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  1. Cheah KSL, Abdullah Z, Xiao M
    Int J Environ Res Public Health, 2022 Sep 16;19(18).
    PMID: 36141967 DOI: 10.3390/ijerph191811697
    Universities across China have set up crisis management teams (CMTS) to deal with the crisis brought on by the COVID-19 pandemic. This study focuses on how the paternalistic leadership practices of a Chinese university CMT influence crisis strategic decisions by managing conflict. These relationships were verified using hierarchical regression analysis on 312 samples from the surveyed university during the pandemic and found the following: benevolent leadership and moral leadership have positive effects on decision quality. However, unlike most studies on paternalistic leadership, in crisis situations, the negative effects of authoritarian leadership disappear under the mediating effect of affective conflict. This means that affective conflict within CMT fully mediates the relationship between authoritarian leadership and decision quality, and partially mediates the relationship between moral leadership and decision quality, while cognitive conflict partially mediates the relationship between benevolent leadership and crisis decision quality. It indicates that a CMT must stimulate and maintain a certain level of cognitive conflict while suppressing affective conflict to achieve high-quality crisis decision-making. This state can be achieved by practicing lower levels of authoritarian leadership and maintaining high levels of moral and benevolent leadership practices.
    Matched MeSH terms: Humans
  2. Wong ZW, New SY
    Mikrochim Acta, 2022 Dec 08;190(1):16.
    PMID: 36480078 DOI: 10.1007/s00604-022-05591-0
    A fluorescence biosensor has been developed based on hybridisation chain reaction (HCR) amplification coupled with silver nanoclusters (AgNCs) for nucleic acid detection. The fluorescence was activated via end-to-end transfer of dark AgNCs caged within a DNA template to another DNA sequence that could enhance their red fluorescence emission at 611 nm. Such cluster-transfer approach allows us to introduce fluorogenic AgNCs as external signal transducers, thereby enabling HCR to perform in a predictable manner. The resulted HCR-AgNC biosensor was able to detect target DNA with a detection limit of 3.35 fM, and distinguish the DNA target from single-base mismatch sequences. Moreover, the bright red fluorescence emission was detectable with the naked eye, with concentration of target DNA down to 1 pM. The biosensor also performed well in human serum samples with good recovery. Overall, our cluster-transfer approach provides a good alternative to construct HCR-AgNC assay with less risk of circuit leakage and produce AgNCs in a controllable manner.
    Matched MeSH terms: Humans
  3. Zeng R, Li H, Jia L, Lee SH, Jiang R, Zhang Y, et al.
    BMC Cancer, 2022 Dec 16;22(1):1317.
    PMID: 36527000 DOI: 10.1186/s12885-022-10369-x
    BACKGROUND: Acquired chemo-drug resistance constantly led to the failure of chemotherapy for malignant cancers, consequently causing cancer relapse. Hence, identifying the biomarker of drug resistance is vital to improve the treatment efficacy in cancer. The clinical prognostic value of CYP24A1 remains inconclusive, hence we aim to evaluate the association between CYP24A1 and the drug resistance in cancer patients through a meta-analysis approach.

    METHOD: Relevant studies detecting the expression or SNP of CYP24A1 in cancer patients up till May 2022 were systematically searched in four common scientific databases including PubMed, EMBASE, Cochrane library and ISI Web of Science. The pooled hazard ratios (HRs) indicating the ratio of hazard rate of survival time between CYP24A1high population vs CYP24A1low population were calculated. The pooled HRs and odds ratios (ORs) with 95% confidence intervals (CIs) were used to explore the association between CYP24A1's expression or SNP with survival, metastasis, recurrence, and drug resistance in cancer patients.

    RESULT: Fifteen studies were included in the meta-analysis after an initial screening according to the inclusion and exclusion criteria. There was a total of 3784 patients pooled from all the included studies. Results indicated that higher expression or SNP of CYP24A1 was significantly correlated with shorter survival time with pooled HRs (95% CI) of 1.21 (1.12, 1.31), metastasis with pooled ORs (95% CI) of 1.81 (1.11, 2.96), recurrence with pooled ORs (95% CI) of 2.14 (1.45, 3.18) and drug resistance with pooled HRs (95% CI) of 1.42 (1.17, 1.68). In the subgroup analysis, cancer type, treatment, ethnicity, and detection approach for CYP24A1 did not affect the significance of the association between CYP24A1 expression and poor prognosis.

    CONCLUSION: Findings from our meta-analysis demonstrated that CYP24A1's expression or SNP was correlated with cancer progression and drug resistance. Therefore, CYP24A1 could be a potential molecular marker for cancer resistance.

    Matched MeSH terms: Humans
  4. Jameel SK, Aydin S, Ghaeb NH, Majidpour J, Rashid TA, Salih SQ, et al.
    Biomolecules, 2022 Dec 16;12(12).
    PMID: 36551316 DOI: 10.3390/biom12121888
    Corneal diseases are the most common eye disorders. Deep learning techniques are used to perform automated diagnoses of cornea. Deep learning networks require large-scale annotated datasets, which is conceded as a weakness of deep learning. In this work, a method for synthesizing medical images using conditional generative adversarial networks (CGANs), is presented. It also illustrates how produced medical images may be utilized to enrich medical data, improve clinical decisions, and boost the performance of the conventional neural network (CNN) for medical image diagnosis. The study includes using corneal topography captured using a Pentacam device from patients with corneal diseases. The dataset contained 3448 different corneal images. Furthermore, it shows how an unbalanced dataset affects the performance of classifiers, where the data are balanced using the resampling approach. Finally, the results obtained from CNN networks trained on the balanced dataset are compared to those obtained from CNN networks trained on the imbalanced dataset. For performance, the system estimated the diagnosis accuracy, precision, and F1-score metrics. Lastly, some generated images were shown to an expert for evaluation and to see how well experts could identify the type of image and its condition. The expert recognized the image as useful for medical diagnosis and for determining the severity class according to the shape and values, by generating images based on real cases that could be used as new different stages of illness between healthy and unhealthy patients.
    Matched MeSH terms: Humans
  5. Lin Y, Cai CZ, Alias H, Wong LP, Hu Z
    Complement Ther Med, 2022 Dec;71:102898.
    PMID: 36372316 DOI: 10.1016/j.ctim.2022.102898
    OBJECTIVE: To investigate user behavioural profiles and the prevalence of self-medication with traditional Chinese medicine (TCM) for COVID-19 among the general public in China.

    DESIGN: Cross-sectional study.

    SETTING: Self-administered online survey was carried out between January and June 2021 in China.

    RESULTS: A total of 1132 complete responses were received from a nationwide sample. A considerable proportion viewed TCM to be more effective than Western medicine for treating COVID-19 (67.1 %) and stated that it is safer to use TCM (63.5 %) and easier to access TCM for treating COVID-19 (63.5 %). A total of 16.4 % (95 %CI 14.3-18.7) reported ever self-medicating with TCM to resolve COVID-19 symptoms and 12.2 % (95 % CI 10.3-14.2) ever using TCM to prevent SARS-CoV-2 infection. Lianhua Qingwen capsule/granule (53.2 %), Ganmao granule (50.5 %) and Banlangen granule (44.6 %) were most commonly used to resolve COVID-19 symptoms whereas Banlangen granule (60.1 %) was commonly used for the prevention of SARS-CoV-2 infection. Older age participants, from rural areas, with chronic diseases, higher socioeconomic status, and a positive attitude towards TCM were more likely to self-medicate using TCM to resolve COVID-19 symptoms.

    CONCLUSION: Self-medication with TCM during the COVID-19 pandemic for symptom control or prevention is prevalent. The findings of the user behavioural profile and types of TMCs commonly used in this study provide beneficial information for the development of strategies to improve public health-seeking behaviour and the performance of the country's healthcare system in the era of the COVID-19 pandemic.

    Matched MeSH terms: Humans
  6. Abdul Hadi MFR, Abdullah AN, Hashikin NAA, Ying CK, Yeong CH, Yoon TL, et al.
    Med Phys, 2022 Dec;49(12):7742-7753.
    PMID: 36098271 DOI: 10.1002/mp.15980
    PURPOSE: Monte Carlo (MC) simulation is an important technique that can help design advanced and challenging experimental setups. GATE (Geant4 application for tomographic emission) is a useful simulation toolkit for applications in nuclear medicine. Transarterial radioembolization is a treatment for liver cancer, where microspheres embedded with yttrium-90 (90 Y) are administered intra-arterially to the tumor. Personalized dosimetry for this treatment may provide higher dosimetry accuracy compared to the conventional partition model (PM) calculation. However, incorporation of three-dimensional tomographic input data into MC simulation is an intricate process. In this article, 3D Slicer, free and open-source software, was utilized for the incorporation of patient tomographic images into GATE to demonstrate the feasibility of personalized dosimetry in hepatic radioembolization with 90 Y.

    METHODS: In this article, the steps involved in importing, segmenting, and registering tomographic images using 3D Slicer were thoroughly described, before importing them into GATE for MC simulation. The absorbed doses estimated using GATE were then compared with that of PM. SlicerRT, a 3D Slicer extension, was then used to visualize the isodose from the MC simulation.

    RESULTS: A workflow diagram consisting of all the steps taken in the utilization of 3D Slicer for personalized dosimetry in 90 Y radioembolization has been presented in this article. In comparison to the MC simulation, the absorbed doses to the tumor and normal liver were overestimated by PM by 105.55% and 20.23%, respectively, whereas for lungs, the absorbed dose estimated by PM was underestimated by 25.32%. These values were supported by the isodose distribution obtained via SlicerRT, suggesting the presence of beta particles outside the volumes of interest. These findings demonstrate the importance of personalized dosimetry for a more accurate absorbed dose estimation compared to PM.

    CONCLUSION: The methodology provided in this study can assist users (especially students or researchers who are new to MC simulation) in navigating intricate steps required in the importation of tomographic data for MC simulation. These steps can also be utilized for other radiation therapy related applications, not necessarily limited to internal dosimetry.

    Matched MeSH terms: Humans
  7. Tamana S, Xenophontos M, Minaidou A, Stephanou C, Harteveld CL, Bento C, et al.
    Elife, 2022 Dec 01;11.
    PMID: 36453528 DOI: 10.7554/eLife.79713
    Haemoglobinopathies are the commonest monogenic diseases worldwide and are caused by variants in the globin gene clusters. With over 2400 variants detected to date, their interpretation using the American College of Medical Genetics and Genomics (ACMG)/Association for Molecular Pathology (AMP) guidelines is challenging and computational evidence can provide valuable input about their functional annotation. While many in silico predictors have already been developed, their performance varies for different genes and diseases. In this study, we evaluate 31 in silico predictors using a dataset of 1627 variants in HBA1, HBA2, and HBB. By varying the decision threshold for each tool, we analyse their performance (a) as binary classifiers of pathogenicity and (b) by using different non-overlapping pathogenic and benign thresholds for their optimal use in the ACMG/AMP framework. Our results show that CADD, Eigen-PC, and REVEL are the overall top performers, with the former reaching moderate strength level for pathogenic prediction. Eigen-PC and REVEL achieve the highest accuracies for missense variants, while CADD is also a reliable predictor of non-missense variants. Moreover, SpliceAI is the top performing splicing predictor, reaching strong level of evidence, while GERP++ and phyloP are the most accurate conservation tools. This study provides evidence about the optimal use of computational tools in globin gene clusters under the ACMG/AMP framework.
    Matched MeSH terms: Humans
  8. Tan TL, Salleh SA, Che Man Z, Tan MHP, Kader R, Jarmin R
    Medicina (Kaunas), 2022 Dec 05;58(12).
    PMID: 36556993 DOI: 10.3390/medicina58121789
    Background and Objectives: The objective of this study is to examine the effect of the BNT162b2 vaccine on systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and pulse pressure (PP) before and 15 min after two doses that were given 21 days apart. Materials and Methods: This active surveillance study of vaccine safety was conducted on 15 and 16 March (for the first dose) and 5 and 6 April (for the second dose) 2021 in an academic hospital. For both doses, SBP, DBP, MAP, and PP levels were measured before and 15 min after both doses were given to healthcare workers over the age of 18. The results of the study were based on measurements of the mean blood pressure (BP), the mean changes in BP, and the BP trends. Results: In total, 287 individuals received the vaccine. After the first dose, 25% (n = 72) of individuals had a decrease in DBP of at least 10 mmHg (mean DBP decrease: 15 mmHg, 95% CI: 14-17 mmHg), and after the second dose it was 12.5% (mean DBP decrease: 13 mmHg, 95% CI: 12-15 mmHg). After the first dose, 28.6% (n = 82) had a PP that was wider than 40 mmHg. After the first dose, 5.2% and 4.9% of the individuals experienced an increase or decrease in SBP, respectively, of more than 20 mmHg. After the second dose, the SBP of 11% (n = 32) decreased by at least 20 mmHg. Conclusions: Improved understanding of vaccine effects on BP may help address vaccine hesitancy in healthcare workers.
    Matched MeSH terms: Humans
  9. Eikelboom JW, Bosch J, Connolly SJ, Tyrwitt J, Fox KAA, Muehlhofer E, et al.
    Eur Heart J Cardiovasc Pharmacother, 2022 Dec 02;8(8):786-795.
    PMID: 35383832 DOI: 10.1093/ehjcvp/pvac023
    AIMS: To describe outcomes of patients with chronic coronary artery disease (CAD) and/or peripheral artery disease (PAD) enrolled in the Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) randomized trial who were treated with the combination of rivaroxaban 2.5 mg twice daily and aspirin 100 mg once daily during long-term open-label extension (LTOLE).

    METHODS AND RESULTS: Of the 27 395 patients enrolled in COMPASS, 12 964 (mean age at baseline 67.2 years) from 455 sites in 32 countries were enrolled in LTOLE and treated with the combination of rivaroxaban and aspirin for a median of 374 additional days (range 1-1191 days). During LTOLE, the incident events per 100 patient years were as follows: for the primary outcome [cardiovascular death, stroke, or myocardial infarction (MI)] 2.35 [95% confidence interval (CI) 2.11-2.61], mortality 1.87 (1.65-2.10), stroke 0.62 (0.50-0.76), and MI 1.02 (0.86-1.19), with CIs that overlapped those seen during the randomized treatment phase with the combination of rivaroxaban and aspirin. The incidence rates for major and minor bleeding were 1.01 (0.86-1.19) and 2.49 (2.24-2.75), compared with 1.67 (1.48-1.87) and 5.11 (95% CI 4.77-5.47), respectively, during the randomized treatment phase with the combination.

    CONCLUSION: In patients with chronic CAD and/or PAD, extended combination treatment for a median of 1 year and a maximum of 3 years was associated with incidence rates for efficacy and bleeding that were similar to or lower than those seen during the randomized treatment phase, without any new safety signals.

    Matched MeSH terms: Humans
  10. Tan KT, Benedict SLH, Gani YM, Chidambaran SK
    Med J Malaysia, 2022 Sep;77(5):590-596.
    PMID: 36169071
    INTRODUCTION: During the COVID-19 pandemic, bloodstream infection (BSI) rates were substantially rising in Sungai Buloh Hospital (HSB). It is believed that the COVID-19 pandemic has had an adverse impact on BSI incidence caused by contaminated periphery vascular catheters (PVCs). The study's objective is to reduce the BSI rates in HSB by improving adherence to the PVC care bundle via the Plan-Do-Study-Act (PDSA) approach.

    MATERIALS AND METHODS: A quality improvement (QI) project was employed over four months, from June to September 2021, during the COVID-19 pandemic in HSB. All adults hospitalised for COVID-19 with intravenous lines were subjected to data collection. A baseline audit was conducted to study BSI incidence from April to May 2021. Implementation was carried out by PDSA cycles and data on BSI rates per 100 admissions was described using a monthly run chart.

    RESULTS: At baseline, the BSI rate per 100 admissions was 5.44 before implementing our QI project. Initial changes via PDSA cycles did not bring significant improvements to BSI rates and a rising trend in BSI rates was observed after two PDSA cycles. Further audits identified the problem of noncompliance with the practice of aseptic non-touch technique (ANTT) and a lack of effective leadership in implementing the PVC care bundle. The third PDSA cycle focused on adopting practical leadership skills among senior clinicians to ensure compliance with the prevention bundle and to encourage the use of ultrasound guidance for difficult line insertion. After the third PDSA cycle, the BSI rate per 100 admissions was reduced from 6.41 to 4.34 (p < 0.05). The BSI rates continued to decline down the line for another five months.

    CONCLUSION: Through QI initiatives, the risk of BSI can be significantly reduced.

    Matched MeSH terms: Humans
  11. Al-Herz W, Ziyab AH, Adeli M, Al Farsi T, Al-Hammadi S, Al Kuwaiti AA, et al.
    Pediatr Allergy Immunol, 2022 Dec;33(12):e13901.
    PMID: 36564872 DOI: 10.1111/pai.13901
    BACKGROUND: There is an increased demand for hematopoietic stem cell transplant (HSCT) to treat various diseases including combined immunodeficiencies (CID), with limited worldwide availability. Variables affecting the decision regarding CID patients' prioritization for HSCT are not known. We aimed to determine general, clinical, and immunologic factors associated with the higher risk of early death (≤6 months after diagnosis) in untransplanted CID patients.

    METHODS: Data collection was done retrospectively from five centers and included general patients' information, and clinical and laboratory variables. Inclusion criteria were untransplanted patients who are either dead or alive with a follow-up period ≥6 months after diagnosis.

    RESULTS: Two hundred and thirty-six CID patients were reported by participating centers, of whom 111 were included in the study with a cumulative follow-up period of 278.6 years. Seventy-two patients died with the median age of death of 10.5 months. 35.1% of the patients succumbed within 6 months after the diagnosis. Having a history of Candida infections, sepsis or hepatomegaly was associated with an increased risk of early death. None of the other general or clinical variables was associated with such risk. Bivariate analysis of lymphocyte subsets showed that patients with the following counts: CD3+  

    Matched MeSH terms: Humans
  12. Puthiaparampil T, Rahman MM, Shazrina AR, Nariman S, Lukas S, Chai CS, et al.
    Med J Malaysia, 2022 Nov;77(6):724-729.
    PMID: 36448391
    INTRODUCTION: Our faculty used one long case (LC) and three short cases for the clinical component of the final professional examinations. During the COVID-19 pandemic, the LC had to be replaced with scenario-based clinical examination (SBCE) due to the impracticability of using recently hospitalised patients. While keeping the short case component as usual, the LC had to be replaced with SBCE in 2020 for the first time at a short notice. To evaluate the positive and negative aspects of SBCE and LC to determine the feasibility of replacing LC with SBCE in future examinations.

    MATERIALS AND METHODS: We compared the LC scores of three previous years with those of the SBCE and studied the feedback of the three stakeholders: students, examiners, and simulated patients (SPs), regarding their experience with SBCE and the suitability of SBCE as an alternative for LC in future examinations.

    RESULTS: The SBCE scores were higher than those of the LC. Most of the examiners and students were not in favour of SBCE replacing LC, as such. The SPs were more positive about the proposition. The comments of the three stakeholders brought out the plus and minus points of LC and SBCE, which prompted our proposals to make SBCE more practical for future examinations.

    CONCLUSION: Having analysed the feedback of the stakeholders, and the positive and negative aspects of LC and SBCE, it was evident that SBCE needed improvements. We have proposed eight modifications to SBCE to make it a viable alternative for LC.

    Matched MeSH terms: Humans
  13. Jaishree S, Chong KW, Lim TA
    Med J Malaysia, 2022 Nov;77(6):655-660.
    PMID: 36448381
    INTRODUCTION: Burnout is a psychological problem which is becoming more prevalent among medical professionals resulting in various negative outcomes. Physical activity has been found to be an effective method in alleviating burnout. The aim of this study was to determine the association between physical activity and burnout among postgraduate anaesthesia trainees in Malaysia. The study also intended to determine the level of physical activity among trainees, the factors affecting this practice, and the prevalence of burnout among anaesthesia trainees.

    MATERIALS AND METHODS: An online self-administered questionnaire was sent out to all postgraduate anaesthesia trainees between August 2020 and January 2021 via email and respondents were recruited on a voluntary basis.

    RESULTS: The prevalence of burnout among postgraduate anaesthesia trainees was high (54%). This prevalence was higher among trainees with low a level of physical activity. Half of the trainees (50.8%) engaged in moderate physical activity while only 12% reported a high level of physical activity. The postgraduate study year was found to be a significant factor affecting the practice of physical activity.

    CONCLUSION: There is a significant association between physical activity and burnout among postgraduate anaesthesia trainees in Malaysia. Physical activity has the potential to be an essential method of reducing burnout. Hence, measures should be implemented to improve the practice of physical activity among healthcare professionals in order to reduce workplace burnout.

    Matched MeSH terms: Humans
  14. Le VT, Thuy Le MA, Nguyen DH, Tang LNP, Pham TA, Nguyen AM, et al.
    Epilepsia Open, 2022 Dec;7(4):710-717.
    PMID: 36136063 DOI: 10.1002/epi4.12650
    OBJECTIVE: Although epilepsy surgery is more effective than medical therapy for drug-resistant patients, it is underutilized in both high-income and low- and middle-income countries. In light of our efforts to establish an epilepsy surgery program in a resource-limited setting, this study aimed to determine the outcome of the epilepsy surgery program in Ho Chi Minh City (HCMC), Vietnam.

    METHODS: In 2018, we developed the HCMC epilepsy core multidisciplinary team with members from various hospitals and centers. The team typically included neurologists, neurosurgeons, neuropsychologists, psychiatrists, and nursing specialists. Presurgical evaluations were performed for patients with drug-resistant epilepsy, fulfilling the ILAE criteria, with an epileptogenic lesion (mesial temporal sclerosis, low-grade gliomas, or focal cortical dysplasia). All epilepsy surgeries were performed in two epilepsy surgery centers in HCMC between 2018 and 2021. The patients were followed up for at least 12 months.

    RESULTS: Fifty-two patients with drug-resistant epilepsy underwent presurgical evaluation, of which 35 underwent surgery. Among the 52 patients, 20 (38.5%) underwent surgery after showing concordance among the results of standard presurgical assessments such as semiology, scalp interictal or ictal electroencephalography, and brain imaging. Among the 26 people with epilepsy who required more advanced evaluations, 15 underwent surgery with intraoperative electrocorticography to delineate the optimal resection borders. The outcomes of Engel Class I and Class II were achieved in 29/35 (82.8%) and 6/35 (17.2%) patients, respectively.

    SIGNIFICANCE: The epilepsy surgery program with a multicentered collaborative model in a resource-limited setting showed favorable outcomes in HCMC, Vietnam.

    Matched MeSH terms: Humans
  15. Walsh SM, Forward CL, Flaherty GT
    J Sleep Res, 2022 Dec;31(6):e13672.
    PMID: 35726362 DOI: 10.1111/jsr.13672
    Parasomnias are undesirable events that occur during sleep. They can be classified into rapid eye movement parasomnias and non-rapid eye movement parasomnias. Those who experience parasomnias may be anxious about travel for many reasons, including the occurrence of unwanted events during the trip, increased exposure to environmental trigger factors, and the propensity for harm to occur due to unfamiliar surroundings while travelling. There is a paucity of literature examining this area. This review summarizes the relevant literature and the clinical experience of the authors to compile clinical practice recommendations. The clinical features of parasomnias and how they relate to trans-meridian and long-distance travel are described. Triggers for non-rapid eye movement parasomnias, particularly the use of sedative hypnotic drugs, alcohol, drug withdrawal, sleep deprivation, emotional stress and environmental stimulations, are described. Management of parasomnias whilst travelling is reviewed, with a particular focus on trigger minimalization. The role for clonazepam and melatonin is outlined. At the pre-travel health consultation, the physician is strongly advised to screen the traveller for co-morbid sleep conditions, which exacerbate parasomnias. Areas for further research are explored, including the extent to which these sleep disorders impact on the travel experience.
    Matched MeSH terms: Humans
  16. Sugano K, Spechler SJ, El-Omar EM, McColl KEL, Takubo K, Gotoda T, et al.
    Gut, 2022 Aug;71(8):1488-1514.
    PMID: 35725291 DOI: 10.1136/gutjnl-2022-327281
    OBJECTIVE: An international meeting was organised to develop consensus on (1) the landmarks to define the gastro-oesophageal junction (GOJ), (2) the occurrence and pathophysiological significance of the cardiac gland, (3) the definition of the gastro-oesophageal junctional zone (GOJZ) and (4) the causes of inflammation, metaplasia and neoplasia occurring in the GOJZ.

    DESIGN: Clinical questions relevant to the afore-mentioned major issues were drafted for which expert panels formulated relevant statements and textural explanations.A Delphi method using an anonymous system was employed to develop the consensus, the level of which was predefined as ≥80% of agreement. Two rounds of voting and amendments were completed before the meeting at which clinical questions and consensus were finalised.

    RESULTS: Twenty eight clinical questions and statements were finalised after extensive amendments. Critical consensus was achieved: (1) definition for the GOJ, (2) definition of the GOJZ spanning 1 cm proximal and distal to the GOJ as defined by the end of palisade vessels was accepted based on the anatomical distribution of cardiac type gland, (3) chemical and bacterial (Helicobacter pylori) factors as the primary causes of inflammation, metaplasia and neoplasia occurring in the GOJZ, (4) a new definition of Barrett's oesophagus (BO).

    CONCLUSIONS: This international consensus on the new definitions of BO, GOJ and the GOJZ will be instrumental in future studies aiming to resolve many issues on this important anatomic area and hopefully will lead to better classification and management of the diseases surrounding the GOJ.

    Matched MeSH terms: Humans
  17. Sari ARP, Radiono S, Soebono H, Ferronika P
    Malays J Pathol, 2022 Dec;44(3):491-498.
    PMID: 36591716
    INTRODUCTION: Less biopsies were expected when large scale social restrictions were enforced during COVID-19 pandemic.

    AIM: To compare the skin diseases prompting biopsy before and during the COVID-19 pandemic.

    MATERIALS AND METHODS: A retrospective study of skin diseases was performed; the skin problems were then grouped into major histopathological reactions.

    RESULTS: A total of 229 biopsies were performed before the COVID-19 outbreak, whereas only 160 biopsies were done during the pandemic. Before versus during the outbreak, the proportion of major reactions were granulomatous 20.52% vs 21.88%, neoplasms 17.47% vs 20%, psoriasiform 14.85% vs 10%, vesiculobullous 9.61% vs 8.75%, others 10.92% vs 7.50%, interface dermatitis 6.99% vs 10%, vasculopathy 6.99% vs 5.63%, spongiotic 6.55% vs 8.13%, panniculitis 3.49% vs 3.75%, and superficial and deep dermal infiltrate 2.62% vs 4.38%.

    CONCLUSION: A decreased total number of patients prompting less biopsies were reported during the COVID-19 outbreak. However, the three largest percentages of major histopathological reactions were still similar, namely granulomatous, neoplasms, and psoriasiform.

    Matched MeSH terms: Humans
  18. Tyrrell L, Scruggs M, Kerwin A, Kahwash SB
    Malays J Pathol, 2022 Dec;44(3):397-413.
    PMID: 36591709
    Platelets, along with coagulation factors and vasculature, represent the three main compartments of hemostasis. Upon investigation of a suspected hemostasis disorder, platelet count, size and morphology often offer important clues to the diagnosis or help narrow the differential diagnosis. In this review, we describe a general approach to diagnosing platelet disorders, starting with easily obtained data such as findings of complete blood count (CBC) and microscopic review of a stained peripheral blood smear. We discuss general findings that help separate consumptive from underproduction thrombocytopenia. We further touch on inherited thrombocytopenia disorders after classifying them into those associated with small, normal sized or large platelets. Illustrative microscopic images are provided where contributory. We conclude with a suggested algorithmic step-by-step approach to investigating a suspected platelet disorder in children.
    Matched MeSH terms: Humans
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