Annals Academy of Medicine Singapore最新文献

{"title":"The eye as a window to the brain.","authors":"Misha L Pless","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9083555","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}

{"title":"Reducing non-clinical working hours of junior doctors could benefit patient outcomes.","authors":"Joshua Yi Min Tung, Jia Long Chua, Zeenathnisa Mougammadou Aribou, Gerald Gui Ren Sng","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9083556","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}

{"title":"Concordance of self-reporting of diabetes compared with medical records: A comparative study using polyclinic data in Singapore.","authors":"Khai Wei Tan,&nbsp;Jeremy Kaiwei Lew,&nbsp;Poay Sian Sabrina Lee,&nbsp;Sin Kee Ong,&nbsp;Hui Li Koh,&nbsp;Doris Yee Ling Young,&nbsp;Eng Sing Lee","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Studies of concordance between patients' self-report of diseases and a criterion standard (e.g. chart review) are usually conducted in epidemiological studies to evaluate the agreement of self-reported data for use in public health research. To our knowledge, there are no published studies on concordance for highly prevalent chronic diseases such as diabetes and pre-diabetes. The aims of this study were to evaluate the concordance between patients' self-report and their medical records of diabetes and pre-diabetes diagnoses, and to identify factors associated with diabetes concordance.</p><p><strong>Method: </strong>A cross-sectional, interviewer-administered survey was conducted on patients with chronic diseases after obtaining written consent to assess their medical notes. Interviewers were blinded to the participants' profiles. Concordance was evaluated using Cohen's kappa (κ). A multivariable logistic regression model was used to identify factors associated with diabetes concordance.</p><p><strong>Results: </strong>There was substantial agreement between self-reported and medical records of diabetes diagnoses (κ=0.76) and fair agreement for pre-diabetes diagnoses (κ=0.36). The logistic regression model suggested that non-Chinese patients had higher odds of diabetes concordance than Chinese patients (odds ratio [OR]=4.10, 95% confidence interval [CI] 1.19-14.13, <i>P</i>=0.03). Patients with 3 or more chronic diseases (i.e. multimorbidity) had lower odds of diabetes concordance than patients without multimorbidity (OR=0.21, 95% CI 0.09-0.48, <i>P</i><0.001).</p><p><strong>Conclusion: </strong>Diabetes concordance was substantial, supporting the use of self-report of diabetes by patients with chronic diseases in the primary care setting for future research. Pre-diabetes concordance was fair and may have important clinical implications. Further studies to explore and improve health literacy and patient-physician communication are needed.</p>","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10869939","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}

{"title":"Immune and coagulation profiles in 3 adults with multisystem inflammatory syndrome.","authors":"Ruth Xian Lynn Yap,&nbsp;Bernard Pui Lam Leung,&nbsp;Hwee Siew Howe,&nbsp;Mung Ee Loh,&nbsp;Barnaby Edward Young,&nbsp;Bingwen Eugene Fan,&nbsp;Xin Rong Lim","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>There is a paucity of information on the cytokine, complement, endothelial activation, and coagulation profiles of multisystem inflammatory syndrome in adults (MIS-A), a rare but serious complication following recovery from SARS-CoV-2 infection. We aim to examine the immune biomarker and coagulation profiles in association with the clinical presentation and course of MIS-A.</p><p><strong>Method: </strong>The clinical features of MIS-A patients admitted to our tertiary hospital were documented. Their levels of interleukin (IL)-1β, IL-6, IL-10, IL-17, IL-18, interferon-α (IFN-α), IFN-γ, interferon gamma-induced protein 10 (IP-10), tumour necrosis factor (TNF)-α, monocyte chemoattractant protein (MCP)-1, complement activation product (complement 5a [C5a]), and endothelial biomarker intercellular adhesion molecule-1 (ICAM-1) levels were assayed. The haemostatic profile was assessed with standard coagulation testing and thromboelastography.</p><p><strong>Results: </strong>Three male patients were diagnosed with MIS-A at our centre from January to June 2022 with a median age of 55 years. All had tested positive for SARS-CoV-2 12-62 days prior to MIS-A presentation, with gastrointestinal and cardiovascular systems as the most commonly involved. Levels of IL-6, IL-10, IL-18, IP-10 and MCP-1 were raised whereas IL-1β, IFN-α, IFN-γ, IL-17 and TNF-α remained normal. Markedly elevated levels of C-reactive protein (CRP), ferritin and ICAM-1 were present in all. C5a was elevated in 2 patients. A hypercoagulable state was demonstrated by raised levels of D-dimer, factor VIII, von Willebrand factor antigen, and ristocetin cofactor with corresponding raised parameters in thromboelastography in the 2 patients who had their coagulation profile assessed.</p><p><strong>Conclusion: </strong>MIS-A patients demonstrate activation of pro-inflammatory cytokines, endotheliopathy, complement hyperactivation and hypercoagulability.</p>","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10869941","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}

{"title":"Diabetes: Know thy foe.","authors":"P. Wong","doi":"10.47102/annals-acadmedsg.202324","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.202324","url":null,"abstract":"","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43910488","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}

{"title":"The eye as a window to the brain.","authors":"Misha L Pless","doi":"10.47102/annals-acadmedsg.202317","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.202317","url":null,"abstract":"The University Eye Clinic Maastricht is leading in eye care in the Netherlands, and home to 'the Maastricht Study', an ongoing population-based cohort study that focuses on the etiology, pathophysiology, complications and comorbidities of type 2 diabetes mellitus [1]. The Maastricht Study aims to include 10,000 participants aged between 40 and 75 years and living in the southern part of the Netherlands. The Maastricht Study is characterized by an extensive phenotyping approach, including the assessment of cardiovascular diseases, chronic diseases, public health medicine, biomarkers, lifestyle and behavior, and neurological diseases, including eye diseases (see Figure 1). The following ophthalmic measurements are performed at The Maastricht Study: autorefraction and intraocular pressure, visual acuity, dynamic vessel analysis, Scheimpflug camera of the anterior eye segment, macular pigment reflectometer, fundus photography, perimetry, optical coherence tomography, and confocal microscopy of the cornea.","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49384583","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}

{"title":"Concordance of self-reporting of diabetes compared with medical records: A comparative study using polyclinic data in Singapore.","authors":"Khai Wei Tan, Jeremy Kaiwei Lew, P. S. Lee, Sin Kee Ong, Hui Li Koh, D. Young, Eng Sing Lee","doi":"10.47102/annals-acadmedsg.2022246","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2022246","url":null,"abstract":"INTRODUCTION\u0000Studies of concordance between patients' self-report of diseases and a criterion standard (e.g. chart review) are usually conducted in epidemiological studies to evaluate the agreement of self-reported data for use in public health research. To our knowledge, there are no published studies on concordance for highly prevalent chronic diseases such as diabetes and pre-diabetes. The aims of this study were to evaluate the concordance between patients' self-report and their medical records of diabetes and pre-diabetes diagnoses, and to identify factors associated with diabetes concordance.\u0000\u0000\u0000METHOD\u0000A cross-sectional, interviewer-administered survey was conducted on patients with chronic diseases after obtaining written consent to assess their medical notes. Interviewers were blinded to the participants' profiles. Concordance was evaluated using Cohen's kappa (κ). A multivariable logistic regression model was used to identify factors associated with diabetes concordance.\u0000\u0000\u0000RESULTS\u0000There was substantial agreement between self-reported and medical records of diabetes diagnoses (κ=0.76) and fair agreement for pre-diabetes diagnoses (κ=0.36). The logistic regression model suggested that non-Chinese patients had higher odds of diabetes concordance than Chinese patients (odds ratio [OR]=4.10, 95% confidence interval [CI] 1.19-14.13, P=0.03). Patients with 3 or more chronic diseases (i.e. multimorbidity) had lower odds of diabetes concordance than patients without multimorbidity (OR=0.21, 95% CI 0.09-0.48, P<0.001).\u0000\u0000\u0000CONCLUSION\u0000Diabetes concordance was substantial, supporting the use of self-report of diabetes by patients with chronic diseases in the primary care setting for future research. Pre-diabetes concordance was fair and may have important clinical implications. Further studies to explore and improve health literacy and patient-physician communication are needed.","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45529328","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}

{"title":"Safety and effectiveness of nitrous oxide procedural sedation in a paediatric emergency department.","authors":"S. Tan, L. P. Tham","doi":"10.47102/annals-acadmedsg.2022195","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2022195","url":null,"abstract":"","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44106518","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}

{"title":"Diabetes: Know thy foe.","authors":"Peng Yong Andrew Wong","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9136717","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}

{"title":"Factors associated with deep infiltrating endometriosis, adenomyosis and ovarian endometrioma.","authors":"Xi-wei Yuan, B. W. Wong, N. Randhawa, Thu PP Win, Y. Chan, Li Ma, E. Yong","doi":"10.47102/annals-acadmedsg.2022334","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2022334","url":null,"abstract":"INTRODUCTION\u0000To compare epidemiological features and clinical presentations of deep infiltrating endometriosis with endometrioma and adenomyosis, as well as to identify risk factors for the respective histologically confirmed conditions.\u0000\u0000\u0000METHOD\u0000Patients undergoing index surgery at the National University Hospital, Singapore for endometriosis or adenomyosis over a 7-year period-from 2015 to 2021-were identified from hospital databases using the Table of Surgical Procedures coding. Social and epidemiological features of cases with histologically confirmed diagnoses of endometrioma only, adenomyosis only, and deep infiltrating endometriosis were compared. Significant variables from univariate analysis were entered into 3 binary multivariate logistic regression models to obtain independent risk factors for: deep infiltrating endometriosis versus endometrioma only, deep infiltrating endometriosis versus adenomyosis only, and adenomyosis only versus endometrioma only.\u0000\u0000\u0000RESULTS\u0000A total of 258 patients were included with 59 ovarian endometrioma only, 47 adenomyosis only, and 152 deep infiltrating endometrioses. Compared to endometrioma only, deep infiltrating endometriosis was associated with higher rates of severe dysmenorrhoea (odds ratio [OR] 2.80, 95% confidence interval [CI] 1.02-7.70) and out-of-pocket private surgical care (OR 4.72, 95% CI 1.85-12.04). Compared to adenomyosis only, deep infiltrating endometriosis was associated with a higher fertility desire (OR 13.47, 95% CI 1.01-180.59) and a lower body mass index (OR 0.89, 95% CI 0.79-0.99). In contrast, heavy menstrual bleeding was the hallmark of adenomyosis, being less common in patients with endometriosis.\u0000\u0000\u0000CONCLUSION\u0000Deep infiltrating endometriosis is associated with severe dysmenorrhoea, pain related to urinary and gastrointestinal tracts, higher fertility desire and infertility rate. Patients with pain symptomatology and subfertility should be referred early to a tertiary centre with the capability to diagnose and manage deep infiltrating endometriosis.","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44760100","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}