Annals of the Academy of Medicine, Singapore最新文献_第2页

Frailty-aware surgical care: Validation of Hospital Frailty Risk Score (HFRS) in older surgical patients 体弱意识外科护理：老年手术患者的医院虚弱风险评分（HFRS）验证

Annals of the Academy of Medicine, Singapore Pub Date : 2024-02-28 DOI: 10.47102/annals-acadmedsg.2023221

Christine Shi Min Chau, Samuel Cheng En Ee, Xiaoting Huang, W. S. Siow, Michelle Bee Hua Tan, Sarah Kher Ru Sim, Ting Yu Chang, Kah Meng Kwok, Kangqi Ng, Li Fang Yeo, Aileen Lim, Lydia Euphemia Sim, Simon Conroy, B. H. Rosario

{"title":"Frailty-aware surgical care: Validation of Hospital Frailty Risk Score (HFRS) in older surgical patients","authors":"Christine Shi Min Chau, Samuel Cheng En Ee, Xiaoting Huang, W. S. Siow, Michelle Bee Hua Tan, Sarah Kher Ru Sim, Ting Yu Chang, Kah Meng Kwok, Kangqi Ng, Li Fang Yeo, Aileen Lim, Lydia Euphemia Sim, Simon Conroy, B. H. Rosario","doi":"10.47102/annals-acadmedsg.2023221","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2023221","url":null,"abstract":"Introduction: Frailty has an important impact on the health outcomes of older patients, and frailty screening is recommended as part of perioperative evaluation. The Hospital Frailty Risk Score (HFRS) is a validated tool that highlights frailty risk using 109 International Classification of Diseases, 10th revision (ICD-10) codes. In this study, we aim to compare HFRS to the Charlson Comorbidity Index (CCI) and validate HFRS as a predictor of adverse outcomes in Asian patients admitted to surgical services.\u0000\u0000Method: A retrospective study of electronic health records (EHR) was undertaken in patients aged 65 years and above who were discharged from surgical services between 1 April 2022 to 31 July 2022. Patients were stratified into low (HFRS <5), intermediate (HFRS 5–15) and high (HFRS >15) risk of frailty.\u0000\u0000Results: Those at high risk of frailty were older and more likely to be men. They were also likely to have more comorbidities and a higher CCI than those at low risk of frailty. High HFRS scores were associated with an increased risk of adverse outcomes, such as mortality, hospital length of stay (LOS) and 30-day readmission. When used in combination with CCI, there was better prediction of mortality at 90 and 270 days, and 30-day readmission.\u0000\u0000Conclusion: To our knowledge, this is the first validation of HFRS in Singapore in surgical patients and confirms that high-risk HFRS predicts long LOS (≥7days), increased unplanned hospital readmissions (both 30-day and 270-day) and increased mortality (inpatient, 10-day, 30-day, 90-day, 270-day) compared with those at low risk of frailty.","PeriodicalId":513926,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":"24 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140422278","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}

引用次数: 0

Oral antiviral utilisation among older adults with COVID-19 in primary care: A population-wide study during successive Omicron waves in Singapore 基层医疗机构中患有 COVID-19 的老年人口服抗病毒药物的使用情况：在新加坡连续发生的 "Omicron "波期间进行的全人口研究

Annals of the Academy of Medicine, Singapore Pub Date : 2024-02-28 DOI: 10.47102/annals-acadmedsg.2023297

Ren Ying Tan, B. Dickens, J. Tan, Ching Li Lee, Betty Wong, Ruth Lim, Kelvin Bryan Tan, Liang En Wee

引用次数: 0

Effect of drug interactions with non-vitamin-K oral anticoagulants on thromboembolic events in patients with nonvalvular atrial fibrillation 药物与非维生素 K 口服抗凝剂的相互作用对非瓣膜性心房颤动患者血栓栓塞事件的影响

Annals of the Academy of Medicine, Singapore Pub Date : 2024-02-28 DOI: 10.47102/annals-acadmedsg.2023137

Jin-Hua Chen, Ming-Chia Lee, Tzu-Hsin Yen, Pei-Yu Huang, De-En Lu, Chih-Hsin Lee, Hsien-Chen Chang, Jann-Yuan Wang, Jen-Ai Lee

{"title":"Effect of drug interactions with non-vitamin-K oral anticoagulants on thromboembolic events in patients with nonvalvular atrial fibrillation","authors":"Jin-Hua Chen, Ming-Chia Lee, Tzu-Hsin Yen, Pei-Yu Huang, De-En Lu, Chih-Hsin Lee, Hsien-Chen Chang, Jann-Yuan Wang, Jen-Ai Lee","doi":"10.47102/annals-acadmedsg.2023137","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2023137","url":null,"abstract":"Introduction: Few real-world studies have investigated drug-drug interactions (DDIs) involving non-vitamin-K antagonist oral anticoagulants (NOACs) in patients with nonvalvular atrial fibrillation (NVAF). The interactions encompass drugs inducing or inhibiting cytochrome P450 3A4 and permeability glycoprotein. These agents potentially modulate the breakdown and elimination of NOACs. This study investigated the impact of DDIs on thromboembolism in this clinical scenario. \u0000\u0000Method: Patients who had NVAF and were treated with NOACs were selected as the study cohort from the National Health Insurance Research Database of Taiwan. Cases were defined as patients hospitalised for a thromboembolic event and who underwent a relevant imaging study within 7 days before hospitalisa-tion or during hospitalisation. Each case was matched with up to 4 controls by using the incidence density sampling method. The concurrent use of a cytochrome P450 3A4/permeability glycoprotein inducer or inhibitor or both with NOACs was identified. The effects of these interactions on the risk of thromboembolic events were examined with univariate and multivariate conditional logistic regressions. \u0000\u0000Results: The study cohort comprised 60,726 eligible patients. Among them, 1288 patients with a thromboembolic event and 5144 matched control patients were selected for analysis. The concurrent use of a cytochrome P450 3A4/permeability glycoprotein inducer resulted in a higher risk of thromboembolic events (adjusted odds ratio [AOR] 1.23, 95% confidence interval [CI] 1.004–1.51). \u0000\u0000Conclusion: For patients with NVAF receiving NOACs, the concurrent use of cytochrome P450 3A4/ permeability glycoprotein inducers increases the risk of thromboembolic events.","PeriodicalId":513926,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":"25 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140420218","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}

引用次数: 0

The potential of RNA therapeutics in dermatology RNA 疗法在皮肤病学中的潜力

Annals of the Academy of Medicine, Singapore Pub Date : 2024-02-28 DOI: 10.47102/annals-acadmedsg.2023316

Eleanor Shu Xian Chai, Sophie Carrie Shan Cai, Yong Yao Chun, Yingrou Tan, Timothy TY Tan, H. Tey

引用次数: 0

Direct oral anticoagulant: Looking beyond convenience 直接口服抗凝剂：超越便利性

Annals of the Academy of Medicine, Singapore Pub Date : 2024-02-28 DOI: 10.47102/annals-acadmedsg.202413

Samuel Ji Quan Koh, Jonathan Jiunn Liang Yap

引用次数: 0

Consensus statements and guideline for the diagnosis and management of plantar fasciitis in Singapore 新加坡足底筋膜炎诊治共识声明和指南

Annals of the Academy of Medicine, Singapore Pub Date : 2024-02-28 DOI: 10.47102/annals-acadmedsg.2023211

Victor Aik Khien Tan, Chin Chuen Tan, N. Yeo, Mandy Zhang, K. Mehta, Roger Ho Heng Tian, Benedict Tan

{"title":"Consensus statements and guideline for the diagnosis and management of plantar fasciitis in Singapore","authors":"Victor Aik Khien Tan, Chin Chuen Tan, N. Yeo, Mandy Zhang, K. Mehta, Roger Ho Heng Tian, Benedict Tan","doi":"10.47102/annals-acadmedsg.2023211","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2023211","url":null,"abstract":"Introduction: Plantar fasciitis (PF) is a common cause of heel pain among the general population. The lack of standard practice guideline in Singapore presents challenges in education and clinical practice for this painful condition. These consensus statements and guideline were developed to streamline and improve the management of PF, covering key aspects such as diagnosis, investigations, risk factors, treatment modalities, monitoring and return to work/play.\u0000\u0000Method: A multidisciplinary expert panel consisting of 6 sports physicians, 2 orthopaedic surgeons, 2 podiatrists and 1 physiotherapist from SingHealth Duke-NUS Sport & Exercise Medicine Centre (SDSC) was convened based on their clinical and academic experience with PF. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach was used to evaluate the quality of the evidence and subsequently prepare a set of clinical recommendations pertaining to the management of PF. A modified Delphi process was used to reach consensus.\u0000\u0000Results: Eighteen consensus statements were developed to cover key components of PF management, from initial diagnosis to treatment modalities and finally, clinical progression. They were subsequently consolidated under a proposed treatment pathway guideline for PF.\u0000\u0000Conclusion: The SDSC consensus statements and guideline provide concise recommendations for the management of PF in Singapore.","PeriodicalId":513926,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":"26 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140422144","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}

引用次数: 0

Breast cancer-related lymphedema (BCRL): Should we be doing more or less for the axilla? 乳腺癌相关淋巴水肿 (BCRL)：我们应该为腋窝做更多还是更少的治疗？

Annals of the Academy of Medicine, Singapore Pub Date : 2024-02-28 DOI: 10.47102/annals-acadmedsg.202440

Chuang En Xue, Clement Luck Khng Chia

{"title":"Breast cancer-related lymphedema (BCRL): Should we be doing more or less for the axilla?","authors":"Chuang En Xue, Clement Luck Khng Chia","doi":"10.47102/annals-acadmedsg.202440","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.202440","url":null,"abstract":"Breast cancer mortality has declined steadily over the years with breast cancer screening and improvement in diagnostic and therapeutic regimens. Despite cancer survivors living longer, breast cancer-related lymphedema (BCRL) is a significant complication after major breast surgery that can impact quality of life adversely. The incidence of BCRL reported ranges from 10.1% to 42.2%1-5 with risk factors that include higher body mass index, larger number of dissected nodes, taxane-based regimen, total mastectomy, larger irradiation field, and conventional fractionation.5 To mitigate the risk of BCRL, de-escalating axilla surgery and axilla radiotherapy in place of axillary dissection are increasingly recognised as the new standard of care in recent years for early breast cancer with sentinel lymph node positive.6 Surgical innovation and advancements have also led to proponents of immediate lymphatic reconstruction to decrease the incidence of BCRL.7 However, immediate lymphatic reconstruction is a costly additional procedure and whether it constitutes value-based care to recommend this as a routine procedure in relation to the prevalence of lymphedema in Singapore is an important decision that requires careful deliberation by the breast cancer surgical community.","PeriodicalId":513926,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":"17 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140419804","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}

引用次数: 0

Caregiver reported long-term outcomes in children with major trauma and traumatic brain injuries: A single-centre retrospective study 护理人员报告的重大创伤和脑外伤儿童的长期疗效：单中心回顾性研究

Annals of the Academy of Medicine, Singapore Pub Date : 2024-01-30 DOI: 10.47102/annals-acadmedsg.202387

Joel Song Kai Koh, Zhi Min Ng, J. Feng, Junaidah Badron, Chiang Wei Li, Angelina Su Yin Ang, S. Chong

{"title":"Caregiver reported long-term outcomes in children with major trauma and traumatic brain injuries: A single-centre retrospective study","authors":"Joel Song Kai Koh, Zhi Min Ng, J. Feng, Junaidah Badron, Chiang Wei Li, Angelina Su Yin Ang, S. Chong","doi":"10.47102/annals-acadmedsg.202387","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.202387","url":null,"abstract":"Introduction: We aim to investigate the functional outcomes and long-term health-related quality of life (HRQOL) in children with major trauma associated with traumatic brain injury (TBI).\u0000\u0000Method: We performed a retrospective review of records among patients >2 and ≤16 years old in a tertiary paediatric hospital between January 2014 and October 2019 with major trauma (Injury Severity Score of ≥16) and TBI of all severities. We recorded each child’s Glasgow Outcome Scale-Extended Pediatric Version (GOS-E Peds) at 12 months post-injury and Pediatric Quality of Life Inventory (PedsQL) scores at 6 and 12 months post-injury based on the parent proxy-report scales.\u0000\u0000Results: We included 53 patients with a median age of 9.0 years old (interquartile range 2.3–15.5). Most injuries were due to falls (30, 56.6%) or road traffic collisions (15, 28.3%); 41 patients (77.3%) required intensive care while 30 patients (56.6%) underwent neurosurgical intervention. Most patients (43, 81.1%) had GOS-E Peds scores of ≤2 at 12 months post-injury. We reported a significant mean difference between the 6- and 12-month parent-reported scores for physical functioning (6.6, 95% confidence interval [CI] 0.3–12.8, P=0.041), psychosocial functioning (4.1, 95% CI 1.0–7.2, P=0.012) and overall scores (5.0, 95% CI 1.4–8.7, P=0.008). Compared with the validated PedsQL scores, our mean scores were higher across all domains at 12 months.\u0000\u0000Conclusion: With current standard of care, parents of children with major trauma and TBI reported gains in quality of life, physical, psychosocial and overall function between 6 and 12 months post-injury.","PeriodicalId":513926,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":"140 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140480749","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}

引用次数: 0

Normative data for baseline and longitudinal neuropsychological assessments in Singapore 新加坡基线和纵向神经心理学评估的标准数据

Annals of the Academy of Medicine, Singapore Pub Date : 2024-01-30 DOI: 10.47102/annals-acadmedsg.202398

Wilbur Zhi Hao Koh, See Ann Soo, Seyed Ehsan Saffari, H. Chiew, A. Ng, K. Ng, N. Kandiah

引用次数: 0

Perinatal outcomes of pregnancies affected by COVID-19 in Singapore: A cohort study 新加坡受 COVID-19 影响的孕妇的围产期结果：一项队列研究

Annals of the Academy of Medicine, Singapore Pub Date : 2024-01-30 DOI: 10.47102/annals-acadmedsg.2023278

Alicia May Lim, J. Low, Mary Grace Tan, A. Ngeow, Wing Yee Tong, Ka Hee Chua, Chee Fu Yung, Selina Kah Ying Ho, Zubair Amin, K. T. Yeo

引用次数: 0