Displaying publications 181 - 200 of 1178 in total

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  1. Fulltext Breast cancer research in Asia: adopt or adapt Western knowledge?
    Bhoo-Pathy N, Yip CH, Hartman M, Uiterwaal CS, Devi BC, Peeters PH, et al.
    Eur J Cancer, 2013 Feb;49(3):703-9.
    PMID: 23040889 DOI: 10.1016/j.ejca.2012.09.014
    The incidence and mortality of breast cancer continues to rise rapidly in Asian countries. However, most of our current knowledge on breast cancer has been generated in Western populations. As the socio-economic profile, life style and culture of Asian and Western women are substantially different, and genetic backgrounds vary to some extent, we need to answer the question on whether to 'adopt' or 'adapt' Western knowledge before applying it in the Asian setting. It is generally accepted that breast cancer risk factors, which have mainly been studied in Western populations are similar worldwide. However, the presence of gene-environment or gene-gene interactions may alter their importance as causal factors across populations. Diagnostic and prognostic study findings, including breast cancer prediction rules, are increasingly shown to be 'setting specific' and must therefore be validated in Asian women before implementing them in clinical care in Asia. Interventional research findings from Caucasian patients may not be applicable in patients in Asia due to differences in tumour biology/profiles, metabolism of drugs and also health beliefs which can influence treatment acceptance and adherence. While breast cancer research in Asia is warranted in all domains of medical research, it is felt that for Asian breast cancer patients, needs are highest for diagnostic and prognostic studies. International clinical trials meanwhile need to include breast cancer patients from various Asian settings to provide an insight into the effectiveness of new treatment modalities in this part of the world.
    Matched MeSH terms: Prognosis
  2. Fulltext Feature selection methods for optimizing clinicopathologic input variables in oral cancer prognosis
    Chang SW, Kareem SA, Kallarakkal TG, Merican AF, Abraham MT, Zain RB
    Asian Pac J Cancer Prev, 2011;12(10):2659-64.
    PMID: 22320970
    The incidence of oral cancer is high for those of Indian ethnic origin in Malaysia. Various clinical and pathological data are usually used in oral cancer prognosis. However, due to time, cost and tissue limitations, the number of prognosis variables need to be reduced. In this research, we demonstrated the use of feature selection methods to select a subset of variables that is highly predictive of oral cancer prognosis. The objective is to reduce the number of input variables, thus to identify the key clinicopathologic (input) variables of oral cancer prognosis based on the data collected in the Malaysian scenario. Two feature selection methods, genetic algorithm (wrapper approach) and Pearson's correlation coefficient (filter approach) were implemented and compared with single-input models and a full-input model. The results showed that the reduced models with feature selection method are able to produce more accurate prognosis results than the full-input model and single-input model, with the Pearson's correlation coefficient achieving the most promising results.
    Matched MeSH terms: Prognosis
  3. Fulltext Diagnosis delay of breast cancer and its associated factors in Malaysian women
    Norsa'adah B, Rampal KG, Rahmah MA, Naing NN, Biswal BM
    BMC Cancer, 2011;11:141.
    PMID: 21496310 DOI: 10.1186/1471-2407-11-141
    Breast cancer is the leading cause of cancer mortality among women in Malaysia. Delayed diagnosis is preventable and has major effects on patients' prognosis and survival. The objectives of our study were to identify the magnitude of delayed diagnosis and its associated factors in women with breast cancer in Malaysia.
    Matched MeSH terms: Prognosis
  4. Fulltext Apoptosis in cancer: from pathogenesis to treatment
    Wong RS
    J Exp Clin Cancer Res, 2011;30:87.
    PMID: 21943236 DOI: 10.1186/1756-9966-30-87
    Apoptosis is an ordered and orchestrated cellular process that occurs in physiological and pathological conditions. It is also one of the most studied topics among cell biologists. An understanding of the underlying mechanism of apoptosis is important as it plays a pivotal role in the pathogenesis of many diseases. In some, the problem is due to too much apoptosis, such as in the case of degenerative diseases while in others, too little apoptosis is the culprit. Cancer is one of the scenarios where too little apoptosis occurs, resulting in malignant cells that will not die. The mechanism of apoptosis is complex and involves many pathways. Defects can occur at any point along these pathways, leading to malignant transformation of the affected cells, tumour metastasis and resistance to anticancer drugs. Despite being the cause of problem, apoptosis plays an important role in the treatment of cancer as it is a popular target of many treatment strategies. The abundance of literature suggests that targeting apoptosis in cancer is feasible. However, many troubling questions arise with the use of new drugs or treatment strategies that are designed to enhance apoptosis and critical tests must be passed before they can be used safely in human subjects.
    Matched MeSH terms: Prognosis
  5. Pattern of weight changes in women with breast cancer
    Yaw YH, Kandiah M, Shariff ZM, Mun CY, Hashim Z, Yusof RM, et al.
    Asian Pac J Cancer Prev, 2010;11(6):1535-40.
    PMID: 21338193
    This study describes weight changes experienced by Malaysian women with breast cancer. Women with breast cancer (n=368) were recruited from eight hospitals and four breast cancer support groups in Peninsular Malaysia. Current weight was measured and weight at the time of diagnosis and a year preceding diagnosis were based on self-reports. Change in weight was determined from the year preceding breast cancer diagnosis to study entry (time 1), at the time of diagnosis to study entry (time 2) and from a year preceding breast cancer diagnosis to the time of diagnosis (time 3). Current body mass index, at a year preceding diagnosis and at the time of diagnosis were determined. Waist circumference was also measured. The sample comprised 57% Malay, 34% Chinese and 9.8% Indian women. The mean age of the women was 54 ∓ 9.04 years and over 80% were post-menopausal. Majority of the women were in stage I and stage II breast cancer at the time of diagnosis. The most common treatments received by these women were chemotherapy followed by radiotherapy and mastectomy. Overweight and obesity were prevalent in over 40% of the survivors at all three periods. Significant weight changes were observed during time 1 (-0.74 ∓ 4.78kg, p< 0.001), time 2 (2.73 ∓ 8.06kg, p< 0.001) and time 3 (3.47 ∓ 7.53kg, p< 0.001). At time 1, almost 50% showed no changes in their weight. At time 2, nearly two-thirds had gained weight and at time 3, 69% had gained weight, abdominal obesity was observed in nearly two-thirds of the women at study entry. A significant difference in weight change among age groups was observed in time 2 and time 3. All ethnic groups had significant weight change in time 1 and time 2. Significant weight gain was observed in relation to body mass index prior to diagnosis, at diagnosis and at study entry. However, no significant difference in weight change by educational level, family history of cancer and cancer stages were observed in all 3 periods. In conclusion, significant weight gain was evident in this sample of women after diagnosis of breast cancer and treatment. Women with breast cancer should be encouraged to maintain normal body mass index and waist circumference through appropriate diet and regular physical activity which may help to reduce their risk of recurrence, secondary cancer and metastasis.
    Matched MeSH terms: Prognosis
  6. Fulltext Acute stroke patients with high BMI are less likely to have severe disability at initial presentation
    Choo WS, Foo S, Tan E, Thayaparan FS, Chung YY, Raman S, et al.
    Med J Malaysia, 2009 Mar;64(1):34-6.
    PMID: 19852318 MyJurnal
    This is a prospective study to determine the severity of disability and prognosis of acute stroke patients related to their Body Mass index (BMI). A total of 79 consecutive CT-scan-proven acute stroke patients who were admitted to Hospital Tuanku Ja'afar, Seremban between November 2006 and April 2007 were recruited (male:female 49:30; mean age 62.7 years; ischemic stroke 70, intracerebral bleed 9). The patients were divided according to BMI less than 25 (Group A) and equal or greater than 25 (Group B). Severity of disability was measured between 24-48 hours by modified Rankin's score. Patients were followed up after one month. Thirty-seven patients had severe disability (Rankin Score 5). Twenty-nine patients had adverse outcomes including 11 deaths and 18 rehospitalizations or prolonged hospital/nursing home stay. 34.3% of Group B had severe disability compared to 56.8% of Group A (chi2 P = 0.046). Conversely 42.9% of Group B had adverse events at one month compared to 31.8% of Group A (chi2 P = 0.312). There were no statistical differences between high- and low-BMI groups for gender ratio, smoking, hypertension, diabetes, prior cardiovascular disease, mean age, mean lipid profile and blood pressure. When comparing patients with Rankin Score 1-4 versus 5, age and BMI were statistically significant between the two groups. By multivariate analysis only age is independent predictor for severe disability (P < 0.05). The results of this pilot study should be confirmed in larger prospective multicentre trial.
    Matched MeSH terms: Prognosis
  7. Fulltext A case of neonatal diarrhoea caused by congenital glucose-galactose malabsorption
    Lee WS, Tay CG, Nazrul N, Paed M, Chai PF
    Med J Malaysia, 2009 Mar;64(1):83-5.
    PMID: 19852331 MyJurnal
    A five-month-old Indian girl, product of consanguineous marriage, presented with diarrhoea with an onset within two days after birth, severe malnutrition and metabolic acidosis. The diarrhoea persisted even with lactose-free formula, amino acid-based formula and glucose-containing oral rehydration solution, but stopped when fasted. She required prolonged parenteral nutrition. Fructose and glucose tolerance tests were performed, confirming the child was able to absorb and metabolize fructose but not glucose, indicating a diagnosis of glucose-galactose malabsorption. This case illustrate how simple and pertinent clinical observations and laboratory investigations is sufficient to allow a firm diagnosis to be made.
    Matched MeSH terms: Prognosis
  8. "Focal" ventricular tachycardia: insights from catheter ablation
    Mittal S
    Heart Rhythm, 2008 Jun;5(6 Suppl):S64-7.
    PMID: 18456205 DOI: 10.1016/j.hrthm.2008.03.023
    Catheter ablation has come to play an important therapeutic role in the management of some patients with ventricular arrhythmias. An important advance in catheter ablation of ventricular tachycardia (VT) has been the development of three-dimensional catheter-based mapping systems, which permit identification of the tachycardia circuit and facilitate a strategy for catheter ablation. As a result, patients who suffer from "focal" forms of VT have been identified. This can have implications with respect to underlying arrhythmia mechanism, patient prognosis, and therapeutic strategies. The article reviews some insights learned from catheter ablation of focal forms of VT.
    Matched MeSH terms: Prognosis
  9. Fulltext Melioidosis in children from Kuala Lumpur, Malaysia
    Sam IC, Puthucheary SD
    Ann Trop Paediatr, 2006 Sep;26(3):219-24.
    PMID: 16925959
    There are few data on paediatric melioidosis in endemic areas outside rural north-eastern Thailand and northern Australia. This study reports 16 culture-confirmed cases of melioidosis in children aged < or = 15 years seen between 1976 and 2005 at an urban teaching hospital in Kuala Lumpur, Malaysia. Seven (43.8%) patients had septicaemic melioidosis (with three known deaths) and nine (56.2%) had localised disease (one death). Eleven (68.8%) patients had underlying diseases, including five with haematological malignancies. Skin, soft tissue and lymph nodes were most commonly affected. There were no cases of parotitis or pharyngocervical disease (seen in Thailand), or encephalomyelitis (seen in Australia). The differences in disease seen in this study compared with the mostly rural patients described in previous studies might be owing to a different patient population in an urban environment. Septicaemic melioidosis has a high mortality, but localised disease has a good prognosis, and selected cases may be cured without the full recommended treatment regimen.
    Matched MeSH terms: Prognosis
  10. Fulltext A preliminary finding: immunohistochemical localisation and distribution of placental angiotensin II receptor subtypes in normal and preeclamptic pregnancies
    Judson JP, Nadarajah VD, Bong YC, Subramaniam K, Sivalingam N
    Med J Malaysia, 2006 Jun;61(2):173-80.
    PMID: 16898308
    Pre-eclampsia or pregnancy induced hypertension (PIH) affects 6-8% of all pregnancies. Although the underlying mechanism of PIH is still unknown, it is widely believed that the placenta plays an important role. It was thought that an ischemic placenta due to poor perfusion can precipitate the signs and symptoms of PIH. This study aims to investigate the possible role of Type 1(AT1) and Type 2 (AT2) angiotensin II receptor subtypes in the mechanism of PIH. AT1 receptor stimulation causes vasoconstriction and AT2 receptor stimulation causes vasodilatation. Investigating the interactions of these two receptors in the placenta provides an insight as to the balance that may exist between AT1 and AT2 receptors in normal pregnancy. Any disruption to the balance might cause a disruption of the blood flow in the placenta, leading to PIH. Placentas were collected from 11 PIH patients and 11 normal patients. Immunohistochemistry techniques were performed on the placental tissue to determine the distribution of AT1 and AT2 receptors in the placental tissue qualitatively and quantitatively. It was observed that in normal patients, the balance between AT1 and AT2 receptors is that the level of AT2 receptors is higher than the level of AT1 receptors. However in the PIH patient, it was observed that the normal balance was disrupted. In PIH patients the level of AT1 receptors was observed to be higher than the level of AT2 receptors. This study suggests that disruption of the balance between AT1 and AT2 receptors observed in PIH placentas might cause a decrease in blood flow to the placenta, causing it to be poorly perfused. This may cause placental ischemia which may lead to PIH.
    Matched MeSH terms: Prognosis
  11. Fulltext Haemophagocytic syndrome presenting as pyrexia of unknown origin
    Fadilah SA, Raymond AA, Leong CF, Cheong SK
    Med J Malaysia, 2006 Mar;61(1):91-3.
    PMID: 16708741
    Haemophagocytic syndrome (HPS) should be included in the differential diagnosis of pyrexia of unknown origin (PUO). The hallmark of HPS is the accumulation of activated macrophages that engulf haematopoietic cells in the reticuloendothelial system. We describe a patient with unexplained fever in which a final diagnosis of HPS was established in a bone marrow study.
    Matched MeSH terms: Prognosis
  12. Extrinsic allergic alveolitis
    Ismail T, McSharry C, Boyd G
    Respirology, 2006 May;11(3):262-8.
    PMID: 16635083
    Extrinsic allergic alveolitis (also known as hypersensitivity pneumonitis) is caused by repeated inhalation of mainly organic antigens by sensitized subjects. This induces a hypersensitivity response in the distal bronchioles and alveoli and subjects may present clinically with a variety of symptoms. The aims of this review are to describe the current concepts of the immunological response, the diverse clinical presentation of this disease, the relevant investigations and management, and areas for future studies.
    Matched MeSH terms: Prognosis
  13. Changing trends of prostate cancer in Asia
    Pu YS, Chiang HS, Lin CC, Huang CY, Huang KH, Chen J
    Aging Male, 2004 Jun;7(2):120-32.
    PMID: 15672937
    Although Asian people have the lowest incidence and mortality rates of prostate cancer in the world, these rates have risen rapidly in the past two decades in most Asian countries. Prostate cancer has become one of the leading male cancers in some Asian countries. In 2000, the age-adjusted incidence was over 10 per 100000 men in Japan, Taiwan, Singapore, Malaysia, the Philippines and Israel. Although some of the increases may result from enhanced detection, much of the increased incidence may be associated with westernization of the lifestyle, with increasing obesity and increased consumption of fat. The differences in incidences between native Americans and Asian immigrants are getting smaller, reflecting a possible improvement of diagnostic efforts and changes of environmental risk factors in Asian immigrants. Nevertheless, the huge variations in incidences among ethnic groups imply that there are important genetic risk factors. The stage distributions of prostate cancer in Asian populations are still unfavorable compared to those of Western developed countries. However, a trend towards diagnosing cancer with more favorable prognosis is seen in most Asian countries. Both genetic and environmental risk factors responsible for elevated risks in Asian people are being identified, which may help to reduce prostate cancer incidence in a chemopreventive setting.
    Matched MeSH terms: Prognosis
  14. Characteristics of patients with organic brain syndromes : A cross-sectional 2-year follow-up study in Kuala Lumpur, Malaysia
    Chandrasekaran PK, Jambunathan ST, Zainal NZ
    Ann Gen Psychiatry, 2005 Apr 15;4(1):9.
    PMID: 15876360
    BACKGROUND: Organic Brain Syndromes (OBS) are often missed in clinical practice. Determining their varied presentations may help in earlier detection, better management, and, assessing prognosis and outcome. We described the in-patient referrals of patients suffering from the psychiatric effects of organic states and compared the symptomatology and mortality between those with the Acute and Chronic varieties. METHODS: 59 patients referred to our Consultation-Liaison (C-L) Psychiatry services and given a clinical diagnosis of OBS were selected over a 6-month period. Psychiatric and cognitive abnormalities and treatment regimes were recorded and fatality rates determined. Information regarding their condition 24 months after their index hospitalization was recorded. All data were entered into a proforma and analyzed after exclusion. RESULTS: The mean duration of detecting the symptoms by the physician was 3.52 days. The presence of a premorbid psychiatric illness had no influence on the clinical presentation but did on the mortality of patients with OBS (p = 0.029).Patients with the Acute syndrome had significantly more symptom resolution as compared to those with the Chronic syndrome (p = 0.001) but mortalityrates did not differ. Elderly patients and those with symptom resolution upon discharge did not show statistically significant higher mortality rates. The most popular combination of treatment was that of a low-dose neuroleptic and a benzodiazepine (34.7%). The need for maintenance treatment was not significantly different in any group, even in those with a past history of a functional disorder. CONCLUSION: Other than the Acute group having a significantly better outcome in terms of symptom resolution, our findings suggest that there was no significant difference in the clinical presentation between those with Acute or Chronic OBS. Mortality-wise, there was also no difference between the Acute and Chronic syndromes, nor was there any difference between the elderly and the younger group. There was also no significant difference in the need for continued treatment in both groups.
    Matched MeSH terms: Prognosis
  15. Fulltext Expression of E-cadherin in normal oral mucosa, in oral precancerous lesions and in oral carcinomas
    Sridevi U, Jain A, Nagalaxmi V, Kumar UV, Goyal S
    Eur J Dent, 2015 10 3;9(3):364-372.
    PMID: 26430364 DOI: 10.4103/1305-7456.163238
    OBJECTIVE: The aim of the present study was to assess the expression of E-cad in oral precancerous lesions and conditions and oral carcinomas in comparison with normal mucosa.

    MATERIALS AND METHODS: Total of 50 samples were selected for the study and were categorized into five groups and 10 samples in each group as Group I-oral leukoplakia (OL), Group II-oral lichen planus (OLP), Group III-oral submucous fibrosis (OSMF), Group IV-oral squamous cell carcinoma (OSCC) and Group V-normal oral mucosa (NOM) as control group. All the samples were assessed for the expression of E-cad by immunohistochemical study.

    RESULTS: Upon assessing the expression of E-cad in OL, OSMF, OLP and OSCC, as majority of the samples with OSCC (90%), OL (80%), OLP (70%) and OSMF (60%) showed mild to moderate expression of E-cad staining, which was suggestive of reduction in dysplastic cells on comparison to NOM cells. This difference in expression and variation of E-cad upon comparison with normal mucosa was statistically significant (P < 0.001).

    CONCLUSION: There is significant (P < 0.001) variation of expression of E-cad with the histopathological dysplasia of the oral precancerous lesions and conditions, and the tumor differentiation of the oral cancers. However, there was no correlation of the degree of loss of expression of E-cad with the degree of dysplasia or the tumor differentiation of oral cancers. We conclude with our study that, there is a variation in the expression of E-cad but its value as a prognostic marker is questionable.

    Matched MeSH terms: Prognosis
  16. Fulltext Role of mitochondrial DNA mutations in brain tumors: A mini-review
    Mohamed Yusoff AA
    J Cancer Res Ther, 2015 Jul-Sep;11(3):535-44.
    PMID: 26458578 DOI: 10.4103/0973-1482.161925
    Brain tumor is molecularly a heterogeneous group of diseases, and genetic factors seem to play a crucial role in its genesis. Even though multiple alterations in the nuclear-encoded genes such as tumor suppressor and oncogenes are believed to play a key role in brain tumorigenesis, the involvement of the mitochondrial genome to this event remains controversial to date. Mitochondrial DNA (mtDNA) has been suspected to be associated with the carcinogenesis because of its high sensitivity to mutations and inefficient repair mechanisms in comparison to nuclear DNA. Thus, defects in mtDNA could also lead to the development of brain tumor. By virtue of their clonal nature and high copy number, mtDNA mutations may provide a new effective molecular biomarker for the cancer detection. It has been suggested that establishing mtDNA defective pattern might be useful in cancer diagnostics and detection, the prognosis of cancer outcome, and/or the response to certain treatments. This mini-review gives a brief overview on the several aspects of mtDNA, with a particular focus on its role in tumorigenesis and progression of brain tumor. Understanding the role of mitochondria and brain tumor development could potentially translate into therapeutic strategies for patients with these tumors.
    Matched MeSH terms: Prognosis
  17. Fulltext Intrauterine management of fetal supraventricular tachycardia (SVT) with cardiac failure
    Muniswaran G, Japaraj RP, Asri Ranga AR, Cheong HK
    Med J Malaysia, 2015 Dec;70(6):371-2.
    PMID: 26988216 MyJurnal
    Fetal arrhythmias are not uncommon in pregnancy. The diagnosis can be established on routine ultrasound scan. Fetal supraventricular tachycardia (SVT) is the most common cause of fetal tachycardia. If left undiagnosed and untreated, these fetuses may develop cardiac failure, hydrops fetalis and eventually death. We report two fetuses diagnosed antenatally to have fetal SVT. Both fetuses were in cardiac failure and were successfully treated with maternal administration of antiarrhythmic medications. Digoxin, and in severe instances, a combination with flecanaide significantly improved fetal outcomes and prevented fetal mortality. The long term prognosis of such patients are good.
    Matched MeSH terms: Prognosis
  18. Fulltext Enteropathy-associated T-cell lymphoma: An extremely rare cause of chronic diarrhoea
    Liong CC, Ravindran S, Gnana Kumar G, Chin EF, Koh PS, Chan WK
    Med J Malaysia, 2016 04;71(2):88-90.
    PMID: 27326953 MyJurnal
    Chronic diarrhoea in tropical countries may be due to a myriad of causes from infective to non-infective. This case report illustrates the challenges faced in the investigation of a middle-age Chinese gentleman who presented with chronic diarrhoea and weight loss. The diagnosis of type II enteropathy-associated T-cell lymphoma (EATL) was finally made. The diagnosis of EATL was least suspected as the condition is almost unheard of in this part of the world. The epidemiology, presentation, diagnosis, management and prognosis of this rare condition are discussed.
    Matched MeSH terms: Prognosis
  19. Fulltext Surgical Management of Bulky Mediastinal Metastases in Follicular Thyroid Carcinoma
    Adwin Z, Nur A, Suhaimi S, Rahman R
    Oman Med J, 2016 Jan;31(1):69-72.
    PMID: 26816570 DOI: 10.5001/omj.2016.13
    Follicular thyroid adenoma and carcinoma are very common. Benign and malignant lesions are usually indistinguishable from cytology alone and often require confirmatory resection. The spread of follicular carcinoma is usually hematogenous and is treated with surgery and adjuvant radioactive iodine. Very rarely, metastases occur in the mediastinum. Patients usually present with severe compressive symptoms. With proper treatment and follow-up, the prognosis for these type of thyroid malignancies is excellent. In the case presented here, our patient presented to the Universiti Kebangsaan Malaysia Medical Center with a progressively enlarging anterior neck swelling. The swelling had started 10 years before his presentation. We diagnosed him with an advanced thyroid malignancy with bulky mediastinal metastases. After extensive investigations and counseling, we chose to treat the patient with tumor excision and mediastinal metastases resection. Typically, mediastinal resection involves the removal of the sternum and use of an acrylic implant to recreate the sternum. In this case, the sternum and ribs were removed with subsequent myocutaneous flap coverage for the wound defect. Our experience represents an alternative treatment option in cases where implant use is unsuitable.
    Matched MeSH terms: Prognosis
  20. Fulltext Utility of pre-treatment neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as prognostic factors in breast cancer
    Koh CH, Bhoo-Pathy N, Ng KL, Jabir RS, Tan GH, See MH, et al.
    Br. J. Cancer, 2015 Jun 30;113(1):150-8.
    PMID: 26022929 DOI: 10.1038/bjc.2015.183
    Peripheral blood-derived inflammation-based scores such as the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) have recently been proposed as prognostic markers in solid tumours. Although evidence to support these markers as unfavourable prognostic factors is more compelling in gastrointestinal cancers, very little is known of their impact on breast cancer. We investigated the association between the NLR and PLR, and overall survival after breast cancer.
    Matched MeSH terms: Prognosis
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