Singapore medical journal最新文献

{"title":"Approach to palpitations in primary care.","authors":"Chun En Chua, Suphadetch Leungsuwan, Li Yan Ng, Desmond Boon Seng Teo","doi":"10.4103/singaporemedj.SMJ-2021-417","DOIUrl":"10.4103/singaporemedj.SMJ-2021-417","url":null,"abstract":"","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11321539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of wearable technology in cardiac monitoring after cryptogenic stroke or embolic stroke of undetermined source: a systematic review.","authors":"Jamie Sy Ho, Elizabeth Sy Ho, Leonard Ll Yeo, William Kf Kong, Tony Yw Li, Benjamin Yq Tan, Mark Y Chan, Vijay K Sharma, Kian-Keong Poh, Ching-Hui Sia","doi":"10.4103/singaporemedj.SMJ-2022-143","DOIUrl":"10.4103/singaporemedj.SMJ-2022-143","url":null,"abstract":"<p><strong>Introduction: </strong>Prolonged cardiac monitoring after cryptogenic stroke or embolic stroke of undetermined source (ESUS) is necessary to identify atrial fibrillation (AF) that requires anticoagulation. Wearable devices may improve AF detection compared to conventional management. We aimed to review the evidence for the use of wearable devices in post-cryptogenic stroke and post-ESUS monitoring.</p><p><strong>Methods: </strong>We performed a systematic search of PubMed, EMBASE, Scopus and clinicaltrials.gov on 21 July 2022, identifying all studies that investigated the use of wearable devices in patients with cryptogenic stroke or ESUS. The outcomes of AF detection were analysed. Literature reports on electrocardiogram (ECG)-based (external wearable, handheld, patch, mobile cardiac telemetry [MCT], smartwatch) and photoplethysmography (PPG)-based (smartwatch, smartphone) devices were summarised.</p><p><strong>Results: </strong>A total of 27 relevant studies were included (two randomised controlled trials, seven prospective trials, 10 cohort studies, six case series and two case reports). Only four studies compared wearable technology to Holter monitoring or implantable loop recorder, and these studies showed no significant differences on meta-analysis (odds ratio 2.35, 95% confidence interval [CI] 0.74-7.48, I 2 = 70%). External wearable devices detected AF in 20.7% (95% CI 14.9-27.2, I 2 = 76%) of patients and MCT detected new AF in 9.6% (95% CI 7.4%-11.9%, I 2 = 56%) of patients. Other devices investigated included patch sensors, handheld ECG recorders and PPG-based smartphone apps, which demonstrated feasibility in the post-cryptogenic stroke and post-ESUS setting.</p><p><strong>Conclusion: </strong>Wearable devices that are ECG or PPG based are effective for paroxysmal AF detection after cryptogenic stroke and ESUS, but further studies are needed to establish how they compare with Holter monitors and implantable loop recorder.</p>","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11321540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140051436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ischaemia with no obstructive coronary arteries: a review with focus on the Asian population.","authors":"Rodney Yu-Hang Soh, Ting-Ting Low, Ching-Hui Sia, William Kok-Fai Kong, Tiong-Cheng Yeo, Poay-Huan Loh, Kian-Keong Poh","doi":"10.4103/singaporemedj.SMJ-2023-116","DOIUrl":"10.4103/singaporemedj.SMJ-2023-116","url":null,"abstract":"<p><strong>Abstract: </strong>Ischaemia with no obstructive coronary arteries (INOCA) has been a diagnostic and therapeutic challenge for decades. Several studies have demonstrated that INOCA is associated with an increased risk of death, adverse cardiovascular events, poor quality of life and high healthcare cost. Although there is increasing recognition of this entity in the Western population, in the Asian population, INOCA remains elusive and its prevalence uncertain. Despite its prognostic significance, diagnosis of INOCA is often delayed. In this review, we identified the multiple barriers to its diagnosis and management, and proposed strategies to overcome them.</p>","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11321541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symptoms and coronary risk factors predictive of adverse cardiac events in chest pain patients in an Asian emergency department: the need for a local prediction score.","authors":"Ziwei Lin, Swee Han Lim, Qai Ven Yap, Cheryl Shumin Kow, Yiong Huak Chan, Siang Jin Terrance Chua, Anantharaman Venkataraman","doi":"10.4103/singaporemedj.SMJ-2023-260","DOIUrl":"10.4103/singaporemedj.SMJ-2023-260","url":null,"abstract":"<p><strong>Introduction: </strong>Clinical assessment is pivotal in diagnosing acute coronary syndrome. Our study aimed to identify clinical characteristics predictive of major adverse cardiac events (MACE) in an Asian population and to derive a risk score for MACE.</p><p><strong>Methods: </strong>Patients presenting to the emergency department (ED) with chest pain and non-diagnostic 12-lead electrocardiograms were recruited. Clinical history was recorded in a predesigned template. Random glucose and direct low-density lipoprotein measurements were taken, in addition to serial troponin. We derived the age, coronary risk factors (CRF), sex and symptoms (ACSS) risk score based on multivariate analysis results, considering age, CRF, sex and symptoms and classifying patients into very low, low, moderate and high risk for MACE. Comparison was made with the ED Assessment of Chest Pain Score (EDACS) and the history, electrocardiogram, age, risk factors, troponin (HEART) score. We also modified the HEART score with the CRF that we had identified. The outcomes were 30-day and 1-year MACE.</p><p><strong>Results: </strong>There were a total of 1689 patients, with 172 (10.2%) and 200 (11.8%) having 30-day and 1-year MACE, respectively. Symptoms predictive of MACE included central chest pain, radiation to the jaw/neck, associated diaphoresis, and symptoms aggravated by exertion and relieved by glyceryl trinitrate. The ACSS score had an area under the curve of 0.769 (95% confidence interval [CI]: 0.735-0.803) and 0.760 (95% CI: 0.727-0.793) for 30-day and 1-year MACE, respectively, outperforming EDACS. Those in the very-low-risk and low-risk groups had <1% risk of 30-day MACE.</p><p><strong>Conclusion: </strong>The ACSS risk score shows potential for use in the local ED or primary care setting, potentially reducing unnecessary cardiac investigations and admission.</p>","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11321542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrocardiographic manifestations of cardiac disorders in rheumatological conditions.","authors":"Elinor Tan, Samuel Shang Ming Lee, Kian-Keong Poh, Chuanhui Xu, Ching-Hui Sia","doi":"10.4103/singaporemedj.SMJ-2024-084","DOIUrl":"10.4103/singaporemedj.SMJ-2024-084","url":null,"abstract":"","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11321537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances and challenges in cardiology.","authors":"Ching-Hui Sia, Kian-Keong Poh","doi":"10.4103/singaporemedj.SMJ-2024-128","DOIUrl":"10.4103/singaporemedj.SMJ-2024-128","url":null,"abstract":"","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11321536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomic sequencing: ending the diagnostic odyssey for a child with microcephaly and dystonia with a perioperative challenge.","authors":"Duo-Tong Cheng, Tong Hong Yeo, Michaela Su-Fern Seng, Oon Hoe Teoh, Sumin Lee, Ai Ling Koh","doi":"10.4103/singaporemedj.SMJ-2023-134","DOIUrl":"https://doi.org/10.4103/singaporemedj.SMJ-2023-134","url":null,"abstract":"","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474412","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":"Access to dental care and caries experience among children with cerebral palsy: a Singapore experience.","authors":"Joanne Mui Ching Tan, Yebeen Ysabelle Boo, Logan Manikam, Tong Hong Yeo, Jeremy Bingyuan Lin, Ruixiang Yee, Zhi Min Ng","doi":"10.4103/singaporemedj.SMJ-2022-022","DOIUrl":"https://doi.org/10.4103/singaporemedj.SMJ-2022-022","url":null,"abstract":"<p><strong>Introduction: </strong>Cerebral palsy (CP) is one of the most severe childhood neurodevelopmental disabilities resulting from non-progressive insult to the developing brain. We aimed to report our experience regarding dental visit attendance, caries prevalence and factors affecting dental access in children with CP in Singapore.</p><p><strong>Methods: </strong>Patients diagnosed with CP who were born in or after 1994 were included in this study. We reviewed the data of all 151 patients recruited under the CP Registry in Singapore (SingCPR) from September 2017 to May 2020. The SingCPR was launched in September 2017 to assist in future planning of services and resources for CP in Singapore.</p><p><strong>Results: </strong>The mean age of the patients was 7.8 years, with the interquartile range being 3 years and 8 months-10 years and 10 months. Only 41.7% reported a visit to the dentist ever, with 25.4% reporting presence of dental caries. Age was the only statistically significant factor influencing access to dental care. None of the children less than 2 years old ever received any dental care, and 20% of the children with CP aged 2-6 years had received dental care before. Age range with the highest percentage of dental visits was 7-12 years, with up to 44.0% having ever received dental care. We believe the prevalence of dental caries was underreported as many children did not receive any dental care and therefore may have undetected dental caries.</p><p><strong>Conclusion: </strong>Dental care in children with CP should be advocated early for prevention and detection of caries.</p>","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428641","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":"Impact of the COVID-19 'circuit breaker' on emergency orthopaedic admissions in a local tertiary teaching hospital.","authors":"Tzong-Yee Colin Wang, Hamid Rahmatullah Bin Abd Razak, Yilun Huang, Keng-Lin Francis Wong, Bing-Howe Lee, Merng-Koon Wong","doi":"10.4103/singaporemedj.SMJ-2020-490","DOIUrl":"https://doi.org/10.4103/singaporemedj.SMJ-2020-490","url":null,"abstract":"","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428643","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":"Association between social support and health-related outcomes among older adults with type 2 diabetes mellitus in a primary care setting.","authors":"Keith Dihao Tan, Shu Yun Tan, Hui Li Koh, Edwin Fueng Chee Liang, Sabrina Kay Wye Wong","doi":"10.4103/singaporemedj.SMJ-2023-121","DOIUrl":"https://doi.org/10.4103/singaporemedj.SMJ-2023-121","url":null,"abstract":"","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428642","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}