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Kuala Selangor, Malaysia

Kuan W.P.,Hospital Selayang | Li E.K.,Chinese University of Hong Kong | Tam L.-S.,Chinese University of Hong Kong
Lupus | Year: 2010

Assessment of organ damage has become the standard outcome measure for morbidity and mortality in patients with lupus. Ethnicity is thought to be a marker for genetic, environmental, behavioral, and other variables that may affect disease outcomes. Previous studies suggest that Asians residing in western countries had significantly higher prevalence of damage compared with Whites. In contrast, studies performed in Chinese, Korean and Arab patients showed that the overall prevalence of damage and the most commonly involved organs (neuropsychiatric and musculoskeletal) were similar to Whites. Compared with their Asian counterparts, Pakistani and Jewish patients appeared to have a higher prevalence of damage, most likely secondary to longer disease duration. Chinese patients had an increased prevalence of premature gonadal failure, whereas patients residing in western and southern Asia had more skin damage. When compared with Whites, Asian patients had more renal damage but less ocular and cardiovascular damage. Risk factors associated with organ damage in Asian lupus patients included older age, higher disease activity, and the use of cyclophosphamide and steroids. Further investigations into other determinants such as genetic predisposition, socioeconomic factors, prevalence and severity of disease manifestations, and treatment, is needed in order to understand the variation in damage accrual in lupus patients from different ethnicities. © 2010 The Author(s).

Git K.-A.,Hospital Selayang | Fioravante L.A.B.,Jose Michel Kalaf Research Institute | Fernandes J.L.,Jose Michel Kalaf Research Institute
British Journal of Radiology | Year: 2015

Objective: To assess whether an online open-source tool would provide accurate calculations of T2∗ values for iron concentrations in the liver and heart compared with a standard reference software. Methods: An online open-source tool, written in pure HTML5/Javascript, was tested in 50 patients (age 26.06 18.9 years, 46% males) who underwent T2∗ MRI of the liver and heart for iron overload assessment as part of their routine workup. Automated truncation correction was the default with optional manual adjustment provided if needed. The results were compared against a standard reference measurement using commercial software with manual truncation (CVI42â v. 5.1; Circle Cardiovascular Imaging; Calgary, AB). Results: The mean liver T2∗ values calculated with the automated tool was 4.3ms [95% confidence interval (CI) 3.1 to 5.5ms] vs 4.26ms using the reference software (95% CI 3.1 to 5.4ms) without any significant differences (p50.71). In the liver, the mean difference was 0.036ms (95% CI 20.1609 to 0.2329ms) with a regression correlation coefficient of 0.97. For the heart, the automated T2∗ value was 26.0ms (95% CI 22.9 to 29.0ms) vs 25.3ms (95% CI 22.3 to 28.3ms), p50.28. The mean difference was 0.72ms (95% CI 0.08191 to 1.3621ms) with a correlation coefficient of 0.96. Conclusion: The automated online tool provides similar T2∗ values for the liver and myocardial iron concentrations as compared with a standard reference software. Advances in knowledge: The online program provides an open-source tool for the calculation of T2∗ values, incorporating an automated correction algorithm in a simple and easy-to-use interface. © 2015 The Authors.

Goh P.,Hospital Selayang | Omar M.A.,Institute of Health Management | Yusoff A.F.,Institute of Medical Research
Singapore Medical Journal | Year: 2010

Introduction: Diabetic retinopathy (DR) is the commonest complication of diabetes mellitus (DM), and is the leading cause of blindness among working adults. Modification of the associated risk factors as well as early detection and treatment of sight-threatening DR can prevent blindness. Clinical practice guidelines recommend annual eye screening for patients with DM. The proportion of patients in Malaysia who adhere to this recommendation was initially unknown. Methods: The Malaysian National Health and Morbidity Survey is a population-based survey conducted once every decade on the various aspects of health, behaviour and diseases. The DM questionnaire on eye screening was administered as face-to-face interviews with 2,373 patients with known DM who were aged 18 years and older. Results: In all, 55 percent of patients with known DM had never undergone an eye examination. Among patients who had undergone eye examinations, 32.8 percent had the last examination within the last one year, 49.8 percent within the last one to two years, and 17.4 percent more than two years ago. A signifcantly lower proportion of younger patients and patients who received treatment for DM from non-government facilities had previously undergone eye examinations. Conclusion: The prevalence of DM observed among Malaysians aged 30 and above is 14.9 percent; thus, there is a signifcant number of people with potential blinding DR. Adherence to eye screening guidelines and the prompt referral of sight-threatening DR are essential in order to reduce the incidence of blindness among patients with DM.

Yu S.-L.,Chinese University of Hong Kong | Kuan W.-P.,Hospital Selayang | Wong C.-K.,Chinese University of Hong Kong | Li E.K.,Chinese University of Hong Kong | Tam L.-S.,Chinese University of Hong Kong
Clinical and Developmental Immunology | Year: 2012

Systemic lupus erythematosus (SLE) is an autoimmune disease with unknown etiology affecting more than one million individuals each year. It is characterized by B- and T-cell hyperactivity and by defects in the clearance of apoptotic cells and immune complexes. Understanding the complex process involved and the interaction between various cytokines, chemokines, signaling molecules, and pattern-recognition receptors (PRRs) in the immune pathways will provide valuable information on the development of novel therapeutic targets for treating SLE. In this paper, we review the immunopathological roles of novel cytokines, chemokines, signaling molecules, PRRs, and their interactions in immunoregulatory networks and suggest how their disturbances may implicate pathological conditions in SLE. Copyright 2012 Shui-Lian Yu et al.

Kuan W.P.,Hospital Selayang | Tam L.-S.,Chinese University of Hong Kong | Wong C.-K.,Chinese University of Hong Kong | Ko F.W.S.,Chinese University of Hong Kong | And 3 more authors.
Journal of Rheumatology | Year: 2010

Objective. To assess whether serum levels of CC and CXC chemokines correlate with disease activity in patients with rheumatoid arthritis (RA), and to determine whether these effects predict clinical response. Methods. Serum levels of the chemokines CC (CCL2, CCL5) and CXC (CXCL8, CXCL9, CXCL10) were quantified at baseline and after 12 weeks of treatment with disease-modifying antirheumatic drugs or biologic agents in 28 patients using flow cytometry. Serum from 40 healthy individuals was collected for comparison at baseline. Response to treatment was classified according to the European League Against Rheumatism (EULAR) response criteria. Remission of disease was defined as a Disease Activity Score < 2.6. Results. The baseline serum concentrations of CC and CXC chemokines were significantly elevated in patients with active RA compared to healthy controls (p < 0.05) except for CCL2. Significant improvement in all disease activity measurements was observed after 12 weeks of treatment. Seventeen (60.7%) patients achieved good to moderate response based on the EULAR response criteria, and 5 (17.9%) patients achieved remission. The improvement in clinical activity in patients with RA was accompanied by a significant reduction in the serum concentration of CXCL9 and CXCL10 (p < 0.001).Asignificant reduction in the serum level of CXCL10 was also observed in the group that achieved EULAR response. Serum concentration of CCL5 remained significantly elevated in patients with RA (n = 5) who achieved remission compared to the healthy controls (p < 0.05). Conclusion. Serum concentration of CXCL9 and CXCL10 may serve as sensitive biomarkers for disease activity in patients with RA. The Journal of Rheumatology Copyright © 2010. All rights reserved.

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