasopharyngeal carcinoma, in the context of COVID-19 and other airborne pandemics, and in future unexpected settings of severe resource constraints and insufficiency of personal protective equipment.