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  1. Article ; Online: Covid-19 dermatoses: Acral vesicular pattern evolving into bullous pemphigoid.

    Goon, P K C / Bello, O / Adamczyk, L A / Chan, J Y H / Sudhoff, H / Banfield, C C

    Skin health and disease

    2020  Volume 1, Issue 1, Page(s) e6

    Abstract: Bullous pemphigoid (BP) appears to be rising in incidence across the Western World, especially in the elderly. Some of the pathogenetic mechanisms involving antigen mimicry and antibody cross-reactivity have been elucidated for cases associated with ... ...

    Abstract Bullous pemphigoid (BP) appears to be rising in incidence across the Western World, especially in the elderly. Some of the pathogenetic mechanisms involving antigen mimicry and antibody cross-reactivity have been elucidated for cases associated with neurological disease and certain drugs. There have been reports of cutaneous manifestations of Covid-19 (SARS-Cov2 infection) as the pandemic has raged across the world. We report here a case of prolonged Covid-19, symptomatic with dermatoses only, which was seen to evolve initially from a maculo-papular exanthema with acral vesicular dermatitis, into classical BP disease. This was confirmed histologically by positive skin autoantibody serology, direct IMF on peri-lesional skin and also salt-split IMF. Although possible that the development of BP could be a purely co-incidental finding during Covid-19, we suggest that it is more likely that prolonged SARS-Cov2 infection triggered an autoimmune response to the basement membrane antigens, BP 180 and 230. To our knowledge, this is the first case of BP developing during concurrent Covid-19 disease. It will be necessary to continue dermatological surveillance as the pandemic continues, to collate data on BP incidence and to test these patients for Covid-19 disease. As the pandemic continues, even potential and rare associations such as this will be clarified eventually. What's already known about this topic? Covid-19 disease has been associated with a spectrum of dermatosesCommon presentations in up to 20% of patients include exanthema, pseudo-chilblain like acral lesions 'Covid toes', livedo-/retiform purpuric/necrotic vascular lesions, acute urticarial lesions, and vesicular/varicella-like lesionsA multi-system inflammatory syndrome in children akin to Kawasaki syndrome has been described What does this study add? To our knowledge, this is the first description of classic Bullous Pemphigoid evolving from vesicular lesions caused by prolonged SARS-Cov2 induced skin inflammation.
    Language English
    Publishing date 2020-11-11
    Publishing country England
    Document type Case Reports
    ISSN 2690-442X
    ISSN (online) 2690-442X
    DOI 10.1002/ski2.6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Real-world NHS drug survival and efficacy data for Secukinumab in chronic plaque psoriasis.

    Goon, P K C / Banfield, C C / Bello, O / Abraham, T / Lim, H Y / Summerfield, E / Shalders, K / Sudhoff, H / Mallett, R B

    Journal of the European Academy of Dermatology and Venereology : JEADV

    2020  Volume 34, Issue 11, Page(s) e716–e718

    MeSH term(s) Antibodies, Monoclonal, Humanized ; Humans ; Pharmaceutical Preparations ; Psoriasis/drug therapy ; Severity of Illness Index ; State Medicine ; Treatment Outcome
    Chemical Substances Antibodies, Monoclonal, Humanized ; Pharmaceutical Preparations ; secukinumab (DLG4EML025)
    Language English
    Publishing date 2020-06-04
    Publishing country England
    Document type Letter
    ZDB-ID 1128828-0
    ISSN 1468-3083 ; 0926-9959
    ISSN (online) 1468-3083
    ISSN 0926-9959
    DOI 10.1111/jdv.16538
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Limb-threatening extravasation injury: topical negative pressure and limb salvage.

    Goon, P K Y / Dalal, M

    Plastic and reconstructive surgery

    2006  Volume 117, Issue 3, Page(s) 1064–1065

    MeSH term(s) Arm/pathology ; Debridement ; Extravasation of Diagnostic and Therapeutic Materials/complications ; Extravasation of Diagnostic and Therapeutic Materials/pathology ; Extravasation of Diagnostic and Therapeutic Materials/therapy ; Humans ; Limb Salvage ; Lymphoma, Non-Hodgkin/drug therapy ; Male ; Middle Aged ; Necrosis ; Pressure ; Skin Transplantation
    Language English
    Publishing date 2006-03
    Publishing country United States
    Document type Case Reports ; Letter
    ZDB-ID 208012-6
    ISSN 1529-4242 ; 0032-1052 ; 0096-8501
    ISSN (online) 1529-4242
    ISSN 0032-1052 ; 0096-8501
    DOI 10.1097/01.prs.0000201225.07427.85
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Involvement of circulating endothelial progenitor cells and vasculogenic factors in the pathogenesis of diabetic retinopathy.

    Goon, P K Y / Lip, G Y H

    Eye (London, England)

    2007  Volume 21, Issue 6, Page(s) 838–9; author reply 838

    MeSH term(s) Angiogenesis Inducing Agents/blood ; Diabetic Retinopathy/blood ; Endothelium, Vascular/pathology ; Humans ; Stem Cells/physiology ; Vascular Endothelial Growth Factor A/blood
    Chemical Substances Angiogenesis Inducing Agents ; Vascular Endothelial Growth Factor A
    Language English
    Publishing date 2007-06
    Publishing country England
    Document type Comment ; Letter
    ZDB-ID 91001-6
    ISSN 1476-5454 ; 0950-222X
    ISSN (online) 1476-5454
    ISSN 0950-222X
    DOI 10.1038/sj.eye.6702650
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Low uptake of COVID-19 prevention behaviours and high socioeconomic impact of lockdown measures in South Asia: Evidence from a large-scale multi-country surveillance programme.

    Kusuma, Dian / Pradeepa, Rajendra / Khawaja, Khadija I / Hasan, Mehedi / Siddiqui, Samreen / Mahmood, Sara / Ali Shah, Syed Mohsin / De Silva, Chamini K / de Silva, Laksara / Gamage, Manoja / Loomba, Menka / Rajakaruna, Vindya P / Hanif, Abu Am / Kamalesh, Rajan Babu / Kumarendran, Balachandran / Loh, Marie / Misra, Archa / Tassawar, Asma / Tyagi, Akansha /
    Waghdhare, Swati / Burney, Saira / Ahmad, Sajjad / Mohan, Viswanathan / Sarker, Malabika / Goon, Ian Y / Kasturiratne, Anuradhani / Kooner, Jaspal S / Katulanda, Prasad / Jha, Sujeet / Anjana, Ranjit Mohan / Mridha, Malay K / Sassi, Franco / Chambers, John C

    SSM - population health

    2021  Volume 13, Page(s) 100751

    Abstract: ... of unemployment rose from 9.3% to 39.4% (P < 0.001), and household income fell by 52% (P < 0.001) during ... Sedentary time increased by 32% and inadequate fruit and vegetable intake increased by 10% (P < 0.001 ... for both), while tobacco and alcohol consumption dropped by 41% and 80%, respectively (P < 0.001), during the lockdown ...

    Abstract Background: South Asia has become a major epicentre of the COVID-19 pandemic. Understanding South Asians' awareness, attitudes and experiences of early measures for the prevention of COVID-19 is key to improving the effectiveness and mitigating the social and economic impacts of pandemic responses at a critical time for the Region.
    Methods: We assessed the knowledge, behaviours, health and socio-economic circumstances of 29,809 adult men and women, at 93 locations across four South Asian countries. Data were collected during the national lockdowns implemented from March to July 2020, and compared with data collected prior to the pandemic as part of an ongoing prospective surveillance initiative.
    Results: Participants were 61% female, mean age 45.1 years. Almost half had one or more chronic disease, including diabetes (16%), hypertension (23%) or obesity (16%). Knowledge of the primary COVID-19 symptoms and transmission routes was high, but access to hygiene and personal protection resources was low (running water 63%, hand sanitisers 53%, paper tissues 48%). Key preventive measures were not widely adopted. Knowledge, access to, and uptake of COVID-19 prevention measures were low amongst people from disadvantaged socio-economic groups. Fifteen percent of people receiving treatment for chronic diseases reported loss of access to long-term medications; 40% reported symptoms suggestive of anxiety or depression. The prevalence of unemployment rose from 9.3% to 39.4% (P < 0.001), and household income fell by 52% (P < 0.001) during the lockdown. Younger people and those from less affluent socio-economic groups were most severely impacted. Sedentary time increased by 32% and inadequate fruit and vegetable intake increased by 10% (P < 0.001 for both), while tobacco and alcohol consumption dropped by 41% and 80%, respectively (P < 0.001), during the lockdown.
    Conclusions: Our results identified important knowledge, access and uptake barriers to the prevention of COVID-19 in South Asia, and demonstrated major adverse impacts of the pandemic on chronic disease treatment, mental health, health-related behaviours, employment and household finances. We found important sociodemographic differences for impact, suggesting a widening of existing inequalities. Our findings underscore the need for immediate large-scale action to close gaps in knowledge and access to essential resources for prevention, along with measures to safeguard economic production and mitigate socio-economic impacts on the young and the poor.
    Language English
    Publishing date 2021-02-13
    Publishing country England
    Document type Journal Article
    ISSN 2352-8273
    ISSN 2352-8273
    DOI 10.1016/j.ssmph.2021.100751
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Endothelial progenitor cells in the vascular pathophysiology of hypertension: arterial stiffness, ageing and more.

    Boos, C J / Goon, P K Y / Lip, G Y H

    Journal of human hypertension

    2006  Volume 20, Issue 7, Page(s) 475–477

    MeSH term(s) Aging/physiology ; Antigens, CD34/analysis ; Blood Vessels/chemistry ; Blood Vessels/pathology ; Endothelial Cells/chemistry ; Endothelial Cells/pathology ; Humans ; Hypertension/metabolism ; Hypertension/pathology ; Hypertension/physiopathology ; Stem Cells/chemistry ; Stem Cells/pathology
    Chemical Substances Antigens, CD34
    Language English
    Publishing date 2006-07
    Publishing country England
    Document type Comment ; Journal Article
    ZDB-ID 639472-3
    ISSN 1476-5527 ; 0950-9240
    ISSN (online) 1476-5527
    ISSN 0950-9240
    DOI 10.1038/sj.jhh.1001991
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Hypertension and breast cancer: an association revisited?

    Goon, P K Y / Messerli, F H / Lip, G Y H

    Journal of human hypertension

    2006  Volume 20, Issue 10, Page(s) 722–724

    MeSH term(s) Age Factors ; Aged ; Breast Neoplasms/etiology ; Diuretics/administration & dosage ; Diuretics/adverse effects ; Female ; Follow-Up Studies ; Humans ; Hypertension/complications ; Hypertension/drug therapy ; Middle Aged ; Pregnancy ; Retrospective Studies ; Risk Factors ; Surveys and Questionnaires ; Time Factors
    Chemical Substances Diuretics
    Language English
    Publishing date 2006-10
    Publishing country England
    Document type Comment ; Journal Article
    ZDB-ID 639472-3
    ISSN 1476-5527 ; 0950-9240
    ISSN (online) 1476-5527
    ISSN 0950-9240
    DOI 10.1038/sj.jhh.1002053
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Effects of atorvastatin on circulating CD34+/CD133+/ CD45- progenitor cells and indices of angiogenesis (vascular endothelial growth factor and the angiopoietins 1 and 2) in atherosclerotic vascular disease and diabetes mellitus.

    Jaumdally, R J / Goon, P K Y / Varma, C / Blann, A D / Lip, G Y H

    Journal of internal medicine

    2010  Volume 267, Issue 4, Page(s) 385–393

    Abstract: ... progenitor cell counts increased (P < 0.001) in Group A compared with a nonsignificant change in Group B (P = 0.37 ... VEGF levels fell significantly in Group A (P = 0.04) but no significant change was seen in Group B (P ... 0.16). Whilst Ang-1 remained unchanged (P = 0.41), Ang-2 levels increased markedly in both groups (P ...

    Abstract Background: Cardiovascular disease (CVD) remains a major cause of morbidity and mortality, especially in the presence of diabetes, possibly because of endothelial damage. Increased circulating progenitor cells (CPCs) and increased plasma markers of angiogenesis [vascular endothelial growth factor (VEGF) and the angiopoietins (Ang-1 and -2)] may be evidence of this damage. Treatment with hydroxy-methyl-glutaryl (HMG-CoA) reductase inhibitors ('statins') improves outcomes in patients with vascular disease, including diabetic patients. We hypothesized that 80 mg per day atorvastatin influences CPC counts of VEGF and the angiopoietins in patients with atherosclerotic CVD with or without diabetes mellitus.
    Methods: Cardiovascular disease patients with diabetes mellitus (Group A, n = 14) and nondiabetic patients with CVD only (Group B, n = 10) took atorvastatin 80 mg per day for a period of 8-10 weeks. CPCs (CD34+/CD133+/CD45-) were defined by flow cytometry, plasma levels VEGF and Ang-1 and Ang-2 by ELISA).
    Results: Circulating progenitor cell counts increased (P < 0.001) in Group A compared with a nonsignificant change in Group B (P = 0.37). VEGF levels fell significantly in Group A (P = 0.04) but no significant change was seen in Group B (P = 0.16). Whilst Ang-1 remained unchanged (P = 0.41), Ang-2 levels increased markedly in both groups (P < 0.05). These effects were independent of LDL and total cholesterol changes but were associated with HDL changes.
    Conclusion: High-dose atorvastatin increased circulating CPCs, reduced VEGF and increased Ang-2 in patients with diabetes and CVD, providing another possible pathophysiological mechanism for the beneficial effects of statins in CVD.
    MeSH term(s) Aged ; Angiopoietin-1/blood ; Angiopoietin-2/blood ; Antigens, CD/blood ; Antigens, CD34/blood ; Atherosclerosis/blood ; Atherosclerosis/drug therapy ; Atherosclerosis/pathology ; Atorvastatin Calcium ; Diabetes Mellitus/blood ; Diabetes Mellitus/drug therapy ; Diabetes Mellitus/pathology ; Female ; Heptanoic Acids/therapeutic use ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Leukocyte Common Antigens/blood ; Male ; Middle Aged ; Neovascularization, Pathologic/blood ; Prospective Studies ; Pyrroles/therapeutic use ; Stem Cells ; Vascular Endothelial Growth Factor A/metabolism
    Chemical Substances Angiopoietin-1 ; Angiopoietin-2 ; Antigens, CD ; Antigens, CD34 ; Heptanoic Acids ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Pyrroles ; Vascular Endothelial Growth Factor A ; Atorvastatin Calcium (48A5M73Z4Q) ; Leukocyte Common Antigens (EC 3.1.3.48)
    Language English
    Publishing date 2010-04
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 96274-0
    ISSN 1365-2796 ; 0954-6820
    ISSN (online) 1365-2796
    ISSN 0954-6820
    DOI 10.1111/j.1365-2796.2009.02151.x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: Endothelial progenitor cells: from pathophysiology to clinical practice.

    Goon, P K Y / Watson, T / Stonelake, P S / Lip, G Y H

    International journal of clinical practice

    2008  Volume 62, Issue 1, Page(s) 4–6

    MeSH term(s) Endothelial Cells/physiology ; Endothelial Cells/transplantation ; Endothelium, Vascular/cytology ; Humans ; Neoplasms/blood supply ; Neovascularization, Pathologic/pathology ; Stem Cell Transplantation ; Stem Cells/physiology
    Language English
    Publishing date 2008-01
    Publishing country England
    Document type Editorial
    ZDB-ID 1386246-7
    ISSN 1742-1241 ; 1368-5031
    ISSN (online) 1742-1241
    ISSN 1368-5031
    DOI 10.1111/j.1742-1241.2007.01555.x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: The effects of exercise stress testing, diurnal variation and temporal decline on circulating progenitor cells.

    Watson, T / Shantsila, E / Karthikeyan, V J / Jessani, S / Goon, P K / Lip, G Y H

    Thrombosis and haemostasis

    2010  Volume 103, Issue 2, Page(s) 419–425

    Abstract: ... Baseline CPC numbers demonstrated a negative correlation with vWf (r=-0.551, p=0.012) and sE-selectin ... levels (r=-0.494, p=0.027). CPC counts showed a significant diurnal variation, being significantly higher ... at 12 a.m. compared to 12 p.m. (p=0.046) and 6 p.m. (p=0.023). A 4 hour delay in sample preparation did ...

    Abstract Endothelial damage/dysfunction is involved in numerous cardiovascular disease processes. Given that the mature endothelial cells have limited capacity for self regeneration, circulating progenitor cells (CPCs) may modulate the balance between vascular damage and regeneration. The three aims of the present study were 1) to define the influence of exercise treadmill testing (ETT) on peripheral CPC levels; 2) to assess the diurnal variation of CPC counts; and 3) to investigate the rate of temporal decline in CPCs once ex vivo . The dynamics of CPC count changes following an ETT were assessed on consecutive 20 patients referred to our 'rapid-access' chest pain clinic (70% male, age 69.9 +/- 7.8) with venous blood samples taken pre-exercise, immediately post-exercise and at 30 minutes post-exercise. Diurnal variation in CPCs was assessed in 13 stable in-hospital patients (46% male, age 69.1 +/- 7.5 years) with blood samples were taken five times every 6 hours. To investigate the temporal decline, blood samples from 12 patients (58.3% male, age 69.9 +/- 7.9 years) were reprocessed for CPC counts at 4 hours and at 24 hours after sample collection. Plasma levels of von Willebrand factor (vWf) and soluble E-selectin (sE-selectin) were assessed by ELISA. CPCs were enumerated with flow cytometry as CD34+, CD133+, CD45dim events. Exercise led to significant increases in vWF and sE-selectin levels, but no significant influence on CPC counts were observed. Baseline CPC numbers demonstrated a negative correlation with vWf (r=-0.551, p=0.012) and sE-selectin levels (r=-0.494, p=0.027). CPC counts showed a significant diurnal variation, being significantly higher at 12 a.m. compared to 12 p.m. (p=0.046) and 6 p.m. (p=0.023). A 4 hour delay in sample preparation did not affect CPCs counts, but there was a significant decline in CPC recovery when sample processing was delayed by 24 hours (p<0.05). Routine exercise stress testing does not significantly affect CPC counts. Peripheral CPC levels showed a significant diurnal variation. Delays in sample preparation for CPC counts should be avoided as they may influence the accuracy of the test by resulting in a significant decline in CPC recovery. Thus, various factors may affect accuracy of CPC enumeration that may limit their role as a reliable clinical marker and biomarker of endothelial damage.
    MeSH term(s) Aged ; Biomarkers/blood ; Blood Cell Count ; Circadian Rhythm/physiology ; Endothelial Cells/cytology ; Endothelial Cells/physiology ; Exercise Test ; Female ; Flow Cytometry ; Humans ; Male ; Middle Aged ; Regeneration ; Stem Cells/cytology ; Stress, Physiological/physiology ; Time Factors
    Chemical Substances Biomarkers
    Language English
    Publishing date 2010-02
    Publishing country Germany
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 518294-3
    ISSN 0340-6245
    ISSN 0340-6245
    DOI 10.1160/TH09-06-0386
    Database MEDical Literature Analysis and Retrieval System OnLINE

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