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Fulltext Methods to improve rehabilitation of patients following breast cancer surgery: a review of systematic reviews

Loh SY, Musa AN

Breast Cancer (Dove Med Press), 2015;7:81-98.
PMID: 25792854 DOI: 10.2147/BCTT.S47012

CONTEXT: Breast cancer is the most prevalent cancer amongst women but it has the highest survival rates amongst all cancer. Rehabilitation therapy of post-treatment effects from cancer and its treatment is needed to improve functioning and quality of life. This review investigated the range of methods for improving physical, psychosocial, occupational, and social wellbeing in women with breast cancer after receiving breast cancer surgery.
METHOD: A search for articles published in English between the years 2009 and 2014 was carried out using The Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, PubMed, and ScienceDirect. Search terms included: 'breast cancer', 'breast carcinoma', 'surgery', 'mastectomy', 'lumpectomy', 'breast conservation', 'axillary lymph node dissection', 'rehabilitation', 'therapy', 'physiotherapy', 'occupational therapy', 'psychological', 'psychosocial', 'psychotherapy', 'exercise', 'physical activity', 'cognitive', 'occupational', 'alternative', 'complementary', and 'systematic review'.
STUDY SELECTION: Systematic reviews on the effectiveness of rehabilitation methods in improving post-operative physical, and psychological outcomes for breast cancer were selected. Sixteen articles met all the eligibility criteria and were included in the review.
DATA EXTRACTION: Included review year, study aim, total number of participants included, and results.
DATA SYNTHESIS: Evidence for exercise rehabilitation is predominantly in the improvement of shoulder mobility and limb strength. Inconclusive results exist for a range of rehabilitation methods (physical, psycho-education, nutritional, alternative-complementary methods) for addressing the domains of psychosocial, cognitive, and occupational outcomes.
CONCLUSION: There is good evidence for narrowly-focused exercise rehabilitation in improving physical outcome particularly for shoulder mobility and lymphedema. There were inconclusive results for methods to improve psychosocial, cognitive, and occupational outcomes. There were no reviews on broader performance areas and lifestyle factors to enable effective living after treatment. The review suggests that comprehensiveness and effectiveness of post-operative breast cancer rehabilitation should consider patients' self-management approaches towards lifestyle redesign, and incorporate health promotion aspects, in light of the fact that breast cancer is now taking the form of a chronic illness with longer survivorship years.
KEYWORDS: breast cancer surgery; lifestyle redesign; quality of life; rehabilitation methods; self-management; symptom-management
Fulltext Cystic lung disease as a complication of post-tuberculosis infection in young patients: A rare manifestation of a common disease

Johari B, Khor BH, Musa AN, Abdul Kadir RF

Respirol Case Rep, 2022 Mar;10(3):e0911.
PMID: 35223042 DOI: 10.1002/rcr2.911

Tuberculosis (TB) is a common disease which is still endemic in many countries including Malaysia. Acquired cystic lung disease is a rare complication of post-TB infection. We aim to describe two cases of young patients who developed cystic lung disease during treatment for TB, which were further complicated with recurrent pneumothorax. We reiterate the need to consider TB in the differential diagnoses of cystic lung disease in the appropriate clinical context.
Fulltext Unilateral pulmonary artery agenesis: An unusual cause of hemoptysis

Wong YS, Abidin ZZ, Musa AN, Kadir RFA, Johari B

Respir Med Case Rep, 2023;43:101834.
PMID: 36950023 DOI: 10.1016/j.rmcr.2023.101834

INTRODUCTION: Unilateral pulmonary artery agenesis (UPAA) is a rare congenital malformation of the pulmonary artery due to agenesis of the sixth aortic arch during embryogenesis. Diagnosis can be challenging due to variable clinical presentations.
CASE: A 29-year-old female at third trimester of twin pregnancy presented with massive hemoptysis. Computed tomography angiogram (CTA) showed unilateral absence of the right pulmonary artery with multiple dilated tortuous bronchial arteries supplying the right lung. Selective embolization of the bronchial artery was performed post-partum.
CONCLUSION: Clinicians should have a high clinical suspicion of collateral artery bleeding in patients who present with unexplained hemoptysis and typical UPAA radiographic findings.
Fulltext Influenza in Malaysian adult patients hospitalized with community-acquired pneumonia, acute exacerbation of chronic obstructive pulmonary disease or asthma: a multicenter, active surveillance study

Pang YK, Ismail AI, Chan YF, Cheong A, Chong YM, Doshi P, et al.

BMC Infect Dis, 2021 Jul 05;21(1):644.
PMID: 34225647 DOI: 10.1186/s12879-021-06360-9

BACKGROUND: Available data on influenza burden across Southeast Asia are largely limited to pediatric populations, with inconsistent findings.
METHODS: We conducted a multicenter, hospital-based active surveillance study of adults in Malaysia with community-acquired pneumonia (CAP), acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and acute exacerbation of asthma (AEBA), who had influenza-like illness ≤10 days before hospitalization. We estimated the rate of laboratory-confirmed influenza and associated complications over 13 months (July 2018-August 2019) and described the distribution of causative influenza strains. We evaluated predictors of laboratory-confirmed influenza and severe clinical outcomes using multivariate analysis.
RESULTS: Of 1106 included patients, 114 (10.3%) were influenza-positive; most were influenza A (85.1%), with A/H1N1pdm09 being the predominant circulating strain during the study following a shift from A/H3N2 from January-February 2019 onwards. In multivariate analyses, an absence of comorbidities (none versus any comorbidity [OR (95%CI), 0.565 (0.329-0.970)], p = 0.038) and of dyspnea (0.544 (0.341-0.868)], p = 0.011) were associated with increased risk of influenza positivity. Overall, 184/1106 (16.6%) patients were admitted to intensive care or high-dependency units (ICU/HDU) (13.2% were influenza positive) and 26/1106 (2.4%) died (2.6% were influenza positive). Males were more likely to have a severe outcome (ICU/HDU admission or death).
CONCLUSIONS: Influenza was a significant contributor to hospitalizations associated with CAP, AECOPD and AEBA. However, it was not associated with ICU/HDU admission in this population. Study registration, NMRR ID: NMRR-17-889-35,174.