Annals Academy of Medicine Singapore最新文献_第9页

Diagnostic accuracy of multiparametric MRI in endometrial cancer and its adjunctive value in identifying high-risk women requiring surgical staging. 多参数MRI对子宫内膜癌症的诊断准确性及其在识别需要手术分期的高危女性中的辅助价值。

IF 5.2 4区医学

Annals Academy of Medicine Singapore Pub Date : 2022-12-01 DOI: 10.47102/annals-acadmedsg.2022125

L. Chew, Bernard Ji Guang Chua, I. Busmanis, A. Tay, C. Lim, Jack Junjie Chan, Kiattissa Sommat, S. Tay, T. Ho, J. Kwek

引用次数: 1

Low skeletal muscle mass predicts poor prognosis of elderly patients after emergency laparotomy: A single Asian institution experience. 低骨骼肌质量预测急诊剖腹手术后老年患者预后不良:一个亚洲机构的经验。

IF 5.2 4区医学

Annals Academy of Medicine Singapore Pub Date : 2022-12-01

Edmund Wooi Keat Tan, Jia Yi Yeo, Yao Zong Lee, Rahul Lohan, Woan Wui Lim, Daniel Jin Keat Lee

{"title":"Low skeletal muscle mass predicts poor prognosis of elderly patients after emergency laparotomy: A single Asian institution experience.","authors":"Edmund Wooi Keat Tan, Jia Yi Yeo, Yao Zong Lee, Rahul Lohan, Woan Wui Lim, Daniel Jin Keat Lee","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Sarcopenia, defined as low skeletal muscle mass and poor muscle function, has been associated with worse postoperative recovery. This study aims to evaluate the significance of low muscle mass in the elderly who require emergency surgeries and the postoperative outcomes.Method: Data from the emergency laparotomy database were retrieved from Khoo Teck Puat Hospital, Singapore, between 2016 and 2019. A retrospective analysis was performed on patients aged 65 years and above. Data collected included skeletal muscle index (SMI) on computed tomography scan, length of stay, complications and mortality. Low muscle mass was determined based on 25th percentile values and correlation with previous population studies.Results: A total of 289 patients were included for analysis. Low muscle mass was defined as L3 SMI of <22.09cm2/m2 for females and <33.4cm2/m2 for males, respectively. Seventeen percent of our patients were considered to have significantly low muscle mass. In this group, the length of stay (20.8 versus 16.2 P=0.041), rate of Clavien-Dindo IV complications (18.4% vs 7.5% P=0.035) and 1-year mortality (28.6% vs 14.6%, P=0.03) were higher. Further multivariate analysis showed that patients with low muscle mass had increased mortality within a year (odds ratio 2.16, 95% confidence interval 1.02-4.55, P=0.04). Kaplan-Meier analysis also shows that the 1-year overall survival was significantly lower in patients with low muscle mass.Conclusion: Patients with low muscle mass have significantly higher post-surgical complication rates and increased mortality.","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":"51 12","pages":"766-773"},"PeriodicalIF":5.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10475780","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

Characteristics of anti-transcriptional intermediary factor 1 gamma autoantibody-positive dermatomyositis patients in Singapore. 新加坡抗转录中间因子1γ自身抗体阳性皮肌炎患者的特征。

IF 5.2 4区医学

Annals Academy of Medicine Singapore Pub Date : 2022-12-01 DOI: 10.47102/annals-acadmedsg.2022278

C. Chua, Jia Zhen Low, W. Lim, M. Manghani

{"title":"Characteristics of anti-transcriptional intermediary factor 1 gamma autoantibody-positive dermatomyositis patients in Singapore.","authors":"C. Chua, Jia Zhen Low, W. Lim, M. Manghani","doi":"10.47102/annals-acadmedsg.2022278","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2022278","url":null,"abstract":"INTRODUCTION\u0000This 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.\u0000\u0000\u0000METHOD\u0000Data 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.\u0000\u0000\u0000RESULTS\u0000Ninety-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 (P<0.05). They had less frequent interstitial lung disease, polyarthritis, cutaneous ulcers, palmar papules and mechanic's hands (P<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; P<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%, P=0.031), and Kaplan-Meier survival estimates at 24 months were 66% and 89%, respectively (P=0.0153).\u0000\u0000\u0000CONCLUSION\u0000These observational data support periodic screening of NPC and other malignancies in patients with anti-TIF1-γ Ab-positive dermatomyositis in Singapore.","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":"51 12 1","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":"42115402","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: 1

Meeting today's healthcare needs: Medicine at the interface. 满足当今的医疗保健需求:界面上的药物。

IF 5.2 4区医学

Annals Academy of Medicine Singapore Pub Date : 2022-12-01

John Tshon Yit Soong, Derek Bell, Marcus Eng Hock Ong

{"title":"Meeting today's healthcare needs: Medicine at the interface.","authors":"John Tshon Yit Soong, Derek Bell, Marcus Eng Hock Ong","doi":"","DOIUrl":"","url":null,"abstract":"The demographic of Singapore has undergone dramatic change. Historically, younger patients with communicable diseases predominated, whereas patients are now older with chronic multimorbidity and functional impairment. This shift challenges existing health and social care systems in Singapore, which must pivot to meet the changing need. The consequences of mismatched health and social care to patient needs are the fragmentation of care, dysfunctional acute care utilisation and increasing care costs. In Singapore and internationally, there is an inexorable rise in acute care utilisation, with patients facing the greatest point of vulnerability at transitions between acute and chronic care. Recently, innovative care models have developed to work across the boundaries of traditional care interfaces. These \"Interface Medicine\" models aim to provide a comprehensive and integrated approach to meet the healthcare needs of today and optimise value with our finite resources. These models include Acute Medical Units, Ambulatory Emergency Care, Extensivist-Comprehensivist Care, Virtual Wards, Hospital-at-Home and Acute Frailty Units. We describe these models of care across the acute care chain and explore how they may apply to the Singapore setting. We discuss how these models have evolved, appraise the evidence for clinical effectiveness, point out gaps in knowledge for further study and make recommendations for future progress.","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":"51 12","pages":"787-792"},"PeriodicalIF":5.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10475776","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

Idiopathic inflammatory myopathies: Not nearly the end of the road. 特发性炎症性肌病：还没有走到尽头。

IF 5.2 4区医学

Annals Academy of Medicine Singapore Pub Date : 2022-12-01 DOI: 10.47102/annals-acadmedsg.2022455

N. A. Allameen, A. Mak

引用次数: 0

Pharmacokinetic and pharmacogenomic considerations in managing use of nirmatrelvir-ritonavir and molnupiravir and dermatological treatments. 尼马特利韦-利托那韦和莫努匹拉韦用药及皮肤病治疗的药代动力学和药物基因组学考虑。

IF 5.2 4区医学

Annals Academy of Medicine Singapore Pub Date : 2022-12-01

Sylvia Chen, Wai Fook Leong, Sze Sing Lee, Balram Chowbay

引用次数: 0

Rapid exome sequencing to aid diagnostics in genetic disorders: Implementation and challenges in the Singapore context. 快速外显子组测序，以帮助诊断遗传疾病:实施和挑战在新加坡的背景下。

IF 5.2 4区医学

Annals Academy of Medicine Singapore Pub Date : 2022-12-01

Nikki Fong, Jiin Ying Lim, Breana Cham, Sylvia Kam, Chew Yin Goh, Heming Wei, Yuen Ming Tan, Hai Yang Law, Weng Khong Lim, Ee Shien Tan, Ene Choo Tan, Saumya Shekhar Jamuar

引用次数: 0

Rapid exome sequencing to aid diagnostics in genetic disorders: Implementation and challenges in the Singapore context. 快速外显子组测序，以帮助诊断遗传疾病:实施和挑战在新加坡的背景下。

IF 5.2 4区医学

Annals Academy of Medicine Singapore Pub Date : 2022-12-01 DOI: 10.47102/annals-acadmedsg.202252

Nikki Fong, J. Lim, B. Cham, Sylvia Kam, C. Goh, Heming Wei, Y. Tan, H. Law, W. K. Lim, E. Tan, E. Tan, S. Jamuar

引用次数: 0

Lichen planus pemphigoides after pembrolizumab immunotherapy in an older man. 派姆单抗免疫治疗后的老年男性扁平苔藓类天疱疮。

IF 5.2 4区医学

Annals Academy of Medicine Singapore Pub Date : 2022-12-01

Siqing Ee, Michelle Weiting Liang, Shang Ian Tee, Ding Yuan Wang

引用次数: 0

Pharmacokinetic and pharmacogenomic considerations in managing use of nirmatrelvir-ritonavir and molnupiravir and dermatological treatments. 尼马特利韦-利托那韦和莫努匹拉韦用药及皮肤病治疗的药代动力学和药物基因组学考虑。