Displaying publications 21 - 40 of 426 in total

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  1. Fulltext Pharmacotherapy for comorbid adult attention-deficit hyperactivity disorder and stimulant dependence: a systematic review
    Woon, L.S., Hazli Z., Gan, L.L.Y.
    International Medical Journal Malaysia, 2018;17(2):149-161.
    MyJurnal
    Comorbid adult attention-deficit hyperactivity disorder (ADHD) and stimulant dependence is widely recognized, but efficacy of pharmacotherapy in this patient population is not well established. We aimed to review whether pharmacotherapy is efficacious in reducing ADHD symptoms and stimulant use in comorbid adult ADHD and stimulant use disorder. English articles until June 2017 were systematically searched in electronic databases (MEDLINE and PsycINFO), an online clinical trials register (ClinicalTrial.gov), and through hand-search of article references. Randomized, double-blind, placebo-controlled trials that studied efficacy of pharmacotherapy in adults with comorbid ADHD and stimulant dependence were included. Two reviewers assessed studies for inclusion and extracted data; disagreements were resolved by consensus. Study outcomes included were changes in ADHD symptom severity, substance abstinence, treatment retention rates and safety. From the 1394 records identified, five trials (n=358) were included. Four studies involved methylphenidate; in another study extended-release mixed amphetamine were used. The comorbid stimulant was cocaine in three studies, and amphetamines in the rest. All were short-term studies involving predominantly young male adults conducted in outpatient settings. There is early promising but mixed evidence for therapeutic efficacy in improving ADHD symptoms. Stimulant medications did not worsen stimulant dependence or adverse effects of stimulant medications. Side effects were mild and tolerable. High attrition rates and small sample size limited the generalizability of findings. Current limited evidence suggests that stimulant treatment for comorbid adult ADHD and stimulant dependence is feasible. Welldesigned trials with adequate power are needed for more robust evidence on ADHD and stimulant use outcomes.
    Matched MeSH terms: Central Nervous System Stimulants
  2. Fulltext Knowledge, belief and barriers to adult influenza and pneumococcal vaccination among primary care doctors in Sarawak
    Wong, L. K. S., Muthupalaniappen, L., Tie, S. T.
    Medicine & Health, 2017;12(2):275-285.
    MyJurnal
    Adult influenza and pneumococcal vaccinations are grossly underutilized although there is clear benefit in reducing mortality and morbidity among those at risk. The aim of the study was to assess primary care physician’s knowledge on adult influenza and pneumococcal vaccinations, their beliefs and barriers to vaccination. A cross-sectional study using self-administered questionnaires was conducted at eight primary care centres in Kuching, Sarawak. A total of 108 primary care physicians participated in this study. Median age of participants was 29 years (IQR 4.0). The median knowledge score for influenza vaccine was 9 (IQR 3) and for pneumococcal vaccine was 8 (IQR 4). Female participants scored higher compared to their male counterparts for influenza and pneumococcal vaccines (P = 0.005 & 0.007). The highest percentage of correct responses for influenza vaccination was for side effects (75.3%) while the lowest was for contraindications (9.3%). The highest percentage of correct responses for pneumococcal vaccination was for side effects (69.1%) while the lowest was for advocated target groups (6.2%). Most participants believed that pneumococcal and influenza vaccines were safe (92.8 & 99%) and beneficial for patients (89.7 & 93.8%). Cost of influenza and pneumococcal vaccines (94.8% & 96.9%) and their availability (86.6% & 89.7%) were the main barriers to prescribing them. Primary care physicians in the public sector have moderate knowledge of both adult vaccinations. Areas of knowledge paucity and barriers need to be addressed to ensure a more comprehensive health care delivery to the aging Malaysian population.
    Keywords: adult, belief, influenza vaccines, knowledge, pneumococcal vaccines
    Matched MeSH terms: Autonomic Nervous System Diseases
  3. Fulltext Prevalence of microvascular complications in newly diagnosed type 2 diabetes mellitus in primary healthcare clinics
    Wong WL, Valliappan VN, Leong MC, Aminudin SNA, Chew SCJ, Cheong AT
    Malaysian Journal of Medicine and Health Sciences, 2020;16(2):237-243.
    MyJurnal
    Introduction: Delayed diagnosis of type 2 diabetes mellitus (T2D) increases the risk of presenting late with microvas- cular complications due to untreated long-standing hyperglycaemia. This study aimed to determine the prevalence of microvascular complications in newly diagnosed T2D patients in primary healthcare clinics.
    Methods: This was a cross-sectional study carried out in three government primary healthcare clinics in the state of Selangor, Malaysia. Malaysian aged 18 years and above with newly diagnosed T2D (<6 months of diagnosis) were invited to participate in the study. Data collected included the sociodemographic characteristic and the clinical profile (weight, height, waist circumference, blood pressure, lipid, glycaemic, urine albumin, microalbuminuria and renal profile). The assessment of nephropathy, peripheral neuropathy and retinopathy were performed using standard protocol. Multivariate logistic regression analysis was used to identify the significant factors that contribute to the presence of microvascular complications.
    Results: A total of 162 newly diagnosed patients were recruited. The majority was women (64%). The mean age was 51 (SD 11) years. About one-third of the patients (27.7%) had developed at least one microvascular complication. Nephropathy was the commonest microvascular complication (19.2%), followed by peripheral neuropathy (8.6%) and retinopathy (6.5%). Poor glycaemic control was found to be a significant factor contributing to the presence of microvascular complications (OR 5.8, 95%CI:1.466, 23.288).
    Conclusion: There is a high prevalence of microvascular complications among the newly diagnosed T2D. There is a need to develop appropriate strategies to increase the awareness and early detection of T2D.
    Study site: three Klinik Kesihatan, Selangor, Malaysia
    Matched MeSH terms: Peripheral Nervous System Diseases
  4. Fulltext CRISPR Gene-Editing Models Geared Toward Therapy for Hereditary and Developmental Neurological Disorders
    Wong PK, Cheah FC, Syafruddin SE, Mohtar MA, Azmi N, Ng PY, et al.
    Front Pediatr, 2021;9:592571.
    PMID: 33791256 DOI: 10.3389/fped.2021.592571
    Hereditary or developmental neurological disorders (HNDs or DNDs) affect the quality of life and contribute to the high mortality rates among neonates. Most HNDs are incurable, and the search for new and effective treatments is hampered by challenges peculiar to the human brain, which is guarded by the near-impervious blood-brain barrier. Clustered Regularly Interspaced Short Palindromic Repeat (CRISPR), a gene-editing tool repurposed from bacterial defense systems against viruses, has been touted by some as a panacea for genetic diseases. CRISPR has expedited the research into HNDs, enabling the generation of in vitro and in vivo models to simulate the changes in human physiology caused by genetic variation. In this review, we describe the basic principles and workings of CRISPR and the modifications that have been made to broaden its applications. Then, we review important CRISPR-based studies that have opened new doors to the treatment of HNDs such as fragile X syndrome and Down syndrome. We also discuss how CRISPR can be used to generate research models to examine the effects of genetic variation and caffeine therapy on the developing brain. Several drawbacks of CRISPR may preclude its use at the clinics, particularly the vulnerability of neuronal cells to the adverse effect of gene editing, and the inefficiency of CRISPR delivery into the brain. In concluding the review, we offer some suggestions for enhancing the gene-editing efficacy of CRISPR and how it may be morphed into safe and effective therapy for HNDs and other brain disorders.
    Matched MeSH terms: Nervous System Diseases
  5. Clinical and pathological manifestations of human henipavirus infection
    Wong KT, Tan CT
    Curr. Top. Microbiol. Immunol., 2012;359:95-104.
    PMID: 22427144 DOI: 10.1007/82_2012_205
    The clinicopathological features of human Nipah virus and Hendra virus infections appear to be similar. The clinical manifestations may be mild, but if severe, includes acute encephalitic and pulmonary syndromes with a high mortality. The pathological features in human acute henipavirus infections comprise vasculopathy (vasculitis, endothelial multinucleated syncytia, thrombosis), microinfarcts and parenchymal cell infection in the central nervous system, lung, kidney and other major organs. Viral inclusions, antigens, nucleocapsids and RNA are readily demonstrated in blood vessel wall and numerous types of parenchymal cells. Relapsing henipavirus encephalitis is a rare complication reported in less than 10% of survivors of the acute infection and appears to be distinct from the acute encephalitic syndrome. Pathological evidence suggests viral recrudescence confined to the central nervous system as the cause.
    Matched MeSH terms: Central Nervous System/pathology*; Central Nervous System/virology
  6. Enterovirus 71 encephalomyelitis and Japanese encephalitis can be distinguished by topographic distribution of inflammation and specific intraneuronal detection of viral antigen and RNA
    Wong KT, Ng KY, Ong KC, Ng WF, Shankar SK, Mahadevan A, et al.
    Neuropathol. Appl. Neurobiol., 2012 Aug;38(5):443-53.
    PMID: 22236252 DOI: 10.1111/j.1365-2990.2011.01247.x
    To investigate if two important epidemic viral encephalitis in children, Enterovirus 71 (EV71) encephalomyelitis and Japanese encephalitis (JE) whose clinical and pathological features may be nonspecific and overlapping, could be distinguished.
    Matched MeSH terms: Central Nervous System/pathology*; Central Nervous System/virology
  7. Fulltext The distribution of inflammation and virus in human enterovirus 71 encephalomyelitis suggests possible viral spread by neural pathways
    Wong KT, Munisamy B, Ong KC, Kojima H, Noriyo N, Chua KB, et al.
    J. Neuropathol. Exp. Neurol., 2008 Feb;67(2):162-9.
    PMID: 18219253 DOI: 10.1097/nen.0b013e318163a990
    Previous neuropathologic studies of Enterovirus 71 encephalomyelitis have not investigated the anatomic distribution of inflammation and viral localization in the central nervous system (CNS) in detail. We analyzed CNS and non-CNS tissues from 7 autopsy cases from Malaysia and found CNS inflammation patterns to be distinct and stereotyped. Inflammation was most marked in spinal cord gray matter, brainstem, hypothalamus, and subthalamic and dentate nuclei; it was focal in the cerebrum, mainly in the motor cortex, and was rare in dorsal root ganglia. Inflammation was absent in the cerebellar cortex, thalamus, basal ganglia, peripheral nerves, and autonomic ganglia. The parenchymal inflammatory response consisted of perivascular cuffs, variable edema, neuronophagia, and microglial nodules. Inflammatory cells were predominantly CD68-positive macrophage/microglia, but there were a few CD8-positive lymphocytes. There were no viral inclusions; viral antigens and RNA were localized only in the somata and processes of small numbers of neurons and in phagocytic cells. There was no evidence of virus in other CNS cells, peripheral nerves, dorsal root autonomic ganglia, or non-CNS organs. The results indicate that Enterovirus 71 is neuronotropic, and that, although hematogenous spread cannot be excluded, viral spread into the CNS could be via neural pathways, likely the motor but not peripheral sensory or autonomic pathways. Viral spread within the CNS seems to involve motor and possibly other pathways.
    Matched MeSH terms: Central Nervous System/physiopathology; Central Nervous System/virology*
  8. Emerging and re-emerging epidemic encephalitis: a tale of two viruses
    Wong KT
    Neuropathol. Appl. Neurobiol., 2000 Aug;26(4):313-8.
    PMID: 10931364
    Two major epidemics of viral encephalitis occurred in Asia in 1997 and 1998. The first was a re-emergence of neurovirulent strains of enterovirus 71, which caused severe encephalomyelitis in children in Malaysia, Taiwan and Japan, on a background of hand, foot and mouth disease. Necropsy studies of patients who died of enterovirus 71 infection showed severe perivascular cuffing, parenchymal inflammation and neuronophagia in the spinal cord, brainstem and diencephalon, and in focal areas in the cerebellum and cerebrum. Although no viral inclusions were detected, immunohistochemistry showed viral antigen in the neuronal cytoplasm. Inflammation was often more extensive than neuronal infection, suggesting that other factors, in addition to direct viral cytolysis, may be involved in tissue damage. The second epidemic of viral encephalitis was the result of a novel paramyxovirus called Nipah, which mainly involved pig handlers in Malaysia and Singapore. Pathological evidence suggested that the endothelium of small blood vessels in the central nervous system was particularly susceptible to infection. This led to disseminated endothelial damage and syncytium formation, vasculitis, thrombosis, ischaemia and microinfarction. However, there was also evidence of neuronal infection by the virus and this may also have contributed to the neurological dysfunction in Nipah encephalitis. Some patients who seemed to recover from the acute symptoms have been re-admitted with clinical findings suggestive of relapsing encephalitis. As these two epidemics indicate, the emergence and re-emergence of viral encephalitides continue to pose considerable challenges to the neuropathologist, in establishing the diagnosis and unravelling the pathogenesis of the neurological disease.
    Matched MeSH terms: Central Nervous System/blood supply; Central Nervous System/pathology; Central Nervous System/virology
  9. Nipah virus infection: pathology and pathogenesis of an emerging paramyxoviral zoonosis
    Wong KT, Shieh WJ, Kumar S, Norain K, Abdullah W, Guarner J, et al.
    Am J Pathol, 2002 Dec;161(6):2153-67.
    PMID: 12466131
    In 1998, an outbreak of acute encephalitis with high mortality rates among pig handlers in Malaysia led to the discovery of a novel paramyxovirus named Nipah virus. A multidisciplinary investigation that included epidemiology, microbiology, molecular biology, and pathology was pivotal in the discovery of this new human infection. Clinical and autopsy findings were derived from a series of 32 fatal human cases of Nipah virus infection. Diagnosis was established in all cases by a combination of immunohistochemistry (IHC) and serology. Routine histological stains, IHC, and electron microscopy were used to examine autopsy tissues. The main histopathological findings included a systemic vasculitis with extensive thrombosis and parenchymal necrosis, particularly in the central nervous system. Endothelial cell damage, necrosis, and syncytial giant cell formation were seen in affected vessels. Characteristic viral inclusions were seen by light and electron microscopy. IHC analysis showed widespread presence of Nipah virus antigens in endothelial and smooth muscle cells of blood vessels. Abundant viral antigens were also seen in various parenchymal cells, particularly in neurons. Infection of endothelial cells and neurons as well as vasculitis and thrombosis seem to be critical to the pathogenesis of this new human disease.
    Matched MeSH terms: Central Nervous System/pathology; Central Nervous System/virology; Central Nervous System Viral Diseases/diagnosis; Central Nervous System Viral Diseases/epidemiology; Central Nervous System Viral Diseases/pathology; Central Nervous System Viral Diseases/virology
  10. An Overview of Culinary and Medicinal Mushrooms in Neurodegeneration and Neurotrauma Research
    Wong KH, Ng CC, Kanagasabapathy G, Yow YY, Sabaratnam V
    Int J Med Mushrooms, 2017;19(3):191-202.
    PMID: 28605334 DOI: 10.1615/IntJMedMushrooms.v19.i3.10
    Culinary and medicinal mushrooms have been appreciated since prehistoric times as valuable resources for food and medicine. Edible mushrooms represent an untapped source of nutraceuticals and valuable palatable food. Long considered tonics, they are now treasured as functional foods that can improve human health and quality of life. Numerous studies have provided insights into the neuroprotective effects of edible mushrooms, which are attributed to their antioxidant, antineuroinflammatory, and cholinesterase inhibitory properties, and their ability to prevent neuronal death. Here we review the recent literature on the role of culinary and medicinal mushrooms in the management of neurodegenerative diseases and neurotrauma. We highlight some of the molecular mechanisms for how these alternative medicines provide health benefits that could help us to harness their neuroprotective effects.
    Matched MeSH terms: Nervous System; Trauma, Nervous System/therapy*
  11. Fulltext Bickerstaff brainstem encephalitis with Guillain-Barré syndrome overlap following chlamydia infection
    Wong CK, Ng CF, Tan HJ, Mukari SAM
    BMJ Case Rep, 2021 May 24;14(5).
    PMID: 34031085 DOI: 10.1136/bcr-2021-242090
    Bickerstaff brainstem encephalitis (BBE) is a rare autoimmune encephalitis characterised by ataxia, ophthalmoplegia and altered consciousness. An overlap between BBE with Guillain-Barré syndrome (GBS) shows similar clinical and immunological features. We report a case of BBE with GBS overlap secondary to Chlamydia pneumoniae infection. The triad of altered consciousness, ataxia and ophthalmoplegia were present in the patient. The investigations included cerebrospinal fluid cytoalbuminological dissociation, nerve conduction test that showed prolonged or absent F wave latencies, hyperintensity in the left occipital region on brain MRI and diffuse slow activity on the electroencephalogram. The chlamydia serology was positive indicating a postinfectious cause of BBE syndrome. He required artificial ventilation as his consciousness level deteriorated with tetraparesis, oropharyngeal and respiratory muscle weakness. Immunotherapy with intravenous immunoglobulin and methylprednisolone was commenced. He made good recovery with the treatment. Prompt recognition of this rare condition following chlamydia infection is important to guide the management.
    Matched MeSH terms: Autoimmune Diseases of the Nervous System*
  12. Fulltext Olfaction, experience and neural mechanisms underlying mosquito host preference
    Wolff GH, Riffell JA
    J Exp Biol, 2018 02 27;221(Pt 4).
    PMID: 29487141 DOI: 10.1242/jeb.157131
    Mosquitoes are best known for their proclivity towards biting humans and transmitting bloodborne pathogens, but there are over 3500 species, including both blood-feeding and non-blood-feeding taxa. The diversity of host preference in mosquitoes is exemplified by the feeding habits of mosquitoes in the genus Malaya that feed on ant regurgitation or those from the genus Uranotaenia that favor amphibian hosts. Host preference is also by no means static, but is characterized by behavioral plasticity that allows mosquitoes to switch hosts when their preferred host is unavailable and by learning host cues associated with positive or negative experiences. Here we review the diverse range of host-preference behaviors across the family Culicidae, which includes all mosquitoes, and how adaptations in neural circuitry might affect changes in preference both within the life history of a mosquito and across evolutionary time-scales.
    Matched MeSH terms: Nervous System Physiological Phenomena*
  13. Fulltext A call for a global COVID-19 Neuro Research Coalition
    Winkler AS, Knauss S, Schmutzhard E, Leonardi M, Padovani A, Abd-Allah F, et al.
    Lancet Neurol, 2020 06;19(6):482-484.
    PMID: 32470416 DOI: 10.1016/S1474-4422(20)30150-2
    Matched MeSH terms: Nervous System Diseases/therapy; Nervous System Diseases/virology*
  14. Fulltext Newborn with Gastroschisis associated with Limb Anomalies
    Win PP
    J Neonatal Surg, 2017 01 01;6(1):8.
    PMID: 28083494 DOI: 10.21699/jns.v6i1.443
    Gastroschisis is often found together with other extra intestinal conditions such as limb, spine, cardiac, central nervous system and genitourinary abnormalities. There are reports of its association with young maternal age. The cases presented here highlight the association of gastroschisis with limbs anomalies and young maternal age.
    Matched MeSH terms: Nervous System
  15. Fulltext Evoked K-complexes and altered interaction between the central and autonomic nervous systems during sleep in alcohol use disorder
    Willoughby AR, de Zambotti M, Baker FC, Colrain IM
    Alcohol, 2020 May;84:1-7.
    PMID: 31539623 DOI: 10.1016/j.alcohol.2019.09.005
    There is evidence for impairment in both central nervous system (CNS) and autonomic nervous system (ANS) function with prolonged alcohol use. While these impairments persist into abstinence, partial recovery of function has been demonstrated in both systems during sleep. To investigate potential ANS dysfunction associated with cortical CNS responses (impairment in CNS-ANS coupling), we assessed phasic heart rate (HR) fluctuation associated with tones that did and those that did not elicit a K-complex (KC) during stable N2 non-rapid eye movement (NREM) sleep in a group of 16 recently abstinent alcohol use disorder (AUD) patients (41.6 ± 8.5 years) and a group of 13 sex- and age-matched control participants (46.6 ± 9.3 years). Electroencephalogram (EEG) and electrocardiogram (ECG) data were recorded throughout the night. Alcohol consumption questionnaires were also administered to the AUD patients. AUD patients had elevated HR compared to controls at baseline prior to tone presentation. The HR fluctuation associated with KCs elicited by tone presentation was significantly smaller in amplitude, and tended to be delayed in time, in the AUD group compared with the control group, and the subsequent deceleration was also smaller in AUD patients. In both groups, the increase in HR was larger and occurred earlier when KCs were produced than when they were not, and there was no difference in the magnitude of the KC effect between groups. Phasic HR changes associated with KCs elicited by tones are impaired in AUD participants, reflecting ANS dysfunction possibly caused by an alteration of cardiac vagal trafficking. However, only the timing of the HR response was found to relate to estimated lifetime alcohol consumption in AUD. The clinical meaning and implications of these novel findings need to be determined.
    Matched MeSH terms: Autonomic Nervous System/physiopathology*; Central Nervous System/physiology*
  16. Combination of transcranial direct current stimulation and methylphenidate in subacute stroke
    Wang QM, Cui H, Han SJ, Black-Schaffer R, Volz MS, Lee YT, et al.
    Neurosci Lett, 2014 May 21;569:6-11.
    PMID: 24631567 DOI: 10.1016/j.neulet.2014.03.011
    Noninvasive transcranial direct current stimulation (tDCS) and methylphenidate (MP) are associated with motor recovery after stroke. Based on the potentially complementary mechanisms of these interventions, we examined whether there is an interactive effect between MP and tDCS. In this preliminary study, we randomized subacute stroke subjects to receive tDCS alone, MP alone or combination of tDCS and MP. A blinded rater measured safety, hand function, and cortical excitability before and after treatment. None of the treatments caused any major or severe adverse effects or induced significant differences in cortical excitability. Analysis of variance of gain score, as measured by Purdue pegboard test, showed a significant between-group difference (F(2,6)=12.167, p=0.008). Post hoc analysis showed that the combination treatment effected greater Purdue pegboard gain scores than tDCS alone (p=0.017) or MP alone (p=0.01). Our preliminary data with nine subjects shows an interesting dissociation between motor function improvement and lack of motor corticospinal plasticity changes as indexed by transcranial magnetic stimulation in subacute stroke subjects.
    Matched MeSH terms: Central Nervous System Stimulants/therapeutic use*
  17. Penjadualan kerja berkala jururawat menggunakan kaedah pengaturcaraan gol 0-1
    Wan Rosmanira Ismail, Liong CY, Mohd. Khairi Muda, Ruzzakiah Jenal
    Sains Malaysiana, 2009;38.
    Penjadualan jururawat merupakan perkara penting dalam memastikan perkhidmatan yang berterusan dapat diberikan kepada para pesakit. Corak bertugas yang berterusan iaitu 24 jam sehari 7 hari seminggu, memerlukan waktu kerja mengikut syif yang boleh mengakibatkan perubahan kepada kehidupan sosial dan masalah kesihatan kepada jururawat. Oleh itu, pembangunan sebuah model penjadualan jururawat yang boleh diterima pakai oleh semua pihak dan bersifat adil amatlah penting untuk memastikan perkhidmatan berterusan yang berkualiti. Proses penjadualan melibatkan beberapa peraturan dan kekangan yang perlu dipertimbangkan, iaitu berdasarkan polisi yang telah ditentukan oleh pihak hospital dan permintaan daripada jururawat sendiri. Polisi atau objektif hospital antara lain adalah memastikan bilangan minimum jururawat setiap syif, mengelakkan pengasingan hari bertugas dan mempertimbangkan permintaan cuti daripada jururawat. Permintaan jururawat yang diambil kira pula adalah seperti mendapat bilangan hari bertugas yang sama per jadual, bilangan syif pagi yang melebihi syif petang dan memperolehi sekurang-kurangnya sekali cuti hujung minggu dalam tempoh jadual 2 minggu. Model dibangunkan menggunakan data daripada sebuah hospital tempatan. Kaedah pengaturcaraan gol 0-1 diaplikasikan di dalam pembangunan model penjadualan jururawat ini kerana keupayaannya menghasilkan sebuah model dengan pelbagai matlamat. Jadual kerja berkala ini akan dibina setiap 2 minggu. Daripada hasil penyelesaian yang diperoleh menggunakan perisian Lingo, didapati model penjadualan jururawat yang dibangunkan memenuhi polisi pihak hospital dan permintaan jururawat. Model penjadualan jururawat ini mampu memberikan penyelesaian yang lebih baik berbanding penjadualan semasa secara manual yang mana pengagihan syif adalah lebih sama rata di kalangan jururawat dari segi bilangan syif pagi, petang dan juga malam.
    Matched MeSH terms: Autonomic Nervous System Diseases
  18. Fulltext Deep vein thrombosis as a rare presentation in a female with anti-neutrophil cytoplasmic antibodies-associated vasculitis
    Wan Ghazali WS, Mohammad N, Ismail AM
    Arch Rheumatol, 2017 Jun;32(2):171-174.
    PMID: 30375559 DOI: 10.5606/ArchRheumatol.2017.6108
    This article aims to report a case of a young female patient with anti-neutrophil cytoplasmic antibodies-associated vasculitis complicated with pulmonary renal syndrome, multiple relapses, and who later developed venous thromboembolism. Pulmonary renal syndrome is a well- recognized and lethal complication; however, incidence of venous thromboembolism has not been well-described. In this article, we described a 38-year-old Malay female patient admitted in 2008 with three-month history of peripheral neuropathy of lower limbs and right ankle ulcers. Initial inflammatory markers were high and perinuclear Anti-Neutrophil Cytoplasmic Antibodies were positive. She was diagnosed as anti-neutrophil cytoplasmic antibodies-associated vasculitis and started on intravenous methylprednisolone with methotrexate. She presented with relapse of skin vasculitis complicated with pulmonary renal syndrome after being stable for one year. She was intubated and proceeded with plasmapheresis and hemodialysis. She completed six cycles of cyclophosphamide. Renal biopsy revealed chronic changes consistent with end stage renal disease. She further relapsed in 2011 with nasal blockage, epistaxis, and nasal deviation. Chest X-ray revealed lung nodules. Prednisolone was increased, her symptoms settled, and she was discharged with azathioprine. She was readmitted at the end of the same year due to two-day history of right deep vein thrombosis and she later succumbed to methicillin-resistant Staphylococcus aureus sepsis.
    Matched MeSH terms: Peripheral Nervous System Diseases
  19. Dexamphetamine increased speech and visual unimodal illusions in healthy participants without affecting temporal binding window
    Voon FL, Loffman SJ, Lim MJH, Lee JWY, Iyyalol R, Martin-Iverson MT
    Hum Psychopharmacol, 2024 May;39(3):e2896.
    PMID: 38353526 DOI: 10.1002/hup.2896
    OBJECTIVE: Stimuli received beyond a very short timeframe, known as temporal binding windows (TBWs), are perceived as separate events. In previous audio-visual multisensory integration (McGurk effect) studies, widening of TBWs has been observed in people with schizophrenia. The present study aimed to determine if dexamphetamine could increase TBWs in unimodal auditory and unimodal visual illusions that may have some validity as experimental models for auditory and visual hallucinations in psychotic disorders.

    METHODS: A double-blind, placebo-controlled, counter-balanced crossover design with permuted block randomisation for drug order was followed. Dexamphetamine (0.45 mg/kg, PO, q.d.) was administered to healthy participants. Phantom word illusion (speech illusion) and visual-induced flash illusion/VIFI (visual illusion) tests were measured to determine if TBWs were altered as a function of delay between stimuli presentations. Word emotional content for phantom word illusions was also analysed.

    RESULTS: Dexamphetamine significantly increased the total number of phantom words/speech illusions (p 

    Matched MeSH terms: Central Nervous System Stimulants/administration & dosage; Central Nervous System Stimulants/pharmacology
  20. Fulltext Central nervous system Erdheim Chester disease presenting with raised intracranial pressure and cerebellar signs mimicking neurosarcoidosis with secondary cerebral venous thrombosis
    Viswanathan S, Kadir NA, Lip AC, Rafia MH
    Neurol India, 2014 Jul-Aug;62(4):446-8.
    PMID: 25237960 DOI: 10.4103/0028-3886.141250
    Matched MeSH terms: Central Nervous System Diseases/diagnosis*
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