Singapore medical journal最新文献_第7页

Improving the predictive capability of Framingham Risk Score for the risk of myocardial infarction based on coronary artery calcium score in healthy Singaporeans. 根据健康新加坡人的冠状动脉钙化评分提高弗雷明汉风险评分对心肌梗死风险的预测能力。

IF 2.7 4区医学

Singapore medical journal Pub Date : 2024-02-01 Epub Date: 2021-10-11 DOI: 10.11622/smedj.2021151

Ching Yee Ivory Yeo, John Carson Jr Allen, Weiting Huang, Wei Ying Tan, Siew Ching Kong, Khung Keong Yeo

{"title":"Improving the predictive capability of Framingham Risk Score for the risk of myocardial infarction based on coronary artery calcium score in healthy Singaporeans.","authors":"Ching Yee Ivory Yeo, John Carson Jr Allen, Weiting Huang, Wei Ying Tan, Siew Ching Kong, Khung Keong Yeo","doi":"10.11622/smedj.2021151","DOIUrl":"10.11622/smedj.2021151","url":null,"abstract":"Introduction: Cardiovascular disease was the top cause of deaths and disability in Singapore in 2018, contributing extensively to the local healthcare burden. Primary prevention identifies at-risk individuals for the swift implementation of preventive measures. This has been traditionally done using the Singapore-adapted Framingham Risk Score (SG FRS). However, its most recent recalibration was more than a decade ago. Recent changes in patient demographics and risk factors have undermined the accuracy of SG FRS, and the rising popularity of wearable health metrics has led to new data types with the potential to improve risk prediction.Methods: In healthy Singaporeans enrolled in SingHEART study (absence of any clinical outcomes), we investigated improvements in SG FRS to predict myocardial infarction risk based on high/low classification of the Agatston score (surrogate outcome). Logistic regression, receiver operating characteristic and net reclassification index (NRI) analyses were conducted.Results: We demonstrated a significant improvement in the area under curve (AUC) of SG FRS (AUC = 0.641) after recalibration and incorporation of additional variables (fasting blood glucose and wearable-derived activity levels) (AUC = 0.774) ( P < 0.001). SG FRS++ significantly increases accuracy in risk prediction (NRI = 0.219, P = 0.00254).Conclusion: Existing Singapore cardiovascular disease risk prediction guidelines should be updated to improve risk prediction accuracy. Recalibrating existing risk functions and utilising wearable metrics that provide a large pool of objective health data can improve existing risk prediction tools. Lastly, activity levels and prediabetic state are important factors for coronary heart disease risk stratification, especially in low-risk individuals.","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"74-83"},"PeriodicalIF":2.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10942132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39501477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ulcerative colitis: STRIDE-ing beyond symptoms with new standards. 溃疡性结肠炎：用新标准超越症状。

IF 2.7 4区医学

Singapore medical journal Pub Date : 2024-02-01 Epub Date: 2021-11-26 DOI: 10.11622/smedj.2021173

Shu Wen Tay, Kevin Kim Jun Teh, Tiing-Leong Ang, Malcolm Tan

引用次数: 0

Perceptions of Singaporeans towards informed consent: a cross-sectional survey. 新加坡人对知情同意的看法：横断面调查。

IF 2.7 4区医学

Singapore medical journal Pub Date : 2024-02-01 Epub Date: 2021-10-31 DOI: 10.11622/smedj.2021163

Mehek Gupta, Sudharsan Madhavan, Felicia Siok Ying Teo, Jee Keem Low, Vishal G Shelat

{"title":"Perceptions of Singaporeans towards informed consent: a cross-sectional survey.","authors":"Mehek Gupta, Sudharsan Madhavan, Felicia Siok Ying Teo, Jee Keem Low, Vishal G Shelat","doi":"10.11622/smedj.2021163","DOIUrl":"10.11622/smedj.2021163","url":null,"abstract":"Introduction: In a patient-centric health system, it is essential to know patients' views about informed consent. The objective of this study was to understand the perceptions of the local population regarding informed consent.Methods: Spanning 6 weeks from January 2016 to March 2016, a cross-sectional survey of adults attending the General Surgery outpatient clinics at Tan Tock Seng Hospital was conducted. Sociodemographic data, lifestyle- and health-related information, perception and purpose of consent forms, and decision-making preferences were studied.Results: A total of 445 adults participated in the survey. Most participants were aged below 40 years ( n = 265, 60.1%), female ( n = 309, 70.1%) and degree holders ( n = 196, 44.4%). Also, 56.9% of participants wanted to know every possible risk, while 28.3% wanted to know the common and serious risks. On multivariate analysis, age (61-74 years: odds ratio [OR] 11.1, 95% confidence interval [CI] 2.2-56.1, P = 0.004; age >75 years: OR 22.2, 95% CI 1.8-279.1, P = 0.017) was a predictor of not wanting to know any risks. Age also predicted risk of disclosure for death (age 61-74 years: OR 13.4, 95% CI 4.2-42.6, P < 0.001; age >75 years: OR 32.0, 95% CI 4.5-228.0, P = 0.001). Most participants (48.1%) preferred making shared decisions with doctors, and an important predictor was employment status (OR 4.8, 95% CI 1.9-12.2, P = 0.001).Conclusion: Sociodemographic factors and educational level influence decision-making, and therefore, the informed consent process should be tailored for each patient.","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"91-98"},"PeriodicalIF":2.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10942135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39664105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predictors of postoperative hospital length of stay after total knee arthroplasty. 全膝关节置换术后住院时间的预测因素。

IF 2.7 4区医学

Singapore medical journal Pub Date : 2024-02-01 Epub Date: 2021-10-24 DOI: 10.11622/smedj.2021142

Davide Tornese, Alessandro Robustelli, Gabriele Ricci, Paola Maria Vittoria Rancoita, Nicola Maffulli, Giuseppe Michele Peretti

{"title":"Predictors of postoperative hospital length of stay after total knee arthroplasty.","authors":"Davide Tornese, Alessandro Robustelli, Gabriele Ricci, Paola Maria Vittoria Rancoita, Nicola Maffulli, Giuseppe Michele Peretti","doi":"10.11622/smedj.2021142","DOIUrl":"10.11622/smedj.2021142","url":null,"abstract":"Introduction: We aimed to collect and analyse clinical and functional variables of patients undergoing rehabilitation after total knee arthroplasty (TKA), to identify the variables that influence the postoperative hospital length of stay (LOS).Methods: We conducted a retrospective analysis of prospectively collected data of 1,082 consecutive patients (746 females and 336 males) who underwent primary TKA and rehabilitation in our orthopaedic institute between January 2013 and July 2017. Clinical and anthropometric data were analysed using a multivariate linear regression model.Results: The average LOS was 5.08 ± 2.52 days in the Department of Orthopaedic Surgery and 12.67 ± 5.54 days in the Sports Rehabilitation Unit. Factors such as age, female sex and the presence of comorbidities were predictive of a longer stay. The presence of caregiver assistance at home was associated with shorter LOS. There was no evidence of a statistically significant positive association between body mass index and LOS.Conclusion: An in-depth and early knowledge of factors that influence LOS may enable the multidisciplinary team to plan a patient-tailored rehabilitation path and better allocate resources to maximise patients' functional recovery, while reducing LOS and the overall cost of the procedure.","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"68-73"},"PeriodicalIF":2.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10942137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39550113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Image quality, contrast enhancement and radiation dose of electrocardiograph- versus non-electrocardiograph-triggered computed tomography angiography of the aorta. 心电图与非心电图触发的主动脉计算机断层扫描血管造影的图像质量、对比度增强和辐射剂量。

IF 2.7 4区医学

Singapore medical journal Pub Date : 2024-02-01 Epub Date: 2021-10-24 DOI: 10.11622/smedj.2021166

Ying Mei Wong, Ching Ching Ong, Chong Ri Liang, Choon Ann Tan, Lynette Li San Teo

{"title":"Image quality, contrast enhancement and radiation dose of electrocardiograph- versus non-electrocardiograph-triggered computed tomography angiography of the aorta.","authors":"Ying Mei Wong, Ching Ching Ong, Chong Ri Liang, Choon Ann Tan, Lynette Li San Teo","doi":"10.11622/smedj.2021166","DOIUrl":"10.11622/smedj.2021166","url":null,"abstract":"Introduction: Computed tomography angiography of the aorta (CTAA) is the modality of choice for investigating aortic disease. Our aim was to evaluate the image quality, contrast enhancement and radiation dose of electrocardiograph (ECG)-triggered and non-ECG-triggered CTAA on a 256-slice single-source CT scanner. This allows the requesting clinician and the radiologist to balance radiation risk and image quality.Methods: We retrospectively assessed the data of 126 patients who had undergone CTAA on a single-source CT scanner using ECG-triggered (group 1, n = 77) or non-ECG-triggered (group 2, n = 49) protocols. Radiation doses were compared. Qualitative (4-point scale) and quantitative image quality assessments were performed.Results: The mean volume CT dose index, dose length product and effective dose in group 1 were 12.4 ± 1.9 mGy, 765.8 ± 112.4 mGy cm and 13.0 ± 1.9 mSv, respectively. These were significantly higher compared to group 2 values (9.1 ± 2.6 mGy, 624.1 ± 174.8 mGy cm and 10.6 ± 3.0 mSv, respectively) ( P < 0.001). Qualitative assessment showed the image quality at the aortic root-proximal ascending aorta was significantly higher in group 1 (median 3) than in group 2 (median 2, P < 0.001). Quantitative assessment showed significantly better mean arterial attenuation, signal-to-noise ratio and contrast-to-noise ratio in ECG-triggered CTAA compared to non-ECG-triggered CTAA.Conclusion: ECG-triggered CTAA in a single-source scanner has superior image quality and vessel attenuation of aortic root/ascending aorta, but a higher radiation dose of approximately 23%. Its use should be considered specifically when assessing aortic root/ascending aorta pathology.","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"84-90"},"PeriodicalIF":2.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10942131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39550054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bronchial thermoplasty for severe asthmatics: a real-world clinical study from Malaysia. 严重哮喘患者的支气管热成形术：来自马来西亚的真实世界临床研究。

IF 2.7 4区医学

Singapore medical journal Pub Date : 2024-02-01 Epub Date: 2021-10-07 DOI: 10.11622/smedj.2021144

Chun Ian Soo, Woh Wei Mak, Mona Zaria Nasaruddin, Rosmadi Ismail, Andrea Yu-Lin Ban, Jamalul Azizi Abdul Rahaman

引用次数: 0

Percutaneous iliosacral screw fixation of sacral U-type fracture using a mid-foot intramedullary bolt: a case report 使用中足髓内栓经皮髂骶螺钉固定骶骨 U 型骨折：病例报告

IF 2.7 4区医学

Singapore medical journal Pub Date : 2024-01-08 DOI: 10.4103/singaporemedj.smj-2021-172

Peng Lee, Yong Sheng Chen, Amritpal Singh, Antony Gardner

引用次数: 0

Femoral neck system as a safe alternative to cannulated compression screw and dynamic hip screw in femoral neck fractures: an early comparative study 股骨颈系统在股骨颈骨折中作为插管加压螺钉和动态髋螺钉的安全替代品：早期比较研究

IF 2.7 4区医学

Singapore medical journal Pub Date : 2024-01-08 DOI: 10.4103/singaporemedj.smj-2022-024

Zhe Zheng Clyde Lim, Cheryl Marise Peilin Tan, Rex Premchand Antony Xavier, M. G. J. Yam, I. T. Chua

{"title":"Femoral neck system as a safe alternative to cannulated compression screw and dynamic hip screw in femoral neck fractures: an early comparative study","authors":"Zhe Zheng Clyde Lim, Cheryl Marise Peilin Tan, Rex Premchand Antony Xavier, M. G. J. Yam, I. T. Chua","doi":"10.4103/singaporemedj.smj-2022-024","DOIUrl":"https://doi.org/10.4103/singaporemedj.smj-2022-024","url":null,"abstract":"\u0000 \u0000 \u0000 The femoral neck system (FNS) is a safe alternative to cannulated compression screw (CCS) and dynamic hip screw (DHS) in femoral neck fractures.\u0000 \u0000 \u0000 \u0000 A dual-centre retrospective cohort study was performed on femoral neck fractures (AO type 31-B) treated with closed reduction and internal fixation using FNS, DHS or CCS between April 2016 and April 2020. Exclusion criteria were as follows: patients aged below 16 years; chronic fractures beyond 7 days; pathological fractures; fracture extension to the intertrochanteric region or ipsilateral neck and shaft fractures; and open fractures. A total of 85 patients were identified: FNS (n = 28), DHS (n = 29) and CCS (n = 28).\u0000 \u0000 \u0000 \u0000 The FNS and CCS groups had a lower Garden and Pauwels classification compared to the DHS group (both P < 0.001). Both FNS and CCS groups were comparable in postoperative orthopaedic complications (10.7% [n = 3] vs. 3.6% [n = 1], adjusted P = 0.321). The DHS group had more postoperative orthopaedic complications than the FNS group, but this was not statistically significant (27.6% [n = 8] vs. 10.7% [n = 3], adjusted P = 0.321). There were no significant differences in median time to radiological union or median femoral neck shortening at union (both P > 0.05) among the three groups.\u0000 \u0000 \u0000 \u0000 The new DePuy Synthes FNS is a safe alternative to CCS with comparable complication rates for femoral neck fractures that are less displaced and more stable. The FNS also appears to be a safe alternative to DHS in the fixation of femoral neck fractures for the few cases of high-energy femoral neck fractures.\u0000","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":"57 48","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139447147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Successful treatment of psoriasis-associated uveitis with ixekizumab after failure of secukinumab and risankizumab 在secukinumab和risankizumab治疗失败后使用ixekizumab成功治疗银屑病相关葡萄膜炎

IF 2.7 4区医学

Singapore medical journal Pub Date : 2024-01-02 DOI: 10.4103/singaporemedj.smj-2023-133

Angelyn Chen Yin Lua, Soon-Phaik Chee, Hazel Hwee Boon Oon

引用次数: 0

Jarisch–Herxheimer reaction in a patient with Weil’s disease 一名魏尔病患者的雅利什-赫克海默反应

IF 2.7 4区医学

Singapore medical journal Pub Date : 2024-01-02 DOI: 10.4103/singaporemedj.smj-2022-196

J. N. Ngiam, Tiara Joy Foo, Genevieve MY Tan, Jason Phua, Hui Fang Lim, P. Tambyah, G. Yan

引用次数: 0