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Ding NS, De Cruz P, Lim L, Thompson A, Desmond P. Androgenic-anabolic steroid drug-induced liver injury. Intern Med J 2013; 43:215-6. [DOI: 10.1111/imj.12054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2012] [Accepted: 10/28/2012] [Indexed: 11/28/2022]
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Thavichachart N, Kongsakon R, Lo WTL, Lim L, Singh S, Sobrevega E, Banaag C, Bautista J, Evangelista ML, Dimatalac B, Choi A, Nerapusee O. The psychopathological characteristics of treatment discontinuation group in 6-month treatment with paliperidone ER. Int J Clin Pract 2012; 66:969-75. [PMID: 22994331 DOI: 10.1111/j.1742-1241.2012.03016.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To examine the demographic and psychopathological characteristics of the treatment discontinuation group compared with patients who completed with paliperidone ER treatment for 6 months. METHODS A total of 984 patients meeting the DSM-IV criteria for schizophrenia who switched their antipsychotics were recruited from 61 sites in five countries in Southeast Asia. The patients with early discontinuation were then compared with those who completed the 6-month treatment in terms of demographic and psychopathological variables at baseline and also at the end of the evaluation period, which included PANSS score, sleep quality, daytime drowsiness, PSP score, ESRS score and clinical global impression-severity (CGI-S) score. Finally, logistic regression analysis was applied to determine predictive factors that were associated with discontinuation. RESULTS Of 984 patients, 284 patients (28.9%) discontinued without completing the 6-month treatment period with paliperidone. Significant differences in patient baseline characteristics for the discontinuation group compared with the completion group were observed for gender, number of previous hospitalisations with psychosis, PANSS total score and all of its subscales, daytime drowsiness score, total ESRS score, CGI-S, PSP and Insight. Patients who completed the study period had significantly better scores in all psychopathology variables compared with the discontinuation group at the end of the evaluation period. Numbers of previous hospitalisations because of psychosis, being exposed with first generation antipsychotics, gender and PANSS total scores were found to be significant predictors of discontinuation. CONCLUSION Patients who discontinued early from a 6-month treatment period with Paliperidone have some characteristic differences compared with completion patients. Many factors including frequent hospitalisations, female gender, high PANSS score (indicating more disease severity) and previous exposure to first generation of antipsychotic agent might lead patients to discontinue from treatment.
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Swa H, Blackstock W, Lim L, Gunaratne J. 96P Quantitative Proteomics Profiling of Murine Mammary Gland Cells Unravels Impact of Annexin-1 On Dna Damage, Cell Adhesion and Migration. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(19)65739-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Santos-Moreno P, Bello J, Palomino A, Villarreal L, Zambrano D, Amador L, Andrade O, Urbina A, Guzman C, Cubides M, Arbelaez A, Valle-Onate R, Galarza-Maldonado C, Brickmann K, Furst F, Kielhauser S, Hermann J, Brezinsek HP, Graninger W, Ziaee V, Sadghi P, Moradinejad MH, Yoo DH, Woo JH, Kim YJ, Kim JJ, Choi CB, Sung YK, Kim TH, Jun JB, Bae SC, Park W, Joo K, Lim MJ, Kwon SR, Jung. KH, Choi CB, Bang SY, Park SR, Lee KW, Kim TH, Bae SC, Donmez S, Pamuk ON, Pamuk GE, Aksoy A, Almoallim H, Almasari A, Khadawardi H, Haroyan A, Petrova M, Shah D, Bhatnagar A, Wanchu A, Okada M, Ardakani FE, Owlia M, Hesami S, Owlia MB, Soleimani H, Saleh-Abadi HS, Lotfi M, Owlia MB, Dehghan A, Saberir B, Moradinejad MH, Zamani G, Aghamohammadi A, Soheili H, shahinpour S, Abolhassani H, Hirbod A, Arandi N, Tavassoli M, Parvaneh N, Rezaei N, Rezaieyazdi Z, Hatef MR, Sedighi S, Ah Kim H, Chung CK, Martinez Perez R, Leon M, Uceda J, Rodriguez Montero S, Munoz A, Velloso M, Marenco J, Tsiliakou N, Giotakos O, Koutsogeorgopoulou L, Kassimos D, Fernandes N, Silva V, Hernandez Sanchez R, Gonzalez Moreno P, Uceda Montanes J, Marenco de la Fuente J, Aytekin E, Demir SE, Okur SC, Caglar NS, Tutun S, Eroglu Demir S, Rezvani A, Ozaras N, Rezvani A, Eroglu Demir S, Ozaras N, Poyraz E, Guneser M, Demir SE, Asik Celik HK, Rezvani A, Ozaras N, Poyraz E, Batmaz I, Sariyildiz M, Dilek B, Yildiz I, Ayyildiz O, Nas K, Cevik R, Gunay T, Garip Y, Bodur H, Baykal T, Seferoglu B, Senel K, Baykal T, Seferoglu B, Senel K, Kara M, Tiftik T, Kaya A, Engin Tezcan M, Akif Ozturk M, Ozel S, Akinci A, Ozcakar L, Saliha Eroglu D, Ebru A, Ilhan K, Teoman A, Gulis D, Ileana F, Linda G, Cristina P, Laura D, Simona S, Simona R, Kaya A, Kara M, Tiftik T, Engin Tezcan M, Akif Ozturk M, Ataman S, Akinci A, Ozcakar L, Venkatesan S, Ng L, Carbone C, Jaeggi E, Silverman E, Kamphuis S, Mak N, Carbone C, Lim L, Levy D, Silverman E, Kamphuis S, Ciobanu E, Mazur M, Mazur-Nicorici L, Ah Kim H, Jin Park S, Cheon EJ, Chung CK, Tugnet N, Dixey J, Cheng C, Schmidt S, Stoy K, Seisenbayev A, Togizbaev G, Santos-Moreno P, Bello J, Gonzalez F, Cubides M, Arbelaez A, Palomino A, Villareal L, Urbina A, Valle-Onate R, Galarza C, Nikiphorou E, MacGregor A, Morris S, James D, Young A, Alomari MA, Shammaa R, Shqair DM, Alawneh K, Khabour OF, Namey TC, Kolahi S, Haghjoo AG, Lee MJ, Suh CH, Park YW, Bae SC, Lee HS, Bang SY, Kang YM, Shim SC, Lee WK, Park H, Lee J, Wong RH, Huang CH, Cheng-Chung Wei J, Chiou SP, Tu YC, Lee HS, Eroglu Demir S, Rezvani A, Ok S, Kim JO, Lee JS, Sung IH, Kim JH, Kim TH, Lee SH, Choi J, Kim S, Song R, Lee YA, Hong SJ, Yang HI, Lee YA, Lee SH, Matsui K, Yoshida K, Oshikawa H, Kobayashi T, Nakano H, Utsunomiya M, Kimura M, Rezvani A, Seniz O, Eroglu Demir S, Yoon J, Yoon N, Lee S, Kim Y. Poster Presentations (PP01-PP67). Rheumatology (Oxford) 2012. [DOI: 10.1093/rheumatology/kes005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
We report a rare case of small bowel infarction due to superior mesenteric artery occlusion secondary to cardiac tumour embolism. To our knowledge, this has not been previously reported in the literature. This case highlights a rare case and reviews current knowledge on the subject.
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Yuen LH, Mehta JS, Shilbayeh R, Lim L, Tan DT. Hemi-automated lamellar keratoplasty (HALK). Br J Ophthalmol 2011; 95:1513-8. [DOI: 10.1136/bjophthalmol-2011-300195] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Lim L, Jackson-Lewis V, Wong LC, Shui GH, Goh AXH, Kesavapany S, Jenner AM, Fivaz M, Przedborski S, Wenk MR. Lanosterol induces mitochondrial uncoupling and protects dopaminergic neurons from cell death in a model for Parkinson's disease. Cell Death Differ 2011; 19:416-27. [PMID: 21818119 PMCID: PMC3278725 DOI: 10.1038/cdd.2011.105] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder marked by the selective degeneration of dopaminergic neurons in the nigrostriatal pathway. Several lines of evidence indicate that mitochondrial dysfunction contributes to its etiology. Other studies have suggested that alterations in sterol homeostasis correlate with increased risk for PD. Whether these observations are functionally related is, however, unknown. In this study, we used a toxin-induced mouse model of PD and measured levels of nine sterol intermediates. We found that lanosterol is significantly (∼50%) and specifically reduced in the nigrostriatal regions of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-treated mice, indicative of altered lanosterol metabolism during PD pathogenesis. Remarkably, exogenous addition of lanosterol rescued dopaminergic neurons from 1-methyl-4-phenylpyridinium (MPP+)-induced cell death in culture. Furthermore, we observed a marked redistribution of lanosterol synthase from the endoplasmic reticulum to mitochondria in dopaminergic neurons exposed to MPP+, suggesting that lanosterol might exert its survival effect by regulating mitochondrial function. Consistent with this model, we find that lanosterol induces mild depolarization of mitochondria and promotes autophagy. Collectively, our results highlight a novel sterol-based neuroprotective mechanism with direct relevance to PD.
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Hacking SA, Pauyo T, Lim L, Legoux JG, Bureau MN. Tissue response to the components of a hydroxyapatite-coated composite femoral implant. J Biomed Mater Res A 2010; 94:953-60. [PMID: 20730932 DOI: 10.1002/jbm.a.32758] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Bone loss around femoral implants used for THA is a persistent clinical concern. It may be caused by stress shielding, generally attributed to a mismatch in stiffness between the implants and host bone. In this regard, a fatigue resistant, carbon fiber (CF) composite femoral implant with bone-matching stiffness has been developed. This study evaluated the tissue response to the three material components of this implant in normal and textured (blasted with 24 grit alumina) surfaces: the hydroxyapatite (HA) coating, the CF composite and the intermediate crystalline HA particulate composite layer to bond to the HA coating (blended). Sprague-Dawley rats underwent bilateral femoral implantation each receiving two rod-like implants. Bone apposition to the HA (37%) and textured Ti (41%) implants was not significantly different. Bone apposition to the untextured CF (14%) and blended (19%) implants and polished Ti (8%) implants was significantly lower. Bone apposition to the textured CF (9%) and blended (11%) implants was lower (but not statistically from the as received or untextured counterparts). Nearly all sections from femurs containing CF implants presented CF debris. There was no evidence of localized bone loss or any strong immune response associated with any of the implant materials. All materials were well tolerated with minimal inflammation despite the presence of particulate debris. The high degree of bone apposition to the HA-coated composite implants and the lack of short-term inflammation and adverse tissue response to the three material implant component support continued evaluation of this composite technology for use in THA.
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Powles T, Chowdhury S, Shamash J, Bazeos A, Gillessen S, Saunders N, Lim L, Sarwar N, Sadev A, Wilson P, Nathan P, Boleti K, Peters J, Agrawal S. Increased haematopoietic progenitor cells are associated with poor outcome in patients with metastatic renal cancer treated with sunitinib. Ann Oncol 2010; 22:815-820. [PMID: 20943595 DOI: 10.1093/annonc/mdq469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Haematopoietic progenitor cells (HPCs) are present in blood in metastatic renal cell cancer (mRCC). We investigate their expression in mRCC patients treated with sunitinib and correlate their expression with plasma growth factor levels [insulin-like growth factor (IGF)-1]. METHODS Circulating HPCs (CD34(+)/CD45(+)) and plasma IGF-1 levels were measured at specific sequential time points (0, 6, 18 and 28 weeks) in 43 untreated mRCC patients receiving sunitinib (50 mg for 28 days followed by 14-day off treatment). Univariate and multivariate analysis assessed the prognostic significance of HPCs and IGF-1. RESULTS HPCs levels were raised in 40 of 43 (93%) of patients. IGF-1 levels were raised in 9 of 43 patients (21%). Univariate and multivariate analysis revealed that high HPCs before treatment were associated with a significantly shorter overall survival (hazard ratio 3.3, 95% confidence interval 1.23-8.8, P=0.01), which was not the case for IGF-1 levels. Both HPC and IGF-1 levels fell with sunitinib (61% and 14% fall, respectively, P <0.05 for both). A positive correlation between the falls in HPC and IGF-1 occurred (P<0.001). CONCLUSIONS HPCs are over expressed in the peripheral blood in the majority of patients with mRCC. Higher levels are associated with poor prognosis. A concurrent fall in HPCs and growth factor expression (IGF-1) with sunitinib occurs.
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Matakidou A, Mutsvangwa K, Ansell W, Lim L, Powles T, Oliver R, Shamash J. Single-agent carboplatin AUC10 for metastatic seminoma with IGCCCG good prognosis disease; a feasibility study of the Orchid Clinical Trials Group. Ann Oncol 2010; 21:1730-1731. [DOI: 10.1093/annonc/mdq300] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gillessen S, Powles T, Lim L, Wilson P, Shamash J. Low-dose induction chemotherapy with Baby-BOP in patients with metastatic germ-cell tumours does not compromise outcome: a single-centre experience. Ann Oncol 2010; 21:1589-1593. [DOI: 10.1093/annonc/mdq019] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Chowdhury S, O’Brien TS, Sarwar N, Shamash J, McGrath S, Agrawal S, Lim L, Rudman SM, Harper PG, Powles T. The effect of sunitinib on immune parameters and haemopoetic stem cell markers in patients with untreated clear cell renal cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.4620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Siow JK, Alshaikh NA, Balakrishnan A, Chan KO, Chao SS, Goh LG, Hwang SY, Lee CY, Leong JL, Lim L, Menon A, Sethi DS, Tan H, Wang DY. Ministry of Health clinical practice guidelines: Management of Rhinosinusitis and Allergic Rhinitis. Singapore Med J 2010; 51:190-197. [PMID: 20428739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The Ministry of Health publishes national clinical practice guidelines to provide doctors and patients in Singapore with evidence-based guidance on managing important medical conditions. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the Ministry of Health clinical practice guidelines on Management of Rhinosinusitis and Allergic Rhinitis, for the information of readers of the Singapore Medical Journal. Chapters, page and figure numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website (http://www.moh.gov.sg/mohcorp/publications.aspx?id=24046). The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.
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Sanderson B, Lim L, Lei K, Smith J, Camporota L, Beale R. A comparison of core and tympanic temperature measurement in the critically ill. Crit Care 2010. [PMCID: PMC2934437 DOI: 10.1186/cc8561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Potpara T, Grujic M, Ostojic M, Vujisic B, Polovina M, Mujovic N, Hatzinikolaou-Kotsakou E, Reppas E, Beleveslis TH, Moschos G, Kotsakou M, Tsakiridis K, Simeonidou E, Papandreou A, Tsigas G, Michalakeas C, Tsitlakidis C, Alexopoulos D, Lekakis J, Kremastinos DT, Poci D, Backmn L, Karlsson TH, Edvardsson N, Golzio PG, Vinci M, Amellone C, Jorfida M, Veglio V, Gaido E, Trevi GP, Bongiorni MG, Ding L, Hua WEI, Zhang SHU, Chen KEPING, Wang FZ, Chen XIN, Dokumaci B, Dokumaci AS, Ozyildirim S, Yolcu M, Uyan C, Nicolas-Franco S, Rodriguez Gonzalez J, Albacete-Moreno C, Ruiz-Villa G, Sanchez-Martos A, Bixquert-Genoves D, Skoczynski P, Gajek J, Zysko D, Porebska M, Josiak K, Mazurek W, Providencia RA, Silva J, Seca L, Gomes PL, Barra S, Mota P, Nascimento J, Leitao-Marques AM, Kikuchi Y, Brady PA, Erne P, Val-Mejias J, Schwab J, Schimpf R, Orlov M, Mattioni T, Amlie J, Sacher F, Lahitton B, Laborderie J, Wright M, Haissaguerre M, Berger T, Zwick R, Dichtl W, Stuehlinger M, Pachinger O, Hintringer F, Toli K, Koutras K, Stauropoulos J, Vichos S, Mantas J, Rodriguez Artuza CR, Hidalgo L JA, Garcia A, Fumero P, Perez A, Rangel I, Providencia RA, Silva J, Seca L, Gomes PL, Nascimento J, Leitao-Marques AM, Perl S, Stiegler P, Kollmann A, Rotman B, Lercher P, Anelli-Monti M, Tscheliessnigg KH, Pieske BM, Nakamura K, Naito S, Kumagai K, Goto K, Iwamoto J, Funabashi N, Oshima S, Komuro I, Toli K, Stavropoulos J, Koutras D, Vichos S, Mantas J, Di Biase L, Beheiry S, Hongo R, Horton R, Morganti K, Hao S, Javier Sanchez J, Natale A, Digby G, Parfrey B, Morriello F, Lim L, Hopman WM, Simpson CS, Redfearn DP, Baranchuk A, Madsen T, Schmidt EB, Toft E, Christensen JH, Patel D, Shaheen M, Sonne K, Mohanty P, Dibiase L, Horton RP, Sanchez JE, Natale A, Krynski T, Stec SM, Stanke A, Baszko A, Kulakowski P, Rondano E, Bortnik M, Occhetta E, Teodori G, Caimmi PP, Marino PN, Osmancik P, Peroutka Z, Herman D, Stros P, Budera P, Straka Z, Petrac D, Radeljic V, Delic-Brkljacic D, Manola S, Pavlovic N, Inama G, Pedrinazzi C, Adragao P, Arribas F, Landolina M, Merino JL, De Sousa J, Gulizia M, Neuzil P, Holy F, Skoda J, Petru J, Sediva L, Kralovec S, Brada J, Taborsky M, Takami M, Yoshida A, Fukuzawa K, Takami K, Kumagai H, Tanaka S, Itoh M, Hirata K, Jacques F, Champagne J, Doyle D, Charbonneau E, Dagenais F, Voisine P, Dumont E, Aboelhoda A, Nawar M, Khadragui I, Loutfi M, Ramadan B, Makboul G, Gianfranchi L, Pacchioni F, Bettiol K, Alboni P, Gallardo Lobo R, Pap R, Bencsik G, Makai A, Marton G, Saghy L, Forster T, Stockburger M, Trautmann F, Nitardy A, Just-Teetzmann M, Schade S, Celebi O, Krebs A, Dietz R, Pastore CA, Douglas RA, Samesima N, Martinelli Filho M, Nishioka SAD, Pastor Fuentes A, Perea J, Tur N, Berzal B, Boldt LH, Polotzki M, Posch MG, Perrot A, Lohse M, Rolf S, Ozcelik C, Haverkamp W, Tunyan LG, Grigoryan SV, Barsheshet A, Abu Sham'a R, Kuperstein R, Feinberg MS, Sandach A, Luria D, Eldar M, Glikson M, Vatasescu RG, Berruezo A, Iorgulescu C, Fruntelata A, Dorobantu M, Chaumeil A, Philippon F, O'hara G, Blier L, Molin F, Gilbert M, Champagne J, Paslawska U, Gajek J, Zysko D, Noszczyk-Nowak A, Skrzypczak P, Nicpon J, Mazurek W, Chevallier S, Van Oosterom A, Pruvot E, Iga A, Igarashi M, Itou H, Fujino T, Tsubota T, Yamazaki J, Yoshihara K, Arsenos P, Gatzoulis K, Dilaveris P, Gialernios T, Papaioannou T, Masoura K, Archontakis S, Stefanadis C, Nasr GM, Khashaba A, Osman H, El-Barbary M, Heinke M, Heinke T, Ismer B, Kuehnert H, Surber R, Figulla HR. Poster session 3: Miscellaneous. Europace 2009. [DOI: 10.1093/europace/euq230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ngeow JY, Quek R, Tao M, Tan HC, Lim L, Tan I, Kaneswaran R, Lim ST. Analysis of long-term treatment outcomes and toxicty of HL. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e19536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e19536 Background: Prognosis of patients with Hodgkin lymphoma (HL) has substantially improved but therapy of HL can however contribute to delayed toxicity. Long term treatment outcomes of HL in our local population were evaluated. Methods: Clinical and treatment data was prospectively collected from all patients with a histological diagnosis of HL. Patients were all fully staged with CT scan and bone marrow biopsy. Results: On the basis of 217 patients seen at the National Cancer Centre Singapore between 1990–2008, we found that there was a peak in young adulthood with 103 patients who were diagnosed before the age of 30 (48%), median age of presentation 32 (range 17–84). Patients who were young (< 30 years) were more likely to present with nodular sclerosis HL (p=0.0001). Treatment outcomes were comparable to other published series, 85% of cases received ABVD based treatment. 5 year OS for early stage HL was 92% and 88% for advanced stage HL. Overall FFTF was 93% at 5 years. Of note, comparing patients with early stage (Stage I/ II) HL (n=114) who had ABVD 4 cycles followed by involved field radiotherapy (IFRT) with those who received 6–8 cycles of ABVD, there was no difference in OS, FFTF (p= 0.99, 0.48 respectively). Bulky early stage HL who received 6 cycles of ABVD and IFRT had better FFTF rates than those who had just 4 cycles of ABVD followed by IFRT (p=0.06). In contrast, patients patients with advanced HL (Stage III/ IV) (n=70) who completed 6–8 cycles of ABVD did not benefit from additional IFRT even in the presence of bulky disease (n=15). Acute toxicities included that of bleomycin induced pneumonitis (BIP) seen in 15% of cases. Neither the omission of bleomycin nor the presence BIP adversely affected treatment outcomes. Hematological malignancies were seen in 1% of survivors appearing after a median of 7.3 years. Hypothyroidism was noted in 3% of cases. Conclusions: 1) Epidemiology of HL in Singapore is increasingly similar to that of developed countries with a peak in young adults. 2)Young age was predictive of a nodular sclerosis subtype 3) Abbreviated chemotherapy using 4 cycles of ABVD followed by IFRT performed similarly to 6 cycles of ABVD in early stage HL, but in patients with bulky disease this may not be sufficient. 4) BIP occurred in 15% of cases. BIP and the omission of bleomycin did not adversely affect treatment outcomes. No significant financial relationships to disclose.
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Ananda S, Kosmider S, Lim L, Barnett F, Desai J, Gibbs P. Adjuvant chemotherapy for stage II and stage III colon cancer—What is happening in routine practice? J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e15046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e15046 Background: Randomised studies have defined adjuvant chemotherapy as standard treatment for stage III colon cancer (SIIICC), with multiple options available. For stage II (SII) disease, the selection of patients for adjuvant treatment remains controversial. There remains limited data on clinician decision making regarding adjuvant chemotherapy in routine clinical practice. Methods: A review of patients treated with SII & IIICC at 4 hospitals, utilising data from BioGrid Australia, where clinician choice and rationale were prospectively documented. Results: 372 patients (37%) with SII and 307 (30%) with SIIICC were identified from 1015 CC patients treated from January 2003 till November 2008. Median age was 68 years, 51% were male; 49% female. 66 (25%) of patients with SIIICC were not offered chemotherapy, predominantly due to advanced age or co-morbidity. Since oxaliplatin and capecitabine became widely available in 2005, 66% of treated patients have received oxaliplatin based therapy, 15% bolus 5-FU alone and 19% capecitabine. For SII disease, overall 81 (26%) pts received adjuvant chemotherapy. Age was the dominant influence on treatment choice with 41% aged 70 (p<0.001) receiving treatment. Patients with high risk features were also more likely to receive adjuvant therapy. (p= 0.006 for those with lymphovascular invasion and p= 0.0068 for those with T4 tumours). Dose reductions and completion rates were similar for SII and III disease, and for older and younger patients. Conclusions: Over 25% of patients with SIIICC do not receive adjuvant chemotherapy in routine practice, with physicians basing non-treatment recommendations predominantly on patient age and co-morbidity. Where treatment is used, oxaliplatin-based therapy is the dominant regimen, except in older patients. In SIICC, adjuvant chemotherapy is used in one in four patients, more frequently in younger patients and those with high risk features. No significant financial relationships to disclose.
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Sigrist M, Chiarelli G, Lim L, Levin A. EARLY INITIATION OF PHOSPHATE LOWERING DIETARY THERAPY IN NON-DIALYSIS CHRONIC KIDNEY DISEASE: A CRITICAL REVIEW. J Ren Care 2009; 35 Suppl 1:71-8. [DOI: 10.1111/j.1755-6686.2009.00064.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Banwell C, Lim L, Seubsman SA, Bain C, Dixon J, Sleigh A. Body mass index and health-related behaviours in a national cohort of 87,134 Thai open university students. J Epidemiol Community Health 2009; 63:366-72. [PMID: 19151014 DOI: 10.1136/jech.2008.080820] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Thailand is undergoing a health-risk transition with overweight and obesity emerging as an important population health problem. This paper reports on a study of the transition, focusing on "lifestyle" factors such as diet (fried foods, soft drinks, Western-style fast foods) and physical activity (mild, moderate, strenuous exercise, housework/gardening and screen time). METHODS A baseline survey was administered to 87 134 adult students from all regions of Thailand attending an open university. RESULTS 54% of the cohort was female. Participants' median age was 29 years. By self-reported Asian standards, 16% of the sample was obese (body mass index (BMI)>or=25) and 15% overweight at risk (BMI>or=23-24.9). Men were twice as likely as women to be overweight (21% vs 9%) or obese (23% vs 10%). Obesity was associated with urban residence and doing little housework or gardening and with spending more than 4 hours a day watching television or using computers. The latter occurred among 30% of the cohort, with a population attributable fraction (PAF) suggesting that it accounts for 11% of the current problem. Daily consumption of fried food was associated with obesity, and eating fried foods every second day or daily had a PAF of nearly 20%. CONCLUSIONS These health-related behaviours underpinning the Thai health transition are associated with increasing obesity. They are modifiable through policies addressing structural issues and with targeted health promotion activities to prevent future obesity gains. Insights into future trends in the Thai health transition can be gained as this student cohort ages.
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Chua J, Lim L. Systemic Wegener's granulomatosis with severe orbito-ocular involvement. Singapore Med J 2008; 49:e259-e262. [PMID: 18946592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Orbito-ocular involvement in Wegener's granulomatosis is the result of both focal ischaemic vasculitis and granulomatous soft tissue inflammation. Necrotising keratoscleritis and orbital inflammation are two most characteristic ophthalmic presentations. We describe a 56-year-old man with systemic limited Wegener's granulomatosis, presenting with pulmonary fibrosis, pansinusitis and left mastoiditis. This was complicated by the development of a left severe necrotising anterior scleritis, peripheral ulcerative keratitis and orbital apex syndrome. Both c-ANCA and anti-PR3 were positive. Despite mainstay systemic immunosuppressive therapy with cyclophosphamide and prednisolone, the visual prognosis remained very poor. This was largely due to the presence of an irreversible ischaemic optic neuropathy, extensive corneoscleral melt and corneal neovascularisation. This case highlights the possible extent of orbital and ocular surface involvement in Wegener's granulomatosis, and hence the importance of vigilance by the physician.
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Lim L, Gazzard G, Chan YH, Fong A, Kotecha A, Sim EL, Tan D, Tong L, Saw SM. Corneal biomechanics, thickness and optic disc morphology in children with optic disc tilt. Br J Ophthalmol 2008; 92:1461-6. [PMID: 18703551 DOI: 10.1136/bjo.2008.139113] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Lim L, Chao M, Shapiro J, Millar JL, Kipp D, Rezo A, Fong A, Jones IT, McLaughlin S, Gibbs P. Long-term outcomes of patients with localized rectal cancer treated with chemoradiation or radiotherapy alone because of medical inoperability or patient refusal. Dis Colon Rectum 2007; 50:2032-9. [PMID: 17896138 DOI: 10.1007/s10350-007-9062-x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2006] [Revised: 12/31/2006] [Accepted: 02/18/2007] [Indexed: 02/07/2023]
Abstract
PURPOSE The standard management of rectal cancer continues to be defined by the results of randomized, clinical trials exploring the optimal timing and use of adjuvant chemotherapy and radiation therapy in relation to surgery. The patient with rectal cancer who is elderly and/or has significant comorbidities and the patient who refuses surgery are clinical contexts for which there is limited current data to guide decision making. METHODS A retrospective analysis was performed at six Australian centers of patients with rectal cancer treated with radiation therapy or chemoradiation alone because of excessive operative risk or patient refusal of surgery. RESULTS We identified 48 patients treated between August 1998 and June 2005 with a median age of 76 (range, 49-94) years. Twenty-four patients (50 percent) were considered medically inoperable and 24 patients refused surgery. Treatment was with chemoradiation (with 5-fluorouracil) in 36 patients and radiotherapy alone in 12 patients; 93 percent completed the planned therapy. A clinical complete response was seen in 56 percent and a partial response in 30 percent of patients. At a median follow-up of 49 months, 18 patients have disease progression, including 10 of 24 in the medically inoperable group and 8 of 24 in the refused surgery group. Of the 25 deceased patients, 16 died from progressive disease and 9 from noncancer causes. CONCLUSIONS Chemoradiation or radiotherapy alone is a safe alternative that results in significant progression-free and overall survival times in patients who are considered medically inoperable or refuse to undergo surgery. Ultimately, however, many patients will progress.
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Nice EC, Rothacker J, Weinstock J, Lim L, Catimel B. Use of multidimensional separation protocols for the purification of trace components in complex biological samples for proteomics analysis. J Chromatogr A 2007; 1168:190-210; discussion 189. [PMID: 17597136 DOI: 10.1016/j.chroma.2007.06.015] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2007] [Revised: 06/06/2007] [Accepted: 06/07/2007] [Indexed: 01/09/2023]
Abstract
The routine detection of low abundance components in complex samples for detailed proteomics analysis continues to be a challenge. Whilst the potential of multidimensional chromatographic fractionation for this purpose has been proposed for some years, and was used effectively for the purification to homogeneity of trace components in bulk biological samples for N-terminal sequence analysis, its practical application in the proteomics arena is still limited. This article reviews some of the recent data using these approaches, including the use of microaffinity purification as part of multidimensional protocols for downstream proteomics analysis.
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Lim L, Chao M, Shapiro J, Millar J, Kipp D, Rezo A, Fong A, Jones I, McLaughlin S, Gibbs P. A multicentre analysis of the long-term outcomes of patients with localized rectal cancer treated with chemotherapy and/or radiotherapy alone due to medical inoperability or patient refusal. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.3633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3633 Background: The outcome for patients with localized rectal cancer treated with chemoradiotherapy (CMT) or radiotherapy alone (RT) and no planned subsequent surgery is unknown. Insights can be provided by study of patients that do not undergo surgery due to excessive operative risk (medically inoperable) as a result of advanced age and/or co-morbidities, or patient refusal. Methods: A retrospective analysis at 6 Australian centers. Patients with recurrent rectal cancer, metastatic disease or primary tumors that were considered unresectable were excluded from the study. Results: We identified 48 patients treated between August 1998 and June 2005 meeting our criteria. There were 13 females and 35 males with a median age of 76 years (range 49 - 94). 24 patients (50%) were deemed medically inoperable and 24 patients refused surgery (the most common reasons were the desire to avoid a stoma or fear of surgery). Treatment was with standard long course radiation plus 5-FU (either bolus or continuous infusion) in 36 patients (75%) and 12 (25%) received RT alone. A complete clinical response was documented in 23 patients (48%) and a partial clinical response was documented in 14 patients (30%). At a median follow-up of 49 months, 18 patients (37.5%) have documented disease progression including 10 of 24 in the medically inoperable group and 8 of 24 in the refused surgery group. The median progression-free survival for all patients was 30+ months. 7 had local progression only, 7 had distant progression only and 4 patients had both local and distant progression. Of the 23 deceased patients, 16 (70%) died from progressive disease and 7 (30%) from non-cancer causes, including 4 from the refused surgery group. The median survival for all patients was 35 + months. Conclusions: In patients who are not suitable candidates for surgical resection due to advanced age and/or comorbidity CRT or RT alone is a safe alternative that results in significant progression-free and overall survival times, with many patients succumbing to co-morbidities rather than progressive disease. Many of these patients refusing surgery will have long periods of disease control after treatment with CRT or RT. No significant financial relationships to disclose.
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Lim L, Gibbs P, Yip D, Shapiro JD, Dowling R, Smith D, Little A, Bailey W, Liechtenstein M. A prospective evaluation of treatment with Selective Internal Radiation Therapy (SIR-spheres) in patients with unresectable liver metastases from colorectal cancer previously treated with 5-FU based chemotherapy. BMC Cancer 2005; 5:132. [PMID: 16225697 PMCID: PMC1274303 DOI: 10.1186/1471-2407-5-132] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2005] [Accepted: 10/15/2005] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND To prospectively evaluate the efficacy and safety of Selective Internal Radiation (SIR) spheres in patients with inoperable liver metastases from colorectal cancer who have failed 5FU based chemotherapy. METHODS Patients were prospectively enrolled at three Australian centres. All patients had previously received 5-FU based chemotherapy for metastatic colorectal cancer. Patients were ECOG 0-2 and had liver dominant or liver only disease. Concurrent 5-FU was given at investigator discretion. RESULTS Thirty patients were treated between January 2002 and March 2004. As of July 2004 the median follow-up is 18.3 months. Median patient age was 61.7 years (range 36-77). Twenty-nine patients are evaluable for toxicity and response. There were 10 partial responses (33%), with the median duration of response being 8.3 months (range 2-18) and median time to progression of 5.3 mths. Response rates were lower (21%) and progression free survival shorter (3.9 mths) in patients that had received all standard chemotherapy options (n = 14). No responses were seen in patients with a poor performance status (n = 3) or extrahepatic disease (n = 6). Overall treatment related toxicity was acceptable, however significant late toxicity included 4 cases of gastric ulceration. CONCLUSION In patients with metastatic colorectal cancer that have previously received treatment with 5-FU based chemotherapy, treatment with SIR-spheres has demonstrated encouraging activity. Further studies are required to better define the subsets of patients most likely to respond.
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