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  1. Ahmad Najib M, Winter A, Mustaffa KMF, Ong EBB, Selvam K, Khalid MF, et al.
    Sci Rep, 2024 Nov 18;14(1):28416.
    PMID: 39557915 DOI: 10.1038/s41598-024-78685-9
    Aptamers have emerged as prominent ligands in clinical diagnostics because they provide various advantages over antibodies, such as quicker generation time, reduced manufacturing costs, minimal batch-to-batch variability, greater modifiability, and improved thermal stability. In the present study, we isolated and characterized DNA aptamers that can specifically bind to the hemolysin E (HlyE) antigen of Salmonella Typhi for future development of typhoid diagnostic tests. The DNA aptamers against Salmonella Typhi HlyE were isolated using systematic evolution of ligands by exponential enrichment (SELEX), and their binding affinity and specificity were assessed utilizing enzyme-linked oligonucleotide assay (ELONA). A total of 11 distinct aptamers were identified, and the binding affinities and species selectivities of the three most probable aptamers were determined. Kd values were obtained in the nanomolar range, with the highest affinity of 83.6 nM determined for AptHlyE97. In addition, AptHlyE11, AptHlyE45 and AptHlyE97 clearly distinguished S. Typhi HlyE from other tested bacteria, such as Salmonella Paratyphi A, Salmonella Paratyphi B, Shigella flexneri, Klebsiella pneumonia and Escherichia coli, therefore displaying desirable specificity. These novel aptamers could be used as diagnostic ligands for the future development of inexpensive and effective point-of-care tests for typhoid surveillance, especially in developing countries of the tropics and subtropics.
    Matched MeSH terms: Typhoid Fever/diagnosis
  2. Hajjaj AA, Senok AC, Al-Mahmeed AE, Issa AA, Arzese AR, Botta GA
    Saudi Med J, 2006 Apr;27(4):487-91.
    PMID: 16598325
    To investigate the occurrence of human papillomavirus (HPV) infection and the associated risk factors in Bahrain's female population.
    Matched MeSH terms: Papillomavirus Infections/diagnosis
  3. Zakaria H, Hussain I, Zulkifli NS, Ibrahim N, Noriza NJ, Wong M, et al.
    PLoS One, 2023;18(7):e0283862.
    PMID: 37506072 DOI: 10.1371/journal.pone.0283862
    BACKGROUND AND AIMS: There is growing evidence on the contribution of psychological factors to internet addiction; yet it remains inconsistent and deserves further exploration. The aim of this study was to determine the relationship between the psychological symptoms (Attention Deficit Hyperactivity Disorder (ADHD) symptoms, stress, depression, anxiety and loneliness) and internet addiction (IA) among the university students in Malaysia.

    MATERIALS AND METHODS: A total of 480 students from different faculties in a Malaysian public university participated in this study. They were selected by simple random sampling method. They completed self-administered questionnaires including the Malay Version of Internet Addiction Test (MVIAT)) to measure internet addiction and Adult Self-Report Scale (ASRS) Symptom Checklist, Depression Anxiety Stress Scales (DASS) and UCLA Loneliness Scale (Version 3) to assess for ADHD symptoms, depression, anxiety, stress, and loneliness respectively.

    RESULTS: The prevalence of IA among university students was 33.33% (n = 160). The respondents' mean age was 21.01 ± 1.29 years old and they were predominantly females (73.1%) and Malays (59.4%). Binary logistic regression showed that gender (p = 0.002; OR = 0.463, CI = 0.284-0.754), ADHD inattention (p = 0.003; OR = 2.063, CI = 1.273-3.345), ADHD hyperactivity (p<0.0001; OR = 2.427, CI = 1.495-3.939), stress (p = 0.048; OR = 1.795, CI = 1.004-3.210) and loneliness (p = 0.022; OR = 1.741, CI = 1.084-2.794) were significantly associated with IA.

    CONCLUSION: A third of university students had IA. In addition, we found that those who were at risk of IA were males, with ADHD symptoms of inattention and hyperactivity, who reported stress and loneliness. Preventive strategy to curb internet addiction and its negative sequelae may consider these factors in its development and implementation.

    Matched MeSH terms: Anxiety/diagnosis
  4. Mazalan SL, Yubbu P, Velayudham VR
    Cardiol Young, 2023 Jul;33(7):1206-1208.
    PMID: 36484132 DOI: 10.1017/S1047951122003687
    Intrapericardial teratoma is a germ-cell tumor that typically arises from the base of the heart. This rare cardiac tumour is the second most common tumor diagnosed in fetuses and newborn. Although benign, it can be massive in size causing direct compression on the heart and associated with significant pericardial effusion resulting life-threatening complications such as cardiac tamponade, heart failure, foetal hydrops, and sudden death. Early antenatal diagnosis and surgical intervention improve the survival. We present a case of immature intrapericardial teratoma diagnosed at 25 weeks of gestation but required multiple foetal pericardiocentesis and premature delivery due to massive pericardial effusion. The importance of multidisciplinary team approach to ensure successful management was highlighted in this case report.
    Matched MeSH terms: Hydrops Fetalis/diagnosis
  5. Ummu SF, Ding CH, Wahab AA, Tzar MN
    Trop Biomed, 2023 Jun 01;40(2):170-173.
    PMID: 37650403 DOI: 10.47665/tb.40.2.007
    Vibrio cholerae is a gram-negative bacterium synonymous with its namesake disease, cholera. Thus, gastrointestinal symptoms are the norm and V. cholerae is very rarely associated with skin and soft tissue infections. We describe a case of a 63-year-old Chinese woman with multiple medical comorbidities on corticosteroid therapy who developed fever and a painful swelling on her left leg after being pricked by a branch while gardening. There was no abdominal pain, vomiting or diarrhea. A diagnosis of bullous cellulitis was made clinically, and blood was sent for bacteriological culture. A beta-hemolytic commashaped gram-negative bacillus was isolated from the blood. It was also oxidase-positive and produced an acid/alkaline (A/K) reaction on triple sugar iron agar. It was identified biochemically as Vibrio cholerae. After additional testing, it was found to be of the O1 serogroup and Ogawa serotype. The infection resolved following a 10-day course of high-dose co-trimoxazole therapy.
    Matched MeSH terms: Cellulitis/diagnosis
  6. Tan GJ, Kioh SH, Mat S, Chan SHL, Lee JMY, Tan YW, et al.
    Postgrad Med J, 2023 Sep 21;99(1176):1104-1109.
    PMID: 37392161 DOI: 10.1093/postmj/qgad049
    PURPOSE: Knee pain and osteoarthritis (OA) are common and often lead to disability among older adults. Existing published evidence, however, utilizes differing criteria to define studies' knee OA populations. We, therefore, aimed to determine whether differences exist in the characteristics of individuals with the presence of knee pain and different diagnostic criteria for knee OA.

    METHODS: The Promoting Independence in Seniors with Arthritis (PISA) study is a longitudinal observational study of individuals with and without knee pain and knee OA recruited from the orthopaedics clinic of the Universiti Malaya Medical Centre and the local hospital catchment. Patients were diagnosed with OA based on the American College of Rheumatology (ACR) criteria, the presence of knee pain, and a history of physician-diagnosed knee OA. Psychosocial parameters were measured using validated measures for social participation, independence, and ability to perform activities of daily living, and life satisfaction.

    RESULTS: Of the 230 included participants, mean age was 66.9 years (standard deviation: 7.2) and 166 (72.2%) were women. Kappa agreement between ACR criteria and knee pain was 0.525 and for ACR and physician-diagnosed OA it was 0.325. Binomial logistic regression analysis showed that weight, anxiety, and handgrip strength (HGS) were predictive of ACR OA. Knee pain was only predicted by HGS but not weight and anxiety. Physician-diagnosed OA was predicted by weight and HGS but not anxiety. HGS was predictive of ACR OA, knee pain, and physician-diagnosed OA.

    CONCLUSION: Our study showed that the characteristics of patients with OA are different, physically and psychosocially, depending on the criteria used. Poor agreement was observed between radiological diagnosis and the other diagnostic criteria. Our findings have important implications for the interpretation and comparison of published studies using different OA criteria.

    Matched MeSH terms: Pain/diagnosis
  7. Mohamed R, Yip C, Singh S
    Eur J Gastroenterol Hepatol, 2023 Jul 01;35(7):742-752.
    PMID: 37161976 DOI: 10.1097/MEG.0000000000002548
    BACKGROUND: Viral hepatitis B and C (HBV, HCV) and non-alcoholic fatty liver disease (NAFLD) are the commonest etiologies of liver-related deaths in Malaysia. Herein, this study aims to explore and understand the knowledge and attitudes of the public toward liver-related health and diseases in Malaysia.

    METHODS: A cross-sectional, self-reported, web-based questionnaire was conducted among 500 adults between February and March 2020. Questionnaire items pertained to the knowledge and attitudes toward liver-related health and diseases.

    RESULTS: Half of the respondents were aged ≥35 years and 52.0% were males. Gaps in knowledge included the lack of awareness of different types of hepatitis, including the potential transmission risks and complications of HBV and HCV. About half acknowledged liver fibrosis and cirrhosis as key determinants of liver-related disease progression. A higher proportion rightly recognized the diagnostic test for HCV (40.8%) than HBV (30.0%) despite more being aware of HBV than HCV. Less than one-third were aware of the risk factors, screening tests, and complications of NAFLD. Despite the majority (92.8%) agreeing that regular screening was important for liver health, only 67.0% attended recent health screening and one-fifth were unlikely to seek medical consultation upon exposure to viral hepatitis risk factors. Reasons for this low urgency included the perception of being healthy, cost-related concerns, and societal discrimination.

    CONCLUSION: Robust education efforts are needed to raise awareness and empower the community with knowledge of liver-related diseases, particularly viral hepatitis and NAFLD in Malaysia.

    Matched MeSH terms: Liver Cirrhosis/diagnosis
  8. Lai CCK, Yaacub YJ, Siow YC, Baharum N
    Med J Malaysia, 2023 Nov;78(6):780-786.
    PMID: 38031221
    INTRODUCTION: Prolonged grief disorder (PGD) is a diagnosis characterised by severe, persistent and disabling grief beyond 6 months post-death of a loved one. The new text revision of DSM-5 (DSM-5-TR) approved a new diagnosis PGD on March 2022. In Malaysia, PGD is not routinely screened in healthcare settings and hence goes untreated. The aim of this study is to identify prevalence and factors related to PGD among bereaved relatives whose loved ones had access to PCU services.

    MATERIALS AND METHODS: A cross-sectional study involving bereaved individuals in Palliative Care Unit Hospital Selayang. Participants (n=175) were recruited through telephone, and a validated tool Prolonged Grief Disorder Scale (PG-13) was asked to identify PGD. Further data collected were concomitant stressors in life and support system in the bereaved individual.

    RESULTS: Prevalence of PGD was 2.9% (n=5), and subthreshold PGD was 4% (n=7). A model of multiple logistic regression calculated most of the traditional risk factors were not significant except having an increased responsibility as a single parent after passing of a spouse or loved one, had 10 times increased odds of PGD (Odds Ratios: 10.93; 95% Confidence Interval: 2.937, 40.661). Otherwise, immediate family support (80%), religion (60%) and community (40%) support were the top three coping mechanisms of our PGD cohort, although they were not significant in a multiple logistic regression model.

    CONCLUSION: Our PGD percentage may not be as high as those of other countries, but nonetheless they exist and their needs are just as important. The authors hope that this paper may create an awareness among the healthcare clinicians about PGD in our society, for a greater access of service to understand them and better public awareness.

    Matched MeSH terms: Preimplantation Diagnosis*
  9. Mohd Safien A, Ibrahim N, Subramaniam P, Singh DKA, Mat Ludin AF, Chin AV, et al.
    Geriatr Gerontol Int, 2024 Feb;24(2):225-233.
    PMID: 38199952 DOI: 10.1111/ggi.14801
    AIM: The present study determines the prevalence of depression and the extent of clinical depression symptoms among community-dwelling older adults with cognitive frailty and its associated factors.

    METHODS: A total of 755 older adults aged ≥60 years were recruited. Their cognitive performance was determined using the Clinical Dementia Rating. Fried's criteria was applied to identify physical frailty, and the Beck Depression Inventory assessed their mental states.

    RESULTS: A total of 39.2% (n = 304) of the participants were classified as cognitive frail. In this cognitive frail subpopulation, 8.6% (n = 26) had clinical depressive symptoms, which were mostly somatic such as disturbance in sleep pattern, work difficulty, fatigue, and lack of appetite. Older adults with cognitive frailty also showed significantly higher depression levels as compared with the noncognitive frail participants (t (622.06) = -3.38; P = 0.001). There are significant associations between depression among older adults with cognitive frailty and multimorbidity (P = 0.009), polypharmacy (P = 0.009), vision problems (P = 0.046), and hearing problems (P = 0.047). The likelihood of older adults with cognitive frailty who experience impairments to their vision and hearing, polypharmacy, and multimorbidity to be depressed also increased by 2, 3, 5, and 7-fold.

    CONCLUSIONS: The majority of the Malaysian community-dwelling older adults were in a good mental state. However, older adults with cognitive frailty are more susceptible to depression due to impairments to their hearing and vision, multimorbidity, and polypharmacy. As common clinical depressive symptoms among older adults with cognitive frailty are mostly somatic, it is crucial for health professionals to recognize these and not to disregard them as only physical illness. Geriatr Gerontol Int 2024; 24: 225-233.

    Matched MeSH terms: Depression/diagnosis
  10. Suhaila N, Hussin S, Rahman MM
    Pak J Biol Sci, 2010 Nov 01;13(21):1057-61.
    PMID: 21313878
    Abstract: A total number of 157 samples were examined by 4 different tests-In-house rapid urease (iRUT), Culture, Histopathology and Immunochromatography (Immuno CardSTAT) for the detection of Helicobacter pylori from the patients reported to Hospital Kuala Lumpur, Malaysia during 2007 to 2008. Out of the samples examined 47 (29.9%) were positive for H. pylori by the tests used in the laboratory. Efficacy of detection of the bacteria by the tests- In-house rapid urease, Culture, Histopathology and Immuno CardSTAT were 31.8, 13.9, 30.3 and 32.8%, respectively. However, sensitivity and specificity of the iRUT were 91.5 and 93.6%, respectively and the Positive Predictive Value (PPV) was 86% and the Negative Predictive Value (NPV) was 96.3%. The sensitivity for Immuno CardSTAT rapid test was 100% and the specificity was 79.3%. The PPV was 50% and the NPV was 100%. Convenient methods to the authors were 'In house rapid urease test and Immunochromatography though variability of specificities were observed.
    Matched MeSH terms: Helicobacter Infections/diagnosis*
  11. Yenyuwadee S, Achavanuntakul P, Phisalprapa P, Levin M, Saokaew S, Kanchanasurakit S, et al.
    Acta Derm Venereol, 2024 Jan 08;104:adv18477.
    PMID: 38189223 DOI: 10.2340/actadv.v104.18477
    Utilization of lasers and energy-based devices for surgical scar minimization has been substantially evaluated in placebo-controlled trials. The aim of this study was to compare reported measures of efficacy of lasers and energy-based devices in clinical trials in preventing surgical scar formation in a systematic review and network meta-analyses. Five electronic databases, PubMed, Scopus, Embase, ClinicalTrials.gov, and the Cochrane Library, were searched to retrieve relevant articles. The search was limited to randomized controlled trials that reported on clinical outcomes of surgical scars with treatment initiation no later than 6 months after surgery and a follow-up period of at least 3 months. A total of 18 randomized controlled trials involving 482 participants and 671 postsurgical wounds were included in the network meta-analyses. The results showed that the most efficacious treatments were achieved using low-level laser therapy) (weighted mean difference -3.78; 95% confidence interval (95% CI) -6.32, -1.24) and pulsed dye laser (weighted mean difference -2.46; 95% CI -4.53, -0.38). Nevertheless, low-level laser therapy and pulsed dye laser demonstrated comparable outcomes in surgical scar minimization (weighted mean difference -1.32, 95% CI -3.53, 0.89). The findings of this network meta-analyses suggest that low-level laser therapy and pulsed dye laser are both effective treatments for minimization of scar formation following primary closure of surgical wounds with comparable treatment outcomes.
    Matched MeSH terms: Cicatrix/diagnosis
  12. Nordin FZ, Shaharir SS, Mohamed Said MS, Mohd R, Sakthiswary R, Tengku Mohd TAM, et al.
    Lupus, 2024 Dec;33(14):1645-1653.
    PMID: 39506570 DOI: 10.1177/09612033241297548
    INTRODUCTION: Heterogeneity of the clinical manifestations of systemic lupus erythematosus (SLE) may lead to diagnostic delays. This study is aimed at determining the health-seeking behaviour patterns and factors associated with diagnostic delays in a multi-ethnic SLE cohort in Malaysia.

    METHODOLOGY: This was a cross-sectional study involving SLE patients who visited our institute between January 2020 and June 2021. A review of the medical records and face-to-face interviews were conducted to obtain sociodemographics, SLE disease characteristics and the intervals from the first symptoms to the diagnosis. Health-seeking behaviours were assessed by asking about the patients' first action during the initial symptoms and were divided into: (i) seeking professional health personnel; (ii) self-treatment; and (iii) the use of the internet as a primary source of information. Diagnostic delays were defined as the interval between initial symptoms and SLE diagnosis of more than 6 months. Low-level disease activity state (LLDAS) at 12 months was assessed from the medical records. Univariate and multivariate logistic regression analysis was subsequently conducted to determine factors associated with diagnostic delays.

    RESULTS: Among the 154 patients included in the study, 24% (n = 37) had delayed diagnosis. The delay was significantly higher among the Indian versus Malay versus Chinese (42.9% vs 28% vs 10.8%, p = 0.037). Patients with rash tend to have delayed diagnosis (37.8% vs 22.2%, p = 0.08) while fewer patients with frothy urine had delayed diagnosis (8.1% vs 21.4%, p = 0.09). No significant association was found between health-seeking behaviours and diagnostic delays. The rate of LLDAS at 12 months was significantly lower among patients with delayed diagnosis (43.2% vs 70.0%, p = 0.006). Chinese ethnicity remained the only significant factor associated with lesser diagnostic delays in the multivariate analysis, with OR 0.30 (CI 0.09-0.93), p = 0.037.

    CONCLUSION: There were ethnic disparities in the early diagnosis of SLE in Malaysia, with Indian patients having a longer interval between the first symptom and diagnosis while the Chinese were associated with lower diagnostic delays. Early diagnosis predicted early attainment of LLDAS, suggesting that prompt recognition of the initial SLE symptoms is important.

    Matched MeSH terms: Delayed Diagnosis*
  13. Kang WH, Adam II, Wahab NA
    J ASEAN Fed Endocr Soc, 2024;39(2):97-102.
    PMID: 39620176 DOI: 10.15605/jafes.039.02.05
    Managing a patient with both pituitary hypersecretory and hyposecretory manifestations may be perplexing. We report a 14-year-old female who presented with weight gain, polyuria and polydipsia. Biochemical results were consistent with Cushing disease with central diabetes insipidus. Pituitary magnetic resonance imaging showed a right adenoma with stalk thickening. The immunohistochemistry staining of both adenomas was positive for adrenocorticotropic hormone, thyroid stimulating hormone, growth hormone and luteinizing hormone. Postoperatively, the patient developed panhypopituitarism with persistent diabetes insipidus. The coexistence of double adenomas can pose diagnostic and management challenges and is a common cause of surgical failure. Intraoperative evaluation is important in the identification of double or multiple pituitary adenomas in a patient presenting with multiple secretory manifestations.
    Matched MeSH terms: Diabetes Insipidus, Neurogenic/diagnosis
  14. Tohyama J, Nakashima M, Nabatame S, Gaik-Siew C, Miyata R, Rener-Primec Z, et al.
    J Hum Genet, 2015 Apr;60(4):167-73.
    PMID: 25631096 DOI: 10.1038/jhg.2015.5
    Recent progress in genetic analysis reveals that a significant proportion of cryptogenic epileptic encephalopathies are single-gene disorders. Mutations in numerous genes for early-onset epileptic encephalopathies have been rapidly identified, including in SPTAN1, which encodes α-II spectrin. The aim of this review is to delineate SPTAN1 encephalopathy as a distinct clinical syndrome. To date, a total of seven epileptic patients with four different in-frame SPTAN1 mutations have been identified. The major clinical features of SPTAN1 mutations include epileptic encephalopathy with hypsarrhythmia, no visual attention, acquired microcephaly, spastic quadriplegia and severe intellectual disability. Brainstem and cerebellar atrophy and cerebral hypomyelination, as observed by magnetic resonance imaging, are specific hallmarks of this condition. A milder variant is characterized by generalized epilepsy with pontocerebellar atrophy. Only in-frame SPTAN1 mutations in the last two spectrin repeats in the C-terminal region lead to dominant negative effects and these specific phenotypes. The last two spectrin repeats are required for α/β spectrin heterodimer associations and the mutations can alter heterodimer formation between the two spectrins. From these data we suggest that SPTAN1 encephalopathy is a distinct clinical syndrome owing to specific SPTAN1 mutations. It is important that this syndrome is recognized by pediatric neurologists to enable proper diagnostic work-up for patients.
    Matched MeSH terms: Brain Diseases/diagnosis*; Diagnosis, Differential; Epilepsy/diagnosis*
  15. Ragu R, Eng JY, Azlina AR
    Med J Malaysia, 2014 Aug;69(4):199-201.
    PMID: 25500854
    Kimura's disease is rare chronic inflammatory disease with a distinct clinicopathological entity. It has three major components; inflammatory, vascular and fibrosis. It has to be considered as a differential diagnosis in young patient presenting with head and neck swelling. Although of unknown aetiology many hypothesis has been postulated. Inflammation is the most prominent and predominating characteristic in this disease. Although reported to be predominant in Asian literature regarding this disease is scanty. We report a complete clinical-radiological and pathological picture of this disease.
    Matched MeSH terms: Diagnosis, Differential
  16. Singh SJ, Iacono T, Gray KM
    Int J Lang Commun Disord, 2015 Mar-Apr;50(2):202-14.
    PMID: 25585674 DOI: 10.1111/1460-6984.12128
    Depending on the severity of their disabilities, children with Down syndrome (DS) and with cerebral palsy (CP) may remain pre-symbolic for prolonged periods of time. When interacting with pre-symbolic children, communication partners have a role in identifying which of their behaviours are communicative, to be able to respond to those behaviours and maintain reciprocal interaction. To date, most research on these children's communication development has been conducted within the context of mother-child interaction. Seldom have they been observed interacting with other family members, and in interactions other than dyadic, despite these interactions also occurring daily.
    Matched MeSH terms: Cerebral Palsy/diagnosis*; Communication Disorders/diagnosis*; Down Syndrome/diagnosis*
  17. Ishak WS, Zhao F, Rajenderkumar D, Arif M
    Int Tinnitus J, 2013;18(1):35-44.
    PMID: 24995898 DOI: 10.5935/0946-5448.20130006
    The general consensus on the roles of hearing loss in triggering tinnitus seems not applicable in patients with normal hearing thresholds. The absence of hearing loss on the audiogram in this group of patients poses a serious challenge to the cochlear theories in explaining tinnitus generation in this group of patients.
    Matched MeSH terms: Neuroma, Acoustic/diagnosis; Tinnitus/diagnosis*; Hearing Loss/diagnosis*
  18. Sreeramareddy CT, Qin ZZ, Satyanarayana S, Subbaraman R, Pai M
    Int J Tuberc Lung Dis, 2014 Mar;18(3):255-66.
    PMID: 24670558 DOI: 10.5588/ijtld.13.0585
    OBJECTIVE: To systematically review Indian literature on delays in tuberculosis (TB) diagnosis and treatment.
    METHODS: We searched multiple sources for studies on delays in patients with pulmonary TB and those with chest symptoms. Studies were included if numeric data on any delay were reported. Patient delay was defined as the interval between onset of symptoms and the patient's first contact with a health care provider. Diagnostic delay was defined as the interval between the first consultation with a health care provider and diagnosis. Treatment delay was defined as the interval between diagnosis and initiation of anti-tuberculosis treatment. Total delay was defined as time interval from the onset of symptoms until treatment initiation.
    RESULTS: Among 541 potential citations identified, 23 studies met the inclusion criteria. Included studies used a variety of definitions for onset of symptoms and delays. Median estimates of patient, diagnostic and treatment delay were respectively 18.4 (IQR 14.3-27.0), 31.0 (IQR 24.5-35.4) and 2.5 days (IQR 1.9-3.6) for patients with TB and those with chest symptoms combined. The median total delay was 55.3 days (IQR 46.5-61.5). About 48% of all patients first consulted private providers; an average of 2.7 health care providers were consulted before diagnosis. Number and type of provider first consulted were the most important risk factors for delay.
    CONCLUSIONS: These findings underscore the need to develop novel strategies for reducing patient and diagnostic delays and engaging first-contact health care providers.
    Matched MeSH terms: Tuberculosis, Pulmonary/diagnosis*; Delayed Diagnosis*
  19. Chang Y, Kim BK, Yun KE, Cho J, Zhang Y, Rampal S, et al.
    J Am Coll Cardiol, 2014 Jun 24;63(24):2679-86.
    PMID: 24794119 DOI: 10.1016/j.jacc.2014.03.042
    The purpose of this study was to compare the coronary artery calcium (CAC) scores of metabolically-healthy obese (MHO) and metabolically healthy normal-weight individuals in a large sample of apparently healthy men and women.
    Matched MeSH terms: Coronary Artery Disease/diagnosis*; Obesity/diagnosis*; Vascular Calcification/diagnosis*
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