MATERIALS AND METHODS: Between 16-April-2020 to 30-April- 2020, patients with suspected or confirmed for COVID-19 indicated for in-patient treatment with hydroxychloroquine with or without lopinavir-ritonavir to the Sarawak General Hospital were monitored with KardiaMobile smartphone electrocardiogram (AliveCor®, Mountain View, CA) or standard 12-lead electrocardiogram. The baseline and serial QTc intervals were monitored till the last dose of medications or until the normalization of the QTc interval.
RESULTS: Thirty patients were treated with hydroxychloroquine, and 20 (66.7%) patients received a combination of hydroxychloroquine and lopinavir-ritonavir therapy. The maximum QTc interval was significantly prolonged compared to baseline (434.6±28.2msec vs. 458.6±47.1msec, p=0.001). The maximum QTc interval (456.1±45.7msec vs. 464.6±45.2msec, p=0.635) and the delta QTc (32.6±38.5msec vs. 26.3±35.8msec, p=0.658) were not significantly different between patients on hydroxychloroquine or a combination of hydroxychloroquine and lopinavir-ritonavir. Five (16.7%) patients had QTc of 500msec or more. Four (13.3%) patients required discontinuation of hydroxychloroquine and 3 (10.0%) patients required discontinuation of lopinavirritonavir due to QTc prolongation. However, no torsade de pointes was observed.
CONCLUSIONS: QTc monitoring using smartphone electrocardiogram was feasible in COVID-19 patients treated with hydroxychloroquine with or without lopinavir-ritonavir. The usage of hydroxychloroquine and lopinavir-ritonavir resulted in QTc prolongation, but no torsade de pointes or arrhythmogenic death was observed.
METHODS: PubMed and Google Scholar were systematically searched for the relevant studies by following the PRISMA 2009 checklist. A past decade literature search was conducted from 2010 until November 2020 to secure the relevance of the phantom study. Databases were recruited using keywords such as phantom, quantification, standardisation, harmonisation, image quality, standardised uptake value and multicentre study. However, all keywords were related to PET/CT. All abstracts and eligible full-text articles were screened independently, and finally, the quality assessments of this review were performed.
RESULTS: From the 200 retrieved articles, 80 were rejected after the screening of the abstracts and 35 after reading the full-text. The 20 accepted articles addressed the distribution of phantom types used in selected articles studies which were NEMA (67%), ACR (8%) and others (25%). The articles showed the various experimental studies, either phantom studies (35%) or phantom plus clinical studies (65%). For clinical studies (n = 829), the distribution of prospective studies was (n = 674) and retrospective studies was (n =155). The distribution of phantom pathway application showed the studies focused on 40% of reconstruction protocol studies, 30% of the multicentre and standardisation of accreditation program studies, and 30% of the quantification of uptake values studies.
CONCLUSIONS: According to this review, the phantom study have a pivotal role in hybrid nuclear imaging of PET/CT either in technical aspects of the scanners (such as data acquisition and reconstruction protocol) or clinical characteristics of patients. In addition to this, the necessity to identify the suitable system phantoms to use within PET/CT scans by considering the continuous development of new phantom studies are needed. Researchers are encouraged to adopt efforts on phantom quantitative validation, including verification with clinical data of patients.
METHODS: A systematic search was conducted on PubMed, EBSCOHost, and Web of Science. We identified 22 casecontrol studies that matched our inclusion and exclusion criteria. Information such as study characteristics, genetic polymorphisms associated with SLE, and organ manifestations was extracted and reported in this review.
RESULTS: In total, 30 polymorphisms in 16 genes were found to be associated with SLE among Asians. All included polymorphisms also reported associations with various SLE clinical features. The association of rs1234315 in TNFSF4 linking to SLE susceptibility (P=4.17x10-17 OR=1.45 95% CI=1.34-1.59) and musculoskeletal manifestation (P=3.35x10-9, OR=1.37, 95%CI= 1.23-1.51) might be the most potential biomarkers to differentiate SLE between Asian and other populations. In fact, these associated genetic variants were found in loci that were implicated in immune systems, signal transduction, gene expression that play important roles in SLE pathogenesis.
DISCUSSIONS AND CONCLUSIONS: This review summarized the potential correlation between 30 genetic polymorphisms associated with SLE and its clinical manifestations among Asians. More efforts in dissecting the functional implications and linkage disequilibrium of associated variants may be required to validate these findings.
MATERIALS AND METHODS: In this retrospective cross-sectional analysis, clinical data, including clinical staging, Computed Tomography (CT) scan findings and histopathological results were collected and analysed in the Department of Obstetrics and Gynaecology, Hospital Ampang, Ministry of Health Malaysia.
RESULTS: A total of 31 patients had surgery for CC from 1st August 2018 till 31st August 2020. Radical hysterectomy was done on 23 of them as primary treatment for early stage cervical cancer. Both pelvic and para-aortic lymph node dissection was done in 6 patients while 17 patients had only pelvic lymph node dissection. All patients had thoracoabdomino- pelvic CT scans done preoperatively. Among the 82.6% patients with no enlarged pelvic lymph nodes on CT scan, all were confirmed by histology to be negative of malignancy. In the remainder 17.4% of patients with enlarged pelvic nodes on CT scan, three quarters had histology positive pelvic nodes for malignancy (p=0.002). Among patients with no enlarged para-aortic lymph nodes on CT scan, 83.3% had histologically negative para-aortic nodes. Among patients with clinical tumour diameter 2- 3.9 cm, 14.3% had positive pelvic nodes while a quarter of patients with clinical tumour diameter ≥ 4cm had histological positive pelvic nodes. None of the patients with tumour diameter < 2cm had positive pelvic nodes (p=0.993). Positive pelvic lymph nodes involvement was present in 37.5% of those with positive lymphovascular space invasion (LVSI). All patients with negative LVSI had no histological positive pelvic nodes (p=0.103). Among patients with tumour invasion involving the inner third of the stroma, 16.7% had histological positive pelvic nodes while 18.2% with outer third stromal invasion had positive nodes (p=0.977). None of the patients had histologically positive para-aortic lymph nodes with negative pelvic lymph nodes. Among patients with clinical stage 1B2, 20% would have been upstaged to stage 3C based on radiological imaging and final histology confirmation.
CONCLUSION: This study shows that in early stage CC, there is a statistically significant correlation between CT scan findings of enlarged pelvic lymph nodes and histological positive pelvic lymph nodes.