Displaying publications 41 - 60 of 205 in total

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  1. Ho LY, Zairi J
    Trop Biomed, 2013 Mar;30(1):125-30.
    PMID: 23665718 MyJurnal
    A 14-months survey was carried out to identify the species composition of Anopheles mosquitoes from Kampung Bongor, Grik, Perak. Adding to that, a preliminary one month mosquito population screening was done at Kampung Tepin, Serian, Sarawak. Consequently, the insecticide susceptibility status of a pyrethroid was tested against two selected species of Anopheles collected from these two locations in Malaysia. A total of 4,497 Anopheles from 11 species were identified from collections in Kampung Bongor, whereas 2,654 An. letifer were collected from Kampung Tepin. The An. maculatus of Kampung Bongor and An. letifer of Kampung Tepin were then selected and tested using WHO standard diagnostic test kits and impregnated papers with 0.75% permethrin. The response values of KT50 and KT95 for An. maculatus were recorded at 28.09 minutes and 62.98 minutes respectively. Anopheles letifer recorded much slower response values of KT50 and KT95, which was at 35.09 minutes and 73.03 minutes respectively. Both An. maculatus and An. letifer showed 100% mortality after 24 hours holding period. The results indicate that both species were still susceptible to the tested pyrethroid. For effective vector control and resistance management, accurate and periodic insecticide resistance monitoring should be undertaken especially in rural areas with agricultural usage of insecticides.
    Matched MeSH terms: Survival Analysis
  2. Ismail NA, Pettitt AN
    Stat Med, 2004 Apr 30;23(8):1247-58.
    PMID: 15083481
    A new method for estimating the time to colonization of Methicillin-resistant Staphylococcus Aureus (MRSA) patients is developed in this paper. The time to colonization of MRSA is modelled using a Bayesian smoothing approach for the hazard function. There are two prior models discussed in this paper: the first difference prior and the second difference prior. The second difference prior model gives smoother estimates of the hazard functions and, when applied to data from an intensive care unit (ICU), clearly shows increasing hazard up to day 13, then a decreasing hazard. The results clearly demonstrate that the hazard is not constant and provide a useful quantification of the effect of length of stay on the risk of MRSA colonization which provides useful insight.
    Matched MeSH terms: Survival Analysis*
  3. Mire CE, Versteeg KM, Cross RW, Agans KN, Fenton KA, Whitt MA, et al.
    Virol J, 2013 Dec 13;10:353.
    PMID: 24330654 DOI: 10.1186/1743-422X-10-353
    BACKGROUND: Nipah virus (NiV) is a highly pathogenic zoonotic agent in the family Paramyxoviridae that is maintained in nature by bats. Outbreaks have occurred in Malaysia, Singapore, India, and Bangladesh and have been associated with 40 to 75% case fatality rates. There are currently no vaccines or postexposure treatments licensed for combating human NiV infection.

    METHODS AND RESULTS: Four groups of ferrets received a single vaccination with different recombinant vesicular stomatitis virus vectors expressing: Group 1, control with no glycoprotein; Group 2, the NiV fusion protein (F); Group 3, the NiV attachment protein (G); and Group 4, a combination of the NiV F and G proteins. Animals were challenged intranasally with NiV 28 days after vaccination. Control ferrets in Group 1 showed characteristic clinical signs of NiV disease including respiratory distress, neurological disorders, viral load in blood and tissues, and gross lesions and antigen in target tissues; all animals in this group succumbed to infection by day 8. Importantly, all specifically vaccinated ferrets in Groups 2-4 showed no evidence of clinical illness and survived challenged. All animals in these groups developed anti-NiV F and/or G IgG and neutralizing antibody titers. While NiV RNA was detected in blood at day 6 post challenge in animals from Groups 2-4, the levels were orders of magnitude lower than animals from control Group 1.

    CONCLUSIONS: These data show protective efficacy against NiV in a relevant model of human infection. Further development of this technology has the potential to yield effective single injection vaccines for NiV infection.

    Matched MeSH terms: Survival Analysis
  4. Ong TA, Yip CH
    Asian J Surg, 2003 Jul;26(3):169-75.
    PMID: 12925293
    OBJECTIVE: To study the impact of various clinicopathological factors on short-term survival in a cohort of breast cancer patients treated at the University of Malaya Medical Centre (UMMC).
    METHODS: All cases of breast cancer treated at UMMC from January 1999 to June 2001, except for stage IV disease, were included in the study. Survival analysis was carried out using Kaplan-Meier for univariate analysis and Cox regression for multivariate analysis. The log-rank test was used to test the significance of differences between the different survival curves.
    RESULTS: A total of 385 patients were included. The mean patient age at presentation was 50.3 years (SD, 11.4); 198 (51.4%) patients had lymph node-positive disease, and 187 (48.6%) had node-negative disease. The mean follow-up period was 18.7 months (SD, 8.8). The Malay ethnic group, tumours of larger size, node-positive disease, more than five positive lymph nodes, oestrogen receptor (ER) negativity and the presence of lymphovascular invasion were significant prognostic factors for shorter recurrence-free survival (RFS) in the univariate analysis. In the multivariate analysis, ER negativity was the only independent adverse prognostic factor for RFS. For overall survival (OS), tumours of larger size, node-positive disease, more than five positive lymph nodes, ER negativity and high grade tumours were associated with significantly shorter OS. However, more than five positive lymph nodes was the only independent prognostic factor for shorter OS in the multivariate analysis. Further multivariate analysis of the patients with node-positive disease showed that the Malay ethnic group, ER negativity and more than five positive lymph nodes were independent prognostic factors for shorter RFS. On the other hand, ER negativity and more than five positive lymph nodes were independent negative prognostic factors for OS in this subgroup of patients.
    CONCLUSION: The evaluation of various prognostic factors would provide useful information on disease progression in local patients, especially for the planning of adjuvant therapies and follow-up protocols. Differences in the pattern of breast cancer among the different ethnic groups in Malaysia warrant further studies.
    Matched MeSH terms: Survival Analysis
  5. Sthaneshwar P, Nadarajan V, Maniam JA, Nordin N, Gin Gin G
    Clin Chem Lab Med, 2009;47(9):1101-7.
    PMID: 19728852 DOI: 10.1515/CCLM.2009.260
    Measurement of serum free light chains (FLCs) has recently become available for the diagnosis and monitoring of patients with plasma cell dyscrasias. The aim of this study was to investigate the performance of the serum FLC assay as a tumour marker by comparing FLC concentrations with serum protein electrophoresis (PE) results in the diagnosis of multiple myeloma (MM). In addition, we also evaluated the prognostic value of the baseline serum FLC ratio in patients with MM.
    Matched MeSH terms: Survival Analysis
  6. Ghani RA, Zainudin S, Ctkong N, Rahman AF, Wafa SR, Mohamad M, et al.
    Nephrology (Carlton), 2006 Oct;11(5):386-93.
    PMID: 17014550
    Sepsis is characterized by an uncontrolled release of pro-inflammatory and anti-inflammatory mediators leading to immunoparalysis, cellular and humoral dysfunction, multiorgan dysfunction and death. This study evaluated the efficacy of high-volume haemofiltration (HVHF) compared with continuous venovenous haemofiltration (CVVH) in removing these inflammatory mediators. Clinical responses were assessed with the sequential organ failure assessment (SOFA) score.
    Matched MeSH terms: Survival Analysis
  7. Al-Rofaai A, Rahman WA, Abdulghani M
    Parasitol Res, 2013 Feb;112(2):893-8.
    PMID: 22961237 DOI: 10.1007/s00436-012-3113-5
    The sensitivity of larval paralysis assay (LPA) and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide-formazan (MTT-formazan) assay was compared to evaluate the anthelmintic activity of plant extracts. In this study, the methanolic extract of Azadirachta indica (neem) was evaluated for its activity against the infective-stage larvae (L(3)) of susceptible and resistant Haemonchus contortus strains using the two aforementioned assays. In both in vitro assays, the same serial concentrations of the extract were used, and the median lethal concentrations were determined to compare the sensitivity of both assays. The results revealed a significant difference (P < 0.05) in the sensitivity of the LPA and the MTT-formazan assay. The MTT-formazan assay is more feasible for practical applications because it measured the L(3) mortality more accurately than LPA. This study may help find a suitable assay for investigating the anthelmintic activity of plant extracts against trichostrongylid nematodes.
    Matched MeSH terms: Survival Analysis
  8. Javaid A, Shaheen Z, Shafqat M, Khan AH, Ahmad N
    Am J Infect Control, 2017 Feb 01;45(2):190-193.
    PMID: 27769706 DOI: 10.1016/j.ajic.2016.07.026
    Among 186 retrospectively evaluated patients with multidrug-resistant tuberculosis, 33.9% were cured, 6.6% completed treatment, 25% died, 18.3% were lost to follow-up, 2.2% failed treatment, and 13.8% were still undergoing treatment by the end of the study period. Rural residence was a risk factor for loss to follow-up (odds ratio [OR], 3.315; P = .016), whereas baseline body weight <40 kg (OR, 2.175; P = .042) and resistance to ofloxacin (OR, 2.889; P = .025) were risk factors for death. Despite programmatic management, treatment outcomes of the current cohort were distressing.
    Matched MeSH terms: Survival Analysis
  9. Ahmad P, Nawaz R, Qurban M, Shaikh GM, Mohamed RN, Nagarajappa AK, et al.
    Medicine (Baltimore), 2021 Sep 10;100(36):e27127.
    PMID: 34516504 DOI: 10.1097/MD.0000000000027127
    In Malaysia, oral cancer is very common and the reported 5-year survival of such patients is nearly 50% after treatment with surgery and radiotherapy, much lower than most of the developed countries. This study aimed to investigate the socio-demographic and clinicopathological parameters that influence the mortality rate of the patients suffering from oral squamous cell carcinoma (OSCC) in the Kelantanse population.In this retrospective study, data regarding socio-demographic, clinicopathological factors, and treatment outcome associated with OSCC were gathered from the archives of the medical records office of Hospital Universiti Sains Malaysia. For statistical analysis, simple and multiple logistic regression were performed. The significance level was set to P 
    Matched MeSH terms: Survival Analysis
  10. Sam SS, Omar SF, Teoh BT, Abd-Jamil J, AbuBakar S
    PLoS Negl Trop Dis, 2013;7(5):e2194.
    PMID: 23658849 DOI: 10.1371/journal.pntd.0002194
    Dengue is a mosquito-borne viral disease endemic in many countries in the tropics and sub-tropics. The disease affects mainly children, but in recent years it is becoming more of an adult disease. Malaysia experienced a large dengue outbreak in 2006 to 2007, involving mostly adults, with a high number of deaths.
    Matched MeSH terms: Survival Analysis
  11. Faridah K, Azmi MT
    MyJurnal
    Background : Foot ulcers and its complications are an important cause of morbidity and mortality in diabetes. The aim of this retrospective study is to determine the ulcer-free survival in diabetic foot and its relevant predictors in a cohort of diabetic patients in the primary health care setting.
    Methods : Data of newly diagnosed diabetics (n=1121) who received treatment in five health centers in the district of Kuala Langat, Selangor between 1st January 1999 until the 30th June 2008 were studied. Information was gathered by reviewing patient’s medical records. All patients were followed until 31st December 2008. The duration of ulcer-free survival was measured from the date of being diagnosed as diabetic until the development of the ulcer.
    Results : The total incidence of diabetic foot ulcer was 9.9% (n=111), with an average annual incidence of 1%. The total incidence of amputation was 1.2%. Mean age of being diagnosed having diabetic was 52+10.7 year old and mean age of being diagnosed having diabetic foot ulcer was 54.68+10.16 year old. The mean for overall ulcer-free survival was 99 months (95%CI:96-102). Male gender (LR=6.56; p=0.01), smokers (LR=3.94; p=0.04), low body mass index (LR=4.45; p=0.03), impaired renal function (LR=5.17; p=0.02) and long duration between follow-up (LR=25.10; p
    Matched MeSH terms: Survival Analysis
  12. Kuze N, Sipangkui S, Malim TP, Bernard H, Ambu LN, Kohshima S
    Primates, 2008 Apr;49(2):126-34.
    PMID: 18297473 DOI: 10.1007/s10329-008-0080-7
    We analysed the reproductive parameters of free-ranging female orangutans at Sepilok Orangutan Rehabilitation Centre (SORC) on Borneo Island, Sabah, Malaysia. Fourteen adult females produced 28 offspring in total between 1967 and 2004. The average censored interbirth interval (IBI) (i.e. offspring was still alive when mother produced a next offspring) was 6 years. This was shorter than censored IBIs reported in the wild but similar to IBIs reported for those in captivity. The nonparametric survival analysis (Kaplan-Meier method) revealed a significantly shorter IBI at SORC compared with wild orangutans in Tanjung Putting. The infant (0-3 years) mortality rate at SORC of 57% was much higher than rates reported both in the wild and captivity. The birth sex-ratio was significantly biassed toward females: 24 of the 27 sex-identified infants were females. The average age at first reproduction was 11.6 years, which is younger than the age in the wild and in captivity. The high infant mortality rate might be caused by human rearing and increased transmission of disease due to frequent proximal encounters with conspecifics around the feeding platforms (FPs). This young age of first reproduction could be because of the uncertainty regarding estimated ages of the female orangutans at SORC. It may also be affected by association with other conspecifics around FPs, which increased the number of encounters of the females with males compared with the number of encounters that would take place in the wild. Provision of FPs, which improves the nutritional condition of the females, caused the shorter IBI. The female-biassed birth sex-ratio can be explained by the Trivers and Willard hypothesis. The female-biassed sex ratio could be caused by the mothers being in poor health, parasite prevalence and/or high social stress (but not food scarcity) due to the frequent encounters with conspecifics around FPs.
    Matched MeSH terms: Survival Analysis
  13. Kamarajah SK, Chan WK, Nik Mustapha NR, Mahadeva S
    Hepatol Int, 2018 Jan;12(1):44-55.
    PMID: 29372507 DOI: 10.1007/s12072-018-9843-4
    INTRODUCTION: The value of repeated liver stiffness measurement (LSM) in non-alcoholic fatty liver disease (NAFLD) has not been shown before.

    METHODS: A longitudinal study of biopsy-proven NAFLD patients was conducted at the Asian tertiary hospital from November 2012 to January 2017. Patients with paired liver biopsies and LSM were followed prospectively for liver-related and non-liver related complications, and survival.

    RESULTS: The data for 113 biopsy-proven NAFLD patients (mean age 51.3 ± 10.6 years, male 50%) were analyzed. At baseline, advanced fibrosis based on histology and LSM was observed in 22 and 46%, respectively. Paired liver biopsy and LSM at 1-year interval was available in 71 and 80% of patients, respectively. High-risk cases (defined as patients with advanced fibrosis at baseline who had no fibrosis improvement, and patients who developed advanced fibrosis on repeat assessment) were seen in 23 and 53% of patients, based on paired liver biopsy and LSM, respectively. Type 2 diabetes mellitus was independently associated with high-risk cases. The median follow-up was 37 months with a total follow-up of 328 person-years. High-risk cases based on paired liver biopsy had significantly higher rates of liver-related complications (p = 0.002) but no difference in other outcomes. High-risk patients based on paired LSM had a significantly higher rate of liver-related complications (p = 0.046), cardiovascular events (p = 0.025) and composite outcomes (p = 0.006).

    CONCLUSION: Repeat LSM can predict liver-related complications, similar to paired liver biopsy, and may be useful in identifying patients who may be at an increased risk of cardiovascular events. Further studies in a larger cohort and with a longer follow-up should be carried out to confirm these observations.

    Matched MeSH terms: Survival Analysis
  14. Ohno T, Thinh DH, Kato S, Devi CR, Tung NT, Thephamongkhol K, et al.
    J Radiat Res, 2013 May;54(3):467-73.
    PMID: 23192700 DOI: 10.1093/jrr/rrs115
    The purpose of this study was to evaluate the efficacy and toxicity of radiotherapy concurrently with weekly cisplatin, followed by adjuvant chemotherapy, for the treatment of N2-3 nasopharyngeal cancer (NPC) in Asian countries, especially regions of South and Southeast Asian countries where NPC is endemic. Between 2005 and 2009, 121 patients with NPC (T1-4 N2-3 M0) were registered from Vietnam, Malaysia, Indonesia, Thailand, The Philippines, China and Bangladesh. Patients were treated with 2D radiotherapy concurrently with weekly cisplatin (30 mg/m (2)), followed by adjuvant chemotherapy, consisting of cisplatin (80 mg/m(2) on Day 1) and fluorouracil (800 mg/m(2) on Days 1-5) for 3 cycles. Of the 121 patients, 56 patients (46%) required interruption of RT. The reasons for interruption of RT were acute non-hematological toxicities such as mucositis, pain and dermatitis in 35 patients, hematological toxicities in 11 patients, machine break-down in 3 patients, poor general condition in 2 patients, and others in 8 patients. Of the patients, 93% completed at least 4 cycles of weekly cisplatin during radiotherapy, and 82% completed at least 2 cycles of adjuvant chemotherapy. With a median follow-up time of 46 months for the surviving 77 patients, the 3-year locoregional control, distant metastasis-free survival and overall survival rates were 89%, 74% and 66%, respectively. No treatment-related deaths occurred. Grade 3-4 toxicities of mucositis, nausea/vomiting and leukopenia were observed in 34%, 4% and 4% of the patients, respectively. In conclusion, further improvement in survival and locoregional control is necessary, although our regimen showed acceptable toxicities.
    Matched MeSH terms: Survival Analysis
  15. Bhoo-Pathy N, Verkooijen HM, Wong FY, Pignol JP, Kwong A, Tan EY, et al.
    Int J Cancer, 2015 Nov 15;137(10):2504-12.
    PMID: 26018878 DOI: 10.1002/ijc.29617
    The value of adjuvant radiotherapy in triple-negative breast cancer (TNBC) is currently debated. We assessed the association between adjuvant radiotherapy and survival in a large cohort of Asian women with TNBC. Women diagnosed with TNBC from 2006 to 2011 in five Asian centers (N = 1,138) were included. Survival between patients receiving mastectomy only, breast-conserving therapy (BCT, lumpectomy and adjuvant radiotherapy) and mastectomy with radiotherapy were compared, and adjusted for demography, tumor characteristics and chemotherapy types. Median age at diagnosis was 53 years (range: 23-96 years). Median tumor size at diagnosis was 2.5 cm and most patients had lymph node-negative disease. The majority of patients received adjuvant chemotherapy (n = 861, 76%) comprising predominantly anthracycline-based regimes. In 775 women with T1-2, N0-1, M0 TNBCs, 5-year relative survival ratio (RSR) was highest in patients undergoing mastectomy only (94.7%, 95% CI: 88.8-98.8%), followed by BCT (90.8%, 95% CI: 85.0-94.7%), and mastectomy with radiotherapy (82.3%, 95% CI: 73.4-88.1%). The adjusted risks of mortality between the three groups were not significantly different. In 363 patients with T3-4, N2-3, M0 TNBCs, BCT was associated with highest 5-year RSR (94.1%, 95% CI: 81.3-99.4%), followed by mastectomy with radiotherapy (62.7%, 95% CI: 54.3-70.1%), and mastectomy only (58.6%, 95% CI: 43.5-71.6%). Following multivariable adjustment, BCT and mastectomy with radiotherapy remained significantly associated with lower mortality risk compared to mastectomy only. Overall, adjuvant radiotherapy was associated with higher survival in women aged <40 years, but not in older women. Adjuvant radiotherapy appears to be independently associated with a survival gain in locally advanced as well as in very young TNBC.
    Matched MeSH terms: Survival Analysis
  16. Schubert T, Renninger M, Schmid MA, Hassan FN, Sokolakis I, Fahmy O, et al.
    Urol Oncol, 2020 01;38(1):4.e7-4.e15.
    PMID: 31537484 DOI: 10.1016/j.urolonc.2019.08.013
    OBJECTIVES: To assess whether the presence and location of tumor-associated immune cell infiltrates (TAIC) on histological slides obtained from cystectomy specimens impacts on oncological outcomes of patients with bladder cancer (BC).

    MATERIAL AND METHODS: A total of 320 consecutive patients staged with cM0 bladder cancer underwent radical cystectomy (RC) between 2004 and 2013. The presence of TAIC (either located peritumorally [PIC] and/or intratumorally [IIC]) on histological slides was retrospectively assessed and correlated with outcomes. Kaplan-Meier analyses were used to estimate the impact of TAIC on recurrence-free (RFS), cancer-specific (CSS), and overall survival (OS). Multivariable Cox-regression analysis was carried out to evaluate risk factors of recurrence. The median follow-up was 37 months (IQR: 10-55).

    RESULTS: Of the 320 patients, 42 (13.1%) exhibited IIC, 141 (44.1%) PIC and 137 (42.8%) no TAIC in the cystectomy specimens. Absence of TAIC was associated with higher ECOG performance status (P = 0.042), histologically advanced tumor stage (≥pT3a; P < 0.001), lymph node tumor involvement (pN+; P = 0.022), positive soft tissue surgical margins (P = 0.006), lymphovascular invasion (P < 0.001), and elevated serum C-reactive protein levels (P < 0.001). The rate of never smokers was significantly higher in the IIC-group (64.3%) compared to the PIC-group (39.7%, P = 0.007) and those without TAIC (35.8%, P = 0.001). The 3-year RFS/CSS/OS was 73.9%/88.5%/76.7% for patients with IIC, 69.4%/85.2%/70.1% for PIC and 47.6%/68.5%/56.1% for patients without TAIC (P < 0.001/<0.001/0.001 for TAIC vs. no TAIC). In multivariable analysis, adjusted for all significant parameters of univariable analysis, histologically advanced tumor stage (P = 0.003), node-positive disease (P = 0.002), and the absence of TAIC (P = 0.035) were independent prognosticators for recurrence.

    CONCLUSIONS: In this analysis, the presence and location of TAIC in cystectomy specimens was a strong prognosticator for RFS after RC. This finding suggests that the capability of immune cells to migrate into the tumor at the time of RC is prognostically important in invasive bladder cancer.

    Matched MeSH terms: Survival Analysis
  17. Voralu K, Norsa'adah B, Naing NN, Biswal BM
    Singapore Med J, 2006 Aug;47(8):688-92.
    PMID: 16865209
    The aim of this study was to identify the prognostic factors that influence the survival of differentiated thyroid cancer patients treated at Hospital Universiti Sains Malaysia (HUSM).
    Matched MeSH terms: Survival Analysis
  18. Phua CE, Bustam AZ, Yip CH, Taib NA
    Asian Pac J Cancer Prev, 2010;11(5):1205-11.
    PMID: 21198264
    BACKGROUND: Information about elderly breast cancer patients' outcome is limited. This study aimed to evaluate the treatment outcomes in women aged 70 and above with specific analysis on prognostic clinicopathological features and treatment modalities.

    MATERIALS AND METHODS: This retrospective study examined breast cancer patients between 1st January 1994 and 31st December 2004 in UMMC. Survival analysis was performed using the Kaplan-Meier method and comparisons between groups using the log-rank test. Univariate and multivariate analysis on prognostic factors were carried out using the Cox's proportionate hazard model for patient demographics, and tumour and treatment factors.

    RESULTS: One hundred and thirty six patients were identified, with a median age at diagnosis of 75 years. Most had at least one co-morbidity (61.8%). Only 75.0% had a good performance status (ECOG 0-1). Mean tumour size was 4.4 cm. Primary tumour stages (T stages) 3 and 4 were present in 8.1% and 30.1% of patients respectively, and 30.9% had stage III and 8.8% had stage IV disease based on overall AJCC staging. ER positivity was 58.1%. PR status was positive in 30.1%. Surgery was performed in 69.1% of the patients and mastectomy and axillary clearance were the commonest surgical procedures (50.7%). Some 79.4% of patients received hormonal therapy, 30.1% radiotherapy and only 3.6% chemotherapy. Non-standard treatment was given to 39.0% of patients due to a variety of reasons. The cumulative 5 years overall, relapse free and cause specific survivals were 51.9%, 79.7% and 73.3% respectively. Performance status, T3-4 tumour, presence of metastasis, tumour grade and ER status were independent prognostic factors for overall survival. For cause specific survival they were T4 tumour, presence of metastasis and ER status.

    CONCLUSION: The 5 years overall survival rate was 51.9% and 41.8% of deaths were non-breast cancer related deaths. Low survival rate was related to low life expectancy in this population. Locally advanced disease, metastatic disease and high ER negative rates play a major role in the survival of elderly breast cancer patients in Malaysia.

    Matched MeSH terms: Survival Analysis
  19. Carroll RP, Deayton S, Emery T, Munasinghe W, Tsiopelas E, Fleet A, et al.
    Hum Immunol, 2019 Aug;80(8):573-578.
    PMID: 31014826 DOI: 10.1016/j.humimm.2019.04.005
    High levels of angiotensin receptor antibodies (ATRab) are associated with acute cellular and humoral rejection, vascular occlusion, de novo human leucocyte antigen donor specific antibody (HLA DSA) and poor graft survival in kidney transplant recipients (KTR). Since 2015 we proactively managed patients "at risk" (AR) with ATRab >17 U/ml with perioperative plasma exchange (PLEX) and/or angiotensin receptor blockade (ARB). 44 patients were treated with this protocol. 265 KTR with ATRab ≤17 U/ml deemed "low risk" (LR) were transplanted under standard conditions. PLEX and ARB were not associated with increased risk of: delayed graft function requiring haemodialysis (HDx), hyperkalaemia >5.5 mmol/l requiring HDx, and the combined clinical end-point of severe hypotension, blood transfusion and re-operation for bleeding. Rejection rates were similar at 90 days: 8/44 (18%) in the AR group and 36/265 (14%) in the LR group (p = 0.350). Death censored graft survival was the same between the AR and LR groups with a 94% 48-month graft survival - hazard ratio (log-rank) 1.16 [95% CI 0.2-5.8] p = 0.844. Proactive treatment of ATRab >17 U/ml with PLEX and/or ARB is not associated with increased rates of perioperative complications and comparable rates of rejection and death censored graft survival at 4 years compared to KTR <17 U/ml ATRab.
    Matched MeSH terms: Survival Analysis
  20. Mohammed R, Goh KL, Wong NW
    Med J Malaysia, 1996 Mar;51(1):99-102.
    PMID: 10967987
    Primary biliary cirrhosis is an uncommon disease amongst Malaysians. Over a 12-year period, between 1979 and 1991, only seven patients with clinical, biochemical and histologic evidence of primary biliary cirrhosis were identified in University Hospital Kuala Lumpur. All were Chinese females between the ages of 30 to 55 years. The presenting complaint was pruritus in 5 patients. All except one patient was jaundiced when the diagnosis was made. These patients were followed up from 1 to 11 years. Three deaths were reported, one from massive hemetemesis and two from liver failure.
    Matched MeSH terms: Survival Analysis
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