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  1. Preventing cervical cancer through human papillomavirus vaccination: perspective from focus groups
    Wong LP
    J Low Genit Tract Dis, 2009 Apr;13(2):85-93.
    PMID: 19387128 DOI: 10.1097/LGT.0b013e3181865f44
    OBJECTIVE: It has been a little more than a year ago since the prophylactic vaccine against human papillomavirus (HPV) was released in Malaysia. Little is known about parental knowledge and acceptability of the vaccine. The objective of this study is to assess the mother's knowledge and attitudes toward HPV vaccination. The results are aimed to provide insights into the provision of appropriate educational and promotional program for effective immunization uptake.
    MATERIALS AND METHODS: Purposive sampling method was adopted for recruitment of participants. A total of 47 mothers participated across 8 focus group discussions carried out between October and November 2007. The transcribed group discussions were analyzed using open-, axial-, and selective-coding procedures.
    RESULTS: Respondents have low awareness about the newly released vaccine and the link between HPV and cervical cancer. When provided with information about HPV and cervical cancer, most mothers were in favor of protecting their daughters from cervical cancer using the vaccine. As with any new vaccine, efficacy and safety were the major concern, particularly when the vaccine is recommended to preadolescent. Many expressed concern about the high cost of the vaccine and hope that the inoculation could be at least partially subsidized by the government. A minority were concerned that the sexually transmitted disease-related vaccine would promote sexual activities, and some opposed making vaccination mandatory. For Muslim respondents, the kosher issue of HPV vaccine was an important factor for acceptance.
    CONCLUSIONS: Developing public health messages that focus on the susceptibility of HPV infection and its link to cervical cancer to educate parents may have the greatest impact on improving the uptake of the vaccine. Apart from the major concern about safety and efficacy, affordability, and acceptability of vaccinating young children, religious and ethnic backgrounds were important considerations when recommending the HPV vaccine. To foster broad acceptance, these issues need to be addressed before mass vaccination is pushed forward to the Malaysian public.insights into the provision of appropriate educational and promotional program for effective immunization uptake.
    Matched MeSH terms: Age Factors
  2. Retinal vascular caliber, blood pressure, and cardiovascular risk factors in an Asian population: the Singapore Malay Eye Study
    Sun C, Liew G, Wang JJ, Mitchell P, Saw SM, Aung T, et al.
    Invest Ophthalmol Vis Sci, 2008 May;49(5):1784-90.
    PMID: 18436813 DOI: 10.1167/iovs.07-1450
    To describe the relationship of retinal vascular caliber with cardiovascular risk factors in an Asian population.
    Matched MeSH terms: Age Factors
  3. Pattern of maxillofacial injuries in motorcyclists in Malaysia
    Ramli R, Abdul Rahman R, Abdul Rahman N, Abdul Karim F, Krsna Rajandram R, Mohamad MS, et al.
    J Craniofac Surg, 2008 Mar;19(2):316-21.
    PMID: 18362705 DOI: 10.1097/SCS.0b013e318163f94d
    Motorcycle casualties represent significant number in road traffic accidents in Malaysia, and among all the injuries, facial injuries pose many significant problems physiologically, functionally, and aesthetically. The aim of this study was to analyze the pattern of maxillofacial as well as other injuries in motorcyclists who were seen at Hospital Universiti Kebangsaan Malaysia.Patients' records from January 2004 to December 2005 were reviewed. Data related to demographics, vehicle/object involved in collision, involvement as a rider or pillion, whether a helmet was worn or not, location of injuries on the face/facial bones, and other associated injuries were collected.A total of 113 cases of motorcycle accidents were recorded; 106 males and 7 females were involved. Mean age was 25.8 years. Among all the races, Malay had the highest involvement (72.3%), followed by Chinese (14.3%), Indians (8.9%), and others (5.4%). The types of collision were either a single-vehicle collision (i.e., skidded) or with another vehicle/s or object (e.g., tree, stone, or lamppost). The injuries were mainly seen on the lower face (46.9%) followed by midface (25.7%) and a combination of the midface and lower face (15%) and others (12.4%). The most frequent other associated injuries recorded were orthopedic and head injuries.
    Matched MeSH terms: Age Factors
  4. Fulltext Young patients with colorectal cancer have poor survival in the first twenty months after operation and predictable survival in the medium and long-term: analysis of survival and prognostic markers
    Chan KK, Dassanayake B, Deen R, Wickramarachchi RE, Kumarage SK, Samita S, et al.
    World J Surg Oncol, 2010;8:82.
    PMID: 20840793 DOI: 10.1186/1477-7819-8-82
    This study compares clinico-pathological features in young (<40 years) and older patients (>50 years) with colorectal cancer, survival in the young and the influence of pre-operative clinical and histological factors on survival.
    Matched MeSH terms: Age Factors
  5. Fulltext Cervical cancer screening: patients understanding in major hospitals in Malaysia
    Othman NH, Devi BC, Halimah Y
    Asian Pac J Cancer Prev, 2009 Oct-Dec;10(4):569-74.
    PMID: 19827871
    We studied women with cervical cancer to determine whether they had had a Pap smear within the 3 years preceding cancer development and their understanding of screening for this cancer. The study had 2 parts; Pathology Data and Survey Data. For pathology data, all cases of cervical cancer diagnosed in 2000-2006 were retrieved from eight hospitals and Pap smear history was obtained from clinical records. For the Survey data; patients who were still undergoing treatment in some of these hospitals and three others were administered structured questionnaires to determine their awareness about screening. The results showed 1431 cases of cervical cancer in women aged 25-85 were diagnosed in these hospitals. Most had not had a Pap smear within 3 years before cancer development. The percentages of patients who had had Pap smear ranged from 0-12%. Questionnaires were returned by 221 patients; 56.3% had none or only primary education and 61.1% had a household income of RM 1,000 or less. Level of education and the household income were strongly associated (p<0.05) with knowledge and having had a Pap test. The main reasons cited for not having had a Pap smear were "Never heard about it" (36.2%), "Shy" (10.4%), "Afraid to do it" (13.1%), "Think the test is not important" (8.1%) and "No encouragement from family" (4.5%). A large majority (95.9%) of the patients did not know the optimal interval. In conclusion, a large number of cervical cancer patients had not had a Pap smear within 3 years preceding cancer development and most had inadequate knowledge about this screening test.
    Matched MeSH terms: Age Factors
  6. Delays in seeking treatment for symptomatic tuberculosis in Sabah, East Malaysia: factors for patient delay
    Rundi C, Fielding K, Godfrey-Faussett P, Rodrigues LC, Mangtani P
    Int J Tuberc Lung Dis, 2011 Sep;15(9):1231-8, i.
    PMID: 21943851 DOI: 10.5588/ijtld.10.0585
    SETTING: The state of Sabah contributes one third of the tuberculosis (TB) cases in Malaysia.

    OBJECTIVE: To collect information on factors that affect the time period from the onset of symptoms to first contact with health care providers, whether private or government.

    DESIGN: A cross-sectional study using a pre-tested questionnaire was conducted among 296 newly registered smear-positive TB patients in 10 districts in Sabah. Univariable and multivariable analyses were used to determine which risk factors were associated with patient delay (>30 days) and 'extreme' patient delay (>90 days).

    RESULTS: The percentage of patients who sought treatment after 30 and 90 days was respectively 51.8% (95%CI 45.7-57.9) and 23.5% (95%CI 18.6-29.0). The strongest factors associated with patient delay and 'extreme' patient delay was when the first choice for treatment was a non-government health facility and in 30-39-year-olds. 'Extreme' patient delay was also weakly associated, among other factors, with comorbidity and livestock ownership.

    CONCLUSION: Delay and extreme delay in seeking treatment were more common when the usual first treatment choice was a non-government health facility. Continuous health education on TB aimed at raising awareness and correcting misconceptions is needed, particularly among those who use non-government facilities.

    Matched MeSH terms: Age Factors
  7. Fulltext Somatisation disorder and its associated factors in multiethnic primary care clinic attenders
    Khoo EM, Mathers NJ, McCarthy SA, Low WY
    Int J Behav Med, 2012 Jun;19(2):165-73.
    PMID: 21562781 DOI: 10.1007/s12529-011-9164-7
    Background Somatisation disorder (SD) has been reported as common in all ethnic groups, but the estimates of its prevalence have varied and the evidence for its associated factors has been inconsistent.
    Purpose This study seeks to determine the prevalence of SD and its associated factors in multiethnic primary care clinic attenders.
    Methods This cross-sectional study was on clinic attenders aged 18 years and above at three urban primary care clinics in Malaysia. The operational definition of SD was based on ICD-10 criteria for SD for research, frequent attendance, and excluded moderate to severe anxiety and depression. The instruments used were the ICD-10 symptom list, the Hospital Anxiety and Depression Scale, a semi-structured questionnaire, and SF-36.
    Results We recruited 1,763 patients (response rate 63.8%). The mean age of respondents was 44.7±15.8 years, 807 (45.8%) were male; there were 35.3% Malay, 30.1% Chinese and 34.6% Indian. SD prevalence was 3.7%; the prevalence in Malay was 5.8%, Indian 3.0% and Chinese 2.1%. Significant associations were found between SD prevalence and ethnicity, family history of alcoholism, blue-collar workers and the physical component summary (PCS) score of SF-36. Multivariate analysis showed that SD predictors were Malay ethnicity (OR 2.7, 95% CI 1.6, 4.6), blue-collar worker (OR 2.0, 95% CI 1.2, 3.5) and impaired PCS score of SF-36 (OR 0.92, 95% CI 0.90, 0.95).
    Conclusion The prevalence of SD was relatively uncommon with the stringent operational criteria used. SD preponderance in blue-collar workers may be attributable to secondary gain from getting sickness certificates and being paid for time off work.
    Keywords Somatisation disorder . Associated factors . Primary care . Ethnic groups . Prevalence Questionnaire: ICD-10 symptom list; Hospital Anxiety Depression Scale; HADS; SF-36
    Matched MeSH terms: Age Factors
  8. Fulltext Palm vitamin E and glucosamine sulphate in the treatment of osteoarthritis of the knee
    Haflah NH, Jaarin K, Abdullah S, Omar M
    Saudi Med J, 2009 Nov;30(11):1432-8.
    PMID: 19882056
    OBJECTIVE: To assess the efficacy of oral palm vitamin E in reducing symptoms of patients with osteoarthritis (OA) of the knee compared to oral glucosamine sulphate.
    METHODS: This open study was carried out at the Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia between March 2006 and November 2007. Seventy-nine patients were recruited to receive either 1.5 g oral glucosamine sulphate or 400 mg oral palm vitamin E for 6 months. Symptoms were assessed using the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index and visual analogue scale (VAS).
    RESULTS: Sixty-four patients completed the trial (vitamin E n=33, glucosamine sulfate n=31). After 6 months of treatment, both groups showed a significant improvement in WOMAC scale and significant reduction in the VAS score during standing and walking. There was no significant difference in WOMAC scale and VAS score between the 2 groups. Except for mild allergic reaction and abdominal discomfort in one patient, there were no other serious adverse effects reported. Serum malondialdehyde was significantly higher in the glucosamine group compared to palm vitamin E treated group at the end of the study. Serum of vitamin E was significantly higher in the palm vitamin E group compared to glucosamine.
    CONCLUSION: The finding of this study suggests that oral palm vitamin E in a dose of 400 mg taken daily has a potential role in reducing symptoms of patients with OA of the knee. It may be just as effective as glucosamine sulphate in reducing the symptoms and free from serious side effects. Further study is required to ascertain the mechanism of action beside its antioxidant effect.
    Matched MeSH terms: Age Factors
  9. Obstructive sleep apnea among express bus drivers in Malaysia: important indicators for screening
    Yusoff MF, Baki MM, Mohamed N, Mohamed AS, Yunus MR, Ami M, et al.
    Traffic Inj Prev, 2010 Dec;11(6):594-9.
    PMID: 21128189 DOI: 10.1080/15389588.2010.505255
    Obstructive sleep apnea (OSA) has been identified as one of the significant risk factors for motor vehicle crashes (MVCs). In the interest of public safety, this study was conducted to determine the prevalence of OSA and its associated factors among express bus drivers in Malaysia. Identifying factors or conditions related with OSA is very important because they can be used as indicators to subject a person to a confirmatory diagnosis using polysomnography testing.
    Matched MeSH terms: Age Factors
  10. Prevalence, risk factors, and predictors of female sexual dysfunction in a primary care setting: a survey finding
    Ishak IH, Low WY, Othman S
    J Sex Med, 2010 Sep;7(9):3080-7.
    PMID: 20584130 DOI: 10.1111/j.1743-6109.2010.01848.x
    INTRODUCTION: Female sexual dysfunction (FSD) is a highly prevalent sexual health problem but poorly investigated at the primary care level.
    AIM: This article examines the prevalence of sexual dysfunction and its possible risk factors associated with women at high risk of FSD in a hospital-based primary practice.
    METHODS: A validated Malay version of the Female Sexual Function Index (MVFSFI) was utilized to determine FSD in a cross-sectional study design, involving 163 married women, aged 18-65 years, in a tertiary hospital-based primary care clinic in Kuala Lumpur, Malaysia. Sociodemographic, marital profile, health, and lifestyle for women at high risk of FSD and those who were not at high risk were compared and their risk factors were determined.
    MAIN OUTCOME MEASURES: Prevalence of FSD in Malaysian women based on the MVFSFI, and its risk factors for developing FSD.
    RESULTS: Some 42 (25.8%) out of 163 women had sexual dysfunction. Prevalence of sexual dysfunction increased significantly with age. Sexual dysfunctions were detected as desire problem (39.3%), arousal problem (25.8%), lubrication problem (21.5%), orgasm problem (16.6%), satisfaction problem (21.5%) and pain problems (16.6%). Women at high risk of FSD were significantly associated with age (OR 4.1, 95% CI 1.9 to 9.0), husband's age (OR 4.3 95% C.I 1.9 to 9.3), duration of marriage (OR 3.3, 95% CI 1.6 to 6.8), medical problems (OR 8.5, 95% CI 3.3 to 21.7), menopausal status (OR 6.6, 95% CI 3.1 to 14.3), and frequency of sexual intercourse (OR 10.7, 95% CI 3.6 to 31.7). Multivariate analysis showed that medical problem (adjusted OR 4.6, 95% CI 1.6 to 14.0) and frequency of sexual intercourse (adjusted OR 7.2, 95% CI 2.1 to 24.0) were associated with increased risk of having FSD. Those who practiced contraception were less likely to have FSD.
    CONCLUSION: Sexual health problems are prevalent in women attending primary care clinic where one in four women were at high risk of FSD. Thus, primary care physician should be trained and prepared to address this issue.
    Study site: Primary Care Clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Age Factors
  11. Effects of ascorbic acid on impaired vascular reactivity in aortas isolated from age-matched hypertensive and diabetic rats
    Ajay M, Mustafa MR
    Vascul Pharmacol, 2006 Aug;45(2):127-33.
    PMID: 16807125 DOI: 10.1016/j.vph.2006.05.001
    Impaired vascular reactivity is a hallmark of several cardiovascular diseases that include hypertension and diabetes. This study compared the changes in vascular reactivity in age-matched experimental hypertension and diabetes, and, subsequently, tested whether these changes could be affected directly by ascorbic acid (10 microM). Endothelium-derived nitric oxide (NO) modulation of ascorbic acid effects was also investigated. All the experiments were performed in the presence of a cyclooxygenase inhibitor, indomethacin (10 microM). Results showed that the endothelium-dependent and -independent relaxations induced by acetylcholine (ACh) and sodium nitroprusside (SNP), respectively, were blunted to a similar extent in isolated aortic rings from age-matched spontaneously hypertensive (SHR) (R(max): ACh = 72.83+/-1.86%, SNP = 96.6+/-1.90%) and diabetic (Rmax: ACh = 64.09+/-5.14%, SNP = 95.84+/-1.41%) rats compared with aortic rings of normal rats (Rmax: ACh = 89%, SNP = 104.0+/-1.0%). The alpha1-receptor-mediated contractions induced by phenylephrine (PE) were augmented in diabetic (Cmax = 148.8+/-9.0%) rat aortic rings compared to both normal (Cmax = 127+/-6.9%) and SHR (Cmax = 118+/-4.5%) aortic rings. Ascorbic acid pretreatment was without any significant effects on the vascular responses to ACh, SNP and PE in aortic rings from normal rats. Ascorbic acid significantly improved ACh-induced relaxations in SHR (Rmax = 89.09+/-2.82%) aortic rings to a level similar to that observed in normal aortic rings, but this enhancement in ACh-induced relaxations was only partial in diabetic aortic rings. Ascorbic acid lacked any effects on SNP-induced relaxations in both SHR and diabetic aortic rings. Ascorbic acid markedly attenuated contractions induced by PE in aortic rings from both SHR (Cmax = 92.9+/-6.68%) and diabetic (Cmax = 116.9+/-9.4%) rats. Additionally, following inhibition of nitric oxide synthesis with l-NAME, ascorbic acid attenuated PE-induced contractions in all aortic ring types studied. These results suggest that (1) vascular hyper-responsiveness to alpha(1)-receptor agonists in diabetic arteries is independent of endothelial nitric oxide dysfunction; (2) ascorbic acid directly modulates contractile responses of hypertensive and diabetic rat aortas, likely through mechanisms in part independent of preservation of endothelium-derived nitric oxide.
    Matched MeSH terms: Age Factors
  12. Type 2 diabetes in youth from the Western Pacific region: glycaemic control, diabetes care and complications
    Eppens MC, Craig ME, Jones TW, Silink M, Ong S, Ping YJ, et al.
    Curr Med Res Opin, 2006 May;22(5):1013-20.
    PMID: 16709323 DOI: 10.1185/030079906X104795
    OBJECTIVE: To describe the glycaemic control, diabetes care and prevalence of complications in youth with type 2 diabetes from the Western Pacific Region.
    RESEARCH DESIGN AND METHODS: Cross-sectional, clinic-based audit of 331 patients aged < 18 years from 56 centres in Australia, China-Beijing, China-Shanghai, China-Hong Kong, Indonesia, Japan, South Korea, Malaysia, Philippines, Singapore, Taiwan and Thailand. Clinical and management data were recorded along with glycated haemoglobin (HbA(1c)), lipids and complication rates.
    MAIN OUTCOME MEASURES: Glycaemic control, complications, diabetes management.
    RESULTS: Median age was 14.9 years (interquartile range 13.2-16.4 years) and median diabetes duration 2.3 years (1.4-3.6 years). Median HbA(1c) was 7% (5.9-9.9%) and HbA(1c) was > 7.5% in 40% of patients. In multiple regression analysis, glycaemic control varied significantly between countries (p = 0.02); higher HbA(1c) was associated with fewer home blood glucose measurements (p = 0.005) and higher insulin dose/kg (p < 0.0001). Blood glucose monitoring was performed by 65% of patients (range 33-96% by country). In 25% of patients, management consisted of diet alone or no treatment (range 0-53% by country); oral anti-diabetic drugs alone were used in 49%, insulin alone in 11% and both in 15%. Microalbuminuria was found in 8% and hypertension in 24%. The risk of hypertension increased with higher BMI (OR 1.16, 95% CI 1.09-1.24, p < 0.0001); antihypertensive agents were used in 4% of patients.
    CONCLUSIONS: The management of type 2 diabetes in youth from the Western Pacific Region varies widely. Hypertension and microalbuminuria were frequent, but not commonly treated. Further investigation into the natural history and risk factors for complications in youth with type 2 diabetes is required to assist in developing evidence based management guidelines.
    Matched MeSH terms: Age Factors
  13. Nerve conduction study of healthy Asian Malays: the influence of age on median, ulnar, and sural nerves
    Awang MS, Abdullah JM, Abdullah MR, Tahir A, Tharakan J, Prasad A, et al.
    Med Sci Monit, 2007 Jul;13(7):CR330-2.
    PMID: 17599028
    Nerve conduction study is essential in the diagnosis of focal neuropathies and diffuse polyneuropathies. There are many factors that can affect nerve conduction velocity, and age is one of them. Most of the many studies of this effect, and the values from them, were on Caucasian subjects. Therefore, this study was designed to investigate the effect of age on conduction velocity among healthy Asian Malay subjects by analyzing its influence on the median, ulnar, and sural nerves.
    Matched MeSH terms: Age Factors
  14. How do men perceive erectile dysfunction and its treatment? A qualitative study on opinions of men
    Low WY, Ng CJ, Choo WY, Tan HM
    Aging Male, 2006 Sep;9(3):175-80.
    PMID: 17050117 DOI: 10.1080/13685530600914601
    INTRODUCTION: Erectile dysfunction (ED) is a common medical disorder affecting the aging male. A man's perception of a disease affects his health seeking behaviour. This study aimed to explore perceptions of ED among men with ED and how these perceptions came about.
    METHODS: This qualitative study utilized in-depth interviews involving 17 urban men aged between 40 and 75 years old.
    RESULTS: Misconceptions existed regarding the definitions of ED. Most men perceived impotence to be more serious than ED. Although most were aware of the medical causes of ED, 'overuse of penis' and black magic were mentioned as culturally-related causes. ED was perceived as a serious problem associated with loss of manhood and it had a significant impact on relationships with their partners. However, some adopted an 'accepting' view and attributed it to aging and fate. Most men were only familiar with PDE-5 inhibitors and traditional therapies. PDE-5 inhibitors were perceived to be effective but they were concerned about side effects and costs.
    CONCLUSIONS: Identifying men's perceptions of ED and its treatment would help doctors in their consultation, and inform health policy makers in planning appropriate public education and services.
    Matched MeSH terms: Age Factors
  15. The age of menopause and the menopause transition in a multiracial population: a nation-wide Singapore study
    Loh FH, Khin LW, Saw SM, Lee JJ, Gu K
    Maturitas, 2005 Nov-Dec;52(3-4):169-80.
    PMID: 16257608
    To describe the prevalence of menopausal symptoms, define the mean age of menopause, and determine contributory factors, which influence the experience of symptoms among Singaporean women of different racial groups.
    Matched MeSH terms: Age Factors
  16. Occupational pressure-targeting organisational factors to ameliorate occupational dysfunction
    Loh SY, Than W, Quek KF
    J Occup Rehabil, 2011 Dec;21(4):493-500.
    PMID: 21365305 DOI: 10.1007/s10926-011-9287-3
    INTRODUCTION: Chronic pressure at work has debilitating impact on healthcare employers (e.g. reduced productivity, high costs, poor patient care) and on female healthcare employees (e.g. sickness, dysfunction). This paper highlights relationship at work as the key occupational source of work-stress which is organisational in nature.

    METHODS: A cross-sectional study (n = 230) was conducted using the Pressure Management Inventory on several female dominated health professions within a large public hospital. Analysis of variance was used to show relationship between sources and outcome of pressure. Linear regressions were used to predict which sources of pressure (IV) was linked to the outcomes of occupational pressure (DV).

    RESULTS: The number one source of occupational pressure is relationships at work (i.e. with supervisors), and not workload. 'Relationship' is also the key predictor of several negative outcomes of pressure at work. Analysis of variance showed significant differences in two sources of pressures, i.e. Workload (P = 0.04) and Home-work balance (P = 0.03).

    CONCLUSION: This paper provides insights into the occupational pressure of women health professionals by highlighting the organisational sources of pressure and the implications for preventing occupational dysfunction secondary to stress at work.

    Matched MeSH terms: Age Factors
  17. Fulltext Neonatal feed restriction modulates circulating levels of corticosterone and expression of glucocorticoid receptor and heat shock protein 70 in aged Japanese quail exposed to acute heat stress
    Soleimani AF, Zulkifli I, Omar AR, Raha AR
    Poult Sci, 2011 Jul;90(7):1427-34.
    PMID: 21673157 DOI: 10.3382/ps.2011-01403
    This study aimed to determine the effect of neonatal feed restriction on plasma corticosterone concentration (CORT), hippocampal glucocorticoid receptor (GR) expression, and heat shock protein (Hsp) 70 expression in aged male Japanese quail subjected to acute heat stress. Equal numbers of chicks were subjected to either ad libitum feeding (AL) or 60% feed restriction on d 4, 5, and 6 (FR). At 21 (young) and 270 (aged) d of age, birds were exposed to 43 ± 1°C for 1 h. Blood and hippocampus samples were collected to determine CORT and Hsp 70 and GR expressions before heat stress and following 1 h of heat stress, 1 h of post-heat stress recovery, and 2 h of post-heat stress recovery. With the use of real-time PCR and enzyme immunoassay, we examined the hippocampal expression of GR and Hsp 70 and CORT. The GR expression of the young birds increased following heat stress and remained consistent throughout the period of recovery. Conversely, no significant changes were noted on GR expression of aged birds. Although both young and aged birds had similar CORT before and during heat stress, the latter exhibited greater values following 1 and 2 h of recovery. Within the young group, feeding regimens had no significant effect on Hsp 70 expression. However, neonatal feed restriction improved Hsp 70 expression in aged birds. Neonatal feed restriction, compared with the AL group, resulted in higher CORT on d 21 but the converse was noted on d 270. Neonatal feed restriction appears to set a robust reactive hypothalamo-pituitary-adrenal response allowing the development of adaptive, healthy, and resilient phenotypes in aged quail as measured by a higher hippocampal Hsp 70 expression along with lower CORT.
    Matched MeSH terms: Age Factors
  18. Fulltext Seroepidemiology of toxoplasmosis in renal patients
    Nissapatorn V, Leong TH, Lee R, Init-Ithoi, Ibrahim J, Yen TS
    Southeast Asian J Trop Med Public Health, 2011 Mar;42(2):237-47.
    PMID: 21710842
    Toxoplasmosis is an important parasitic disease in immunosuppressed patients. This prospective study was conducted to determine the seroprevalence, associated risk factors and the incidence of clinically confirmed toxoplasmosis among renal patients at the University of Malaya Medical Center, Kuala Lumpur, Malaysia. We interviewed 247 renal patients, each of whom answered an epidemiological questionnaire, and collected blood samples for measurement of anti-Toxoplasma IgG and IgM antibodies by ELISA. Overall seroprevalence of latent toxoplasmosis was observed in 126 (51%) renal patients. Race (Malays), marital status (married) and primary level of education, were all factors associated with a greater chance of Toxoplasma infection. A case of clinically confirned toxoplasmosis was diagnosed in a renal transplant recipient as a result of immunosuppression. Based on the findings obtained, this preliminary study shows a high prevalence of latent toxoplasmosis in renal patients. Risk factors may have significantly contributed to Toxoplasma acquisition in these patients. We recommend further studies be carried out to monitor for trends in toxoplasmosis among immunosuppressed patients.
    Matched MeSH terms: Age Factors
  19. Factors affecting warfarin-related knowledge and INR control of patients attending physician- and pharmacist-managed anticoagulation clinics
    Hasan SS, Shamala R, Syed IA, Basariah N, Chong DW, Mei TK, et al.
    J Pharm Pract, 2011 Oct;24(5):485-93.
    PMID: 21844213 DOI: 10.1177/0897190011415684
    OBJECTIVES: To assess the anticoagulation knowledge and international normalized ratio (INR) control among patients on warfarin.
    METHODS: A cross-sectional study with 156 randomly sampled patients from physician- (non-medication therapy adherence clinic [non-MTAC]) and pharmacist (MTAC)-run anticoagulation clinics using a validated interviewer-administered questionnaire. Patients' INR readings from 2008 to 2010 were recorded.
    RESULTS: Patients on warfarin scored an average of 66.5% ± 36.0% for their knowledge on how warfarin works, 42.9% ± 44.9% for interaction between warfarin and alcohol, and 49.2% ± 21.1% for adverse effects. No significant differences were found between MTAC and non-MTAC patients on their knowledge. There was a negative correlation between patients' knowledge and age (P = .001, r (s) = -.293) and a positive correlation between patients' knowledge and education level (P = .001, r (s) = .365). MTAC patients were found to have better INR control than non-MTAC when compared for mean percentage days in range (63.4% ± 18.9% vs 52.5% ± 18.2%; P = .006) and mean percentage visits in range (58.8% ± 17.9% vs 46.8% ± 18.6%; P = .001).
    CONCLUSIONS: MTAC patients were found to have better INR control compared to non-MTAC patients. A joint cooperation between physicians, pharmacists, and nurses should exist to achieve desired therapeutic outcomes.

    Study site: warfarin patients
    attending the anticoagulation clinics
    Matched MeSH terms: Age Factors
  20. Proteomic analysis reveals that treatment with tocotrienols reverses the effect of H₂O₂ exposure on peroxiredoxin expression in human lymphocytes from young and old individuals
    Dahlan HM, Karsani SA, Rahman MA, Hamid NA, Top AG, Ngah WZ
    J Nutr Biochem, 2012 Jul;23(7):741-51.
    PMID: 21840697 DOI: 10.1016/j.jnutbio.2011.03.018
    Vitamin E has been suggested to modulate age-associated changes by altering the redox balance resulting in altered gene and/or protein expression. Here we have utilized proteomics to determine whether such regulation in protein expression occurs in human lymphocytes from two different age groups stressed with H₂O₂ and then treated with vitamin E in the form of tocotrienol-rich fraction (TRF). In this study, lymphocytes obtained from young (30-49 years old) and old (>50 years old) volunteers were first challenged with 1 mM H₂O₂. They were then treated by exposure to 50, 100 and 200 μg/ml TRF. Two-dimensional gel electrophoresis followed by MALDI-TOF/TOF (matrix-assisted laser desorption/ionization time-of-flight/time-of-flight) tandem mass spectrometry was then performed on whole-cell protein extracts to identify proteins that have changed in expression. A total of 24 proteins were found to be affected by H₂O₂ and/or TRF treatment. These included proteins that were related to metabolism, antioxidants, structural proteins, protein degradation and signal transduction. Of particular interest was the regulation of a number of proteins involved in stress response--peroxiredoxin-2, peroxiredoxin-3 and peroxiredoxin-6-all of which were shown to be down-regulated with H₂O₂ exposure. The effect was reversed following TRF treatment. The expression of peroxiredoxin-2 and peroxiredoxin-6 was confirmed by quantitative reverse transcriptase polymerase chain reaction. These results suggested that TRF directly influenced the expression dynamics of the peroxiredoxin-2, thus improving the cells ability to resist damage caused by oxidative stress.
    Matched MeSH terms: Age Factors
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