ORCID Profile
0000-0001-8195-2078
Current Organisations
Westmead Hospital
,
Universiti Malaya
,
Aston University
,
MAHSA University
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Publisher: Wiley
Date: 05-07-2023
DOI: 10.1002/MUS.27842
Publisher: Wiley
Date: 10-2020
DOI: 10.1111/IMJ.15027
Publisher: Springer Science and Business Media LLC
Date: 21-07-2020
Publisher: Hindawi Limited
Date: 13-10-2018
DOI: 10.1111/JCPT.12634
Abstract: Bleeding risk scores (BRSs) aid in the assessment of oral anticoagulant-related bleeding risk in patients with atrial fibrillation. Ideally, the applicability of a BRS needs to be assessed, prior to its routine use in a population other than the original derivation cohort. Therefore, we evaluated the performance of 6 established BRSs to predict major or clinically relevant bleeding (CRB) events associated with the use of oral anticoagulant (OAC) among Malaysian patients. The pharmacy supply database and the medical records of patients with non-valvular atrial fibrillation (NVAF) receiving warfarin, dabigatran or rivaroxaban at two tertiary hospitals were reviewed. Patients who experienced an OAC-associated major or CRB event within 12 months of follow-up, or who have received OAC therapy for at least 1 year, were identified. The BRSs were fitted separately into patient data. The discrimination and the calibration of these BRSs as well as the factors associated with bleeding events were then assessed. A total of 1017 patients with at least 1-year follow-up period, or those who developed a bleeding event within 1 year of OAC use, were recruited. Of which, 23 patients experienced a first major bleeding event, whereas 76 patients, a first CRB event. Multivariate logistic regression results show that age of 75 or older, prior bleeding and male gender are associated with major bleeding events. On the other hand, prior gastrointestinal bleeding, a haematocrit value of less than 30% and renal impairment are independent predictors of CRB events. All the BRSs show a satisfactory calibration for major and CRB events. Among these BRSs, only HEMORR To the best of our knowledge, this is the first evaluation study of the predictive performance of these 6 BRSs on clinically relevant bleeding events applied to the same cohort consisting of mainly Asian novel oral anticoagulant users. These BRSs show poor to acceptable predictive performance on OAC-induced major or CRB events. An improvement in the existing BRSs for OAC users is warranted.
Publisher: BMJ Publishing Group Ltd
Date: 08-2021
Publisher: The Korean Movement Disorder Society
Date: 31-05-2021
DOI: 10.14802/JMD.20159
Publisher: Wiley
Date: 16-03-2015
DOI: 10.1002/MDC3.12139
Abstract: People diagnosed with Parkinson's disease (PD) frequently experience visual and non‐visual hallucinations often with comorbid psychosis, however, there is currently no gold standard tool for accurately assessing these symptoms. To address this problem, we designed a novel questionnaire to evaluate the presence of hallucinatory and psychotic symptoms in PD, as well as related symptoms, such as attentional dysfunction and sleep disturbance. We administered the 20‐item Psychosis and Hallucinations Questionnaire (PsycH‐Q) and three common questionnaire measures in a large cohort of 197 patients with idiopathic PD via a postal survey. We established concurrent validity, convergent validity, and internal consistency of the questionnaire and then assessed test‐retest reliability in a subcohort of 44 patients. PsycH‐Q was found to be a valid instrument when analogous items were compared across three other existing tools (Spearman's rho range: 0.34–0.64 P 0.01). PsycH‐Q demonstrated a strong relationship between self‐reported hallucinations and psychosis and symptoms of the broader hallucinatory phenotype (Kendall's tau = 0.41 P 0.01 positive predictive value = 0.97). PsycH‐Q also displayed a high level of internal consistency (Cronbach's alpha = 0.900 range, 0.696–0.923) and reproducibility (intraclass correlation coefficient = 0.928). PsycH‐Q is a simple, valid, self‐completed instrument that reliably identifies hallucinations and psychosis in PD and has the ability to characterize related patterns of attentional and sleep impairments. As such, PsycH‐Q is a highly valuable tool for use in both clinical and research settings.
Publisher: BMJ Publishing Group Ltd
Date: 08-2021
Publisher: BMJ
Date: 24-05-2018
DOI: 10.1136/JNNP-2018-ANZAN.75
Abstract: The classic phenotype of anti-N-methyl-d-aspartate receptor (NMDA-R) encephalitis is a constellation of prodromal psychiatric symptoms, seizures, movement disorder and progressive autonomic dysfunction, frequently associated with ovarian teratoma. We describe four cases illustrating the expanding phenotype of NMDA-R encephalitis. We present two cases from two tertiary hospitals Case 1 A 31 year old woman presented with focal onset seizures. She developed epilepsia partialis continua. CSF and serum NMDA-R antibodies were detected and PET of the brain showed bi-frontal hyper-metabolism. The seizures resolved with immunotherapy. Case 2 A 26 year old woman presented with vomiting and dysequilibrium. She was found to have torsional downbeat nystagmus with otherwise normal eye movements and vestibulo-ocular reflexes. She developed bilateral appendicular and truncal ataxia, head bobbing and ocular flutter. PET demonstrated diffuse cerebellar hyper-metabolism. CSF NMDA-R antibodies were detected and an ovarian teratoma was identified. Case 3 A 67 year old right-handed woman was treated for HSV encephalitis. MRI of the brain demonstrated typical changes in the right anteromedial temporal lobe, inferior frontal lobe and insular cortex. Five months later, she deteriorated with progressive cognitive dysfunction and prominent orofacial dyskinesia. Initially both CSF and serum were negative for NMDAR antibodies, but repeat CSF and serum were positive. Case 4 A 61 year old woman presented with progressive cognitive impairment over eight months initially characterised by difficulty with calculations and making mistakes at work but subsequent severe impairment of language, executive function and memory and the development of facile and disinhibited behaviour. PET demonstrated mesial bi-temporal hyopo-metabolism and NMDA-R antibodies were detected in serum. She recovered with immunotherapy. NMDA-R encephalitis should be considered in various neurological presentations including explosive onset focal epilepsy, rapidly progressive dementia, post HSV encephalitis and rhombencephalitis. Early detection is important given the frequent response to immunotherapy.
Publisher: Wiley
Date: 25-03-2022
DOI: 10.1111/ENE.15317
Abstract: Susac syndrome (SuS) is an inflammatory condition of the brain, eye and ear. Diagnosis can be challenging, and misdiagnosis is common. This is a retrospective review of the medical records of 32 adult patients from an Australasian cohort of SuS patients. An alternative diagnosis prior to SuS was made in 30 patients (94%) with seven patients receiving two or more diagnoses. The median time to diagnosis of SuS was 3 months (range 0.5–100 months). The commonest misdiagnoses were migraine in 10 patients (31%), cerebral vasculitis in six (19%), multiple sclerosis in five (16%) and stroke in five (16%). Twenty‐two patients were treated for alternative diagnoses, 10 of whom had further clinical manifestations prior to SuS diagnosis. At presentation seven patients (22%) met criteria for definite SuS, 19 (59%) for probable SuS and six (19%) for possible SuS. Six patients (19%) presented with brain–eye–ear involvement, 14 with brain–ear (44%), six with brain–eye (19%) and six (19%) with only brain involvement. In patients with the complete triad of symptoms the median delay to diagnosis was 3 months (range 1–9 months) compared to 5.25 months (range 0.5–100 months) for patients with encephalopathy and ocular symptoms at presentation. Susac syndrome patients are frequently misdiagnosed at initial presentation, despite many having symptoms or radiological features that are red flags for the diagnosis. Delayed diagnosis can lead to patient morbidity. The varied ways in which SuS can present, and clinician failure to consider or recognize SuS, appear to be the main factors leading to misdiagnosis.
Publisher: The Royal Australian College of General Practitioners
Date: 08-2022
Publisher: Elsevier BV
Date: 10-2020
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Jessica Qiu.