MyMedR

Oesophageal hepatoid carcinoma with liver metastasis, a diagnostic dilemma

Yahaya A, Wa Kammal WS, Abd Shukor N, Osman SS

Malays J Pathol, 2019 Apr;41(1):59-63.

Alpha-fetoprotein (AFP)-producing carcinoma which microscopically mimics hepatocellular carcinoma (HCC) is a rare entity known as hepatoid adenocarcinoma (HC). They usually arise in the stomach, while oesophageal origin is only occasionally encountered. This tumour is highly aggressive and is associated with a poor prognosis. They frequently metastasise to the liver, thus giving rise to diagnostic difficulty, especially in cases where simultaneous oesophageal and liver mass are present. We reported a case of oesophageal hepatoid carcinoma with multiple liver metastasis, that was associated with an increased serum AFP. The distinction between HCC and HC is important because HC is more aggressive and has a poorer prognosis with limited therapeutic options. An extensive diagnostic work-up which include a thorough clinical history, radiological investigations (computed tomography or magnetic resonance imaging) as well as tissue biopsy supported by a panel of immunohistochemical markers are necessary to aid in the diagnosis of HC.

Matched MeSH terms: Prognosis

Fulltext A comprehensive overview of mitochondrial DNA 4977-bp deletion in cancer studies

Yusoff AAM, Abdullah WSW, Khair SZNM, Radzak SMA

Oncol Rev, 2019 Jan 14;13(1):409.

PMID: 31044027 DOI: 10.4081/oncol.2019.409

Mitochondria are cellular machines essential for energy production. The biogenesis of mitochondria is a highly complex and it depends on the coordination of the nuclear and mitochondrial genome. Mitochondrial DNA (mtDNA) mutations and deletions are suspected to be associated with carcinogenesis. The most described mtDNA deletion in various human cancers is called the 4977-bp common deletion (mDNA4977) and it has been explored since two decades. In spite of that, its implication in carcinogenesis still unknown and its predictive and prognostic impact remains controversial. This review article provides an overview of some of the cellular and molecular mechanisms underlying mDNA4977 formation and a detailed summary about mDNA4977 reported in various types of cancers. The current knowledges of mDNA4977 as a prognostic and predictive marker are also discussed.

Matched MeSH terms: Prognosis

Fulltext Kimura disease: a differential diagnosis in a nephrotic child

Aziz, A., Mohamad, I., Zawawi, N.

Malaysian Family Physician, 2018;13(2):32-35.

MyJurnal

Kimura disease presents as benign lesion and is commonly present among the Asian population. It
is a disease with a favourable prognosis and a peak age of onset in the third decade. It is a chronic
inflammatory disorder of unknown etiology that involves the lymph nodes and subcutaneous
tissues of the head and neck region. We report a case of a 15-year-old boy with multiple Kimura
lymphadenopathies involving the left posterior auricular region as well as the anterior and posterior
triangles of the neck.

Matched MeSH terms: Prognosis

Clinical interpretation of findings from a systematic review and a comprehensive meta-analysis on clinicopathological and prognostic characteristics of oral squamous cell carcinomas (OSCC) arising in patients with oral lichen planus (OLP)

Jayaraj R, Shetty SS, Kumaraswamy C, Gothandam KM, Ram MR, Shaw P

Oral Oncol, 2020 09;108:104974.

PMID: 32798186 DOI: 10.1016/j.oraloncology.2020.104974

Matched MeSH terms: Prognosis

Fulltext Gonadotropin-releasing hormone stimulation test and diagnostic cutoff in precocious puberty: a mini review

Ab Rahim SN, Omar J, Tuan Ismail TS

Ann Pediatr Endocrinol Metab, 2020 Sep;25(3):152-155.

PMID: 32871650 DOI: 10.6065/apem.2040004.002

The gonadotropin-releasing hormone (GnRH) stimulation test is a valuable tool in diagnosing and differentiating causes of early pubertal occurrences. Utility of the test can be limited in some instances, however, including the early phases of pubertal hypothalamic-pituitary-gonadal axis activation, in girls showing commonly overlapping pictures, and in obese children due to excess circulating estrogen that suppresses luteinizing hormone (LH). A lack of consistent baseline and stimulated gonadotropin cutoffs observed in different studies also contributes to limitations in testing. Nevertheless, early detection of true pathological causes for pubertal disorders is needed to allow prompt treatment and better prognosis. While basal LH can be beneficial as a good screening tool for detecting pubertal disorder, it does not preclude the need for GnRH testing. The aim of this review was to highlight the role of GnRH stimulation tests and varying testing cutoffs in diagnosis of precocious puberty and its classification.

Matched MeSH terms: Prognosis

Impact of metabolic risk factors on the severity and outcome of patients with alcohol-associated acute-on-chronic liver failure

Duseja A, De A, Taneja S, Choudhury AK, Devarbhavi H, Hu J, et al.

Liver Int, 2021 01;41(1):150-157.

PMID: 32970356 DOI: 10.1111/liv.14671

BACKGROUND: Metabolic risk factors may impact the severity and outcome of alcoholic liver disease. The present study evaluated this effect in patients with alcohol-associated acute-on-chronic liver failure (ACLF).

METHODOLOGY: One thousand two hundred and sixteen prospectively enrolled patients with ACLF (males 98%, mean age 42.5 ± 9.4 years, mean CTP, MELD and AARC scores of 12 ± 1.4, 29.7 ± 7 and 9.8 ± 2 respectively) from the Asian Pacific Association for the Study of the Liver (APASL) ACLF Research Consortium (AARC) database were analysed retrospectively. Patients with or without metabolic risk factors were compared for severity (CTP, MELD, AARC scores) and day 30 and 90 mortality. Information on overweight/obesity, type 2 diabetes mellitus (T2DM), hypertension and dyslipidaemia were available in 1028 (85%), 1019 (84%), 1017 (84%) and 965 (79%) patients respectively.

RESULTS: Overall, 392 (32%) patients died at day 30 and 528 (43%) at day 90. Overweight/obesity, T2DM, hypertension and dyslipidaemia were present in 154 (15%), 142 (14%), 66 (7%) and 141 (15%) patients, respectively, with no risk factors in 809 (67%) patients. Patients with overweight/obesity had higher MELD scores (30.6 ± 7.1 vs 29.2 ± 6.9, P = .007) and those with dyslipidaemia had higher AARC scores (10.4 ± 1.2 vs 9.8 ± 2, P = .014). Overweight/obesity was associated with increased day 30 mortality (HR 1.54, 95% CI 1.06-2.24, P = .023). None of other metabolic risk factors, alone or in combination, had any impact on disease severity or mortality. On multivariate analysis, overweight or obesity was significantly associated with 30-day mortality (aHR 1.91, 95% CI 1.41-2.59, P

Matched MeSH terms: Prognosis

Fulltext Clinical management of chronic mercury intoxication secondary to skin lightening products: A proposed algorithm

Ramli FF

Bosn J Basic Med Sci, 2021 Jun 01;21(3):261-269.

PMID: 32415819 DOI: 10.17305/bjbms.2020.4759

Mercury is a toxic substance that is commonly used in skin lightening products. Various effects on humans have been observed, which affect both users and non-users. Many studies reported delayed diagnosis and treatment, even after weeks of hospitalization. The possible reasons are non-specific clinical manifestation and lack of awareness and knowledge regarding chronic mercury intoxication secondary to skin lightening products. A thorough history of mercury exposure is crucial. Physical assessment and relevant supporting tests are indicated to establish a diagnosis. Blood and urine mercury levels are an essential examination for diagnosis and monitoring of the progress and response to treatment. The primary treatment is the discontinuation of the skin lightening products. Chelation therapy is not mandatory and is usually indicated for symptomatic patients. The prognosis depends on the duration of the product use, concentration of mercury in the skin product, and the severity of clinical presentation.

Matched MeSH terms: Prognosis

Fulltext Optic neuritis in a child with biotinidase deficiency: case report and literature review

Hayati AA, Wan-Hitam WH, Cheong MT, Yunus R, Shatriah I

Clin Ophthalmol, 2012;6:389-95.

PMID: 22457589 DOI: 10.2147/OPTH.S29048

Optic atrophy has often been reported in children with biotinidase deficiency. The visual prognosis is usually poor. This report is of a 6-year-old boy with an early onset of biotinidase deficiency who presented with acute profound visual loss in both eyes. Fundoscopy revealed swollen discs in both eyes, and the imaging was consistent with bilateral optic neuritis. He was treated with systemic corticosteroid, and commenced on oral biotin. The final visual outcome was promising.

Matched MeSH terms: Prognosis

Natural history and clinical features of ALS in Malaysia

Abdul Aziz NA, Toh TH, Goh KJ, Loh EC, Capelle DP, Abdul Latif L, et al.

Amyotroph Lateral Scler Frontotemporal Degener, 2021 02;22(1-2):108-116.

PMID: 33084408 DOI: 10.1080/21678421.2020.1832121

OBJECTIVE: Studies from multiethnic populations are rarely reported but do indicate differences in phenotypic presentation and survival in amyotrophic lateral sclerosis (ALS). In this study, we aimed to investigate the natural history of a cohort of ALS patients from a multiethnic population. Methods: Data from ALS patients presenting to our multidisciplinary ALS clinic were prospectively collected from January 2015 to June 2020 as part of an ongoing hospital-based patient registry. Kaplan-Meier and Cox regression model were performed to identify potential prognostic factors. Results: A total of 144 ALS patients were recruited. We estimated the crude ALS incidence as 0.53 per 100,000 for 2019 but rises to 2 per 100,000 in patients aged 60-74 years. The majority of patients were of Chinese ethnicity (59.7%), followed by Malay (24.3%), Indian (11.1%), and others (4.9%). Malaysian Indians had a significantly steeper ALSFRS-R slope at diagnosis (p = 0.040). We found a worse prognosis in patients with bulbar-onset (HR = 1.915, p = 0.019), older age (HR = 1.052, p = 0.000), and who were fast-progressors (HR = 1.274, p = 0.000). In contrast, a higher body mass index (HR = 0.921, p = 0.007) and a longer time to diagnosis (HR = 0.967, p = 0.006), noninvasive ventilation (HR = 0.820, p = 0.000) and percutaneous endoscopic gastrostomy insertion (HR = 0.823, p = 0.000) were associated with better survival. On multivariate analysis, diagnostic delay and slow disease progression were associated with better survival. Conclusions: In our cohort, diagnostic delay and a slow disease progression were significantly associated with better survival in ALS. We also found ethnic variation with Chinese preponderance and more rapid disease progression in patients of Indian descent.

Matched MeSH terms: Prognosis

Fulltext Giant pyogenic granuloma gravidarum of the hand

Khan ES, Ariff MS, Eshagroni A, Haflah NHM, Abdullah S, Sapuan J

International Medical Journal Malaysia, 2014;13(2):55-58.

MyJurnal

We describe a case of a giant pyogenic granuloma affecting the left index finger of a 23-year-old pregnant lady requiring surgical excision. Pyogenic granuloma gravidarum is a benign hyperplastic lesion that commonly presents on oral mucosa, typically the gums, in approximately 5% of pregnant women. Skin lesions over the fingers are an unusual site during pregnancy with only a few cases reported in the literature. The lesion was excised and a diagnosis of lobular capillary haemangioma was made based on histopathological evaluation. We delayed surgery until after parturition since recurrence is likely to be lower due to lower levels of circulating oestrogen and progesterone. The prognosis is usually excellent following resection. However, recurrences have been reported regardless of the treatment method.

Matched MeSH terms: Prognosis

Fulltext Intracranial germinoma – a case report

Subha, S.T., Puaviappan, P., Ramesh, N., Dass, Dipak B

Malaysian Journal of Medicine and Health Sciences, 2013;9(1):81-82.

MyJurnal

Intracranial germinomas belong to the class of germ cell tumors which are relatively rare intracranial tumors. Early recognition of this neoplasm is vital as germinomas are highly radiosensitive and effective/ early radiation therapy can result in relatively favourable overall prognosis. In this article we describe a 19 years old man who presented with pituitary tumor in the suprasellar region for which transsphenoidal decompression and biopsy was done. The histopathological examination confirmed it to be germinoma and he underwent craniospinal radiotherapy.

Matched MeSH terms: Prognosis

Fulltext Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA)

Sartelli M, Weber DG, Ruppé E, Bassetti M, Wright BJ, Ansaloni L, et al.

World J Emerg Surg, 2016;11:33.

PMID: 27429642 DOI: 10.1186/s13017-016-0089-y

Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance. The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally. The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria. An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs. The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections). The authors hope that AGORA, involving many of the world's leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs.

Matched MeSH terms: Prognosis

Fulltext Dilemma of pregnant ladies with breast cancer

Zainur Rashid, Z., S. Sulaiha S.A., Lew, K.G., Nurhana, S.

International e-Journal of Science, Medicine & Education, 2009;3(2):-.

MyJurnal

Gestational breast cancer (GBC) or pregnancy-associated breast cancer was defined as breast cancer diagnosed during pregnancy and within 1 year of delivery. Breast cancer is the second commonest cancer after cervical seen in pregnancy and lactation. Nevertheless, the incidence is low and accounts for approximately 1 in 3000 of pregnancies. A delay in diagnosis is common and 70% to 89% of patients with operable primary lesions already have positive axillary lymph nodes. Breast cancer identified during pregnancy can be extremely distressing for the mother despite it has similar course of disease and prognosis seen in non-pregnant women of the same age and stage of disease. Diagnostic and treatment options should be carefully decided to prevent further harm to the mother or any potential risk to the developing fetus.

Matched MeSH terms: Prognosis

Fulltext Anterior Myocardial Infarction Associated with Myocardial Bridging in a Young Man

Ngow, H.A., Wan Khairina, W.M.N.

International Medical Journal Malaysia, 2010;9(2):67-70.

MyJurnal

A 43-year-old man presented with acute extensive anterior ST-segment elevation myocardial infarction. During coronary angiogram, a segment of myocardial bridging was noted in the mid-segment of left anterior descending artery. The association of myocardial bridging and an anterior ST segment elevation is rarely reported in the medical literature. Myocardial bridging is caused by systolic compression of a coronary artery by overlying myocardium tissue. It is a rare coronary artery anomaly, which usually has a benign prognosis despite some case reports of myocardial ischemia leading to myocardial infarction, lethal arrhythmias and sudden cardiac death. We report one such case of myocardial bridging that was complicated with acute extensive anterior myocardial infarction.

Matched MeSH terms: Prognosis

Managing cancer using community participatory approach

Khalib Abdul Latiff

Journal of Health Management, 2008;4(1):10-14.

MyJurnal

Researchers all over the world have continuously contributed knowledge on common human cancers and its related risks. Despite these mountains of information, the trend of cancer problems has not significantly declined and perhaps in certain occasion, it gradually increased affecting those who are previously known to be less risky'. Cancer is still identified to be one of the top leading killer worldwide and is also the main source of psychosocial burden of the community particularly to the caregiver' Its problems are expected to be further increased as human beings are constantly modified and manipulated by unpredictable and dynamic human activities and globalization phenomena. Furthermore, the current advances in cancer therapy and others clinical interventions are not always guaranteed of a permanent cure, improve survival or prognosis, sustainable compliances, prolonging life and improving quality of life, thus the mortality and its associated biological and management complications are still prevalence. (Copied from article).

Matched MeSH terms: Prognosis

The diabetic: his ocular complications and his visual prognosis

SINGH P

Med J Malaya, 1955 Sep;10(1):83-6.

PMID: 13287497

Matched MeSH terms: Prognosis

Fulltext Expression of gamma glutamyl hydrolase and carbonic anhydrase 9 in oral squamous cell carcinoma and their association with extracapsular spread

Nor Aszlitah Burhanudin, Thomas George Kallarakkal

International Medical Journal Malaysia, 2017;16(21):17-17.

MyJurnal

Extracapsular spread (ECS) is one of the most important prognostic factors in oral
squamous cell carcinoma (OSCC). Gamma Glutamyl Hydrolase (GGH) is a lysosomal enzyme which is involved in folate homeostasis. It is overexpressed in several human malignancies but its role in
OSCC has never been reported. Carbonic Anhydrase 9 (CA9) is a transmembrane glycoprotein and is
related to hypoxia. High expression of CA9 has been associated with poor prognosis in several
tumours including OSCC. This study was aimed to investigate the expression of GGH and CA9 in
OSCC and their potential use as biomarkers to predict ECS. (Copied from article).

Matched MeSH terms: Prognosis

Fulltext The evaluation of Streptococcus mutans content of saliva in patients with recurrent oral ulceration

Al-Ahmad, Basma Ezzat Mustafa, Muhannad Ali Kashmoola, Nur Aini Zakaria

International Medical Journal Malaysia, 2017;16(21):14-14.

MyJurnal

Recurrent oral ulcer is a chronic inflammatory condition characterized by mucosa
ulceration, which was believed to have bacterial etiology. Streptococcus mutans is one of the
bacteria which have been implicated in this case; it is gram-positive bacteria that reside in the
biofilms on the tooth surfaces. The aim of this study was to evaluate Streptococcus mutans content
in saliva of recurrent oral ulcer patients and its role as a prognostic factor. (Copied from article).

Matched MeSH terms: Prognosis

Fulltext Lumen-Nuclei ensemble machine learning system for diagnosing Prostate cancer in histopathology images

Dheeb Albashish, Shahnorbanun Sahran, Azizi Abdullah, Nordashima Abd Shukor, Suria Hayati Md Pauzi

Pertanika Journal of Science & Technology, 2017;25(106):39-48.

MyJurnal

The Gleason grading system assists in evaluating the prognosis of men with prostate cancer. Cancers with a higher score are more aggressive and have a worse prognosis. The pathologists observe the tissue components (e.g. lumen, nuclei) of the histopathological image to grade it. The differentiation between Grade 3 and Grade 4 is the most challenging, and receives the most consideration from scholars. However, since the grading is subjective and time-consuming, a reliable computer-aided prostate cancer diagnosing techniques are in high demand. This study proposed an ensemble computer-added system (CAD) consisting of two single classifiers: a) a specialist, trained specifically for texture features of the lumen and the other for nuclei tissue component; b) a fusion method to aggregate the decision of the single classifiers. Experimental results show promising results that the proposed ensemble system (area under the ROC curve (Az) of 88.9% for Grade 3 versus Grad 4 classification task) impressively outperforms the single classifier of nuclei (Az=87.7) and lumen (Az=86.6).

Matched MeSH terms: Prognosis

Fulltext A Combination of Tachycardia-Mediated Heart Failure and Coronary Artery Vasospasm-Induced Silent Myocardial Infarction in a Patient with Severe Thyrotoxicosis

Khoo SSK, Chu CM, Fung YK

Case Rep Cardiol, 2018;2018:4827907.

PMID: 29713551 DOI: 10.1155/2018/4827907

Severe thyrotoxicosis can present with a myriad of cardiovascular complications. It may be mild features such as palpitations, tachycardia, and exertional dyspnea or may progress to life-threatening consequences such as atrial fibrillation, tachyarrhythmias, heart failure, myocardial infarction, and shock. In rare cases, they may present with myocardial ischemia secondary to coronary artery vasospasm. We report a case of a 59-year-old Malay gentleman who presented with fast atrial fibrillation and tachycardia-mediated heart failure that evolved to a silent myocardial infarction secondary to severe coronary artery vasospasm with undiagnosed severe thyrotoxicosis. He had complete resolution of heart failure and no further recurrence of coronary artery vasospasm once treatment for thyrotoxicosis was initiated and euthyroidism achieved. This life-threatening consequence has an excellent prognosis if recognised early and treated promptly.

Matched MeSH terms: Prognosis

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