Displaying publications 1 - 20 of 104 in total

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  1. Yusof MS, Kadir MA, Yamin BM
    PMID: 22807736 DOI: 10.1107/S1600536812025081
    In the centrosymmetric mononuclear title complex, [Cu(C₁₈H₂₀N₂O₂)₂], the Cu(II) atom is four-coordinated in a trans-CuN₂O₂ square-planar geometry with the N-Cu-O chelate angle being 89.97 (11)°. The dihedral angles made by the planes defined by the aromatic ring carbons of the 4-methyl-benzene and 2,4-dimethyl-benzene fragments with the plane defined by the chelate ring are 13.43 (15) and 82.69 (13)° respectively. The angle between the planes defined by the aromatic carbons of the two rings is 89.40 (16)°. A a weak intra-molecular C-H⋯N hydrogen bond occurs.
  2. Sadek AF, Halim AS, Ismail FW, Imran YM
    Ann Plast Surg, 2014 Oct;73(4):402-4.
    PMID: 23851368 DOI: 10.1097/SAP.0b013e31827fb387
    Reconstruction of major bone defects using free fibular transfer provides a good biological option in unsound situations. Most authors recommend selection of the recipient blood vessels outside the zone of injury to achieve successful free fibular transfer. Occasionally, in polytraumatized patients, the surgeon has to use a previously fractured fibula as a graft, with increased risk of inclusion of the injury zone that may lead to failure.
  3. Yusof MR, Fahmey O, Lee C, Azli MS, Arunasalam AP, Khairul-Asri MG
    Ann R Coll Surg Engl, 2022 Mar;104(3):e64-e66.
    PMID: 34812656 DOI: 10.1308/rcsann.2021.0110
    Renal cell carcinoma (RCC) has been shown to cause venous migration in the inferior vena cava (IVC). It is very important for preoperative imaging to be carried out, which will decide the surgical approach for the patient. Duplication of IVC is an uncommon anomaly. We report a case of RCC with duplication of IVC.
  4. Jagwani AV, Mugialan P, Lee C, Fairuz M, Lee FY, Yusof MR, et al.
    Ann R Coll Surg Engl, 2022 Jun;104(6):e164-e167.
    PMID: 34846183 DOI: 10.1308/rcsann.2021.0241
    An elderly man was treated for severe acute scrotum pain with centesis. We report the diagnosis, underlying causes and management, and discuss the procedure. Centesis is performed rarely, but could be undertaken more often given the added benefits.
  5. Perera D, Yusof MA, Podin Y, Ooi MH, Thao NT, Wong KK, et al.
    Arch Virol, 2007;152(6):1201-8.
    PMID: 17308978
    A phylogenetic analysis of VP1 and VP4 nucleotide sequences of 52 recent CVA16 strains demonstrated two distinct CVA16 genogroups, A and B, with the prototype strain being the only member of genogroup A. CVA16 G-10, the prototype strain, showed a nucleotide difference of 27.7-30.2% and 19.9-25.2% in VP1 and VP4, respectively, in relation to other CVA16 strains, which formed two separate lineages in genogroup B with nucleotide variation of less than 13.4% and less than 16.3% in VP1 and VP4, respectively. Lineage 1 strains circulating before 2000 were later displaced by lineage 2 strains.
  6. Md Yusof M, Abdullah MM, Yap BK, Ng SC, Low JSH, Lam KS, et al.
    Asia Pac J Clin Oncol, 2021 Nov 23.
    PMID: 34811924 DOI: 10.1111/ajco.13667
    AIM: A large proportion of cancer patients are at high risk for chemotherapy-induced nausea and vomiting (CINV), but the choice of anti-emetics for CINV in Malaysia is limited.

    METHODS: This was a real-world study of a fixed-dose combination of netupitant and palonosetron (NEPA) to inhibit CINV in adult patients receiving moderately (MEC) or highly emetogenic chemotherapy (HEC) for solid/hematological malignancies at eight Malaysian centers. Each HEC/MEC cycle received one dose of NEPA + dexamethasone for CINV prevention. Complete response (no emesis, no rescue medication) (CR), no more than mild nausea (severity score ≤ 2.5), and complete control (CR) (no more than mild nausea) during the acute (0-24 h), delayed (25-120 h), and overall (0-120 h) phases post-chemotherapy were measured. Treatment-related adverse events (AEs) were recorded.

    RESULTS: During March 2016-April 2018 (NMRR-17-3286-38282), NEPA + dexamethasone was administered to 54 patients (77.8% solid, 22.2% hematological malignancies). Note that 59.3% received HEC, while 40.7% received MEC regimen. During the overall phase of the first cycle, the majority had CR (77.8%), no more than mild nausea (74.1%), and complete control (61.1%). Seventeen patients received two consecutive cycles at any point of chemotherapy cycles. During the overall phases across two consecutive cycles, all patients achieved CR, and the majority reported no more than mild nausea and complete control. No grades 3-4 AEs were reported.

    CONCLUSIONS: NEPA had sustained efficacy and tolerability at first administration and across two cycles of MEC/HEC for CINV prevention.

  7. Yusof M, Dasor MM, Ariffin F, Reduwan NH, Kamil W, Mah MC
    Aust Dent J, 2020 Dec;65(4):308-312.
    PMID: 32259287 DOI: 10.1111/adj.12756
    This report presents two cases of idiopathic osteosclerosis involving the maxilla and mandible which were identified as a buccally impacted canine and a retained root, respectively, on clinical and plain radiographical examinations. Both patients were females who presented with hypodontia. Radiographic evaluation revealed solitary well-defined radiopaque masses with thickened cortical border. Both patients were undergoing orthodontic treatment and one was planned for a surgical traction of unerupted tooth prior to cone-beam CT assessment. In this report, we reviewed the clinical findings and explained the radiographic appearance of idiopathic osteosclerosis through plain radiographs and cone-beam CT to facilitate its identification among general dentists and oral and maxillofacial radiologists.
  8. Aziz FAA, Ahmad NA, Razak MAA, Omar M, Kasim NM, Yusof M, et al.
    BMC Public Health, 2018 Dec 11;18(1):1363.
    PMID: 30537956 DOI: 10.1186/s12889-018-6266-z
    BACKGROUND: Globally, diarrhoea is one of the major causes of morbidity and mortality among children under than 5 years of age. There is a scarcity of published data on acute gastroenteritis (AGE) prevalence in Malaysia among children. This study aims to determine factors associated with diarrhoea in children aged less than 5 years in Malaysia.

    METHOD: Data from the National Health and Morbidity Survey 2016 conducted by Ministry of Health was analysed. This nationwide survey involved 15,188 children below five years old. The survey was carried out using a two-stage stratified sampling design to ensure national representativeness. The Questionnaire from UNICEF's Multiple Indicator Cluster Survey (MCIS) was adapted to suit local requirements. Analysis was done using SPSS Version 23. Descriptive followed by multiple logistic regression were done to identify relevant factors.

    RESULT: The prevalence of diarrhoea among children under five in Malaysia was 4.4% (95% CI: 3.8,5.2). Analysis using logistic regression indicated that only ethnicity and usage of untreated water were significantly associated with diarrhoea among children after controlling for relevant factors. By ethnicity, children in the 'Other Bumiputera' group had 2.5 times the odds of having diarrhoea compared to children of Malay ethnicity. Children of Indian ethnicity were also at higher risk, at almost double the odds, as well as other ethnic groups (1.5 times). Children who used untreated water supply were two times more likely to develop diarrhoea.

    CONCLUSION: There is a higher risk of diarrhoea among children of 'Other Bumiputera' ethnicity, Indian ethnicities, and other ethnic groups and those who consume untreated water. Strategies to reduce diarrhoea among children should be targeted towards these at-risk populations. In addition, the Government must strive to ensure universal access to treated clean water in Malaysia and the Ministry of Health must focus on raising awareness on how to prevent diarrhoea.

  9. Ahmad NA, Mohamad Kasim N, Mahmud NA, Mohd Yusof Y, Othman S, Chan YY, et al.
    BMC Public Health, 2017 09 29;17(1):756.
    PMID: 28962562 DOI: 10.1186/s12889-017-4793-7
    BACKGROUND: Reliable national data on disability which is internationally comparable is needed in Malaysia. This study aims to examine the prevalence of disability among adults in Malaysia and its determinants, particularly the socioeconomic factors and comorbidities.

    METHODS: This study was based on the disability module, which is part of the National Health and Morbidity Survey 2015. This survey was implemented using a multi-stage stratified sampling design. A locally validated Washington Group questionnaire was used to collect data on disability.

    RESULTS: Based on the definition of having at least one domain scored "a lot of difficulty or unable to do at all" or at least "some difficulty" scored in two domains, the prevalence of disability among adults in Malaysia was 11.8% (95% CI: 11.15, 12.53). Logistic regression analysis performed showed that population at risk of having disability in Malaysia were those of older people, ethnic minority, low level of education, single, obese, physically inactive and having mental health problems. Among older people, disability was significantly higher among those with no formal education, having mental health problems and physically inactive.

    CONCLUSIONS: The prevalence of disability among adults in Malaysia is comparable to WHO estimates and most developing countries. Planning for healthcare services should consider at-risk population, particularly older people and those from disadvantaged background to ensure equity healthcare.
    Study name: National Health and Morbidity Survey (NHMS-2015)
  10. Mohamad Nor NS, Ambak R, Mohd Zaki N, Abdul Aziz NS, Cheong SM, Abd Razak MA, et al.
    BMC Womens Health, 2018 07 19;18(Suppl 1):114.
    PMID: 30066661 DOI: 10.1186/s12905-018-0590-4
    BACKGROUND: Obesity is a global health burden in the non-communicable diseases and much efforts have been implemented in the past decade in response to the rise of obesity prevalence among the Malaysian population. These include the development of the national policies, health programmes and research activities. The main aim of the scoping review was to identify obesity research pattern among adults in Malaysia in terms of the scopes, topics and the research designs.

    METHODS: The scoping review was conducted based on the framework by Arksey and O'Malley. The Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) diagram was used as a guide to record the review process. Articles from year 2008 until 2017 on overweight and obesity among adults aged 18 years and above were retrieved based on the keywords using electronic databases (Embase/Ovid, Pubmed, Cochrane library and Google Scholar). Local journals, Nutrition Research in Malaysia Biblography (2011 and 2016), online local theses databases, virtual library databases were also included in the searches. Consultations with relevant key informants from the National Institutes of Health and local universities were also conducted. Search activities were managed using Endnote software and MS Excelsheet.

    RESULTS: The characteristics of the results were described based on the objectives of the review. A total of 2004 articles and reports were retrieved, and 188 articles related to obesity in Malaysia were included in the final review. Scopes and topics of obesity research based on the Nutrition Research Priorities in Malaysia (NRPM) for 11th Malaysia Plan were obesity prevalence, weight loss intervention, association of physical activities and dietary factors with obesity. The majority of obesity research among adults in Malaysia was cross sectional studies and only a small number of intervention studies, qualitative studies and systematic review were indentified. Research gaps were identified in order to make useful recommendations to the stakeholders.

    CONCLUSIONS: In the past decade, there has been an emerging evidence on obesity research among adults in Malaysia. More obesity research needs to be conducted particularly on obesity intervention among specific gender, qualitative studies, economic cost and genetic factors of obesity.

  11. Mei Hsien CC, Wan Azman WA, Md Yusof M, Ho GF, Krupat E
    BMJ Open, 2012;2(5).
    PMID: 23035016 DOI: 10.1136/bmjopen-2012-001799
    Psychological distress is common in patients with cancer. We need a rapid means of screening for and identifying depression and anxiety in patients with cancer. The present study evaluates the potential of the Eastern Cooperative Oncology Group (ECOG) performance status (PS) scoring as a brief screening tool to assess psychological distress in routine cancer care. The ECOG PS is widely used by oncologists and the WHO, as a standardised measure to assess general well-being in patients with cancer and quality of life in cancer trials. We examine the discrepancy between patient-rated and oncologist-rated PS scores on the ECOG in a comparative assessment against the Hospital Anxiety and Depression Scale (HADS).
  12. Ahmad NA, Silim UA, Rosman A, Mohamed M, Chan YY, Mohd Kasim N, et al.
    BMJ Open, 2018 05 14;8(5):e020649.
    PMID: 29764882 DOI: 10.1136/bmjopen-2017-020649
    INTRODUCTION: An estimated 13% of women in the postnatal period suffer from postnatal depression (PND) worldwide. In addition to underprivileged women, women who are exposed to violence are at higher risk of PND. This study aimed to investigate the relationship between intimate partner violence (IPV) and PND in Malaysia.

    METHODS: This survey was conducted as a nationwide cross-sectional study using a cluster sampling design. Probable PND was assessed using a self-administered Edinburgh Postnatal Depression Scale (EPDS). Demographic profiles and IPV were assessed using a locally validated WHO Multicountry Study on Women's Health and Life Events Questionnaire that was administered in a face-to-face interview. An EPDS total score of 12 or more and/or a positive tendency to self-harm were used to define PND.

    RESULTS: Out of 6669 women, 5727 respondents were successfully interviewed with a response rate of 85.9%. The prevalence of probable PND was 4.4% (95% CI 2.9 to 6.7). The overall prevalence of IPV was 4.9% (95% CI 3.8 to 6.4). Among the women in this group, 3.7% (95% CI 2.7 to 5.0), 2.6% (95% CI 1.9 to 3.5) and 1.2% (95% CI 0.9 to 1.7) experienced emotional, physical and sexual violence, respectively. Logistic regression analysis revealed that women who were exposed to IPV were at 2.3 times the risk for probable PND, with an adjusted OR (aOR) of 2.34 (95% CI 1.12 to 4.87). Other factors for PND were reported emotional violence (aOR 3.79, 95% CI 1.93 to 7.45), unplanned pregnancy (aOR 3.32, 95% CI 2.35 to 4.69), lack of family support during confinement (aOR 1.79, 95% CI 1.12 to 2.87), partner's use of alcohol (aOR 1.59, 95% CI 1.07 to 2.35) or being from a household with a low income (aOR 2.99; 95% CI 1.63 to 5.49).

    CONCLUSIONS: Exposure to IPV was significantly associated with probable PND. Healthcare personnel should be trained to detect and manage both problems. An appropriate referral system and support should be made available.
  13. Halmi MI, Zuhainis SW, Yusof MT, Shaharuddin NA, Helmi W, Shukor Y, et al.
    Biomed Res Int, 2013;2013:384541.
    PMID: 24383052 DOI: 10.1155/2013/384541
    Bacteria with the ability to tolerate, remove, and/or degrade several xenobiotics simultaneously are urgently needed for remediation of polluted sites. A previously isolated bacterium with sodium dodecyl sulfate- (SDS-) degrading capacity was found to be able to reduce molybdenum to the nontoxic molybdenum blue. The optimal pH, carbon source, molybdate concentration, and temperature supporting molybdate reduction were pH 7.0, glucose at 1.5% (w/v), between 25 and 30 mM, and 25°C, respectively. The optimum phosphate concentration for molybdate reduction was 5 mM. The Mo-blue produced exhibits an absorption spectrum with a maximum peak at 865 nm and a shoulder at 700 nm. None of the respiratory inhibitors tested showed any inhibition to the molybdenum-reducing activity suggesting that the electron transport system of this bacterium is not the site of molybdenum reduction. Chromium, cadmium, silver, copper, mercury, and lead caused approximately 77, 65, 77, 89, 80, and 80% inhibition of the molybdenum-reducing activity, respectively. Ferrous and stannous ions markedly increased the activity of molybdenum-reducing activity in this bacterium. The maximum tolerable concentration of SDS as a cocontaminant was 3 g/L. The characteristics of this bacterium make it a suitable candidate for molybdenum bioremediation of sites cocontaminated with detergent pollutant.
  14. Khan S, Sudhakar K, Hazwan Yusof M, Sundaram S
    Chem Rec, 2024 Jan 10.
    PMID: 38200590 DOI: 10.1002/tcr.202300308
    The transition to sustainable transportation has fueled the need for innovative electric vehicle (EV) charging solutions. Building Integrated Photovoltaics (BIPV) systems have emerged as a promising technology that combines renewable energy generation with the infra-structure of buildings. This paper comprehensively reviews the BIPV system for EV charging, focusing on its technology, application, and performance. The review identifies the gaps in the existing literature, emphasizing the need for a thorough examination of BIPV systems in the context of EV charging. A detailed review of BIPV technology and its application in EV charging is presented, covering aspects such as the generation of solar cell technology, BIPV system installation, design options and influencing factors. Furthermore, the review examines the performance of BIPV systems for EV charging, focusing on energy, economic, and environmental parameters and their comparison with previous studies. Additionally, the paper explores current trends in energy management for BIPV and EV charging, highlighting the need for effective integration and recommending strategies to optimize energy utilization. Combining BIPV with EV charging provides a promising approach to power EV chargers, enhances building energy efficiency, optimizes the building space, reduces energy losses, and decreases grid dependence. Utilizing BIPV-generated electricity for EV charging provides electricity and fuel savings, offers financial incentives, and increases the market value of the building infrastructure. It significantly lowers greenhouse gas emissions associated with grid and vehicle emissions. It creates a closed-loop circular economic system where energy is produced, consumed, and stored within the building. The paper underscores the importance of effective integration between Building Integrated Photovoltaics (BIPV) and Electric Vehicle (EV) charging, emphasizing the necessity of innovative grid technologies, energy storage solutions, and demand-response energy management strategies to overcome diverse challenges. Overall, the study contributes to the knowledge of BIPV systems for EV charging by presenting practical energy management, effectiveness and sustainability implications. It serves as a valuable resource for researchers, practitioners, and policymakers working towards sustainable transportation and energy systems.
  15. Kambara H, Yamada T, Tsujioka M, Matsunaga S, Tanaka R, Ali HI, et al.
    Chem Biodivers, 2006 Dec;3(12):1301-6.
    PMID: 17193244
    As a part of our chemical studies on Malaysian medicinal plants, five Malaysian plant species were evaluated by cytotoxicity assays using P388 murine leukemia cells. Since Acalypha siamensis exhibited the strongest growth inhibition, its constituents were studied as the object of search for bioactive materials. A novel tetraterpene, acalyphaser A (1), was isolated in the course of the purification. Its structure was elucidated on the basis of 1D- and 2D-NMR techniques, and mass spectrometry.
  16. Abdullah BJ, Mohd Yusof MY, Khoo BH
    Clin Radiol, 1998 Mar;53(3):212-4.
    PMID: 9528873
    Nosocomial infections are posing an increasingly serious problem in the hospital setting. With the increasing use of ultrasound in medical diagnosis, there is the potential for transmission of nosocomial infections via the ultrasound transducer and coupling gel. We evaluated the use of different membranes (three types of commercially available household cling film, condom, surgical glove and Opsite) applied over the ultrasound probe to determine if these were safe, convenient, cost-effective and did not impair the performance parameters of the ultrasound probe. None of the membranes impaired the physical scanning parameters using a Multi-Purpose Tissue/Cyst Phantom. The cling film was ideal for general use in terms of cost and convenience as well as safety. For sterile use the Opsite was better overall compared to the surgical glove, though it costs significantly more. The condom and surgical glove, though safe, were not very convenient to use for scanning.
  17. Low CL, Kow RY, Abd Aziz A, Mohd Yusof M, Lim BC, Kamarudin NA, et al.
    Cureus, 2023 Jun;15(6):e40484.
    PMID: 37461753 DOI: 10.7759/cureus.40484
    Introduction Computed tomography pulmonary angiography (CTPA) is the reference investigation of choice to diagnose pulmonary embolism (PE). Nevertheless, the use of CTPA should be weighed against its risks, such as radiation and contrast-induced nephropathy. We aim to assess the yield of CTPA in diagnosing PE at a tertiary centre in Malaysia. We also identify predictive factors associated with the yield of CTPA in this cohort. Methods This was a cross-sectional study involving all patients who had had CTPA done at Hospital Tengku Ampuan Afzan, Kuantan, Malaysia, from January 1, 2021, to November 30, 2021. All patients' records were retrieved and reviewed. CTPA images were retrieved from the Radiology Information System (RIS) and Picture Archiving and Communication System (PACS). They were double-reviewed by the authors, with the initial reports redacted from reporting radiologists to prevent reporting bias. The predictive factors were determined using simple logistic regression and multiple logistic regression. Results A total of 351 CTPAs were reviewed, of which 93 were found to be positive for PE, giving rise to an overall CTPA yield of 26.5%. Upon simple logistic regression, factors such as gender, discipline, history of trauma, presence of COVID-19 infection, and pneumonia were found to be associated with positive CTPA. Upon multiple logistic regression, male patients were found to have a higher chance of positive CTPA results. On the other hand, patients with COVID-19 infection and pneumonia have a lower chance of positive results in CTPA. Conclusion The yield of CTPA in diagnosing PE at our institution was acceptable at 26.5%. Upon multiple logistic regression, patients with COVID-19 infection and pneumonia were more likely to have a negative CTPA result, highlighting the need for clinicians to be more prudent in requesting CTPAs in these patients.
  18. Kow RY, Razali K, Low CL, Siron KN, Zakaria Mohamad Z, Mohd Yusof M, et al.
    Cureus, 2023 Jul;15(7):e41979.
    PMID: 37593261 DOI: 10.7759/cureus.41979
    CT pulmonary angiography (CTPA) is the investigation of choice for diagnosing pulmonary embolism (PE). Due to the speed and ease of performing the CTPA scans, more clinicians are becoming overly reliant on them, even for patients without strong suspicion of PE. We conducted a bibliometric analysis on the PubMed database from 1990 to 2022 to investigate the literature on the diagnostic yield of CTPA in the diagnosis of PE. A total of 166 articles were published in 98 journals. The number of publications has steadily increased since 2010 and peaked in 2020. Authors from 24 countries contributed to these publications, with the overwhelming majority emanating from United States of America, totaling 66 articles. The authors' contributions were relatively well spread out, with the top four authors publishing the highest number of articles at six each. When we investigated the collaboration between the authors, we found limited multinational and multi-institutional collaborations on this topic. Therefore, more multinational and multi-institutional collaborations will be valuable in future studies. In conclusion, this bibliometric analysis summarizes the literature on diagnostic yield of CTPA in the diagnosis of PE and sheds light on the future pathway that researchers and institutions can focus on.
  19. Nazni WA, Hoffmann AA, NoorAfizah A, Cheong YL, Mancini MV, Golding N, et al.
    Curr Biol, 2019 Dec 16;29(24):4241-4248.e5.
    PMID: 31761702 DOI: 10.1016/j.cub.2019.11.007
    Dengue has enormous health impacts globally. A novel approach to decrease dengue incidence involves the introduction of Wolbachia endosymbionts that block dengue virus transmission into populations of the primary vector mosquito, Aedes aegypti. The wMel Wolbachia strain has previously been trialed in open releases of Ae. aegypti; however, the wAlbB strain has been shown to maintain higher density than wMel at high larval rearing temperatures. Releases of Ae. aegypti mosquitoes carrying wAlbB were carried out in 6 diverse sites in greater Kuala Lumpur, Malaysia, with high endemic dengue transmission. The strain was successfully established and maintained at very high population frequency at some sites or persisted with additional releases following fluctuations at other sites. Based on passive case monitoring, reduced human dengue incidence was observed in the release sites when compared to control sites. The wAlbB strain of Wolbachia provides a promising option as a tool for dengue control, particularly in very hot climates.
  20. Dawood S, Chiu JW, Huang CS, Nag S, Sookprasert A, Yap YS, et al.
    Curr Med Res Opin, 2020 08;36(8):1363-1373.
    PMID: 32544344 DOI: 10.1080/03007995.2020.1783646
    Breast cancer is the most frequent cancer amongst women worldwide including in Asia where the incidence rate is rapidly increasing. Even with treatment, around 30% of patients with early breast cancer progress to metastatic disease, with hormone receptor positive (HR+) and human epidermal growth factor receptor 2 negative (HER2-) breast cancer the most common phenotype. First-line endocrine therapy targeting the estrogen receptor signaling pathway provides a median progression-free survival or time to progression of 6-15 months in HR + HER2- metastatic breast cancer. Recently, cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors, combined with endocrine therapy, have achieved more than two years median progression-free survival in HR + HER2- metastatic breast cancer. However, the characteristics of the Asian breast cancer population differ from those of Western populations and need to be considered when selecting a suitable treatment. Breast cancer is diagnosed at a younger age in Asian populations and late stage at presentation is generally more common in low-/middle-income countries than high-income countries. Consequently, the proportion of premenopausal women with metastatic breast cancer is higher in Asian compared with Western populations. While CDK4/6 inhibitors have been approved in the USA (FDA) since 2015, experience with them in Asia is more limited. We review the experience with the CDK4/6 inhibitor palbociclib in Asian patients with HR + HER2- metastatic breast cancer and provide guidance on the use of palbociclib in these patients.
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