World Kidney Day 2020: Advances in Preventive Nephrology.
PMID: 32419005 [PubMed - in process] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - April 1, 2020 Category: General Medicine Authors: Kwek JL, Kee TYS Tags: Ann Acad Med Singapore Source Type: research

Sedation and Delirium in the Intensive Care Unit-A Practice-Based Approach.
CONCLUSION: More effort is required to develop a practical, time-weighted sedation scoring system. Emphasis on a balanced, multimodal appraoch that targets light sedation from the early phase of acute critical illness is important to achieve optimal sedation, lower mortality, shorten time on ventilator and reduce delirium. PMID: 32419006 [PubMed - in process] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - April 1, 2020 Category: General Medicine Authors: Wong IMJ, Thangavelautham S, Loh SCH, Ng SY, Murfin B, Shehabi Y Tags: Ann Acad Med Singapore Source Type: research

Emerging Treatment Options for Migraine.
Abstract Migraine is one of top 5 medical conditions that contribute to Years Lived with Disability and affects approximately 1 billion people from around the world. To date, preventive treatment and acute therapies for migraine are limited, have undesirable side effects and are poorly tolerated in patients. In the last few decades, considerable advances in our understanding of migraine and its pathophysiology have paved the way for the development of targeted treatment options. Calcitonin gene-related peptide (CGRP) plays an integral role in the neurobiology of migraine, and new classes of drugs that target the C...
Source: Annals of the Academy of Medicine, Singapore - April 1, 2020 Category: General Medicine Authors: Zhao YJ, Ong JJY, Goadsby PJ Tags: Ann Acad Med Singapore Source Type: research

The Link Between Amitriptyline and Movement Disorders: Clinical Profile and Outcome.
Abstract INTRODUCTION: Amitriptyline (AMT) is a tricyclic antidepressant. In this review, we evaluate the clinical and epidemiological profile, pathological mechanisms and management of AMT-associated movement disorders. MATERIALS AND METHODS: A search for relevant reports in 6 databases was performed. Studies that reported patients developed only ataxia or tremor after AMT use were excluded. RESULTS: A total of 48 reports on 200 cases were found. AMT-associated movement disorders included myoclonus (n = 26), dyskinesia (n = 11), dystonia (n = 8), stutter (n = 5), akathisia (n = 3) and restless legs synd...
Source: Annals of the Academy of Medicine, Singapore - April 1, 2020 Category: General Medicine Authors: Rissardo JP, Caprara ALF Tags: Ann Acad Med Singapore Source Type: research

Artificial Intelligence and Medical Innovation.
PMID: 32419009 [PubMed - in process] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - April 1, 2020 Category: General Medicine Authors: Tan EC Tags: Ann Acad Med Singapore Source Type: research

Anxiety and Morale in Front-Line Healthcare Workers During the Coronavirus Disease 2019 (COVID-19) Outbreak at the National Screening Centre in Singapore.
PMID: 32419010 [PubMed - indexed for MEDLINE] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - April 1, 2020 Category: General Medicine Authors: Goh SSN, Chia MYC Tags: Ann Acad Med Singapore Source Type: research

Decision-Making in Dementia Care: a Qualitative Study of Chinese Family Caregivers in Singapore.
PMID: 32419011 [PubMed - in process] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - April 1, 2020 Category: General Medicine Authors: Tan LL, Ong PS, Ng LL, Ng WF, Wong HK, Sim ACC Tags: Ann Acad Med Singapore Source Type: research

Indurated Skin and Iron Overload-the Missing Link.
PMID: 32419012 [PubMed - in process] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - April 1, 2020 Category: General Medicine Authors: Cao T, Chia HY, Lee JSS, Chong WS, Heng YK Tags: Ann Acad Med Singapore Source Type: research

Laparoscopic Tubal Re-Anastomosis or IVF in Previously Ligated Patients: A Comparison of Fertility Outcomes and Survey of Patient Attitudes.
Abstract STUDY OBJECTIVE: To compare live birth rates, cost analysis and a survey of patient attitudes between laparoscopic tubal re-anastomosis and IVF in patients with previous tubal ligation Design: Retrospective cohort review and survey. SETTING: Single Reproductive Medicine and IVF unit in Singapore. PATIENTS: Retrospective study: Patients who underwent previous tubal ligation and currently seeking fertility. Survey: Patients attending the subfertility clinic. INTERVENTIONS: Retrospective study: Laparoscopic tubal re-anastomosis or IVF, from January 2011 to December 2016. Survey: Questionnaire ...
Source: Annals of the Academy of Medicine, Singapore - April 1, 2020 Category: General Medicine Authors: Chua KH, Chan JKY, Liu S, Tan TY, Phoon JWL, Viardot-Foucault VC, Nadarajah S, Tan HH Tags: Ann Acad Med Singapore Source Type: research

Recovery in Psychosis: Perspectives of Clients With First Episode Psychosis.
CONCLUSIONS: The emergent themes provide an understanding of the meaning of recovery to persons with first episode psychosis, their experiences as they proceed with their recovery journey and factors they found helpful. The importance of acceptance of the condition and the personal role the individual plays in his or her own recovery was evident in the narratives of the participants. The study suggests a need to incorporate recovery-relevant approaches right from the first episode of psychosis. PMID: 32296807 [PubMed - in process] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - April 1, 2020 Category: General Medicine Authors: Vaingankar JA, Cetty L, Subramaniam M, Lee YY, Chong SA, Lee H, Verma S Tags: Ann Acad Med Singapore Source Type: research

Extracorporeal Membrane Oxygenation for Severe Respiratory Failure during Respiratory Epidemics and Pandemics: A Narrative Review.
CONCLUSION: The role of ECMO in managing ARDS during respiratory pandemics continues to grow. This is supported by efforts to redefine optimal ventilatory strategies, reinforce infection control measures and enhance patient selection. PMID: 32296808 [PubMed - in process] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - April 1, 2020 Category: General Medicine Authors: Lim JKB, Qadri SK, Toh TSW, Lin CB, Mok YH, Lee JH Tags: Ann Acad Med Singapore Source Type: research

Artificial Intelligence: a Singapore Response.
PMID: 32296809 [PubMed - in process] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - April 1, 2020 Category: General Medicine Authors: Ooi GSK, Liew C, Ting DSW, Lim TCC Tags: Ann Acad Med Singapore Source Type: research

A "Saga" of Adenanthera Pavonina Seed Ingestion in a Toddler.
A "Saga" of Adenanthera Pavonina Seed Ingestion in a Toddler. Ann Acad Med Singapore. 2020 Apr;49(4):1-10 Authors: James V, Warier A, Ong GY PMID: 32296810 [PubMed - in process] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - April 1, 2020 Category: General Medicine Authors: James V, Warier A, Ong GY Tags: Ann Acad Med Singapore Source Type: research

Cup-Disc Ratio Grading.
PMID: 32246705 [PubMed - as supplied by publisher] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - February 1, 2020 Category: General Medicine Authors: Aquino MC, Chew PT Tags: Ann Acad Med Singapore Source Type: research

Bleeding Complications and Adverse Events After Desmopressin Acetate for Percutaneous Renal Transplant Biopsy.
Abstract INTRODUCTION: Percutaneous renal biopsy remains critical for the workup of renal allograft dysfunction but is associated with the risk of bleeding. Prophylactic intravenous desmopressin has been proposed to reduce bleeding risk in native renal biopsies, but its efficacy in the renal transplant population is unclear and adverse events such as severe hyponatraemia have been reported. MATERIALS AND METHODS: We conducted a single-centre retrospective cohort study involving adult (≥21 years old) renal transplant recipients with impaired renal function (serum creatinine ≥150 µmol/L) who underwe...
Source: Annals of the Academy of Medicine, Singapore - February 1, 2020 Category: General Medicine Authors: Ho QY, Lim CC, Thangaraju S, Siow B, Chin YM, Hao Y, Lee PH, Foo M, Tan CS, Kee T Tags: Ann Acad Med Singapore Source Type: research

Imaging Features Differentiating Vestibular Ganglion from Intracanalicular Schwannoma on Single-Sequence Non-Contrast Magnetic Resonance Imaging Study.
This study aimed to identify imaging features on single-sequence noncontrast magnetic resonance imaging (MRI) that differentiate the vestibular ganglion from small intracanalicular schwannomas. MATERIALS AND METHODS: Ninety patients (42 men and 48 women; age: 24‒87 years old) with 102 internal auditory canal (IAC) nodules (59 vestibular ganglia and 43 intracanalicular schwannoma) who underwent both single-sequence T2-weighted (T2W) non-contrast enhanced MRI studies and contrast-enhanced T1-weighted (T1W) MRI studies between May 2012 and April 2017 were evaluated. The length, width, distance to the IAC fundus and len...
Source: Annals of the Academy of Medicine, Singapore - February 1, 2020 Category: General Medicine Authors: Wu YW, Karandikar A, Goh JP, Tan TY Tags: Ann Acad Med Singapore Source Type: research

Perspectives on Palliative Care Among Duchenne Muscular Dystrophy Patients and Their Families in Singapore.
CONCLUSION: There is a need to improve awareness and provision of palliative care services for DMD patients in Singapore where discussion of end-of-life care is often considered taboo. Prevention and correction of scoliosis and provision of appropriate ventilatory support may improve quality of life in DMD patients. PMID: 32246708 [PubMed - as supplied by publisher] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - February 1, 2020 Category: General Medicine Authors: Tapawan SJC, Wang FS, Lee MW, Chua AQ, Lin JB, Han V, Lim MT, Ong HT, Tay SK Tags: Ann Acad Med Singapore Source Type: research

Impact of Air Pollution and Trans-Boundary Haze on Nation-Wide Emergency Department Visits and Hospital Admissions in Singapore.
CONCLUSION: Increased PSI was not associated with increase in total ED visits and hospital admissions, but was associated with increased ED visits and hospital admissions for respiratory conditions in Singapore. PMID: 32246709 [PubMed - as supplied by publisher] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - February 1, 2020 Category: General Medicine Authors: Chan SL, Ho AF, Ding H, Liu N, Earnest A, Koh MS, Chuah JS, Lau ZY, Tan KB, Zheng H, Morgan GG, Ong ME Tags: Ann Acad Med Singapore Source Type: research

The Communicable Disease Centre and Challenges in Infectious Disease Management in Singapore.
PMID: 32246710 [PubMed - as supplied by publisher] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - February 1, 2020 Category: General Medicine Authors: Mohammad Raji KS, Hsu LY, Loh KS Tags: Ann Acad Med Singapore Source Type: research

Results and Long-Term Functional Outcomes of Rib Fracture Fixation: A Case Series in Singapore and a Review of Indications for Surgical Fixation.
PMID: 32246711 [PubMed - as supplied by publisher] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - February 1, 2020 Category: General Medicine Authors: Hwee J, Yeo M, Ho M, Aneez D, Pek CH Tags: Ann Acad Med Singapore Source Type: research

Fatal Cerebral Haemorrhage in a Thrombolysed Patient with Ischaemic Stroke Who Developed Interval Thrombocytopaenia from Acute Dengue Infection.
PMID: 32246712 [PubMed - as supplied by publisher] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - February 1, 2020 Category: General Medicine Authors: Pang YH, Divakar TG, De Silva DA Tags: Ann Acad Med Singapore Source Type: research

Global Leprosy Status in 2020: Still Losing Touch.
PMID: 32200391 [PubMed - in process] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - January 1, 2020 Category: General Medicine Authors: Paredes CF, Montes de Oca Sanchez G, White C Tags: Ann Acad Med Singapore Source Type: research

Elderly Asian Patients Have Lower Revascularisation Rates and Poorer Outcomes for ST-Elevation Myocardial Infarction Compared to Younger Patients.
This study aimed to study the outcomes of elderly Asian patients with STEMI compared to younger patients. MATERIALS AND METHODS: The study utilised data from 2007 to 2012 from the Singapore Myocardial Infarction Registry, a mandatory national population-based registry. Elderly patients were defined as ≥80 years of age, middle-aged to old (MAO) patients were defined as 45-80 years of age and young patients were defined as ≤45 years of age. The primary outcome of the study was 1-year mortality and secondary outcomes included in-hospital complications and mortality. RESULTS: There were 12,409 STEMI patients wi...
Source: Annals of the Academy of Medicine, Singapore - January 1, 2020 Category: General Medicine Authors: Cai JX, Yap J, Gao F, Koh TH, Tong KL, Ong HY, Kojodjojo P, Tan HC, Ong ME, Foo D, Ee B, Low LP, Chui P, Yeo KK Tags: Ann Acad Med Singapore Source Type: research

Obsessive-Compulsive Disorder in Singapore: Prevalence, Comorbidity, Quality of Life and Social Support.
CONCLUSION: OCD prevalence in Singapore is high. Most people with OCD do not seek treatment despite experiencing significant comorbidity and loss of quality of life. PMID: 32200393 [PubMed - in process] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - January 1, 2020 Category: General Medicine Authors: Subramaniam M, Abdin E, Vaingankar J, Shafie S, Chang S, Seow E, Chua BY, Jeyagurunathan A, Heng D, Kwok KW, Chong SA Tags: Ann Acad Med Singapore Source Type: research

Impact of Air Pollution and Seasonal Haze on Neurological Conditions.
CONCLUSION: Air pollution is associated with increased risk of certain common neurological disorders. More specific studies are needed to investigate the impact of seasonal haze on neurological conditions in Southeast Asia. PMID: 32200394 [PubMed - in process] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - January 1, 2020 Category: General Medicine Authors: Rocha II, Narasimhalu K, De Silva DA Tags: Ann Acad Med Singapore Source Type: research

Intractable Restless Legs Syndrome - Look for Other Causes.
PMID: 32200395 [PubMed - in process] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - January 1, 2020 Category: General Medicine Authors: Tan SN, Lim EC Tags: Ann Acad Med Singapore Source Type: research

A Qualitative Study on Perspectives and Lived Experiences of Caregivers of Individuals With Hoarding Behaviour in an Asian Population.
PMID: 32200396 [PubMed - in process] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - January 1, 2020 Category: General Medicine Authors: Samari E, Chang S, Vaingankar J, Chong SA, Jeyagurunathan A, Siva Kumar FD, Goveas RR, Ng K, Tan WM, Chong R, Ye P, Lim LL, Babjee R, Subramaniam M Tags: Ann Acad Med Singapore Source Type: research

Acquired Antibody-Mediated Pure Red Cell Aplasia Following Treatment With Darbepoetin.
PMID: 32200397 [PubMed - in process] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - January 1, 2020 Category: General Medicine Authors: Sia CS, Jen WY, Poon ML Tags: Ann Acad Med Singapore Source Type: research

The Novel Coronavirus (SARS-CoV-2) Epidemic.
PMID: 32200398 [PubMed - in process] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - January 1, 2020 Category: General Medicine Authors: Hsu LY, Chia PY, Lim JF Tags: Ann Acad Med Singapore Source Type: research

Mental Health Strategies to Combat the Psychological Impact of COVID-19 Beyond Paranoia and Panic.
PMID: 32200399 [PubMed - in process] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - January 1, 2020 Category: General Medicine Authors: Ho CS, Chee CY, Ho RC Tags: Ann Acad Med Singapore Source Type: research

Rapid Progression to Acute Respiratory Distress Syndrome: Review of Current Understanding of Critical Illness from COVID-19 Infection.
We report a case of COVID-19 infection in a 64-year-old man who developed rapidly worsening respiratory failure and acute respiratory distress syndrome (ARDS) that required intubation. As the clinical spectrum of COVID-19 ranges widely from mild illness to ARDS with a high risk of mortality, there is a need for more research to identify early markers of disease severity. Current evidence suggests that patients with advanced age, pre-existing comorbidities or dyspnoea should be closely monitored, especially at 1-2 weeks after symptom onset. It remains to be seen if laboratory findings such as lymphopenia or elevated lactate...
Source: Annals of the Academy of Medicine, Singapore - January 1, 2020 Category: General Medicine Authors: Goh KJ, Choong MC, Cheong EH, Kalimuddin S, Duu Wen S, Phua GC, Chan KS, Haja Mohideen S Tags: Ann Acad Med Singapore Source Type: research

The Greying Pandemic: Implications of Ageing Human Immunodeficiency Virus-Positive Population in Singapore.
PMID: 32112063 [PubMed - as supplied by publisher] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - December 1, 2019 Category: General Medicine Authors: Ng DH, Beh DL, Sutjipto S, Archuleta S, Wong CS Tags: Ann Acad Med Singapore Source Type: research

Relationship Satisfaction Mediates the Association Between Emotional Expressiveness and Depressive Symptoms Among Asian Women.
Abstract INTRODUCTION: Few studies in Asia have examined the association among depressive symptoms, relationship satisfaction, sexual dysfunction and emotional expressiveness. Examining the role of emotional expressiveness in the context of depression and relationships is important as it can be a point for therapeutic intervention. MATERIALS AND METHODS: Guided by the Marital Discord Model of Depression and based on data from partnered women in Singapore (n = 193), we conducted a path analysis to examine the mediating role of relationship satisfaction and sexual dysfunction in the link between difficulty in e...
Source: Annals of the Academy of Medicine, Singapore - December 1, 2019 Category: General Medicine Authors: Teo I, Cheng GH, Tewani K Tags: Ann Acad Med Singapore Source Type: research

Renal Transplant Outcomes in Spousal and Living-Related Donors in Malaysia.
CONCLUSION: A good match for HLA-A, HLA-B, HLA-DR and HLA-DQ can prevent acute rejection risk in renal transplant patients. Consequently, spousal donor transplants could be a safe intervention in renal patients. PMID: 32112065 [PubMed - as supplied by publisher] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - December 1, 2019 Category: General Medicine Authors: Guad RM, Ng KP, Lim SK, Hirayama K, Eng HS, Wan Md Adnan WAH Tags: Ann Acad Med Singapore Source Type: research

Sun Exposure and Sun Safety Habits Among Adults in Singapore: A Cross-Sectional Study.
Abstract INTRODUCTION: Sun exposure increases skin cancer risk. Studies have shown that demographic factors influence sun safety behaviour but there is a paucity of such data in Singapore. We aimed to identify sociodemographic predictors of sun safety habits in Singapore. MATERIALS AND METHODS: A total of 2328 adults participated in a cross-sectional survey on time spent under the sun and sun safety habits (using protective headgear, body attire, umbrellas and sunscreens). A composite Sun Protection Score (higher scores represented better habits [range, 0-15]) and the average daily hours (ADH) of sun exposure...
Source: Annals of the Academy of Medicine, Singapore - December 1, 2019 Category: General Medicine Authors: Cheong KW, Yew YW, Seow WJ Tags: Ann Acad Med Singapore Source Type: research

Marital Status and Positive Mental Health of Psychiatric Outpatients.
PMID: 32112067 [PubMed - as supplied by publisher] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - December 1, 2019 Category: General Medicine Authors: Siva Kumar FD, Vaingankar JA, Sambasivam R, Abdin E, Jeyagurunathan A, Seow E, Picco L, Chong SA, Subramaniam M Tags: Ann Acad Med Singapore Source Type: research

Ventricular Assist Device Support in End-Stage Heart Failure From Cardiac Amyloidosis.
PMID: 32112068 [PubMed - as supplied by publisher] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - December 1, 2019 Category: General Medicine Authors: Lim CP, Lim YP, Lim CH, Ong HY, Tan D, Chew HC, Omar AR Tags: Ann Acad Med Singapore Source Type: research

Unusual Atlantoaxial Stenosis Adjacent to Long Segment Cervical Spinal Fusion.
PMID: 32112069 [PubMed - as supplied by publisher] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - December 1, 2019 Category: General Medicine Authors: Lee MJ, Kaliya-Perumal AK, Oh JY Tags: Ann Acad Med Singapore Source Type: research

Board of Reviewers.
Authors: PMID: 32112070 [PubMed - as supplied by publisher] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - December 1, 2019 Category: General Medicine Tags: Ann Acad Med Singapore Source Type: research

The Era of Geriatric Surgery.
PMID: 31960013 [PubMed - in process] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - November 1, 2019 Category: General Medicine Authors: Chia CL, Tan KY Tags: Ann Acad Med Singapore Source Type: research

Outcome of Enhanced Recovery After Surgery (ERAS) for Colorectal Surgery in Early Elderly and Late Elderly Patients.
CONCLUSION: ERAS is a safe and effective protocol that can be used in EE and LE colorectal surgery patients. PMID: 31960014 [PubMed - in process] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - November 1, 2019 Category: General Medicine Authors: Lohsiriwat V Tags: Ann Acad Med Singapore Source Type: research

The Changing Epidemiology of Serious Trauma in the Elderly Population: An Increasing Concern of a Tertiary Hospital in Singapore.
This study examined serious trauma in young and elderly patients and hypothesised that the increase in incidence of elderly serious trauma has led to greater burden of care in hospitals and health services. MATERIALS AND METHODS: Details of trauma patients admitted with an Injury Severity Score ≥9 or to the intensive care unit or high dependency unit of a tertiary acute hospital between 2004 and 2015 were retrospectively reviewed. Patients ≥65 years old who sustained low-impact trauma that resulted from same-level falls with isolated hip fractures or compression fractures of the vertebral column were excluded. P...
Source: Annals of the Academy of Medicine, Singapore - November 1, 2019 Category: General Medicine Authors: Go KT, Cheng JY, Seah X, Goh MH, Teo LT, Cole E Tags: Ann Acad Med Singapore Source Type: research

Sarcopenia in Elderly Surgery.
Abstract Sarcopenia is a condition in which patients have an abnormally low muscle mass with poor muscle function. It is prevalent in older patients and is often associated with frailty. It has gained increasing recognition as a significant indicator of poor surgical outcomes. In this review, we examine the concept of sarcopenia and its impact on surgical outcomes and current research on its management. We also discuss the diagnosis of sarcopenia in terms of muscle mass and muscle function and common definitions of both terms. An overview of the impact of sarcopenia on different surgical specialties is reviewed. L...
Source: Annals of the Academy of Medicine, Singapore - November 1, 2019 Category: General Medicine Authors: Woo EC, Rodis B Tags: Ann Acad Med Singapore Source Type: research

Personalising Care in the Older Woman with Primary Breast Cancer.
Abstract The incidence of breast cancer increases with age. Despite this, most research in the field is targeted at younger patients. Age-specific guidelines are not widely referred to and guidelines which allude to the older woman as an individual are based solely on conventional factors. This creates a problem for older women with primary operable breast cancer who are not fit, too frail or do not wish to have surgery. Preliminary studies have shown that older women with breast cancer have distinct biological features compared to their younger counterparts. This means that they are likely to have less aggressive...
Source: Annals of the Academy of Medicine, Singapore - November 1, 2019 Category: General Medicine Authors: Parks RM, Cheung KL Tags: Ann Acad Med Singapore Source Type: research

Perioperative Medicine for Older People.
Abstract Global demographic changes have resulted in an older, frailer surgical population with significant multimorbidity causing higher frequency of adverse postoperative outcomes. The need for restructuring of perioperative care pathways to address this issue has been recognised. Comprehensive geriatric assessment (CGA) and optimisation are emerging as innovative perioperative pathways. This paper describes one centre's approach in applying CGA in the surgical setting and presents the evidence in support of this. Similar models are being established in Singapore in hip fracture, colorectal and vascular populati...
Source: Annals of the Academy of Medicine, Singapore - November 1, 2019 Category: General Medicine Authors: Rogerson A, Partridge JS, Dhesi JK Tags: Ann Acad Med Singapore Source Type: research

The Elderly Emergency Laparotomy Patient - More Than Just the Operation.
Abstract The elderly patient presenting with an acute surgical abdomen or bowel obstruction has become a common and challenging situation. These patients bring comorbidity and frailty that necessitate appropriate risk assessment and comprehensive perioperative management. Robust communication is required between patients, families and health professions. The Australia and New Zealand Emergency Laparotomy Audit-Quality Improvement (ANZELA-QI) study is based on the United Kingdom's National Emergency Laparotomy Audit (NELA) and will gather large scale data, providing hospital-level information to enable clinicians t...
Source: Annals of the Academy of Medicine, Singapore - November 1, 2019 Category: General Medicine Authors: Fernando J, Loh SM Tags: Ann Acad Med Singapore Source Type: research

Prehabilitation and Its Role in Geriatric Surgery.
Abstract As the world's population ages rapidly, many elderly people are living to a much more advanced age than before. Consequently, medical conditions that require surgical interventions such as solid organ cancers are also getting more common. While young and fit patients may be able to withstand surgical stresses and recover rapidly after operation, older adults may find these challenging. Rehabilitation that is instituted in the postoperative period aims to help patients regain physical fitness and robustness to preoperative levels. However, recent studies have shown that prehabilitation may be more effectiv...
Source: Annals of the Academy of Medicine, Singapore - November 1, 2019 Category: General Medicine Authors: Kow AW Tags: Ann Acad Med Singapore Source Type: research

Declining Stroke Mortality in Singapore and The Challenges Ahead.
PMID: 31875467 [PubMed - in process] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - October 1, 2019 Category: General Medicine Authors: Hung J, De Silva DA, Seet RC Tags: Ann Acad Med Singapore Source Type: research

Confirmatory Factor Analysis and Measurement Invariance of the Multidimensional Scale of Perceived Social Support in Young Psychiatric and Non-Psychiatric Asians.
CONCLUSION: The 3-factor model of MSPSS can be used to compare psychiatric and non-psychiatric subjects locally. Since psychiatric patients reported lower MSPSS scores, future research could examine the causative factors that contribute to lower perceived social support in young adults seeking psychiatric intervention. PMID: 31875468 [PubMed - in process] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - October 1, 2019 Category: General Medicine Authors: Teh WL, Shahwan S, Abdin E, Zhang Y, Sambasivam R, Devi F, Verma S, Chong SA, Subramaniam M Tags: Ann Acad Med Singapore Source Type: research

Clinical Findings of Ankylosing Spondylitis With and Without Human Leukocyte Antigen (HLA)-B27 and HLA-B51.
CONCLUSION: HLA-B27 was associated with the development of uveitis but not with other clinical findings or disease activity in AS patients. HLA-B51 was not associated with the clinical findings or disease activity of AS. PMID: 31875469 [PubMed - in process] (Source: Annals of the Academy of Medicine, Singapore)
Source: Annals of the Academy of Medicine, Singapore - October 1, 2019 Category: General Medicine Authors: Jung JH, Bang CH, Seok H, Choi SJ, Song GG Tags: Ann Acad Med Singapore Source Type: research