1.Patient characteristics, disease burden, treatment patterns and outcomes in patients with acromegaly: Real-world evidence from the Malaysian acromegaly registry
Mohamed Badrulnizam Long Bidin ; Abdul Mueed Khan ; Florence Hui Sieng Tan ; Nor Azizah Aziz ; Norhaliza Mohd Ali ; Nor Azmi Kamaruddin ; Shireene Vethakkan ; Balraj Sethi ; Zanariah Hussein
Journal of the ASEAN Federation of Endocrine Societies 2023;38(1):75-80
Objective:
This study aims to report the demographic features of patients with acromegaly the disease burden, and the corresponding treatment patterns and outcomes in Malaysia.
Methodology:
This is a retrospective study that included patients from the Malaysian Acromegaly registry who were diagnosed with acromegaly from 1970 onwards. Data collected included patient demographics, clinical manifestations of acromegaly, biochemical results and imaging findings. Information regarding treatment modalities and their outcomes was also obtained.
Results:
Registry data was collected from 2013 to 2016 and included 140 patients with acromegaly from 12 participating hospitals. Median disease duration was 5.5 years (range 1.0 – 41.0 years). Most patients had macroadenoma (67%), while 15% were diagnosed with microadenoma. Hypertension (49.3%), diabetes (37.1%) and hypopituitarism (27.9%) were the most common co-morbidities for patients with acromegaly. Majority of patients had surgical intervention as primary treatment (65.9%) while 20.7% were treated medically, mainly with dopamine agonists (18.5%). Most patients had inadequate disease control after first-line treatment regardless of treatment modality (79.4%).
Conclusion
This registry study provides epidemiological data on patients with acromegaly in Malaysia and serves as an initial step for further population-based studies.
acromegaly
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treatment outcomes
2.Emerging utility of endovascular thrombectomy in the Philippines: A single-center clinical experience
Glenn Anthony A. Constantino ; Miguela Marie A. Señ ; ga ; Jo Ann R. Soliven ; Victor Erwin D. Jocson
Acta Medica Philippina 2023;57(5):44-50
Background and Objective:
Stroke has remained one of the primary causes of significant morbidity and mortality. Among the therapeutic options for acute stroke management, endovascular thrombectomy is intended to remove the thrombi within the intracerebral vasculature and restore adequate perfusion to the surrounding penumbra. It is recommended up to 24 hours from onset of neurologic symptom. In the Philippines, only a few tertiary healthcare institutions are able to offer and perform endovascular thrombectomies. The aim was to describe the profile and discharge outcomes of endovascular thrombectomy for acute ischemic stroke at a tertiary hospital in our country.
Methods:
We conducted a retrospective records review among 924 patients admitted for acute ischemic stroke from October 2018 to August 2021 who underwent mechanical thrombectomy. Clinical and functional outcomes were measured using the National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin Score (mRS).
Results:
Among 31 patients included in the study, 29 subjects (93.5%) had moderate to severe disability (mRS 3–5), and 25 (80.6%) had moderate stroke (NIHSS 6–21) on admission. The identified site of the cerebrovascular thrombi was within the M1 segment of the middle cerebral artery (41.9%, n=13). The stent retriever approach was performed in 19 participants (61.2%). Upon discharge, only 7 (22.6%) had favorable functional outcomes (MRS 0–2), and 9 (29.0%) resulted in mortality. Successful reperfusion was achieved in 92.3% of the patients.
Conclusion
Overall, endovascular thrombectomy is a possible treatment option for large vessel acute ischemic stroke in developing countries.
thrombectomy
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endovascular procedures
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ischemic stroke
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treatment outcomes