Annals of the Academy of Medicine, Singapore最新文献

{"title":"Factors associated with willingness to quit smoking in a hospital-based smoking cessation programme.","authors":"Liesel Fong, Rachel Shiyi Lu, Mariko Siyue Koh, Ken Cheah Hooi Lee, Pei Yee Tiew","doi":"10.47102/annals-acadmedsg.2026172","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2026172","url":null,"abstract":"<p><strong>Introduction: </strong>Hospital admissions provide an important opportunity for smoking cessation interventions. However, factors associated with willingness to quit smoking among hospitalised smokers remain underexplored, particularly in the multi-ethnic Asian population.</p><p><strong>Method: </strong>In this cross-sectional study of hospitalised smokers referred to an inpatient smoking cessation service between 2021 and 2025, enrolment data on willingness to quit, demographics, and clinical characteristics were analysed using multivariable logistic regression. A clinical feature score was developed to assess dose-response associations.</p><p><strong>Results: </strong>Of 953 smokers (median age 57 years; 92% male), 49% reported willingness to quit smoking. In the multivariable analysis, ischaemic heart disease (odds ratio [OR] 2.20, 95% confidence interval [CI] 1.50-3.24, P<0.001), cerebrovascular accident (OR 2.30, 95% CI 1.30-4.12, P=0.005), chronic obstructive pulmonary disease assessment score ≥10 (OR 2.16, 95% CI 1.10- 4.38, P=0.03), modified Medical Research Council dyspnoea score ≥2 (OR 1.87, 95% CI 1.06-3.31, P=0.03), post-secondary education (OR 13.47, 95% CI 5.51- 38.75, P<0.001), and primary/secondary education (OR 3.49, 95% CI 1.45-9.85, P=0.01) relative to no formal education and respiratory admission or visit in the past year (OR 3.55, 95% CI 1.43-9.87, P=0.009) remained associated with willingness to quit smoking. A graded association was observed between accumulation of these clinical features and readiness to quit, with each additional feature associated with higher odds of willingness to quit (OR 2.79, 95% CI 2.18-3.57, P<0.001).</p><p><strong>Conclusion: </strong>Greater clinical burden was associated with willingness to quit smoking among referred hospitalised smokers. Accumulated clinical risk factors may help identify patients with greater readiness to quit and guide targeted counselling although longitudinal studies are needed to assess clinical utility.</p>","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommendations for the diagnosis and management of neurofibromatosis type 1 in Singapore: A Delphi consensus.","authors":"Nikki Fong, Ee Shien Tan, Joanne Ngeow, Jeanette Yuen, Jianbang Chiang","doi":"10.47102/annals-acadmedsg.2026152","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2026152","url":null,"abstract":"<p><strong>Introduction: </strong>Neurofibromatosis type 1 (NF1) is a multisystem genetic disorder with wide phenotypic variability, necessitating coordinated multidisciplinary care and Singapore-relevant guidance. This study aimed to develop Singapore-specific, consensus-based recommendations for NF1 diagnosis, surveillance, and management.</p><p><strong>Method: </strong>The study involved 2 rounds of online surveys and a participant meeting with 24 experts from Singapore. Following a literature review, a 151-statement questionnaire was developed (133 Likert-style statements, 13 open-ended questions, 5 single-select questions). Statements were rated on a 9-point Likert scale with a predefined consensus threshold of ≥75%; analyses were performed after each round.</p><p><strong>Results: </strong>Surveys 1 and 2 involved 19 and 17 participants, respectively, with 14 attending the meeting. Consensus was reached for 113/133 statements in Survey 1 and 9/21 in Survey 2. Experts reached consensus on genetic testing across diagnostic scenarios, including Sproutyrelated EVH1 domain‑containing protein 1 analysis and ribonucleic acid testing. Agreed surveillance incorporated examinations twice a year until the age of 5 years, at least annually thereafter in childhood, annual symptom checks in adults with triennial specialist review, and targeted MRI-based imaging, including whole-body magnetic resonance imaging around transition. Management recommendations favoured multidisciplinary review and surgical resection when feasible.</p><p><strong>Conclusion: </strong>This Delphi consensus provides unified recommendations to support consistent NF1 care across paediatric and adult services in Singapore, while highlighting areas without consensus and priorities for implementation and further research.</p>","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Closing the gender gap in human papillomavirus protection: A survey of healthcare workers.","authors":"Jessica Weizhen Chen, Chaoyan Dong, Derrick Chen Wee Aw","doi":"10.47102/annals-acadmedsg.2026419","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2026419","url":null,"abstract":"","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world doxycycline post-exposure prophylaxis and bacterial STI incidence among MSM using HIV PrEP in Singapore.","authors":"Ren Jie Tsai, Xiahong Zhao, Linus Cheng, Benson Koon Wee Yeo","doi":"10.47102/annals-acadmedsg.2026427","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2026427","url":null,"abstract":"","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":"55 9","pages":"492-494"},"PeriodicalIF":2.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traditional Chinese Medicine in Singapore: Integrating education, practice, and research in a modern healthcare system.","authors":"Sarah Ann Phua, Ern-Lyn Chloe Sarah Yen, Desmond B Teo, Hui Ping Ng, Shih-Hui Lim","doi":"10.47102/annals-acadmedsg.2026323","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2026323","url":null,"abstract":"","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":"55 9","pages":"480-484"},"PeriodicalIF":2.0,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond haemodynamics: Do SGLT2 inhibitors protect the podocyte?","authors":"Arshvini Vijaya Kumar, Emmett Tsz Yeung Wong","doi":"10.47102/annals-acadmedsg.2026555","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2026555","url":null,"abstract":"","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":"55 9","pages":"447-449"},"PeriodicalIF":2.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coblation intracapsular tonsillectomy outcomes in paediatric obstructive sleep disordered breathing: A Singapore study.","authors":"Elaine Yf Huang, Stephanie Yan Yu Yeap, Hasmin Hannah Lara-Layno, Henry Kk Tan","doi":"10.47102/annals-acadmedsg.2025420","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2025420","url":null,"abstract":"<p><strong>Introduction: </strong>Coblation intracapsular tonsillectomy (ICT) may offer a more favourable post-operative morbidity profile compared with extracapsular tonsillectomy for paediatric obstructive sleep-disordered breathing (oSDB). Data from the Singapore paediatric population remain limited. This study examines the outcomes of coblation ICT in children with oSDB at a tertiary centre in Singapore.</p><p><strong>Method: </strong>This was a single-centre prospective cohort study of 102 consecutive children aged 21 months to 15 years undergoing coblation ICT for oSDB (April-October 2023). Concurrent adenoidectomy was performed in 98.0% of patients. Primary outcomes included complications and disease-specific quality of life (QoL) via the Obstructive Sleep Apnea-18 Quality of Life (OSA-18) questionnaire (where higher scores indicate greater symptom burden and poorer quality of life), assessed pre-operatively and at 3 months. Secondary outcomes included pain, analgesia, diet, and snoring resolution.</p><p><strong>Results: </strong>No post-operative haemorrhage or major complications occurred. All 102 patients completed a 3-month review. The median OSA-18 score improved significantly from 74 (interquartile range [IQR] 54-89) to 29.5 (IQR 23-40) post-operatively (P<0.001), representing a shift from the moderate to the minimal impact band. The mean change of 39.3 points exceeded twice the published minimal clinically important difference (standardised response mean 2.17). Perceived QoL score improved from median 5 (IQR 4-6.6) to 8 (IQR 8-9) (P<0.001). At 3 months, 82.4% had no snoring. Postoperative pain was mild, with 75.5% requiring analgesia for 3 days or fewer.</p><p><strong>Conclusion: </strong>In this uncontrolled single-arm cohort, coblation ICT with concurrent adenoidectomy was associated with low morbidity and clinically meaningful improvements in caregiver-reported outcomes. These hypothesis-generating findings warrant further investigation through multicentre comparative studies with longer follow-up.</p>","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":"55 9","pages":"472-479"},"PeriodicalIF":2.0,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-assisted analysis of public data to identify diabetes stakeholder priorities in Singapore: A proof-of-concept study.","authors":"Mabel Qi He Leow, Sonia Gupta, Denise Lin, Ngiap Chuan Tan","doi":"10.47102/annals-acadmedsg.2026124","DOIUrl":"10.47102/annals-acadmedsg.2026124","url":null,"abstract":"","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":" ","pages":"488-491"},"PeriodicalIF":2.0,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148979041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes, chronic kidney disease, and annual hospital costs in older patients: A cost decomposition analysis.","authors":"Hui Foh Foong, Amanda En Yap, Amartya Mukhopadhyay","doi":"10.47102/annals-acadmedsg.2026338","DOIUrl":"10.47102/annals-acadmedsg.2026338","url":null,"abstract":"","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":" ","pages":"495-497"},"PeriodicalIF":2.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148979103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomised controlled study of canagliflozin in improving diabetic kidney disease through a podocyte protection mechanism.","authors":"Suping Gu, Najun Zhu, Guojuan Hang, Weiping Tu","doi":"10.47102/annals-acadmedsg.2026231","DOIUrl":"10.47102/annals-acadmedsg.2026231","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate whether canagliflozin improves diabetic kidney disease (DKD) through a podocyte protective mechanism.</p><p><strong>Method: </strong>DKD patients were randomly assigned to the experimental group (87 patients: standard therapy plus cangliflozin 100 mg/day) and the control group (85 patients: standard therapy plus placebo tablets), with a treatment course of 12 weeks. Investigators and outcome assessors were blinded to allocation. Changes in blood glucose, DKD-related indicators (serum albumin, serum creatinine, blood urea nitrogen [BUN], 24-hour urinary protein [24h-UP], urinary albumin-to-creatinine ratio (UACR), and podocyte injury markers (urinary podocyte count, urinary podocalyxin-to-urinary creatinine ratio [UPCX/Ucr]) were compared. Linear mixed-effects models were used to compare intergroup differences, and mediation effect analysis was performed to evaluate the role of UPCX/Ucr in the improvement of DKD-related indicators by canagliflozin.</p><p><strong>Results: </strong>Under comparable blood glucose control, the experimental group showed superior outcomes in reducing BUN (between‑group difference at week 12: -0.67 mmol/L, 95% confidence interval [CI] -1.10 to -0.24), 24h-UP (geometric mean ratio 0.73, 95% CI 0.65 to 0.82), UACR (geometric mean ratio 0.72, 95% CI 0.65 to 0.80), urinary podocyte count (geometric mean ratio 0.48, 95% CI 0.43 to 0.54), and UPCX/Ucr (geometric mean ratio 0.72, 95% CI 0.66 to 0.79) compared to the control group. Mediation analysis revealed that UPCX/ Ucr exerted a significant indirect effect in the reduction of UACR (indirect effect = -0.968, 95% CI -1.171 to -0.774) and 24h‑UP (indirect effect = -0.783, 95% CI -1.127 to -0.655) by canagliflozin, with no statistically significant direct effects. For serum creatinine reduction, UPCX/Ucr played a partial mediating role with a small indirect effect (indirect effect = -0.301, 95% CI -0.437 to -0.153), alongside a significant direct effect.</p><p><strong>Conclusion: </strong>Canagliflozin provides significant renal protective effects for DKD patients, effectively lowering blood glucose while reducing urinary protein, lowering serum creatinine from baseline, and protecting podocytes. The reduction in urinary protein appears to be statistically mediated by podocyte protection, rather than being solely dependent on blood glucose control. However, this mediation analysis does not establish causality.</p>","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":" ","pages":"450-460"},"PeriodicalIF":2.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148979049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}