Objective To evaluate the role of CT and MR/in the diagnosis of posterior reversible encephalopathy syndrome(PRES).Methods Eight women with PRES(6 pregnant women,1 case after chemotherapy,and 1 patient with hypertension)were enrolled in our study.All of them had MR imaging (T_1WI,T_2WI,FLAIR,DWI),and five cases underwent post-contrast T_1WI and three dimensional contrast enhanced MR angiography(3D CEMRA).Two cases also had CT scan.Results MRV in all 8 patients showed no evidence of stenosis,dilation,or thrombosis in cranial veins and sinuses.MRI demonstrated multiple lesions located in bilateral parieto-occipital lobes(8 cases),bilateral basal ganglia(2 cases),and bilateral frontal lobes(4 cases).The lesions were prominent within white matter,some of them involved gray matter(3 cases).Lesions appeared as hyperintense signals on FLAIR and T_2-weighted images, isointense or mildly hypointense signals on T_1-weighted images,normal or decreased intensity on DWI,and isointensity or hyperintensity on apparent diffusion coefficient(ADC)maps.Post-contrast T_1WI showed mild reversible enhancement and 3D CEMFdisplayed numerous reversible“grape-like”enhancements in terminal arterial branches along the middle cerebral artery(MCA),anterior cerebral artery(ACA)and posterior cerebral artery(PCA).Follow-up scan showed decreased abnormal signals.Conclusion Lesions of PRES are usually located in parieto-occipital lobes,especially in white matter,but they can also be seen in frontal lobes and basal ganglia bilaterally.Post-contrast T_1WI and 3D enhanced MRA can provide useful information in the manifestation of reversible enhancement.MRI has advantages to display lesion in PRES,

INTRODUCTIONSince the emergence of the pandemic influenza A/H1N1/2009 virus in April 2009, diagnostic testing in many countries has revealed the rapid displacement and then replacement of circulating seasonal influenza viruses by this novel virus.

MATERIALS AND METHODSIn-house seasonal and pandemic influenza-specific polymerase chain reaction assays were introduced and/or developed at the Molecular Diagnosis Centre (MDC) at the National University Hospital (NUH), Singapore. These assays have been used to test all samples received from in-patients, out-patients, staff and visitors for suspected pandemic influenza A/H1N1/2009 infection.

RESULTSPrior to the arrival of the pandemic A/H1N1/2009 virus in Singapore at the end of May 2009, seasonal influenza A/H3N2 predominated in this population, with very little seasonal influenza A/H1N1 and B viruses detected. Within about 1 month of its arrival in Singapore (mainly during June to July 2009), this pandemic virus rapidly displaced seasonal influenza A/H3N2 to become the predominant strain in the Singaporean population served by MDC/NUH.

CONCLUSIONSRealtime molecular techniques have allowed the prompt detection of different influenza subtypes during this current pandemic, which has revealed the displacement/replacement of previously circulating seasonal subtypes with A/H1N1/2009. Although some of this may be explained by immunological cross-reactivity between influenza subtypes, more studies are required.

Communicable Diseases, Emerging ; Cross Reactions ; Disease Outbreaks ; Humans ; Influenza A Virus, H1N1 Subtype ; isolation & purification ; Influenza B virus ; isolation & purification ; Influenza, Human ; classification ; diagnosis ; epidemiology ; Influenzavirus C ; isolation & purification ; Molecular Diagnostic Techniques ; Polymerase Chain Reaction ; Singapore ; epidemiology

Although gastroesophageal reflux disease is not as common in Asia as in western countries, the prevalence has increased substantially during the past decade. Gastroesophageal reflux disease is associated with considerable reductions in subjective well-being and work productivity, as well as increased healthcare use. Proton pump inhibitors (PPIs) are currently the most effective treatment for gastroesophageal reflux disease. However, there are limitations associated with these drugs in terms of partial and non-response. Dexlansoprazole is the first PPI with a dual delayed release formulation designed to provide 2 separate releases of medication to extend the duration of effective plasma drug concentration. Dexlansoprazole has been shown to be effective for healing of erosive esophagitis, and to improve subjective well-being by controlling 24-hour symptoms. Dexlansoprazole has also been shown to achieve good plasma concentration regardless of administration with food, providing flexible dosing. Studies in healthy volunteers showed no clinically important effects on exposure to the active metabolite of clopidogrel or clopidogrel-induced platelet inhibition, with no dose adjustment of clopidogrel necessary when coprescribed. This review discusses the role of the new generation PPI, dexlansoprazole, in the treatment of gastroesophageal reflux disease in Asia.
Asia* ; Blood Platelets ; Delayed-Action Preparations ; Delivery of Health Care ; Dexlansoprazole* ; Efficiency ; Esophagitis ; Gastroesophageal Reflux* ; Healthy Volunteers ; Plasma ; Prevalence ; Proton Pump Inhibitors ; Proton Pumps* ; Protons*

Background and Objective: There is a paucity of studies looking into the frequency of complications after stroke among Asians. We sought to determine the frequency and rate of complications among Asians after acute stroke. Methods: Consecutive patients with acute stroke among 10 participating Asian countries were included in the study. The frequency and timing of pre-determined complications, and their relation to area of admission were noted. Results: Of the 1,153 patients included in the study, 423 (41.9%) developed complications within the first 2 weeks of stroke. Recurrent stroke, chest infections and urinary tract infections were most commonly encountered, and were most frequent within the first week of stroke onset. A lower rate of complications was noted among patients admitted at an organized stroke unit. Conclusion: There is a similar rate of frequency and timing of complications after acute stroke among Asians as compared with other populations.