[Show abstract][Hide abstract] ABSTRACT: Early diagnosis of dengue virus infection during the febrile stage is essential for adjusting appropriate management. This study is to identify the predictive markers of clinical and laboratory findings in the acute stage of dengue infection during a major outbreak of dengue virus type 1 that occurred in southern Taiwan during 2007. A retrospective, hospital-based study was conducted at a university hospital in southern Taiwan from January to December, 2007. Patient who was reported for clinically suspected dengue infection was enrolled. Laboratory-positive dengue cases are confirmed by enzyme-linked immunosorbent assay of specific dengue IgM, fourfold increase of dengue-specific IgG titers in convalescent serum, or by reverse transcription-polymerase chain reaction (RT-PCR) of dengue virus.
The suspected dengue cases consist of 100 children (<= 18 years) and 481 adults. Among the 581 patients, 67 (67%) children and 309 (64.2%) adults were laboratory-confirmed. Patients who had laboratory indeterminate were excluded. Most cases were uncomplicated and 3.8% of children and 2.9% of adults developed dengue hemorrhagic fever or dengue shock syndrome (DHF/DSS). The overall mortality rate in those with DHF/DSS was 7.1%, and the average duration of hospitalization was 20 days. The most common symptoms/signs at admission were myalgia (46.8%), petechiae (36.9%) and nausea /vomiting (33.5%). The most notable laboratory findings included leukopenia (2966 +/- 1896/cmm), thrombocytopenia (102 +/- 45 x 103/cmm), prolonged activated partial thromboplastin time (aPTT) (45 +/- 10 s), and elevated serum levels of aminotransferase (AST, 166 +/- 208 U/L; ALT, 82 +/- 103 U/L) and low C - reactive protein (CRP) (6 +/- 11 mg/L). Based on the clinical features for predicting laboratory-confirmed dengue infection, the sensitivities of typical rash, myalgia, and positive tourniquet test are 59.2%, 46.8%, and 34.2%, while the specificities for above features are 75.4%, 53.5% and 100%, respectively. The positive predictive value (PPV) for combination of leukopenia, thrombocytopenia (< 150 x 103/cmm), elevated aminotransferase (AST/ALT > 1.5) and low CRP (< 20 mg/L) is 89.5%, while the negative predictive value is 37.4%. Furthermore, the PPV of the combination was increased to 93.1% by adding prolonged aPTT (>38 secs).
Leukopenia, thrombocytopenia, elevated aminotransferases, low CRP and prolonged aPTT, were useful predictive markers for early diagnosis of dengue infection during a large outbreak in southern Taiwan.
Journal of Biomedical Science 10/2013; 20(1):75. · 2.74 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to evaluate the larvicidal activity of Mentha x villosa essential oil (MVEO) and its major constituent, rotundifolone, against larvae of Aedes aegypti. Additionally, a set of 15 analogues of the rotundifolone were evaluated to identify the molecular characteristics which contribute to the larvicidal effect. The results from the present study showed that the MVEO exhibited outstanding toxic effects against Ae. aegypti larvae (LC50=45.0ppm). Rotundifolone exhibited reasonable larvicidal activity (LC50=62.5ppm). With respect to comparative study of rotundifolone and its analogues, all tested compounds were less potent than rotundifolone, except (-)-limonene. In general, replacement of C-C double bonds by epoxides groups decreases the larvicidal potency. The presence of α,β-unsaturated carbonyls contributes to the larvicidal toxicity. The addition of hydroxyl groups in the chemical structure resulted in less potent compounds. Furthermore, the enantioselectivity seems to play an important role for the larvicidal toxicity.
[Show abstract][Hide abstract] ABSTRACT: While extensively studied in liquid water, there have been no prior investigations exploring the evolution of ring structures as a means of tracking order during the transition of water into ice. In this study, we identify key ring motifs participating in water crystallization; the populations of singlet and coupled rings involving 5, 6 and 7-member rings increase significantly in the interfacial region relative to the bulk liquid, with those involving of 5 and 7-member rings exhibiting maxima while only those for 6-member rings increase continuously. The configurations and populations of ring motifs facilitate the exploration of potential pathways through which water rings evolve to bulk ice.
Chemical Physics Letters 12/2011; · 1.99 Impact Factor
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