Annals of the Academy of Medicine, Singapore最新文献

{"title":"Impact of risk stratification on cardiovascular outcomes in patients with stable chest pain.","authors":"Yi Yi Chua, Jonathan Yap, Yi Ling Eileen Koh, Khung Keong Yeo, Siang Jin Terrance Chua, Ngiap Chuan Tan, Zhen Sinead Wang","doi":"10.47102/annals-acadmedsg.202455","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.202455","url":null,"abstract":"","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127884","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":"\"Leveraging ChatGPT to aid patient education on coronary angiogram\": Correspondence.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.47102/annals-acadmedsg.2024205","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2024205","url":null,"abstract":"","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127882","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":"Repetitive transcranial magnetic stimulation for major depression and obsessive-compulsive disorders in Singapore.","authors":"Si Jia Ye, LinShan Lu, Hui Huang Phu, Xiao Wei Tan, Phern Chern Tor","doi":"10.47102/annals-acadmedsg.202496","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.202496","url":null,"abstract":"<p><strong>Introduction: </strong>Repetitive transcranial magnetic stimulation (rTMS) is used for treatment-resistant major depressive disorder (MDD) and obsessive-compulsive disorder (OCD), but there are few studies on patient outcomes in Southeast Asia. In this study, we describe the clinical profile and outcome of patients with MDD and OCD treated with rTMS in Singapore.</p><p><strong>Method: </strong>A naturalistic retrospective study of 71 patients (inpatient and outpatient) who received rTMS treatment between June 2018 and April 2023 was conducted. The depressive and obsessive outcome rating scales used were clinician-rated Montgomery-Åsberg Depression Rating Scale (MADRS), Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Clinical Global Impressions-Severity (CGI-S) and self-rated Depression Anxiety and Stress Scale-21 (DASS-21).</p><p><strong>Results: </strong>Clinician-rated and self-rated mood and general condition improved significantly. MADRS mean score improved from 28.1 (standard deviation [SD] 7.3) to 20.7 (SD 10.1) (<i>P</i><0.0001) (20.8% response rate/17% remission rate). CGI-S mean 4.6 (SD 0.8) improved to 3.3 (SD 1.2) (<i>P</i><0.0001). DASS-21 total mean improved from 67.3 (SD 24.6) to 49.6 (SD 28.0) (<i>P</i><0.0001). Y-BOCS mean score displayed a trend towards improvement from 30.1 (SD 7.5) to 27.2 (SD 6.9) (<i>P</i>=0.799). However, 44.4% of patients with OCD responded with a minimal 20% reduction in baseline Y-BOCS. Moreover, the subgroup of 35.8% of patients with less than 30 rTMS sessions had contributed disproportionately to nonresponse (85.7%). Patients who received rTMS treatment (>30 sessions) had a trend of larger improvement of MADRS score when compared to patients with (≤30 sessions) (9.4 [SD 9.7] versus 3.8 [SD 12.3] [<i>P</i>=0.078]).</p><p><strong>Conclusion: </strong>Response and remission rates for MDD and OCD suggest patients have a good response to rTMS treatment. Dosing longer rTMS sessions after an acute course helps to maximise effectiveness. Further research to determine predictors of outcome and characterise clinical features of late responders to target treatment more effectively is recommended.</p>","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127890","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":"Deep brain stimulation in Parkinson's disease: Looking back, looking forward.","authors":"Erle Ch Lim, Amy Ml Quek, Raymond Cs Seet","doi":"10.47102/annals-acadmedsg.2024260","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2024260","url":null,"abstract":"","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127883","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":"Isolated remote site musculoskeletal <i>Mycobacterium bovis</i> infections after BCG immunisation in immunocompetent children.","authors":"Jiawen Fong, Dawn Sinn Yii Chia, Darryl Ee Ming Chew, Kenneth Pak Leung Wong","doi":"10.47102/annals-acadmedsg.202449","DOIUrl":"10.47102/annals-acadmedsg.202449","url":null,"abstract":"","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127885","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":"Transcranial magnetic stimulation in psychiatry: A Singapore perspective.","authors":"Christopher Yi Wen Chan, Johnson Fam","doi":"10.47102/annals-acadmedsg.2024208","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2024208","url":null,"abstract":"","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127891","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":"Long-term outcomes of subthalamic nucleus deep brain stimulation for Parkinson's disease in Singapore.","authors":"Yi Zhan Cai, Yilong Zheng, Wei Li, Seyed Ehsan Saffari, Hwee Lan Ng, Angela Zhan, Zheyu Xu, Kay Yaw Tay, Wing Lok Au, Wai Hoe Ng, Louis Chew Seng Tan, Kai Rui Wan, Shermyn Neo","doi":"10.47102/annals-acadmedsg.2023374","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2023374","url":null,"abstract":"<p><strong>Introduction: </strong>Subthalamic nucleus deep brain stimulation (STN-DBS) is a proven treatment modality for Parkinson's disease (PD), reducing dyskinesia and time spent in the \"OFF\" state. This study evaluates the long-term outcomes of STN-DBS in PD patients up to 10 years post-surgery in Singapore.</p><p><strong>Method: </strong>We conducted a retrospective review of Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) scores, activities of daily living (ADLs), disease milestones, dopaminergic drug prescriptions, and adverse events in patients before and after STN-DBS surgery.</p><p><strong>Results: </strong>A total of 94 PD patients who underwent bilateral STN-DBS were included. STN-DBS reduced time in the \"OFF\" state by 36.9% at 1 year (<i>P</i>=0.034) and 40.9% at 5 years (<i>P</i>=0.006). Time with dyskinesia did not significantly change. Levodopa equivalent daily dose was reduced by 35.1% by 5 years (<i>P</i><0.001). MDS-UPDRS-II and III scores increased from 5 years post-DBS by 40.5% and 35.4%, respectively. Independence in ADLs decreased, though not significantly. The prevalence of frequent falls increased at 5 years. Surgery- and device-related adverse events were uncommon and generally mild.</p><p><strong>Conclusion: </strong>STN-DBS provides sustained relief from motor complications and reduced medication requirements in PD patients in Singapore. This study highlights STN-DBS as an effective treatment option, significantly enhancing the quality of life for those with PD.</p>","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127887","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":"Quality of life of family caregivers of children and young adults with Down syndrome: A systematic review and meta-analysis.","authors":"Fergus Edward Cheok, Natania Rae Xiangqin Tan, Yu Yi Chan, Bryan Wei Zhi Wong, Gwyneth Kong, Zubair Amin, Yvonne Peng Mei Ng","doi":"10.47102/annals-acadmedsg.202420","DOIUrl":"10.47102/annals-acadmedsg.202420","url":null,"abstract":"<p><strong>Introduction: </strong>The aims of this systematic review and meta-analysis are to synthesise quality of life (QOL) of family caregivers of children and young adults with Down syndrome (DS) and determine factors affecting their QOL.</p><p><strong>Method: </strong>This review was conducted as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Key search terms were \"quality of life\", \"down syndrome\" and \"trisomy 21\". Meta-analysis using random effect model was conducted where feasible. All studies underwent qualitative synthesis. The study protocol was registered with PROSPERO (CRD42023413532).</p><p><strong>Results: </strong>Eighteen studies with 1956 caregivers were included. Of the 10 studies utilising the World Health Organization Quality of Life Instrument-Brief Version, 5 were included in the meta-analysis. Psychosocial domain had the highest score with mean (95% confidence interval [CI]) of 63.18 (39.10-87.25). Scores were poorer in physical, environmental and social domains: 59.36 (28.24-90.48), 59.82 (19.57-100.07) and 59.83 (44.24-75.41), respectively. Studies were heterogenous with <i>I</i>2 values ranging from 99-100% (<i>P</i><0.01). The remaining 8 studies used 6 other instruments. Qualitative synthesis revealed that caregivers' QOL was adversely affected by child-related factors, such as level of functional independence, developmental delay, presence of multiple comorbidities, impaired activities of daily living and poor sleep quality. Environmental factors that adversely affected caregivers' QOL included number of children, housing and support from the family. Personal factors that affected caregivers' QOL included age, being a single mother, low education and low income.</p><p><strong>Conclusion: </strong>QOL of caregivers of children with DS was lower than population reference data. Understand-ing the factors that influence family caregivers' QOL is an essential step towards improving the QOL of caregivers and their children with DS.</p>","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127889","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":"Quality of life of children and young adults with Down syndrome from caregivers' perspective: A systematic review and meta-analysis.","authors":"Yu Yi Chan, Bryan Wei Zhi Wong, Fergus Edward Cheok, Natania Rae Xiangqin Tan, Gwyneth Kong, Zubair Amin, Yvonne Peng Mei Ng","doi":"10.47102/annals-acadmedsg.2023415","DOIUrl":"10.47102/annals-acadmedsg.2023415","url":null,"abstract":"<p><strong>Introduction: </strong>Down syndrome (DS) negatively impacts the well-being of affected individuals. This study aimed to summarise the evidence on quality of life (QOL) of children and young adults with DS using quantitative measures from caregivers' perspective and identify factors that affected their QOL.</p><p><strong>Method: </strong>Database search was conducted on PubMed, Embase, Web of Science and CINAHL on 24 April 2024. Meta-analysis using random effects model was conducted where feasible. All studies underwent qualitative synthesis. The study protocol was registered with PROSPERO (CRD42023413532).</p><p><strong>Results: </strong>Seventeen studies involving 3038 children with DS using various QOL measures were included: Pediatric Quality of Life Inventory (PedsQL) (8 studies), KIDSCREEN (4 studies), KidsLife (2 studies), The Netherlands Organization for Applied Scientific Research Academic Medical Center Children's QOL (2 studies) and Personal Outcome Scale (1 study). Meta-analysis on PedsQL studies compared scores between children with DS and typically developing (TD) children. Total scale score was lower in children with DS (mean 70.28, 95% confidence interval [CI] 64.31-76.24) compared to TD children (mean 88.17, 95% CI 80.50-95.83). All subdomains of PedsQL were also lower in children with DS. Within the domain of psychosocial health, children with DS had statistically significant lower social functioning (standardised mean difference -1.40, 95% CI -2.27 to -0.53) and school functioning (standardised mean difference -1.09, 95% CI -1.55 to -0.62) scores, but similar emotional functioning scores. Qualitative synthesis revealed poorer subdomain QOL compared to TD children, especially in social functioning and cognitive functioning. QOL worsened during adolescent years. Family variables (parental education and occupation) did not affect parental perception of children's QOL. Children with DS who had higher intelligent quotient had better QOL.</p><p><strong>Conclusion: </strong>Children with DS have lower caregiver-reported QOL than TD children, especially in social functioning and school functioning subdomains.</p>","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127888","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":"Living longer and stronger: Are children and young adults with Down syndrome experiencing healthier and better lives?","authors":"Cristelle Chow","doi":"10.47102/annals-acadmedsg.2024188","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2024188","url":null,"abstract":"","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127886","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}