Displaying publications 301 - 320 of 573 in total

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  1. Steffi W, Zaliana B, Amreen A, Nasirudin N
    Med J Malaysia, 2017 10;72(5):316-317.
    PMID: 29197891 MyJurnal
    Chronic exudative malodorous fungating wound of four years at the right arm due to diffuse large B cell lymphoma managed with silver dressings. In two months of application with nanocrystalline silver coated dressings, there was significant improvement in wound.
    Matched MeSH terms: Chronic Disease
  2. Dariah Mohd Yusoff, Junaiti Yusof, Kueh, Yee Cheng
    MyJurnal
    Patients with chronic diseases such as diabetes, hypertension and cardiovascular diseases are known as
    high-risk groups for developing chronic kidney disease (CKD). Adequate related knowledge among them
    helps to increase their awareness towards CKD and adapt healthy attitude and practices for CKD
    prevention, which will result in better health outcomes. This study aimed to identify the patients'
    knowledge, attitude, and practices (KAP) towards the risks for CKD. This cross-sectional study used a selfadministered
    survey questionnaire on 103 adult male and female patients at four general surgical and
    medical wards in a teaching hospital using convenient sampling method. The data were computed using
    STATA version 12. Data on KAP were obtained through the Chronic Kidney Disease Screening Index
    questionnaire. The majority of respondents had poor knowledge (69.9%, n=72), but most of them had good
    attitude (68.9%, n=71) and good practices (88.3%, n=91) towards the risk of CKD. Significant associations
    were indicated between education level, occupation and monthly family income with knowledge (p-value <
    0.05). Significant associations were also indicated between age, sex, marital status and occupation with
    their attitude (p-value < 0.05). Meanwhile, marital status was found to be significantly associated with the
    practices towards the risk for CKD (p-value=0.008).
    Poor knowledge on the risk of getting CKD among hospitalized adults in this study implied the need for
    improvement in the public understanding towards the risk for CKD.
    Matched MeSH terms: Chronic Disease
  3. Shim YW, Chua SS, Wong HC, Alwi S
    Ther Clin Risk Manag, 2018;14:1115-1125.
    PMID: 29942134 DOI: 10.2147/TCRM.S146218
    Background: The elderly population is the largest consumer of medications as this age group is at high risk for developing chronic diseases. However, medication use among elderly people is complicated by an increased risk of drug-related problems. Therefore, the present study was conducted to investigate the effects of collaborative interventions between pharmacists and physicians on health-related outcomes of elderly patients.
    Patients and methods: This was a randomized controlled trial (RCT) conducted on elderly outpatients who sought treatment in the Medical Outpatient Department of a public tertiary hospital in Malaysia and who were taking at least five medications. The participants were randomly allocated to the intervention and control groups. The intervention group received pharmaceutical care from a pharmacist in collaboration with physicians and was followed-up for 6 months, while the control group received usual care in the outpatient pharmacy.
    Results: A total of 73 participants in the intervention group and 79 participants in the control group completed the study. Participants in the intervention group had significantly better medication adherence (median =7.0 vs 5.0, U=1224.5, p<0.001, r=0.503) and better Medication Appropriateness Index (MAI) score (median =8.0 vs 20.0, U=749.5, p<0.001, r=0.639).
    Conclusion: Collaborative interventions between pharmacists and physicians improved medication adherence and MAI scores of the elderly patients. Therefore, such services should be implemented in all hospitals, especially in countries where pharmacists are still not playing a substantial role in patient care.
    Trial registration: NMRR-12-958-13020.
    Study site: Outpatient clinic (MOPD), Duchess of Kent Hospital, Sandakan, Sabah, Malaysia
    Matched MeSH terms: Chronic Disease
  4. Ng YK, Shah NM, Loong LS, Pee LT, Hidzir SAM, Chong WW
    Patient Prefer Adherence, 2018;12:615-624.
    PMID: 29731609 DOI: 10.2147/PPA.S159113
    Purpose: This study investigated patients' and pharmacists' attitudes toward concordance in a pharmacist-patient consultation and how patients' attitudes toward concordance relate to their involvement and self-efficacy in decision making associated with medication use.

    Subjects and methods: A cross-sectional study was conducted among patients with chronic diseases and pharmacists from three public hospitals in Malaysia. The Revised United States Leeds Attitudes toward Concordance (RUS-LATCon) was used to measure attitudes toward concordance in both patients and pharmacists. Patients also rated their perceived level of involvement in decision making and completed the Decision Self-Efficacy scale. One-way analysis of variance (ANOVA) and independent t-test were used to determine significant differences between different subgroups on attitudes toward concordance, and multiple linear regression was performed to find the predictors of patients' self-efficacy in decision making.

    Results: A total of 389 patients and 93 pharmacists participated in the study. Pharmacists and patients scored M=3.92 (SD=0.37) and M=3.84 (SD=0.46) on the RUS-LATCon scale, respectively. Seven items were found to be significantly different between pharmacists and patients on the subscale level. Patients who felt fully involved in decision making (M=3.94, SD=0.462) scored significantly higher on attitudes toward concordance than those who felt partially involved (M=3.82, SD=0.478) and not involved at all (M=3.68, SD=0.471; p<0.001). Patients had an average score of 76.7% (SD=14.73%) on the Decision Self-Efficacy scale. In multiple linear regression analysis, ethnicity, number of medications taken by patients, patients' perceived level of involvement, and attitudes toward concordance are significant predictors of patients' self-efficacy in decision making (p<0.05).

    Conclusion: Patients who felt involved in their consultations had more positive attitudes toward concordance and higher confidence in making an informed decision. Further study is recommended on interventions involving pharmacists in supporting patients' involvement in medication-related decision making.

    Matched MeSH terms: Chronic Disease
  5. Mohamed M, Lau DSC, Loh CK, Syed Zakaria SZ, Alias H, A Jamal AR, et al.
    MyJurnal
    Introduction: Parents of children with chronic illness such as thalassaemia, experience parental anxiety as a result of multiple stressors; these parents will consequently undergo the process of coping and adjustment in order to overcome the situation. Identifying families who may require psychosocial intervention is an important step towards providing holistic management for these children.

    Methodology: A cross-sectional study was conducted to determine the level of parenting stress amongst parents of children with thalassaemia. Risk factors associated with high parenting stress score were identified. Research instruments used were the Parenting Stress Index/Short Form and Coping Inventory for Stressful Situations.

    Results: A total of 54 subjects were recruited. High total parenting stress score (TPSS, defined at 75th centile) for this cohort was 99.5 whereas the mean TPSS was 86.18. Overall, 24% of these parents have high TPSS. Chinese ethnicity, number of children, monthly income, task-oriented and emotion-oriented coping mechanisms were significantly associated with a high TPSS. Logistic regression analysis revealed that low task-oriented but high emotion-oriented scores were risk factors with the greatest predictive power.

    Conclusion: Early recognition of parenting stress is important to identify at risk parents so that interventions such as counseling and social support may be given.
    Matched MeSH terms: Chronic Disease
  6. Lee WS, Jalaludin MY, Wong SY, Ong SY, Foo HW, Ng RT
    Pediatr Neonatol, 2019 02;60(1):12-18.
    PMID: 29680189 DOI: 10.1016/j.pedneo.2018.03.011
    BACKGROUND: To determine vitamin D status in children with chronic liver disease (CLD) in a tropical country.

    METHODS: Cross-sectional study in Malaysian children with CLD. Factors affecting serum vitamin D level (definition: deficient 

    Matched MeSH terms: Chronic Disease
  7. Tan, Kok-Leong, Fhun, Lai-Chan, Ahmad Tajudin Liza Sharmini, Maizan Yaakub, Chong, Mei-Fong
    MyJurnal
    Glaucoma is a chronic disease that could affect the quality of life and is a potential stressor for patients. Visual field assessment is important in monitoring disease progression among glaucoma patients. Stress could influence the performance of patients in visual field test that may affect the reliability of the test. Our objective in this study was to determine the association between stress score using Depression, Anxiety and Stress Scale (DASS) questionnaire and reliability indices of Humphrey visual field analysis (HFA). A total of 155 primary and secondary glaucoma patients were recruited in the study. Face to face interview using stress component of DASS questionnaire was conducted after automated HFA test. Reliability indices; i.e. fixation loss, false positive, and false negative error, were used to determine the accuracy of HFA result. Only 12 patients (7.7%) were found to have elevated stress score. No significant correlation was found between DASS stress score and the reliability indices of HFA. There was 0.2 folds (95% confidence interval (CI) [-2.35, -0.06], p = 0.039) reduction of fixation loss for every number of HFA done. For every one year increase in age, there was 0.2 folds (95% CI [-0.38, -0.07], p = 0.006) reduction in false positive error in HFA.
    Minimal stress may not affect the reliability of HFA assessment. Minimising stress among glaucoma patients is important not only for assessment of visual field but also for improvement of quality of life.
    Matched MeSH terms: Chronic Disease
  8. Elias MH, Azlan H, Baba AA, Ankathil R
    PMID: 29669505 DOI: 10.2174/1871529X18666180419101416
    BACKGROUND: In exploring the cause of Imatinib Mesylate (IM) resistance among Chronic Myeloid Leukemia (CML) patients who do not harbor BCR-ABL dependent mechanism, BCR-ABL independent pathways are the most probable pathways that should be explored. In BCR-ABL independent pathway, SOCS1 plays an important role as it helps in regulating optimal JAK/STAT activity.

    OBJECTIVE: To identify the association of SOCS1 gene hypermethylation in mediating IM Resistance.

    METHOD: The SOCS1 promoter methylation level of 92 BCR-ABL non mutated IM resistant CML patients, 83 IM good response CML patients and 5 normal samples from healthy individuals were measured using Methylation Specific-High Resolution Melt (MS-HRM) analysis.

    RESULTS: Both primers used to amplify promoter region from -333 to -223 and from -332 to -188 showed less than 10% methylation in all CML and normal samples. Consequently, there was no significant difference in SOCS1 promoter methylation level between IM resistant and IM good response patients.

    CONCLUSION: SOCS1 promoter methylation level is not suitable to be used as one of the biomarkers for predicting the possibility of acquiring resistance among CML patients treated with IM.

    Matched MeSH terms: Chronic Disease
  9. Abdul Ghani R, Mohamed Shah FZ, Hanafiah M, Abdul Aziz M
    BMJ Case Rep, 2019 Feb 01;12(2).
    PMID: 30709882 DOI: 10.1136/bcr-2018-225687
    A 30-year-old ex-smoker with a background history of childhood asthma presented with worsening shortness of breath despite receiving high doses of oral corticosteroid for pemphigus vulgaris which was diagnosed 5 years earlier. A high-resolution CT examination of the thorax reported non-specific bronchiectatic changes and revealed an incidental suprarenal mass. A subsequent CT scan confirmed a large adrenal mass with areas of necrosis and calcification. Serum renin and aldosterone, urinary catecholamine and 5-hydroxyindoleacetic acid were within normal limits. Surgical intervention was delayed due to difficulty in optimising preoperative respiratory functions. He finally underwent a midline laparotomy for removal of the tumour. Histopathological examinations revealed extrapulmonary inflammatory myofibroblastic tumour arising from the periadrenal soft-tissue, with presence of normal adrenal gland. He showed immediate improvements of his asthmatic symptoms and pemphigus vulgaris following the surgery. His oral steroid was rapidly reduced and he achieved complete remission 2 months later.
    Matched MeSH terms: Chronic Disease
  10. ISBN: 983-42556-7-5
    NCD Risk Factors in Malaysia. Putrajaya: Ministry of Health, Malaysia, 2006
    Study name: Malaysia Non-Communicable Disease Surveillance-1 (MyNCDS-1) survey
    Matched MeSH terms: Chronic Disease
  11. Chan SC
    Family Physician, 1995;7:3-10.
    This study aimed to established baseline data on patients' demographic and morbidity patterns over three months in the Outpatients Department (OPD) Ipoh Hospital. Entry of the first ten thousand patients into a computerised database for analysis showed that the majority were unemployed and from the low income group. There were more Malays and Indians, less Chinese. Respiratory infections accounted for 18.5 % while major chronic diseases (hypertension, diabetes mellitus, asthma) were common. Overall a wide spectrum of illnesses were seen. A career structure for OPD doctors and incorporation of Family Medicine concepts were proposed to improve primary care in OPD.
    Study site: Outpatients Department (OPD), Hospital Ipoh, Perak, Malaysia
    Matched MeSH terms: Chronic Disease
  12. Cahir C, Wallace E, Cummins A, Teljeur C, Byrne C, Bennett K, et al.
    Ann Fam Med, 2019 Mar;17(2):133-140.
    PMID: 30858256 DOI: 10.1370/afm.2359
    PURPOSE: To evaluate a patient-report instrument for identifying adverse drug events (ADEs) in older populations with multimorbidity in the community setting.

    METHODS: This was a retrospective cohort study of 859 community-dwelling patients aged ≥70 years treated at 15 primary care practices. Patients were asked if they had experienced any of a list of 74 symptoms classified by physiologic system in the previous 6 months and if (1) they believed the symptom to be related to their medication, (2) the symptom had bothered them, (3) they had discussed it with their family physician, and (4) they required hospital care due to the symptom. Self-reported symptoms were independently reviewed by 2 clinicians who determined the likelihood that the symptom was an ADE. Family physician medical records were also reviewed for any report of an ADE.

    RESULTS: The ADE instrument had an accuracy of 75% (95% CI, 77%-79%), a sensitivity of 29% (95% CI, 27%-31%), and a specificity of 93% (95% CI, 92%-94%). Older people who reported a symptom had an increased likelihood of an ADE (positive likelihood ratio [LR+]: 4.22; 95% CI, 3.78-4.72). Antithrombotic agents were the drugs most commonly associated with ADEs. Patients were most bothered by muscle pain or weakness (75%), dizziness or lightheadedness (61%), cough (53%), and unsteadiness while standing (52%). On average, patients reported 39% of ADEs to their physician. Twenty-six (3%) patients attended a hospital outpatient clinic, and 32 (4%) attended an emergency department due to ADEs.

    CONCLUSION: Older community-dwelling patients were often not correct in recognizing ADEs. The ADE instrument demonstrated good predictive value and could be used to differentiate between symptoms of ADEs and chronic disease in the community setting.

    Matched MeSH terms: Chronic Disease
  13. Flaherty G, De Freitas S
    Ir Med J, 2016 Dec 12;109(10):486.
    PMID: 28644591
    Cardiovascular disease is the leading cause of death in adult international travellers. Patients living with heart disease should receive specific, individualised pre-travel health advice. The purpose of this article is to provide evidence-based advice to physicians who are consulted by travellers with cardiovascular disease. Fitness-to-travel evaluation will often be conducted by the general practitioner but other medical specialists may also be consulted for advice. Patients with chronic medical conditions should purchase travel health insurance. The general pre-travel health consultation addresses food and water safety, insect and animal bite avoidance, malaria chemoprophylaxis, and travel vaccinations. Patients with devices such as cardiac pacemakers should be familiar with how these may be affected by travel. Cardiac medications may cause adverse effects in cold or hot environments, and specific precautions must be followed by anticoagulated travellers. The physician should be aware of how to access medical care abroad, and of the potential for imported tropical diseases in returned travellers.
    Matched MeSH terms: Chronic Disease
  14. Abu Hassan MR, Aziz N, Ismail N, Shafie Z, Mayala B, Donohue RE, et al.
    PLoS Negl Trop Dis, 2019 03;13(3):e0007243.
    PMID: 30883550 DOI: 10.1371/journal.pntd.0007243
    BACKGROUND: Melioidosis, a fatal infectious disease caused by Burkholderia pseudomallei, is increasingly diagnosed in tropical regions. However, data on risk factors and the geographic epidemiology of the disease are still limited. Previous studies have also largely been based on the analysis of case series data. Here, we undertook a more definitive hospital-based matched case-control study coupled with spatial analysis to identify demographic, socioeconomic and landscape risk factors for bacteremic melioidosis in the Kedah region of northern Malaysia.

    METHODOLOGY/PRINCIPAL FINDINGS: We obtained patient demographic and residential information and clinical presentation and medical history data from 254 confirmed melioidosis cases and 384 matched controls attending Hospital Sultanah Bahiyah (HSB), the main tertiary hospital of Alor Setar, the capital city of Kedah, during the period between 2005 and 2011. Crude and adjusted odds ratios employing conditional logistic regression analysis were used to assess if melioidosis in this region is related to risk factors connected with socio-demographics, various behavioural characteristics, and co-occurring diseases. Spatial clusters of cases were determined using a continuous Poisson model as deployed in SaTScan. A land cover map in conjunction with mapped case data was used to determine disease-land type associations using the Fisher's exact test deploying simulated p-values. Crude and adjusted odds ratios indicate that melioidosis in this region is related to gender (males), race, occupation (farming) and co-occurring chronic diseases, particularly diabetes. Spatial analyses of disease incidence, however, showed that disease risk and geographic clustering of cases are related strongly to land cover types, with risk of disease increasing non-linearly with the degree of human modification of the natural ecosystem.

    CONCLUSIONS/SIGNIFICANCE: These findings indicate that melioidosis represents a complex socio-ecological public health problem in Kedah, and that its control requires an understanding and modification of the coupled human and natural variables that govern disease transmission in endemic communities.

    Matched MeSH terms: Chronic Disease
  15. Park YG, Choi J, Song I, Park SY, Seol JW, Jackson CJ
    Sains Malaysiana, 2017;46:1895-1902.
    Rheumatoid arthritis (RA) is a chronic disease characterized by inflammation of the joints and their lining or synovium. Previous studies showed that the synovium in RA patients is more hypoxic than normal synovium. Activated protein C (APC) has anticoagulant and anti-inflammatory effects and is highly expressed in the joints of RA patients. We examined the effect of APC on RA and normal synovial fibroblasts under hypoxic conditions. Human synovial fibroblasts were isolated from the synovial tissues of RA patients and normal controls and cells were exposed to recombinant APC under normoxic (21% oxygen) or hypoxic (1% oxygen) conditions. Cell proliferation was measured using MTT assays. Cell lysates and conditioned media were collected and assayed for matrix metalloproteinase (MMP)-2, MMP-9 and p38 using zymography and western blots. Proliferation of both normal and RA synovial fibroblasts dose-dependently increased after APC treatment in normoxic conditions. Under hypoxia, APC enhanced RA cell proliferation but had no effect on normal fibroblasts. MMP-2 production and activation were significantly augmented by APC in both cell types under normoxia and hypoxia conditions. However, activated MMP-2 was more reduced in cells under hypoxia than normoxia. APC substantially reduced the phosphorylation of p38 in normal and RA synovial fibroblasts under hypoxia. No difference in p38 phosphorylation was observed under normoxia. The receptor for APC, endothelial protein C receptor (EPCR), was elevated in normal fibroblasts under hypoxic conditions whereas in RA cells, EPCR was highly expressed under both normoxic and hypoxic conditions. We found that hypoxia enhanced the effect of APC on RA synovial fibroblasts through activation of MMP2 and inhibition of p38 phosphorylation. Our results suggested that APC may suppress joint destruction and progression of inflammation in a hypoxic RA environment.
    Matched MeSH terms: Chronic Disease
  16. Wong YL, Mohd Amin J
    JUMMEC, 2005;8:53-58.
    Malaysia, like many aspiring developing countries, is undergoing a health transition that has seen the concomitant decrease in communicable diseases and increase in chronic diseases due to urbanization, modernization and ageing population. Health in the Malaysian society will thus increasingly focus on emerging problems that are both chronic and infectious in nature, such as, heart disease, diabetes, cancer, mental health, hepatitis and HIV/AIDS. Re-emerging diseases previously well-controlled, such as, tuberculosis for instance is another addition to these immediate health issues facing Malaysian society today. Despite the tremendous health gains and above average health status that Malaysians now enjoy, we are compelled to take stock of these urgent issues as well as to anticipate and handle serious challenges to our health in the 21st century. In this paper, we review the changing trends and discuss related challenges in disease pattern, environmental health, demographic impacts on health, migration influxes and health, effects of globalization on health, mental health and wellness as well as fundamental access and equality in health care. Being proactive, resilient and innovative, Malaysian society would forge ahead towards our Vision for Health in this new era. KEYWORDS: Society and health, health trends and issues, Vision for Health, Malaysia
    Matched MeSH terms: Chronic Disease
  17. Razak I, Chung TY, Ahmad TS
    J Altern Complement Med, 2019 Aug;25(8):861-867.
    PMID: 31211607 DOI: 10.1089/acm.2019.0052
    Objectives:
    The study aims to assess, evaluate, and compare the efficacy of acupressure and hypnotherapy in the management of pain in patients presenting with chronic brachial neuralgia (CBN).
    Design:
    Randomized controlled trial.
    Settings/location:
    Department of Orthopaedic Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia.
    Subjects:
    Forty patients with CBN following traumatic brachial plexus injury from 2012 to 2017.
    Intervention:
    Therapy for a duration of 1 month in two groups; subjects in the hypnotherapy group received a weekly session of clinical hypnotherapy (total of four times) using a standardized protocol, while subjects in the acupressure group were guided by an acupuncturist during the initial session, received 2 month take home supply of acupressure patches, and were reviewed fortnightly.
    Outcome measures:
    The Visual Analog Scale, the Brief Pain Inventory, and the SF-36v2® Health Survey were recorded at different time points; 1 month pretreatment (week 0), pretreatment (week 4), post-treatment (week 8), and 4 months post-treatment (week 20).
    Results:
    There was a statistically significant improvement in the average pain intensity from pretreatment to post-treatment score in both groups. The pain intensity increased 4 months later; however, the pain intensity was still significantly reduced in comparison with pretreatment scores. The study suggests that both treatment outcomes are effective in terms of alleviating pain and improving quality of life in subjects with CBN, to a different degree.
    Conclusion:
    Overall, both therapies were able to improve the pain intensity and quality of life significantly during the treatment period. Hypnotherapy was observed to have a better carryover effect compared to acupressure, especially in terms of improving quality of life and the mental component score.
    Matched MeSH terms: Chronic Disease
  18. Dai J, Zulkefli NF, Moy FM, Keene D, Humphries D
    Curr Dev Nutr, 2019 Jun;3(Suppl 1).
    PMID: 31224508 DOI: 10.1093/cdn/nzz034.P10-024-19
    Objectives: Malaysia is currently experiencing the nutrition transition, with an increased consumption of refined carbohydrates and fats paralleling an increase in prevalence of obesity and chronic disease. These dietary changes have occurred despite 90% of urban women reporting awareness of the health risks posed by obesity. This study sought to characterize how working women, an understudied population at risk for diet-related chronic disease, navigate food decisions. As Malaysia is a multiethnic nation, we aimed to explore the sociocultural determinants of eating behavior in this unique population.

    Methods: A purposive design in combination with a convenience sampling approach was used to recruit 24 women ages 26 to 55 of Malay, Indian, and Chinese descent across 15 university departments in Kuala Lumpur, Malaysia. Audio recordings of the individual semi-structured interviews were transcribed and analyzed using grounded theory.

    Results: Women identified two important life transitions, getting married and having children, as particularly influential in changing eating behavior. Women reported a desire to eat healthier that was in tension with pressures to cater to the taste preferences of their household members and to accommodate their work schedules. Persistent social norms of eating in group settings and difficulty in accessing foods perceived as nutritious were reported as barriers to changing individual eating behavior. Regardless of education level and marital status, women agreed that the act of eating was closely connected with cultural values and embodied important meanings that took precedence over eating as a health-promoting behavior. While all participants expressed a desire to eat healthier, many reported limited confidence in their ability to consistently give up familiar and tasty foods for healthier alternatives. Shifts in eating behavior such as trying new healthy recipes and adopting a more restrictive diet were reported as most feasible and personally applicable after learning about a family member's declining health.

    Conclusions: In this urban, multiethnic population, increasing the accessibility of nutritious foods and changing cultural perceptions of the relationship between food and nutrition may be important for enabling healthy eating behaviors.

    Funding Sources: Yale Sustainable Food Program, Yale School of Public Health.

    Matched MeSH terms: Chronic Disease
  19. Kuan JW, Su AT, Leong CF, Osato M, Sashida G
    Acta Haematol., 2020;143(2):96-111.
    PMID: 31401626 DOI: 10.1159/000501146
    The treatment of chronic myeloid leukaemia (CML) requires quantitative polymerase chain reaction (qPCR) to monitor BCR-ABL1 in International Scale (IS). Some normal subjects were found to harbour BCR-ABL1. We performed a systematic review on normal subjects harbouring BCR-ABL1. A literature search was done on July 16, 2017 using EBSCOhost Research Databases interface and Western Pacific Region Index Medicus. Two authors selected the studies, extracted the data, and evaluated the quality of studies using the modified Appraisal Tool for Cross-Sectional Studies independently. The outcomes were prevalence, level of BCR-ABL1IS, proportion, and time of progression to CML. The initial search returned 4,770 studies. Eleven studies, all having used convenient sampling, were included, with total of 1,360 subjects. Ten studies used qualitative PCR and one used qPCR (not IS). The mean prevalence of M-BCR was 5.9, 15.5, and 15.9% in cord blood/newborns/infants (CB/NB/I) (n = 170), children (n = 90), and adults (n = 454), respectively, while m-BCR was 15, 26.9, and 23.1% in CB/NB/I (n = 786), children (n = 67), and adults (n = 208), respectively. No study reported the proportion and time of progression to CML. Nine studies were graded as moderate quality, one study as poor quality, and one study as unacceptable. The result of the studies could neither be inferred to the general normal population nor compared. Follow-up data were scarce.
    Matched MeSH terms: Chronic Disease
  20. Wan Muhamad Hatta SF, Lekkakou L, Viswananth A, Buch H
    BMJ Case Rep, 2019 Aug 20;12(8).
    PMID: 31434676 DOI: 10.1136/bcr-2019-230636
    Ectopic adrenocorticotropic hormone (ACTH) syndrome (EAS) is rarely caused by a phaeochromocytoma. We report a case of a 51-year-old woman with an 8-year history of severe constipation who underwent extensive investigations including gastroscopy, colonoscopy, ultrasonography, colonic transit studies and isotope defeacography, which did not reveal any pathology other than slow colonic transit time. The unifying diagnosis of ectopic ACTH and phaeochromocytoma was made after the case was initially investigated for an adrenal incidentaloma. Multiple challenges had to be overcome prior to surgery for the functioning adrenal adenoma including management of refractory hypokalaemia, poor nutritional status, persistent hyperglycaemia, labile blood pressure and florid hypercortisolaemia driving the metabolic derangements. She underwent an uneventful left-sided adrenalectomy and required no medication thereafter with normal blood pressure, blood glucose and serum potassium and resolution of constipation and abdominal symptoms. In conclusion, patients with EAS related to phaeochromocytoma are rare and present with distinctive diagnostic and management challenges but if diagnosed successfully and managed intensively, they are curable.
    Matched MeSH terms: Chronic Disease
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