Browse publications by year: 2013

Fulltext Identification of effective screening strategies for cardiovascular disease prevention in a developing country: using cardiovascular risk-estimation and risk-reduction tools for policy recommendations

Selvarajah S, Haniff J, Kaur G, Guat Hiong T, Bujang A, Chee Cheong K, et al.

BMC Cardiovasc Disord, 2013;13:10.
PMID: 23442728 DOI: 10.1186/1471-2261-13-10

Recent increases in cardiovascular risk-factor prevalences have led to new national policy recommendations of universal screening for primary prevention of cardiovascular disease in Malaysia. This study assessed whether the current national policy recommendation of universal screening was optimal, by comparing the effectiveness and impact of various cardiovascular screening strategies.

MeSH terms: Adult; Age Factors; Aged; Cardiovascular Diseases/economics; Cardiovascular Diseases/epidemiology; Cardiovascular Diseases/prevention & control*; Cost-Benefit Analysis; Female; Humans; Malaysia/epidemiology; Male; Middle Aged; Policy Making*; Predictive Value of Tests; Risk Factors; Sex Factors; Prevalence; Health Care Costs; Practice Guidelines as Topic; Risk Assessment
Fulltext Impact of malocclusion on oral health related quality of life in young people

Masood Y, Masood M, Zainul NN, Araby NB, Hussain SF, Newton T

Health Qual Life Outcomes, 2013;11:25.
PMID: 23443041 DOI: 10.1186/1477-7525-11-25

The objectives for this study were to assess Oral Health Related Quality of Life (OHRQoL) in young people aged 15-25 who sought orthodontic treatment, and to measure the association between orthodontic treatment need (using the IOTN), sex, age and education level, and oral health related quality of life (OHRQoL).

MeSH terms: Adolescent; Adult; Age Factors; Educational Status; Female; Humans; Male; Malocclusion/psychology*; Quality of Life/psychology*; Surveys and Questionnaires; Sex Factors; Young Adult
River water quality assessment using environmentric techniques: case study of Jakara River Basin

Mustapha A, Aris AZ, Juahir H, Ramli MF, Kura NU

Environ Sci Pollut Res Int, 2013 Aug;20(8):5630-44.
PMID: 23443942 DOI: 10.1007/s11356-013-1542-z

Jakara River Basin has been extensively studied to assess the overall water quality and to identify the major variables responsible for water quality variations in the basin. A total of 27 sampling points were selected in the riverine network of the Upper Jakara River Basin. Water samples were collected in triplicate and analyzed for physicochemical variables. Pearson product-moment correlation analysis was conducted to evaluate the relationship of water quality parameters and revealed a significant relationship between salinity, conductivity with dissolved solids (DS) and 5-day biochemical oxygen demand (BOD5), chemical oxygen demand (COD), and nitrogen in form of ammonia (NH4). Partial correlation analysis (r p) results showed that there is a strong relationship between salinity and turbidity (r p=0.930, p=0.001) and BOD5 and COD (r p=0.839, p=0.001) controlling for the linear effects of conductivity and NH4, respectively. Principal component analysis and or factor analysis was used to investigate the origin of each water quality parameter in the Jakara Basin and identified three major factors explaining 68.11 % of the total variance in water quality. The major variations are related to anthropogenic activities (irrigation agricultural, construction activities, clearing of land, and domestic waste disposal) and natural processes (erosion of river bank and runoff). Discriminant analysis (DA) was applied on the dataset to maximize the similarities between group relative to within-group variance of the parameters. DA provided better results with great discriminatory ability using eight variables (DO, BOD5, COD, SS, NH4, conductivity, salinity, and DS) as the most statistically significantly responsible for surface water quality variation in the area. The present study, however, makes several noteworthy contributions to the existing knowledge on the spatial variations of surface water quality and is believed to serve as a baseline data for further studies. Future research should therefore concentrate on the investigation of temporal variations of water quality in the basin.

MeSH terms: Quaternary Ammonium Compounds/analysis; Environmental Monitoring/statistics & numerical data*; Factor Analysis, Statistical; Hydrogen-Ion Concentration; Malaysia; Oxygen/analysis; Water Pollutants, Chemical/analysis*; Discriminant Analysis; Metals, Heavy/analysis; Principal Component Analysis; Rivers/chemistry*; Biological Oxygen Demand Analysis; Water Quality
Heavy metals in spices and herbs from wholesale markets in Malaysia

Nordin N, Selamat J

Food Addit Contam Part B Surveill, 2013;6(1):36-41.
PMID: 24786623 DOI: 10.1080/19393210.2012.721140

As, Cd, Pb and Hg were analysed in commonly consumed spices and herbs in Malaysia. The range of As, Cd, Pb and Hg content was 0.24-2.54, 0.23-8.07, 1.54-8.94 and 0.06-0.52 µg g(-1), respectively. The highest concentration of Cd, Pb and Hg in spices and herbs exceeded the maximum permitted proportion, which are 1, 2 and 0.05 µg g(-1), respectively. This study suggests further monitoring of Cd, Pb and Hg on daily consumption of spices and herbs and its toxicological implication for consumers since only the amount of As was lower than the permitted concentration.

MeSH terms: Arsenic/analysis; Cadmium/analysis; Food Contamination/analysis; Lead/analysis; Malaysia; Maximum Allowable Concentration; Mercury/analysis; Quality Control; Spices/analysis*; Metals, Heavy/analysis*
Bionomics and vectorial capacity of Anopheles annularis with special reference to India: a review

Singh RK, Haq S, Kumar G, Dhiman RC

J Commun Dis, 2013 Mar-Jun;45(1-2):1-16.
PMID: 25141549

Anopheles annularis is widely distributed mosquito species all over the country. An. annularis has been incriminated as a malaria vector in India, Sri Lanka, Bangladesh, Myanmar, Indonesia, Malaysia and China. In India, it has been reported to play an important role in malaria transmission as a secondary vector in certain parts of Assam, West Bengal and U.P. In Odisha and some neighbouring countries such as Sri Lanka, Nepal and Myanmar it has been recognised as a primary vector of malaria. This is a species complex of two sibling species A and B but the role of these sibling species in malaria transmission is not clearly known. An. annularis is resistant to DDT and dieldrin/HCH and susceptible to malathion and synthetic pyrethorides in most of the parts of India. In view of rapid change in ecological conditions, further studies are required on the bionomics of An. annularis and its role in malaria transmission in other parts of the country. Considering the importance of An. annularis as a malaria vector, the bionomics and its role in malaria transmission has been reviewed in this paper. In this communication, an attempt has been made to review its bionomics and its role as malaria vector. An. annularis is a competent vector of malaria, thus, due attention should be paid for its control under the vector control programmes specially in border states where it is playing a primary role in malaria transmission.

MeSH terms: Animals; Anopheles/drug effects; Anopheles/parasitology*; Anopheles/physiology*; India/epidemiology; Insect Vectors/parasitology*; Insect Vectors/physiology*; Insecticides/pharmacology; Malaria/epidemiology; Malaria/transmission*
Fulltext Neofusicoccum ribis Associated with Leaf Blight on Rubber (Hevea brasiliensis) in Peninsular Malaysia

Nyaka Ngobisa AI, Zainal Abidin MA, Wong MY, Wan Noordin MW

Plant Pathol J, 2013 Mar;29(1):10-6.
PMID: 25288924 DOI: 10.5423/PPJ.OA.07.2012.0110

Hevea brasiliensis is a natural source of rubber and an important plantation tree species in Malaysia. Leaf blight disease caused by Fusicoccum substantially reduces the growth and performance of H. brasiliensis. The aim of this study was to use a combination of both morphological characteristics and molecular data to clarify the taxonomic position of the fungus associated with leaf blight disease. Fusicoccum species were isolated from infected leaves collected from plantations at 3 widely separated locations - Selangor, Perak, and Johor states - in Peninsular Malaysia in 2010. All the isolates were identified according to their conidial patterns and DNA sequences generated from internal transcribed spacers (ITS1 and ITS2), the 5.8S rRNA, and an unknown locus (BotF15) containing microsatellite repeats. Based on taxonomic and sequence data, Neofusicoccum ribis was identified as the main cause of leaf blight disease in H. brasiliensis in commercial plantations in Malaysia. A pathogenicity trial on detached leaves further confirmed that N. ribis causes leaf blight disease. N. ribis is an important leaf pathogen, and its detection in Malaysia has important implications for future planting of H. brasiliensis.
Fulltext Early Functional Outcome of Resection and Endoprosthesis Replacement for Primary Tumor around the Knee

Sharil A, Nawaz A, Nor Azman M, Zulmi W, Faisham W

Malays Orthop J, 2013 Mar;7(1):30-5.
PMID: 25722804 MyJurnal DOI: 10.5704/MOJ.1303.013

We evaluated functional outcomes for patients who underwent surgery for resection and endoprosthesis replacement for primary tumours around the knee. We used the Musculoskeletal Tumour Society Scoring System (MSTS) for functional evaluations to compare differences between distal femur (DF) and proximal tibia (PT) placements. The study sample included 34 cases of distal femur and 20 cases of proximal tibia endoprosthesis replacement. Primary tumours were classified as follows: 33 osteosarcoma, 20 stage III giant cell tumour (GCT) and one case of mesenchymal chondrosarcoma. The mean MSTS score for both DF and PT endoprosthesis together was 21.13 (70.43%), and The MSTS scores for DF was 21.94 (73.13%) and PT was 19.75 (65.83%) Infection developed in 7 cases and 5 of which were PT endoprosthesis cases. Three deep infections required early, two-stage revision and resulted in poor MSTS scores. We conclude that endoprosthesis replacement for primary bone tumours had early good to excellent functional outcome. There were no differences in functional outcomes when comparing distal femur endoprostheses with proximal tibia endoprostheses.
KEY WORDS: functional outcome, bone tumour, knee, and endoprosthesis.
Fulltext The In-Vitro Effects of Sea Cucumber (Stichopus sp1) Extract on Human Osteoblast Cell Line

Shahrulazua A, Samsudin A, Iskandar M, Amran A

Malays Orthop J, 2013 Mar;7(1):41-8.
PMID: 25722806 MyJurnal DOI: 10.5704/MOJ.1303.015

Despite its claimed therapeutic effects, the action of sea cucumber (known as gamat in the Malay language) on human osteoblast cells is still unknown. We performed in vitro studies utilising extract of Stichopus sp1 (gamat) to elucidate its effects on cell viability and functional activity. We found an inverse relationship between gamat concentration and its effect on osteoblast cell viability (p<0.001). Only gamat concentration at 1mg/ml significantly promoted cell viability at day 3 of incubation. There was a trend towards increased osteoblast cell function in the presence of gamat at 5mg/ml and 10mg/ml but this observation was not consistent at different incubation periods.

MeSH terms: Animals; Cell Physiological Phenomena; Cell Survival; Humans; Language; Malaysia; Musculoskeletal Physiological Phenomena; Osteoblasts; Plant Extracts; Research Design; Sea Cucumbers; Stichopus
Fulltext Comparative study between coaptive film versus suture for wound closure after long bone fracture fixation

Anuar Ramdhan I, Zulmi W, Hidayah A, Kamel M, Fadhil M, Anwar Hau M

Malays Orthop J, 2013 Mar;7(1):52-5.
PMID: 25722808 MyJurnal DOI: 10.5704/MOJ.1303.017

Coaptive film (i.e., Steri-Strips™) is an adhesive tape used to replace sutures in wound closure. The use of coaptive film for wound closure after long bone fracture fixation has not been well documented in the literature.

MeSH terms: Adhesives; Fracture Fixation; Sutures; Surgical Tape
Fulltext Outcome of surgical treatment of pelvic osteosarcoma: hospital universiti sains malaysia experience

Ariff M, Zulmi W, Faisham W, Nor Azman M, Nawaz A

Malays Orthop J, 2013 Mar;7(1):56-62.
PMID: 25722809 MyJurnal DOI: 10.5704/MOJ.1303.018

We reviewed the surgical treatment and outcomes of 13 patients with pelvic osteosarcoma treated in our centre in the past decade. The study sample included 9 males and 4 females with a mean age of 28.1 years. Four patients had ileal lesions, five had acetabulum lesions, one had a ischiopubis lesion, and three had involvement of the whole hemipelvis. Seven patients presented with distant metastases at diagnosis. Limb salvage was performed in 6 patients and amputation in 7. In 60% of cases in the limb salvage surgery group, we attempted wide resection with positive microscopic margin compared to only 16.7% in the amputation group. Local recurrence was higher in the limb salvage group. Overall survival was 18 months for mean follow up of 14.8 months. Median survival was 19 months in the limb salvage group compared to 9 months in amputation group. The outcome of surgical treatment of pelvic osteosarcoma remains poor despite advancements in musculoskeletal oncology treatment.

MeSH terms: Acetabulum; Adult; Amputation; Bone Neoplasms; Extremities; Female; Follow-Up Studies; Humans; Male; Neoplasm Recurrence, Local; Osteosarcoma; Salvage Therapy; Treatment Outcome; Limb Salvage
Fulltext Spontaneous subtrochanteric femoral stress fracture related to alendronate : a case report

Chew PC, Julaihi B, Ibrahim Z

Malays Orthop J, 2013 Mar;7(1):70-3.
PMID: 25722811 MyJurnal DOI: 10.5704/MOJ.1303.002

Spontaneous atypical fractures of the femur have been reported in patients on long-term antiresorptive bisphosphonate therapy. Here, we report a case of subtrochanteric stress fracture in a seventy-year-old female patient on long-term alendronate therapy, and accompanying management challenges. Potential measures to prevent this complication of antiresorptive treatment for osteoporosis include the following: setting strict criteria for prescribing antiresorptive therapy, limiting the duration of continuous antiresorptive therapy, and increasing the use of bone anabolic agents.

MeSH terms: Aged; Female; Femur; Fractures, Spontaneous; Hip Fractures; Humans; Osteoporosis; Fractures, Stress; Alendronate; Anabolic Agents
Fulltext Modified pectoralis major tendon transfer for reanimation of elbow flexion as a salvage procedure in complete brachial plexus injury: a case report

Taran S, Nawfar S

Malays Orthop J, 2013 Mar;7(1):79-81.
PMID: 25722813 MyJurnal DOI: 10.5704/MOJ.1303.004

Traumatic brachial plexus injuries rarely recover spontaneously and if the window period for neurotisation has elapsed, the only option for restoration of function lies in a salvage procedure. Many such salvage procedures have been described in the literature with variable functional results. We report the case of a 16-year-old boy who presented after unsuccessful treatment for a complete brachial plexus injury; we performed a pectoralis major tendon transfer to attain elbow flexion. Postoperatively, the elbow was splinted with flexion at 100°. After 4 weeks of immobilization the splint was removed and the patient could actively flex his elbow from 30° to 100°.

MeSH terms: Adolescent; Brachial Plexus; Elbow; Elbow Joint; Humans; Male; Splints; Tendon Transfer; Range of Motion, Articular; Nerve Transfer
Epidemiology of a fast emerging disease in the Asia-Pacific region: non-alcoholic fatty liver disease

Chan WK, Goh KL

Hepatol Int, 2013 Mar;7(1):65-71.
PMID: 26201622 DOI: 10.1007/s12072-012-9384-1

Non-alcoholic fatty liver disease (NAFLD) is rapidly increasing in the Asia-Pacific and affects up to 30 % of the general population. In younger children, prevalence has been reported to be between 2.1 and 4.5 %. The prevalence of NAFLD increases with increasing age. NAFLD is more prevalent in men than women, but this trend fades in older age group. NAFLD is one of the most common causes of raised serum ALT levels and the latter is closely related to the presence of features of metabolic syndrome. NAFLD may contribute to metabolic syndrome in a similar way as visceral adiposity and can be an early predictor of metabolic disorders. NAFLD increases the risk of developing diabetes mellitus and is closely related to degree of glucose intolerance. A significant proportion of patients with NAFLD have impaired glucose tolerance or diabetes mellitus but with normal fasting blood glucose, highlighting the importance of oral glucose tolerance test in NAFLD patients with normal fasting blood glucose. Besides liver-related complications, NAFLD has been associated with cardiovascular complications, hyperuricemia, gout, chronic kidney disease, gallstone disease, colorectal adenomatous polyp, and polycystic ovarian syndrome. NAFLD seems to be related to host metabolic factors rather than viral factors and does not seem to affect severity of the liver disease in patients with chronic hepatitis B. On the other hand, hepatic steatosis may be related to both host metabolic and viral factors in patients with chronic hepatitis C and seems to adversely impact on the severity of liver disease and possibly response to antiviral therapy.

MeSH terms: Asia; Fatty Liver*; Humans; Prediabetic State
Outcome of molar pregnancies in Malaysia: a tertiary centre experience

Nirmala CK, Nor Azlin MI, Harry SR, Lim PS, Shafiee MN, Nur Azurah AG, et al.

J Obstet Gynaecol, 2013 Feb;33(2):191-3.
PMID: 23445147 DOI: 10.3109/01443615.2012.741150

Gestational trophoblastic disease (GTD) is a common problem among Asian ethnics. A total of 102 women with molar pregnancies between 1 January 2005 and 31 December 2010, were analysed. The aim of the study was to determine the outcome of all molar pregnancies in our institution. The local incidence of molar pregnancy was 2.6 per 1,000 deliveries. A total of 48 women (47.1%) had complete hydatidiform mole and another 54 (52.9%) had partial mole. The mean age of the women with molar pregnancies was 32.0 ± 7.9 years. The mean gestational age at initial diagnosis was 11 weeks ± 3 days. The majority (97 women, 95.1%) had symptoms of vaginal bleeding and 18 (17.6%) women had a uterus larger than dates. A total of 48 (47.1%) women had ultrasound scan findings of 'snow-storm' appearance. None of the women with uncomplicated molar pregnancy had evidence of relapse following one undetectable serum β-hCG level. Four out of the 102 women (3.9%) developed persistent trophoblastic disease before attaining one undetectable serum β-hCG level. All four women required single agent methotrexate and they remained in remission. The prognosis for uncomplicated molar pregnancy is good. Establishment of a National Trophoblastic Centre is recommended to maintain optimal outcome.

MeSH terms: Adolescent; Adult; Female; Humans; Hydatidiform Mole/epidemiology*; Malaysia/epidemiology; Middle Aged; Pregnancy; Retrospective Studies; Urban Population; Young Adult; Tertiary Care Centers/statistics & numerical data
Optimization of semi-aerobic stabilized leachate treatment using ozone/Fenton's reagent in the advanced oxidation process

Abu Amr SS, Aziz HA, Adlan MN, Bashir MJ

J Environ Sci Health A Tox Hazard Subst Environ Eng, 2013;48(7):720-9.
PMID: 23445415 DOI: 10.1080/10934529.2013.744611

The objective of this study was to investigate the performance of employing Fenton's reagent in the advanced oxidation of ozone to treat stabilized landfill leachate in an ozone reactor. A central composite design (CCD) with response surface methodology (RSM) was applied to evaluate the relationships between operating variables, such as ozone and Fenton dosage, pH, and reaction time, to identify the optimum operating conditions. Quadratic models for the following four responses proved to be significant with very low probabilities (<0.0001): chemical oxygen demand (COD), color, NH-N, and ozone consumption (OC). The obtained optimum conditions included a reaction time of 90 min, 30 g/m³ ozone, 0.01 mol/L₂H₂O,0.02 mol/L Fe²⁺, and pH 5. COD, color, and NH₃-N removal rates of 79%, 100%, and 20%, respectively, and 0.18 kg O₃/kg COD OC were obtained. The predictions correspond well with experimental results (COD, color, and NH-N removal rates of 78%, 98.5%, and 19%, respectively, and 0.29 kg O₃/kg COD OC). This method reduces the treatment time and improves the treatment efficiency relative to a previously published method that used Fenton's reagent prior to ozonation.

MeSH terms: Ammonia/analysis; Color; Hydrogen Peroxide/chemistry*; Hydrogen-Ion Concentration; Iron/chemistry*; Models, Chemical; Oxidation-Reduction; Ozone/analysis; Ozone/chemistry*; Reaction Time; Spectrophotometry; Water Pollutants, Chemical/chemistry*; Water Purification/methods*; Biological Oxygen Demand Analysis
Risk factors of erectile dysfunction in patients receiving methadone maintenance therapy

Nik Jaafar NR, Mislan N, Abdul Aziz S, Baharudin A, Ibrahim N, Midin M, et al.

J Sex Med, 2013 Aug;10(8):2069-76.
PMID: 23445463 DOI: 10.1111/jsm.12105

INTRODUCTION: While methadone effectively treats opiate dependence, the side effect of erectile dysfunction (ED) may interfere with treatment adherence and benefits.
AIM:To determine the rate of ED and the associated factors which predict ED in male patients on methadone maintenance therapy (MMT) in a Malaysian population.
MAIN OUTCOME MEASURES: The main outcome measures were the International Index of Erectile Function-15 (IIEF-15) and the Beck Depression Inventory (BDI).
METHODS: A total of 108 participants diagnosed with heroin dependence were assessed. We used the Structured Clinical Interview for DSM-IV Axis-I Disorders (SCID-I) on subjects who received MMT, and they were assessed using the IIEF-15, the BDI, and measures of other clinical and sociodemographic variables.
RESULTS: The rate of ED among men on MMT was 68.5% (mild ED, 36.1%; mild to moderate ED, 22.2%; severe ED, 3.7%). The mean age of the participants was 43.45 years. Older age (P = 0.002), concurrent illicit heroin use (P = 0.024), and having an older partner (P = 0.039) were significantly associated with ED. Following multivariate analysis, it was found that older age was the only significant predictor of ED, with an adjusted odds ratio of 1.07 (95% CI = 1.02-1.16). Methadone dose and duration of methadone treatment were not significantly associated with ED.
CONCLUSION: ED was highly prevalent among male patients on MMT. This suggests that there is a need for routine assessment of sexual function in patients on methadone. Among the risk factors, age was the only factor that was significantly associated with ED. The current use of MMT in Malaysia in terms of dosage and duration did not pose a significant risk for ED.
KEYWORDS: Erectile Dysfunction; Methadone Therapy; Opiate Dependence
Study site: outpatient clinic for opiate substitution therapy, Hospital Kuala Lumpur (HKL), Malaysia

MeSH terms: Adult; Aged; Hospitals, General; Humans; Erectile Dysfunction/epidemiology*; Malaysia; Male; Methadone/administration & dosage; Methadone/therapeutic use*; Middle Aged; Opioid-Related Disorders/drug therapy*; Outpatient Clinics, Hospital; Surveys and Questionnaires; Risk Factors
Fulltext Nucleospora cyclopteri n. sp., an intranuclear microsporidian infecting wild lumpfish, Cyclopterus lumpus L., in Icelandic waters

Freeman MA, Kasper JM, Kristmundsson Á

Parasit Vectors, 2013;6:49.
PMID: 23445616 DOI: 10.1186/1756-3305-6-49

Commercial fisheries of lumpfish Cyclopterus lumpus have been carried out in Iceland for centuries. Traditionally the most valuable part is the eggs which are harvested for use as a caviar substitute.Previously reported parasitic infections from lumpfish include an undescribed intranuclear microsporidian associated with abnormal kidneys and mortalities in captive lumpfish in Canada. During Icelandic lumpfish fisheries in spring 2011, extensive enlargements to the kidneys were observed in some fish during processing. The aim of this study was to identify the pathogen responsible for these abnormalities.

MeSH terms: Animals; DNA, Fungal/genetics; DNA, Fungal/chemistry; DNA, Ribosomal/genetics; DNA, Ribosomal/chemistry; Fish Diseases/microbiology*; Fish Diseases/pathology; Histocytochemistry; Iceland; Kidney/microbiology; Kidney/pathology; Microscopy; Molecular Sequence Data; Phylogeny; Cluster Analysis; Apansporoblastina/classification*; Apansporoblastina/genetics; Apansporoblastina/isolation & purification*; Microsporidiosis/microbiology; Microsporidiosis/pathology; Microsporidiosis/veterinary*; Sequence Analysis, DNA; Chordata
Fulltext Risk assessment of exposure to lead in tap water among residents of Seri Kembangan, Selangor state, Malaysia

Lim CS, Shaharuddin MS, Sam WY

Glob J Health Sci, 2013 Mar;5(2):1-12.
PMID: 23445691 DOI: 10.5539/gjhs.v5n2p1

A cross sectional study was conducted to estimate risk of exposure to lead via tap water ingestion pathway for the population of Seri Kembangan (SK).

MeSH terms: Adolescent; Adult; Aged; Cross-Sectional Studies; Drinking; Environmental Exposure/analysis; Environmental Exposure/statistics & numerical data*; Female; Humans; Hydrogen-Ion Concentration; Lead/analysis*; Malaysia/epidemiology; Male; Middle Aged; Socioeconomic Factors; Temperature; Urban Population; Water Pollutants, Chemical/analysis*; Water Pollution, Chemical/statistics & numerical data; Water Supply/statistics & numerical data; Risk Assessment; Young Adult; Drinking Water/chemistry*
Techniques of extracorporeal cytokine removal: a systematic review of the literature on animal experimental studies

Atan R, Crosbie D, Bellomo R

Int J Artif Organs, 2013 Mar;36(3):149-58.
PMID: 23446761 DOI: 10.5301/ijao.5000128

BACKGROUND AND AIMS: Extracorporeal cytokine removal may be desirable. We sought to assess extracorporeal blood purification (EBP) techniques for cytokine removal in experimental animal studies. 
METHODS: We conducted a targeted, systematic search and identified 17 articles. We analyzed cytokine clearance, sieving coefficient (SC), ultrafiltrate (UF) concentration, and percentage removal. As this review concerns technical appraisal of EBP techniques, we made no attempts to appraise the methodology of the studies included. Results are in descriptive terms only. 
RESULTS: Applying predicted clearance for 80 kg human, high volume hemofiltration (HVHF) techniques and plasmafiltration (PF) showed the highest rates of cytokine removal. High cutoff (HCO)/HF and PF techniques showed modest ability to clear cytokines using low to medium flows. Standard hemofiltration had little efficacy. At higher flows, HCO/HF achieved clearances between 30 and 70 ml/min for IL-6 and IL-10. There was essentially no removal of tumor necrosis factor (TNF)-alpha outside of PF. 
CONCLUSIONS: Experimental animal studies indicate that HVHF (especially with HCO filters) and plasmafiltration have the potential to achieve appreciable IL-6 and IL-10 clearances. However, only PF can remove TNF-alpha reliably.

MeSH terms: Animals; Hemofiltration/methods*; Humans; Membranes, Artificial; Tumor Necrosis Factor-alpha/blood; Interleukin-6/blood; Cytokines/blood*; Interleukin-10/blood
Is rheumatic aetiology a predictor of poor outcome in the current era of mitral valve repair? Contemporary long-term results of mitral valve repair in rheumatic heart disease

Yakub MA, Dillon J, Krishna Moorthy PS, Pau KK, Nordin MN

Eur J Cardiothorac Surg, 2013 Oct;44(4):673-81.
PMID: 23447474 DOI: 10.1093/ejcts/ezt093

Contemporary experience with mitral valve (MV) repair in the rheumatic population is limited. We aimed to examine the long-term outcomes of rheumatic MV repair, to identify the predictors of durability and to compare the repair for rheumatic and degenerative MVs.

MeSH terms: Adolescent; Adult; Aged; Child; Child, Preschool; Female; Heart Valve Prosthesis; Humans; Male; Middle Aged; Mitral Valve/surgery*; Postoperative Complications; Prospective Studies; Prosthesis Failure; Reoperation; Rheumatic Heart Disease/surgery*; Chi-Square Distribution; Treatment Outcome; Heart Valve Prosthesis Implantation/adverse effects; Heart Valve Prosthesis Implantation/methods*; Kaplan-Meier Estimate; Young Adult

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