A cohort study to identify incidence and risk factors of hookworm infection was conducted in a rural community, central Thailand from November 2005 to February 2007. Stool specimens were examined for hookworm eggs using wet preparation, Kato thick smear, and water-ethyl acetate sedimentation technique. The incidence rate of hookworm infection was 7.5/100 person-years. The independent risk factors for acquiring hookworm infection were barefoot walking (incidence rate ratio [IRR] = 4.2, 95% confidence interval [CI] = 1.2–14.5) and raising buffaloes around the house (IRR = 4.8, 95% CI = 1.9–11.8). Sequencing of internal transcribed spacer 1 (ITS1)-5.8S-ITS2 region of the ribosomal RNA gene were performed for identifying species of hookworm. Necator americanus was the most common hookworm identified in this population. Ancylostoma duodenale and A. ceylanicum were also detected. Our data suggest transmission of both human and animal hookworms in this community. Thus, prevention and control strategies of hookworm infection should cover both human and animal infection.

Objectives: To study the prevalence of fluoroquinolone-resistant and extended spectrum β-lactamase-producing isolates at Phramongkutklao Hospital, Thailand, and to identify the risk factors predicting the carriage of these organisms. Methods: Menundergoing transrectal ultrasound-guided prostate biopsy were prospectively enrolled between February and October2015. Rectal swab culture was obtained before antimicrobial prophylaxis andprostate biopsy. Univariate and multivariate analyses were performed to identify the independent risk factors associated with antimicrobial-resistant flora. Results: In total, 99 patients underwent biopsy, of whom 38 (38.4%) had antimicrobial-resistant rectal flora,with 26 (26.3%) having fluoroquinolone-resistant rectal flora and12 (12.1%) having both fluoroquinolone-resistant rectal flora and extended spectrum β-lactamase.The incidence of postbiopsy infections was 6.1%. The use of antibiotics in the past 6 months was found in 23.7% of the resistant group vs.6.6% of the sensitive group(odds ratio = 4.86,p= 0.030),with the previous biopsy history being 31.6% and14.8% (odds ratio = 3.17, p= 0.036),respectively. Postbiopsy infectionsoccurred in13.2% and1% (odds ratio = 10.69,p= 0.045) of patients in the resistant and sensitive groups, respectively. Conclusions: The prevalence offluoroquinolone-resistant rectal flora increased in patients undergoing transrectal prostate biopsyat Phramongkutklao Hospital, Thailand. A history of antibiotics in the past 6 months, previous biopsy, andpostbiopsy infections were associated with antimicrobialresistance. Culture-directed prophylaxis antibiotics may reduce postbiopsy infections after transrectal prostate biopsy.

Background: Renal cell carcinoma (RCC) is the most common kidney cancer in adults. Computed Tomography (CT) with contrast study is used to diagnose RCC. The enhancement in the nephrogenic phase more than 15 Hounsfield units (HU) is suspected of RCCs. However, this threshold HU shows 15-20% false positive results for RCCs. Objectives: This study aimed to determine RCC enhancement in CT that was below the standard threshold and to analyze the attenuation range of RCCs in noncontrast CT. Methods: Patients with pathological RCC and undergoing CT with contrast study were retrospectively reviewed. An average of attenuation values of three regions of interest (ROI) were measured in noncontrast and nephrogenic phases, by avoiding foci of calcification and peritumoral region. ROI values were calculated for enhancement and range of attenuation values in the noncontrast CT. Results: A total of 152 pathologically RCCs were included in the study. Mean ± SD attenuation values were 32.54 ± 8.02 HU (range 13.3-57.23 HU) and 71.26 ± 33.1 HU (range 16.87-202.8 HU) for noncontrast and contrast CT, respectively. Thirty-one (20.4%) of RCCs did not reach 15 HU enhancement. Using multivariate analysis, significant differences among subtypes (p<0.001) and renal mass less than 7 cm (p<0.001) were observed. In noncontrast CT, using a range of 20-60 HU, 129 (84.9%) RCCs were entirely within this range. To improve the accuracy of RCC diagnosis, the combined use of both non-contrast attenuation group (<20 HU and >20 HU) and enhancement >15 HU could increase the accuracy to 96.7%. Conclusion: One-fifth of RCCs did not reach the standard enhancement threshold that were mostly found in nonclear cell subtype. Especially, when the mass was larger than 7 cm or involved nonclear cell RCCs, the enhancement threshold >15 HU must be carefully used for diagnosis. Using a noncontrast phase regardless HU combined with enhancement >15 HU could improve the accuracy of RCC diagnosis.

Background: The risk stratification of prostate cancer using Gleason grade group (GG), serum prostate-specific antigen (PSA), and T staging has an important role for appropriate treatment. In fact, the GG of biopsy was not the same as the prostatectomy specimen. The upgrading of GG has a significant risk of delay treatment. The study aims to evaluate the concordance of GG between biopsy and prostatectomy specimens and the factors of upgrading GG. Materials and Methods: Retrospectively reviewed data from January 2010 to December 2019, 137 patients underwent prostate biopsy and followed by prostatectomy. Patients’ data include pathological reports, imaging reports, serum PSA, PSA density (PSAD), and free PSA were analyzed by univariate and multivariate analysis. Results: The concordance between the pathology was found in 54 specimens (39.4%) with the upgrading of GG in the prostatectomy was 57 specimens (41.6%). Furthermore, the downgrading was 26 specimens (18.9%). Serum PSA >10 ng/ml (P 0.003), PSAD >0.2 ng/ml/cm3 (P 0.002), free/total PSA ratio (P 0.003), margin positive for malignancy (P 0.033), and extraprostatic involvement (P 0.039) were significantly related with upgrading at the univariate analysis. Only a PSAD >0.2 (P 0.014) was found to be an independent factor that is predictive of upstaging in multivariate analysis. Conclusions: The prevalence of upgrading of GG from prostate biopsy to radical prostatectomy is as high as the other study. The factor that related to upstaging of GG was PSAD. Therefore, additional tools for biopsy were required to enhance the accurate diagnosis and staging of prostate cancer.