Displaying publications 81 - 100 of 373 in total

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  1. Fulltext Diagnostic and Prognostic Indications of Nasopharyngeal Carcinoma
    E A R ENS, Irekeola AA, Yean Yean C
    Diagnostics (Basel), 2020 Aug 19;10(9).
    PMID: 32825179 DOI: 10.3390/diagnostics10090611
    Nasopharyngeal carcinoma (NPC) is a disease that is highly associated with the latent infection of Epstein-Barr virus. The absence of obvious clinical signs at the early stage of the disease has made early diagnosis practically impossible, thereby promoting the establishment and progression of the disease. To enhance the stride for a reliable and less invasive tool for the diagnosis and prognosis of NPC, we synopsize biomarkers belonging to the two most implicated biological domains (oncogenes and tumor suppressors) in NPC disease. Since no single biomarker is sufficient for diagnosis and prognosis, coupled with the fact that the known established methods such as methylation-specific polymerase chain reaction (PCR), multiplex methylation-specific PCR, microarray assays, etc., can only accommodate a few biomarkers, we propose a 10-biomarker panel (KIT, LMP1, PIKC3A, miR-141, and miR-18a/b (oncogenic) and p16, RASSF1A, DAP-kinase, miR-9, and miR-26a (tumor suppressors)) based on their diagnostic and prognostic values. This marker set could be explored in a multilevel or single unified assay for the diagnosis and prognosis of NPC. If carefully harnessed and standardized, it is hoped that the proposed marker set would help transform the diagnostic and prognostic realm of NPC, and ultimately, help prevent the life-threatening late-stage NPC disease.
    Matched MeSH terms: Disease Progression
  2. Fulltext The expression of microrna-744 (Mir-744) in nasopharyngeal carcinoma: a preliminary study
    Noor Syamila Othman, Wan Ishlah Leman, Kahairi Abdullah, Siti Aesah @ Naznin Muhammad, Mohd Arifin Kaderi
    International Journal of Allied Health Sciences, 2018;2(1):191-203.
    MyJurnal
    The aim of this study was to investigate the level of miR-744 expression in nasopharyngeal carcinoma (NPC) tumour tissue and to provide initial clue on its potential as biomarkers for early detection of NPC in a preliminary analysis. Total miRNAs was extracted from NPC tissue as well as normal nasopharynx tissue taken from Hospital Tengku Ampuan Afzan (HTAA), Kuantan and converted into cDNA. The level of miR-744 expression in the cDNA was quantified using quantitative reverse transcription polymserase chain reaction (RT-qPCR) technique. The expression level of SNORD48 was measured simultaneously for each sample, which served as endogenous control. The difference in the expression of miR-744 in NPC and normal nasopharynx tissue were analysed using relative quantification, 2-ΔΔCT. In this preliminary analysis, this study found that miR-744 was upregulated in NPC as compared to normal nasopharynx tissue by 2.5 fold changes, respectively suggesting it may involve in progression of tumour. However, the finding is not significant and may not accurately reflect the overall population, due to small sample size involved in the study. Findings from the current study suggest the potential of miR-744 to serve as useful diagnostic and prognostic biomarker in NPC.
    Matched MeSH terms: Disease Progression
  3. Association between microRNA-196A2 and microRNA-146A polymorphisms and progression to cirrhosis and hepatocellular carcinoma in patients with viral hepatitis B
    Riazalhosseini B, Mohamed Z, Apalasamy YD, Eng HS, Mohamed R
    Pharmacogenet Genomics, 2016 Feb;26(2):74-9.
    PMID: 26529280 DOI: 10.1097/FPC.0000000000000187
    MicroRNAs (miRNAs) are small noncoding RNAs that have been implicated in mechanisms underlying various types of cancers including hepatocellular carcinoma (HCC). Reports have indicated that single nucleotide polymorphisms in miRNA-196A2 and miRNA-146A genes may contribute to the risk of progression of hepatitis B virus (HBV) infection to cirrhosis and HCC. This study aimed to examine the effect of miRNA-196A2 and miRNA-146A polymorphisms on the progression of HBV infection to cirrhosis and/or HCC in HBV patients in the Malaysian population.
    Matched MeSH terms: Disease Progression
  4. Fulltext Depression and HIV Disease Progression: A Mini-Review
    Yousuf A, Mohd Arifin SR, Musa R, Md Isa ML
    Clin Pract Epidemiol Ment Health, 2019;15:153-159.
    PMID: 32174997 DOI: 10.2174/1745017901915010153
    Background: Depression is the most common mental disorder and a leading cause of disability, which commonly presents unexplained psychological and physical symptoms. Depression and HIV/AIDS are commonly comorbid. This review provides an insight into the effect of depression on disease progression among people living with HIV.

    Methods: A search for relevant articles was conducted using a database like MEDLINE, Scopus, PsycINFO and CINAHL. Peer-reviewed English journals published between 2015 and 2019 were included in the review.

    Results: A total of eight studies conducted in different settings were included in the review. This review has found that psychosocial, neurohormonal and virologic factors associated with depression affect HIV disease progression. Yet, the chronicity of depression, absence of the hormones that have a buffer effect on depression and lack of examination if depression is a predictor, or an outcome of disease progression, were some of the gaps that require further investigation.

    Conclusion: Considerably, more research is needed to better understand the effect of mental disorder, especially depression, on HIV disease progression to AIDS and future interventions should, therefore, concentrate on the integration of mental health screening in HIV clinical setup.

    Matched MeSH terms: Disease Progression
  5. Fulltext Hormones in experimental autoimmune encephalomyelitis (EAE) animal models
    Ghareghani M, Ghanbari A, Eid A, Shaito A, Mohamed W, Mondello S, et al.
    Transl Neurosci, 2021 Jan 01;12(1):164-189.
    PMID: 34046214 DOI: 10.1515/tnsci-2020-0169
    Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system (CNS) in which activated immune cells attack the CNS and cause inflammation and demyelination. While the etiology of MS is still largely unknown, the interaction between hormones and the immune system plays a role in disease progression, but the mechanisms by which this occurs are incompletely understood. Several in vitro and in vivo experimental, but also clinical studies, have addressed the possible role of the endocrine system in susceptibility and severity of autoimmune diseases. Although there are several demyelinating models, experimental autoimmune encephalomyelitis (EAE) is the oldest and most commonly used model for MS in laboratory animals which enables researchers to translate their findings from EAE into human. Evidences imply that there is great heterogeneity in the susceptibility to the induction, the method of induction, and the response to various immunological or pharmacological interventions, which led to conflicting results on the role of specific hormones in the EAE model. In this review, we address the role of endocrine system in EAE model to provide a comprehensive view and a better understanding of the interactions between the endocrine and the immune systems in various models of EAE, to open up a ground for further detailed studies in this field by considering and comparing the results and models used in previous studies.
    Matched MeSH terms: Disease Progression
  6. Role of therapeutic agents on repolarisation of tumour-associated macrophage to halt lung cancer progression
    Aldawsari HM, Gorain B, Alhakamy NA, Md S
    J Drug Target, 2020 02;28(2):166-175.
    PMID: 31339380 DOI: 10.1080/1061186X.2019.1648478
    Tumour-associated macrophages (TAMs) represent as much as 50% of the solid mass in different types of human solid tumours including lung, breast, ovarian and pancreatic adenocarcinomas. The tumour microenvironment (TME) plays an important role in the polarisation of macrophages into the M1 phenotype, which is tumour-suppressive, or M2 phenotype, which is tumour promoting. Preclinical and clinical evidences suggest that TAMs are predominantly of the M2 phenotype that supports immune suppression, tumour growth, angiogenesis, metastasis and therapeutic resistance. Hence, significant attention has been focussed on the development of strategies for the modification of TAMs to halt lung cancer progression. The promotion of repolarisation from the M2 to the M1 subtype, or the prevention of M2 polarisation of TAMs in the stromal environment is potential approaches to reduce progression and metastasis of lung cancer. The focus of this article is an introduction to the development and evaluation of therapeutic agents that may halt lung cancer progression via the manipulation of macrophage polarisation. This article will address recent advances in the therapeutic efficacy of nanomedicine exploiting surface functionalisation of nanoparticles and will also consider future perspectives.
    Matched MeSH terms: Disease Progression
  7. Systematic Review and Meta-Analysis on the Impact of Hexaminolevulinate- Versus White-Light Guided Transurethral Bladder Tumor Resection on Progression in Non-Muscle Invasive Bladder Cancer
    Gakis G, Fahmy O
    Bladder cancer (Amsterdam, Netherlands), 2016 Jul 27;2(3):293-300.
    PMID: 27500197
    Introduction: Although there is evidence that hexaminolevulinate (HAL)-based transurethral bladder tumor resection (TURBT) improves the detection of Ta-T1 non-muscle-invasive bladder cancer (NMIBC) as well as carcinoma in situ there is uncertainty about its beneficial effects on progression. Material and Methods: A systematic literature search was conducted according to the PRISMA statement to identify studies reporting on HAL- vs. white-light (WL-) based TUR-BT in non-muscle invasive bladder cancer between 2000 and 2016. A two-stage selection process was utilized to determine eligible studies. Of a total of 294 studies, 5 (4 randomized and one retrospective) were considered for final analysis. The primary objective was the rate of progression. Results: The median follow-up for patients treated with HAL- and WL-TURBT was 27.6 (1-55.1) and 28.9 (1-53) months, respectively. Of a total of 1301 patients, 644 underwent HAL- and 657 WL-based TURBT. Progression was reported in 44 of 644 patients (6.8%) with HAL- and 70 of 657 patients (10.7%) with WL-TURBT, respectively (median odds ratio: 1.64, 1.10-2.45 for HAL vs. WL; p = 0.01). Data on progression-free survival was reported in a single study with a trend towards improved survival for patients treated with HAL-TURBT (p = 0.05). Conclusions: In this meta-analysis the rate of progression was significantly lower in patients treated with HAL- vs. WL-based TURBT. These results support the initiation of randomized trials on HAL with progression as primary endpoint.
    Matched MeSH terms: Disease Progression
  8. Fulltext Ambiguous presentations of pulmonary epithelioid hemangioendothelioma: Two case reports of a rare pulmonary malignancy
    Soo CI, Ng BH, Tan EL, Abdul Hamid F
    SAGE Open Med Case Rep, 2016;4:2050313X16650323.
    PMID: 27489719 DOI: 10.1177/2050313X16650323
    Pulmonary epithelioid hemangioendothelioma is an uncommon lung malignancy of endothelial origin. Besides demonstrating unpredictable presentation features and prognosis, the paucity of established treatment guidelines remains a challenge in managing these patients. We present two patients. The first patient presented with chronic productive cough over 1-year duration. He was initially diagnosed and showed partial response to treatment for cardiac failure. A persistent right upper zone consolidation on chest radiograph prompted further investigations which revealed the diagnosis of pulmonary epithelioid hemangioendothelioma. The second patient presented with right-sided hemiparesis for 1-month duration. Initial computer tomography scan of the brain showed findings of distant metastatic foci. Subsequent investigations revealed pulmonary epithelioid hemangioendothelioma as the primary lesion. Both patients succumbed without any treatment due to rapid progression of the disease. We believe that pulmonary epithelioid hemangioendothelioma is undoubtedly rarely reported in south-east Asia region. In these two case reports, the patients were diagnosed in west and east Malaysia, respectively, in the same year (2015). Both cases highlight the increasing prevalence of pulmonary epithelioid hemangioendothelioma. We postulate that this could possibly be secondary to the advancement in diagnostic capabilities and improved healthcare facilities available in this region. Late presentation of pulmonary epithelioid hemangioendothelioma generally results in grave prognosis. Further investigations are required to elucidate the nature of progression and therapeutic options for patients with pulmonary epithelioid hemangioendothelioma.
    Matched MeSH terms: Disease Progression
  9. Fulltext Negative Checkpoint Regulatory Molecule 2B4 (CD244) Upregulation Is Associated with Invariant Natural Killer T Cell Alterations and Human Immunodeficiency Virus Disease Progression
    Ahmad F, Shankar EM, Yong YK, Tan HY, Ahrenstorf G, Jacobs R, et al.
    Front Immunol, 2017;8:338.
    PMID: 28396665 DOI: 10.3389/fimmu.2017.00338
    The CD1d-restricted invariant natural killer T (iNKT) cells are implicated in innate immune responses against human immunodeficiency virus (HIV). However, the determinants of cellular dysfunction across the iNKT cells subsets are seldom defined in HIV disease. Herein, we provide evidence for the involvement of the negative checkpoint regulator (NCR) 2B4 in iNKT cell alteration in a well-defined cohort of HIV-seropositive anti-retroviral therapy (ART) naïve, ART-treated, and elite controllers (ECs). We report on exaggerated 2B4 expression on iNKT cells of HIV-infected treatment-naïve individuals. In sharp contrast to CD4(-)iNKT cells, 2B4 expression was significantly higher on CD4(+) iNKT cell subset. Notably, an increased level of 2B4 on iNKT cells was strongly correlated with parameters associated with HIV disease progression. Further, iNKT cells from ART-naïve individuals were defective in their ability to produce intracellular IFN-γ. Together, our results suggest that the levels of 2B4 expression and the downstream co-inhibitory signaling events may contribute to impaired iNKT cell responses.
    Matched MeSH terms: Disease Progression
  10. Fulltext Why metabonomics?
    Yap, Ivan K.S.
    International e-Journal of Science, Medicine & Education, 2011;5(1):17-26.
    MyJurnal
    Metabonomics can be used to quantitatively measure dynamic biochemical responses of living organisms to physiological or pathological stimuli. A range of analytical tools such as high-resolution nuclear magnetic resonance (NMR) spectroscopy and mass spectrometry (MS) combined with multivariate statistical analysis can be employed to create comprehensive metabolic signatures of biological samples including urine, plasma, faecal water and tissue extracts. These metabolic signatures can reflect the physiological or pathological condition of the organism and indicate imbalances in the homeostatic regulation of tissues and extracellular fluids. This technology has been employed in a diverse range of application areas including investigation of disease mechanisms, diagnosis/prognosis of pathologies, nutritional interventions and drug toxicity. Metabolic profiling is becoming increasingly important in identifying biomarkers of disease progression and drug intervention, and can provide additional information to support or aid the interpretation of genomic and proteomic data. With the new generation of postgenomic technologies, the paradigm in many biological fields has shifted to either top down systems biology approaches, aiming to achieve a general understanding of the global and integrated response of an organism or to bottom up modelling of specific pathways and networks using a priori knowledge based on mining large bodies of literature. Whilst metabolic profiling lends itself to either approach, using it in an exploratory and hypothesis generating capacity clearly allows new mechanisms to be uncovered.
    Matched MeSH terms: Disease Progression
  11. Fulltext The natural history of optic neuritis in Asian patients: an observational cohort study
    Seah, B.H.A., Tow, S.L.C., Ong, K.C.B. Ong, Yang, C.C., Tsai, C.P., Lee, K.H., et al.
    Neurology Asia, 2017;22(4):341-348.
    MyJurnal
    Optic neuritis, which may be a precursor to multiple sclerosis (MS), is an uncommon disease in
    Asian patients. The Asian Collaborative Longitudinal Optic Neuritis Epidemiology (ACLONE) is
    an observational cohort study that assessed the risk of recurrent optic neuritis and/or progression
    of further neurologic events, either MS or neuromyelitis optica (NMO) in Asian patients with firstever
    optic neuritis. Secondary aims were to study the presenting characteristics and visual outcome,
    and to identify risk factors for development of either MS or NMO. A total of 112 patients (25 men
    and 87 women) aged from 12 to 61 years were recruited from Singapore, Taiwan, South Korea and
    Malaysia. Of these, 94 (84%) had unilateral optic neuritis, with the right eye involved in 45 patients
    and the left eye in 49 patients and the remaining 18 (16%) had bilateral optic neuritis. Follow up
    data was available for 104 patients, and patients were followed for a median duration of 25.9 months.
    Of these patients, 6 patients were adjudicated to have reached the primary endpoint (composite of
    MS/NMO and optic neuritis): 3 patients with recurrent optic neuritis also subsequently experienced
    neurologic symptoms, and 3 patients without recurrent eye involvement had neurologic symptoms.
    Only one patient was considered to have prototypical MS, the other 5 were diagnosed with NMO,
    all with subsequent antibody confirmation. Optic neuritis in Asian patients has significantly different
    presenting characteristics from the classic description. However, in the majority of the patients it is
    usually a benign disease, with good visual outcome and no further events.
    Matched MeSH terms: Disease Progression
  12. Fulltext Neuropsychiatric manifestations of neurosyphilis: a case report
    Abdul Taib, N.I., Seed, H.F., Yeoh, C.M., Thon,g K.S.
    Malaysian Journal of Psychiatry, 2016;25(1):0-0.
    MyJurnal
    Neurosyphilis has been known to present with wide array of neuropsychiatric
    signs and symptoms. However little is known of the severity of its
    manifestations especially in our Malaysia setting. We are reporting a case of
    a middle-aged ex-military Malay man who contracted neurosyphilis during
    active service and since then had severe neuropsychiatric symptoms which
    caused deterioration in his activities of daily living skills which warrants
    constant supervision. We discuss the various presentations of neurosyphilis
    and its sequelae despite completion of antibiotics treatment.
    Matched MeSH terms: Disease Progression
  13. Fulltext Disseminated Intravascular Coagulation and Excessive Fibrinolysis (DIC XFL) Syndrome in Prostate Cancer: A Rare Complicated Disorder
    Hamzah AB, Choo YM, Hassali MA, Saleem F, Verma AK
    J Clin Diagn Res, 2017 Jan;11(1):XD01-XD02.
    PMID: 28274032 DOI: 10.7860/JCDR/2017/22582.9313
    Disseminated Intravascular Coagulation (DIC) develops in patient with prostate cancer, which is manifested by systemic, intracranial, intracavitary or intracutaneous bleeding indicating uncompensated or excessive fibrinolysis (XFL). This case report is a description of a 61-year-old male with metastatic prostate cancer that progressed to manifest DIC. The condition is rare in clinical practice, and even rarer when is coupled with XFL. Treatment was mainly replenishing coagulation factors, platelets and controlling the disease progression with aggressive hormonal therapy. The patient progressed to coagulopathy further with fibrinolysis, hence leading to mortality. This case study discusses the pathophysiology of this complication and various methods to monitor the disease progression are discussed.
    Matched MeSH terms: Disease Progression
  14. Fulltext Delineating inflammatory bowel disease through transcriptomic studies: current review of progress and evidence
    Chan SN, Low END, Raja Ali RA, Mokhtar NM
    Intest Res, 2018 Jul;16(3):374-383.
    PMID: 30090036 DOI: 10.5217/ir.2018.16.3.374
    Inflammatory bowel disease (IBD), which comprises of Crohn's disease and ulcerative colitis, is an idiopathic relapsing and remitting disease in which the interplay of different environment, microbial, immunological and genetic factors that attribute to the progression of the disease. Numerous studies have been conducted in multiple aspects including clinical, endoscopy and histopathology for the diagnostics and treatment of IBD. However, the molecular mechanism underlying the aetiology and pathogenesis of IBD is still poorly understood. This review tries to critically assess the scientific evidence at the transcriptomic level as it would help in the discovery of RNA molecules in tissues or serum between the healthy and diseased or different IBD subtypes. These molecular signatures could potentially serve as a reliable diagnostic or prognostic biomarker. Researchers have also embarked on the study of transcriptome to be utilized in targeted therapy. We focus on the evaluation and discussion related to the publications reporting the different approaches and techniques used in investigating the transcriptomic changes in IBD with the intention to offer new perspectives to the landscape of the disease.
    Matched MeSH terms: Disease Progression
  15. Clubroot Disease Stimulates Early Steps of Phloem Differentiation and Recruits SWEET Sucrose Transporters within Developing Galls
    Walerowski P, Gündel A, Yahaya N, Truman W, Sobczak M, Olszak M, et al.
    Plant Cell, 2018 Nov 09.
    PMID: 30413655 DOI: 10.1105/tpc.18.00283
    Successful biotrophic plant pathogens can divert host nutrition towards infection sites. Here we describe how the protist Plasmodiophora brassicae establishes a long-term feeding relationship with its host by stimulating phloem differentiation and phloem-specific expression of sugar transporters within developing galls. Development of galls in infected Arabidopsis thaliana plants is accompanied by stimulation of host BREVIS RADIX (BRX), COTYLEDON VASCULAR PATTERN 2 (CVP2) and OCTOPUS (OPS) gene expression leading to an increase in phloem complexity. We characterised how the arrest of this developmental reprogramming influences both the host and the invading pathogen. Furthermore, we found that infection leads to phloem-specific accumulation of SUGARS WILL EVENTUALLY BE EXPORTED TRANSPORTERS (SWEET11 and SWEET12) facilitating local distribution of sugars towards the pathogen. Utilising Fourier-transform infrared (FTIR) microspectroscopy to monitor spatial distribution of carbohydrates, we found that infection leads to the formation of a strong physiological sink at the site of infection. High resolution metabolic and structural imaging of sucrose distributions revealed that sweet11 sweet12 double mutants are impaired in sugar transport towards the pathogen, delaying disease progression. This work highlights the importance of precise regulation of sugar partitioning for plant-pathogen interactions and the dependence of P. brassicae's performance on its capacity to induce a phloem sink at the feeding site.
    Matched MeSH terms: Disease Progression
  16. Fulltext Disseminated AIDS-related Kaposi's sarcoma
    Tang ASO, Teh YC, Chea CY, Yeo ST, Chua HH
    Oxf Med Case Reports, 2018 Dec;2018(12):omy107.
    PMID: 30487992 DOI: 10.1093/omcr/omy107
    We present a case of disseminated Kaposi's sarcoma with both cutaneous and extracutaneous involvement in an HIV-infected patient with a relatively high CD4 count of 369 cell/mm3. He developed chronic diarrhea, constitutional symptoms, worsening bilateral pleural effusion with respiratory distress, and progression of skin lesions distributed over his chest and extremities. The temporal relationship between rapid clinical progression and initiation of HAART suggested the possibility of Kaposi's sarcoma-associated immune reconstitution inflammatory syndrome, which eventually resulted in the death of this patient.
    Matched MeSH terms: Disease Progression
  17. Fulltext Tumour-Associated Macrophages (TAMs) in Colon Cancer and How to Reeducate Them
    Yahaya MAF, Lila MAM, Ismail S, Zainol M, Afizan NARNM
    J Immunol Res, 2019;2019:2368249.
    PMID: 30931335 DOI: 10.1155/2019/2368249
    Tumour-associated macrophage (TAM) serves as the site in which most inflammatory cells coreside. It plays an important role in determining the progression and metastasis of a tumour. The characteristic of TAM is largely dependent on the stimuli present in its tumour microenvironment (TME). Under this environment, however, M2 macrophages are found to be in abundance compared to M1 macrophages which later promote tumour progression. Numerous studies have elucidated the relationship between TAM and the progression of tumour; hence, TAM has now been the subject of interest among researchers for anticancer therapy. This review discusses the role of TAM in colorectal cancer (CRC) and some of the potential candidates that could reeducate TAM to fight against CRC. It is with hope that this review will serve as the foundation in understanding TAM in CRC and helping other researchers to select the most suitable candidate to reeducate TAM that could assist in enhancing the tumouricidal activity of M1 macrophage and eventually repress the development of CRC.
    Matched MeSH terms: Disease Progression
  18. Challenges in predicting risks of premature coronary artery disease (pcad)
    Muhammad Faizan A. Shukor, Noor Akmal Shareela Ismail, Wan Zurinah Wan Ngah
    Sains Malaysiana, 2018;47:2543-2556.
    Coronary artery disease (CAD) predominantly manifests in older population above the age of 60 years old. The incidence
    of CAD in younger individuals has been reported and is called premature CAD (pCAD). The prevalence for pCAD in
    individuals below 45 years old is about 3-10% worldwide. Advances in risk prediction are of great importance as
    absolute values of risk factors sometimes correlate poorly with individuals. The measurement of traditional risk factors
    such as cholesterol level and blood pressure might be inadequate to predict risk for pCAD and therefore new biomarkers
    are required. The introduction of omics technology offers insight into the mechanism and interactions involved during
    disease progression and open the possibilities of discovering new biomarkers. Currently, new potential biomarkers for
    pCAD have been explored such as homocysteine, apolipoproteins, microRNAs and single nucleotide polymorphisms. In
    this review, we discussed the associated risk factors for pCAD, several reported and newly proposed biomarkers and
    their potential to be used clinically.
    Matched MeSH terms: Disease Progression
  19. Cardiopulmonary exercise testing: utility in research and patient care
    Elina RA, Husain R, Lang CC
    JUMMEC, 2005;8:9-22.
    Cardiopulmonary exercise testing is a non-invasive physiological test which incorporates the conventional method of exercise stress test with a more advanced breath-to-breath ventilatory analysis. The physiological parameters obtained from the test help to illustrate the cardiovascular, respiratory and metabolic responses to physical exertion. Individual's functional capacity and aerobic fitness is reflected by the value of maximal oxygen consumption (VO2 max) obtained from the cardiopulmonary exercise test. This non-invasive and sophisticated test is regarded as a valuable assessment tool in research and clinical practice. Cardiopulmonary exercise test has been extensively utilized to define the mechanisms of exercise intolerance in various clinical disorders, to evaluate responses to therapy and indicate disease prognosis. Emerging data obtained from the use of the cardiopulmonary exercise testing in the research field, has led to its extensive clinical usage. It is now utilized as an integral part of the patients' clinical evaluation in the field of respiratory and cardiovascular medicine, sports medicine, surgery as well as occupational and rehabilitative medicine. It has a clinical role in assessing patient's functional capacity, monitoring disease progression and response to therapy, predicting prognosis, and perioperative morbidity and mortality, as well as constructing and monitoring training and rehabilitative programs. This article aims to give an overview of the physiological profiles obtained from cardiopulmonary exercise testing, its methodological aspects, as well as its utility in research and clinical practice. KEYWORDS: Cardiopulmonary, exercise, physiology, respiratory medicine, oxygen consumption
    Matched MeSH terms: Disease Progression
  20. Fulltext Clinical Course and Characteristics of Generalized Pustular Psoriasis
    Choon SE, Navarini AA, Pinter A
    Am J Clin Dermatol, 2022 Jan;23(Suppl 1):21-29.
    PMID: 35061227 DOI: 10.1007/s40257-021-00654-z
    Generalized pustular psoriasis (GPP) is a rare, potentially life-threatening disease characterized by episodes of widespread sterile macroscopic pustules, with or without systemic inflammation and/or plaque psoriasis. Multiple GPP subtypes have been described, from acute GPP of von Zumbusch to milder, annular pustular psoriasis. Generalized pustular psoriasis mainly affects adults, with a female preponderance, but juvenile GPP also occurs. Flares are a hallmark of GPP and may occur de novo or be provoked by triggers, including withdrawal of systemic corticosteroids, infections, stress, pregnancy, and menstruation. Severity of flares varies widely between patients, and between flares in an individual patient. Significant flares are often accompanied by systemic symptoms, notably fever, general malaise, and extracutaneous manifestations such as arthritis, uveitis, and neutrophilic cholangitis. Common laboratory abnormalities include neutrophilia, elevated C-reactive protein levels, hypocalcemia, and abnormal liver function tests. The clinical course of GPP is highly variable; it can be a relapsing disease with recurrent flares and no pustulation between flares or a persistent disease with perpetual mild pustulation punctuated with flares of greater severity. Patients may have multiple flares per year or a flare every few years. Most flares last 2-5 weeks and approximately 50% require hospitalization. Life-threatening complications include sepsis and renal, hepatic, respiratory, and heart failure. Reported mortality rates are 2-16%.
    Matched MeSH terms: Disease Progression
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