Displaying publications 121 - 140 of 203 in total

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  1. Malko P, Syed Mortadza SA, McWilliam J, Jiang LH
    Front Pharmacol, 2019;10:239.
    PMID: 30914955 DOI: 10.3389/fphar.2019.00239
    Microglial cells in the central nervous system (CNS) are crucial in maintaining a healthy environment for neurons to function properly. However, aberrant microglial cell activation can lead to excessive generation of neurotoxic proinflammatory mediators and neuroinflammation, which represents a contributing factor in a wide spectrum of CNS pathologies, including ischemic stroke, traumatic brain damage, Alzheimer's disease, Parkinson's disease, multiple sclerosis, psychiatric disorders, autism spectrum disorders, and chronic neuropathic pain. Oxidative stress is a salient and common feature of these conditions and has been strongly implicated in microglial cell activation and neuroinflammation. The transient receptor potential melastatin-related 2 (TRPM2) channel, an oxidative stress-sensitive calcium-permeable cationic channel, is highly expressed in microglial cells. In this review, we examine the recent studies that provide evidence to support an important role for the TRPM2 channel, particularly TRPM2-mediated Ca2+ signaling, in mediating microglial cell activation, generation of proinflammatory mediators and neuroinflammation, which are of relevance to CNS pathologies. These findings lead to a growing interest in the TRPM2 channel, a new player in neuroinflammation, as a novel therapeutic target for CNS diseases.
    Matched MeSH terms: Central Nervous System Diseases
  2. Chen IC, Teng G, Chen CJ, Lan TH, Liu HJ
    Front Psychiatry, 2019;10:944.
    PMID: 31998160 DOI: 10.3389/fpsyt.2019.00944
    Background: The intrinsic motivation behind the "need to complete" is more influential than external incentives. We introduced a novel progress-bar tool to motivate the completion of programs designed to treat stimulant and cannabis use disorders. We further examined the effectiveness of the progress bar's scoring approach in forecasting consistently negative urine tests. Methods: This study's participants included 568 patients with stimulant, amphetamine-type, and cannabis use disorders who were undergoing 12-month mandatory treatment programs at Taichung Veterans General Hospital in Taiwan. Patients were given scores of 1, -1, or 0 depending on whether they received negative, positive, or missing urinalysis reports, respectively. The autonomic progress bar generated weekly score totals. At the group level, scorei donated scores from all patients for a given week (i denoted the week). Scorei was standardized to adjusted scorei. We then conducted Autoregressive Integrated Moving Average (ARIMA) Model of time-series analyses for the adjusted scorei. Results: A total of 312 patients maintained treatment progress over the 12-month program. The autonomic score calculator totaled the shared achievements of these patients. The coefficients of the lag variables for mean (p), lag variables for residual error term (q), and number of orders for ensuring stationary (d) were estimated at p = 3, d = 4, and q = 7 for the first half of the treatment program, and were estimated at p = 2, d = 2, and q = 3 for the second half. Both models were stationary and tested as fit for prediction (p < 0.05). Sharply raised adjusted scores were predicted during the high-demand treatment phase. Discussion: This study's novel progress-bar tool effectively motivated treatment completion. It was also effective in forecasting continually negative urine tests. The tool's free open-source code makes it easy to implement among many substance-treatment services.
    Matched MeSH terms: Central Nervous System Stimulants
  3. Singh D, Müller CP, Murugaiyah V, Hamid SBS, Vicknasingam BK, Avery B, et al.
    J Ethnopharmacol, 2018 Mar 25;214:197-206.
    PMID: 29248450 DOI: 10.1016/j.jep.2017.12.017
    ETHNOPHARMACOLOGICAL RELEVANCE: Kratom (Mitragyna speciosa Korth.) from the Rubiaceae family is an indigenous tropical medicinal tree of Southeast Asia. Kratom leaves have been used for decades in Malaysia and Thailand in traditional context for its perceived vast medicinal value, and as a mild stimulant among manual labourers. Kratom consumption has been reported to cause side-effects in kratom users.

    AIM OF THE STUDY: To evaluate kratom's effects towards hematological and clinical-chemistry parameters among regular kratom users in Malaysia.

    METHODS: A total of 77 subjects (n=58 regular kratom users, and n=19 healthy controls) participated in this cross-sectional study. All the surveys were conducted through face-to-face interview to elicit subject's socio-demographic characteristics and kratom use history. A full-blood test was also administered. Laboratory analysis was conducted using GC-MS to determine mitragynine content in the acquired kratom samples in order to relate mitragynine consumption with possible alterations in the blood parameters of kratom users.

    RESULTS: Findings showed that there were no significant differences in the hematological and clinical-chemistry parameters of traditional kratom users and healthy controls, except for HDL and LDL cholesterol values; these were found to be above the normal reference range for the former. Similarly, long-term kratom consumption (>5 years), and quantity of daily kratom use (≥3 ½ glasses; mitragynine content 76.3-114.8mg) did not appear to alter the hematological and biochemical parameters of kratom users.

    CONCLUSION: These data suggest that even long-term and heavy kratom consumption did not significantly alter the hematological and clinical-chemistry parameters of kratom users in a traditional setting.

    Matched MeSH terms: Central Nervous System Stimulants/administration & dosage*; Central Nervous System Stimulants/adverse effects; Central Nervous System Stimulants/isolation & purification
  4. Soo RA, Cho BC, Kim JH, Ahn MJ, Lee KH, Zimina A, et al.
    J Thorac Oncol, 2023 Dec;18(12):1756-1766.
    PMID: 37865896 DOI: 10.1016/j.jtho.2023.08.017
    INTRODUCTION: Lazertinib, a third-generation mutant-selective EGFR tyrosine kinase inhibitor, improved progression-free survival compared with gefitinib in the phase 3 LASER301 study (ClinicalTrials.gov Identifier: NCT04248829). Here, we report the efficacy of lazertinib and gefitinib in patients with baseline central nervous system (CNS) metastases.

    METHODS: Treatment-naive patients with EGFR-mutated advanced NSCLC were randomized one-to-one to lazertinib (240 mg/d) or gefitinib (250 mg/d). Patients with asymptomatic or stable CNS metastases were included if any planned radiation, surgery, or steroids were completed more than 2 weeks before randomization. For patients with CNS metastases confirmed at screening or subsequently suspected, CNS imaging was performed every 6 weeks for 18 months, then every 12 weeks. End points assessed by blinded independent central review and Response Evaluation Criteria in Solid Tumors version 1.1 included intracranial progression-free survival, intracranial objective response rate, and intracranial duration of response.

    RESULTS: Of the 393 patients enrolled in LASER301, 86 (lazertinib, n = 45; gefitinib, n = 41) had measurable and or non-measurable baseline CNS metastases. The median intracranial progression-free survival in the lazertinib group was 28.2 months (95% confidence interval [CI]: 14.8-28.2) versus 8.4 months (95% CI: 6.7-not reached [NR]) in the gefitinib group (hazard ratio = 0.42, 95% CI: 0.20-0.89, p = 0.02). Among patients with measurable CNS lesions, the intracranial objective response rate was numerically higher with lazertinib (94%; n = 17) versus gefitinib (73%; n = 11, p = 0.124). The median intracranial duration of response with lazertinib was NR (8.3-NR) versus 6.3 months (2.8-NR) with gefitinib. Tolerability was similar to the overall LASER301 population.

    CONCLUSIONS: In patients with CNS metastases, lazertinib significantly improved intracranial progression-free survival compared with gefitinib, with more durable responses.

    Matched MeSH terms: Central Nervous System
  5. Isabel BE, Rogelio HP
    Malays J Med Sci, 2014 Jan;21(1):4-10.
    PMID: 24639606
    Cerebral tuberculosis is the most severe type of extrapulmonary disease that is in developing countries highly predominant in children. Meningeal tuberculosis is the most common form and usually begins with respiratory infection followed by early haematogenous dissemination to extrapulmonary sites involving the brain. In comparison with the lung, Mycobacterium tuberculosis induces a very different immune response when infect the central nervous system. Herein, we review several aspects of the pathogenesis and immune response in pulmonary and cerebral tuberculosis in humans and experimental models and discuss the implications of this response in the cerebral infection outcome.
    Matched MeSH terms: Central Nervous System
  6. Kaewkaen K, Wongsamud P, Ngaothanyaphat J, Supawarapong P, Uthama S, Ruengsirarak W, et al.
    Malays J Med Sci, 2018 Feb;25(1):67-74.
    PMID: 29599636 DOI: 10.21315/mjms2018.25.1.8
    Background: The walking gait of older adults with balance impairment is affected by dual tasking. Several studies have shown that external cues can stimulate improvement in older adults' performance. There is, however, no current evidence to support the usefulness of external cues, such as audio-visual cueing, in dual task walking in older adults. Thus, the aim of this study was to investigate the influence of an audio-visual cue (simulated traffic light) on dual task walking in healthy older adults and in older adults with balance impairments.

    Methods: A two-way repeated measures study was conducted on 14 healthy older adults and 14 older adults with balance impairment, who were recruited from the community in Chiang Rai, Thailand. Their walking performance was assessed using a four-metre walking test at their preferred gait speed and while walking under two further gait conditions, in randomised order: dual task walking and dual task walking with a simulated traffic light. Each participant was tested individually, with the testing taking between 15 and 20 minutes to perform, including two-minute rest periods between walking conditions. Two Kinect cameras recorded the spatio-temporal parameters using MFU gait analysis software. Each participant was tested for each condition twice. The mean parameters for each condition were analysed using a two-way repeated measures analysis of variance (ANOVA) with participant group and gait condition as factors.

    Result: There was no significant between-group effect for walking speed, stride length and cadence. There were also no significant effects between gait condition and stride length or cadence. However, the effect between gait condition and walking speed was found to be significant [F(1.557, 40.485) = 4.568,P= 0.024, [Formula: see text]].

    Conclusion: An audio-visual cue (simulated traffic light) was found to influence walking speed in both healthy older adults and in older adults with balance impairment. The results suggest that audio-visual cues could be incorporated into healthy lifestyle promotion in older adults with balance impairment.

    Matched MeSH terms: Central Nervous System Stimulants
  7. Teoh PH, Shu-Chien AC, Chan WK
    Dev. Dyn., 2010 Mar;239(3):865-74.
    PMID: 20108353 DOI: 10.1002/dvdy.22221
    pbx1, a TALE (three-amino acid loop extension) homeodomain transcription factor, is involved in a diverse range of developmental processes. We examined the expression of pbx1 during zebrafish development by in situ hybridization. pbx1 transcripts could be detected in the central nervous system and pharyngeal arches from 24 hpf onwards. In the swim bladder anlage, pbx1 was detected as early as 28 hpf, making it the earliest known marker for this organ. Morpholino-mediated gene knockdown of pbx1 revealed that the swim bladder failed to inflate, with eventual lethality occurring by 8 dpf. The knockdown of pbx1 did not perturb the expression of prdc and foxA3, with both early swim bladder markers appearing normally at 36 and 48 hpf, respectively. However, the expression of anxa5 was completely abolished by pbx1 knockdown at 60 hpf suggesting that pbx1 may be required during the late stage of swim bladder development.
    Matched MeSH terms: Central Nervous System/embryology
  8. Abdullah JM, Ahmad F, Ahmad KA, Ghazali MM, Jaafar H, Ideris A, et al.
    Neurol Res, 2007 Apr;29(3):239-42.
    PMID: 17509221
    Brain tumorigenesis is a complex process involving multiple genetic alterations. Cyclin D1 and BAX genes are two of the most important regulators in controlling the normal proliferation and apoptosis of cells, respectively. In this study, we analysed the possibilities of involvement of cyclin D1 and BAX genes in the gliomagenesis.
    Matched MeSH terms: Central Nervous System Neoplasms/genetics*
  9. Aye SM, Lim KS, Ramli NM, Tan CT
    Lupus, 2013 Apr;22(5):510-4.
    PMID: 23358870 DOI: 10.1177/0961203312474705
    This is a case report on an uncommon correlation between periodic lateralized epileptiform discharges (PLEDs) and white-matter lesions in cerebral lupus, and with a reduced cerebral blood flow (CBF) in single-photon emission computed tomography (SPECT). A 47-year-old woman with a long-term history of systemic lupus erythematosus (SLE) presented with a seizure followed by frontal lobe dysfunction clinically. An electroencephalogram (EEG) showed bilateral independent PLEDs in the frontal region. A magnetic resonance image of the brain showed white-matter changes in the frontal periventricular region. Cerebral angiogram did not reveal any evidence of vasculitis. A cerebral SPECT with tracer injected during the EEG showing PLEDs showed a reduction in CBF in the frontal regions. Clinical recovery was observed with intravenous immunoglobulin. This case shows that PLEDs can be seen with white-matter changes in SLE.
    Matched MeSH terms: Lupus Vasculitis, Central Nervous System*
  10. Kimura K, Yokoyama K, Sato H, Nordin RB, Naing L, Kimura S, et al.
    Ind Health, 2005 Apr;43(2):285-94.
    PMID: 15895843
    We examined the effects of pesticides on the central and peripheral nervous system in the setting of a tobacco farm at a developing country. Maximal motor and sensory nerve conduction velocities (MCV and SCV, respectively) in the median, sural and tibial nerves, postural sway, and brain-evoked potentials (auditory event-related and visual-evoked potentials) were measured in 80 male tobacco farmers and age- and sex-matched 40 controls in Kelantan, Malaysia. Median SCV (finger-wrist) in farmers using Delsen (mancozeb, dithiocarbamate fungicide), who showed significant decrease of serum cholinesterase activities, were significantly lower compared with the controls. Sural SCV in farmers using Fastac (alpha-cypermethrin, pyrethroid insecticide) and median MCV (elbow-wrist) in farmers using Tamex (butralin, dinitroaniline herbicide) were significantly slowed compared with their respective controls. In Delsen (mancozeb, dithiocarbamate) users, the power of postural sway of 0-1 Hz was significantly larger than that in the controls both in the anterior-posterior direction with eyes open and in the right-left direction with eyes closed. The former type of sway was also significantly increased in Tamaron (methamidophos, organophosphorus insecticide) users. In conclusion, nerve conduction velocities and postural sway seem to be sensitive indicators of the effects of pesticides on the central and peripheral nervous system.
    Matched MeSH terms: Central Nervous System/physiopathology*
  11. Wang QM, Cui H, Han SJ, Black-Schaffer R, Volz MS, Lee YT, et al.
    Neurosci Lett, 2014 May 21;569:6-11.
    PMID: 24631567 DOI: 10.1016/j.neulet.2014.03.011
    Noninvasive transcranial direct current stimulation (tDCS) and methylphenidate (MP) are associated with motor recovery after stroke. Based on the potentially complementary mechanisms of these interventions, we examined whether there is an interactive effect between MP and tDCS. In this preliminary study, we randomized subacute stroke subjects to receive tDCS alone, MP alone or combination of tDCS and MP. A blinded rater measured safety, hand function, and cortical excitability before and after treatment. None of the treatments caused any major or severe adverse effects or induced significant differences in cortical excitability. Analysis of variance of gain score, as measured by Purdue pegboard test, showed a significant between-group difference (F(2,6)=12.167, p=0.008). Post hoc analysis showed that the combination treatment effected greater Purdue pegboard gain scores than tDCS alone (p=0.017) or MP alone (p=0.01). Our preliminary data with nine subjects shows an interesting dissociation between motor function improvement and lack of motor corticospinal plasticity changes as indexed by transcranial magnetic stimulation in subacute stroke subjects.
    Matched MeSH terms: Central Nervous System Stimulants/therapeutic use*
  12. Lau KF, Tan KS, Goh KJ, Ramli N, Tai SM
    Ann Acad Med Singap, 2019 Mar;48(3):109-111.
    PMID: 30997481
    Matched MeSH terms: Central Nervous System Vascular Malformations/complications
  13. Ismail A, Bhatti MS, Faye I, Lu CK, Laude A, Tang TB
    Graefes Arch Clin Exp Ophthalmol, 2018 Sep;256(9):1711-1721.
    PMID: 29876732 DOI: 10.1007/s00417-018-4030-9
    PURPOSE: To evaluate and compare the temporal changes in pulse waveform parameters of ocular blood flow (OBF) between non-habitual and habitual groups due to caffeine intake.

    METHOD: This study was conducted on 19 healthy subjects (non-habitual 8; habitual 11), non-smoking and between 21 and 30 years of age. Using laser speckle flowgraphy (LSFG), three areas of optical nerve head were analyzed which are vessel, tissue, and overall, each with ten pulse waveform parameters, namely mean blur rate (MBR), fluctuation, skew, blowout score (BOS), blowout time (BOT), rising rate, falling rate, flow acceleration index (FAI), acceleration time index (ATI), and resistive index (RI). Two-way mixed ANOVA was used to determine the difference between every two groups where p 

    Matched MeSH terms: Central Nervous System Stimulants/administration & dosage*
  14. Muhamad Effendi F, Nam Y, Shin CH, Cho TJ, Yoo WJ, Cheon JE, et al.
    J Pediatr Orthop B, 2018 Sep;27(5):407-411.
    PMID: 28704300 DOI: 10.1097/BPB.0000000000000477
    Heterotopic ossification in soft tissue or muscle is rare in the pediatric and adolescent age group. Most cases are associated with musculoskeletal injury and trauma to the central nervous system. Here, we describe an adolescent patient without a history of trauma or lesions in the central nervous system who presented with a painful limp with limited motion of the left hip. Investigations indicated unusually large heterotopic ossification extending from the inner aspect of the ilium down to the anterior part of the hip, highly likely to have developed after an unrecognized periacetabular pyomyositis primarily involving the iliacus muscle. Surgical excision was performed successfully without perioperative complications. No recurrence was detected at the final follow-up.
    Matched MeSH terms: Central Nervous System/pathology
  15. Kuan CS, Cham CY, Singh G, Yew SM, Tan YC, Chong PS, et al.
    PLoS One, 2016;11(8):e0161008.
    PMID: 27570972 DOI: 10.1371/journal.pone.0161008
    Cladophialophora bantiana is a dematiaceous fungus with a predilection for causing central nervous system (CNS) infection manifesting as brain abscess in both immunocompetent and immunocompromised patients. In this paper, we report comprehensive genomic analyses of C. bantiana isolated from the brain abscess of an immunocompetent man, the first reported case in Malaysia and Southeast Asia. The identity of the fungus was determined using combined morphological analysis and multilocus phylogeny. The draft genome sequence of a neurotrophic fungus, C. bantiana UM 956 was generated using Illumina sequencing technology to dissect its genetic fundamental and basic biology. The assembled 37.1 Mb genome encodes 12,155 putative coding genes, of which, 1.01% are predicted transposable elements. Its genomic features support its saprophytic lifestyle, renowned for its versatility in decomposing hemicellulose and pectin components. The C. bantiana UM 956 was also found to carry some important putative genes that engaged in pathogenicity, iron uptake and homeostasis as well as adaptation to various stresses to enable the organism to survive in hostile microenvironment. This wealth of resource will further catalyse more downstream functional studies to provide better understanding on how this fungus can be a successful and persistent pathogen in human.
    Matched MeSH terms: Central Nervous System Fungal Infections/microbiology
  16. Masiran R
    BMJ Case Rep, 2018 Sep 05;2018.
    PMID: 30185454 DOI: 10.1136/bcr-2018-226270
    An adolescent with autism spectrum disorder and improperly treated attention deficit hyperactivity disorder presented with recurrent hair pulling. Treatment with selective serotonin reuptake inhibitor and stimulant improved these conditions.
    Matched MeSH terms: Central Nervous System Stimulants/therapeutic use*
  17. Siddiqui R, Rajendran K, Abdella B, Ayub Q, Lim SY, Khan NA
    Parasitol Res, 2020 Jul;119(7):2351-2358.
    PMID: 32451717 DOI: 10.1007/s00436-020-06711-6
    Naegleria fowleri causes a deadly infection known as primary amoebic meningoencephalitis (PAM). To our knowledge, there are very few transcriptome studies conducted on these brain-eating amoebae, despite rise in the number of cases. Although the Naegleria genome has been sequenced, currently, it is not well annotated. Transcriptome level studies are needed to help understand the pathology and biology of this fatal parasitic infection. Recently, we showed that nanoparticles loaded with the flavonoid Hesperidin (HDN) are potential novel antimicrobial agents. N. fowleri trophozoites were treated with and without HDN-conjugated with silver nanoparticles (AgNPs) and silver only, and then, 50% minimum inhibitory concentration (MIC) was determined. The results revealed that the MIC of HDN-conjugated AgNPs was 12.5 microg/mL when treated for 3 h. As no reference genome exists for N. fowleri, de novo RNA transcriptome analysis using RNA-Seq and differential gene expression analysis was performed using the Trinity software. Analysis revealed that more than 2000 genes were differentially expressed in response to N. fowleri treatment with HDN-conjugated AgNPs. Some of the genes were linked to oxidative stress response, DNA repair, cell division, cell signalling and protein synthesis. The downregulated genes were linked with processes such as protein modification, synthesis of aromatic amino acids, when compared with untreated N. fowleri. Further transcriptome studies will lead to understanding of genetic mechanisms of the biology and pathogenesis and/or the identification of much needed drug candidates.
    Matched MeSH terms: Central Nervous System Protozoal Infections/parasitology*
  18. Aziz MNM, Kumar J, Muhammad Nawawi KN, Raja Ali RA, Mokhtar NM
    Nutrients, 2021 Aug 31;13(9).
    PMID: 34578939 DOI: 10.3390/nu13093061
    Patients with irritable bowel syndrome (IBS) are increasingly presenting with a wide range of neuropsychiatric symptoms, such as deterioration in gastroenteric physiology, including visceral hypersensitivity, altered intestinal membrane permeability, and gastrointestinal motor dysfunction. Functional imaging of IBS patients has revealed several abnormalities in various brain regions, such as significant activation of amygdala, thinning of insular and anterior cingulate cortex, and increase in hypothalamic gray matter, which results in poor psychiatric and cognitive outcomes. Interrelations between the enteric and central events in IBS-related gastrointestinal, neurological, and psychiatric pathologies have compelled researchers to study the gut-brain axis-a bidirectional communication that maintains the homeostasis of the gastrointestinal and central nervous system with gut microbiota as the protagonist. Thus, it can be disrupted by any alteration owing to the gut dysbiosis or loss of diversity in microbial composition. Available evidence indicates that the use of probiotics as a part of a balanced diet is effective in the management of IBS and IBS-associated neurodegenerative and psychiatric comorbidities. In this review, we delineate the pathogenesis and complications of IBS from gastrointestinal and neuropsychiatric standpoints while also discussing the neurodegenerative events in enteric and central nervous systems of IBS patients and the therapeutic potential of gut microbiota-based therapy established on clinical and preclinical data.
    Matched MeSH terms: Central Nervous System/physiopathology
  19. Willoughby AR, de Zambotti M, Baker FC, Colrain IM
    Alcohol, 2020 May;84:1-7.
    PMID: 31539623 DOI: 10.1016/j.alcohol.2019.09.005
    There is evidence for impairment in both central nervous system (CNS) and autonomic nervous system (ANS) function with prolonged alcohol use. While these impairments persist into abstinence, partial recovery of function has been demonstrated in both systems during sleep. To investigate potential ANS dysfunction associated with cortical CNS responses (impairment in CNS-ANS coupling), we assessed phasic heart rate (HR) fluctuation associated with tones that did and those that did not elicit a K-complex (KC) during stable N2 non-rapid eye movement (NREM) sleep in a group of 16 recently abstinent alcohol use disorder (AUD) patients (41.6 ± 8.5 years) and a group of 13 sex- and age-matched control participants (46.6 ± 9.3 years). Electroencephalogram (EEG) and electrocardiogram (ECG) data were recorded throughout the night. Alcohol consumption questionnaires were also administered to the AUD patients. AUD patients had elevated HR compared to controls at baseline prior to tone presentation. The HR fluctuation associated with KCs elicited by tone presentation was significantly smaller in amplitude, and tended to be delayed in time, in the AUD group compared with the control group, and the subsequent deceleration was also smaller in AUD patients. In both groups, the increase in HR was larger and occurred earlier when KCs were produced than when they were not, and there was no difference in the magnitude of the KC effect between groups. Phasic HR changes associated with KCs elicited by tones are impaired in AUD participants, reflecting ANS dysfunction possibly caused by an alteration of cardiac vagal trafficking. However, only the timing of the HR response was found to relate to estimated lifetime alcohol consumption in AUD. The clinical meaning and implications of these novel findings need to be determined.
    Matched MeSH terms: Central Nervous System/physiology*
  20. Thumboo J, Fong KY, Chng HH, Koh ET, Chia HP, Leong KH, et al.
    J Rheumatol, 1998 Jul;25(7):1299-304.
    PMID: 9676760
    OBJECTIVE: To determine the effects of ethnicity on disease manifestations in Oriental patients with systemic lupus erythematosus (SLE) and to describe the risk of developing renal or central nervous system (CNS) involvement with time.
    METHODS: A retrospective study of 472 patients with SLE seen at the only Rheumatology Unit in Singapore. The effect of ethnicity on selected disease manifestations at diagnosis was assessed after adjusting for demographic variables using multiple logistic regression. The probability of developing selected disease manifestations with time was determined using the Kaplan-Meier product limit method.
    RESULTS: At diagnosis, Malays had a higher risk of renal or CNS involvement than Chinese (OR 2.26, 95% CI 1.21 to 4.21, and OR 3.07, 95% CI 1.01 to 9.34, respectively), and Indians a lower risk of malar rash and a higher risk of oral ulcers than Chinese (OR 0.30, 95% CI 0.13 to 0.68, and OR 2.90, 95% CI 1.45 to 7.34, respectively). The prevalence of renal or CNS involvement in the entire cohort increased with time, reaching 75.6% (95% CI 66.1% to 85.0%) and 16.7% (95% CI 11.7% to 21.6%), respectively, after 18 years of disease.
    CONCLUSION: Ethnicity influenced disease manifestations at diagnosis in this cohort of Oriental patients with SLE. Renal or CNS involvement developed in previously unaffected patients up to 18 years after diagnosis, highlighting the need for continued vigilance in patients with lupus.
    Matched MeSH terms: Central Nervous System Diseases/complications
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