Displaying publications 1 - 20 of 648 in total

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  1. Azizan E, Brown M
    Malays J Pathol, 2020 Dec;42(3):363-367.
    PMID: 33361716
    In 2003, it was discovered that the entry receptor for the Severe Acute Respiratory Syndrome coronavirus (SARS-CoV) is a protein called the angiotensin-converting enzyme 2 (ACE2). This protein is present in a number of cell types, including those from the respiratory tract. Soon after the emergence of SARS-CoV-2 that is responsible for the disease Covid-19, scientists found that ACE2 was also used by the new coronavirus to infect cells. This opened some interesting possibilities to explain the striking variation in risks of catching and dying from Covid-19. The best recognised of these are the much higher risk of serious illness in older than younger people, in men than women, and in those with pre-existing comorbidities such as hypertension and cardiovascular diseases. There are several ways in which the ACE2 protein might contribute to this variation. The most obvious would be if there is more ACE2, there would be more entry points for the virus to infect the cell, e.g. in older people or in men. However, the evidence for this is rather small, partly because it is not that easy to obtain representative healthy tissues. Alternatively, it could be related to ACE2 membership of a family of proteins that has one end of the protein anchored inside the cell while most of the protein protrudes from the outside of the cell which therefore can be shed when cleaved by proteases at the cell membrane. Herein we review current evidence and theories of ACE2 role on SARS-CoV-2 infectivity and Covid-19 severity.
    Matched MeSH terms: Severity of Illness Index
  2. Chang YF, Loi WY, Chiu PY, Huang HN
    Am J Alzheimers Dis Other Demen, 2020;35:1533317520970788.
    PMID: 33176431 DOI: 10.1177/1533317520970788
    BACKGROUND/AIMS: This study used HAICDDS screening questionnaire to classify the severity of dementia in Taiwan based on the clinical dementia rating scale.

    METHODS: LDA was applied to 6,328 Taiwanese clinical patients for classification purposes. Clustering method was used to identify the associated influential symptoms for each severity level.

    RESULT: LDA shows only 36 HAICDDS questions are significant to distinguish the 5 severity levels with 80% overall accuracy and it increased to 85.83% when combining normal and MCI groups. Severe dementia patients have the most serious declination in most cognitive and functionality domains, follows by moderate dementia, mild dementia, MCI and normal patients.

    CONCLUSION: HAICDDS is a reliable and time-saved diagnosis tool in classifying the severity of dementia before undergoing a more in-depth clinical examination. The modified CDR may be indicated for epidemiological study and provide a solid foundation to develop a machine-learning derived screening instrument to detect dementia symptoms.

    Matched MeSH terms: Severity of Illness Index*
  3. Khoo KL, Tan H, Liew YM
    Med J Malaysia, 2000 Jun;55(2):249-58.
    PMID: 19839155
    This paper highlights two cases of paediatric familial hyperlipidaemia (hypercholesterolaemia and hypertriglyceridaemia). The first case was an 11 year old Chinese boy, a "homozygous" (Type II) hypercholesterolaemic patient. He had extremely high blood cholesterol level (19.4 mmol/l), severe multiple xanthoma and abnormal resting electrocardiogram. He had repeated heart attacks and died at the age of 15 in spite of early intervention, treatment and follow up. The second case was a 2 1/2 years old girl who had severe hypertriglyceridaemia. She had raised cholesterol (6.2 mmol/l) and extremely high triglycerides (14.8 mmol/l). The patient did not resemble Type I lipoproteinaemia which is classically seen in childhood. On the contrary, the patient exhibited clinical and biochemical manifestations of a Type V lipoproteinaemia which often occurs in adults. Apart from a Type V lipoprotein pattern, the patient had low post hepatic lipase activity (PHLA), Apo C II and Apo E2/E3 phenotype. In addition, the lipid profile of her family members (both the parents and brothers) had raised triglycerides and thus ruled out the Type I lipoprotein inheritance pattern, which is an autosomal recessive condition. The issue of paediatric hyperlipidaemia, their management and treatments are discussed.
    Matched MeSH terms: Severity of Illness Index*
  4. Kulkarni D, Lee B, Ismail NF, Rahman AE, Spinardi J, Kyaw MH, et al.
    J Glob Health, 2025 Feb 07;15:04032.
    PMID: 39916552 DOI: 10.7189/jogh.15.04032
    BACKGROUND: Our previous systematic review estimated the cumulative incidence of SARS-CoV-2 reinfections as 1.16% (95% CI = 1.01-1.33%) during the pre-Omicron period. The Omicron variant that emerged in November 2021 was significantly genetically distinct from the previous SARS-CoV-2 variants and thus, more transmissible and posed an increased risk of SARS-CoV-2 reinfections in the population. We, therefore, conducted a fresh systematic review and meta-analysis to estimate the SARS-CoV-2 reinfection burden during the Omicron period.

    METHODS: We searched CINAHL, Medline, Global Health, Embase, and WHO COVID-19 in October 2023 for studies reporting the SARS-CoV-2 reinfection incidence during the Omicron period. The quality of the included studies was assessed using the Joanna Briggs Institute checklists. Random effects meta-analyses were conducted to estimate the incidence, and requirement of hospitalisation of SARS-CoV-2 reinfections. Symptomatic severity of reinfections and case fatality rates were analysed narratively.

    RESULTS: Thirty-six studies were included. The reinfection cumulative incidence during the Omicron period was 3.35% (95% CI = 1.95-5.72%) based on data from 28 studies. The cumulative incidence was higher in 18-59-year-old adults (6.62% (95% CI = 3.22-13.12%)) compared to other age groups and in health care workers (9.88% (95% CI = 5.18-18.03%)) compared to the general population (2.48% (95% CI = 1.34-4.54%)). We estimated about 1.81% (95% CI = 0.18-15.87%) of the reinfected cases required hospitalisation based on limited and highly variable data.

    CONCLUSIONS: There was an increased risk of reinfections during the Omicron period compared to the pre-Omicron period. The incidence was higher in 18-59-year-old adults and health care workers and generally less severe during the Omicron period. However, data were limited on disease severity and long-term outcomes.

    REGISTRATION: PROSPERO: CRD42023482598.

    Matched MeSH terms: Severity of Illness Index*
  5. Ainine A, Heward E, Kapasi R, Rocke J, Darby D, Kumar N, et al.
    Med J Malaysia, 2021 11;76(6):881-883.
    PMID: 34806677
    INTRODUCTION: The COVID-19 pandemic has prompted the medical world to look at factors that may influence outcomes. There have been connections made between vitamin D and COVID-19, as vitamin D has previously been shown to play a role in the maintenance of immune homeostasis.

    MATERIALS AND METHODS: We performed a prospective cohort study on 103 patients at Wigan Wrightington and Leigh NHS Foundation Trust looking at serum vitamin D levels of patients with positive COVID-19 swabs. Results were collated and correlations were made to compare vitamin D levels with age; severity of illness; hospital outcomes; and frailty. Comparisons were also made between frailty and outcome.

    RESULTS: The results showed that there was a significant statistical difference between vitamin D levels and severity of infection: those who were treated in the intensive care units (ICU) (severe symptoms) had lower vitamin D levels than those treated on the ward (p=0.0446). There was also a correlation between vitamin D levels and frailty: those who were more frail had higher vitamin D levels than fitter patients (P=0.005). Vitamin D and frailty had no effect on hospital outcomes of COVID-19 infection.

    CONCLUSION: Ultimately, we concluded that low vitamin D can increase susceptibility of contracting COVID-19, increase severity of infection but does not affect mortality.

    Matched MeSH terms: Severity of Illness Index
  6. Kow CS, Ramachandram DS, Hasan SS
    Hypertens Res, 2023 May;46(5):1353-1354.
    PMID: 36843117 DOI: 10.1038/s41440-023-01207-z
    Matched MeSH terms: Severity of Illness Index
  7. Kaewdech A, Sripongpun P, Treeprasertsuk S, Charatcharoenwitthaya P, Chan WK, GO ASIA Study Group, et al.
    Clin Gastroenterol Hepatol, 2024 Dec;22(12):2535-2537.
    PMID: 38880124 DOI: 10.1016/j.cgh.2024.06.003
    Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as nonalcoholic fatty liver disease (NAFLD),1 represents a global public health issue. Fibrosis stage is the most important risk for long-term undesirable outcomes.2,3 From recent meta-analyses, all-cause and liver-related mortalities significantly increased from fibrosis stage 2 (significant fibrosis; F≥2) onward.4,5 In primary care setting, those with F≥2 should be referred to hepatologists; therefore, noninvasive tests to stratify risk of patients with MASLD are crucial. Steatosis-associated fibrosis estimator (SAFE) was recently developed to predict F≥2.6 SAFE has been externally validated and outperformed fibrosis-4 (FIB-4) and NAFLD fibrosis score (NFS).7,8 Recently, international guidelines proposed sequential diagnostic steps, initially using FIB-4 and then transient elastography (TE) in non-low-risk patients.9,10 However, the guidelines focused on identifying advanced fibrosis (F≥3), which might be too late. This study aimed to compare the performance among SAFE, FIB-4, and NFS, and evaluate SAFE-TE sequential approach. We hypothesized that by initially using SAFE, the proportion of patients misclassified as low risk despite already having F≥2 could be diminished.
    Matched MeSH terms: Severity of Illness Index
  8. Naing C, Ni H, Basavaraj AK, Aung HH, Tung WS, Whittaker MA
    Acta Trop, 2024 Dec;260:107447.
    PMID: 39477046 DOI: 10.1016/j.actatropica.2024.107447
    This study aimed to synthesise evidence comparing the levels of cytokines in severe falciparum malaria with those in uncomplicated malaria from available systematic reviews and meta- analyses. Relevant individual meta-analyses were searched in PubMed, Ovid, and Google Scholar, following the selection criteria specified for this umbrella review. The AMSTAR-2 tool was applied to grade the quality of the meta-analyses identified. The random-effects model was applied to recalculate the effect sizes of each included meta-analysis. Heterogeneity between meta-analyses was investigated with I2 value. 95% predicting interval (PI) for the summary random-effects model was also made. In each meta-analysis identified, information on largest study's effect, the excess significance test, small study effects, and publication bias were addressed. This umbrella review included nine meta-analyses (n = 12,674) for nine unique cytokines (IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, IL-13, and TNF-α). Only one individual meta-analysis showed significantly higher levels of cytokine IL-1β (p: 0.009) amongst those with severe falciparum malaria compared to those with uncomplicated malaria. The 95% PIs did not show significance in any individual meta-analyses. Nine individual meta-analyses showed substantial heterogeneity, with I2 tests ranging from 81% to 99%. Two independent meta-analyses (the IL-4 and IL-12) showed evidence of 'excess significant bias'. The meta-analysis of IL-1β only showed "Class III evidence", indicating that this cytokine was "suggestive" in contributing to those with severity of malaria in comparison to those with uncomplicated malaria. The remaining eight cytokines showed "Class IV evidence," indicating "weak" evidence on the impact of malaria severity. In conclusion, the findings suggest that compared to uncomplicated malaria, pro-inflammatory cytokine IL-1β contributes to the development of severe falciparum malaria. Due to the limited level of evidence, further well-designed larger studies with multiple cytokines are needed to investigate cytokine levels as reliable biomarkers in malaria severity.
    Matched MeSH terms: Severity of Illness Index
  9. Chin SP, Ng CK, Sim KH
    Indian Heart J, 2007 May-Jun;59(3):211-3.
    PMID: 19124927
    Matched MeSH terms: Severity of Illness Index*
  10. Dreyfus GD, Martin RP, Chan KM, Dulguerov F, Alexandrescu C
    J Am Coll Cardiol, 2015 Jun 2;65(21):2331-6.
    PMID: 26022823 DOI: 10.1016/j.jacc.2015.04.011
    The assessment of the etiology and severity of functional tricuspid regurgitation (FTR) has many limitations, especially when tricuspid regurgitation (TR) is more than severe. Instead of relying solely on TR severity, a new approach not only takes into account the severity of TR, but also pays strict attention to tricuspid annular dilation (size), the mode of tricuspid leaflet coaptation, and tricuspid leaflet tethering-factors often influenced by right ventricular enlargement and dysfunction. To simplify things, we propose a new staging system for functional tricuspid valve pathology using 3 parameters that may more accurately reflect the severity of the disease: TR severity, annular dilation, and mode of leaflet coaptation (extent of tethering). We believe that by utilizing these parameters, cardiologists and cardiac surgeons will be offered a better system for appraisal and decision-making in FTR.
    Matched MeSH terms: Severity of Illness Index*
  11. Nair HKR, Chong SS, Othman AM
    J Wound Care, 2020 Apr 01;29(Sup4):S44-S48.
    PMID: 32279612 DOI: 10.12968/jowc.2020.29.Sup4.S44
    OBJECTIVE: To validate the accuracy and reliability of Harikrishna Periwound Skin Classification (HPSC) for wound assessment.

    METHOD: Post-basic students (staff nurses and medical assistants) were given real life pictures showing the wound and periwound area. The students were asked to classify all pictures according to the HPSC at zero months (before attachment) and after two months of attachment. The images were the same but the answers were never given or discussed after the first test.

    RESULTS: A total of 30 post-basic students participated in the study, assessing wound 30 images. The results showed that there was an increase of 25.42% in accuracy of wound assessment using the HSPC after two months of clinical attachment compared to pre-attachment. The reliability of the HPSC in wound assessment 79.87%.

    CONCLUSION: Health professionals have to be able to assess and classify wounds accurately to be able to manage them accordingly. Assessment and classifications of the periwound skin are important and need to be validated and integrated as a part of a full wound assessment. With experience and adequate training, health professionals are able to comprehensively assess wounds using the validated tool, to enable effective wound management and treatment, accelerating wound healing and improving the quality of life for patients.

    Matched MeSH terms: Severity of Illness Index*
  12. Golder V, Kandane-Rathnayake R, Hoi AY, Huq M, Louthrenoo W, An Y, et al.
    Arthritis Res Ther, 2016 11 09;18(1):260.
    PMID: 27829463 DOI: 10.1186/s13075-016-1163-2
    BACKGROUND: Systemic lupus erythematosus (SLE) is a chronic heterogeneous disease with considerable burden from disease activity and damage. A novel clinical treatment target in the form of the lupus low disease activity state (LLDAS) has been recently reported, with retrospective validation showing that time spent in LLDAS translates to reduced damage accrual. The objectives of this study were to describe the frequency and identify the predictors of attaining LLDAS in a large multinational cohort of patients with SLE.
    METHODS: Data were collected at the recruitment visit in patients with SLE enrolled in a longitudinal study in nine countries. Data were analysed cross-sectionally against the recently published definition of LLDAS, and the frequency and characteristics associated with presence of LLDAS were determined. Stepwise multivariable logistic regression was used to determine predictors of LLDAS.
    RESULTS: Of the 1846 patients assessed, criteria for LLDAS were met by 44 %. Patients with shorter disease duration were less likely to be in LLDAS (OR 0.31, 95 % CI 0.19-0.49, p 
    Matched MeSH terms: Severity of Illness Index*
  13. Siboni S, Sozzi M, Kristo I, Boveri S, Rogers BD, De Bortoli N, et al.
    United European Gastroenterol J, 2024 Jun;12(5):552-561.
    PMID: 38536701 DOI: 10.1002/ueg2.12565
    OBJECTIVE: A definitive diagnosis of gastroesophageal reflux disease (GERD) depends on endoscopic and/or pH-study criteria. However, high resolution manometry (HRM) can identify factors predicting GERD, such as ineffective esophageal motility (IEM), esophago-gastric junction contractile integral (EGJ-CI), evaluating esophagogastric junction (EGJ) type and straight leg raise (SLR) maneuver response. We aimed to build and externally validate a manometric score (Milan Score) to stratify the risk and severity of the disease in patients undergoing HRM for suspected GERD.

    METHODS: A population of 295 consecutive patients undergoing HRM and pH-study for persistent typical or atypical GERD symptoms was prospectively enrolled to build a model and a nomogram that provides a risk score for AET > 6%. Collected HRM data included IEM, EGJ-CI, EGJ type and SLR. A supplemental cohort of patients undergoing HRM and pH-study was also prospectively enrolled in 13 high-volume esophageal function laboratories across the world in order to validate the model. Discrimination and calibration were used to assess model's accuracy. Gastroesophageal reflux disease was defined as acid exposure time >6%.

    RESULTS: Out of the analyzed variables, SLR response and EGJ subtype 3 had the highest impact on the score (odd ratio 18.20 and 3.87, respectively). The external validation cohort consisted of 233 patients. In the validation model, the corrected Harrel c-index was 0.90. The model-fitting optimism adjusted calibration slope was 0.93 and the integrated calibration index was 0.07, indicating good calibration.

    CONCLUSIONS: A novel HRM score for GERD diagnosis has been created and validated. The MS might be a useful screening tool to stratify the risk and the severity of GERD, allowing a more comprehensive pathophysiologic assessment of the anti-reflux barrier.

    TRIAL REGISTRATION: ClinicalTrials.gov (Identifier: NCT05851482).

    Matched MeSH terms: Severity of Illness Index*
  14. Hao Y, Hansen D, Louthrenoo W, Chen YH, Cho J, Lateef A, et al.
    Lupus Sci Med, 2024 Sep 18;11(2).
    PMID: 39299757 DOI: 10.1136/lupus-2024-001217
    OBJECTIVES: The lupus low disease activity state (LLDAS) allows for certain clinical and/or serological activity of SLE, provided overall disease activity does not exceed predefined cut-offs. This study aimed to evaluate the outcomes of patients who achieved LLDAS with clinical activity, serological activity only or neither clinical nor serological activity.

    METHODS: Patients with SLE enrolled in a prospective multinational cohort from March 2013 to December 2020 who were in LLDAS at least once were included. Visits that fulfilled both LLDAS and Definition of Remission in SLE (DORIS) criteria were excluded.

    RESULTS: 2099 patients were included, with median follow-up of 3.5 (IQR 1.3-5.8) years. At 6150 visits, patients were in LLDAS but not DORIS criteria; of these 1280 (20.8%) had some clinical activity, 3102 (50.4%) visits had serological activity only and 1768 (28.8%) visits had neither clinical nor serological activity. Multivariable regression analysis showed that compared with non-LLDAS, all three subsets of LLDAS had a protective association with flares in the ensuing 6 months and damage accrual in the ensuing 36 months. LLDAS with no clinical or serological activity had a significantly stronger protective association with severe flares in the ensuing 6 months compared with LLDAS with clinical activity (HR 0.47, 95% CI (0.27 to 0.82), p=0.007).

    CONCLUSIONS: LLDAS without any clinical activity accounted for almost 80% of LLDAS visits. This study confirms that all subsets of LLDAS are associated with reduced flare and damage accrual. However, LLDAS without any clinical or serological activity has the strongest protective association with severe flares.

    Matched MeSH terms: Severity of Illness Index*
  15. Simamora M, Zizlavsky S, Harjoprawito TJA, Wiguna T, Medise BE, Wibawanti R
    Med J Malaysia, 2024 Nov;79(6):677-682.
    PMID: 39614784
    INTRODUCTION: Autism spectrum disorder (ASD) is a complex condition impacting social communication, behavior, and interests. ASD affects 1 in 100 children globally, with a higher prevalence in boys. Auditory disorders, including hyperacusis, are common in ASD, yet the correlation between Auditory Brainstem Response (ABR) wave latencies and ASD severity, especially with hyperacusis, is under-researched. This study investigates ABR wave latencies in ASD children, exploring their relationship with ASD severity and h as a potential screening tool for ASD. Early diagnose and therapy could enhance the quality of life in ASD patients.

    MATERIALS AND METHODS: A cross-sectional study was conducted by recruiting normal-hearing children aged 3-8 years old with ASD presenting to a national referral ENT clinic between October and December 2023. The severity of ASD was assessed using the Childhood Autism Rating Scale (CARS), while hyperacusis was diagnosed using Modified Check List for Autism in Toddlers, Revised (M-CHAT-R).

    RESULTS: A total of 26 children with ASD, 23 of whom were male (88%), aged 3-8 years, were included in the analyses. Among these children, 18 (69.2%) had hyperacusis. Analysis of ABR click revealed a prolonged interpeak latency wave I and III (88.5%), followed by a prolonged latency in wave III (42.3%) and V (21.2%). Neither ABR wave latencies nor hyperacusis were correlated with the severity of ASD, although there was a marginally significant association between wave III latency and CARS score in the left ear (r=0.359, p=0.072). However, wave V latency and interpeak wave I-V latency were significantly longer in children without hyperacusis (right ear: p=0.042 and p=0.050; left ear: p=0.005 and p=0.004), while interpeak wave III-V only in the left ear (p=0.006) and wave III only in the right ear (p=0.029).

    CONCLUSION: There was no significant correlation between ABR wave latencies or hyperacusis and the severity of ASD, while ABR wave latencies were generally longer in children without hyperacusis. Further large studies involving a broader spectrum of children with ASD are warranted to confirm our findings.

    Matched MeSH terms: Severity of Illness Index*
  16. Golder V, Kandane-Rathnayake R, Li N, Louthrenoo W, Chen YH, Cho J, et al.
    Lancet Rheumatol, 2024 Aug;6(8):e528-e536.
    PMID: 38876129 DOI: 10.1016/S2665-9913(24)00121-8
    BACKGROUND: Validation of protective associations of the lupus low disease activity state (LLDAS) against flare, irreversible damage, health-related quality of life, and mortality has enabled the adoption of treat-to-target strategies in patients with systemic lupus erythematosus (SLE). Previous validation studies were of short duration, limiting the ability to detect longer term signals in flare rate and irreversible damage. In addition, previous studies have focused on percent time at target, rather than actual periods of time that are more useful in clinical practice and trials. We assessed long-term protective associations of LLDAS and remission, and specifically examined protective thresholds of sustained LLDAS and remission.

    METHODS: Patients aged 18 years or older with SLE were followed up from May 1, 2013, to Dec 31, 2020 in a prospective, multinational, longitudinal cohort study. Patients were recruited from 25 centres in 12 countries. Multi-failure time-to-event analyses were used to assess the effect of sustained LLDAS on irreversible damage accrual (primary outcome; measured with the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index) and flare (key secondary outcome; measured with the SELENA Flare Index), with dose exposure and threshold effects studied. Sustained LLDAS or remission were defined as two or more consecutive visits over at least 3 months in the respective state. This study is registered with ClinicalTrials.gov, NCT03138941.

    FINDINGS: 3449 patients were followed up for a median of 2·8 years (IQR 1·1-5·6), totalling 37 662 visits. 3180 (92·2%) patients were women, and 3031 (87·9%) were of Asian ethnicity. 2506 (72·7%) patients had sustained LLDAS at least once. Any duration of sustained LLDAS or remission longer than 3 months was associated with reduced damage accrual (LLDAS: hazard ratio 0·60 [95% CI 0·51-0·71], p<0·0001; remission: 0·66 [0·57-0·76], p<0·0001) and flare (LLDAS: 0·56 [0·51-0·63], p<0·0001; remission: 0·66 [0·60-0·73], p<0·0001), and increasing durations of sustained LLDAS corresponded to increased protective associations. Sustained DORIS remission or steroid-free remission were less attainable than LLDAS.

    INTERPRETATION: We observed significant protective associations of LLDAS and remission against damage accrual and flare, establish a threshold of 3 months sustained LLDAS or remission as protective, and demonstrate deepening protection with longer durations of sustained LLDAS or remission.

    FUNDING: The Asia Pacific Lupus Collaboration receives project support grants from AstraZeneca, Bristol Myers Squibb, EMD Sereno, GSK, Janssen, Eli Lilly, and UCB.

    Matched MeSH terms: Severity of Illness Index*
  17. Kandane-Rathnayake R, Milea D, Louthrenoo W, Hoi A, Golder V, Cho J, et al.
    Lupus Sci Med, 2025 Jan 19;12(1).
    PMID: 39832908 DOI: 10.1136/lupus-2024-001363
    OBJECTIVE: To estimate the prevalence of organ damage (damage) and flare and to examine longitudinal associations between flares and subsequent damage accrual, in patients with systemic lupus erythematosus (SLE).

    METHODS: Patients enrolled in the Asia Pacific Lupus Collaboration cohort with ≥3 years of prospectively captured data were studied. Flares were assessed at routine visits, while damage ((Systemic Lupus International Collaborating Clinics/American College of Rheumatology) Damage Index) was assessed annually. Multivariable, multifailure survival analyses were carried out to quantify the association between flares and damage accrual.

    RESULTS: 1556 patients with SLE with a median (IQR) of 5.7 (3.9, 7.0) years of follow-up were studied. 39.5% (n=614) of patients had damage at enrolment, and 31.9% (n=496) accrued damage during the study observation period. The incidence of damage accrual during observation was ~58/1000 person-years. Overall, 74.1% (n=1153) of patients experienced a flare of any severity (mild/moderate or severe) at least once; 56.9% (n=885) experienced recurrent (≥2) flares. The risk of subsequent damage accrual in patients who experienced mild-to-moderate flare, after controlling for confounders, was 32% greater than in patients without flares (adjusted HR) (95% CI 1.32 (1.17 to 1.72)). The risk of damage accrual was greater if patients had severe flares (HR (95% CI) 1.58 (1.18 to 2.11)). For each additional flare, the risk of damage accrual increased by 7% (HR (95% CI) 1.07 (1.02 to 1.13)).

    CONCLUSIONS: Flares independently increased the risk of damage accrual. Prevention of flares should be considered a necessary goal of SLE disease management to minimise permanent damage.

    Matched MeSH terms: Severity of Illness Index*
  18. WONG KAH YIN, NUR ELIA NADHIRA MOHD ASMADI, SUHAIZAN LOB, NURUL FAZIHA IBRAHIM
    MyJurnal
    Many chilli producers in Malaysia are facing a huge problem of anthracnose disease that infect the chilli fruits either at pre- or post-harvest stage. Due to this infection, the chilli fruits become rotten and could be colonized by grey conidial masses which is unfit for human consumption and cannot be sold. This study was aimed to isolate the fungal species associated with anthracnose symptoms collected from several mini-markets near Gong Badak, Terengganu. Pathogenicity test was conducted for all these isolates to evaluate their pathogenic level. Based on the results, five fungal isolates were successfully isolated and morphologically identified as Colletotrichum spp. All these isolates were labelled as UMTT46C, UMTT48C, UMTT50C, UMTT52C and UMTT54C. From these, fungal isolate (UMTT54C) showed the highest pathogenic level with disease severity (DS), 68.9%. Other Colletotrichum spp. recorded percentage of DS ranged from 53.3% to 60%. Identification of fungal isolates and their pathogenic level from the infected chilli is very important to assist in control strategy which can further provide a good protection measure for many chilli producers.
    Matched MeSH terms: Severity of Illness Index
  19. Yap LB, Choy CN, Navin S, Koh KW, Jeyamalar R, Balachandran K
    Med J Malaysia, 2023 Jan;78(1):7-13.
    PMID: 36715184
    INTRODUCTION: Coronary artery calcification can lead to suboptimal results when performing coronary angioplasty with conventional techniques. The presence of severe coronary artery calcium increases the complications of percutaneous coronary intervention as it may impede stent delivery and optimal stent expansion. The purpose of this study was to determine the procedural success and safety of orbital atherectomy (OA) in calcified lesions.

    MATERIALS AND METHODS: This was a prospective single-centre study regarding the utility of OA in the treatment of calcified coronaries. Intravascular ultrasound (IVUS) or optical coherence tomography (OCT) was used in all cases to characterise the severity of calcium pre-procedure, guide vessel sizing and assess procedural success. The primary endpoint was procedural success, defined by successful stent implantation following OA treatment. The secondary endpoint was in-hospital and 30-day major adverse cardiovascular event (MACE).

    RESULTS: Ten patients with severely calcified lesions were successfully treated with OA. The primary endpoint was achieved in all patients. All of the lesions were severely calcified with concentric calcium. None of the patients suffered in-hospital or 30-day MACE. The average minimal luminal diameter at baseline was 1.7 ± 0.3 mm and the post- PCI luminal diameter was 3.0 ± 0.3 mm, with a significant luminal gain of 1.3 ± 0.3 mm (p < 0.01). Slow flow during procedure occurred in 2 (20%) cases and dissection occurred in 1 (10%) case during procedure. These were successfully treated with stent delivery to achieve TIMI III flow. There were no cases of stent thrombosis or vessel perforation.

    CONCLUSION: Our experience demonstrates the feasibility and safety of OA in the management of calcified coronary stenosis. Intravascular imaging is an important adjunct to the use of OA to assess the severity of calcified coronary lesions, success of OA treatment and to aid sizing of the vessel for stent implantation. OA is an effective treatment approach to disrupt coronary calcification, facilitating stent implantation with optimal results. It is a safe procedure with good success rate and low rate of complications.

    Matched MeSH terms: Severity of Illness Index
  20. Dayanand ND, Amuthan A, Ballambat SP, Kabbekodu SP, Devi V
    Chin J Integr Med, 2023 Jan;29(1):69-73.
    PMID: 35829957 DOI: 10.1007/s11655-022-3519-y
    OBJECTIVE: To examine data from studies supporting the clinical efficacy of medical approaches from India traditional systems of medicines like Ayurveda, Unani, Siddha, and Homeopathy for psoriasis using outcome indicators employed in clinical practice and research.

    METHODS: Searches were conducted between December 2019 and September 2020 in databases PubMed, Scopus, Web of Science and Ovid Medline using search terms including traditional, complementary, psoriasis, Kushtha, Ayurveda, Siddha, Unani, Homeopathy and clinical. Controlled trials, case series and case reports published from India were included.

    RESULTS: Data of 17 selected studies were extracted. Treatment efficacy in terms of improvement in Psoriasis Area and Severity Index (PASI) score or/and percentage reduction in score (PASI 50, PASI 75 and PASI 90) or/and patient-reported outcomes using instruments like Dermatology Life Quality Index and Psoriasis Disability Index were noted. All studies reported good improvement as per the study specific outcome. However, study characteristics, including study design, sample size, follow-up period, inclusion and exclusion criteria were heterogeneous, and the choice of outcome measures was not adequate to conclude the effectiveness of intervention. The use of some herbs as common ingredients in several formulations across different systems of medicines were noted in analyzing individual formulation.

    CONCLUSIONS: Future studies must incorporate a comprehensive study design with specific outcome measures like PASI, PASI 75, PASI 90, quality of life parameters, compliance to medications, adverse reactions, remission period, relapse rate and cost-effectiveness with long term follow-up. The currently available evidence on the roles of these herbs at molecular level in psoriasis is preliminary.

    Matched MeSH terms: Severity of Illness Index
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