A liver transplant candidate who is CMV serostatus positive and is subjected to calcineurin inhibitor such as tacrolimus post transplant may increase risk of CMV disease, and may promote tumor progression in some. We ...A liver transplant candidate who is CMV serostatus positive and is subjected to calcineurin inhibitor such as tacrolimus post transplant may increase risk of CMV disease, and may promote tumor progression in some. We report a case of a late localized CMV disease manifesting as oesophagitis after 7 years post orthotopic liver transplantation complicated with an aggressive scalp squamous cell carcinoma which recurred despite wide local excision procedure. Hence it is crucial to modulate the patient’s risk factors for tumor progression without compromising the patient to graft rejection.展开更多
Objective: To determine the etiologies of tropical acute febrile illness(TAFI) in West Pahang, Malaysia and to investigate morbidity and mortality factors in relation to TAFI. Methods: A multicenter prospective cohort...Objective: To determine the etiologies of tropical acute febrile illness(TAFI) in West Pahang, Malaysia and to investigate morbidity and mortality factors in relation to TAFI. Methods: A multicenter prospective cohort study was conducted between January and June 2016 in six district hospitals throughout the western part of Pahang State in Peninsular Malaysia. A total of 336 patients answered a standardized questionnaire and blood samples were collected for laboratory confirmation of infectious etiology. Descriptive analysis and logistic regression were performed to identify factors associated with TAFI. Results: A total of 336 patients were included. The patients were mainly Malays(70.2%), males(61.3%), aged(44.6±17.4) years, with more than half(58.9%) presenting with gastrointestinal symptoms. The majority were diagnosed with dengue(35.7%) while malaria(4.5%) was the least frequent. The in-hospital mortality due to TAFI was 9.2%. Patients with meliodosis had five times higher mortality [Adjusted OR: 5.002, 95% CI:(1.233, 20.286)]. Patients with comorbidities such as cardiovascular symptoms(P<0.001) and renal replacement therapy initiation(P<0.001) were significantly associated with in-hospital mortality in all TAFI. Conclusions: The etiology of TAFI in the western Pahang includes dengue, leptospirosis, malaria and melioidosis, which carry the highest risk of in-hospital mortality. The presence of cardiovascular symptoms may be used to assess the disease severity in TAFI, but more studies are needed in the future.展开更多
文摘A liver transplant candidate who is CMV serostatus positive and is subjected to calcineurin inhibitor such as tacrolimus post transplant may increase risk of CMV disease, and may promote tumor progression in some. We report a case of a late localized CMV disease manifesting as oesophagitis after 7 years post orthotopic liver transplantation complicated with an aggressive scalp squamous cell carcinoma which recurred despite wide local excision procedure. Hence it is crucial to modulate the patient’s risk factors for tumor progression without compromising the patient to graft rejection.
文摘Objective: To determine the etiologies of tropical acute febrile illness(TAFI) in West Pahang, Malaysia and to investigate morbidity and mortality factors in relation to TAFI. Methods: A multicenter prospective cohort study was conducted between January and June 2016 in six district hospitals throughout the western part of Pahang State in Peninsular Malaysia. A total of 336 patients answered a standardized questionnaire and blood samples were collected for laboratory confirmation of infectious etiology. Descriptive analysis and logistic regression were performed to identify factors associated with TAFI. Results: A total of 336 patients were included. The patients were mainly Malays(70.2%), males(61.3%), aged(44.6±17.4) years, with more than half(58.9%) presenting with gastrointestinal symptoms. The majority were diagnosed with dengue(35.7%) while malaria(4.5%) was the least frequent. The in-hospital mortality due to TAFI was 9.2%. Patients with meliodosis had five times higher mortality [Adjusted OR: 5.002, 95% CI:(1.233, 20.286)]. Patients with comorbidities such as cardiovascular symptoms(P<0.001) and renal replacement therapy initiation(P<0.001) were significantly associated with in-hospital mortality in all TAFI. Conclusions: The etiology of TAFI in the western Pahang includes dengue, leptospirosis, malaria and melioidosis, which carry the highest risk of in-hospital mortality. The presence of cardiovascular symptoms may be used to assess the disease severity in TAFI, but more studies are needed in the future.
