{"title":"Acting on the Latest SGLT2i Evidence to Treat CKD Patients in Primary Care","authors":"A. Teo, Boon Wee Jimmy","doi":"10.33591/sfp.47.8.u2","DOIUrl":"https://doi.org/10.33591/sfp.47.8.u2","url":null,"abstract":"The prevalence of Chronic Kidney Disease (CKD) in Singapore is increasing due to an ageing Singapore population and the increasing prevalence of risk factors such as hypertension and diabetes. Screening using serum creatinine and urine albumin to creatinine ratio (UACR) aids in the detection and classification of CKD. This allows interventions for the retardation of kidney function decline and the prevention of the complications of CKD, which includes endstage kidney disease (ESKD), anaemia, mineral bone disorder, and mortality. Besides the optimal use of angiotensin-converting enzyme inhibitors (ACE-I) and angiotensin receptor blockers (ARB) in both diabetic and non-diabetic CKD, sodiumglucose cotransporter type 2 inhibitors (SGLT2i) have been identified to retard CKD, prevent ESKD, and mortality. More recent studies suggest that regardless of the degree of albuminuria or glycated haemoglobin, SGLT2i improves the outcomes of CKD patients. Moreover, SGLT2i can be initiated with an estimated glomerular filtration rate as low as 20 mL per minute per 1.73 m2 body surface area. As nephron loss is irreversible, aggressive control of risk factors to target goals and using kidney-protective medications such as ACE-I, ARB, and SGLT2i are crucial in the remission of early CKD.","PeriodicalId":85774,"journal":{"name":"The Singapore family physician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49585865","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":"Preventing Mental Illness: The Role of Primary Care Physicians","authors":"Ng Wei Lik Jared, Peh Lai Huat Andrew","doi":"10.33591/sfp.47.7.uo1","DOIUrl":"https://doi.org/10.33591/sfp.47.7.uo1","url":null,"abstract":"GOH LEE GAN Professorial Fellow Division of Family Medicine Department of Medicine National University Health System ABSTRACT Primary care physicians have been providing treatment for patients with mental illnesses such as depression and anxiety. It is recognised that they are also pivotal in the prevention and early detection of mental illnesses. This paper summarises primary care physicians’ roles in the promotion of mental health as well as the primary, secondary, and tertiary prevention of mental illnesses.","PeriodicalId":85774,"journal":{"name":"The Singapore family physician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48133145","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":"Being Familiar with The New Guidelines in Practice: What Does Asthma Management Look Like in 2021?","authors":"","doi":"10.33591/sfp.47.7.u1","DOIUrl":"https://doi.org/10.33591/sfp.47.7.u1","url":null,"abstract":"","PeriodicalId":85774,"journal":{"name":"The Singapore family physician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42367323","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":"What's New in Asthma Management","authors":"G. Chiang","doi":"10.33591/sfp.47.7.e","DOIUrl":"https://doi.org/10.33591/sfp.47.7.e","url":null,"abstract":"","PeriodicalId":85774,"journal":{"name":"The Singapore family physician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46379656","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":"Incidental lung nodule reported. What do I do next?","authors":"Dr Akash Verma, Akash Verma","doi":"10.33591/sfp.47.7.u2","DOIUrl":"https://doi.org/10.33591/sfp.47.7.u2","url":null,"abstract":"AKASH VERMA Senior Consultant Respiratory and Critical Care Medicine Mount Elizabeth Medical Centre ABSTRACT A lung nodule (white spot < 3 cm in diameter) can either be first detected on a chest radiograph or a Computed Tomography (CT) scan. When detected on the radiograph, the next step is almost always a CT scan. When first detected on a CT scan, the next step is the comparison with any imaging studies available from the past. If no past imaging is available for comparison, then the next step is a biopsy, which is also the gold standard for diagnosis. Although observation with interval imaging has been advocated, this approach is only safe when the likelihood of the nodule being benign is very high. Otherwise, a biopsy should be undertaken to exclude or confirm cancer in the early stage as it carries implications for survival.","PeriodicalId":85774,"journal":{"name":"The Singapore family physician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47117274","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":"Gastric Cancer Prevention: Beyond H. pylori","authors":"","doi":"10.33591/sfp.47.7.up1","DOIUrl":"https://doi.org/10.33591/sfp.47.7.up1","url":null,"abstract":"","PeriodicalId":85774,"journal":{"name":"The Singapore family physician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49242013","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":"Don’t Fall for it. Prevention of falls","authors":"","doi":"10.33591/sfp.47.7.uc1","DOIUrl":"https://doi.org/10.33591/sfp.47.7.uc1","url":null,"abstract":"","PeriodicalId":85774,"journal":{"name":"The Singapore family physician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46328309","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":"COVID-19 Vaccines – What are Known? What are not yet known?","authors":"","doi":"10.33591/sfp.47.7.uo2","DOIUrl":"https://doi.org/10.33591/sfp.47.7.uo2","url":null,"abstract":"","PeriodicalId":85774,"journal":{"name":"The Singapore family physician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47675361","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":"Moving it for Weight Loss","authors":"L. Ivy","doi":"10.33591/sfp.47.5.u5","DOIUrl":"https://doi.org/10.33591/sfp.47.5.u5","url":null,"abstract":"The rate of overweight and obesity is increasing worldwide, with significant health impact. Obesity is a risk factor for morbidity and mortality and weight loss should take a multi-pronged approach, including dietary control and physical activity. The lack of physical activity, sedentary behaviour, as well as poor cardiorespiratory fitness are all independent risk factors for morbidity and mortality as well, thus it is important to advise lifestyle changes to address these issues. Most individuals who have no contraindications can embark on light- to moderate-intensity physical activity without the need for medical clearance. Specific advice on physical activity should be given, targeting the individual, and this can be done using the FITT (frequency, intensity, time, type) principle. Physical activity should also be reviewed regularly and progressed gradually to target physical activity guidelines. Individuals should also be encouraged to replace sedentary behaviour with at least light-intensity physical activity whenever possible.","PeriodicalId":85774,"journal":{"name":"The Singapore family physician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42491088","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}