Siriraj Hospital

Globalising the access to advanced molecular diagnostics of CNS tumors: Experience of the Molecular Neuro-Pathology (MNP) Outreach Consortium

Central nervous system (CNS) tumors pose a major global health challenge, particularly in low- and middle-income countries (LMICs), where outcomes remain disproportionately poor. The global CONCORD-3 study (Lancet Oncology) highlighted stark disparities in five-year survival (201...

Adrenal Infections: An Underrecognized Cause of Primary Adrenal Insufficiency

INTRODUCTION: Adrenal infections are an underrecognized but clinically significant cause of primary adrenal insufficiency (PAI). OBJECTIVES: This review proposes a diagnostic algorithm for the evaluation of suspected cases. RESULTS: The most common causative pathogens are Mycobac...

Immunogenicity and safety of high-dose versus double-dose quadrivalent inactivated influenza vaccine in adult kidney transplant recipients: a randomized controlled trial (2023)

Background Solid organ transplant (SOT) recipients are at increased risk of influenza-related complications and often exhibit suboptimal vaccine responses. While both high-dose (HD) and double-dose (DD) quadrivalent inactivated influenza vaccines (QIIV) aim to enhance immunogenic...

A Registry-Informed Framework for Earlier Detection of Esophageal Adenocarcinoma in Thailand: Evidence from a 16-Year Cohort Study

Esophageal cancer is frequently diagnosed at an advanced stage, limiting opportunities for curative treatment and contributing to poor clinical outcomes. We aimed to identify clinicopathological predictors of advanced-stage presentation and use these findings to inform a registry...

Sagittal aortic‐arch assessment for prenatal diagnosis of coarctation of the aorta: comparative evaluation of 10 published methods and a new predictive model

ABSTRACT Objectives To externally validate the diagnostic performance of 10 previously published fetal echocardiographic sagittal aortic‐arch parameters and to develop an optimal predictive model based on these parameters for the prenatal identification of neonatal coarctation of...

Fourth-generation chimeric antigen receptor T cells targeting mucin 1 for enhanced anti-tumor activity against breast cancer

Breast cancer (BC) is the leading cause of cancer-related mortality worldwide, and current treatments are unmet clinical needs. Although chimeric antigen receptor (CAR) T cells have been approved for hematological malignancies, their advancements in solid tumors are challenging....

Adverse Remodeling and Prognostic Significance of the Systemic Right Ventricle Across Congenital Heart Disease Subtypes

Patients with congenitally corrected transposition of the great arteries (ccTGA), atrial-corrected transposition (acTGA), and right-ventricular-dominant univentricular heart (UVH) are predisposed to systemic right ventricular dysfunction (sRVd). However, lesion-specific differenc...

Immunogenicity and safety of high-dose versus standard-dose quadrivalent inactivated influenza vaccine in patients living with HIV: a randomized controlled trial

Influenza remains a major cause of morbidity in people living with HIV (PLWH), and despite recommendations for annual vaccination with the standard-dose (SD) quadrivalent inactivated influenza vaccine (IIV4), immune responses are often suboptimal in this population. To address th...

A randomized trial of nefopam for postoperative pain management in obstructive sleep apnea patients undergoing uvulopalatopharyngoplasty

Abstract Objective Uvulopalatopharyngoplasty (UPPP) is a surgical treatment for obstructive sleep apnea that often results in significant postoperative pain. Given the risks associated with opioid use in patients with obstructive sleep apnea, multimodal analgesia is preferred. Th...

Randomized generic-sequence crossover pharmacokinetic study of innovator and two generic tacrolimus formulations in kidney transplant recipients according to CYP3A inhibitor co-administration

Tacrolimus is a narrow therapeutic index immunosuppressant widely used in kidney transplantation. Although generic formulations reduce treatment costs, pharmacokinetic comparability under CYP3A inhibitor co-administration remains insufficiently studied. We conducted a prospective...

Advances in Organoid Technology: Bridging the Gap Between Research and Therapy

Organoids Are Us is a symposium series that provides a snapshot in time of the latest and emerging developments in organoid technology [...]

Quality and concordance of international paediatric sepsis guidelines: a cross-sectional appraisal from the SENTINEL International study

Objectives To evaluate the methodological quality of hospital-specific paediatric sepsis clinical practice guidelines (CPGs) from sites participating in an international study using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool and to assess the consi...

Exploratory spatial transcriptomic analysis of compartment-specific recurrence-associated gene expression in gastric cancer

We hypothesized that the prognostic value of immune and stromal gene expression is spatially dependent—specifically, signals driving homeostasis in the superficial mucosa may differ functionally from those at the deep invasive front. We analyzed formalin-fixed paraffin-embedded s...

Perivascular immune organization and spatial architecture are associated with immunotherapy response in non-small cell lung cancer

Clinical responses to immune checkpoint inhibitors (ICIs) in non-small cell lung cancer (NSCLC) remain highly heterogeneous and PD-L1 expression alone has limited predictive performance. Emerging evidence suggests that therapeutic response depends not only on immune cell abundanc...

Cefepime versus piperacillin-tazobactam for the treatment of Pseudomonas aeruginosa pneumonia

BACKGROUND: Both piperacillin-tazobactam and cefepime are widely used for the treatment of pneumonia caused by Pseudomonas aeruginosa. Despite this, no studies have directly compared these agents for this purpose. METHODS: We performed a single-center retrospective cohort study o...

Prothrombin complex concentrate (PCC) vs. non-PCC strategies for warfarin reversal in left ventricular assist device recipients: A systematic review and meta-analysis

Background Left ventricular assist devices (LVADs) prolong survival in end-stage heart failure, and warfarin thromboprophylaxis is recommended to prevent device thrombosis and thromboembolic complications. When bleeding occurs or emergency surgery is required, rapid anticoagulati...

The effect of augmented protein intake on nitrogen balance: A nested cohort study of the TARGET protein trial

Purpose The impact of augmenting enteral protein delivery on nitrogen balance, urea generation, and kidney function in critically ill patients remains poorly defined. This study aimed to investigate these effects in a nested cohort within the TARGET Protein trial. Methods We cond...

Intra-abdominal Bowel Dilation in Experimental Gastroschisis Is Associated With a Modifiable Transcriptomic Program of Intestinal Dysfunction

OBJECTIVE: To characterize intestinal transcriptional profiles in gastroschisis, their temporal evolution, and response to fetal intervention. SUMMARY BACKGROUND DATA: Gastroschisis causes significant intestinal dysfunction, with intra-abdominal bowel dilation clinically shown to...

Human scFv inhibiting broad coronavirus replication: a pandemic preparedness candidate

The ongoing emergence of zoonotic coronaviruses (CoVs) and the rapid evolution of viral variants underscore the need for broadly active antiviral agents. The relatively conserved S2 subunit of the coronavirus spike protein is an attractive target for developing pan-coronavirus th...

Technical note: reconstructing dose distributions from manually planned electron boosts in breast radiotherapy

Purpose In breast radiotherapy, delivery of manually-calculated electron boosts limits retrospective dose–response analyses as dose distribution is unavailable. This work evaluates the feasibility of reconstructing dose distributions from manually planned electron boosts in breas...