Displaying publications 81 - 100 of 815 in total

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  1. Doping in sports among Malaysian universities athlete: survey of the knowledge, beliefs, and perception during Malaysian universities games in Kuala Lumpur 2014
    Jaafar Z, Wan Hamat NH
    J Sports Med Phys Fitness, 2020 May;60(5):794-799.
    PMID: 32037780 DOI: 10.23736/S0022-4707.20.09623-1
    BACKGROUND: Doping in young athletes at present is on escalation. A few doping cases involving athletes from South East Asia (SEA) countries have been reported. The objective of this study is to determine current perceived doping and antidoping climate in Malaysia through an exploration of doping-related knowledge, perception and beliefs among the university athletes.

    METHODS: A survey was conducted during the Malaysian Universities Games in Kuala Lumpur 2014. A total of 614 athletes completed the questionnaires on perception, specific knowledge, environment, behavior and beliefs towards doping.

    RESULTS: From this survey, we found that their knowledge about doping and antidoping was poor, they have misguided beliefs and perception about doping, and their environment seems to be favorable for performance enhancing substances usage in the future. We grouped the athletes based on their doping's environment into ultraclean, potential and high-risk group; and the results showed that they have a significant relationship with their knowledge, beliefs and perception about doping in sports, P<0.001. About 1.5-1.8% of the studied athletes have positive behavior towards doping practice; doping use, χ2 =24.6(2) P<0.001 and doping willingness, χ2 =17.15(2) P<0.001.

    CONCLUSIONS: Doping behavior and doping risks in this region are still under-studied. Hence, we recommended that every South East Asia countries would identify the potential risks of doping among their young athletes, and collectively collaborating in managing doping issues involving this region. Special attention should be given to doping environment as it has negative influences on athletes behavior towards doping.

    Matched MeSH terms: Risk Assessment
  2. Endoscopic transpterygoidal repair of a large cranial defect with cerebrospinal fluid leak in a patient with extensive osteoradionecrosis of the skull base: case report and technical note
    Brand Y, Lim E, Waran V, Prepageran N
    J Laryngol Otol, 2015 Dec;129(12):1243-7.
    PMID: 26412297 DOI: 10.1017/S0022215115002601
    Endoscopic endonasal techniques have recently become the method of choice in dealing with cerebrospinal fluid leak involving the anterior cranial fossa. However, most surgeons prefer an intracranial approach when leaks involve the middle cranial fossa. This case report illustrates the possibilities of using endoscopic techniques for cerebrospinal fluid leaks involving the middle fossa.
    Matched MeSH terms: Risk Assessment
  3. Fulltext Geographical distribution and risk association of human papillomavirus genotype 52-variant lineages
    Zhang C, Park JS, Grce M, Hibbitts S, Palefsky JM, Konno R, et al.
    J Infect Dis, 2014 Nov 15;210(10):1600-4.
    PMID: 24879800 DOI: 10.1093/infdis/jiu310
    Human papillomavirus (HPV) genotype 52 is commonly found in Asian cases of cervical cancer but is rare elsewhere. Analysis of 611 isolates collected worldwide revealed a remarkable geographical distribution, with lineage B predominating in Asia (89.0% vs 0%-5.5%; P(corrected) < .001), whereas lineage A predominated in Africa, the Americas, and Europe. We propose that the name "Asian lineage" be used to denote lineage B, to signify this feature. Preliminary analysis suggested a higher disease risk for lineage B, although ethnogeographical confounders could not be excluded. Further studies are warranted to verify whether the reported high attribution of disease to HPV52 in Asia is due to the high prevalence of lineage B.
    Matched MeSH terms: Risk Assessment
  4. Is reduced susceptibility to disinfectants and antiseptics a risk in healthcare settings? A point/counterpoint review
    Harbarth S, Tuan Soh S, Horner C, Wilcox MH
    J Hosp Infect, 2014 Aug;87(4):194-202.
    PMID: 24996517 DOI: 10.1016/j.jhin.2014.04.012
    Given the breadth and depth of antiseptic use, it is surprising how few large-scale studies have been undertaken into the consequences of their use, particularly in clinical practice. Depending on your point of view, this may either reflect an assurance that reduced susceptibility to antiseptics, and notably whether this confers cross-resistance to systemically administered antimicrobial agents, is not an issue of concern, or relative ignorance about the potential threat.
    Matched MeSH terms: Risk Assessment
  5. Primary Melanoma of the Third Metatarsal
    Singh VA, Lim CY, Yan HC, Rahman NA
    J Foot Ankle Surg, 2017 06 26;56(6):1292-1297.
    PMID: 28659241 DOI: 10.1053/j.jfas.2017.05.005
    Melanoma is a well-known malignant neoplasm of the skin, although it can also arise from other structures. Bone metastasis is not an uncommon event associated with melanoma, although primary osseous melanoma is very rare. In the present report, we describe a case of primary melanoma arising from the left third metatarsal in an adult male. The lesion was treated with surgical excision without adjunct chemotherapy, and recurrence developed approximately 12 months after the foot surgery. The patient died of the cancer 34 months after it had been identified. Primary melanoma arising in a metatarsal is rare, and we wished to highlight this unusual presentation.
    Matched MeSH terms: Risk Assessment
  6. Functional Outcomes After Heel Pad Reconstruction: A Review of 7 Cases
    Khai Luen K, Wan Sulaiman WA
    J Foot Ankle Surg, 2017 8 27;56(5):1114-1120.
    PMID: 28842095 DOI: 10.1053/j.jfas.2017.04.024
    Sensate, durable heel pad reconstruction is challenging. The present study assessed the functional outcomes after heel pad reconstruction using various flap techniques at our institution. From June 2011 to June 2016 (5-year period), 7 consecutive patients underwent heel pad reconstruction for various etiologies, with 3 microvascular free flaps (42.9%; 2 musculocutaneous flaps [66.7%] and 1 contralateral medial plantar flap [33.3%]) and 4 local pedicle flaps (57.1%; 3 instep medial plantar artery flaps [75.0%] and 1 distally based reverse sural flap [25.0%]). The patient records and demographic data were reviewed, and surgically related information was obtained and analyzed. The subjective components of the American Orthopaedic Foot and Ankle Society hindfoot clinical ratings scale were used to evaluate the pain and functional outcomes. Sensation was assessed using Semmes-Weinstein monofilaments, and ulcer recurrence was recorded. The mean age of the patients was 41.7 (range 11 to 70) years, the mean defect size was 59 (range 12 to 270) cm2, and the mean follow-up duration was 22 (range 15 to 43) months. Complete flap survival was achieved without significant complications in all 7 patients. Patients treated with the sensate medial plantar artery flap recorded the highest mean American Orthopaedic Foot and Ankle Society score of 57.3 (maximum score of 60) and experienced a return of deep sensation at 6 (range 6 to 24) months and protective sensation at 1 year. This was followed by the reverse sural flap and the musculocutaneous flap. No recurrent heel ulceration was observed in our series of patients. In conclusion, the sensate medial plantar flap is a satisfactory method for coverage of small- to moderate-size heel defects.
    Matched MeSH terms: Risk Assessment
  7. A Case of Posterior Tibial Nerve Injury After Arthroscopic Calcaneoplasty
    Retrouvey H, Silvanathan J, Bleakney RR, Anastakis DJ
    J Foot Ankle Surg, 2018 01 05;57(3):587-592.
    PMID: 29307741 DOI: 10.1053/j.jfas.2017.10.004
    We report the first case of distal posterior tibial nerve injury after arthroscopic calcaneoplasty. A 59-year-old male had undergone right arthroscopic calcaneoplasty to treat retrocalcaneal bursitis secondary to a Haglund's deformity. The patient complained of numbness in his right foot immediately after the procedure. Two years later and after numerous assessments and investigations, a lateral plantar nerve and medial calcaneal nerve lesion was diagnosed. In the operating room, the presence of an iatrogenic lesion to the distal right lateral plantar nerve (neuroma incontinuity involving 20% of the nerve) and the medial calcaneal nerve (complete avulsion) was confirmed. The tarsal tunnel was decompressed, and both the medial and the lateral plantar nerve were neurolyzed under magnification. To the best of our knowledge, our case report is the first to describe iatrogenic posterior tibial nerve injury after arthroscopic calcaneoplasty. It is significant because this complication can hopefully be avoided in the future with careful planning and creation of arthroscopic ports and treated appropriately with early referral to a nerve specialist if the patient's symptoms do not improve within 3 months.
    Matched MeSH terms: Risk Assessment
  8. Current status in decision making to treat acute type A dissection: limited versus extended repair
    Velayudhan BV, Idhrees M, Matalanis G, Park KH, Tang D, Sfeir PM, et al.
    J Cardiovasc Surg (Torino), 2020 Jun;61(3):285-291.
    PMID: 32337940 DOI: 10.23736/S0021-9509.20.11397-1
    Acute type A aortic dissection remains one of the most challenging conditions in aortic surgery. Despite the advancements in the field, the mortality rate still remains high. Though there is a general consensus that the ascending aorta should be replaced, the distal extension of the surgery still remains a controversy. Few surgeons argue for a conservative approach to reduce operative and postoperative morbidity while others considering the problems associated with "downstream problems" support an aggressive approach including a frozen elephant trunk. The cohort in the Indian subcontinent and APAC is far different from the western world. Many factors determine the decision for surgery apart from the pathology of the disease. Economy, availability of the suitable prosthesis, the experience of the surgeon, ease of access to the medical facility all contribute to the decision making to treat acute type A dissection.
    Matched MeSH terms: Risk Assessment
  9. Fulltext The complex interplay of social networks, geography and HIV risk among Malaysian Drug Injectors: Results from respondent-driven sampling
    Zelenev A, Long E, Bazazi AR, Kamarulzaman A, Altice FL
    Int J Drug Policy, 2016 11;37:98-106.
    PMID: 27639995 DOI: 10.1016/j.drugpo.2016.08.008
    BACKGROUND: HIV is primarily concentrated among people who inject drugs (PWID) in Malaysia, where currently HIV prevention and treatment coverage is inadequate. To improve the targeting of interventions, we examined HIV clustering and the role that social networks and geographical distance play in influencing HIV transmission among PWID.

    METHODS: Data were derived from a respondent-driven survey sample (RDS) collected during 2010 of 460 PWID in greater Kuala Lumpur. Analysis focused on socio-demographic, clinical, behavioural, and network information. Spatial probit models were developed based on a distinction between the influence of peers (individuals nominated through a recruitment network) and neighbours (residing a close distance to the individual). The models were expanded to account for the potential influence of the network formation.

    RESULTS: Recruitment patterns of HIV-infected PWID clustered both spatially and across the recruitment networks. In addition, HIV-infected PWID were more likely to have peers and neighbours who inject with clean needles were HIV-infected and lived nearby (<5km), more likely to have been previously incarcerated, less likely to use clean needles (26.8% vs 53.0% of the reported injections, p<0.01), and have fewer recent injection partners (2.4 vs 5.4, p<0.01). The association between the HIV status of peers and neighbours remained significantly correlated even after controlling for unobserved variation related to network formation and sero-sorting.

    CONCLUSION: The relationship between HIV status across networks and space in Kuala Lumpur underscores the importance of these factors for surveillance and prevention strategies, and this needs to be more closely integrated. RDS can be applied to identify injection network structures, and this provides an important mechanism for improving public health surveillance, accessing high-risk populations, and implementing risk-reduction interventions to slow HIV transmission.

    Matched MeSH terms: Risk Assessment
  10. Fulltext Preconception risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease
    Hussein N, Weng SF, Kai J, Kleijnen J, Qureshi N
    Cochrane Database Syst Rev, 2015 Aug 12.
    PMID: 26264938 DOI: 10.1002/14651858.CD010849.pub2
    BACKGROUND: Globally, about five per cent of children are born with congenital or genetic disorders. The most common autosomal recessive conditions are thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease, with higher carrier rates in specific patient populations. Identifying and counselling couples at genetic risk of the conditions before pregnancy enables them to make fully informed reproductive decisions, with some of these choices not being available if genetic counselling is only offered in an antenatal setting.

    OBJECTIVES: To assess the effectiveness of systematic preconception genetic risk assessment to improve reproductive outcomes in women and their partners who are identified as carriers of thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease in healthcare settings when compared to usual care.

    SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Trials Registers. In addition, we searched for all relevant trials from 1970 (or the date at which the database was first available if after 1970) to date using electronic databases (MEDLINE, Embase, CINAHL, PsycINFO), clinical trial databases (National Institutes of Health, Clinical Trials Search portal of the World Health Organization, metaRegister of controlled clinical trials), and hand searching of key journals and conference abstract books from 1998 to date (European Journal of Human Genetics, Genetics in Medicine, Journal of Community Genetics). We also searched the reference lists of relevant articles, reviews and guidelines and also contacted subject experts in the field to request any unpublished or other published trials.Date of latest search of the registers: 25 June 2015.Date of latest search of all other sources: 10 December 2014.

    SELECTION CRITERIA: Any randomised or quasi-randomised control trials (published or unpublished) comparing reproductive outcomes of systematic preconception genetic risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease when compared to usual care.

    DATA COLLECTION AND ANALYSIS: We identified 19 papers, describing 13 unique trials which were potentially eligible for inclusion in the review. However, after assessment, no randomised controlled trials of preconception genetic risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease were found.

    MAIN RESULTS: No randomised controlled trials of preconception genetic risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease were found.

    AUTHORS' CONCLUSIONS: As no randomised controlled trials of preconception genetic risk assessment for thalassaemia, sickle cell disease, cystic fibrosis, or Tay-Sachs disease were found for inclusion in this review, the research evidence for current policy recommendations is limited to non-randomised studies.Information from well-designed, adequately powered, randomised trials is desirable in order to make more robust recommendations for practice. However, such trials must also consider the legal, ethical, and cultural barriers to implementation of preconception genetic risk assessment.

    Matched MeSH terms: Risk Assessment
  11. Fulltext Preconception risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease
    Hussein N, Weng SF, Kai J, Kleijnen J, Qureshi N
    Cochrane Database Syst Rev, 2018 03 14;3:CD010849.
    PMID: 29537064 DOI: 10.1002/14651858.CD010849.pub3
    BACKGROUND: Globally, about five per cent of children are born with congenital or genetic disorders. The most common autosomal recessive conditions are thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease, with higher carrier rates in specific patient populations. Identifying and counselling couples at genetic risk of the conditions before pregnancy enables them to make fully informed reproductive decisions, with some of these choices not being available if genetic counselling is only offered in an antenatal setting. This is an update of a previously published review.

    OBJECTIVES: To assess the effectiveness of systematic preconception genetic risk assessment to improve reproductive outcomes in women and their partners who are identified as carriers of thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease in healthcare settings when compared to usual care.

    SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Trials Registers. In addition, we searched for all relevant trials from 1970 (or the date at which the database was first available if after 1970) to date using electronic databases (MEDLINE, Embase, CINAHL, PsycINFO), clinical trial databases (National Institutes of Health, Clinical Trials Search portal of the World Health Organization, metaRegister of controlled clinical trials), and hand searching of key journals and conference abstract books from 1998 to date (European Journal of Human Genetics, Genetics in Medicine, Journal of Community Genetics). We also searched the reference lists of relevant articles, reviews and guidelines and also contacted subject experts in the field to request any unpublished or other published trials.Date of latest search of the registers: 20 June 2017.Date of latest search of all other sources: 16 November 2017.

    SELECTION CRITERIA: Any randomised or quasi-randomised controlled trials (published or unpublished) comparing reproductive outcomes of systematic preconception genetic risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease when compared to usual care.

    DATA COLLECTION AND ANALYSIS: We identified 25 papers, describing 16 unique trials which were potentially eligible for inclusion in the review. However, after assessment, no randomised controlled trials of preconception genetic risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease were found.

    MAIN RESULTS: No randomised controlled trials of preconception genetic risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease were included. One ongoing trial has been identified which may potentially eligible for inclusion once completed.

    AUTHORS' CONCLUSIONS: As no randomised controlled trials of preconception genetic risk assessment for thalassaemia, sickle cell disease, cystic fibrosis, or Tay-Sachs disease were found for inclusion in this review, the research evidence for current policy recommendations is limited to non-randomised studies.Information from well-designed, adequately powered, randomised trials is desirable in order to make more robust recommendations for practice. However, such trials must also consider the legal, ethical, and cultural barriers to implementation of preconception genetic risk assessment.

    Matched MeSH terms: Risk Assessment
  12. Fulltext Preconception risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease
    Hussein N, Henneman L, Kai J, Qureshi N
    Cochrane Database Syst Rev, 2021 Oct 11;10(10):CD010849.
    PMID: 34634131 DOI: 10.1002/14651858.CD010849.pub4
    BACKGROUND: Globally, about 6% of children are born with a serious birth defect of genetic or partially genetic origin. Carrier screening or testing is one way to identify couples at increased risk of having a child with an autosomal recessive condition. The most common autosomal recessive conditions are thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease, with higher carrier rates in high-risk populations of specific ancestral backgrounds. Identifying and counselling couples at genetic risk of the conditions before pregnancy enables them to make fully informed reproductive decisions, with some of these choices not being available if testing is only offered in an antenatal setting. This is an update of a previously published review.

    OBJECTIVES: To assess the effectiveness of systematic preconception genetic risk assessment to enable autonomous reproductive choice and to improve reproductive outcomes  in women and their partners who are both identified as carriers of thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease in healthcare settings when compared to usual care.

    SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Trials Registers. Date of latest search of the registers: 04 August 2021. In addition, we searched for all relevant trials from 1970 (or the date at which the database was first available if after 1970) to date using electronic databases (MEDLINE, Embase, CINAHL, PsycINFO), clinical trial databases (National Institutes of Health, Clinical Trials Search portal of the World Health Organization, metaRegister of controlled clinical trials), and hand searching of key journals and conference abstract books from 1998 to date (European Journal of Human Genetics, Genetics in Medicine, Journal of Community Genetics). We also searched the reference lists of relevant articles, reviews and guidelines and also contacted subject experts in the field to request any unpublished or other published trials. Date of latest search of all these sources: 25 June 2021.  SELECTION CRITERIA: Any randomised controlled trials (RCTs) or quasi-RCTs (published or unpublished) comparing reproductive outcomes of systematic preconception genetic risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease when compared to usual care.

    DATA COLLECTION AND ANALYSIS: We identified 37 papers, describing 22 unique trials which were potentially eligible for inclusion in the review. However, after assessment, we found no RCTs of preconception genetic risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease.

    MAIN RESULTS: No RCTs of preconception genetic risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease are included. A trial identified earlier has published its results and has subsequently been listed as excluded in this review.

    AUTHORS' CONCLUSIONS: As there are no RCTs of preconception genetic risk assessment for thalassaemia, sickle cell disease, cystic fibrosis, or Tay-Sachs disease included in either the earlier or current versions of this review, we recommend considering potential non-RCTs studies (for example prospective cohorts or before-and-after studies) for future reviews. While RCTs are desirable to inform evidence-based practice and robust recommendations, the ethical, legal and social implications associated with using this trial design to evaluate the implementation of preconception genetic risk assessment involving carrier testing and reproductive autonomy must also be considered.  In addition, rather than focusing on single gene-by-gene carrier testing for specific autosomal-recessive conditions as the intervention being evaluated, preconception expanded genetic screening should also be included in future searches as this has received much attention in recent years as a more pragmatic strategy. The research evidence for current international policy recommendations is limited to non-randomised studies.

    Matched MeSH terms: Risk Assessment
  13. Left atrial volume index is an independent predictor of major adverse cardiovascular events in acute coronary syndrome
    Gunasekaran R, Maskon O, Hassan HH, Safian N, Sakthiswary R
    Can J Cardiol, 2012 Sep-Oct;28(5):561-6.
    PMID: 22560463 DOI: 10.1016/j.cjca.2012.02.015
    Left atrial volume index (LAVI) is well proven to be a reliable method of determining left atrial size, which has prognostic implications in cardiovascular diseases. Studies demonstrate that increased LAVI is a predictor of mortality in myocardial infarction, but its association with other major adverse cardiovascular events (MACEs) among patients post acute coronary syndrome (ACS) has not been adequately evaluated.
    Matched MeSH terms: Risk Assessment
  14. Fulltext Risk-adjusted surgical audit with the POSSUM scoring system in a developing country. Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity
    Yii MK, Ng KJ
    Br J Surg, 2002 Jan;89(1):110-3.
    PMID: 11851674
    BACKGROUND: The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) is an objective and appropriate scoring system for risk-adjusted comparative general surgical audit. This score was devised in the UK and has been used widely, but application of POSSUM to centres outside the UK has been limited, especially in developing countries. This prospective study validated its application in a surgical practice with a different population and level of resources.
    METHODS: All general surgical patients who were operated on under regional or general anaesthesia as inpatients over a 4-month period at Sarawak General Hospital in 1999 were entered into the study. All data (12 physiological and six operative factors) were analysed for mortality only with the POSSUM equation and the modified Portsmouth POSSUM (P-POSSUM) equation. Comparisons were made between predicted and observed mortality rates according to four groups of risk: 0-4, 5-14, 15-49 and 50 per cent or more using the 'linear' method of analysis.
    RESULTS: There were 605 patients who satisfied the criteria for the study. Some 56.7 per cent of patients were in the lowest risk group. The POSSUM predictor equation significantly overestimated the mortality in this group, by a factor of 9.3. The overall observed mortality rate was 6.1 per cent and, again, the POSSUM predictor equation overestimated it at 10.5 per cent (P < 0.01). In contrast, the observed and predicted mortality rates for all risk groups, including the predicted overall mortality rate of 4.8 per cent, were comparable when the P-POSSUM predictor equation was used.
    CONCLUSION: The POSSUM scoring system with the modified P-POSSUM predictor equation for mortality was applicable in Malaysia, a developing country, for risk-adjusted surgical audit. This scoring system may serve as a useful comparative audit tool for surgical practice in many geographical locations.
    Matched MeSH terms: Risk Assessment
  15. The Malaysian Cataract Surgery Registry: risk Indicators for posterior capsular rupture
    Salowi MA, Chew FLM, Adnan TH, Ismail M, Goh PP
    Br J Ophthalmol, 2017 Nov;101(11):1466-1470.
    PMID: 28292773 DOI: 10.1136/bjophthalmol-2016-309902
    AIM: To identify the risk indicators for posterior capsular rupture (PCR) in the Malaysian Cataract Surgery Registry (CSR).

    METHODS: Data from the web-based CSR were collected for cataract surgery performed from 2008 to 2013. Data was contributed by 36 Malaysian Ministry of Health public hospitals. Information on patient's age, ethnicity, cause of cataract, ocular and systemic comorbidity, type of cataract surgery performed, local anaesthesia and surgeon's status was noted. Combined procedures and type of hospital admission were recorded. PCR risk indicators were identified using logistic regression analysis to produce adjusted OR for the variables of interest.

    RESULTS: A total of 150 213 cataract operations were registered with an overall PCR rate of 3.2%. Risk indicators for PCR from multiple logistic regression were advancing age, male gender (95% CI 1.04 to 1.17; OR 1.11), pseudoexfoliation (95% CI 1.02 to 1.82; OR 1.36), phacomorphic lens (95% CI 1.25 to 3.06; OR 1.96), diabetes mellitus (95% CI 1.13 to 1.29; OR 1.20) and renal failure (95% CI 1.09 to 1.55; OR 1.30). Surgical PCR risk factors were combined vitreoretinal surgery (95% CI 2.29 to 3.63; OR 2.88) and less experienced cataract surgeons. Extracapsular cataract extraction (95% CI 0.76 to 0.91; OR 0.83) and kinetic anaesthesia were associated with lower PCR rates.

    CONCLUSIONS: This study was agreed with other studies for the risk factors of PCR with the exception of local anaesthesia given and type of cataract surgery. Better identification of high-risk patients for PCR decreases intraoperative complications and improves cataract surgical outcomes.

    Matched MeSH terms: Risk Assessment/methods*
  16. Ductal Stenting to Retrain the Involuted Left Ventricle in d-Transposition of the Great Arteries
    Leong MC, Ahmed Alhassan AA, Sivalingam S, Alwi M
    Ann Thorac Surg, 2019 09;108(3):813-819.
    PMID: 30998905 DOI: 10.1016/j.athoracsur.2019.03.045
    BACKGROUND: Ductal stenting is performed to retrain involuted left ventricles (LVs) in patients with d-transposition of the great arteries and intact ventricular septum (TGA-IVS). However, its efficacy is largely unknown. This study aimed to determine the safety and efficacy of ductal stenting in retraining of the involuted LV in patients with TGA-IVS.

    METHODS: This was a single-center, retrospective study. Echocardiographic assessment of the LV geometry, mass, and free wall thickness was performed before stenting and before the arterial switch operation. Patients then underwent the arterial switch operation, and the postoperative outcomes were reviewed.

    RESULTS: There were 11 consecutive patients (male, 81.8%; mean age at stenting, 43.11 ± 18.19 days) with TGA-IVS with involuted LV who underwent LV retraining by ductal stenting from July 2013 to December 2017. Retraining by ductus stenting failed in 4 patients (36.3%). Two patients required pulmonary artery banding, and another 2 had an LV mass index of less than 35 g/m2. Patients in the successful group had improved LV mass index from 45.14 ± 17.91 to 81.86 ± 33.11g/m2 (p = 0.023) compared with 34.50 ± 10.47 to 20.50 ± 9.88 g/m2 (p = 0.169) and improved LV geometry after ductal stenting. The failed group was associated with an increased need for extracorporeal support (14.5% vs 50%, p = 0.012). An atrial septal defect-to-interatrial septum length ratio of more than 0.38 was associated with failed LV retraining.

    CONCLUSIONS: Ductal stenting is an effective method to retrain the involuted LV in TGA-IVS. A large atrial septal defect (atrial septal defect-to-interatrial septum length ratio >0.38) was associated with poor response to LV retraining.

    Matched MeSH terms: Risk Assessment
  17. Fulltext Seroprevalence of Anti-Leptospira IgG and IgM Antibodies and Risk Assessment of Leptospirosis among Urban Poor Communities in Kuala Lumpur, Malaysia
    Sahimin N, Sharif SA, Mohd Hanapi IR, Nai Chuan S, Lewis JW, Douadi B, et al.
    Am J Trop Med Hyg, 2019 12;101(6):1265-1271.
    PMID: 31628737 DOI: 10.4269/ajtmh.19-0003
    Leptospirosis is a zoonotic bacterial disease caused by pathogenic species of the genus Leptospira. Disease incidence is known to be attributed to environmental and social conditions which promote the spread of reservoir hosts, primarily rodents. A well-being program was conducted to determine the seroprevalence and risk factors associated with leptospirosis in urban poor communities occupying low-cost flat accommodation and squatter settlements in the vicinity of Wilayah Persekutuan, Kuala Lumpur. Blood samples from a total of 532 volunteers were screened for the detection of IgG and IgM antibodies against leptospirosis using ELISA. Demographic data were collected for each participant through a questionnaire survey before blood collection. The overall seroprevalence was low (12.6%, n = 67/532; 95% CI: 9.9-15.7%), with 8.1% (n = 43/532) being seropositive for anti-Leptospira IgG, indicating previous infection, and 4.9% (n = 26/532) for anti-Leptospira IgM, indicating current infection. Two significant factors such as host age (P ≤ 0.01) and knowledge of disease transmission (P = 0.017) significantly influenced the presence of anti-Leptospira IgM, whereas the detection of anti-IgG indicated the presence of clean drinking water sources (P = 0.043). Despite the low prevalence, the transmission of leptospirosis does occur among urban poor communities, suggesting the need for undertaking public awareness programs.
    Matched MeSH terms: Risk Assessment
  18. Fulltext Trial of labor after one cesarean: role of the order and number of prior vaginal births on the risk of emergency cesarean delivery and neonatal admission
    Tan PC, Subramaniam RN, Omar SZ
    Taiwan J Obstet Gynecol, 2008 Sep;47(3):305-11.
    PMID: 18935994 DOI: 10.1016/S1028-4559(08)60129-1
    To evaluate the influences of mode of immediate preceding delivery and number of prior vaginal births on the risk of repeat cesarean and neonatal admission at attempted vaginal birth after cesarean.
    Matched MeSH terms: Risk Assessment
  19. Fulltext Efficacy and safety of intravenous recombinant tissue plasminogen activator in mild ischaemic stroke: a meta-analysis
    You S, Saxena A, Wang X, Tan W, Han Q, Cao Y, et al.
    Stroke Vasc Neurol, 2018 Mar;3(1):22-27.
    PMID: 29600004 DOI: 10.1136/svn-2017-000106
    The benefits and safety of intravenous recombinant tissue plasminogen activator (IV-tPA) for patients with mild ischaemic stroke (MIS) are still unclear. The objective of this meta-analysis was to evaluate the efficacy and safety of IV-tPA as treatment for patients with MIS. We performed a systematic literature search across MEDLINE, Embase, Central, Global Health and Cumulative Index to Nursing and Allied Health Literature (CINAHL), from inception to 10 November 2016, to identify all related studies. Where possible, data were pooled for meta-analysis with odds ratio (OR) and corresponding 95% confidence interval (CI) using the fixed-effects model. MIS was defined as having National Institutes of Health Stroke Scale score of ≤6. We included seven studies with a total of 1591 patients based on the prespecified inclusion and exclusion criteria. The meta-analysis indicated a high odds of excellent functional outcome based on the modified Rankin Scale or Oxfordshire Handicap Score 0-1 (OR=1.43; 95% CI 1.14 to 1.79; P=0.002, I2=35%) in patients treated with IV-tPA compared with those not treated with IV-tPA (74.8% vs 67.6%). There was a high risk of symptomatic intracranial haemorrhage (sICH) with IV-tPA treatment (OR=10.13; 95% CI 1.93 to 53.02; P=0.006, I2=0%) (1.9% vs 0.0%) but not mortality (OR=0.78; 95% CI 0.43 to 1.43; P=0.43, I2=0%) (2.4% vs 2.9%). Treatment with IV-tPA was associated with better functional outcome but not mortality among patients with MIS, although there was an increased risk of sICH. Randomised trials are warranted to confirm these findings.
    Matched MeSH terms: Risk Assessment
  20. Fulltext Optimizing protocols for risk prediction in asymptomatic carotid stenosis using embolic signal detection: the Asymptomatic Carotid Emboli Study
    King A, Shipley M, Markus H, ACES Investigators
    Stroke, 2011 Oct;42(10):2819-24.
    PMID: 21852607 DOI: 10.1161/STROKEAHA.111.622514
    Improved methods are required to identify patients with asymptomatic carotid stenosis at high risk for stroke. The Asymptomatic Carotid Emboli Study recently showed embolic signals (ES) detected by transcranial Doppler on 2 recordings that lasted 1-hour independently predict 2-year stroke risk. ES detection is time-consuming, and whether similar predictive information could be obtained from simpler recording protocols is unknown.
    Matched MeSH terms: Risk Assessment/methods
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