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Ray S, Nair T, Sawhney J, Erwinanto, Rosman A, Reyes E, Go L, Sukonthasarn A, Ariyachaipanich A, Hung PM, Chaudhari H, Malhi HS. Role of β-blockers in the cardiovascular disease continuum: a collaborative Delphi survey-based consensus from Asia-Pacific. Curr Med Res Opin 2023; 39:1671-1683. [PMID: 37694536 DOI: 10.1080/03007995.2023.2256218] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/28/2023] [Accepted: 09/04/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVE This Delphi method of consensus was designed to develop scientific statements for β-blockers in the continuum of cardiovascular diseases with a special focus on the role of bisoprolol. METHODS Eleven experienced cardiologists from across the Asia-Pacific countries participated in two rounds of the survey. In the first round, experts were asked to rate agreement/disagreement with 35 statements across seven domains regarding the use of β-blockers for treating hypertension, heart failure, coronary artery diseases, co-morbidities, as well as their safety profile, usage pattern, and pharmacokinetic variability. A consensus for a statement could be reached with >70% agreement. RESULTS Except for seven statements, all attained consensus in the first round. In the second round that was conducted virtually, the experts re-appraised their ratings for the seven statements along with a critical appraisal of two additional statements that were suggested by experts in the preceding round. At the end of the second round, the final version included 36 statements (34 original statements, two statements suggested by experts, and the omission of one statement that did not attain consensus). The final version of statements in the second round was disseminated among experts for their approval followed by manuscript development. CONCLUSION Attainment of consensus for almost all statements reconfirms the clinical benefits of β-blockers, particularly β1-selective blockers for the entire spectrum of cardiovascular diseases.
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Affiliation(s)
- Saumitra Ray
- Department of Cardiology, AMRI Hospital (S), West Bengal, Kolkata, India
| | - Tiny Nair
- Department of Cardiology, PRS Hospital, Trivandrum, Kerala, India
| | - Jps Sawhney
- Department of Cardiology, Member Board of Management at Sir Ganga Ram Hospital, New Delhi, India
| | - Erwinanto
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjajaran University, Jawa Barat, Indonesia
| | | | - Eugene Reyes
- Section of Cardiology, Department of Internal Medicine, UP-Philippine General Hospital, Manila, Philippines
| | - Loewe Go
- Internal Medicine - Cardiology, St. Luke's Medical Center, Taguig, Philippines
| | | | - Aekarach Ariyachaipanich
- Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Phạm Manh Hung
- National Heart Institute, Bach Mai Hospital, Hanoi, Vietnam
| | - Harshal Chaudhari
- Merck Specialities Pvt. Ltd., India, an affiliate of Merck KGaA, Darmstadt, Germany
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Chua YA, Nazli SA, Rosman A, Kasim SS, Ibrahim KS, Md Radzi AB, Mohd Kasim NA, Nawawi H. Attainment of Low-Density Lipoprotein Cholesterol Targets and Prescribing Pattern of Lipid-Lowering Medications among Patients with Familial Hypercholesterolemia Attending Specialist Clinics. J Atheroscler Thromb 2023; 30:1317-1326. [PMID: 36567112 PMCID: PMC10564645 DOI: 10.5551/jat.63389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 10/03/2022] [Indexed: 12/24/2022] Open
Abstract
AIMS Patients with familial hypercholesterolemia (FH) are known to have higher exposure to coronary risk than those without FH with similar low-density lipoprotein cholesterol (LDL-C) level. Lipid-lowering medications (LLMs) are the mainstay treatments to lower the risk of premature coronary artery disease in patients with hypercholesterolemia. However, the LLM prescription pattern and its effectiveness among Malaysian patients with FH are not yet reported. The aim of this study was to report the LLM prescribing pattern and its effectiveness in lowering LDL-C level among Malaysian patients with FH treated in specialist hospitals. METHODS Subjects were recruited from lipid and cardiac specialist hospitals. FH was clinically diagnosed using the Dutch Lipid Clinic Network Criteria. Patients' medical history was recorded using a standardized questionnaire. LLM prescription history and baseline LDL-C were acquired from the hospitals' database. Blood samples were acquired for the latest lipid profile assay. RESULTS A total of 206 patients with FH were recruited. Almost all of them were on LLMs (97.6%). Only 2.9% and 7.8% of the patients achieved the target LDL-C of <1.4 and <1.8 mmol/L, respectively. The majority of patients who achieved the target LDL-C were prescribed with statin-ezetimibe combination medications and high-intensity or moderate-intensity statins. All patients who were prescribed with ezetimibe monotherapy did not achieve the target LDL-C. CONCLUSION The majority of Malaysian patients with FH received LLMs, but only a small fraction achieved the therapeutic target LDL-C level. Further investigation has to be conducted to identify the cause of the suboptimal treatment target attainment, be it the factors of patients or the prescription practice.
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Affiliation(s)
- Yung-An Chua
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM) and Faculty of Medicine, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
| | - Sukma Azureen Nazli
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM) and Faculty of Medicine, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
| | - Azhari Rosman
- National Heart Institute (IJN), Kuala Lumpur, Malaysia
| | - Sazzli Shahlan Kasim
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM) and Faculty of Medicine, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
- Department of Cardiology, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
| | - Khairul Shafiq Ibrahim
- Department of Cardiology, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
| | - Ahmad Bakhtiar Md Radzi
- Department of Cardiology, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
| | - Noor Alicezah Mohd Kasim
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM) and Faculty of Medicine, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
- Department of Pathology, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
| | - Hapizah Nawawi
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM) and Faculty of Medicine, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
- Department of Pathology, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
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Chan SP, Mumtaz M, Ratnasingam J, Tan ATB, Lim SC, Rosman A, Chee KH, Lim SK, Yew SS, Mohd Yusof BN, Lau BK, Kassim SB, Mohamed M. Practical guide in using insulin degludec/insulin aspart: A multidisciplinary approach in Malaysia. Malays Fam Physician 2023; 18:31. [PMID: 37292224 PMCID: PMC10246713 DOI: 10.51866/cpg.255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Insulin degludec/insulin aspart (IDegAsp) co-formulation provides both basal and mealtime glycaemic control in a single injection. The glucose level-lowering efficacy of IDegAsp is reported to be superior or non-inferior to that of the currently available insulin therapies with a lower rate of overall hypoglycaemia and nocturnal hypoglycaemia. An expert panel from Malaysia aims to provide insights into the utilisation of IDegAsp across a broad range of patients with type 2 diabetes mellitus (i.e. treatment-naive or insulin-naive patients or patients receiving treatment intensification from basal-only regimens, premixed insulin and basal-bolus insulin therapy). IDegAsp can be initiated as once-daily dosing for the main meal with the largest carbohydrate content with weekly dose adjustments based on patient response. A lower starting dose is recommended for patients with cardiac or renal comorbidities. Dose intensification with IDegAsp may warrant splitting into twice-daily dosing. IDegAsp twice-daily dosing does not need to be split at a 50:50 ratio but should be adjusted to match the carbohydrate content of meals. The treatment of patients choosing to fast during Ramadan should be switched to IDegAsp early before Ramadan, as a longer duration of titration leads to better glycated haemoglobin level reductions. The pre-Ramadan breakfast/lunch insulin dose can be reduced by 30%-50% and taken during sahur, while the preRamadan dinner dose can be taken without any change during iftar. Education on the main meal concept is important, as carbohydrates are present in almost all meals. Patients should not have a misconception of consuming more carbohydrates while taking IDegAsp.
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Affiliation(s)
- Siew Pheng Chan
- MBBS (Mal) FRCP (Edin), AM (Mal), Consultant Endocrinologist, University of Malaya, Jln Profesor Diraja Ungku Aziz, Kuala Lumpur, Selangor, Malaysia.
| | - Malik Mumtaz
- MBBS (USM), MRCP (UK), FRCP (Edinburgh, Glasgow), Island Hospital Penang, 308, Jalan Macalister, George Town, Pulau, Pinang, Malaysia
| | - Jeyakantha Ratnasingam
- MMed (UM), Fellowship in Endocrinology (Australia), MD (UKM), University of Malaya, Jln Profesor, Diraja Ungku Aziz, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Alexander Tong Boon Tan
- MB ChB (Liverpool), MRCP (UK), FRCP (Edinburgh), Sunway Medical Centre, 5, Jalan Lagoon Selatan, Bandar Sunway, Petaling Jaya, Selangor, Malaysia
| | - Siang Chin Lim
- DM (UKM), MRCP (UK), Fellowship in Endocrinology (Malaysia), Mahkota Medical Centre, No 3, Mahkota Melaka, Jln Merdeka, Melaka, Malaysia
| | - Azhari Rosman
- MD (UM, Mal), MRCP (UK), FNHAM (MAl), FAPSIC (Asia Pacific), FAsCC (ASEAN), FESC (EU), FACC (US), Institut Jantung Negara,145, Jln Tun Razak, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Kok Han Chee
- NHAM, MMed (Mal), MBBS (UM), University of Malaya, Jln Profesor, Diraja Ungku Aziz, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Soo Kun Lim
- AM (MAL), FRCP(Edin), MBBS(MAL), MRCP(UK), University of Malaya, Jln Profesor, Diraja Ungku Aziz, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Shiong Shiong Yew
- MBBS (UM), MRCP (UK), Mahkota Medical Centre, No 3, Mahkota Melaka, Jln Merdeka, Melaka, Malaysia
| | - Barakatun-Nisak Mohd Yusof
- BS (Diabetics; UKM), Ph.D (UKM), Universiti Putra Malaysia, Jalan, Universiti 1 Serdang, Seri Kembangan, Selangor, Malaysia
| | - Bik Kui Lau
- MD (USM), MRCP (UK), KPJ Kuching Specialist Hospital, Lot 18807, Block 11 Muara Tebas, Land District, Jln Stutong, Kuching, Sarawak, Malaysia
| | - Saiful Bahari Kassim
- MB BCh BAO (NUIG), PGCMedEd (QUB), MRCP (U.K.), FRCP (Lon), FRCP (Glasg) FRCPI (Ire) FRCP (Edin), CCST (JRCPTB U.K. Endocrinology & Diabetes; Internal Medicine), Gleneagles Kuala Lumpur, Jalan Ampang, Kampung Berembang, Kuala Lumpur, Wilayah Persekutuan, Kuala Lumpur, Malaysia
| | - Mafauzy Mohamed
- MBBS (Adelaide), MRCP (UK), MMedSci (University of Sheffield), FRCP (Edinburgh), Universiti Sains Malaysia Hospital, Jalan Raja Perempuan Zainab II, Kubang Kerian, Kota Bharu, Kelantan, Malaysia
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Wan Ahmad WA, Rosman A, Bavanandan S, Mohamed M, Kader MASA, Muthusamy TS, Lam KH, Kasim SS, Hoo FK, Fegade M, Looi ZL, Rahman ARA. Current Insights on Dyslipidaemia Management for Prevention of Atherosclerotic Cardiovascular Disease: A Malaysian Perspective. Malays J Med Sci 2023; 30:67-81. [PMID: 36875188 PMCID: PMC9984111 DOI: 10.21315/mjms2023.30.1.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/01/2022] [Indexed: 03/05/2023] Open
Abstract
Dyslipidaemia is highly prevalent in the Malaysian population and is one of the main risk factors for atherosclerotic cardiovascular disease (ASCVD). Low-density lipoprotein cholesterol (LDL-C) is recognised as the primary target of lipid-lowering therapy to reduce the disease burden of ASCVD. Framingham General CV Risk Score has been validated in the Malaysian population for CV risk assessment. The Clinical Practice Guidelines (CPG) on the management of dyslipidaemia were last updated in 2017. Since its publication, several newer randomised clinical trials have been conducted with their results published in research articles and compared in meta-analysis. This underscores a need to update the previous guidelines to ensure good quality care and treatment for the patients. This review summarises the benefits of achieving LDL-C levels lower than the currently recommended target of < 1.8mmol/L without any safety concerns. In most high and very high-risk individuals, statins are the first line of therapy for dyslipidaemia management. However, certain high-risk individuals are not able to achieve the LDL-C goal as recommended in the guideline even with high-intensity statin therapy. In such individuals, lower LDL-C levels can be achieved by combining the statins with non-statin agents such as ezetimibe and PCSK9 inhibitors. Emerging non-statin lipid-lowering therapies and challenges in dyslipidaemia management are discussed in this article. The review also summarises the recent updates on local and international guidelines for dyslipidaemia management.
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Affiliation(s)
- Wan Azman Wan Ahmad
- Department of Medicine, Universiti Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Azhari Rosman
- Cardiology, National Heart Institute, Kuala Lumpur, Malaysia
| | - Sunita Bavanandan
- Department of Nephrology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
| | - Mafauzy Mohamed
- Department of Endocrinology, Hospital Universiti Sains Malaysia, Kelantan, Malaysia
| | | | | | - Kai Huat Lam
- Cardiology, Assunta Hospital, Selangor, Malaysia
| | - Sazzli Shahlan Kasim
- Faculty of Medicine, Cardiac Vascular and Lung Research Institute, Universiti Teknologi MARA, Selangor, Malaysia
| | - Fan Kee Hoo
- Department of Medicine, Faculty of Medicine, University Putra Malaysia, Selangor, Malaysia
| | - Mayuresh Fegade
- Novartis Corporation (Malaysia) Sdn. Bhd., Selangor, Malaysia
| | - Zhi Ling Looi
- Novartis Corporation (Malaysia) Sdn. Bhd., Selangor, Malaysia
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Ashari A, Aris FA, Lim YH, Rosman A. TCTAP C-025 Third In-Stent Restenosis in 5 Years - Are We Doing Enough? Role of Intravascular Ultrasound and Lithotripsy in Severely Calcified ISR. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.03.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lee TJ, Rosman A, Win NT, Kolanthaivelu J. TCTAP C-092 A Lesson Well Learnt - Acute Stent Thrombosis Resulting in Inferior Myocardial Infarction. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.03.221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Vallejo-Vaz AJ, Stevens CA, Lyons AR, Dharmayat KI, Freiberger T, Hovingh GK, Mata P, Raal FJ, Santos RD, Soran H, Watts GF, Abifadel M, Aguilar-Salinas CA, Alhabib KF, Alkhnifsawi M, Almahmeed W, Alnouri F, Alonso R, Al-Rasadi K, Al-Sarraf A, Al-Sayed N, Araujo F, Ashavaid TF, Banach M, Béliard S, Benn M, Binder CJ, Bogsrud MP, Bourbon M, Chlebus K, Corral P, Davletov K, Descamps OS, Durst R, Ezhov M, Gaita D, Genest J, Groselj U, Harada-Shiba M, Holven KB, Kayikcioglu M, Khovidhunkit W, Lalic K, Latkovskis G, Laufs U, Liberopoulos E, Lima-Martinez MM, Lin J, Maher V, Marais AD, März W, Mirrakhimov E, Miserez AR, Mitchenko O, Nawawi H, Nordestgaard BG, Panayiotou AG, Paragh G, Petrulioniene Z, Pojskic B, Postadzhiyan A, Raslova K, Reda A, Reiner Ž, Sadiq F, Sadoh WE, Schunkert H, Shek AB, Stoll M, Stroes E, Su TC, Subramaniam T, Susekov AV, Tilney M, Tomlinson B, Truong TH, Tselepis AD, Tybjærg-Hansen A, Vázquez Cárdenas A, Viigimaa M, Wang L, Yamashita S, Kastelein JJ, Bruckert E, Vohnout B, Schreier L, Pang J, Ebenbichler C, Dieplinger H, Innerhofer R, Winhofer-Stöckl Y, Greber-Platzer S, Krychtiuk K, Speidl W, Toplak H, Widhalm K, Stulnig T, Huber K, Höllerl F, Rega-Kaun G, Kleemann L, Mäser M, Scholl-Bürgi S, Säly C, Mayer FJ, Sablon G, Tarantino E, Nzeyimana C, Pojskic L, Sisic I, Nalbantic AD, Jannes CE, Pereira AC, Krieger JE, Petrov I, Goudev A, Nikolov F, Tisheva S, Yotov Y, Tzvetkov I, Baass A, Bergeron J, Bernard S, Brisson D, Brunham LR, Cermakova L, Couture P, Francis GA, Gaudet D, Hegele RA, Khoury E, Mancini GJ, McCrindle BW, Paquette M, Ruel I, Cuevas A, Asenjo S, Wang X, Meng K, Song X, Yong Q, Jiang T, Liu Z, Duan Y, Hong J, Ye P, Chen Y, Qi J, Liu Z, Li Y, Zhang C, Peng J, Yang Y, Yu W, Wang Q, Yuan H, Cheng S, Jiang L, Chong M, Jiao J, Wu Y, Wen W, Xu L, Zhang R, Qu Y, He J, Fan X, Wang Z, Chow E, Pećin I, Perica D, Symeonides P, Vrablik M, Ceska R, Soska V, Tichy L, Adamkova V, Franekova J, Cifkova R, Kraml P, Vonaskova K, Cepova J, Dusejovska M, Pavlickova L, Blaha V, Rosolova H, Nussbaumerova B, Cibulka R, Vaverkova H, Cibickova L, Krejsova Z, Rehouskova K, Malina P, Budikova M, Palanova V, Solcova L, Lubasova A, Podzimkova H, Bujdak J, Vesely J, Jordanova M, Salek T, Urbanek R, Zemek S, Lacko J, Halamkova H, Machacova S, Mala S, Cubova E, Valoskova K, Burda L, Bendary A, Daoud I, Emil S, Elbahry A, Rafla S, Sanad O, Kazamel G, Ashraf M, Sobhy M, El-Hadidy A, Shafy MA, Kamal S, Bendary M, Talviste G, Angoulvant D, Boccara F, Cariou B, Carreau V, Carrie A, Charrieres S, Cottin Y, Di-Fillipo M, Ducluzeau PH, Dulong S, Durlach V, Farnier M, Ferrari E, Ferrieres D, Ferrieres J, Gallo A, hankard R, Inamo J, Lemale J, Moulin P, Paillard F, Peretti N, Perrin A, Pradignac A, Rabes JP, Rigalleau V, Sultan A, Schiele F, Tounian P, Valero R, Verges B, Yelnik C, Ziegler O, Haack IA, Schmidt N, Dressel A, Klein I, Christmann J, Sonntag A, Stumpp C, Boger D, Biedermann D, Usme MM, Beil FU, Klose G, König C, Gouni-Berthold I, Otte B, Böll G, Kirschbaum A, Merke J, Scholl J, Segiet T, Gebauer M, Predica F, Mayer M, Leistikow F, Füllgraf-Horst S, Müller C, Schüler M, Wiener J, Hein K, Baumgartner P, Kopf S, Busch R, Schömig M, Matthias S, Allendorf-Ostwald N, Fink B, Böhm D, Jäkel A, Koschker AC, Schweizer R, Vogt A, Parhofer K, König W, Reinhard W, Bäßler A, Stadelmann A, Schrader V, Katzmann J, Tarr A, Steinhagen-Thiessen E, Kassner U, Paulsen G, Homberger J, Zemmrich C, Seeger W, Biolik K, Deiss D, Richter C, Pantchechnikova E, Dorn E, Schatz U, Julius U, Spens A, Wiesner T, Scholl M, Rizos CV, Sakkas N, Elisaf M, Skoumas I, Tziomalos K, Rallidis L, Kotsis V, Doumas M, Athyros V, Skalidis E, Kolovou G, Garoufi A, Bilianou E, Koutagiar I, Agapakis D, Kiouri E, Antza C, Katsiki N, Zacharis E, Attilakos A, Sfikas G, Koumaras C, Anagnostis P, Anastasiou G, Liamis G, Koutsogianni AD, Karányi Z, Harangi M, Bajnok L, Audikovszky M, Márk L, Benczúr B, Reiber I, Nagy G, Nagy A, Reddy LL, Shah SA, Ponde CK, Dalal JJ, Sawhney JP, Verma IC, Altaey M, Al-Jumaily K, Rasul D, Abdalsahib AF, Jabbar AA, Al-ageedi M, Agar R, Cohen H, Ellis A, Gavishv D, Harats D, Henkin Y, Knobler H, Leavit L, Leitersdorf E, Rubinstein A, Schurr D, Shpitzen S, Szalat A, Casula M, Zampoleri V, Gazzotti M, Olmastroni E, Sarzani R, Ferri C, Repetti E, Sabbà C, Bossi AC, Borghi C, Muntoni S, Cipollone F, Purrello F, Pujia A, Passaro A, Marcucci R, Pecchioli V, Pisciotta L, Mandraffino G, Pellegatta F, Mombelli G, Branchi A, Fiorenza AM, Pederiva C, Werba JP, Parati G, Carubbi F, Iughetti L, Iannuzzi A, Iannuzzo G, Calabrò P, Averna M, Biasucci G, Zambon S, Roscini AR, Trenti C, Arca M, Federici M, Del Ben M, Bartuli A, Giaccari A, Pipolo A, Citroni N, Guardamagna O, Bonomo K, Benso A, Biolo G, Maroni L, Lupi A, Bonanni L, Zenti MG, Matsuki K, Hori M, Ogura M, Masuda D, Kobayashi T, Nagahama K, Al-Jarallah M, Radovic M, Lunegova O, Bektasheva E, Khodzhiboboev E, Erglis A, Gilis D, Nesterovics G, Saripo V, Meiere R, Upena-RozeMicena A, Terauda E, Jambart S, Khoury PE, Elbitar S, Ayoub C, Ghaleb Y, Aliosaitiene U, Kutkiene S, Kasim NA, Nor NS, Ramli AS, Razak SA, Al-Khateeb A, Kadir SH, Muid SA, Rahman TA, Kasim SS, Radzi AB, Ibrahim KS, Razali S, Ismail Z, Ghani RA, Hafidz MI, Chua AL, Rosli MM, Annamalai M, Teh LK, Razali R, Chua YA, Rosman A, Sanusi AR, Murad NA, Jamal ARA, Nazli SA, Razman AZ, Rosman N, Rahmat R, Hamzan NS, Azzopardi C, Mehta R, Martagon AJ, Ramirez GA, Villa NE, Vazquez AV, Elias-Lopez D, Retana GG, Rodriguez B, Macías JJ, Zazueta AR, Alvarado RM, Portano JD, Lopez HA, Sauque-Reyna L, Herrera LG, Mendia LE, Aguilar HG, Cooremans ER, Aparicio BP, Zubieta VM, Gonzalez PA, Ferreira-Hermosillo A, Portilla NC, Dominguez GJ, Garcia AY, Cazares HE, Gonzalez JR, Valencia CV, Padilla FG, Prado RM, De los Rios Ibarra MO, Villicaña RD, Rivera KJ, Carrera RA, Alvarez JA, Martinez JC, de los Reyes Barrera Bustillo M, Vargas GC, Chacon RC, Andrade MH, Ortega AF, Alcala HG, de Leon LE, Guzman BG, Garcia JJ, Cuellar JC, Cruz JR, Garcia AH, Almada JR, Herrera UJ, Sobrevilla FL, Rodriguez EM, Sibaja CM, Rodriguez AB, Oyervides JC, Vazquez DI, Rodriguez EA, Osorio ML, Saucedo JR, Tamayo MT, Talavera LA, Arroyo LE, Carrillo EA, Isara A, Obaseki DE, Al-Waili K, Al-Zadjali F, Al-Zakwani I, Al-Kindi M, Al-Mukhaini S, Al-Barwani H, Rana A, Shah LS, Starostecka E, Konopka A, Lewek J, Bartłomiejczyk M, Gąsior M, Dyrbuś K, Jóźwiak J, Gruchała M, Pajkowski M, Romanowska-Kocejko M, Żarczyńska-Buchowiecka M, Chmara M, Wasąg B, Parczewska A, Gilis-Malinowska N, Borowiec-Wolna J, Stróżyk A, Woś M, Michalska-Grzonkowska A, Medeiros AM, Alves AC, Silva F, Lobarinhas G, Palma I, de Moura JP, Rico MT, Rato Q, Pais P, Correia S, Moldovan O, Virtuoso MJ, Salgado JM, Colaço I, Dumitrescu A, Lengher C, Mosteoru S, Meshkov A, Ershova A, Rozkova T, Korneva V, Yu KT, Zafiraki V, Voevoda M, Gurevich V, Duplyakov D, Ragino Y, Safarova M, Shaposhnik I, Alkaf F, Khudari A, Rwaili N, Al-Allaf F, Alghamdi M, Batais MA, Almigbal TH, Kinsara A, AlQudaimi AH, Awan Z, Elamin OA, Altaradi H, Rajkovic N, Popovic L, Singh S, Stosic L, Rasulic I, Lalic NM, Lam C, Le TJ, Siang EL, Dissanayake S, I-Shing JT, Shyong TE, Jin TC, Balinth K, Buganova I, Fabryova L, Kadurova M, Klabnik A, Kozárová M, Sirotiakova J, Battelino T, Kovac J, Mlinaric M, Sustar U, Podkrajsek KT, Fras Z, Jug B, Cevc M, Pilcher GJ, Blom D, Wolmarans K, Brice B, Muñiz-Grijalvo O, Díaz-Díaz JL, de Isla LP, Fuentes F, Badimon L, Martin F, Lux A, Chang NT, Ganokroj P, Akbulut M, Alici G, Bayram F, Can LH, Celik A, Ceyhan C, Coskun FY, Demir M, Demircan S, Dogan V, Durakoglugil E, Dural IE, Gedikli O, Hacioglu A, Ildizli M, Kilic S, Kirilmaz B, Kutlu M, Oguz A, Ozdogan O, Onrat E, Ozer S, Sabuncu T, Sahin T, Sivri F, Sonmez A, Temizhan A, Topcu S, Tuncez A, Vural M, Yenercag M, Yesilbursa D, Yigit Z, Yildirim AB, Yildirir A, Yilmaz MB, Atallah B, Traina M, Sabbour H, Hay DA, Luqman N, Elfatih A, Abdulrasheed A, Kwok S, Oca ND, Reyes X, Alieva RB, Kurbanov RD, Hoshimov SU, Nizamov UI, Ziyaeva AV, Abdullaeva GJ, Do DL, Nguyen MN, Kim NT, Le TT, Le HA, Tokgozoglu L, Catapano AL, Ray KK. Global perspective of familial hypercholesterolaemia: a cross-sectional study from the EAS Familial Hypercholesterolaemia Studies Collaboration (FHSC). Lancet 2021; 398:1713-1725. [PMID: 34506743 DOI: 10.1016/s0140-6736(21)01122-3] [Citation(s) in RCA: 117] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/06/2021] [Accepted: 05/11/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND The European Atherosclerosis Society Familial Hypercholesterolaemia Studies Collaboration (FHSC) global registry provides a platform for the global surveillance of familial hypercholesterolaemia through harmonisation and pooling of multinational data. In this study, we aimed to characterise the adult population with heterozygous familial hypercholesterolaemia and described how it is detected and managed globally. METHODS Using FHSC global registry data, we did a cross-sectional assessment of adults (aged 18 years or older) with a clinical or genetic diagnosis of probable or definite heterozygous familial hypercholesterolaemia at the time they were entered into the registries. Data were assessed overall and by WHO regions, sex, and index versus non-index cases. FINDINGS Of the 61 612 individuals in the registry, 42 167 adults (21 999 [53·6%] women) from 56 countries were included in the study. Of these, 31 798 (75·4%) were diagnosed with the Dutch Lipid Clinic Network criteria, and 35 490 (84·2%) were from the WHO region of Europe. Median age of participants at entry in the registry was 46·2 years (IQR 34·3-58·0); median age at diagnosis of familial hypercholesterolaemia was 44·4 years (32·5-56·5), with 40·2% of participants younger than 40 years when diagnosed. Prevalence of cardiovascular risk factors increased progressively with age and varied by WHO region. Prevalence of coronary disease was 17·4% (2·1% for stroke and 5·2% for peripheral artery disease), increasing with concentrations of untreated LDL cholesterol, and was about two times lower in women than in men. Among patients receiving lipid-lowering medications, 16 803 (81·1%) were receiving statins and 3691 (21·2%) were on combination therapy, with greater use of more potent lipid-lowering medication in men than in women. Median LDL cholesterol was 5·43 mmol/L (IQR 4·32-6·72) among patients not taking lipid-lowering medications and 4·23 mmol/L (3·20-5·66) among those taking them. Among patients taking lipid-lowering medications, 2·7% had LDL cholesterol lower than 1·8 mmol/L; the use of combination therapy, particularly with three drugs and with proprotein convertase subtilisin-kexin type 9 inhibitors, was associated with a higher proportion and greater odds of having LDL cholesterol lower than 1·8 mmol/L. Compared with index cases, patients who were non-index cases were younger, with lower LDL cholesterol and lower prevalence of cardiovascular risk factors and cardiovascular diseases (all p<0·001). INTERPRETATION Familial hypercholesterolaemia is diagnosed late. Guideline-recommended LDL cholesterol concentrations are infrequently achieved with single-drug therapy. Cardiovascular risk factors and presence of coronary disease were lower among non-index cases, who were diagnosed earlier. Earlier detection and greater use of combination therapies are required to reduce the global burden of familial hypercholesterolaemia. FUNDING Pfizer, Amgen, Merck Sharp & Dohme, Sanofi-Aventis, Daiichi Sankyo, and Regeneron.
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Baharuddin H, Lim SL, Ch’ng SS, Mohd Zain M, Rosman A, Mohd Yusoof H, Authar Singh AKB, Tay VY. AB0891-HPR PATIENTS WITH RHEUMATIC DISEASE WHO WERE ‘FEELING STRESSED’ DURING THE SECOND WAVE COVID19 INFECTION. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:COVID-19 pandemic has been devastating not only medically but also socially and economically. Selangor, an urbanised state in Malaysia, has been severely affected by COVID19. There is concern that patients with rheumatic diseases (RD) may have higher risk of infection, with increased mortality1.Objectives:To investigate patients’ characteristics which are associated with ‘feeling stressed’ among patients with RD during the second wave of COVID19 infection in Selangor.Methods:This is a cross-sectional study conducted over 3 weeks during the second wave of COVID19 infection in Malaysia. Patients with RD, scheduled for rheumatology clinic appointment in a rheumatology referral centre were invited to participate in this study.Personal and clinical data were collected by phone interview and from patients’ medical records respectively. Patients were asked to grade their disease activity by giving a score from 0 (not active) to 10 (active). All patients were asked ‘are you feeling stressed?’ and the answer was recorded as yes or no. Reasons explored for a yes answer, included financial, social disruption, physical illness and future uncertainties. Categorical and continuous data were analysed using chi-squared test and student t-test, respectively. A p-value of <0.05 is considered statistically significant.Results:Three hundred and sixty-one patients with various RD participated in this study. The mean age of these was 48.2 years (range between 16-80 years). More than half (54.3%) were Malay and other ethnicities were Chinese (25.5%), Indian (18.2%) and others (2%). A quarter of patients (24.7%) were not working (unemployed, retired and students) and a third of patients (32.1%) had unpaid work (mainly housewife). The other patients’ characteristics are shown in Table 1.Table 1.Characteristics of patients who were ‘feeling stressed’ and not ‘feeling stressed’ during the second wave of COVID19 infection.Patients’ characteristicsNo of patientsFeeling stressed (n=83), no of patients (%)Not feeling stressed (n=278), no of patients (%)p-valueAge<6027272 (26.5)200 (73.5)0.006≥608911 (12.4)78 (87.6)GenderMale6116 (26.2)45 (73.8)0.510Female30067 (22.3)233 (77.7)EthnicityMalay19638 (19.4)158 (80.6)0.076Others16545 (27.3)120 (72.7)Relationship statusMarried27559 (21.5)216 (78.5)0.215Unmarried8624 (27.9)62 (72.1)Education levelUp to secondary23348 (20.6)185 (79.4)0.145Tertiary12835 (27.3)93 (72.7)Work statusNo work8913 (14.6)76 (85.4)0.002Unpaid work11620 (17.2)96 (82.8)Paid work15650 (32.1)106 (67.9)Rheumatic diseaseSLE12530 (23.8)96 (76.2)0.259RA15030 19.4)125 (80,6)Others8023 (28.8)57 (71.3)Perceived disease activity3.14 (2.4)1.87 (2.1)<0.001Use biologicsYes257 (28)18 (72)0.537No33676 (22.6)260 (77.4)Eighty-three (23%) admitted to ‘feeling stressed’ and the stressors identified were physical illness in 34 (40.9%), social disruption in 23 (27.7%), financial problems in 23 (27.7%) and future uncertainties in 19 (22.9%). Patients’ characteristics that were significantly different between patients who were ‘feeling stressed’ and not ‘feeling stressed’ were age, employment status and perceived disease activity (Table 1).Conclusion:The COVID19 pandemic has caused mental distress in a significant number of RD patients and associations were found with older age, having paid work and perceived disease activity. Issues that may influence patients’ responses, including access to rheumatology care, medication and fear of getting infection were not explored in this study.References:[1]Williamson EJ, et al. Factors associated with COVID-19-related death using OpenSAFELY. Nature, 2020; 584: 430–436.Disclosure of Interests:None declared
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Nurul-Aain AF, Ch’ng SS, Baharuddin H, Mohd Zain M, Lau IS, Mohd Yusoof H, Ahmad A, Rosman A, Siti-Aisyah AA, Padyukov L, Alfredsson L, Klareskog L, Rönnelid J, Too CL. POS0355 ASSOCIATIONS BETWEEN HLA-DRB1 SHARED EPITOPES ALLELES AND ANTI-RA33 ANTIBODIES IN DIFFERENT SUBSETS OF RHEUMATOID ARTHRITIS IN MALAYSIAN POPULATION. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:The mechanisms affecting anti-RA33 antibody’s involvement in RA pathogenesis is still unclear. Refining our understanding of anti-RA33’s role in RA in relation to known RA-associated genes and serological elements is needed.Objectives:We investigated the relationship between RA-associated HLA-DRB1 epitope (SE) allele and presence of anti-RA33 antibodies in different serological subsets of rheumatoid arthritis in a Malaysian population.Methods:Serum samples from 550 RA cases comprising seronegative (negative for anti-CCP2, IgG and IgM, n=250), seropositive (triple-autoantibody positive, n=150), singular anti-CCP2 positive (n=100), and double RF positive RA (n=50) were chosen from the Malaysian Epidemiological Investigations of RA (MyEIRA) case-control study. Three hundred MyEIRA population controls were used for comparison. All serum samples were assayed using a commercial anti-RA33 ELISA kit. All genetic samples were genotyped for four-digit HLA-DRB1 alleles using the PCR-SSO method on Luminex platform.Results:The proportions of anti-RA33 positive was 20.9% in all RA cases (i.e. 34% in RF only positive RA; 25% in seropositive RA; 18% in seronegative RA and 18% in anti-CCP2 only positive RA). The HLA-DRB1 shared epitope alleles were significantly associated with anti-RA33 positive in the seropositive RA subgroup (OR=6.9, 95% CI 1.4-34.8; p=0.02). We observed significant association between anti-RA33 negative and HLA-DRB1 SE alleles among the seropositive RA patients (OR=4.5, 95% CI 2.8-7.2; p<0.001) and among CCP only positive RA (OR=4.4; 95% CI 2.6-7.4; p<0.01). No association was observed between anti-RA33 status and HLA-DRB1 SE alleles in seronegative RA and RF only positive RA.Conclusion:The HLA-DRB1 SE alleles increased the risk of seropositive and CCP only positive RA independent of anti-RA33 positivity.References:[1]Boeters, Debbie M et al. “The 2010 ACR/EULAR criteria are not sufficiently accurate in the early identification of autoantibody-negative rheumatoid arthritis: Results from the Leiden-EAC and ESPOIR cohorts.” Seminars in arthritis and rheumatism vol. 47,2 (2017): 170-174.[2]de Brito Rocha, Sara et al. “Clinical and pathophysiologic relevance of autoantibodies in rheumatoid arthritis.” Advances in rheumatology (London, England) vol. 59,1 2. 17 Jan. 2019.Acknowledgements:The authors would like to thank the Director General of Health, Ministry of Health Malaysia for supporting this study. The authors are also indebted to participants for their kind participation. This study was financially supported by the Ministry of Health, Malaysia (JPP-IMR 08-012).Disclosure of Interests:None declared
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Mafauzy M, Khoo EM, Hussein Z, Yusoff Azmi NS, Siah GJ, Mustapha FI, Adam NL, Rosman A, Lee BT, Foo SH, Thiagarajan N, Mohammad NM, Moses K, Loke H. Management of prediabetes in Malaysian population: An experts' opinion. Med J Malaysia 2020; 75:419-427. [PMID: 32724007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Prediabetes, typically defined as blood glucose levels above normal but below diabetes thresholds, denotes a risk state that confers a high chance of developing diabetes. Asians, particularly the Southeast Asian population, may have a higher genetic predisposition to diabetes and increased exposure to environmental and social risk factors. Malaysia alone was home to 3.4 million people with diabetes in 2017; the figure is estimated to reach 6.1 million by 2045. Developing strategies for early interventions to treat prediabetes and preventing the development of overt diabetes and subsequent cardiovascular and microvascular complications are therefore important. METHODS An expert panel comprising regional experts was convened in Kuala Lumpur, for a one-day meeting, to develop a document on prediabetes management in Malaysia. The expert panel comprised renowned subject-matter experts and specialists in diabetes and endocrinology, primary-care physicians, as well as academicians with relevant expertise. RESULTS Fifteen key clinical statements were proposed. The expert panel reached agreements on several important issues related to the management of prediabetes providing recommendations on the screening, diagnosis, lifestyle and pharmacological management of prediabetes. The expert panel also proposed changes in forthcoming clinical practice guidelines and suggested that the government should advocate early screening, detection, and intensive management of prediabetes. CONCLUSION This document provides a comprehensive approach to the management of prediabetes in Malaysia in their daily activities and offer help in improving government policies and the decision-making process.
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Affiliation(s)
- M Mafauzy
- Universiti Sains Malaysia, School of Medical Sciences, Medicine Department, Kubang Kerian, Kelantan, Malaysia.
| | - E M Khoo
- University of Malaya, Faculty of Medicine, Department of Primary Care Medicine, Kuala Lumpur, Malaysia
| | - Z Hussein
- Hospital Putrajaya, Department of Medicine, Endocrine Unit, Putrajaya, Malaysia
| | - N S Yusoff Azmi
- Hospital Sultanah Bahiyah, Department of Medicine, Endocrine Unit, Alor Setar, Kedah, Malaysia
| | - G J Siah
- National Heart Institute, Kuala Lumpur, Malaysia
| | - F I Mustapha
- Ministry of Health, Disease Control Division (Non-Communicable Diseases Sector), Putrajaya, Malaysia
| | - N L Adam
- Hospital Tuan Ja'afar, Department of Medicine, Endocrine Unit, Negeri Sembilan Darul Khusus, Malaysia
| | - A Rosman
- National Heart Institute, Kuala Lumpur, Malaysia
| | - B T Lee
- Medicare Clinic, Mid Valley Megamall, Mid Valley City, Kuala Lumpur, Malaysia
| | - S H Foo
- Selayang Hospital, Selangor, Malaysia
| | - N Thiagarajan
- Klinik Kesihatan Kuala Lumpur, Kuala Lumpur, Malaysia
| | - N M Mohammad
- Klinik Kesihatan Kelana Jaya, Petaling Jaya, Selangor, Malaysia
| | - K Moses
- Merck Sdn Bhd, Medical Department, Bandar Sunway, Selangor, Malaysia
| | - H Loke
- Merck Sdn Bhd, Medical Department, Bandar Sunway, Selangor, Malaysia
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Mustapha MH, Baharuddin H, Zainudin N, Ch’ng SS, Mohd Yusoof H, Lau IS, Mohd Zain M, Rosman A. AB0932 FACTORS IN ACHIEVING TARGET SERUM URIC ACID LEVELS IN OUTPATIENT GOUT MANAGEMENT IN A MALAYSIAN TERTIARY RHEUMATOLOGY CENTRE. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Gout is one of the most common inflammatory arthropathies. A target serum uric acid of less than 300µmol/l is recommended when tophi are present, and less than 360µmol/l for non-tophaceous gout. Urate-lowering therapy (ULT) should be titrated until the target is achieved and long-term maintenance of the target concentration is recommended. Although ULT has been proven to reduce the uric acid level, less than half of treated patients achieved the target serum uric acid (sUA) in real-world clinical practice.Objectives:To assess the mean treat-to-target achievement in outpatient management of gout by the tertiary rheumatology centre and to identify factors influencing the success rate.Methods:Retrospective cross-sectional study of all patients with gout attending out-patient clinics in a rheumatology referral centre from 1stJanuary 2018 until 31stDecember 2018. Electronic medical records were reviewed. The successful target achievement is defined as mean of all available sUA in 2018 which is ≤360 and ≤300µmol/l for non-tophaceous and tophaceous gout respectively. Chronic kidney disease (CKD) is defined as glomerular filtration rate of less than 60ml/min.Results:There were 251 patients analysed with mean age of 56.3±13.8 years and disease duration of 10.5±9.2 years. Majority were males (215, 85.7%) and 133 (53%) patients had tophaceous gout. The rate of success achieving the target SUA level of ≤360 and ≤300µmol/l were 33.9% (40) and 15.8% (21) in non-tophaceous and tophaceous gout respectively. However, in patients who are compliant, the target sUA achieved is 52.4% (33) and 31.7% (19) in non-tophaceous and tophaceous gout respectively. Characteristics of patients who achieved the targeted sUA were patients of more than 50 years old (48, 78.7%), without family history of gout (29, 65.9%), were prescribed colchicine prophylaxis upon initiating ULT (46, 76.7%), with absence of joint erosions (34, 73.9%) and those with normal creatinine clearance (40, 65.5%). There were 120 (48.4%) patients who were compliant to ULT. In 42 compliant patients who achieved target sUA, the mean allopurinol dose is 289.66mg±101.2 and 369.23mg±175 in non-tophaceous and tophaceous gout respectively. Sub-analysis in 31 compliant CKD patients, revealed no difference in allopurinol dose between those who achieved versus non-achieved target sUA (mean 243mg versus 263mg respectively). However, we noted that 11 (61%) CKD patients with tophi did not achieved target sUA at dose less than 300mg allopurinol. Lower achievement of target sUA was significantly associated with presence of tophi (p=0.001), poor compliance (p= 0.000) and presence of more than one comorbidity (p=0.041).Conclusion:There are several challenges in achieving target uric acid level contributed by both patient and clinician factors such as compliance, presence of comorbidity and ULT dose. Our study suggests that higher dosage of allopurinol is required in patients with tophaceous gout, with or without renal impairment. However, the limitation of this study is, the small number of subjects which therefore needsfurtherinvestigation.References:[1]Roddy, E., Packham, J., Obrenovic, K., Rivett, A., & Ledingham, J. M. (2018). Management of gout by UK rheumatologists: a British Society for Rheumatology national audit. Rheumatology, 57(5), 826–830.[2]Katayama A, Yokokawa H, Fukuda H, et al. Achievement of Target Serum Uric Acid Levels and Factors Associated with Therapeutic Failure among Japanese Men Treated for Hyperuricemia/Gout. Intern Med. 2019;58(9):1225–1231.Disclosure of Interests:Mariam Hamid Mustapha: None declared, Hazlyna Baharuddin Speakers bureau: Sanofi, J&J, Norliza Zainudin: None declared, Shereen Suyin Ch’ng Speakers bureau: Novartis, Pfizer, GSK, Habibah Mohd Yusoof: None declared, Ing Soo Lau: None declared, Mollyza Mohd Zain: None declared, Azmillah Rosman: None declared
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Wee R, Tey YS, Salleh FM, Raji NA, Bachok N, Rosman A. Review of factors that affect survival during resuscitation, a retrospective study at Institut Jantung Negara, Malaysia. Resuscitation 2019. [DOI: 10.1016/j.resuscitation.2019.06.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Mohd Kasim N, Al-Khateeb A, Chua Y, Ismail S, Sanusi A, Rosman A, Nawawi H. A case of homozygous familial hypercholestrolemia in pregnancy. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lim C, Goay S, Tee T, Lim J, Kasim S, Rosman A. Atrial Fibrillation and Stroke Prevention: How Are We Doing in a Developing Country? Int J Cardiol 2017. [DOI: 10.1016/j.ijcard.2017.09.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abdul-Razak S, Rahmat R, Mohd Kasim A, Rahman TA, Muid S, Nasir NM, Ibrahim Z, Kasim S, Ismail Z, Abdul Ghani R, Sanusi AR, Rosman A, Nawawi H. Diagnostic performance of various familial hypercholesterolaemia diagnostic criteria compared to Dutch lipid clinic criteria in an Asian population. BMC Cardiovasc Disord 2017; 17:264. [PMID: 29037163 PMCID: PMC5644062 DOI: 10.1186/s12872-017-0694-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 10/06/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Familial hypercholesterolaemia (FH) is a genetic disorder with a high risk of developing premature coronary artery disease that should be diagnosed as early as possible. Several clinical diagnostic criteria for FH are available, with the Dutch Lipid Clinic Criteria (DLCC) being widely used. Information regarding diagnostic performances of the other criteria against the DLCC is scarce. We aimed to examine the diagnostic performance of the Simon-Broom (SB) Register criteria, the US Make Early Diagnosis to Prevent Early Deaths (US MEDPED) and the Japanese FH Management Criteria (JFHMC) compared to the DLCC. METHODS Seven hundered fifty five individuals from specialist clinics and community health screenings with LDL-c level ≥ 4.0 mmol/L were selected and diagnosed as FH using the DLCC, the SB Register criteria, the US MEDPED and the JFHMC. The sensitivity, specificity, efficiency, positive and negative predictive values of individuals screened with the SB register criteria, US MEDPED and JFHMC were assessed against the DLCC. RESULTS We found the SB register criteria identified more individuals with FH compared to the US MEDPED and the JFHMC (212 vs. 105 vs. 195; p < 0.001) when assessed against the DLCC. The SB Register criteria, the US MEDPED and the JFHMC had low sensitivity (51.1% vs. 25.3% vs. 47.0% respectively). The SB Register criteria showed better diagnostic performance than the other criteria with 98.8% specificity, 28.6% efficiency value, 98.1% and 62.3% for positive and negative predictive values respectively. CONCLUSION The SB Register criteria appears to be more useful in identifying positive cases leading to genetic testing compared to the JFHMC and US MEDPED in this Asian population. However, further research looking into a suitable diagnosis criterion with high likelihood of positive genetic findings is required in the Asian population including in Malaysia.
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Affiliation(s)
- Suraya Abdul-Razak
- Institute for Pathology, Laboratory and Forensic Medicine (I-PPerForM), University Teknologi MARA, 47000 Sungai Buloh, Selangor Malaysia
- Primary Care Medicine Discipline, Faculty of Medicine, University Teknologi MARA, 68100 Selayang, Selangor Malaysia
| | - Radzi Rahmat
- Pathology Discipline, Faculty of Medicine, University Teknologi MARA, 47000 Sungai Buloh, Selangor Malaysia
| | - Alicezah Mohd Kasim
- Institute for Pathology, Laboratory and Forensic Medicine (I-PPerForM), University Teknologi MARA, 47000 Sungai Buloh, Selangor Malaysia
- Pathology Discipline, Faculty of Medicine, University Teknologi MARA, 47000 Sungai Buloh, Selangor Malaysia
| | - Thuhairah Abdul Rahman
- Institute for Pathology, Laboratory and Forensic Medicine (I-PPerForM), University Teknologi MARA, 47000 Sungai Buloh, Selangor Malaysia
- Pathology Discipline, Faculty of Medicine, University Teknologi MARA, 47000 Sungai Buloh, Selangor Malaysia
| | - Suhaila Muid
- Institute for Pathology, Laboratory and Forensic Medicine (I-PPerForM), University Teknologi MARA, 47000 Sungai Buloh, Selangor Malaysia
- Pathology Discipline, Faculty of Medicine, University Teknologi MARA, 47000 Sungai Buloh, Selangor Malaysia
| | - Nadzimah Mohd Nasir
- Pathology Discipline, Faculty of Medicine, University Teknologi MARA, 47000 Sungai Buloh, Selangor Malaysia
| | - Zubin Ibrahim
- Institute for Pathology, Laboratory and Forensic Medicine (I-PPerForM), University Teknologi MARA, 47000 Sungai Buloh, Selangor Malaysia
- Cardiology Unit, Faculty of Medicine, University Teknologi MARA, 47000 Sungai Buloh, Selangor Malaysia
| | - Sazzli Kasim
- Institute for Pathology, Laboratory and Forensic Medicine (I-PPerForM), University Teknologi MARA, 47000 Sungai Buloh, Selangor Malaysia
- Cardiology Unit, Faculty of Medicine, University Teknologi MARA, 47000 Sungai Buloh, Selangor Malaysia
| | - Zaliha Ismail
- Institute for Pathology, Laboratory and Forensic Medicine (I-PPerForM), University Teknologi MARA, 47000 Sungai Buloh, Selangor Malaysia
- Population Health and Preventive Medicine Discipline, Faculty of Medicine, University Teknologi MARA, 47000 Sungai Buloh, Selangor Malaysia
| | - Rohana Abdul Ghani
- Institute for Pathology, Laboratory and Forensic Medicine (I-PPerForM), University Teknologi MARA, 47000 Sungai Buloh, Selangor Malaysia
- Endocrinology Disciplines, Faculty of Medicine, Universiti Teknologi MARA (UiTM), 47000 Sungai Buloh, Selangor Malaysia
| | - Abdul Rais Sanusi
- National Heart Institute, No 145 Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia
| | - Azhari Rosman
- National Heart Institute, No 145 Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia
| | - Hapizah Nawawi
- Institute for Pathology, Laboratory and Forensic Medicine (I-PPerForM), University Teknologi MARA, 47000 Sungai Buloh, Selangor Malaysia
- Pathology Discipline, Faculty of Medicine, University Teknologi MARA, 47000 Sungai Buloh, Selangor Malaysia
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Vlemmix F, Rosman A, Kok M, van der Post J. Re: An observational study of the success and complications of 2546 external cephalic versions in low-risk pregnancies performed by trained midwives. BJOG 2016; 123:477-8. [PMID: 26810682 DOI: 10.1111/1471-0528.13484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2015] [Indexed: 11/30/2022]
Affiliation(s)
- F Vlemmix
- Academic Medical Centre, Amsterdam, The Netherlands
| | - A Rosman
- Academic Medical Centre, Amsterdam, The Netherlands
| | - M Kok
- Academic Medical Centre, Amsterdam, The Netherlands
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Chen CH, Chen MC, Gibbs H, Kwon SU, Lo S, On YK, Rosman A, Suwanwela NC, Tan RS, Tirador LS, Zirlik A. Antithrombotic treatment for stroke prevention in atrial fibrillation: The Asian agenda. Int J Cardiol 2015; 191:244-53. [DOI: 10.1016/j.ijcard.2015.03.369] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 03/25/2015] [Indexed: 10/23/2022]
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Montoro Alvarez M, Yew Chong O, Janta I, Serrano B, Mata C, Martinez L, Martinez-Barrio J, Hinojosa M, Bello N, Ovalles J, Nieto J, Valor L, Lopez-Longo F, Monteagudo I, Gonzalez C, Garrido J, Rosman A, Ing Soo L, Naredo E, Carreño L. SAT0198 Relation of Doppler Ultrasound Synovitis versus Clinical Synovitis with Changes in Native Complement Component Levels in Rheumatoid Arthritis Patients Treated with Biologic Disease-Modifying Antirheumatic Drugs:. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hilmi BA, Asmahan MI, Rosman A. Use of newly available febuxostat in a case of chronic tophaceous gout contraindicated to allopurinol and probenecid. Med J Malaysia 2012; 67:125-126. [PMID: 22582566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Urate lowering therapy in this country has mainly been achieved by the use of allopurinol and probenecid. A new xanthine oxidase inhibitor called febuxostat has been approved in 2009 for treatment of hyperuricaemia in gout. In this report, we describe the management of a patient with chronic tophaceous gout using febuxostat. The reduction in serum uric acid to target levels was rapid, and the tophi size had also reduced significantly while on therapy. There was no unwanted side effect observed during the therapy. Therefore, febuxostat would be a useful alternative drug in the treatment of hyperuricaemia in gout patients who have contraindications to allopurinol and probenecid.
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Affiliation(s)
- B A Hilmi
- International Islamic University Malaysia, Internal Medicine, Jalan Hospital, Kuantan, Pahang 25100 Malaysia.
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Yean Yip Fong A, Wan Ahmad WA, Rosman A, Sim KH. Brewing a Perfect Blend. Circ J 2012; 76:1807-10. [DOI: 10.1253/circj.cj-66-0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Idris N, Aznal SS, Chin SP, Ahmad WAW, Rosman A, Jeyaindran S, Ismail O, Zambahari R, Sim KH. Acute coronary syndrome in women of reproductive age. Int J Womens Health 2011; 3:375-80. [PMID: 22140324 PMCID: PMC3225466 DOI: 10.2147/ijwh.s15825] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background There is scarce or no data on prevalence and presentation of acute coronary syndrome (ACS) among women of reproductive age. Furthermore, whether women of reproductive age presenting with ACS have the same risk factors as men and older women is not known. Objective To analyze factors associated with ACS in women of reproductive age in comparison with older women and men of a similar age group. Methodology A total of 9702 cases of acute coronary syndrome over a 3-year period ( 2006–2008) from the National Cardiovascular Disease database were analyzed, with focus on women of reproductive age (20–<40 years), looking into association with ethnicity, comorbid illness, and the ACS stratum. Comparison with older women (40–<60 years; Control 1) and men of similar age group (Control 2) was made and analyzed using Fisher’s exact test and chi-square test when necessary. Results From a total of 9702 cases, 2344 (24.2%) were women. Of these, 45 (1.9%) were women between 20 and <40 years, which is significantly lower than the two controls (older women 30.8%, and men of same age 6.2%, respectively; P < 0.0001). The distribution of ethnicity shows a similar pattern between the study group and the controls, but patients of Indian ethnicity were over-represented when compared with the Malaysian demographics of general population (31.3% versus 7.1%; P < 0.0001). ACS in women of reproductive age was associated with diabetes mellitus in 37.8%, hypertension in 40.0%, and dyslipidemia in 24.4% of cases, similar to men of the same age but significantly lower than the older women (P < 0.0001). Smoking is not a major risk factor in the study group, where only 6.7% ever smoked, similar to older women (6.8%, P = 1.000) and significantly much less compared with men of the same age (84.1%; P < 0.0001). Regarding the ACS stratum, a significantly higher percentage of women in the study group had ST-segment elevation myocardial infarction compared with older women (P = 0.0085) but less than that of men of similar age (P = 0.0187). Conclusion ACS is rare in women of reproductive age. Diabetes, hypertension, and Indian ethnicity were identified as important contributors.
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Ahmad WAW, Zambahari R, Ismail O, Sinnadurai J, Rosman A, Piaw CS, Abidin IZ, Kui-Hian S. Malaysian National Cardiovascular Disease Database (NCVD) – Acute Coronary Syndrome (ACS) registry: How are we different? ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.cvdpc.2011.04.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Sheu WHH, Rosman A, Mithal A, Chung N, Lim YT, Deerochanawong C, Soewondo P, Lee MK, Yoon KH, Schnell O. Addressing the burden of type 2 diabetes and cardiovascular disease through the management of postprandial hyperglycaemia: an Asian-Pacific perspective and expert recommendations. Diabetes Res Clin Pract 2011; 92:312-21. [PMID: 21605924 DOI: 10.1016/j.diabres.2011.04.019] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Revised: 03/29/2011] [Accepted: 04/25/2011] [Indexed: 11/16/2022]
Abstract
The world is facing an epidemic of cardiovascular disease (CVD) and type 2 diabetes, with populations in low- to middle-income countries, including many in the Asia Pacific (AP) region, being disproportionately affected. Emerging data identify postprandial hyperglycaemia (PPHG) as an important predictor of CVD, and several professional bodies, including the International Diabetes Federation, have issued guidelines on the management of PPHG in type 2 diabetes. Guidance on how international recommendations could be implemented in Asian populations is currently lacking. Therefore, a panel of experts from the AP region convened to consider the current status of PPHG and CVD in the region, and to develop recommendations for clinical practice. The group concluded that improved awareness of the impact of PPHG on CVD risk, among clinicians and the general public, and more widespread use of routine screening for PPHG, using oral glucose tolerance testing in those without recognised diabetes, are required. Additionally, frequent meal-based testing and effective PPHG management are essential to the management of IGT and type 2 diabetes.
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Affiliation(s)
- Wayne H-H Sheu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
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Muhlfelder TW, Teodorescu V, Rand J, Rosman A, Niemetz J. Human atheromatous plaque extracts induce tissue factor activity (TFa) in monocytes and also express constitutive TFa. Thromb Haemost 1999; 81:146-50. [PMID: 10348707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Tissue factor activity (TFa) is a major activator of the coagulation cascade and may play a role in atheroma-induced thrombosis. Monocyte-macrophages (MO-MF) generate considerable quantities of TFa when stimulated by a variety of inducers. To test the hypothesis that MO could be induced by atheromatous plaque to generate TFa, plaque extracts obtained from patients with obstructive atheromatous disease were used. These extracts were also assayed for constitutive TFa. The constitutive activity was variable from extract to extract but could be very high, up to 250 U TFa. The TFa induced in MO could be also very high, up to 200 U (i.e. 1/5 of the TFa of full strength rabbit brain thromboplastin). These findings point to a major role for MO-MF TFa in the induction or thrombosis by atheromatous plaque.
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Affiliation(s)
- T W Muhlfelder
- Bronx VA Medical Center and The Mount Sinai School of Medicine, New York 10468, USA
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Cavalli-Sforza LT, Rosman A, de Boer AS, Darnton-Hill I. Nutritional aspects of changes in disease patterns in the Western Pacific region. Bull World Health Organ 1996; 74:307-18. [PMID: 8789929 PMCID: PMC2486917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
One impact of socioeconomic progress on populations has been to reduce the number of cases due to diseases of undernutrition and microbial contamination of food, which affected mostly infants and young children, and to increase those due to diseases of excessive food consumption, which are affecting adults and a growing number of children. This article reviews the main dietary factors which have an influence on cardiovascular disease and cancer, and discusses the link between economic development and increased rates of chronic diseases. There is evidence that the noncommunicable diseases and their risk factors have risen rapidly in countries of the WHO Western Pacific Region. Data from 29 countries and areas in the region indicate that 70% of them show lifestyle diseases in three or more of the top five causes of death. While public health measures have been implemented by some countries to prevent and control nutrition-related chronic diseases, further action is needed.
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Affiliation(s)
- L T Cavalli-Sforza
- WHO Regional Centre for Research and Training in Tropical Diseases and Nutrition, Institute for Medical Research, Kuala Lumpur, Malaysia
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Rosman A, Atsumi T, Khamashta MA, Ames PR, Hughes GR. Development of systemic lupus erythematosus after chemotherapy and radiotherapy for malignant thymoma. Br J Rheumatol 1995; 34:1175-6. [PMID: 8608362 DOI: 10.1093/rheumatology/34.12.1175] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Autoimmune conditions such as systemic lupus erythematosus (SLE) are sometimes associated with thymoma. Recently we drew attention to the development of SLE some months or even years following surgical thymectomy or thymomectomy. We now describe the first patient who developed SLE after chemotherapy and radiotherapy alone for malignant thymoma. A 38-yr-old female presented with an anterior mediastinal mass, which was found to be a malignant thymoma. Chemotherapy and radiotherapy were performed with complete resolution of the tumour. She remained stable for 4 yr, but then developed polyarthritis, lymphopenia, high titre anti-dsDNA antibody and antinuclear antibody. The diagnosis of SLE was established 44 months after malignant thymoma was treated. We believe that cases as this highlight the relationship between the thymus and the development of SLE.
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Affiliation(s)
- A Rosman
- Lupus Research Unit, Rayne Institute, St Thomas' Hospital, London
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Ng TK, Tee ES, Rosman A. Rural communities in nutritional transition: emergence of obesity, hypertension and hypercholesterolemia as public health problems in three kampungs in Bagan Datoh, Perak. Malays J Nutr 1995; 1:129-139. [PMID: 22692058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This paper highlights the marked presence of nutritional disorders in a sample (190 males, 237 females, aged 18-80 years) obtained from the adult population in three kampungs i.e. Pasang Api, Sungai Nipah Baroh and Sungai Balai Darat, in the Mukim of Bagan Datoh, Perak in 1992. All subjects (except pregnant females) were measured for blood pressure, weight, height, waist circumference, and hip circumference from which the body mass index (BMI) and waist-hip ratios (WHR) were calculated. A random blood sample was obtained by finger-prick from each subject and analysed for total cholesterol (TC) and glucose, using the Reflotron compact analyser. Elevated means for BMI and WHR indicated that obesity (BMI ≥30.0) was a serious public health problem in these three kampungs, affecting about 5% of males and 14% of females. Another 24% of males and 46% of females had an overweight problem (BMI 25.0-29.9), indicating that on the average, about half the adult population in these kampungs were either overweight or obese. This contrasted with the situation a decade ago in similar-type kampungs in the Peninsula where underweight was the major nutritional disorder in adults, especially males. Overall, there was a shift of an underweight problem to one of overweight, as exemplified by increments of 2.0 to 3.0 BMI units in the adult population, with the phenomenon being more marked in the females. Hypertension (21%) and hyperglycaemia (6.5%) affected the males and females approximately equally. Female adults had higher mean plasma TC compared to males (204 versus 199 mg/dl); these means were some 20 mg/dl (0.52 mmol/L) higher than the corresponding means for adults in similar rural communitites in the early eighties, and approximate the corresponding means for present-day urban adults. The above findings serve to emphasise the nutritional transition undergoing in the rural communities in the Peninsula, viz, the marked emergence in these rural communities of nutritional disorders normally associated with affluent populations.
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Affiliation(s)
- T K Ng
- Division of Human Nutrition, Institute for Medical Research, 50588 Kuala Lumpur
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Abstract
February 1978
Original manuscript received in Society of Petroleum Engineers office Jan. 14, 1977. Paper accepted for publication Aug. 15, 1977. Revised manuscript received Sept. 21, 1977. Paper (SPE 6387) was presented at the SPE-AIME Permian Basin Oil and Gas Recovery Conference, held in Midland, Tex., March 10-11, 1977.
Abstract
This paper presents experimental phase behavior data on two CO2-reservoir oil systems at reservoir pressures and temperatures. pressures and temperatures. The data includepressure-composition diagrams with bubble points, dew points, and critical points;vapor-liquid equilibrium compositions and related K values;vapor and liquid densities compared with values calculated by the Redlich-Kwong equation of state;vapor and liquid viscosities compared with predictions by the Lobrenz-Bray-Clark correlation; andinterfacial tensions for six vapor-liquid mixtures compared with values calculated by the Weinaug-Katz parachor equation.
These and other published data contribute to development of the generalized correlations needed by reservoir and production engineers for evaluating, designing, and efficiently operating CO2-injection projects. projects
Introduction
This paper presents experimental phase behavior data for two CO2-reservoir oil systems. These data are used in predicting the performance of CO2 floods with a compositional simulator. The simulator calculates vapor and liquid compositions, densities, viscosities, and interfacial tensions to describe the phase behavior as the injected CO2 advances through phase behavior as the injected CO2 advances through the reservoir. The simulator predictions are used to evaluate proposed projects and to design and efficiently operate approved ones.
The data in this paper consist of pressure-composition diagrams with bubble points, pressure-composition diagrams with bubble points, dew points, and critical points; and compositions, densities, viscosities, and interfacial tensions of vapors and liquids in equilibrium in the two-phase region. These data were obtained by the experimental procedure shown in Fig. 1. procedure shown in Fig. 1. We have compared our measured data with values calculated by existing methods: Redlich-Kwong equation for densities, Lohrenz-Bray-Clark correlation for viscosities, and the Weinaug-Katz parachor equation for interfacial tension. We found parachor equation for interfacial tension. We found that these published methods give acceptable agreement in some areas, but in general, they are not satisfactory for engineering purposes. Therefore, we conclude that improved calculation methods are needed for CO2 systems. For the special case of compositional simulator applications, we devised a technique for obtaining satisfactory calculated density, viscosity, and interfacial tension values. This technique is discussed in the section on "Measurements vs Calculations."
We believe that our data, along with previously published information and information yet to come, published information and information yet to come, will advance the development of satisfactory correlations, thus reducing the need for extensive laboratory studies of individual systems.
PRESSURE-COMPOSITION DIAGRAMS PRESSURE-COMPOSITION DIAGRAMS OIL A
Ten mixtures of CO2 and Reservoir Oil A were prepared. These mixtures contained CO2 concentrations prepared. These mixtures contained CO2 concentrations of 0, 20, 40, 55, 60, 65. 70, 75, 80, and 90 mol percent. At 130 degrees F, pressure traverses were made with each mixture. These traverses started in the single-phase region at a pressure above the bubble (or dew) points and lowered the pressure in discrete steps, passing from the single-phase into the two-phase region. At each step, the vapor and liquid volumes were measured. The results are described in Fig. 2A. At 130 degrees F, the critical point of the CO2-Reservoir Oil A system (where intensive properties of the gas and liquid phases were equal) properties of the gas and liquid phases were equal) is 2,570 psia and 60-mol percent CO2.
OIL B
Eight mixtures of CO2 and Reservoir Oil B also were prepared and studied in the visual cell at 255 degrees F. CO2 concentrations for these mixtures were 0, 20, 40, 55, 65, 75, 80, and 85 mol percent. The pressure was varied from 800 to 6,100 psia, and the pressure was varied from 800 to 6,100 psia, and the relative vapor and liquid volumes measured. The results are given in Fig. 2B. The critical point of the CO2-Reservoir Oil B system at 255 degrees F is 4,890 psia and 74-mol percent CO2. psia and 74-mol percent CO2. SPEJ
P. 20
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Romano JA, Rosman A. Patient drug information--pharmacy overview. Drug Inf J 1977; 11:187-9. [PMID: 10307443 DOI: 10.1177/009286157701100403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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