Displaying publications 1 - 20 of 2134 in total

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  1. Kwan MK, Chiu CK, Gan CC, Chan CY
    Spine (Phila Pa 1976), 2016 Feb;41(4):E225-30.
    PMID: 26579957 DOI: 10.1097/BRS.0000000000001199
    A prospective, nonrandomized study.
    Matched MeSH terms: Prospective Studies
  2. Mosiun JA, See MH, Teoh LY, Danaee M, Lai LL, Ng CH, et al.
    World J Surg, 2023 Jan;47(1):201-208.
    PMID: 36305952 DOI: 10.1007/s00268-022-06753-0
    BACKGROUND: There is a paucity of data on the use of intraoperative radiotherapy (IORT) with low-energy X-rays in Malaysian women with early breast cancer. The aim of this study is to evaluate the clinical, cosmetic, and patient-reported outcomes in low- and high-risk early breast cancer patients treated with breast conserving surgery (BCS) and IORT.

    METHODOLOGY: Patients suitable for BCS who were treated with IORT between January 2016 and June 2019 from three centres were analysed. They were divided into low-risk and high-risk groups based on the risk of recurrence according to the TARGeted Intraoperative radioTherapy (TARGIT) A and B study criteria. Outcomes of interest included local recurrence, wound complications, and radiation toxicity, with a subset analysed for cosmetic and patient-reported outcomes.

    RESULTS: Within a median follow-up of 31 months, there were 104 and 211 patients in the low- and high-risk groups, respectively. No significant difference was observed in local recurrence rates (low-risk, 1.0% vs. high-risk, 1.4%; p = 1.000). Both cohorts exhibited low frequencies of severe wound complications ranging between 1.4 and 1.9%. No major radiation toxicities were reported in either group. In the subgroup analysis, low-risk patients had significantly better mean scores in the subscales of inframammary fold and scar. Based on the BREAST-Q patient-reported outcomes questionnaire, seven out of nine parameters were scored similarly between both groups with no significant difference.

    CONCLUSION: This study showed that the use of IORT in both low- and high-risk early breast cancers is efficacious and safe with low recurrence rates and an acceptable toxicity profile.

    Matched MeSH terms: Prospective Studies
  3. Aziz T, Haq F, Farid A, Kiran M, Faisal S, Ullah A, et al.
    Environ Res, 2023 Apr 15;223:115429.
    PMID: 36746207 DOI: 10.1016/j.envres.2023.115429
    Cellulose is the most abundant polysaccharide on earth. It has a large number of desirable properties. Its low toxicity makes it more useful for a variety of applications. Nowadays, its composites are used in most engineering fields. Composite consists of a polymer matrix and use as a reinforcing material. By reducing the cost of traditional fibers, it has an increasing demand for environment-friendly purposes. The use of these types of composites is inherent in moisture absorption with hindered natural fibers. This determines the reduction of polymer composite material. By appropriate chemical surface treatment of cellulose composite materials, the effect could be diminished. The most modern and advanced techniques and methods for the preparation of cellulose and polymer composites are discussed here. Cellulosic composites show a reinforcing effect on the polymer matrix as pointed out by mechanical characterization. Researchers tried their hard work to study different ways of converting various agricultural by-products into useful eco-friendly polymer composites for sustainable production. Cellulose plays building blocks, that are critical for polymer products and their engineering applications. The most common method used to prepare composites is in-situ polymerization. This help to increase the yields of cellulosic composites with a significant enhancement in thermal stability and mechanical properties. Recently, cellulose composites used as enhancing the incorporation of inorganic materials in multi-functional properties. Furthermore, we have summarized in this review the potential applications of cellulose composites in different fields like packaging, aerogels, hydrogels, and fibers.
    Matched MeSH terms: Prospective Studies
  4. Yang SL, Ripen AM, Lee JV, Koh K, Yen CH, Chand AK, et al.
    Int J Infect Dis, 2023 Mar;128:98-101.
    PMID: 36581187 DOI: 10.1016/j.ijid.2022.12.025
    OBJECTIVES: To study the incidence of Omicron infections in Malaysia and the exposures that could reduce the hazard of attaining Omicron infection.

    METHODS: We used a multicenter, prospective cohort to study 482 healthcare workers vaccinated with two and three doses of BNT162b2 for SARS-CoV-2 infection during the Omicron-dominant period in Malaysia.

    RESULTS: Between January 31 and July 31, 2022, the cumulative incidence was 44.6% (95% CI 40.2-49.1%), and the incidence rate was 3.33 (95% CI 2.91-3.80) per 1000 person-days. Our study found that protection against Omicron infection was significantly higher for persons with previous SARS-CoV-2 infection (hazard ratio [HR] 0.41, 95% CI 0.27-0.62) and persons with a more recent immunity event (<30 days [reference] vs >90 days, HR 3.82, 95%CI 1.34-10.90) from the beginning of the Omicron period.

    CONCLUSION: Pre-Omicron natural infection and a recent immunity event protect against future Omicron infections.

    Matched MeSH terms: Prospective Studies
  5. Mahmud MN, Othman A, Ilias MI
    Singapore Med J, 2023 Sep;64(9):557-562.
    PMID: 34600452 DOI: 10.11622/smedj.2021128
    INTRODUCTION: The study was performed to determine the psychological problems in children with idiopathic nephrotic syndrome (INS) while they were on steroid therapy, as compared to healthy children.

    METHODS: This prospective cohort study was conducted in a paediatric clinic of a tertiary hospital. Parents of the participants in the INS group and control group (comprising children without chronic illness) completed questionnaires using the Child Behavioural Checklist (CBCL). The CBCL measures a range of age-specific emotional and psychological problems, including internalising and externalising domains. Analyses of the CBCL scores between groups were done using Mann-Whitney U test.

    RESULTS: A total of 140 children were recruited with an equal number in the INS and control groups. There was a significant difference in the mean total CBCL scores between the INS group and the control group, specifically in the withdrawal, somatic, anxious and aggressiveness subdomains. Similar findings were demonstrated in correlation between total psychological problems and corticosteroid dosage. In the INS group, steroid dose and cushingoid features were found to have a significant positive association with internalising psychological problems.

    CONCLUSION: Children with INS on corticosteroid treatment showed an increase in internalising and externalising scores, as compared to healthy children.

    Matched MeSH terms: Prospective Studies
  6. Sha HL, Roslani AC, Poh KS
    Colorectal Dis, 2020 10;22(10):1379-1387.
    PMID: 32337794 DOI: 10.1111/codi.15091
    AIM: The Sodergren score was developed to objectively measure the severity of haemorrhoidal symptoms. This study aimed to determine if there was a difference in the Sodergren score between patients who were offered surgery and patients who underwent successful rubber band ligation of internal haemorrhoidal disease and to assess its performance in guiding management.

    METHOD: This is a prospective, observational study. The preintervention Sodergren scores of subjects with internal haemorrhoidal disease were recorded and blinded to the surgeon in charge. Sodergren scores of subjects in the two arms were unblinded and compared at the end of the study.

    RESULTS: The results for 290 patients were available for final analysis. The median scores of those offered surgery and those who underwent successful rubber band ligation differed significantly [4 (interquartile range 3-10) vs 0 (interquartile range 0-4), P = 0.001]. In predicting treatment, the Sodergren score had an area under the receiver operating characteristic curve of 0.735 (95% CI 0.675-0.795).

    CONCLUSION: There is a significant difference in scores between patients who were offered surgery and patients with successful rubber band ligation. Our study suggests that the Sodergren score has an acceptable discrimination in predicting the need for surgery in internal haemorrhoidal disease. We propose that patients with a Sodergren score of 6 or more be considered for upfront surgery. This score could potentially be used to standardize outcomes of future haemorrhoid trials.

    Matched MeSH terms: Prospective Studies
  7. Loo JT, Md Razif MA
    JUMMEC, 2005;8:56-60.
    Skin closure using simple interrupted nylon sutures was compared with closure using subcuticular nylon sutures in 80 consecutive patients undergoing semiemergency surgery, involving open reduction and internal fixation of either the forearm bones or femur. The simple interrupted technique was shown to be slower than the subcuticular technique with higher early postoperative wound complication rate. It may use an extra packet of sutures particularly if the average wound length is 19.8 cm. There is, however, no statistical difference demonstrated for the late scar complaints or subjective and objective scoring of cosmetic outcomes six months after the surgery. KEYWORDS: Simple interrupted, subcuticular, skin closure, nylon, cosmetic outcome
    Matched MeSH terms: Prospective Studies
  8. Fayad MK, Fahmy O, Abulazayem KM, Salama NM
    Urolithiasis, 2022 Feb;50(1):113-117.
    PMID: 34807274 DOI: 10.1007/s00240-021-01289-9
    This study aimed at investigating the efficacy and safety of retrograde intrarenal surgery (RIRS) in treatment of renal pelvic stone larger than 2 cm against the percutaneous nephrolithotomy (PCNL). Between March 2018 and December 2020, 121 patients were randomized to undergo PCNL (60 patients), or RIRS (61 patients). Both groups were compared in terms of operative time, intraoperative complications. Postoperative complications were assessed based on Clavien-Dindo grading system. Stone-free rates were evaluated by CT scan 6 weeks after surgery. No significant difference were observed between both groups in perioperative criteria. The main operative time was slightly longer in PCNL group (105 vs 95 min, p = 0.49). Stone clearance was higher in PCNL, yet the difference was not significant. (53 patients in PCNL group had either complete clearance or residual fragments 
    Matched MeSH terms: Prospective Studies
  9. Chew LS, Lim XJ, Chang CT, Kamaludin RS, Leow HL, Ong SY, et al.
    Med J Malaysia, 2023 Sep;78(5):602-608.
    PMID: 37775486
    INTRODUCTION: Previous trials and real-world studies have shown that nirmatrelvir/ritonavir (Paxlovid®) reduces hospitalisation and deaths in symptomatic, high-risk, nonsevere COVID-19 patients. However, there was a scarcity of data on its effectiveness in the local setting. This study aimed to determine the effectiveness of Paxlovid® in reducing hospitalisation and mortality among COVID-19 patients and to identify the types of adverse events that occur after taking Paxlovid®.

    MATERIALS AND METHODS: A two-arm prospective cohort study was conducted among adult patients with COVID-19 categories 2 and 3 treated with Paxlovid® and a matched control group. A standard risk-stratified scoring system was used to establish Paxlovid® eligibility. All patients who were prescribed Paxlovid® and took at least one dose of Paxlovid® were included in the study. The control patients were selected from a centralised COVID-19 patient registry and matched based on age, gender and COVID-19 stage severity.

    RESULTS: A total of 552 subjects were included in the study and evenly allocated to the treatment and control groups. There was no statistically significant difference in 28-day hospitalisation after diagnosis [Paxlovid®: 26 (9.4%), Control: 34 (12.3%), OR: 0.74; 95%CI, 0.43-1.27; p=0.274] or all-cause death [Paxlovid®: 2 (0.7%), Control: 3 (1.1%), OR 1.51; 95%CI, 0.25-9.09; p=0.999]. There was no significant reduction in hospitalisation duration, intensive care unit admission events or supplementary oxygen requirement in the treatment arm. Ethnicity, COVID-19 severity at diagnosis, comorbidities and vaccination status were predictors of hospitalisation events.

    CONCLUSION: In this two-arm study, Paxlovid® did not significantly lower the incidence of hospitalisation, all-cause death and the need for supplemental oxygen. Adverse effects were frequent but not severe. Paxlovid® efficacy varied across settings and populations, warranting further real-world investigations.

    Matched MeSH terms: Prospective Studies
  10. Al-Maweri SA, Alhajj MN, Halboub E, Tamimi F, Salleh NM, Al-Ak'hali MS, et al.
    BMC Oral Health, 2023 Sep 09;23(1):658.
    PMID: 37689665 DOI: 10.1186/s12903-023-03378-0
    BACKGROUND: A possible relationship between periodontitis (PD) and COVID-19 and its adverse outcomes has been suggested. Hence, the present systematic review and meta-analysis aimed to investigate the available evidence regarding the potential association between periodontitis (PD) and COVID-19 and its adverse outcomes.

    MATERIALS AND METHODS: PubMed, Scopus, Web of Science, and Google Scholar were searched for relevant studies published up to April 15th, 2023. Studies that evaluated the association between PD and COVID-19 were included. Risk of bias was evaluated by two reviewers, and meta-analyses were performed using RevMan 5.3 software.

    RESULTS: A total of 22 studies involving 92,535 patients from USA, Europe, Asia, the Middle East and South America were included; of these, 12 were pooled into the meta-analysis. Most of the studies (19 studies) reported a significant association between PD and COVID-19. The pooled data found a significant association between PD and COVID-19 outcomes: more severe symptoms (OR = 6.95, P = 0.0008), ICU admissions (OR = 3.15, P = 0.0001), and mortality (OR = 1.92, P = 0.21). Additionally, compared to mild PD, severe PD was significantly associated with higher risks of severe COVID-19 outcomes: severe symptoms (P = 0.02); ICU admission (P = 0.0001); and higher mortality rates (P = 0.0001). The results also revealed 58% higher risk for COVID-19 infection in patients with PD (P = 0.00001).

    CONCLUSIONS: The present findings suggest a possible association between poor periodontal health and the risk of poor COVID-19 outcomes. However, owing to the observed methodological heterogeneity across the included studies, further prospective cohort studies with standardized methodologies are warranted to further unravel the potential association between periodontal disease and COVID-19 and its adverse outcomes.

    Matched MeSH terms: Prospective Studies
  11. Ng YJ, Chan SS, Khoo KS, Munawaroh HSH, Lim HR, Chew KW, et al.
    Biotechnol Adv, 2023 Nov;68:108198.
    PMID: 37330152 DOI: 10.1016/j.biotechadv.2023.108198
    Surfactants have always been a prominent chemical that is useful in various sectors (e.g., cleaning agent production industry, textile industry and painting industry). This is due to the special ability of surfactants to reduce surface tension between two fluid surfaces (e.g., water and oil). However, the current society has long omitted the harmful effects of petroleum-based surfactants (e.g., health issues towards humans and reducing cleaning ability of water bodies) due to their usefulness in reducing surface tension. These harmful effects will significantly damage the environment and negatively affect human health. As such, there is an urgency to secure environmentally friendly alternatives such as glycolipids to reduce the effects of these synthetic surfactants. Glycolipids is a biomolecule that shares similar properties with surfactants that are naturally synthesized in the cell of living organisms, glycolipids are amphiphilic in nature and can form micelles when glycolipid molecules clump together, reducing surface tension between two surfaces as how a surfactant molecule is able to achieve. This review paper aims to provide a comprehensive study on the recent advances in bacteria cultivation for glycolipids production and current lab scale applications of glycolipids (e.g., medical and waste bioremediation). Studies have proven that glycolipids are effective anti-microbial agents, subsequently leading to an excellent anti-biofilm forming agent. Heavy metal and hydrocarbon contaminated soil can also be bioremediated via the use of glycolipids. The major hurdle in the commercialization of glycolipid production is that the cultivation stage and downstream extraction stage of the glycolipid production process induces a very high operating cost. This review provides several solutions to overcome this issue for glycolipid production for the commercialization of glycolipids (e.g., developing new cultivating and extraction techniques, using waste as cultivation medium for microbes and identifying new strains for glycolipid production). The contribution of this review aims to serve as a future guideline for researchers that are dealing with glycolipid biosurfactants by providing an in-depth review on the recent advances of glycolipid biosurfactants. By summarizing the points discussed as above, it is recommended that glycolipids can substitute synthetic surfactants as an environmentally friendly alternative.
    Matched MeSH terms: Prospective Studies
  12. Sun R, Balabanova A, Bajada CJ, Liu Y, Kriuchok M, Voolma SR, et al.
    Emotion, 2024 Mar;24(2):397-411.
    PMID: 37616109 DOI: 10.1037/emo0001235
    The COVID-19 pandemic presents challenges to psychological well-being, but how can we predict when people suffer or cope during sustained stress? Here, we test the prediction that specific types of momentary emotional experiences are differently linked to psychological well-being during the pandemic. Study 1 used survey data collected from 24,221 participants in 51 countries during the COVID-19 outbreak. We show that, across countries, well-being is linked to individuals' recent emotional experiences, including calm, hope, anxiety, loneliness, and sadness. Consistent results are found in two age, sex, and ethnicity-representative samples in the United Kingdom (n = 971) and the United States (n = 961) with preregistered analyses (Study 2). A prospective 30-day daily diary study conducted in the United Kingdom (n = 110) confirms the key role of these five emotions and demonstrates that emotional experiences precede changes in well-being (Study 3). Our findings highlight differential relationships between specific types of momentary emotional experiences and well-being and point to the cultivation of calm and hope as candidate routes for well-being interventions during periods of sustained stress. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
    Matched MeSH terms: Prospective Studies
  13. Azizan A, Justine M, Kuan CS
    Curr Gerontol Geriatr Res, 2013;2013:282315.
    PMID: 24489539 DOI: 10.1155/2013/282315
    Background. This study determines the effects of a behavioral program on exercise adherence (step counts) and level of exercise self-efficacy (ESE) in community-dwelling older persons. Methods. Sixty-three participants (age = 63.8 ± 4.5 years) were enrolled in this controlled quasi-experimental study. They were divided into 3 groups: (1) EBG performed a 6-week exercise intervention followed by a 5-week behavioral program, (2) EG performed exercise intervention similar to EBG, and (3) control group (CG) did not receive any interventions. Step counts were measured based on the scores recorded by a pedometer while ESE was measured by a self-reported ESE scale. Results. Data analysis showed significant differences due to time effect (F(1,2) = 39.884, P < 0.01, and η = .399); time and group interactions (F(2,60) = 112.683, P < 0.01, and η = .790); and between-group effect (F(2,60) = 12.524, P < 0.01, and η = .295) for step counts. As for ESE, significant differences were also found for time effect (F(2,4) = 66.628, P < 0.05, and η = .526); time and group interactions (F(2,60) = 4.562, P = 0.014, and η = .132); and between-group effect (F(2,60) = 13.632, P < 0.05, and η = .312). EBG presented with significantly higher mean changes for both step counts and ESE compared to other groups (all P < 0.05). Conclusion. This study suggests that the addition of a behavioral program is superior as compared to exercising alone on increasing exercise adherence and level of self-efficacy in older persons.
    Matched MeSH terms: Prospective Studies
  14. Bhupinder S, Kumara TK, Syed AM
    Med J Malaysia, 2010 Jun;65(2):123-6.
    PMID: 23756796
    This article describes the completed suicide patterns which occurred in the Timur Laut district of Penang Island, Malaysia. In a prospective cohort study over the three years period (2007-2009) there were 138 cases of suicide deaths. The number of suicide deaths for the year 2007, 2008 and 2009 were 45, 41 and 52 deaths, respectively. Majority of the suicide deaths were by jumping from height (47.1%), followed by hanging (34.1%) and by drowning (10.9%). The male victims outnumbered females in a 3 : 1 ratio.
    Matched MeSH terms: Prospective Studies
  15. Abu Hanifah Y
    Med J Malaysia, 1990 Dec;45(4):293-7.
    PMID: 2152049
    The occurrence of post-operative wound infection was studied respectively over an eight month period in the University Hospital, Kuala Lumpur. One hundred and seventy four (3.4%) surgical wounds out of 5129 operations became infected. The clean wound infection rate was 2.9%, rising to 5.4% and 12.2% for clean-contaminated and contaminated surgical wounds respectively. Of the wound infections, 80.8% occurred within the first two weeks post-operatively. Bacteriological studies revealed that the commonest bacterial isolates were Staphylococcus aureus (36.1%), Pseudomonas aeruginosa (15.4%) and Klebsiella species (10.1%).
    Matched MeSH terms: Prospective Studies
  16. Yigitcanlar T, Butler L, Windle E, Desouza KC, Mehmood R, Corchado JM
    Sensors (Basel), 2020 May 25;20(10).
    PMID: 32466175 DOI: 10.3390/s20102988
    In recent years, artificial intelligence (AI) has started to manifest itself at an unprecedented pace. With highly sophisticated capabilities, AI has the potential to dramatically change our cities and societies. Despite its growing importance, the urban and social implications of AI are still an understudied area. In order to contribute to the ongoing efforts to address this research gap, this paper introduces the notion of an artificially intelligent city as the potential successor of the popular smart city brand-where the smartness of a city has come to be strongly associated with the use of viable technological solutions, including AI. The study explores whether building artificially intelligent cities can safeguard humanity from natural disasters, pandemics, and other catastrophes. All of the statements in this viewpoint are based on a thorough review of the current status of AI literature, research, developments, trends, and applications. This paper generates insights and identifies prospective research questions by charting the evolution of AI and the potential impacts of the systematic adoption of AI in cities and societies. The generated insights inform urban policymakers, managers, and planners on how to ensure the correct uptake of AI in our cities, and the identified critical questions offer scholars directions for prospective research and development.
    Matched MeSH terms: Prospective Studies
  17. Huey CJ, Gopinath SCB, Uda MNA, Zulhaimi HI, Jaafar MN, Kasim FH, et al.
    3 Biotech, 2020 May;10(5):204.
    PMID: 32337150 DOI: 10.1007/s13205-020-02188-3
    In this overview, the authors have discussed the potential advantages of the association between mycorrhizae and plants, their mutual accelerated growth under favorable conditions and their role in nutrient supply. In addition, methods for isolating mycorrhizae are described and spore morphologies and their adaptation to various conditions are outlined. Further, the significant participation of controlled greenhouses and other supported physiological environments in propagating mycorrhizae is detailed. The reviewed information supports the lack of host- and niche-specificity by arbuscular mycorrhizae, indicating that these fungi are suitable for use in a wide range of ecological conditions and with propagules for direct reintroduction. Regarding their prospective uses, the extensive growth of endomycorrhizal fungi suggests it is suited for poor-quality and low-fertility soils.
    Matched MeSH terms: Prospective Studies
  18. Ong TK, Lim GS, Singh M, Fial AV
    J Endod, 2020 Dec;46(12):1856-1866.e2.
    PMID: 32827507 DOI: 10.1016/j.joen.2020.08.016
    INTRODUCTION: The purposes of this review were to appraise the level of evidence of the existing regenerative endodontic therapy (RET) publications, perform a meta-analysis on the survival and healing rates of necrotic immature permanent teeth treated with RET, and run a meta-analysis on the quantitative assessment of the root development of those teeth.

    METHODS: Electronic searches were performed in Web of Science, PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Cochrane Library databases. Two authors independently screened the titles and abstracts for eligibility. The analyses were performed on the clinical outcomes (ie, survival, healing, and root development) of the procedure.

    RESULTS: Eleven articles were included in the qualitative and quantitative syntheses. Three studies were randomized controlled trials, 6 were prospective cohort studies, and 2 were retrospective cohort studies. The pooled survival and healing rates were 97.3% and 93.0%, respectively. The pooled rates of root lengthening, root thickening, and apical closure were 77.3%, 90.6%, and 79.1%, respectively. However, if 20% radiographic changes were used as a cutoff point, there were only 16.1% root lengthening and 39.8% root thickening.

    CONCLUSIONS: Within the limitations of the present study, it can be concluded that RET yielded high survival and healing rates with a good root development rate. However, clinical meaningful root development after RET was unpredictable.

    Matched MeSH terms: Prospective Studies
  19. Nur Izzati Mansor, Nuratiqah Azmi, Ling, King-Hwa, Rozita Rosli, Zurina Hassan, Norshariza Nordin
    Neuroscience Research Notes, 2019;2(1):16-30.
    MyJurnal
    The use of in vitromodel for screening pharmacological compounds or natural products has gained global interest. The choice of cells to be manipulated plays a vital role in coming up with the best-suitedmodel for specific diseases, including neurodegenerativediseases (ND). A good in vitro ND model should provide appropriate morphological and molecular features that mimic ND conditions where it can be used to screen potential properties of natural products in addition to unravelling the molecular mechanisms of ND. In this mini review, we intend to demonstrate two prospective stem cell lines as the potential cell source for in vitroND model and compare them to the commonly used cells. The common source of cells that have been usedas the in vitroND models is discussedbefore going into details talking about the two prospective stem cell lines.
    Matched MeSH terms: Prospective Studies
  20. Rosenberger KD, Lum L, Alexander N, Junghanss T, Wills B, Jaenisch T, et al.
    Trop Med Int Health, 2016 Mar;21(3):445-53.
    PMID: 26752720 DOI: 10.1111/tmi.12666
    OBJECTIVE: Clinical management of dengue relies on careful monitoring of fluid balance combined with judicious intravenous (IV) fluid therapy. However, in patients with significant vascular leakage, IV fluids may aggravate serosal fluid accumulation and result in respiratory distress.
    METHODS: Trained physicians followed suspected dengue cases prospectively at seven hospitals across Asia and Latin America, using a comprehensive case report form that included daily clinical assessment and detailed documentation of parenteral fluid therapy. Applying Cox regression, we evaluated risk factors for the development of shock or respiratory distress with fluid accumulation.
    RESULTS: Most confirmed dengue patients (1524/1734, 88%) never experienced dengue shock syndrome (DSS). Among those with DSS, 176/210 (84%) had fluid accumulation, and in the majority (83%), this was detectable clinically. Among all cases with clinically detectable fluid accumulation, 179/447 (40%) were diagnosed with shock or respiratory distress. The risk for respiratory distress with fluid accumulation increased significantly as the infused volume over the preceding 24 h increased (hazard ratio 1.18 per 10 ml/kg increase; P < 0.001). Longer duration of IV therapy, use of a fluid bolus in the preceding 24 h, female gender and poor nutrition also constituted independent risk factors.
    CONCLUSIONS: Shock and respiratory distress are relatively rare manifestations of dengue, but some evidence of fluid accumulation is seen in around 50% of cases. IV fluids play a crucial role in management, but they must be administered with caution. Clinically and/or radiologically detectable fluid accumulations have potential as intermediate severity endpoints for therapeutic intervention trials and/or pathogenesis studies.
    KEYWORDS: IV fluid therapy; clinical spectrum; dengue; espectro clínico; fluidothérapie IV; fuga vascular; fuite vasculaire; prospectif; prospective; prospectivo; spectre clinique; terapia IV de fluidos; vascular leakage
    Matched MeSH terms: Prospective Studies
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