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  1. Meeting the challenge of epidemic infectious disease outbreaks: an agenda for research
    Phua KL, Lee LK
    J Public Health Policy, 2005 Apr;26(1):122-32.
    PMID: 15906881
    Challenges arising from epidemic infectious disease outbreaks can be more effectively met if traditional public health is enhanced by sociology. The focus is normally on biomedical aspects, the surveillance and sentinel systems for infectious diseases, and what needs to be done to bring outbreaks under control quickly. Social factors associated with infectious disease outbreaks are often neglected and the aftermath is ignored. These factors can affect outbreak severity, its rate and extent of spread, influencing the welfare of victims, their families, and their communities. We propose an agenda for research to meet the challenges of infectious disease outbreaks. What social factors led to the outbreak? What social factors affected its severity and rate and extent of spread? How did individuals, social groups, and the state react to it? What are the short- and long-term effects on individuals, social groups, and the larger society? What programs can be put in place to help victims, their families, and affected communities to cope with the consequences--impaired mental and physical health, economic losses, and disrupted communities? Although current research on infectious disease outbreaks pays attention to social factors related to causation, severity, rate and extent of spread, those dealing with the "social chaos" arising from outbreaks are usually neglected. Inclusion, by combining traditional public health with sociological analysis, will enrich public health theory and understanding of infectious disease outbreaks. Our approach will help develop better programs to combat outbreaks and equally important, to help survivors, their families, and their communities cope better with the aftermath.
    Matched MeSH terms: Communicable Disease Control*; Disease Outbreaks/prevention & control*
  2. Associations between primary aldosteronism and diabetes, poor bone health, and sleep apnea-what do we know so far?
    Loh HH, Sukor N
    J Hum Hypertens, 2020 01;34(1):5-15.
    PMID: 31822780 DOI: 10.1038/s41371-019-0294-8
    Primary aldosteronism (PA), the most common cause of secondary hypertension, is a well-recognized condition that can lead to cardiovascular and renal complications. PA is frequently left undiagnosed and untreated, leading to aldosterone-specific morbidity and mortality. In this review we highlight the evidence linking PA with other conditions such as (i) diabetes mellitus, (ii) obstructive sleep apnea, and (iii) bone health, along with clinical implications and proposed underlying mechanisms.
    Matched MeSH terms: Disease Management
  3. Fulltext Classification of community-acquired outbreaks for the global transmission of COVID-19: Machine learning and statistical model analysis
    Wang WC, Lin TY, Chiu SY, Chen CN, Sarakarn P, Ibrahim M, et al.
    J Formos Med Assoc, 2021 Jun;120 Suppl 1:S26-S37.
    PMID: 34083090 DOI: 10.1016/j.jfma.2021.05.010
    BACKGROUND: As Coronavirus disease 2019 (COVID-19) pandemic led to the unprecedent large-scale repeated surges of epidemics worldwide since the end of 2019, data-driven analysis to look into the duration and case load of each episode of outbreak worldwide has been motivated.

    METHODS: Using open data repository with daily infected, recovered and death cases in the period between March 2020 and April 2021, a descriptive analysis was performed. The susceptible-exposed-infected-recovery model was used to estimate the effective productive number (Rt). The duration taken from Rt > 1 to Rt 

    Matched MeSH terms: Disease Outbreaks
  4. Fulltext Clinical and epidemiological characteristics of children with COVID-19 in Negeri Sembilan, Malaysia
    Ng DC, Tan KK, Chin L, Ali MM, Lee ML, Mahmood FM, et al.
    Int J Infect Dis, 2021 Jul;108:347-352.
    PMID: 34087485 DOI: 10.1016/j.ijid.2021.05.073
    OBJECTIVES: To describe the clinical and epidemiological characteristics of children with coronavirus disease 2019 (COVID-19) in the state of Negeri Sembilan, Malaysia in the setting of mandatory hospital isolation and quarantine for all confirmed cases.

    METHODS: A multi-centre, retrospective observational study was performed among children aged ≤12 years with laboratory-proven COVID-19 between 1 February and 31 December 2020.

    RESULTS: In total, 261 children (48.7% males, 51.3% females) were included in this study. The median age was 6 years [interquartile range (IQR) 3-10 years]. One hundred and fifty-one children (57.9%) were asymptomatic on presentation. Among the symptomatic cases, fever was the most common presenting symptom. Two hundred and forty-one (92.3%) cases were close contacts of infected household or extended family members. Twenty-one (8.4%) cases had abnormal radiological findings. All cases were discharged alive without requiring supplemental oxygen therapy or any specific treatment during hospitalization. The median duration of hospitalization was 7 days (IQR 6-10 days). One (2.1%) of the uninfected guardians accompanying a child in quarantine tested positive for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) upon discharge.

    CONCLUSIONS: COVID-19 in children was associated with mild symptoms and a good prognosis. Familial clustering was an important epidemiologic feature in the outbreak in Negeri Sembilan. The risk of transmission of SARS-CoV-2 from children to guardians in hospital isolation was minimal despite close proximity.

    Matched MeSH terms: Disease Outbreaks
  5. Characteristics and clinical applications of Wharton's jelly-derived mesenchymal stromal cells
    Liau LL, Ruszymah BHI, Ng MH, Law JX
    Curr Res Transl Med, 2020 01;68(1):5-16.
    PMID: 31543433 DOI: 10.1016/j.retram.2019.09.001
    Mesenchymal stromal cells (MSCs) are widely used in the clinic because they involve fewer ethical issues and safety concerns compared to other stem cells such as embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs). MSCs derived from umbilical cord Wharton's jelly (WJ-MSCs) have excellent proliferative potential and a faster growth rate and can retain their multipotency for more passages in vitro compared to adult MSCs from bone marrow or adipose tissue. WJ-MSCs are used clinically for repairing tissue injuries of the spinal cord, liver and heart with the aim of regenerating tissue. On the other hand, WJ-MSCs are also used clinically to ameliorate immune-mediated diseases based on their ability to modulate immune responses. In the field of tissue engineering, WJ-MSCs capable of differentiating into multiple cell lineages have been used to produce a variety of engineered tissues in vitro that can then be transplanted in vivo. This review discusses the characteristics of WJ-MSCs, the differences between WJ-MSCs and adult MSCs, clinical studies involving WJ-MSCs and future perspectives of WJ-MSC research and clinical applications. To summarize, WJ-MSCs have shown promise in treating a variety of diseases clinically. However, most clinical trials/studies reported thus far are relatively smaller in scale. The collected evidence is insufficient to support the routine use of WJ-MSC therapy in the clinic. Thus, rigorous clinical trials are needed in the future to obtain more information on WJ-MSC therapy safety and efficacy.
    Matched MeSH terms: Chronic Disease/therapy; Graft vs Host Disease/therapy
  6. Lessons learned from Asian H5N1 outbreak control
    Sims LD
    Avian Dis, 2007 Mar;51(1 Suppl):174-81.
    PMID: 17494550
    Numerous lessons have been learned so far in controlling H5N1 avian influenza in Asia. Early detection of incursions of virus prevented establishment of the disease in several countries, notably Japan, South Korea, and Malaysia. In countries where detection of early cases was delayed, infection is endemic and has been for three or more years. Control measures implemented in these countries need to reflect this finding. Vaccination will continue to be one of the key measures used in these endemically infected countries. Used alone, vaccination will not result in elimination of H5N1 viruses from a country, but, if used correctly, it will markedly reduce the prevalence of and susceptibility to infection. Vaccination has already played a valuable role in reducing the adverse effects of H5N1 viruses. Mass culling also reduces the level of infection in infected areas. However, the long-term benefits are limited in endemically infected countries owing to the high probability of reinfection on restocking unless other measures are used in parallel. Full epidemiological studies have not been conducted in many infected countries. Nevertheless, it is recognized that the number of clinical cases does not truly reflect the levels of infection. Domestic ducks and large live poultry markets have played a key role in the persistence of infection, because they can be infected silently. In tackling this disease, countries should adopt integrated control programs using the combination of measures best suited to the local environment. All surveillance data should be shared, both positive and negative, and should include information on cases of infection and disease. Socioeconomic and ecological implications of all control measures should be assessed before implementation, especially the impact on the rural poor.
    Matched MeSH terms: Communicable Disease Control/methods*; Disease Outbreaks/veterinary*
  7. Fractalkine (CX3CL1) signaling and neuroinflammation in Parkinson's disease: Potential clinical and therapeutic implications
    Angelopoulou E, Paudel YN, Shaikh MF, Piperi C
    Pharmacol Res, 2020 08;158:104930.
    PMID: 32445958 DOI: 10.1016/j.phrs.2020.104930
    Neuroinflammation plays a crucial role in the pathogenesis of Parkinson's disease (PD) with the dysregulation of microglial activity being tightly linked to dopaminergic degeneration. Fractalkine (CX3CL1), a chemokine mainly expressed by neurons, can modulate microglial activity through binding to its sole G-protein-coupled receptor (CX3CR1), expressed by microglia. Fractalkine/CX3CR1 signaling is one of the most important mediators of the communication between neurons and microglia, and its emerging role in neurodegenerative disorders including PD has been increasingly recognized. Pre-clinical evidence has revealed that fractalkine signaling axis exerts dual effects on PD-related inflammation and degeneration, which greatly depend on the isoform type (soluble or membrane-bound), animal model (mice or rats, toxin- or proteinopathy-induced), route of toxin administration, time course and specific brain region (striatum, substantia nigra). Furthermore, although existing clinical evidence is scant, it has been indicated that fractalkine may be possibly associated with PD progression, paving the way for future studies investigating its biomarker potential. In this review, we discuss recent evidence on the role of fractalkine/CX3CR1 signaling axis in PD pathogenesis, aiming to shed more light on the molecular mechanisms underlying the neuroinflammation commonly associated with the disease, as well as potential clinical and therapeutic implications.
    Matched MeSH terms: Parkinson Disease/drug therapy*; Parkinson Disease/genetics; Parkinson Disease/metabolism*
  8. Advancement in biosensor: "Telediagnosis" and "remote digital imaging"
    Gopinath SCB, Ismail ZH, Shapiai MI, Yasin MNM
    Biotechnol Appl Biochem, 2021 May 19.
    PMID: 34009645 DOI: 10.1002/bab.2196
    Current developments in sensors and actuators are heralding a new era to facilitate things to happen effortlessly and efficiently with proper communication. On the other hand, Internet of Things (IoT) has been boomed up with er potential and occupies a wide range of disciplines. This study has choreographed to design of an algorithm and a smart data-processing scheme to implement the obtained data from the sensing system to transmit to the receivers. Technically, it is called "telediagnosis" and "remote digital monitoring," a revolution in the field of medicine and artificial intelligence. For the proof of concept, an algorithmic approach has been implemented for telediagnosis with one of the degenerative diseases, that is, Parkinson's disease. Using the data acquired from an improved interdigitated electrode, sensing surface was evaluated with the attained sensitivity of 100 fM (n = 3), and the limit of detection was calculated with the linear regression value coefficient. By the designed algorithm and data processing with the assistance of IoT, further validation was performed and attested the coordination. This proven concept can be ideally used with all sensing strategies for immediate telemedicine by end-to-end communications.
    Matched MeSH terms: Parkinson Disease
  9. Fulltext A non-surgical management of delayed diagnosis of an oesophageal perforation due to ingestion of okra: a case report
    Rosmadi Ismail, Ummi Affah Mahamad, Abdul Aziz Marwan
    Malaysian Journal of Medicine and Health Sciences, 2020;16(108):87-89.
    MyJurnal
    Oesophageal perforation is a not uncommon condition, yet it carries a high mortality rate and has been observed as the most grievous trauma to the digestive tract. Common causes include iatrogenic instrumentation, foreign-body swallowing, and physical injury. This report highlighted a case of oesophageal perforation complicated by formation of proximal descending aorta pseudoaneurysm as a result of okra ingestion. The patient was successfully treated with conservative treatment. The possible mechanism of oesophageal rupture, diagnosis, treatment, and other complica- tion will be further discussed.
    Matched MeSH terms: Iatrogenic Disease
  10. Fulltext Occurrences of vibrio parahaemolyticus in retailed freshwater fish
    Jesmie, Babai, Rosdi, Kira, Fazia, Mohd Sinang, Lesley Maurice, Bilung
    Trends in Undergraduate Research, 2020;3(1):1-4.
    MyJurnal
    Vibrio parahaemolyticus is a causative agent of foodborne outbreaks associated with the consumption of raw or under-cooked seafood. This study aimed to quantify and detect the occurrence of V. parahaemolyticus in freshwater fish by performing Most Probable Number (MPN) method in combination with Polymerase Chain Reaction (PCR). In this study, a total of 20 red tilapia (Oreochromis sp.) were collected from nearby local wet markets. Polymerase Chain Reaction (PCR) assay targeting the toxR gene in V. parahaemolyticus was performed, with the expected DNA amplification size of 368 bp. MPN analysis showed that the estimated microbial load of V. parahaemolyticus were more than 1100 MPN/g. The result of the PCR assay confirmed the presence of V. parahaemolyticus in 90% of the isolates. This positive detection elucidated the presence of food-borne bacteria in freshwater fish from local wet-market which may affect not only the health of fish stocks but also raise public health concerns.
    Matched MeSH terms: Disease Outbreaks
  11. An insight into the role of Artificial Intelligence in the early diagnosis of Alzheimer's disease
    Verma RK, Pandey M, Chawla P, Choudhury H, Mayuren J, Bhattamisra SK, et al.
    CNS Neurol Disord Drug Targets, 2021 May 11.
    PMID: 33982657 DOI: 10.2174/1871527320666210512014505
    BACKGROUND: The complication of Alzheimer's disease (AD) has made the development of its therapeutic a challenging task. Even after decades of research, we have achieved no more than a few years of symptomatic relief. The inability to diagnose the disease early is the foremost hurdle behind its treatment. Several studies have aimed to identify potential biomarkers that can be detected in body fluids (CSF, blood, urine, etc) or assessed by neuroimaging (i.e., PET and MRI). However, the clinical implementation of these biomarkers is incomplete as they cannot be validated.

    METHOD: To overcome the limitation, the use of artificial intelligence along with technical tools has been extensively investigated for AD diagnosis. For developing a promising artificial intelligence strategy that can diagnose AD early, it is critical to supervise neuropsychological outcomes and imaging-based readouts with a proper clinical review.

    CONCLUSION: Profound knowledge, a large data pool, and detailed investigations are required for the successful implementation of this tool. This review will enlighten various aspects of early diagnosis of AD using artificial intelligence.

    Matched MeSH terms: Alzheimer Disease
  12. Fulltext Cryptococcal meningoradiculitis presenting with acute flaccid paralysis
    Chang CY
    Rev Soc Bras Med Trop, 2021;54:e0192 2021.
    PMID: 33950130 DOI: 10.1590/0037-8682-0192-2021
    Matched MeSH terms: Acute Disease
  13. Fulltext Risk Factors Associated With Medication Errors Among Patients Suffering From Chronic Disorders
    Rasool MF, Rehman AU, Imran I, Abbas S, Shah S, Abbas G, et al.
    Front Public Health, 2020;8:531038.
    PMID: 33330300 DOI: 10.3389/fpubh.2020.531038
    Introduction: Medication error is unintentional and can be reduced by reducing the risk factors. Patients suffering from chronic diseases are at an increased risk of medication errors. Objective: This work aims to assess the risk factors associated with medication errors among patients suffering from chronic disorders in hospitals of South Punjab, Pakistan. Methodology: Multiple logistic regression analysis was used to assess the impact of different risk factors on the prevalence of medication errors in patients suffering from chronic diseases. Results: A greater risk for the occurrence of medication errors was associated with age ≥60 years (odds ratio, OR = 1.9; 95% CI = 1.3-3.1; p = 0.001), overburdened healthcare system (OR = 2.2; 95% CI = 1.64-3.56; p < 0.000), number of prescribed drugs ≥5 (OR = 1.74; 95% CI = 1.02-2.64; p < 0.000), comorbidities (OR = 2.6; 95% CI = 1.72-3.6; p = 0.003), Charlson comorbidity index (OR = 1.31; 95% CI = 0.49-1.84; p = 0.004), and multiple prescribers to one patient (OR = 1.12; 95% CI = 0.64-1.76; p = 0.001). Conclusion: Older age, overburdened healthcare system, number of prescribed drugs, comorbidities, Charlson comorbidity index, and multiple prescribers to one patient are significant risk factors for the occurrence of medication errors.
    Matched MeSH terms: Chronic Disease
  14. Fulltext Understanding Lung Carcinogenesis from a Morphostatic Perspective: Prevention and Therapeutic Potential of Phytochemicals for Targeting Cancer Stem Cells
    Heng WS, Kruyt FAE, Cheah SC
    Int J Mol Sci, 2021 May 27;22(11).
    PMID: 34071790 DOI: 10.3390/ijms22115697
    Lung cancer is still one of the deadliest cancers, with over two million incidences annually. Prevention is regarded as the most efficient way to reduce both the incidence and death figures. Nevertheless, treatment should still be improved, particularly in addressing therapeutic resistance due to cancer stem cells-the assumed drivers of tumor initiation and progression. Phytochemicals in plant-based diets are thought to contribute substantially to lung cancer prevention and may be efficacious for targeting lung cancer stem cells. In this review, we collect recent literature on lung homeostasis, carcinogenesis, and phytochemicals studied in lung cancers. We provide a comprehensive overview of how normal lung tissue operates and relate it with lung carcinogenesis to redefine better targets for lung cancer stem cells. Nine well-studied phytochemical compounds, namely curcumin, resveratrol, quercetin, epigallocatechin-3-gallate, luteolin, sulforaphane, berberine, genistein, and capsaicin, are discussed in terms of their chemopreventive and anticancer mechanisms in lung cancer and potential use in the clinic. How the use of phytochemicals can be improved by structural manipulations, targeted delivery, concentration adjustments, and combinatorial treatments is also highlighted. We propose that lung carcinomas should be treated differently based on their respective cellular origins. Targeting quiescence-inducing, inflammation-dampening, or reactive oxygen species-balancing pathways appears particularly interesting.
    Matched MeSH terms: Disease Susceptibility*; Disease Management; Genetic Predisposition to Disease
  15. Fulltext Association of Immunoglobulin G abnormalities in diseases: a mini review
    Foong, Audrey Kow Siew, Nuha Fahimah Binti Wan Zahidi, Chau, Ling Tham
    Life Sciences, Medicine and Biomedicine, 2018;2(1):24-39.
    MyJurnal
    Immunoglobulins are antibodies that play important roles in preserving our immune system. They have the ability to initiate humoral responses and remove antigen from the body. Out of the five major isotypes of immunoglobulins, IgG are most abundantly found in human serum. Abnormalities – deficiency or elevation in the level of IgG are found to be associated to the occurrence of several autoimmune diseases. These may include rheumatoid arthritis, Crohn’s disease, Mikulicz’s disease, Kuttner’s tumour and Hashimoto’s thyroiditis. Apart from autoimmune diseases, IgG has been found to play a role in initiating anaphylaxis, a severe and life threatening form of allergy and lately it has been discovered in cases of dengue virus infection too. It is important to acknowledge the roles of IgG on diseases especially subclass IgG4 which the elevation has been tied to numerous diseases such as Kuttner’s tumour and Hashimoto’s thyroiditis hence termed IgG4-related diseases. In addition, the roles of IgG in anaphylaxis are of importance, too, as IgG has been used in allergy immunotherapy. Hence, this review is a mini compilation of effects of IgG abnormalities based on their subclasses. Hopefully it will provide insightful understanding on the development of diagnostic and therapeutic courses for the aforementioned IgG abnormalities in the future.
    Matched MeSH terms: Mikulicz' Disease
  16. Fulltext Physical Activity, Sedentary Behavior, and Weight Status of University Students during the COVID-19 Lockdown: A Cross-National Comparative Study
    Tan ST, Tan CX, Tan SS
    Int J Environ Res Public Health, 2021 07 03;18(13).
    PMID: 34281062 DOI: 10.3390/ijerph18137125
    The temporary closure of learning institutions during the COVID-19 pandemic has dramatically reduced the physical activity of students across all ages. Therefore, this study aimed to investigate the prevalence of physical inactivity and the patterns of physical activity among university students in confinement. This cross-sectional study involved 147 Malaysian students and 107 Indonesian students. Body weight before the pandemic and during the pandemic was self-reported by the respondents, and the International Physical Activity Questionnaire-Short Form (IPAQ-SF) was used to assess the physical activity and sedentary behavior of the respondents. The findings revealed that 79.6% of Malaysians and 77.6% of Indonesians were physically active during the confinement. There was no significant difference (p < 0.05) in the duration devoted to vigorous-intensity activity (MMalaysian = 0.00 MET minutes/week and MIndonesian = 480.00 MET minutes/week) and moderate-intensity activity (MMalaysian = 0.00 MET minutes/week and MIndonesian = 0.00 MET minutes/week) among the studied population. During the pandemic, Malaysian students (M = 1386.00 MET minutes/week) devoted a significantly higher duration to walking (M = 1386.00 MET minutes/week) and sedentary behavior (9.16 ± 4.47 h/day) than Indonesian students (M = 990.00 MET minutes/week and sedentary behavior = 7.85 ± 4.27 h/day). Overall, no significant difference was noted in the total physical activity of Malaysian and Indonesian students during the pandemic (MMalaysian = 2826.00 MET minutes/week and MIndonesian = 1782.00 MET minutes/week). Findings from Spearman's rank correlation test suggested that there was a weak inverse correlation between the duration engaged in vigorous-intensity activity and weight change among the Malaysian students (rs = -0.199, p = 0.016), after adjusting for gender and age. Overall, the closure of learning institutions and exercise facilities has further prevented individuals from complying with the WHO recommendation of moderate-to-vigorous physical activity during the period of home confinement.
    Matched MeSH terms: Communicable Disease Control
  17. Fulltext MTHFR C677T polymorphism, homocysteine and B-vitamins status in a sample of Chinese and Malay subjects in Universiti Putra Malaysia
    Choo SC, Loh SP, Khor GL, Sabariah MN, Rozita R
    Malays J Nutr, 2011 Aug;17(2):249-58.
    PMID: 22303578 MyJurnal
    Methylenetetrahydrofolate reductase (MTHFR) C677T is involved in folate and homocysteine metabolism. Disruption in the activity of this enzyme will alter their levels in the body.
    Matched MeSH terms: Coronary Artery Disease/blood; Coronary Artery Disease/genetics*; Coronary Artery Disease/epidemiology
  18. Fulltext A Critical Evaluation of High Density Lipoprotein Cholesterol As An Index of Coronary Artery Disease Risk in Malaysians
    Malays J Nutr, 1997;3(1):-.
    MyJurnal
    Fasting serum specimens from (a) 217 male and 46 female patients with coronary artery disease (CAD), aged 35-75 years, who had undergone angioplasty (PTCA) / coronary artery bypass graft (CABG), and (b) 160 apparently healthy controls (106 males, 54 females, aged 30-75 years), were assessed for serum lipid profile. Both sex and ethnicity significantly influenced the levels of serum high density lipoprotein cholesterol (HDLC); in the controls, females had higher HDLC levels than males (46.7 mg/dl vs 38.5 mg/dl, p
    Matched MeSH terms: Coronary Artery Disease
  19. Fulltext Effects of young corn ear addition on nutritional composition and acceptability of conventional cake
    Wan Rosli, W.I., Chow, Y.N.
    Malays J Nutr, 2014;20(1):93-99.
    MyJurnal
    Introduction: Scientific evidence indicates that higher dietary fibre consumption protects against various chronic diseases and leads to recovery enhancement. Young corn ear is very rich in total dietary fibre (TDF). The study objective was to evaluate the effects of young corn ear addition on the nutritional composition, textural properties and sensory attributes of conventional cake. Methods: Wheat flour used in the preparation of conventional cake was substituted with different percentages (0%, 5%, 10% and 15%) of young corn ear powder (YCP). Moisture, total ash, fat, protein and TDF content of conventional cake samples were investigated. Textural properties including firmness, cohesiveness, springiness, gumminess and chewiness were examined. The aroma, colour, chewiness, tenderness, flavour and overall acceptance of conventional cake were evaluated via sensory evaluation. Results: The conventional cake with addition of 15% YCP recorded the highest moisture content. There was no predictable trend observed in the ash and fat content following the incorporation of YCP. Addition of 15% of YCP increased the protein content significantly while TDF content of conventional cake increased proportionally (1.42%-2.88%) with the level of YCP added. The incorporation of YCP did not produce any trend on all the textural properties of conventional cake. Conventional cake with 10% of YCP was the most preferred manifested by the highest scores in chewiness, tenderness and flavour attributes. Conclusion: In conclusion, 10% of YCP could be recommended as the ideal formulation in order to produce a healthier conventional cake without jeopardising acceptability.
    Matched MeSH terms: Chronic Disease
  20. Common combinations of medications used among oldest-old women: a population-based study over 15 years
    Thiruchelvam K, Byles J, Hasan SS, Egan N, Cavenagh D, Kairuz T
    Aging Clin Exp Res, 2021 Jul;33(7):1919-1928.
    PMID: 32909246 DOI: 10.1007/s40520-020-01693-y
    BACKGROUND: Older people use many medications, but combinations of medications used among the oldest old (≥ 80 years) are not commonly reported.

    AIMS: This study aimed to determine common combinations of medications used among women aged 77-96 years and to describe characteristics associated with these combinations.

    METHODS: A cohort study of older women enroled in the Australian Longitudinal Study on Women's Health over a 15-year period was used to determine combinations of medications using latent class analysis. Multinomial logistic regression was used to determine characteristics associated with these combinations.

    RESULTS: The highest medication users during the study were for the cardiovascular (2003: 80.28%; 2017: 85.63%) and nervous (2003: 66.03%; 2017: 75.41%) systems. A 3-class latent model described medication use combinations: class 1: 'Cardiovascular & neurology anatomical group' (27.25%) included participants using medications of the cardiovascular and nervous systems in their later years; class 2: 'Multiple anatomical group' (16.49%) and class 3: 'Antiinfectives & multiple anatomical group' (56.27%). When compared to the reference class (class 1), the risk of participants being in class 3 was slightly higher than being in class 2 if they had > 4 general practitioner visits (RRR 2.37; 95% CI 2.08, 2.71), Department of Veterans Affairs' coverage (RRR 1.59; 95% CI 1.36, 1.86), ≥ 4 chronic diseases (RRR 3.16; 95% CI 2.56, 3.90) and were frail (RRR 1.47; 95% CI 1.27, 1.69).

    CONCLUSION: Identification of combinations of medication use may provide opportunities to develop multimorbidity guidelines and target medication reviews, and may help reduce medication load for older individuals.

    Matched MeSH terms: Chronic Disease
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