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Improving the predictive capability of Framingham Risk Score for the risk of myocardial infarction based on coronary artery calcium score in healthy Singaporeans. 根据健康新加坡人的冠状动脉钙化评分提高弗雷明汉风险评分对心肌梗死风险的预测能力。
IF 2.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-02-01 Epub Date: 2021-10-11 DOI: 10.11622/smedj.2021151
Ching Yee Ivory Yeo, John Carson Jr Allen, Weiting Huang, Wei Ying Tan, Siew Ching Kong, Khung Keong Yeo

Introduction: Cardiovascular disease was the top cause of deaths and disability in Singapore in 2018, contributing extensively to the local healthcare burden. Primary prevention identifies at-risk individuals for the swift implementation of preventive measures. This has been traditionally done using the Singapore-adapted Framingham Risk Score (SG FRS). However, its most recent recalibration was more than a decade ago. Recent changes in patient demographics and risk factors have undermined the accuracy of SG FRS, and the rising popularity of wearable health metrics has led to new data types with the potential to improve risk prediction.

Methods: In healthy Singaporeans enrolled in SingHEART study (absence of any clinical outcomes), we investigated improvements in SG FRS to predict myocardial infarction risk based on high/low classification of the Agatston score (surrogate outcome). Logistic regression, receiver operating characteristic and net reclassification index (NRI) analyses were conducted.

Results: We demonstrated a significant improvement in the area under curve (AUC) of SG FRS (AUC = 0.641) after recalibration and incorporation of additional variables (fasting blood glucose and wearable-derived activity levels) (AUC = 0.774) ( P < 0.001). SG FRS++ significantly increases accuracy in risk prediction (NRI = 0.219, P = 0.00254).

Conclusion: Existing Singapore cardiovascular disease risk prediction guidelines should be updated to improve risk prediction accuracy. Recalibrating existing risk functions and utilising wearable metrics that provide a large pool of objective health data can improve existing risk prediction tools. Lastly, activity levels and prediabetic state are important factors for coronary heart disease risk stratification, especially in low-risk individuals.

导言:2018 年,心血管疾病是导致新加坡人死亡和残疾的首要原因,广泛加重了当地的医疗负担。初级预防可识别高危人群,以便迅速实施预防措施。传统上,这项工作是通过新加坡改编的弗雷明汉风险评分(SG FRS)来完成的。不过,最近一次重新校准是在十多年前。最近,患者人口统计学和风险因素的变化削弱了 SG FRS 的准确性,而可穿戴健康指标的日益普及带来了新的数据类型,有可能改善风险预测:方法:在参加 SingHEART 研究(无任何临床结果)的健康新加坡人中,我们调查了 SG FRS 在根据 Agatston 评分(替代结果)的高/低分类预测心肌梗死风险方面的改进情况。我们进行了逻辑回归、接收者操作特征和净重分类指数(NRI)分析:结果:在重新校准并纳入附加变量(空腹血糖和可穿戴活动水平)(AUC = 0.774)后,我们发现 SG FRS 的曲线下面积(AUC)有了明显改善(AUC = 0.641)(P < 0.001)。SG FRS++ 能明显提高风险预测的准确性(NRI = 0.219,P = 0.00254):结论:现有的新加坡心血管疾病风险预测指南应予以更新,以提高风险预测的准确性。重新校准现有的风险函数并利用可提供大量客观健康数据的可穿戴指标,可以改善现有的风险预测工具。最后,活动水平和糖尿病前期状态是冠心病风险分层的重要因素,尤其是对低风险人群而言。
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引用次数: 0
Ulcerative colitis: STRIDE-ing beyond symptoms with new standards. 溃疡性结肠炎:用新标准超越症状。
IF 2.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-02-01 Epub Date: 2021-11-26 DOI: 10.11622/smedj.2021173
Shu Wen Tay, Kevin Kim Jun Teh, Tiing-Leong Ang, Malcolm Tan

The landscape of ulcerative colitis has changed in the last two decades. Advancements in pharmacotherapeutics have heralded the introduction of new treatment options, with many agents in development. Better clinical outcomes are seen with tighter disease control, made possible with greater understanding of inflammatory pathways and their blockade with drugs. There has been a resultant shift in treatment targets, beyond symptoms to endoscopic and histological healing. Controlling the burden of disease activity also lowers the risk of developing colorectal cancer. Colorectal cancer screening now requires the use of dye-based agents and high-definition colonoscopy to improve the detection of colonic neoplasms.

在过去二十年里,溃疡性结肠炎的治疗形势发生了变化。药物治疗学的进步带来了新的治疗方案,许多药物正在研发中。随着对炎症通路和药物阻断通路的深入了解,临床治疗效果越来越好,疾病得到了更严格的控制。因此,治疗目标也发生了转变,从症状转向内窥镜和组织学愈合。控制疾病活动也降低了罹患结直肠癌的风险。现在,大肠癌筛查需要使用染料制剂和高清结肠镜检查,以提高大肠肿瘤的检测率。
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引用次数: 0
Perceptions of Singaporeans towards informed consent: a cross-sectional survey. 新加坡人对知情同意的看法:横断面调查。
IF 2.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-02-01 Epub Date: 2021-10-31 DOI: 10.11622/smedj.2021163
Mehek Gupta, Sudharsan Madhavan, Felicia Siok Ying Teo, Jee Keem Low, Vishal G Shelat

Introduction: In a patient-centric health system, it is essential to know patients' views about informed consent. The objective of this study was to understand the perceptions of the local population regarding informed consent.

Methods: Spanning 6 weeks from January 2016 to March 2016, a cross-sectional survey of adults attending the General Surgery outpatient clinics at Tan Tock Seng Hospital was conducted. Sociodemographic data, lifestyle- and health-related information, perception and purpose of consent forms, and decision-making preferences were studied.

Results: A total of 445 adults participated in the survey. Most participants were aged below 40 years ( n = 265, 60.1%), female ( n = 309, 70.1%) and degree holders ( n = 196, 44.4%). Also, 56.9% of participants wanted to know every possible risk, while 28.3% wanted to know the common and serious risks. On multivariate analysis, age (61-74 years: odds ratio [OR] 11.1, 95% confidence interval [CI] 2.2-56.1, P = 0.004; age >75 years: OR 22.2, 95% CI 1.8-279.1, P = 0.017) was a predictor of not wanting to know any risks. Age also predicted risk of disclosure for death (age 61-74 years: OR 13.4, 95% CI 4.2-42.6, P < 0.001; age >75 years: OR 32.0, 95% CI 4.5-228.0, P = 0.001). Most participants (48.1%) preferred making shared decisions with doctors, and an important predictor was employment status (OR 4.8, 95% CI 1.9-12.2, P = 0.001).

Conclusion: Sociodemographic factors and educational level influence decision-making, and therefore, the informed consent process should be tailored for each patient.

导言:在以患者为中心的医疗系统中,了解患者对知情同意的看法至关重要。本研究旨在了解当地居民对知情同意的看法:从 2016 年 1 月至 2016 年 3 月的 6 周时间内,对在陈笃生医院普通外科门诊就诊的成年人进行了横断面调查。调查内容包括社会人口学数据、生活方式和健康相关信息、对同意书的看法和目的以及决策偏好:结果:共有 445 名成年人参与了调查。大多数参与者年龄在 40 岁以下(265 人,占 60.1%),女性(309 人,占 70.1%),拥有学位(196 人,占 44.4%)。此外,56.9%的参与者希望了解所有可能的风险,28.3%的参与者希望了解常见和严重的风险。OR 22.2,95% CI 1.8-279.1,P = 0.017)是不想知道任何风险的预测因素。年龄也可预测披露死亡的风险(61-74 岁:OR 13.4,95% CI 1.8-279.1,P = 0.017):OR 13.4,95% CI 4.2-42.6,P <0.001;年龄 >75 岁:OR 32.0,95% CI 4.5-228.0,P = 0.001)。大多数参与者(48.1%)倾向于与医生共同做出决定,而就业状况是一个重要的预测因素(OR 4.8,95% CI 1.9-12.2,P = 0.001):结论:社会人口因素和教育水平会影响患者的决策,因此知情同意程序应根据每位患者的具体情况量身定制。
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引用次数: 0
Predictors of postoperative hospital length of stay after total knee arthroplasty. 全膝关节置换术后住院时间的预测因素。
IF 2.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-02-01 Epub Date: 2021-10-24 DOI: 10.11622/smedj.2021142
Davide Tornese, Alessandro Robustelli, Gabriele Ricci, Paola Maria Vittoria Rancoita, Nicola Maffulli, Giuseppe Michele Peretti

Introduction: We aimed to collect and analyse clinical and functional variables of patients undergoing rehabilitation after total knee arthroplasty (TKA), to identify the variables that influence the postoperative hospital length of stay (LOS).

Methods: We conducted a retrospective analysis of prospectively collected data of 1,082 consecutive patients (746 females and 336 males) who underwent primary TKA and rehabilitation in our orthopaedic institute between January 2013 and July 2017. Clinical and anthropometric data were analysed using a multivariate linear regression model.

Results: The average LOS was 5.08 ± 2.52 days in the Department of Orthopaedic Surgery and 12.67 ± 5.54 days in the Sports Rehabilitation Unit. Factors such as age, female sex and the presence of comorbidities were predictive of a longer stay. The presence of caregiver assistance at home was associated with shorter LOS. There was no evidence of a statistically significant positive association between body mass index and LOS.

Conclusion: An in-depth and early knowledge of factors that influence LOS may enable the multidisciplinary team to plan a patient-tailored rehabilitation path and better allocate resources to maximise patients' functional recovery, while reducing LOS and the overall cost of the procedure.

导言:我们旨在收集和分析接受全膝关节置换术(TKA)后康复治疗的患者的临床和功能变量,以确定影响术后住院时间(LOS)的变量:我们对2013年1月至2017年7月期间在本院骨科研究所接受初次TKA和康复治疗的1082名连续患者(女性746人,男性336人)的前瞻性数据进行了回顾性分析。临床和人体测量数据采用多变量线性回归模型进行分析:骨外科的平均住院日为(5.08±2.52)天,运动康复科的平均住院日为(12.67±5.54)天。年龄、女性性别和合并症等因素预示着住院时间的延长。在家中有护理人员的协助与较短的住院时间有关。没有证据表明体重指数与住院时间之间存在统计学意义上的显著正相关:尽早深入了解影响住院时间的因素,可使多学科团队规划出适合患者的康复路径,更好地分配资源,最大限度地促进患者的功能恢复,同时缩短住院时间,降低手术的总体成本。
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引用次数: 0
Image quality, contrast enhancement and radiation dose of electrocardiograph- versus non-electrocardiograph-triggered computed tomography angiography of the aorta. 心电图与非心电图触发的主动脉计算机断层扫描血管造影的图像质量、对比度增强和辐射剂量。
IF 2.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-02-01 Epub Date: 2021-10-24 DOI: 10.11622/smedj.2021166
Ying Mei Wong, Ching Ching Ong, Chong Ri Liang, Choon Ann Tan, Lynette Li San Teo

Introduction: Computed tomography angiography of the aorta (CTAA) is the modality of choice for investigating aortic disease. Our aim was to evaluate the image quality, contrast enhancement and radiation dose of electrocardiograph (ECG)-triggered and non-ECG-triggered CTAA on a 256-slice single-source CT scanner. This allows the requesting clinician and the radiologist to balance radiation risk and image quality.

Methods: We retrospectively assessed the data of 126 patients who had undergone CTAA on a single-source CT scanner using ECG-triggered (group 1, n = 77) or non-ECG-triggered (group 2, n = 49) protocols. Radiation doses were compared. Qualitative (4-point scale) and quantitative image quality assessments were performed.

Results: The mean volume CT dose index, dose length product and effective dose in group 1 were 12.4 ± 1.9 mGy, 765.8 ± 112.4 mGy cm and 13.0 ± 1.9 mSv, respectively. These were significantly higher compared to group 2 values (9.1 ± 2.6 mGy, 624.1 ± 174.8 mGy cm and 10.6 ± 3.0 mSv, respectively) ( P < 0.001). Qualitative assessment showed the image quality at the aortic root-proximal ascending aorta was significantly higher in group 1 (median 3) than in group 2 (median 2, P < 0.001). Quantitative assessment showed significantly better mean arterial attenuation, signal-to-noise ratio and contrast-to-noise ratio in ECG-triggered CTAA compared to non-ECG-triggered CTAA.

Conclusion: ECG-triggered CTAA in a single-source scanner has superior image quality and vessel attenuation of aortic root/ascending aorta, but a higher radiation dose of approximately 23%. Its use should be considered specifically when assessing aortic root/ascending aorta pathology.

简介主动脉计算机断层扫描血管造影术(CTAA)是检查主动脉疾病的首选方法。我们的目的是在 256 排单源 CT 扫描仪上评估心电图(ECG)触发和非 ECG 触发 CTAA 的图像质量、对比度增强和辐射剂量。这样,临床医生和放射科医生就能在辐射风险和图像质量之间取得平衡:我们回顾性地评估了 126 名在单源 CT 扫描仪上使用心电图触发(第 1 组,n = 77)或非心电图触发(第 2 组,n = 49)方案进行 CTAA 的患者的数据。对辐射剂量进行了比较。对图像质量进行定性(4 分制)和定量评估:第 1 组的平均容积 CT 剂量指数、剂量长度乘积和有效剂量分别为 12.4 ± 1.9 mGy、765.8 ± 112.4 mGy cm 和 13.0 ± 1.9 mSv。这些数值明显高于第 2 组(分别为 9.1 ± 2.6 mGy、624.1 ± 174.8 mGy cm 和 10.6 ± 3.0 mSv)(P < 0.001)。定性评估显示,主动脉根部-近端升主动脉的图像质量在第一组(中位数 3)明显高于第二组(中位数 2,P < 0.001)。定量评估显示,与非ECG触发的CTAA相比,ECG触发的CTAA的平均动脉衰减、信噪比和对比度-噪声比明显更好:结论:单源扫描仪的心电图触发 CTAA 在主动脉根部/升主动脉的图像质量和血管衰减方面更胜一筹,但辐射剂量要高出约 23%。在评估主动脉根部/升主动脉病变时,应特别考虑使用该方法。
{"title":"Image quality, contrast enhancement and radiation dose of electrocardiograph- versus non-electrocardiograph-triggered computed tomography angiography of the aorta.","authors":"Ying Mei Wong, Ching Ching Ong, Chong Ri Liang, Choon Ann Tan, Lynette Li San Teo","doi":"10.11622/smedj.2021166","DOIUrl":"10.11622/smedj.2021166","url":null,"abstract":"<p><strong>Introduction: </strong>Computed tomography angiography of the aorta (CTAA) is the modality of choice for investigating aortic disease. Our aim was to evaluate the image quality, contrast enhancement and radiation dose of electrocardiograph (ECG)-triggered and non-ECG-triggered CTAA on a 256-slice single-source CT scanner. This allows the requesting clinician and the radiologist to balance radiation risk and image quality.</p><p><strong>Methods: </strong>We retrospectively assessed the data of 126 patients who had undergone CTAA on a single-source CT scanner using ECG-triggered (group 1, n = 77) or non-ECG-triggered (group 2, n = 49) protocols. Radiation doses were compared. Qualitative (4-point scale) and quantitative image quality assessments were performed.</p><p><strong>Results: </strong>The mean volume CT dose index, dose length product and effective dose in group 1 were 12.4 ± 1.9 mGy, 765.8 ± 112.4 mGy cm and 13.0 ± 1.9 mSv, respectively. These were significantly higher compared to group 2 values (9.1 ± 2.6 mGy, 624.1 ± 174.8 mGy cm and 10.6 ± 3.0 mSv, respectively) ( P < 0.001). Qualitative assessment showed the image quality at the aortic root-proximal ascending aorta was significantly higher in group 1 (median 3) than in group 2 (median 2, P < 0.001). Quantitative assessment showed significantly better mean arterial attenuation, signal-to-noise ratio and contrast-to-noise ratio in ECG-triggered CTAA compared to non-ECG-triggered CTAA.</p><p><strong>Conclusion: </strong>ECG-triggered CTAA in a single-source scanner has superior image quality and vessel attenuation of aortic root/ascending aorta, but a higher radiation dose of approximately 23%. Its use should be considered specifically when assessing aortic root/ascending aorta pathology.</p>","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"84-90"},"PeriodicalIF":2.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10942131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39550054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bronchial thermoplasty for severe asthmatics: a real-world clinical study from Malaysia. 严重哮喘患者的支气管热成形术:来自马来西亚的真实世界临床研究。
IF 2.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-02-01 Epub Date: 2021-10-07 DOI: 10.11622/smedj.2021144
Chun Ian Soo, Woh Wei Mak, Mona Zaria Nasaruddin, Rosmadi Ismail, Andrea Yu-Lin Ban, Jamalul Azizi Abdul Rahaman
{"title":"Bronchial thermoplasty for severe asthmatics: a real-world clinical study from Malaysia.","authors":"Chun Ian Soo, Woh Wei Mak, Mona Zaria Nasaruddin, Rosmadi Ismail, Andrea Yu-Lin Ban, Jamalul Azizi Abdul Rahaman","doi":"10.11622/smedj.2021144","DOIUrl":"10.11622/smedj.2021144","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"119-122"},"PeriodicalIF":2.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10942133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39493749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Percutaneous iliosacral screw fixation of sacral U-type fracture using a mid-foot intramedullary bolt: a case report 使用中足髓内栓经皮髂骶螺钉固定骶骨 U 型骨折:病例报告
IF 2.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-01-08 DOI: 10.4103/singaporemedj.smj-2021-172
Peng Lee, Yong Sheng Chen, Amritpal Singh, Antony Gardner
{"title":"Percutaneous iliosacral screw fixation of sacral U-type fracture using a mid-foot intramedullary bolt: a case report","authors":"Peng Lee, Yong Sheng Chen, Amritpal Singh, Antony Gardner","doi":"10.4103/singaporemedj.smj-2021-172","DOIUrl":"https://doi.org/10.4103/singaporemedj.smj-2021-172","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":"30 10","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139445000","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
Femoral neck system as a safe alternative to cannulated compression screw and dynamic hip screw in femoral neck fractures: an early comparative study 股骨颈系统在股骨颈骨折中作为插管加压螺钉和动态髋螺钉的安全替代品:早期比较研究
IF 2.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-01-08 DOI: 10.4103/singaporemedj.smj-2022-024
Zhe Zheng Clyde Lim, Cheryl Marise Peilin Tan, Rex Premchand Antony Xavier, M. G. J. Yam, I. T. Chua
The femoral neck system (FNS) is a safe alternative to cannulated compression screw (CCS) and dynamic hip screw (DHS) in femoral neck fractures. A dual-centre retrospective cohort study was performed on femoral neck fractures (AO type 31-B) treated with closed reduction and internal fixation using FNS, DHS or CCS between April 2016 and April 2020. Exclusion criteria were as follows: patients aged below 16 years; chronic fractures beyond 7 days; pathological fractures; fracture extension to the intertrochanteric region or ipsilateral neck and shaft fractures; and open fractures. A total of 85 patients were identified: FNS (n = 28), DHS (n = 29) and CCS (n = 28). The FNS and CCS groups had a lower Garden and Pauwels classification compared to the DHS group (both P < 0.001). Both FNS and CCS groups were comparable in postoperative orthopaedic complications (10.7% [n = 3] vs. 3.6% [n = 1], adjusted P = 0.321). The DHS group had more postoperative orthopaedic complications than the FNS group, but this was not statistically significant (27.6% [n = 8] vs. 10.7% [n = 3], adjusted P = 0.321). There were no significant differences in median time to radiological union or median femoral neck shortening at union (both P > 0.05) among the three groups. The new DePuy Synthes FNS is a safe alternative to CCS with comparable complication rates for femoral neck fractures that are less displaced and more stable. The FNS also appears to be a safe alternative to DHS in the fixation of femoral neck fractures for the few cases of high-energy femoral neck fractures.
股骨颈系统(FNS)是股骨颈骨折中套管加压螺钉(CCS)和动态髋螺钉(DHS)的安全替代方案。 2016年4月至2020年4月期间,一项双中心回顾性队列研究对使用FNS、DHS或CCS进行闭合复位和内固定治疗的股骨颈骨折(AO 31-B型)进行了研究。排除标准如下:患者年龄小于16岁;慢性骨折超过7天;病理性骨折;骨折扩展至转子间区或同侧股骨颈和股骨颈轴骨折;开放性骨折。共确定了 85 名患者:FNS组(28人)、DHS组(29人)和CCS组(28人)。 与 DHS 组相比,FNS 组和 CCS 组的 Garden 和 Pauwels 分级较低(P 均<0.001)。在术后骨科并发症方面,FNS 组和 CCS 组具有可比性(10.7% [n = 3] vs. 3.6% [n = 1],调整后 P = 0.321)。DHS 组的术后骨科并发症多于 FNS 组,但差异无统计学意义(27.6% [n = 8] vs. 10.7% [n = 3],调整后 P = 0.321)。三组之间的放射学结合中位时间或结合时股骨颈缩短中位数无明显差异(P均>0.05)。 新型 DePuy Synthes FNS 是 CCS 的安全替代方案,对于移位较少且较稳定的股骨颈骨折,其并发症发生率与 CCS 相当。对于少数高能量股骨颈骨折病例,FNS似乎也是DHS固定股骨颈骨折的安全替代方案。
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引用次数: 0
Successful treatment of psoriasis-associated uveitis with ixekizumab after failure of secukinumab and risankizumab 在secukinumab和risankizumab治疗失败后使用ixekizumab成功治疗银屑病相关葡萄膜炎
IF 2.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-01-02 DOI: 10.4103/singaporemedj.smj-2023-133
Angelyn Chen Yin Lua, Soon-Phaik Chee, Hazel Hwee Boon Oon
{"title":"Successful treatment of psoriasis-associated uveitis with ixekizumab after failure of secukinumab and risankizumab","authors":"Angelyn Chen Yin Lua, Soon-Phaik Chee, Hazel Hwee Boon Oon","doi":"10.4103/singaporemedj.smj-2023-133","DOIUrl":"https://doi.org/10.4103/singaporemedj.smj-2023-133","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":"136 32","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139452922","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
Jarisch–Herxheimer reaction in a patient with Weil’s disease 一名魏尔病患者的雅利什-赫克海默反应
IF 2.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-01-02 DOI: 10.4103/singaporemedj.smj-2022-196
J. N. Ngiam, Tiara Joy Foo, Genevieve MY Tan, Jason Phua, Hui Fang Lim, P. Tambyah, G. Yan
{"title":"Jarisch–Herxheimer reaction in a patient with Weil’s disease","authors":"J. N. Ngiam, Tiara Joy Foo, Genevieve MY Tan, Jason Phua, Hui Fang Lim, P. Tambyah, G. Yan","doi":"10.4103/singaporemedj.smj-2022-196","DOIUrl":"https://doi.org/10.4103/singaporemedj.smj-2022-196","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":"91 23","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139390512","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
期刊
Singapore medical journal
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