Displaying publications 1 - 20 of 437 in total

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  1. Maiwall R, Sarin SK, Kumar S, Jain P, Kumar G, Bhadoria AS, et al.
    Liver Int, 2017 Oct;37(10):1497-1507.
    PMID: 28393476 DOI: 10.1111/liv.13443
    BACKGROUND AND AIM: There is limited data on predictors of acute kidney injury in acute on chronic liver failure. We developed a PIRO model (Predisposition, Injury, Response, Organ failure) for predicting acute kidney injury in a multicentric cohort of acute on chronic liver failure patients.

    PATIENTS AND METHODS: Data of 2360 patients from APASL-ACLF Research Consortium (AARC) was analysed. Multivariate logistic regression model (PIRO score) was developed from a derivation cohort (n=1363) which was validated in another prospective multicentric cohort of acute on chronic liver failure patients (n=997).

    RESULTS: Factors significant for P component were serum creatinine[(≥2 mg/dL)OR 4.52, 95% CI (3.67-5.30)], bilirubin [(<12 mg/dL,OR 1) vs (12-30 mg/dL,OR 1.45, 95% 1.1-2.63) vs (≥30 mg/dL,OR 2.6, 95% CI 1.3-5.2)], serum potassium [(<3 mmol/LOR-1) vs (3-4.9 mmol/L,OR 2.7, 95% CI 1.05-1.97) vs (≥5 mmol/L,OR 4.34, 95% CI 1.67-11.3)] and blood urea (OR 3.73, 95% CI 2.5-5.5); for I component nephrotoxic medications (OR-9.86, 95% CI 3.2-30.8); for R component,Systemic Inflammatory Response Syndrome,(OR-2.14, 95% CI 1.4-3.3); for O component, Circulatory failure (OR-3.5, 95% CI 2.2-5.5). The PIRO score predicted acute kidney injury with C-index of 0.95 and 0.96 in the derivation and validation cohort. The increasing PIRO score was also associated with mortality (P

    Matched MeSH terms: Multivariate Analysis
  2. Dhabali AA, Awang R, Zyoud SH
    Int J Clin Pharmacol Ther, 2011 Aug;49(8):500-9.
    PMID: 21781650 DOI: 10.5414/cp201524
    BACKGROUND: The prescription of contraindicated drugs is a preventable medication error, which can cause morbidity and mortality. Recent data on the factors associated with drug contraindications (DCIs) is limited world-wide, especially in Malaysia.

    AIMS: The objectives of this study are 1) to quantify the prevalence of DCIs in a primary care setting at a Malaysian University; 2) to identify patient characteristics associated with increased DCI episodes, and 3) to identify associated factors for these DCIs.

    METHODS: We retrospectively collected data from 1 academic year using computerized databases at the Universiti Sains Malaysia (USM) from patients of USM's primary care. Descriptive and comparative statistics were used to characterize DCIs.

    RESULTS: There were 1,317 DCIs during the study period. These were observed in a cohort of 923 patients, out of a total of 17,288 patients, representing 5,339 DCIs per 100,000 patients, or 5.3% of all patients over a 1-year period. Of the 923 exposed patients, 745 (80.7%) were exposed to 1 DCI event, 92 (10%) to 2 DCI events, 35 (3.8%) to 3 DCI events, 18 (2%) to 4 DCI events, and 33 patients (3.6%) were exposed to 5 or more DCI events. The average age of the exposed patients was 30.7 ± 15 y, and 51.5% were male. Multivariate logistic regression analysis revealed that being male (OR = 1.3; 95% CI = 1.1 - 1.5; p < 0.001), being a member of the staff (OR = 3; 95% CI = 2.5 - 3.7; p < 0.001), having 4 or more prescribers (OR = 2.8; 95% CI = 2.2 - 3.6; p < 0.001), and having 4 or more longterm therapeutic groups (OR = 2.3; 95%CI = 1.7 - 3.1; p < 0.001), were significantly associated with increased chance of exposure to DCIs.

    DISCUSSION AND CONCLUSIONS: This is the first study in Malaysia that presents data on the prevalence of DCIs. The prescription of contraindicated drugs was found to be frequent in this primary care setting. Exposure to DCI events was associated with specific socio-demographic and health status factors. Further research is needed to evaluate the relationship between health outcomes and the exposure to DCIs.
    Matched MeSH terms: Multivariate Analysis
  3. Chang KY, Riley WJ, Knox SH, Jackson RB, McNicol G, Poulter B, et al.
    Nat Commun, 2021 04 15;12(1):2266.
    PMID: 33859182 DOI: 10.1038/s41467-021-22452-1
    Wetland methane (CH4) emissions ([Formula: see text]) are important in global carbon budgets and climate change assessments. Currently, [Formula: see text] projections rely on prescribed static temperature sensitivity that varies among biogeochemical models. Meta-analyses have proposed a consistent [Formula: see text] temperature dependence across spatial scales for use in models; however, site-level studies demonstrate that [Formula: see text] are often controlled by factors beyond temperature. Here, we evaluate the relationship between [Formula: see text] and temperature using observations from the FLUXNET-CH4 database. Measurements collected across the globe show substantial seasonal hysteresis between [Formula: see text] and temperature, suggesting larger [Formula: see text] sensitivity to temperature later in the frost-free season (about 77% of site-years). Results derived from a machine-learning model and several regression models highlight the importance of representing the large spatial and temporal variability within site-years and ecosystem types. Mechanistic advancements in biogeochemical model parameterization and detailed measurements in factors modulating CH4 production are thus needed to improve global CH4 budget assessments.
    Matched MeSH terms: Multivariate Analysis
  4. Hussain H, Yusoff MK, Ramli MF, Abd Latif P, Juahir H, Zawawi MA
    Pak J Biol Sci, 2013 Nov 15;16(22):1524-30.
    PMID: 24511695
    Nitrate-nitrogen leaching from agricultural areas is a major cause for groundwater pollution. Polluted groundwater with high levels of nitrate is hazardous and cause adverse health effects. Human consumption of water with elevated levels of NO3-N has been linked to the infant disorder methemoglobinemia and also to non-Hodgkin's disease lymphoma in adults. This research aims to study the temporal patterns and source apportionment of nitrate-nitrogen leaching in a paddy soil at Ladang Merdeka Ismail Mulong in Kelantan, Malaysia. The complex data matrix (128 x 16) of nitrate-nitrogen parameters was subjected to multivariate analysis mainly Principal Component Analysis (PCA) and Discriminant Analysis (DA). PCA extracted four principal components from this data set which explained 86.4% of the total variance. The most important contributors were soil physical properties confirmed using Alyuda Forecaster software (R2 = 0.98). Discriminant analysis was used to evaluate the temporal variation in soil nitrate-nitrogen on leaching process. Discriminant analysis gave four parameters (hydraulic head, evapotranspiration, rainfall and temperature) contributing more than 98% correct assignments in temporal analysis. DA allowed reduction in dimensionality of the large data set which defines the four operating parameters most efficient and economical to be monitored for temporal variations. This knowledge is important so as to protect the precious groundwater from contamination with nitrate.
    Matched MeSH terms: Multivariate Analysis
  5. Gul S, Zou X, Hassan CH, Azam M, Zaman K
    Environ Sci Pollut Res Int, 2015 Dec;22(24):19773-85.
    PMID: 26282441 DOI: 10.1007/s11356-015-5185-0
    This study investigates the relationship between energy consumption and carbon dioxide emission in the causal framework, as the direction of causality remains has a significant policy implication for developed and developing countries. The study employed maximum entropy bootstrap (Meboot) approach to examine the causal nexus between energy consumption and carbon dioxide emission using bivariate as well as multivariate framework for Malaysia, over a period of 1975-2013. This is a unified approach without requiring the use of conventional techniques based on asymptotical theory such as testing for possible unit root and cointegration. In addition, it can be applied in the presence of non-stationary of any type including structural breaks without any type of data transformation to achieve stationary. Thus, it provides more reliable and robust inferences which are insensitive to time span as well as lag length used. The empirical results show that there is a unidirectional causality running from energy consumption to carbon emission both in the bivariate model and multivariate framework, while controlling for broad money supply and population density. The results indicate that Malaysia is an energy-dependent country and hence energy is stimulus to carbon emissions.
    Matched MeSH terms: Multivariate Analysis
  6. Al-Naggar, Redhwan Ahmed, Al-Jashamy, Karim, Ramli Musa, Zaleha Mohd Isa
    ASEAN Journal of Psychiatry, 2010;11(1):6-12.
    MyJurnal
    Objective: To determine the knowledge, attitude and practice (KAP) of sleep among medical students of IIUM towards and to determine the impact of socio-demographic data on the knowledge, attitude and practice. Methods: A cross-sectional study was carried out among 106 students from first, second and third year medical students of IIUM. Verbal consent was taken from the students who were willing to take part in this study. Student knowledge about sleep was studied using a questionnaire. Results: A total of 106 medical
    students completed the survey, there were 54 female and 52 male. The mean age of the students was 20 ± 0.56 and ranged from 18 to 22 years. In terms of their sleep knowledge, the mean ± SD knowledge, attitude and practice scores were 81.8 ± 16.8, 65.9 ±15.3 and 176 ± 26.3 respectively. In univariate analysis, there was a significant difference between parents’ marital status regarding knowledge of the students (p = 0.03). There was a significant difference between gender regarding attitude of the students (p=0.05). In
    multivariate analysis, gender and smoking status were significantly affected the overall KAP. Conclusion: This study showed that sleep medicine knowledge was generally low among medical students. Therefore, educational strategies to improve knowledge regarding sleep-related problems and the development of proper sleep practices among medical students are needed.
    Matched MeSH terms: Multivariate Analysis
  7. Nokhala A, Siddiqui MJ, Ahmed QU, Ahamad Bustamam MS, Zakaria AZA
    Biomolecules, 2020 02 12;10(2).
    PMID: 32059529 DOI: 10.3390/biom10020287
    Stone leaf (Tetracera scandens) is a Southeast Asian medicinal plant that has been traditionally used for the management of diabetes mellitus. The underlying mechanisms of the antidiabetic activity have not been fully explored yet. Hence, this study aimed to evaluate the α-glucosidase inhibitory potential of the hydromethanolic extracts of T. scandens leaves and to characterize the metabolites responsible for such activity through gas chromatography-mass spectrometry (GC-MS) metabolomics. Crude hydromethanolic extracts of different strengths were prepared and in vitro assayed for α-glucosidase inhibition. GC-MS analysis was further carried out and the mass spectral data were correlated to the corresponding α-glucosidase inhibitory IC50 values via an orthogonal partial least squares (OPLS) model. The 100%, 80%, 60% and 40% methanol extracts displayed potent α-glucosidase inhibitory potentials. Moreover, the established model identified 16 metabolites to be responsible for the α-glucosidase inhibitory activity of T. scandens. The putative α-glucosidase inhibitory metabolites showed moderate to high affinities (binding energies of -5.9 to -9.8 kcal/mol) upon docking into the active site of Saccharomyces cerevisiae isomaltase. To sum up, an OPLS model was developed as a rapid method to characterize the α-glucosidase inhibitory metabolites existing in the hydromethanolic extracts of T. scandens leaves based on GC-MS metabolite profiling.
    Matched MeSH terms: Multivariate Analysis
  8. Zainal NZ
    Asia Pac J Public Health, 2008;20(4):360-9.
    PMID: 19124330 DOI: 10.1177/1010539508322538
    A household survey was carried out in Peninsular Malaysia to determine the prevalence rate of depressive symptoms in middle-aged women and to explore its associated factors. Women aged 45 to 60 years were assessed on sociodemographic profiles, menopausal status, depressive symptoms, marital dissatisfaction, and coping strategies. A total of 3934 women participated, and the mean age was 51 years. The prevalence rate of depressive symptoms was 54.2%. Of the married women, 38.4% had poor to very severe problems in their marriage. Depressive symptoms were significantly associated with marital status (P < .001), ethnicity (P < .001), educational levels (P < .001), occupational status ( P < .001), domicile (P < .001), and menopausal status ( P < .05). Depressive symptoms were correlated with marital dissatisfaction scores. Women who consulted professionals, shared with relatives, kept problems to themselves, or consulted parents/siblings had higher mean scores on depressive symptoms compared with those who did not use these coping strategies.
    Matched MeSH terms: Multivariate Analysis
  9. Ghani WM, Razak IA, Yang YH, Talib NA, Ikeda N, Axell T, et al.
    BMC Public Health, 2012;12:207.
    PMID: 22429627 DOI: 10.1186/1471-2458-12-207
    BACKGROUND: Tobacco consumption peak in developed countries has passed, however, it is on the increase in many developing countries. Apart from cigarettes, consumption of local hand-rolled cigarettes such as bidi and rokok daun are prevalent in specific communities. Although factors associated with smoking initiation and cessation has been investigated elsewhere, the only available data for Malaysia is on prevalence. This study aims to investigate factors associated with smoking initiation and cessation which is imperative in designing intervention programs.
    METHODS: Data were collected from 11,697 adults by trained recording clerks on sociodemographic characteristics, practice of other risk habit and details of smoking such as type, duration and frequency. Smoking commencement and cessation were analyzed using the Kaplan-Meier estimates and log-rank tests. Univariate and multivariate Cox proportional hazard regression models were used to calculate the hazard rate ratios.
    RESULTS: Males had a much higher prevalence of the habit (61.7%) as compared to females (5.8%). Cessation was found to be most common among the Chinese and those regularly consuming alcoholic beverages. Kaplan-Meier plot shows that although males are more likely to start smoking, females are found to be less likely to stop. History of betel quid chewing and alcohol consumption significantly increase the likelihood of commencement (p < 0.0001), while cessation was least likely among Indians, current quid chewers and kretek users (p < 0.01).
    CONCLUSIONS: Gender, ethnicity, history of quid chewing and alcohol consumption have been found to be important factors in smoking commencement; while ethnicity, betel quid chewing and type of tobacco smoked influences cessation.
    Matched MeSH terms: Multivariate Analysis
  10. Palaniandy K, Haspani MSM, Zain NRM
    Malays J Med Sci, 2017 May;24(3):33-43.
    PMID: 28814931 MyJurnal DOI: 10.21315/mjms2017.24.3.5
    BACKGROUND: Meningioma is the commonest primary intracranial tumour in adults. Excision is curative for low grade meningioma, whereas high-grade meningioma requires adjuvant therapy following surgery. Several studies have examined the association between peritumoural brain Edema - a common feature in meningioma - and histological grading with mixed results. The present study attempted to elucidate this association and if peritumoural brain Edema affects the intra-operative judgement of surgeons on the completeness of resection.

    METHODS: An observational study was conducted among those who underwent surgery for meningioma. Eighteen subjects were recruited each for low- and high-grades, respectively. Magnetic resonance imaging (MRI) prior to surgery was employed for interpreting the Edema index and MRI after surgery was used to determine residual tumour.

    RESULTS: Median age was 50 years, male to female ratio was 1:3.5, 69.4% had peritumoural brain Edema and 75% had reported gross resection. Among the reported gross total resection cases, 40.7% had residual tumour. Analysis showed statistically significant association between peritumoural brain Edema (P = 0.027) and tumour volume (P = 0.001) with high-grade meningioma, however multivariate analysis did not present any association. No association was noted between judgement of tumour resection by surgeons and peritumoural brain Edema.

    CONCLUSION: Odds ratio for peritumoural brain Edema remained high and the tumour volume exhibited marginal P-value marginal significance for prediction of high grade meningioma. These two factors may still contribute to the tumour grade and should be included in further studies on the prognosis of meningioma.

    Matched MeSH terms: Multivariate Analysis
  11. Siti Fatimah, A.G., Aniza, I., Shamsuddin, K., Zailiza, S.
    MyJurnal
    A cross-sectional study was carried out in July-October 2012 in UKM to remeasure, evaluate and compare the changes in health services utilization level among women staff in UKM with a previous study done in 2001 and its influencing factors. The services studied were blood pressure (BP) measurement and Pap smear test. A total of 234 respondents aged between 18 and 55 were selected using stratified random sampling from Bangi, Kuala Lumpur and UKMMC, Malaysia. Data was collected via self-administered questionnaire and was analyzed by using SPSS version 17.0. Majority 85.9% of the respondents were found to have utilized at least one BP measurement which is higher compared to previous study. The Pap smear test, 64.5% of women have had a Pap smear test done also higher compared to previous study. Multivariate analysis shows the factors associated with BP measurement are age (OR 2.7, CI 95% 1.2, 6.3), family history of general health problems (OR 3.4, CI 95% 1.5, 7.6), and health staff influence (OR 5.2, CI 95% 1.1, 25.5). The factors associated with Pap smear test are marital status (OR 62.8, CI 95% 7.2, 546.4), general health problems (OR 2.3, CI 95% 1.2, 4.5), family planning (OR 6.9, CI 95% 3.0, 16.5) and self-interest (OR 3.3, CI 95%, 1.3, 8.6). The level of health services utilization on BP measurement and Pap smear test in 2012 is higher than 2001. For both BP measurement and Pap smear test the determinant factors are differed in the aforesaid years.
    Matched MeSH terms: Multivariate Analysis
  12. Sharif KM, Rahman MM, Azmir J, Khatib A, Sabina E, Shamsudin SH, et al.
    Biomed Chromatogr, 2015 Dec;29(12):1826-33.
    PMID: 26033701 DOI: 10.1002/bmc.3503
    Multivariate analysis of thin-layer chromatography (TLC) images was modeled to predict antioxidant activity of Pereskia bleo leaves and to identify the contributing compounds of the activity. TLC was developed in optimized mobile phase using the 'PRISMA' optimization method and the image was then converted to wavelet signals and imported for multivariate analysis. An orthogonal partial least square (OPLS) model was developed consisting of a wavelet-converted TLC image and 2,2-diphynyl-picrylhydrazyl free radical scavenging activity of 24 different preparations of P. bleo as the x- and y-variables, respectively. The quality of the constructed OPLS model (1 + 1 + 0) with one predictive and one orthogonal component was evaluated by internal and external validity tests. The validated model was then used to identify the contributing spot from the TLC plate that was then analyzed by GC-MS after trimethylsilyl derivatization. Glycerol and amine compounds were mainly found to contribute to the antioxidant activity of the sample. An alternative method to predict the antioxidant activity of a new sample of P. bleo leaves has been developed.
    Matched MeSH terms: Multivariate Analysis
  13. Ling MYJ, Lim KH, Hasani WSR, Rifin HM, Majid NLA, Lourdes TGR, et al.
    Tob Induc Dis, 2020;18:96.
    PMID: 33262682 DOI: 10.18332/tid/128622
    INTRODUCTION: Many studies have revealed that exposure to secondhand smoke (SHS) substantially increases the risk of smoking related diseases especially among the vulnerable groups, yet data on the location of SHS exposure among youth in Malaysia are still lacking. The study aims to describe the prevalence and factors associated with SHS exposure at home, outside the home, and inside the school among school-going adolescents in Malaysia.

    METHODS: We derived the data from the TECMA study, which used a cross-sectional study design and multi-stage sampling method to obtain a representative sample of school-going adolescents aged 11-19 years in Malaysia in 2016. Data were collected through a self-administered approach using a pre-validated standard questionnaire. Descriptive and multivariate analyses were used to analyze the data, and results are presented as adjusted odds ratio (AOR) with 95% confidence interval (95% CI).

    RESULTS: SHS exposure for the past seven days was higher outside the home (51.2%; 95% CI: 49.2-53.2) compared to at home (37.8%; 95% CI: 35.8-39.9) while 27.3% (95% CI: 25.1-29.5) of school-going adolescents reported exposure to SHS inside the school in the past one month. In the regression analyses, older adolescents, those of Malay and Bumiputra Sarawak ethnicities, adolescents from rural areas and current smokers had higher likelihood of exposure to SHS at home, outside home and inside the school. Our study also found that adolescents who were current smokers had higher odds of being exposed to SHS at home (AOR=2.87; 95% CI: 2.57-3.21), outside the home (AOR=3.46; 95% CI: 3.05-3.92) and in the school (AOR=2.25; 95% CI: 2.01-2.51).

    CONCLUSIONS: Health promotion measures should target parents/guardians and household members to reduce SHS exposure among adolescents. In addition, smoke-free regulation should be fully enforced in school. Furthermore, more public places should be designated non-smoking areas to reduce SHS exposure and denormalize smoking behavior.

    Matched MeSH terms: Multivariate Analysis
  14. Nawawi H, Osman NS, Annuar R, Khalid BA, Yusoff K
    Atherosclerosis, 2003 Aug;169(2):283-91.
    PMID: 12921980
    Adhesion molecules and cytokines are involved in the pathogenesis of intimal injury in atherosclerosis but their relationship with endothelial function remains unclear. The objectives of this study were to examine the effects of atorvastatin on soluble adhesion molecules, interleukin-6 (IL-6) and brachial artery endothelial-dependent flow mediated dilatation (FMD) in patients with familial (FH) and non-familial hypercholesterolaemia (NFH). A total of 74 patients (27 FH and 47 NFH) were recruited. Fasting lipid profiles, soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular-cellular adhesion molecule-1 (sVCAM-1), E-selectin, IL-6 and FMD were measured at baseline, 2 weeks, 3 and 9 months post-atorvastatin treatment (FH--80 mg/day, NFH--10 mg/day). In both groups, compared to baseline, sICAM-1 levels were significantly reduced at 2 weeks, further reduced at 3 months and maintained at 9 months (P<0.0001). The IL-6 levels were significantly reduced at 3 months and 9 months compared to baseline for FH (P<0.005) and NFH (P<0.0001). In both groups, the FMD at 2 weeks was higher than baseline (P<0.005), with progressive improvement up to 9 months. FMD was negatively correlated with sICAM-1 and IL-6. In conclusion, both low and high doses of atorvastatin lead to early progressive improvement in endothelial function in patients with primary hypercholesterolaemia. sICAM-1 and IL-6 levels reflect endothelial dysfunction in these patients.
    Matched MeSH terms: Multivariate Analysis
  15. Mohamed I, Othman F, Ibrahim AI, Alaa-Eldin ME, Yunus RM
    Environ Monit Assess, 2015 Jan;187(1):4182.
    PMID: 25433545 DOI: 10.1007/s10661-014-4182-y
    This case study uses several univariate and multivariate statistical techniques to evaluate and interpret a water quality data set obtained from the Klang River basin located within the state of Selangor and the Federal Territory of Kuala Lumpur, Malaysia. The river drains an area of 1,288 km(2), from the steep mountain rainforests of the main Central Range along Peninsular Malaysia to the river mouth in Port Klang, into the Straits of Malacca. Water quality was monitored at 20 stations, nine of which are situated along the main river and 11 along six tributaries. Data was collected from 1997 to 2007 for seven parameters used to evaluate the status of the water quality, namely dissolved oxygen, biochemical oxygen demand, chemical oxygen demand, suspended solids, ammoniacal nitrogen, pH, and temperature. The data were first investigated using descriptive statistical tools, followed by two practical multivariate analyses that reduced the data dimensions for better interpretation. The analyses employed were factor analysis and principal component analysis, which explain 60 and 81.6% of the total variation in the data, respectively. We found that the resulting latent variables from the factor analysis are interpretable and beneficial for describing the water quality in the Klang River. This study presents the usefulness of several statistical methods in evaluating and interpreting water quality data for the purpose of monitoring the effectiveness of water resource management. The results should provide more straightforward data interpretation as well as valuable insight for managers to conceive optimum action plans for controlling pollution in river water.
    Matched MeSH terms: Multivariate Analysis
  16. Nur Arina Bazilah Kamisan, Muhammad Hisyam Lee, Suhartono Suhartono, Abdul Ghapor Hussin, Yong Zulina Zubairi
    Sains Malaysiana, 2018;47:419-426.
    Forecasting a multiple seasonal data is differ from a usual seasonal data since it contains more than one cycle in a
    data. Multiple linear regression (MLR) models have been used widely in load forecasting because of its usefulness in the
    forecast a linear relationship with other factors but MLR has a disadvantage of having difficulties in modelling a nonlinear
    relationship between the variables and influencing factors. Neural network (NN) model, on the other hand, is a good
    model for modelling a nonlinear data. Therefore, in this study, a combination of MLR and NN models has proposed this
    combination to overcome the problem. This hybrid model is then compared with MLR and NN models to see the performance
    of the hybrid model. RMSE is used as a performance indicator and a proposed graphical error plot is introduce to see the
    error graphically. From the result obtained this model gives a better forecast compare to the other two models.
    Matched MeSH terms: Multivariate Analysis
  17. Ng CH, Pathy NB, Taib NA, Mun KS, Rhodes A, Yip CH
    Asian Pac J Cancer Prev, 2012;13(4):1111-3.
    PMID: 22799290
    The ER-/PR+ breast tumor may be the result of a false ER negative result. The aim of this study was to investigate whether there is a difference in patient and tumor characteristics of the ER-/PR+ phenotype in an Asian setting. A total of 2629 breast cancer patients were categorized on the basis of their age, ethnicity, tumor hormonal receptor phenotype, grade and histological type. There were 1230 (46.8%) ER+/PR+, 306 (11.6%) ER+/PR-, 122 (4.6%) ER-/PR+ and 972 (37%) ER-/PR-. ER-/PR+ tumors were 2.5 times more likely to be younger than 50 years at diagnosis (OR: 2.52; 95% CI: 1.72-3.67). Compared to ER+/PR+ tumors, the ER-/ PR+ phenotype was twice more likely to be associated with grade 3 tumors (OR:2.02; 95%CI: 1.00-4.10). In contrast, compared to ER-/PR- tumors, the ER-/PR+ phenotype was 90% less likely to be associated with a grade 3 tumor (OR: 0.12; 95%CI:0.05-0.26), and more likely to have invasive lobular than invasive ductal histology (OR: 3.66; 95%CI: 1.47-9.11). These results show that the ER-/PR+ phenotype occurs in a younger age group and is associated with intermediate histopathological characteristics compared to ER+/PR+ and ER-/PR- tumors. This may imply that it is a distinct entity and not a technical artifact.
    Matched MeSH terms: Multivariate Analysis
  18. Velaiutham S, Taib NA, Ng KL, Yoong BK, Yip CH
    Asian Pac J Cancer Prev, 2008 Jul-Sep;9(3):445-8.
    PMID: 18990019
    INTRODUCTION: CA15-3 is a well-known tumour marker for breast cancer. Currently it is not recommended for screening or diagnosis of breast cancer and its main application is in monitoring response to treatment in women with metastatic breast cancer. The aim of this study was to correlate serum CA15-3 at presentation with the stage of disease and overall survival in women with breast cancer in the University Malaya Medical Centre.

    METHODS: This is a retrospective study of 437 women who had CA15-3 levels determined at initial presentation of breast cancer to UMMC between Jan 1999 and Oct 2003.

    RESULTS: Of those patients who were adequately staged, CA15-3 was found to be elevated (defined as >51 U/ml) in 0% of Stage 1, 7.9% of Stage 2, 36.7% of Stage 3 and 68.6% of Stage 4 cases. In a subset of 331 patients with survival data, patients with normal CA15-3 had a 85% five year overall survival rate compared to 38% in their counterparts with elevation of the tumor marker. The level of elevation was also significantly related to survival; patients with values more than 200 U/ml exhibited only a 28% five year survival. The association of elevated CA15-3 at initial presentation with poor outcome was maintained over univariate and multivariate analyses.

    CONCLUSION: Estimation of CA15-3 at presentation of breast cancer is important as it is an independent prognostic indicator and may prompt the physician to investigate for metastases if elevated.
    Matched MeSH terms: Multivariate Analysis
  19. Ong TA, Yip CH
    Asian J Surg, 2003 Jul;26(3):169-75.
    PMID: 12925293
    OBJECTIVE: To study the impact of various clinicopathological factors on short-term survival in a cohort of breast cancer patients treated at the University of Malaya Medical Centre (UMMC).
    METHODS: All cases of breast cancer treated at UMMC from January 1999 to June 2001, except for stage IV disease, were included in the study. Survival analysis was carried out using Kaplan-Meier for univariate analysis and Cox regression for multivariate analysis. The log-rank test was used to test the significance of differences between the different survival curves.
    RESULTS: A total of 385 patients were included. The mean patient age at presentation was 50.3 years (SD, 11.4); 198 (51.4%) patients had lymph node-positive disease, and 187 (48.6%) had node-negative disease. The mean follow-up period was 18.7 months (SD, 8.8). The Malay ethnic group, tumours of larger size, node-positive disease, more than five positive lymph nodes, oestrogen receptor (ER) negativity and the presence of lymphovascular invasion were significant prognostic factors for shorter recurrence-free survival (RFS) in the univariate analysis. In the multivariate analysis, ER negativity was the only independent adverse prognostic factor for RFS. For overall survival (OS), tumours of larger size, node-positive disease, more than five positive lymph nodes, ER negativity and high grade tumours were associated with significantly shorter OS. However, more than five positive lymph nodes was the only independent prognostic factor for shorter OS in the multivariate analysis. Further multivariate analysis of the patients with node-positive disease showed that the Malay ethnic group, ER negativity and more than five positive lymph nodes were independent prognostic factors for shorter RFS. On the other hand, ER negativity and more than five positive lymph nodes were independent negative prognostic factors for OS in this subgroup of patients.
    CONCLUSION: The evaluation of various prognostic factors would provide useful information on disease progression in local patients, especially for the planning of adjuvant therapies and follow-up protocols. Differences in the pattern of breast cancer among the different ethnic groups in Malaysia warrant further studies.
    Matched MeSH terms: Multivariate Analysis
  20. Ataie-Jafari A, Loke SC, Rahmat AB, Larijani B, Abbasi F, Leow MK, et al.
    Clin Nutr, 2013 Dec;32(6):911-7.
    PMID: 23395257 DOI: 10.1016/j.clnu.2013.01.012
    This participant-blinded parallel-group randomized placebo-controlled study demonstrated that alfacalcidol (vitamin D analogue) preserves beta cell function in newly diagnosed type 1 diabetes (T1DM) in children.
    Matched MeSH terms: Multivariate Analysis
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