Matilda Xinwei Lee, Siyu Peng, Ainsley Ryan Yan Bin Lee, Shi Yin Wong, Ryan Yong Kiat Tay, Jiaqi Li, Areeba Tariq, Claire Xin Yi Goh, Ying Kiat Tan, Benjamin Kye Jyn Tan, Chong Boon Teo, Esther Chan, Melissa Ooi, Wee Joo Chng, Cheng Ean Chee, Carol L F Ho, Robert John Walsh, Maggie Wong, Yan Su, Lezhava Alexander, Sunil Kumar Sethi, Shaun Shi Yan Tan, Yiong Huak Chan, Kelvin Bryan Tan, Soo Chin Lee, Louis Yi Ann Chai, Raghav Sundar
{"title":"Clinical efficacy and long-term immunogenicity of an early triple dose regimen of SARS-CoV-2 mRNA vaccination in cancer patients.","authors":"Matilda Xinwei Lee, Siyu Peng, Ainsley Ryan Yan Bin Lee, Shi Yin Wong, Ryan Yong Kiat Tay, Jiaqi Li, Areeba Tariq, Claire Xin Yi Goh, Ying Kiat Tan, Benjamin Kye Jyn Tan, Chong Boon Teo, Esther Chan, Melissa Ooi, Wee Joo Chng, Cheng Ean Chee, Carol L F Ho, Robert John Walsh, Maggie Wong, Yan Su, Lezhava Alexander, Sunil Kumar Sethi, Shaun Shi Yan Tan, Yiong Huak Chan, Kelvin Bryan Tan, Soo Chin Lee, Louis Yi Ann Chai, Raghav Sundar","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Three doses of SARS-CoV-2 mRNA vaccines have been recommended for cancer patients to reduce the risk of severe disease. Anti-neoplastic treatment, such as chemotherapy, may affect long-term vaccine immunogenicity.</p><p><strong>Method: </strong>Patients with solid or haematological cancer were recruited from 2 hospitals between July 2021 and March 2022. Humoral response was evaluated using GenScript cPASS surrogate virus neutralisation assays. Clinical outcomes were obtained from medical records and national mandatory-reporting databases.</p><p><strong>Results: </strong>A total of 273 patients were recruited, with 40 having haematological malignancies and the rest solid tumours. Among the participants, 204 (74.7%) were receiving active cancer therapy, including 98 (35.9%) undergoing systemic chemotherapy and the rest targeted therapy or immunotherapy. All patients were seronegative at baseline. Seroconversion rates after receiving 1, 2 and 3 doses of SARS-CoV-2 mRNA vaccination were 35.2%, 79.4% and 92.4%, respectively. After 3 doses, patients on active treatment for haematological malignancies had lower antibodies (57.3%±46.2) when compared to patients on immunotherapy (94.1%±9.56, <i>P</i><0.05) and chemotherapy (92.8%±18.1, <i>P</i><0.05). SARS-CoV-2 infection was reported in 77 (28.2%) patients, of which 18 were severe. No patient receiving a third dose within 90 days of the second dose experienced severe infection.</p><p><strong>Conclusion: </strong>This study demonstrates the benefit of early administration of the third dose among cancer patients.</p>","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":"52 1","pages":"8-16"},"PeriodicalIF":5.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10644007","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}
Chang Yi Woon, Serene Si Ning Goh, Lin Seong Soh, Chloe Fu Cui Yeo, Marc Weijie Ong, Benjamin Wong, Joelle Hoi Ting Leong, Jerry Tiong Thye Goo, Clement Luck Khng Chia
{"title":"Surgical margins assessment reduces re-excision rates in breast-conserving surgery.","authors":"Chang Yi Woon, Serene Si Ning Goh, Lin Seong Soh, Chloe Fu Cui Yeo, Marc Weijie Ong, Benjamin Wong, Joelle Hoi Ting Leong, Jerry Tiong Thye Goo, Clement Luck Khng Chia","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":"52 1","pages":"48-51"},"PeriodicalIF":5.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9255485","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":"Combating a resurgence of poliomyelitis through public health surveillance and vaccination.","authors":"C. Chong, Kai-qian Kam, C. Yung","doi":"10.47102/annals-acadmedsg.2022390","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2022390","url":null,"abstract":"Poliomyelitis, or polio, is a highly infectious disease and can result in permanent flaccid paralysis of the limbs. Singapore was certified polio-free by the World Health Organization (WHO) on 29 October 2000, together with 36 other countries in the Western Pacific Region. The last imported case of polio in Singapore was in 2006. Fortunately, polio is vaccine-preventable-the world saw the global eradication of wild poliovirus types 2 and 3 achieved in 2015 and 2019, respectively. However, in late 2022, a resurgence of paralytic polio cases from vaccine-derived poliovirus (VDPV) was detected in countries like Israel and the US (specifically, New York); VDPV was also detected during routine sewage water surveillance with no paralysis cases in London, UK. Without global eradication, there is a risk of re-infection from importation and spread of wild poliovirus or VDPV, or new emergence and circulation of VDPV. During the COVID-19 pandemic, worldwide routine childhood vaccination coverage fell by 5% to 81% in 2020-2021. Fortunately, Singapore has maintained a constantly high vaccination coverage of 96% among 1-year-old children as recorded in 2021. All countries must ensure high poliovirus vaccination coverage in their population to eradicate poliovirus globally, and appropriate interventions must be taken to rectify this if the coverage falters. In 2020, WHO approved the emergency use listing of a novel oral polio vaccine type 2 for countries experiencing circulating VDPV type 2 outbreaks. Environmental and wastewater surveillance should be implemented to allow early detection of \"silent\" poliovirus transmission in the population, instead of relying on clinical surveillance of acute flaccid paralysis based on case definition alone.","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":"52 1 1","pages":"17-26"},"PeriodicalIF":5.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48544057","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":"Early COVID-19 booster is beneficial in cancer patients.","authors":"Jens Samol","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":"52 1","pages":"3-5"},"PeriodicalIF":5.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9255483","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}
G. J. Lim, Serena Low, A. Liu, Y. Shao, T. Subramaniam, C. Sum, S. Lim
{"title":"Association between self-care and chronic kidney disease in patients with type 2 diabetes mellitus.","authors":"G. J. Lim, Serena Low, A. Liu, Y. Shao, T. Subramaniam, C. Sum, S. Lim","doi":"10.47102/annals-acadmedsg.2022299","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2022299","url":null,"abstract":"","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":"52 1 1","pages":"52-54"},"PeriodicalIF":5.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42119539","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":"Board of Reviewers 2022.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":"52 1","pages":"55"},"PeriodicalIF":5.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9228188","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}
Woo Chiao Tay, Joyce Siong See Lee, Wei Sheng Chong
{"title":"Tozinameran (Pfizer-BioNTech COVID-19 vaccine)-induced AGEP-DRESS syndrome.","authors":"Woo Chiao Tay, Joyce Siong See Lee, Wei Sheng Chong","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":"51 12","pages":"796-797"},"PeriodicalIF":5.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10480582","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":"Characteristics of anti-transcriptional intermediary factor 1 gamma autoantibody-positive dermatomyositis patients in Singapore.","authors":"Choon Guan Chua, Jia Zhen Low, Wei Yen Lim, Mona Manghani","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to determine the clinical profile and outcome of anti-transcriptional intermediary factor 1 gamma autoantibody (anti-TIF1-γ Ab)-positive dermatomyositis patients and propose cancer screening programmes based on regional cancer trends.</p><p><strong>Method: </strong>Data on history, physical findings and investigations were collected using chart review on dermatomyositis patients seen at a tertiary hospital in Singapore from 1 January 2015 to 30 June 2021. Comparisons were made between anti-TIF1-γ Ab-positive and anti-TIF1-γ Ab-negative dermatomyositis.</p><p><strong>Results: </strong>Ninety-six dermatomyositis patients were analysed and 36 patients were positive for anti-TIF1-γ Ab. Anti-TIF1-γ Ab-positive patients had more frequent heliotrope rashes, shawl sign, periungual erythema, holster sign, Gottron's papules, dysphagia and truncal weakness (<i>P</i><0.05). They had less frequent interstitial lung disease, polyarthritis, cutaneous ulcers, palmar papules and mechanic's hands (<i>P</i><0.05). After 48 months of follow-up, a higher proportion of anti-TIF1-γ Ab-positive patients developed cancer compared with Ab-negative patients (63.9% versus 8.5%; odds ratio 19.1, 95% confidence interval 6.1-59.8; <i>P</i><0.001). Nasopharyngeal carcinoma (NPC) and breast cancer were the most common malignancies, followed by bowel, lung and non-Hodgkin lymphoma. Most malignancies (78.3%) occurred within 13 months prior to, or 4 months after the onset of dermatomyositis. The mortality rate for anti-TIF1-γ Ab-positive patients was significantly higher than Ab-negative patients (36.1% vs 16.7%, <i>P</i>=0.031), and Kaplan-Meier survival estimates at 24 months were 66% and 89%, respectively (<i>P</i>=0.0153).</p><p><strong>Conclusion: </strong>These observational data support periodic screening of NPC and other malignancies in patients with anti-TIF1-γ Ab-positive dermatomyositis in Singapore.</p>","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":"51 12","pages":"755-765"},"PeriodicalIF":5.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10501078","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}
Stephanie Pei Li Saw, Kevin Lee Min Chua, Boon Hean Ong, Darren Wan Teck Lim, Gillianne Geet Yi Lai, Daniel Shao Weng Tan, Mei Kim Ang
{"title":"Multidisciplinary lung cancer clinic: An emerging model of care.","authors":"Stephanie Pei Li Saw, Kevin Lee Min Chua, Boon Hean Ong, Darren Wan Teck Lim, Gillianne Geet Yi Lai, Daniel Shao Weng Tan, Mei Kim Ang","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":"51 12","pages":"793-795"},"PeriodicalIF":5.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10475777","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}
Kathleen Shu-En Quah, Xiaoling Huang, L. Rénia, Hazel H. Oon
{"title":"Drug interactions between common dermatological medications and the oral anti-COVID-19 agents nirmatrelvir-ritonavir and molnupiravir.","authors":"Kathleen Shu-En Quah, Xiaoling Huang, L. Rénia, Hazel H. Oon","doi":"10.47102/annals-acadmedsg.2022289","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2022289","url":null,"abstract":"INTRODUCTION\u0000The oral antiviral agents nirmatrelvir-ritonavir (NMV/r) and molnupiravir are used to treat mild-to-moderate COVID-19 infection in outpatients. However, the use of NMV/r is complicated by significant drug-drug interactions (DDIs) with frequently prescribed medications. Healthcare professionals should be aware of the possible risk of DDIs, given the emergence of COVID-19 variants and the widespread use of oral COVID-19 treatments. We reviewed available data on DDIs between NMV/r, molnupiravir and common dermatological medications; summarised the potential side effects; and suggest strategies for safe COVID-19 treatment.\u0000\u0000\u0000METHOD\u0000A systematic review using PubMed was conducted on data published from inception to 18 July 2022 to find clinical outcomes of DDIs between NMV/r, molnupiravir and dermatological medications. We also searched the Lexicomp, Micromedex, Liverpool COVID-19 Drug Interactions database and the National Institutes of Health COVID-19 Treatment Guidelines for interactions between NMV/r and molnupiravir, and commonly used dermatological medications.\u0000\u0000\u0000RESULTS\u0000NMV/r containing the cytochrome P-450 (CYP) 3A4 inhibitor ritonavir has DDIs with other medications similarly dependent on CYP3A4 metabolism. Dermatological medications that have DDIs with NMV/r include rifampicin, clofazimine, clarithromycin, erythromycin, clindamycin, itraconazole, ketoconazole, fluconazole, bilastine, rupatadine, dutasteride, ciclosporin, cyclophosphamide, tofacitinib, upadacitinib, colchicine and systemic glucocorticoids. With no potential DDI identified yet in in vitro studies, molnupiravir may be an alternative COVID-19 therapy in patients taking medications that have complicated interactions with NMV/r, which cannot be stopped or dose adjusted.\u0000\u0000\u0000CONCLUSION\u0000NMV/r has significant DDIs with many common dermatological medications, which may require temporary discontinuation, dosage adjustment or substitution with other anti-COVID-19 agents such as molnupiravir.","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":"51 12 1","pages":"774-786"},"PeriodicalIF":5.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46188770","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}