MATERIALS AND METHODS: A total of 8966 voluntary school students aged 13-15 years old were recruited for scoliosis screening. Screening was done by measuring the angle of trunk rotation (ATR) on forward bending test (FBT) using a scoliometer. ATR of 5 degrees or more was considered positive. Positively screened students had standard radiographs done for measurement of the Cobb angle. Cobb angle of >10° was used to diagnose scoliosis. The percentage of radiological assessment referral, prevalence rate and PPV of scoliosis were then calculated.
RESULTS: Percentage of radiological assessment referral (ATR >5°) was 4.2% (182/4381) for male and 5.0% (228/4585) for female. Only 38.0% of those with ATR >5° presented for further radiological assessment. The adjusted prevalence rate was 2.55% for Cobb angle >10°, 0.59% for >20° and 0.12% for >40°. The PPV is 55.8% for Cobb angle >10°, 12.8% for >20° and 2.6% for > 40°.
CONCLUSIONS: This is the largest study of school scoliosis screening in Malaysia. The prevalence rate of scoliosis was 2.55%. The positive predictive value was 55.8%, which is adequate to suggest that the school scoliosis screening programme did play a role in early detection of scoliosis. However, a cost effectiveness analysis will be needed to firmly determine its efficacy.
METHODS: This was a retrospective cross-sectional study of malignant odontogenic tumours diagnosed at the Institute for Medical Research, Malaysia, from 2009 to 2019. All cases were independently reviewed and reclassified following the criteria set out in the latest edition of the World Health Organization 2017 reference text. Demographic and clinico-pathological data were recorded for each case.
RESULTS: Twenty-four cases of malignant odontogenic tumours were identified. The patients' age ranged from 16 to 79 years with the mean age at diagnosis being 50.8 years (SD = 16.18). There was a male predominance (66.7%) in this cohort of patients. The ethnic distribution appeared to reflect the Malaysian population with most cases seen amongst the Malay ethnic group (66.7%). Ameloblastic carcinoma was the most frequently diagnosed malignant odontogenic tumour (45.8%) and was also predominantly seen in males (90.9%). All patients with clear cell odontogenic carcinoma were females. There was no obvious sex predilection in primary odontogenic carcinoma not otherwise specified (NOS). The mandible (79.2%) was more frequently involved compared to the maxilla.
CONCLUSIONS: Diagnosis and management of malignant odontogenic tumours are challenging due to the rarity of these tumours. Our study has elucidated the clinico-pathological features of malignant odontogenic tumours seen in a multi-ethnic Asian population.
Materials and Methods: A cross-sectional study was performed to review the impact of 68Ga-DOTA-peptide (68Ga-DOTATATE or 68Ga-DOTATOC) PET/CT on patients with biopsy-proven GI-NET between January 2011 and December 2015. Suspected NET was excluded. Demographic data, tumoral characteristics, change of disease stage, pre-PET intended management and post-PET management were evaluated.
Results: Over a 5-year period, 82 studies of 68Ga-DOTA-peptide PET/CT were performed on 44 GI-NET patients. The most common primary site was the rectum (50.0%) followed by the small bowel, stomach and colon. Using WHO 2010 grading, 40.9% of patients had low-grade (G1) tumour, 22.7% intermediate (G2) and 4.5% high (G3). Of ten patients scheduled for pre-operative staging, 68Ga-DOTA-peptide PET/CT only led to therapeutic change in three patients. Furthermore, false-negative results of 68Ga-DOTA-peptide PET/CT were reported in one patient after surgical confirmation. However, therapeutic changes were seen in 20/36 patients (55.6%) scheduled for post-surgical restaging or assessment of somatostatin analogue (SSA) eligibility. When 68Ga-DOTA-peptide PET/CT was used for monitoring disease progress during systemic treatment (sandostatin, chemotherapy, everolimus and PRRT) in metastatic disease, impact on management modification was seen in 19/36 patients (52.8%), of which 84.2% had inter-modality change (switch to everolimus, chemotherapy or PRRT) and 15.8% had intra-modality change (increased SSA dosage).
Conclusions: 68Ga-DOTA-peptide PET/CT has a significant impact on management decisions in GI-NET patients as it can provide additional information on occult metastasis/equivocal lesions and supply the clinician an opportunity to select patients for targeted therapy.
AIMS: To describe the MD ASA technique and present its preliminary application.
METHODS: MD ASA breaks down the face into five hierarchies (H1-H5). H1 shifts patients' focus from "distractions" (individual lines and folds) toward the overall messages their face portrays, based on eight Emotional Attributes: four negative (tired, sad, angry, and saggy); four positive (youthful, attractive, contoured, and feminine/masculine). Three priority Emotional Attributes are selected for each patient. This is followed by a process of narrowing down through facial thirds (H2), periorbital and perioral dynamics (H3), facial units (H4), and subunits (H5), to arrive at a final assessment. Based on the key facial signs identified, this can be translated into MD Codes equations and thus a treatment formula. A retrospective analysis was performed based on 12 female patients injected by expert clinicians at an educational event. All patients were selected for, and treated using, a single MD Codes formula derived from a common MD ASA work-up.
RESULTS: There were substantial differences between patients and clinicians in their views of which anatomical areas needed treatment-but good alignment on priority Emotional Attributes. Patients were treated only for three negative Emotional Attributes, but improvements were observed across all eight attributes.
CONCLUSIONS: MD ASA provides a practical method for translating facial messages into actionable injectable treatment plans and facilitates greater patient-clinician alignment. Prospective studies are warranted.
EDUCATIONAL ACTIVITY AND SETTING: Pharmacy students developed a "hands-on" health campaign for delivery to university students. A health promotion topic was chosen and delivered each year for 2015-2017; sexual health, diabetes, and antimicrobial resistance, respectively. All health campaign participants were screened for cardiovascular risk factors. University students who participated in the health campaign in 2017 also completed a questionnaire assessing their understanding and knowledge of antimicrobial resistance.
FINDINGS: In the three health campaigns conducted from 2015 to 2017, 1010 university students and adults were screened. Pharmacy students expressed a high level of professional achievement and satisfaction and felt that the activities provided a meaningful learning experience. Similarly, supervising pharmacists reported satisfaction with students' competency.
SUMMARY: The use of a health education campaign is an alternative model to educate pharmacy students on communication and critical thinking skills, as well as provide an opportunity for service learning.
METHODS: 5 radiologists read 1 identical test set of 200 mammographic (180 normal cases and 20 abnormal cases) 3 times and were requested to adhere to 3 different recall rate conditions: free recall, 15% and 10%. The radiologists were asked to mark the locations of suspicious lesions and provide a confidence rating for each decision. An independent expert radiologist identified the various types of cancers in the test set, including the presence of calcifications and the lesion location, including specific mammographic density.
RESULTS: Radiologists demonstrated lower sensitivity and receiver operating characteristic area under the curve for non-specific density/asymmetric density (H = 6.27, p = 0.04 and H = 7.35, p = 0.03, respectively) and mixed features (H = 9.97, p = 0.01 and H = 6.50, p = 0.04, respectively) when reading at 15% and 10% recall rates. No significant change was observed on cancer characterized with stellate masses (H = 3.43, p = 0.18 and H = 1.23, p = 0.54, respectively) and architectural distortion (H = 0.00, p = 1.00 and H = 2.00, p = 0.37, respectively). Across all recall conditions, stellate masses were likely to be recalled (90.0%), whereas non-specific densities were likely to be missed (45.6%).
CONCLUSION: Cancers with a stellate mass were more easily detected and were more likely to continue to be recalled, even at lower recall rates. Cancers with non-specific density and mixed features were most likely to be missed at reduced recall rates. Advances in knowledge: Internationally, recall rates vary within screening mammography programs considerably, with a range between 1% and 15%, and very little is known about the type of breast cancer appearances found when radiologists interpret screening mammograms at these various recall rates. Therefore, understanding the lesion types and the mammographic appearances of breast cancers that are affected by readers' recall decisions should be investigated.