Displaying publications 1 - 20 of 94 in total

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  1. Chow TJ, Tee SF, Yong HS, Tang PY
    Neuropsychobiology, 2016;73(4):233-240.
    PMID: 27305091
    Age at onset (AAO) is a known prognostic indicator for schizophrenia and is hypothesized to correlate with cognition and symptom severity. TCF4 and AKT1 are schizophrenia risk genes involved in cognitive functions. The current study examined the interactive effects of TCF4 and AKT1 variants with gender, family history of psychiatric disorders and ethnicity on the AAO of schizophrenia.
    Matched MeSH terms: Age of Onset
  2. Jawad AS, Hamid WZWA
    Saudi Med J, 2018 08;39(8):846-847.
    PMID: 30106426 DOI: 10.15537/smj.2018.8.23368
    [No abstract available].
    Matched MeSH terms: Age of Onset
  3. Liew SM, Jackson R, Mant D, Glasziou P
    BMJ Open, 2012;2(2):e000728.
    PMID: 22382122 DOI: 10.1136/bmjopen-2011-000728
    OBJECTIVES: To assess whether delaying risk reduction treatment has a different impact on potential life years lost in younger compared with older patients at the same baseline short-term cardiovascular risk.
    DESIGN: Modelling based on population data.
    METHODS: Potential years of life lost from a 5-year treatment delay were estimated for patients of different ages but with the same cardiovascular risk (either 5% or 10% 5-year risk). Two models were used: an age-based residual life expectancy model and a Markov simulation model. Age-specific case fatality rates and time preferences were applied to both models, and competing mortality risks were incorporated into the Markov model.
    RESULTS: Younger patients had more potential life years to lose if untreated, but the maximum difference between 35 and 85 years was <1 year, when models were unadjusted for time preferences or competing risk. When these adjusters were included, the maximum difference fell to about 1 month, although the direction was reversed with older people having more to lose.
    CONCLUSIONS: Surprisingly, age at onset of treatment has little impact on the likely benefits of interventions that reduce cardiovascular risk because of the opposing effects of life expectancy, case fatality, time preferences and competing risks. These findings challenge the appropriateness of recommendations to use lower risk-based treatment thresholds in younger patients.
    Matched MeSH terms: Age of Onset
  4. Sulaiman W, Othman M, Mokhtar AM, Rosman A, Ong SG, Soo IS, et al.
    APLAR Journal of Rheumatology, 2006;9 Suppl 1:A54-A55.
    DOI: 10.1111/j.1479-8077.2006.00199_24.x
    Objective: To determine the number of RA cases and to evaluate the demographic patterns in all 4 Rheumatology Referral Centers under the Ministry of Health Malaysia. Materials and methods: One thousand and eighty-four rheumatoid arthritis patients from all 4 centers i.e. Hospital Selayang, Putra Jaya, Seremban and Taiping which are situated in the west coast of West Malaysia, using rheumatoid arthritis database comprising of basic clinical and patient questionnaire, until the end of year 2004 were analysed. Results: At the time of documentation, 88.6% were female at all range of ages especially between age of 25 and 54 years (77.6%) with female to male ratio 8 :1. 52.1% were housewives. Mean age of onset of RA was 49.6 ± 11.8 SD with female 49.3 ± 11.7 SD and male 52.0 ± 12.0 SD (p < 0.05). Indian was the predominant ethnic group (54.5%), followed by Malay (31.4%), Chinese (11.6%) and others (27%). Majority had their education up to secondary level (50.8%), followed by primary (32.6%), and tertiary (6.3%) levels while 10.3% of cases had not received any formal education in their lives. 74.4% were seropositive and 87.3% fulfilled at least 4 out of 7 American College of Rheumatology (ACR) revised criteria for rheumatoid arthritis. 74% were diagnosed RA within 2 years after the onset of arthritis. Seropositivity was not significantly related to gender. Positive rheumatoid factor was dominated by Indian followed by Malay and Chinese. 83.3% were married. 23.3% female and 33.9% male between age group 25-54 were employed. 7.4% had achieved their retirement at time of entry whilst 8.9% were unemployed. Employment status was statistically significant across gender (p < 0.001). The cases differed between rheumatology centers as well as individual practices. Conclusion: There are increasing numbers of RA cases in Malaysia. Results from this study did not reflect the true prevalence of RA in Malaysia. Hence, a larger and more comprehensive database on RA with collaboration of all Government and Private Hospitals in the whole nation will provide better information about the patient case mix in different healthcare settings, treatment practice as well as disease complications. The implementation of rheumatology centers with better regional cooperation, will lead to better treatment and outcome in terms of identification of early as well as established RA cases. Early referral to the centers will be made possible for proper treatment institution and rehabilitation. Hence, improve quality of life including socio-economic status especially among those within the productive age.
    Matched MeSH terms: Age of Onset
  5. Bauer M, Glenn T, Alda M, Andreassen OA, Angelopoulos E, Ardau R, et al.
    Eur. Psychiatry, 2015 Jan;30(1):99-105.
    PMID: 25498240 DOI: 10.1016/j.eurpsy.2014.10.005
    PURPOSE: Two common approaches to identify subgroups of patients with bipolar disorder are clustering methodology (mixture analysis) based on the age of onset, and a birth cohort analysis. This study investigates if a birth cohort effect will influence the results of clustering on the age of onset, using a large, international database.

    METHODS: The database includes 4037 patients with a diagnosis of bipolar I disorder, previously collected at 36 collection sites in 23 countries. Generalized estimating equations (GEE) were used to adjust the data for country median age, and in some models, birth cohort. Model-based clustering (mixture analysis) was then performed on the age of onset data using the residuals. Clinical variables in subgroups were compared.

    RESULTS: There was a strong birth cohort effect. Without adjusting for the birth cohort, three subgroups were found by clustering. After adjusting for the birth cohort or when considering only those born after 1959, two subgroups were found. With results of either two or three subgroups, the youngest subgroup was more likely to have a family history of mood disorders and a first episode with depressed polarity. However, without adjusting for birth cohort (three subgroups), family history and polarity of the first episode could not be distinguished between the middle and oldest subgroups.

    CONCLUSION: These results using international data confirm prior findings using single country data, that there are subgroups of bipolar I disorder based on the age of onset, and that there is a birth cohort effect. Including the birth cohort adjustment altered the number and characteristics of subgroups detected when clustering by age of onset. Further investigation is needed to determine if combining both approaches will identify subgroups that are more useful for research.

    Matched MeSH terms: Age of Onset*
  6. Bauer M, Glenn T, Alda M, Andreassen OA, Angelopoulos E, Ardau R, et al.
    J Psychiatr Res, 2015 May;64:1-8.
    PMID: 25862378 DOI: 10.1016/j.jpsychires.2015.03.013
    Environmental conditions early in life may imprint the circadian system and influence response to environmental signals later in life. We previously determined that a large springtime increase in solar insolation at the onset location was associated with a younger age of onset of bipolar disorder, especially with a family history of mood disorders. This study investigated whether the hours of daylight at the birth location affected this association.
    Matched MeSH terms: Age of Onset*
  7. Sirirassamee T, Sirirassamee B, Borland R, Omar M, Driezen P
    PMID: 21323185
    The objective of this study was to examine the smoking behavior among adolescents in Thailand and Malaysia. Population-based, national surveys were conducted among 1,704 adolescents between the ages of 13 and 18 from Thailand (n = 927) and Malaysia (n = 777). Respondents were selected using multistage cluster sampling. Respondents were asked to complete self-administered questionnaires. Approximately 5% of Thai and Malaysian adolescents were current smokers, while an additional 8.6% of Thai and 8.1% of Malaysian adolescents reported being beginning smokers. On average, Thai smokers reported first smoking a whole cigarette at 14.6 years old (SD = 1.9), while Malaysian smokers at age 13.9 years (SD = 2.2). More than half of Thai smokers (60.4%) reported they bought cigarettes themselves and 29.9% got cigarettes from friends. In Malaysia, most smokers (68.3%) reported they bought cigarettes themselves, only 20.7% got cigarettes from friends. Seventy-six percent of Thai adolescent smokers smoked factory-made brands as their usual brand compared to 27.7% of Malaysian adolescent smokers. Eight percent of Thai adolescents and 10% of Malaysian adolescents reported smoking hand-rolled cigarettes. Approximately half of Thais and more than 40% of Malaysian smokers reported they tried to quit smoking within the past month. The smoking prevalence of Thai adolescents is close to that of Malaysian adolescents. Factory-made cigarette consumption is an important problem in Thai adolescents and needs to be targeted.
    Matched MeSH terms: Age of Onset
  8. Lee WS, Chai PF, Looi LM
    Med J Malaysia, 2009 Sep;64(3):216-9.
    PMID: 20527271
    Progressive familial intrahepatic cholestasis (PFIC) is characterized by early onset cholestasis, progressive liver cirrhosis, pruritus, poor growth and inexorable progression to liver cirrhosis in early childhood. The serum level of gamma-glutamyl transferase is low or normal, which is discordant with severe cholestasis. Five Malaysian patients with PFIC, who all had typical features of PFIC with early onset of severe and progressive cholestasis, pruritus, cirrhosis and liver failure, were described. Three patients died as a result of the disease, while another one died due to post-liver transplant complication. The only survivor has compensated liver cirrhosis. Patients with severe cholestasis but has spuriously low yGT should be suspected of having PFIC. Liver transplant, which is life-saving in a majority of patients with PFIC, should be considered in all patients with PFIC.
    Matched MeSH terms: Age of Onset
  9. Lee WS, Boey CC
    J Paediatr Child Health, 1999 Jun;35(3):260-3.
    PMID: 10404446
    OBJECTIVES: To review the causes, clinical features and outcomes of Malaysian children who had chronic diarrhoea.

    METHODOLOGY: A prospective study was performed on children with diarrhoea of more than 14 days' duration who were managed at the Department of Paediatrics, University of Malaya Medical Centre, Kuala Lumpur from 1 January 1996 to 31 December 1997.

    RESULTS: Twenty-seven patients (14 boys and 13 girls) were studied. The median age of onset of diarrhoea was 6 months and the mean duration of symptoms before referral was 66.5 days. The underlying causes of diarrhoea were found to be: (i) prolonged diarrhoea due to well-defined entities (intestinal lymphangiectasia, two cases; congenital glucose-galactose malabsorption, one case; post-small bowel resection, one case; (ii) postenteritis diarrhoea (cow's milk protein intolerance, eight cases; secondary lactose intolerance, four cases; transient monosaccharide intolerance, one case; (iii) gastrointestinal infections (nontyphoid Salmonella gastroenteritis, three cases; trichuriasis, two cases; amoebiasis, one case; adenovirus, one case; (iv) cases in which a firm diagnosis could not be established (three cases). The mean duration of hospital admission was 63 days. Sixteen cases required a change in diet, while nine cases required total parenteral nutrition. One death occurred.

    CONCLUSIONS: Chronic childhood diarrhoea in Malaysia had a variety of aetiologies. A specific diagnosis could be established in 90% of cases. Making a diagnosis was important because this led to appropriate therapy and a good outcome in 96% of cases.

    Matched MeSH terms: Age of Onset
  10. Lee WS, Kaur P, Boey CC, Chan KC
    J Paediatr Child Health, 1998 Dec;34(6):568-70.
    PMID: 9928652
    OBJECTIVE: To describe the clinical features, management and outcome of children with cyclic vomiting syndrome (CVS) from South-East Asia.

    METHODOLOGY: Retrospective review of all children who fulfilled the diagnostic criteria of CVS and who were seen at Department of Paediatrics, University of Malaya Medical Centre, Kuala Lumpur and Paediatric Unit, Penang Hospital, Penang, Malaysia from 1987 to 1997.

    RESULTS: Eight children with CVS were seen at the two units during the study period, five girls and three boys. All had cyclical, self-limited episodes of nausea and vomiting with symptom-free intervals. The mean age of onset was 5.9 years. The clinical features were similar to other series described in the literature. Only two of the eight children were described as 'perfectionist'. Two children identified stress as precipitating factors. Therapy to reduce the number of emeses during acute attacks and to prevent subsequent attacks had been ineffective.

    CONCLUSION: There are similarities and differences in CVS from South-East Asian children as compared to those described in the literature.

    Matched MeSH terms: Age of Onset
  11. Chee KY, Yee OK, Gaillard F, Velakoulis D, Mohd Zain NR, Yogendren L, et al.
    Aust N Z J Psychiatry, 2017 Dec;51(12):1252-1253.
    PMID: 28762277 DOI: 10.1177/0004867417722642
    Matched MeSH terms: Age of Onset
  12. Francis B, Petrus CF, Wong HH
    Asian J Psychiatr, 2020 Apr;50:101986.
    PMID: 32135484 DOI: 10.1016/j.ajp.2020.101986
    BACKGROUND: Electroconvulsive therapy (ECT) is safe and efficacious in the elderly population. However, clinicians are still weary to use it among the old-old population, citing safety concerns. Our case report highlights the use of ECT in a 91 year old lady with late onset Bipolar Mania.

    CASE REPORT: A 91 year old lady presented with an acute manic relapse for the past 2 weeks. She was previously on oral Sodium Valproate, and during this current admission was augmented with oral Quetiapine IR 100 mg bd. She remained unwell and was planned for right unilateral ECT with age-based dosing stimuli. After only 4 sessions, she showed complete resolution of her manic symptoms.

    RESULT: In our case study, the patient showed rapid response to right unilateral ECT. Even though the Post Suppression Index (PSI) was not significant, there is some evidence that in elderly patients, burst suppression (not measured in this case) may be more accurate measure of ECT efficacy. The transient treatment emergent delirium was short lived and ECT was very tolerated in this patient.

    CONCLUSION: Clinicians should not delay ECT in old-old patients who do not respond to pharmacologic treatment, as early switch to ECT results in rapid response with good safety profile.

    Matched MeSH terms: Age of Onset
  13. Bauer M, Glenn T, Alda M, Andreassen OA, Angelopoulos E, Ardau R, et al.
    J Affect Disord, 2014;167:104-11.
    PMID: 24953482 DOI: 10.1016/j.jad.2014.05.032
    The onset of bipolar disorder is influenced by the interaction of genetic and environmental factors. We previously found that a large increase in sunlight in springtime was associated with a lower age of onset. This study extends this analysis with more collection sites at diverse locations, and includes family history and polarity of first episode.
    Matched MeSH terms: Age of Onset*
  14. Moghaddam HM, Esfehani RJ, Panah NY, Esfehani AJ
    Ann Saudi Med, 2014 6 5;34(2):147-52.
    PMID: 24894784 DOI: 10.5144/0256-4947.2014.147
    BACKGROUND AND OBJECTIVES: The rate of consanguineous marriage is high in Middle Eastern countries such as Iran. The relationship between consanguineous marriage and congenital heart disease is discussed in some studies, but there is not much data for relationship between atrial septal defect (ASD) and consanguineous marriage. The aim of this study was to evaluate the relationship between consanguineous marriage and ASD echocardiographic characteristics.

    DESIGN AND SETTINGS: This was a cross-sectional study approved by Mashhad University of Medical Sciences ethics committee and took place in Mashhad, Iran, for a period of 3 years from August 2008 till September 2011.

    METHODS: In this cross-sectional study, 113 ASD patients participated and they were categorized into 3 groups on the basis of family relationship between their parents: first group-"no relationship," second group- "third degree relationship," and third group- "far relationship."

    RESULTS: Among the 54 male and 59 female ASD patients, the most prevalent type of ASD was ASD secundum (85.0%) followed by sinus venosus (8.8%). A total of 56% patients were present in the first group and 15% and 29% in the second group and the third group, respectively." The relationship between consanguinity and type of ASD (P < .001) and gender (P < .001 each) was observed. The relationship between the age of onset of disease and consanguinity (P=.003) was also observed.

    CONCLUSION: Considering the fact that there is a high prevalence of ASD and consanguineous marriage in Iran and bearing in mind the results of the present study, we recommend educating couples about the outcomes of consanguineous marriage in pre-marriage counseling.

    Matched MeSH terms: Age of Onset
  15. Chen BC, Ngu LH, Zabedah MY
    Malays J Pathol, 2010 Dec;32(2):87-95.
    PMID: 21329179 MyJurnal
    Argininosuccinic aciduria is an inborn error of the urea cycle caused by deficiency of argininosuccinate lyase (ASL). ASL-deficient patients present with progressive intoxication due to accumulation of ammonia in the body. Early diagnosis and treatment of hyperammonemia are necessary to improve survival and prevent long-term handicap. Two clinical phenotypes have been recognized--neonatal acute and milder late-onset form. We investigated patients with hyperammonemia by a stepwise approach in which quantitative amino acids analysis was the core diagnostic procedure. Here, we describe the clinical phenotypes and biochemical characteristics in diagnosing this group of patients. We have identified 13 patients with argininosuccinic aciduria from 2003 till 2009. Ten patients who presented with acute neonatal hyperammonemic encephalopathy had markedly elevated blood ammonia (> 430 micromol/L) within the first few days of life. Three patients with late-onset disease had more subtle clinical presentations and they developed hyperammonemia only during the acute catabolic state at two to twelve months of age. Their blood ammonia was mild to moderately elevated (> 75-265 micromol/L). The diagnosis was confirmed by detection of excessive levels of argininosuccinate in the urine and/or plasma. They also have moderately increased levels of citrulline and, low levels of arginine and ornithine in their plasma. Two patients succumbed to the disease. To date, eleven patients remained well on a dietary protein restriction, oral ammonia scavenging drugs and arginine supplementation. The majority of them have a reasonable good neurological outcome.
    Matched MeSH terms: Age of Onset
  16. Pagalavan L, Ong SG
    Med J Malaysia, 2007 Jun;62(2):117-21.
    PMID: 18705442 MyJurnal
    A six year retrospective study of the demography, clinical and laboratory features of patients with systemic sclerosis (SSc) was carried out in Selayang Hospital. There were 61 cases seen between January 2000 and December 2005. Of these, 55 (90.2%) were females and 6 (9.8%) were males. Twenty-eight (45.9%) were Malays, 24 (39.3%) were Chinese and 9 (14.8%) were Indians. The mean age of onset was 38.8 years. Thirty-nine (64.0%) had limited cutaneous SSc, 21 (34.4%) had diffuse cutaneous SSc and one had localized morphoea. Raynaud's phenomenon was present in 82.6%, telangiectasia in 45.9%, calcinosis in 11.5%, sclerodactyly in 83.6%, digital pitting scars in 42.6%, digital infarcts/ulcers/gangrene in 23.0%, arthralgia/arthritis in 49.2% and gastroesophageal reflux disease (GERD) in 47.5%. Forty-three (70.5%) patients had interstitial lung disease. Seven patients had associated myositis, 7 systemic lupus erythematosus and 2 rheumatoid arthritis. Three had two other connective tissue diseases. Antinuclear antibodies were positive in 83.6% and anti-Scl 70 antibodies in 34.4%. This study demonstrates that limited cutaneous SSc is more common and there is a high incidence of interstitial lung disease in our population.
    Study site: Selayang Hospital, Kuala Lumpur, Malaysia
    Matched MeSH terms: Age of Onset
  17. Toh GT, Kang P, Lee SS, Lee DS, Lee SY, Selamat S, et al.
    PLoS One, 2008;3(4):e2024.
    PMID: 18431501 DOI: 10.1371/journal.pone.0002024
    BACKGROUND: In Asia, breast cancer is characterised by an early age of onset: In Malaysia, approximately 50% of cases occur in women under the age of 50 years. A proportion of these cases may be attributable, at least in part, to genetic components, but to date, the contribution of genetic components to breast cancer in many of Malaysia's ethnic groups has not been well-characterised.
    METHODOLOGY: Given that hereditary breast carcinoma is primarily due to germline mutations in one of two breast cancer susceptibility genes, BRCA1 and BRCA2, we have characterised the spectrum of BRCA mutations in a cohort of 37 individuals with early-onset disease (
    Matched MeSH terms: Age of Onset
  18. Yeo JF, Rosnah BZ, Ti LS, Zhao YY, Ngeow WC
    Malays J Pathol, 2007 Jun;29(1):41-7.
    PMID: 19105328 MyJurnal
    This was a retrospective study of dentigerous cysts in people from the Singapore-Malaysian region. The purpose of this study was to present the clinicopathologic features of dentigerous cysts in the Oriental population and to compare these data with those from other reported studies. Biopsy records from 1981 to 1993 of 119 cases of dentigerous cysts from patients in Malaysia and Singapore showed that 36.1% of patients were female and 63.9% patients were male. Among patients with cysts, 70.5% were Chinese, 23.2% were Malays, 2.7% were Indian and 3.6% were other ethnic groups. The mean age of these patients was 30.2 +/- 17.3 years with a peak incidence occurring in the second and third decades. The location of the lesions was almost equal to the maxilla (50.9%) and the mandible (49.1%). There was a marked predilection for the posterior mandible (42.7%) followed by the anterior maxilla (38.2%). Histologically, 90.8% of the cysts were lined by a non-keratinised stratified squamous epithelium. The cyst linings were mainly thin (90.0%) with 38.7% of cases having a mixed thick and thin lining. Mucous metaplasia was observed in 9 (7.6%) cases. Rushton bodies were seen in 3.4% of cases. Cholesterol clefts in the epithelial lining and lumen were found in 16.8% cases while 12.6% of cases exhibited cholesterol clefts in the cyst wall. Other cellular structures within the cyst wall were lymphocytes (66.4%), plasma cells (52.1%), Russell bodies (16.0%) and histiocytes (4.2%). Odontogenic keratocysts were observed in 5.0% of cases. One case of adenomatoid odontogenic tumour was also observed. Epithelial atypia was seen in 9.2% of cases, islands of stratified squamous epithelial cells in 8.4% of cases while one case showed a combination of these two features. In conclusion, some clinical features seen in this study are similar to that for the Caucasian population such as prevalence in male, peak incidence in the second and third decades and the predilection for the posterior mandible and anterior maxilla. Histopathologically, odontogenic keratocyst and adenomatoid odontogenic tumour were observed in dentigerous cysts.
    Matched MeSH terms: Age of Onset
  19. Sim X, Ali RA, Wedren S, Goh DL, Tan CS, Reilly M, et al.
    BMC Cancer, 2006;6:261.
    PMID: 17078893
    From 1968 to 2002, Singapore experienced an almost three-fold increase in breast cancer incidence. This increase appeared to be different across the three main ethnic groups: Chinese, Malays and Indians. This paper used age-period-cohort (APC) modelling, to determine the effects of age at diagnosis, calendar period, and birth cohort on breast cancer incidence for each ethnic group.
    Matched MeSH terms: Age of Onset
  20. Baharin MF, Kader Ibrahim SB, Yap SH, Abdul Manaf AM, Mat Ripen A, Dhaliwal JS
    Malays J Pathol, 2015 Aug;37(2):153-8.
    PMID: 26277674 MyJurnal
    The Wiskott-Aldrich Syndrome (WAS) is an X-linked immunodeficiency condition characterized by microthrombocytopenia, eczema and recurrent infections. It is caused by mutations in the Wiskott-Aldrich Syndrome protein (WASP) gene. We investigated two Malay boys who presented with congenital thrombocytopenia, eczema and recurrent infections. Here we report two cases of WASP mutation in Malaysia from two unrelated families. One had a novel missense mutation in exon 1 while the other had a nonsense mutation in exon 2. Both patients succumbed to diseaserelated complications. A differential diagnosis of WAS should be considered in any male child who present with early onset thrombocytopenia, especially when this is associated with eczema and recurrent infections.
    Matched MeSH terms: Age of Onset
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