METHODS: GARFIELD-VTE is a global, prospective, non-interventional study of real-world treatment practices. In this study, we compared baseline characteristics, treatment patterns, and 12-month outcomes in Asia and ROW.
RESULTS: Of the 10,684 enrolled patients, 1822 (17.1%) were Asian (China n = 420, Hong Kong n = 98, Japan n = 148, Malaysia n = 244, South Korea n = 343, Taiwan n = 232, Thailand n = 337). Compared with ROW patients, those from Asia were more often female (57.4% vs. 48.0%), non-smokers (74.0% vs. 58.9%) and had a lower BMI (24.8 kg/m2 vs. 29.1 kg/m2). Asian patients were more likely to be managed in the hospital (86.9% vs. 70.4%) and to have active cancer (19.8% vs. 8.1%) or a history of cancer (19.1% vs. 12.0%). Asian patients received no anticoagulation more frequently than ROW patients (6.5% vs. 2.1%). Over 12-months follow-up, the rate of all-cause mortality (per 100 person-years [95% confidence interval]) was higher in Asians (15.2 [13.4-17.3] vs. 5.9 [5.4-6.5]). Adjusted hazard ratios indicated a higher risk of all-cause mortality in Asian patients than the ROW (1.32 [1.08-1.62]). The frequencies of major bleeding and recurrent VTE were similar.
CONCLUSION: Asian patients have different risk profiles, treatment patterns and a higher risk of mortality compared with the ROW.
Materials and Methods: This is a retrospective study. Parameters such as patient data, injury details, osteosynthesis implant system information, stability of fracture fragments, occlusion and complications were evaluated at different time intervals and logistic regression applied to determine the association of these factors with complications.
Results: Five hundred and ninety-three patients with mandibular fractures were included in this study (male 87.9% and female 12.1%), age range of 13-72 years (median = 22 years). Most fractures were caused by motor vehicle accidents (85.8%), assault (6.2%) and falls (4.7%). Parasymphyseal fractures were the most common (50.1%), followed by angle (35.2%) and body of mandible (25%). Median time interval between injury and intervention was 7 days (IQR 4-10). Median duration of follow-up from date of surgery was 72 days (IQR 30-230). 76.9% (456) were completely free of complications. Most complications (46%) occurred in the intermediate post-surgical period (1-6 weeks). Median interval period between surgery and complication was 15 days (IQR 7-67.5). Nerve injury and surgical site infection were the most common complications at 6.7% and 5.7%, respectively. There was a significant difference between the plating system in terms of complication outcome (p = 0.017).
Conclusion: Whilst the miniplate dimensions may be similar across different manufacturers, the complication outcome may differ between systems.
METHODS: We conducted a retrospective observational study in our multi-disciplinary Pediatric Intensive Care Unit (ICU) from January 2015 to December 2018. All patients from birth to 16 years of age who were admitted to the pediatric ICU were included. The Kidney Disease Improving Global Outcomes (KDIGO) definition was considered as the reference standard. We compared the incidence data assessed by KDIGO, pediatric risk, injury, failure, loss of kidney function and end- stage renal disease (pRIFLE) and pediatric reference change value optimised for AKI (pROCK).
RESULTS: Out of 7505 patients, 9.2% developed AKI by KDIGO criteria. The majority (59.8%) presented with stage 1 AKI. Recovery from AKI was observed in 70.4% of patients within 7 days from diagnosis. Both pRIFLE and pROCK were less sensitive compared to KDIGO criteria for the classification of AKI. Patients who met all three-KDIGO, pRIFLE and pROCK criteria had a high mortality rate (35.0%).
CONCLUSION: Close to one in ten patients admitted to the pediatric ICU met AKI criteria according to KDIGO. In about 30% of patients, AKI persisted beyond 7 days. Follow-up of patients with persistent kidney function reduction at hospital discharge is needed to reveal the long-term morbidity due to AKI in the pediatric ICU.
Materials and Methods: In two tertiary care selected hospitals, the included diabetic patients were randomly divided into two study arms. In the control group, 200 patients who were receiving usual treatment from hospitals were included. However, in the intervention group, those 200 patients who were receiving usual treatment along with counseling sessions from pharmacists under the Diabetes Medication Therapy Adherence Clinic (DMTAC) program were included. The study continued for 1 year, and there were four follow-up visits for both study arms. A prevalidated data collection form was used to measure the improvement in predictors of diabetic foot in included patients. Data were analyzed by using the Statistical Package for the Social Sciences (SPSS) software program, version 24.0.
Results: With the average decrease of 1.97% of HbA1c values in the control group and 3.43% in the intervention group, the univariate and multivariate analysis showed a statistically significant difference between both of the study arms in the improvement of predictors belonging to the diabetic foot (P < 0.05). The proportion of patients without any signs and symptoms of the diabetic foot in the intervention group was 91.7%, which increased from 42.3% at baseline (P < 0.05). However, this proportion in the control group was 76.9% at the fourth follow-up, from 48.3% at baseline (P < 0.05).
Conclusion: A statistically significant reduction in the signs and symptoms of diabetic foot was observed in the intervention group at the end of 1 year. The progression of diabetic foot was significantly decreased in the pharmacist intervention group.
PURPOSE: To determine if density of breast is an independent risk factor which will contribute to development of breast cancer.
MATERIALS AND METHODS: A prospective cohort study is carried out in two hospitals targeting adult female patients who presented to the Breast Clinic with symptoms suspicious of breast cancer. Participants recruited were investigated for breast cancer based on their symptoms. Breast density assessed from mammogram was correlated with tissue biopsy results and final diagnosis of benign or malignant breast disease.
RESULTS: Participants with dense breasts showed 29% increased risk of breast cancer when compared to those with almost entirely fatty breasts (odds ratio [OR] 1.29, 95% CI 0.38-4.44, P = .683). Among the postmenopausal women, those with dense breasts were 3.1 times more likely to develop breast cancer compared with those with fatty breasts (OR 3.125, 95% CI 0.72-13.64, P = .13). Moreover, the chance of developing breast cancer increases with age (OR 1.046, 95% CI 1.003-1.090, P
OBJECTIVE: To assess the auditory outcome of paediatric bilateral cochlear implant in Universiti Kebangsaan Malaysia.
MATERIALS AND METHODS: This was a cross-sectional and descriptive study single centre analysis. Categories of Auditory Performance (CAP-II) scale and Speech, Spatial and Qualities (SSQ) of Hearing questionnaire were used.
RESULTS: Forty-six patients were recruited. Majority of the children (30.4%) rated 7 and 23.9% scored perfectly (9) based on the CAP-II Scale. The least performing children were rated 5 (average). Children that were implanted sequentially within 24 months showed median CAP-II scale of 7. No significant correlation seen between CAP-II and the duration interval, use and age of 1st CI (p > .05). The speech domain of SSQ-P scale showed median value of 8 indicating good speech understanding. The spatial hearing domain had median value of 7, quality of hearing domain had median of 8. Significant correlation seen in hearing in noise with the duration of use of CI (p
METHODS: This analysis includes 137,851 participants between the ages of 35 and 70 years living on five continents, with a median follow-up of 9.5 years. We used country-specific food-frequency questionnaires to determine dietary intake and estimated the glycemic index and glycemic load on the basis of the consumption of seven categories of carbohydrate foods. We calculated hazard ratios using multivariable Cox frailty models. The primary outcome was a composite of a major cardiovascular event (cardiovascular death, nonfatal myocardial infarction, stroke, and heart failure) or death from any cause.
RESULTS: In the study population, 8780 deaths and 8252 major cardiovascular events occurred during the follow-up period. After performing extensive adjustments comparing the lowest and highest glycemic-index quintiles, we found that a diet with a high glycemic index was associated with an increased risk of a major cardiovascular event or death, both among participants with preexisting cardiovascular disease (hazard ratio, 1.51; 95% confidence interval [CI], 1.25 to 1.82) and among those without such disease (hazard ratio, 1.21; 95% CI, 1.11 to 1.34). Among the components of the primary outcome, a high glycemic index was also associated with an increased risk of death from cardiovascular causes. The results with respect to glycemic load were similar to the findings regarding the glycemic index among the participants with cardiovascular disease at baseline, but the association was not significant among those without preexisting cardiovascular disease.
CONCLUSIONS: In this study, a diet with a high glycemic index was associated with an increased risk of cardiovascular disease and death. (Funded by the Population Health Research Institute and others.).
METHODS: First, 130 subjects were surveyed by self-entry questionnaire for statistical factors related to social demographics and sedentary behavior. These factors were age (years), gender (man/woman), body mass index (BMI, kg/m2), educational history (>13 years, %), employment (full-time or part-time, yes, %), alcohol intake (a certain amount, yes, %), smoking behavior (yes, %), and marital status (yes, %). BMI, as obtained from the participants' weight and height, was collected from the self-reported questionnaire and assessed. Sitting behavior time as an index of sedentary behavior on workdays, non-workdays, and total time was identified by questionnaire. Data were analyzed using the chi square-test and t-test, respectively. The criterion for a statistically significant difference was p < 0.05.
RESULTS: Finally, 107 subjects (68 men, 39 women) were analyzed. The ratios of social demographic factors of the men versus women group were age (58.5 ± 14.7 vs. 61.0 ± 12.1 years, p = 0.36), BMI (23.1 ± 2.6 vs. 21.8 ± 2.6 kg/m2, p = 0.01), educational history (86.7% vs. 56.4%, p < 0.001), employment (51.5% vs. 10.3%, p <0.001), alcohol intake (86.7% vs. 35.9%, p < 0.001), smoking behavior (30.9% vs. 10.3%, p = 0.01), and marital status (88.2% vs. 100%, p = 0.02). Sitting behavior time was 501.8 ± 254.6 vs. 346.0 ± 153.4 minutes (p < 0.001) on workdays, 415.1 ± 225.3 vs. 320.6 ± 178.7 minutes (p = 0.019) on non-workdays, and 458.5 ± 203.9 vs. 333.3 ± 132.1 minutes (p < 0.001) in total.
CONCLUSION: These findings indicated that social demographic factors and sitting behavior time differed by gender. However, there are some limitations. This was a cross-sectional study conducted in only one city with a small number of participants who completed a self-entry questionnaire. In conclusion, assessment of the differences in social demographic factors and postponement of sedentary behavior for both genders may reduce sitting behavior time in overseas Japanese residents and may help in developing public health strategies.
AIMS: A qualitative study to explore the knowledge, current dietary practices, and the barriers and enablers for dietary self-care management in persons with T2DM.
METHODS: In this qualitative study, in-depth interviews were conducted among 35 participants with T2DM who scored minimally and optimally in the Diabetes Self-Management Questionnaire (DSMQ). Interviews were conducted using a validated interview guide. In-depth interviews were audio-recorded, transcribed to verbatim and thematically analysed.
RESULTS: The study included 20 males and 15 females. The three major themes derived in the study. Firstly, "Knowledge, Interpretation and Information" the majority of the participants have understood the influence of diet on control of blood glucose level includes food choices and quantum of food. Secondly, "Current Dietary Practices-Preferences, Availability of food and Convenience influence dietary practices': All participants had their own belief on the side effects and benefits of certain food items. Most of the participants followed a three-meal pattern: breakfast, lunch and dinner. Finally, Barriers and Enablers in dietary self-management practice. Knowledge, physical and emotional factors, behaviour, planning were the intrinsic factors. Elements of the research, social support, season and climate, food environment were the extrinsic factors and communication, and financial management was the intermediate influences observed.
CONCLUSION: The themes generated by this research provide insight into self-management and patient expectations in dietary matters. It would be desirable for physicians and health care providers to be aware of these practices when advising people with T2DM on dietary self - management.