Performance of Risk-Stratification Scores for Patients With Pulmonary Arterial Hypertension in a Multi-Ethnic Asian Population.

Guidelines recommend risk stratification of pulmonary arterial hypertension (PAH) patients to guide management. There are currently several risk stratification scores available, which have largely been validated in various pulmonary hypertension registries in the West but not in Asia. We aim to study the performance of these different risk scores in PAH patients from a multi-ethnic Asian population.

Radiotherapy-Induced Stevens-Johnson Syndrome/ Toxic Epidermal Necrolysis in an Adolescent Girl With Diffuse Glioma of the Pons.

Radiotherapy is a rare cause of Stevens-Johnson syndrome (SJS)/ toxic epidermal necrolysis (TEN), especially in the pediatric age group. Most of the reported cases were concomitantly started on anti-epileptic drugs. Herein, we present a case of radiotherapy induced SJS/TEN in an adolescent girl in the absence of anti-epileptic drug use.

Patient Characteristics, Management, and Outcomes of Adult Asthma in a Singapore Population: Data from the SDG-CARE Asthma Registry.

Purpose: Patients with asthma in Singapore often have complex patient journeys, with diagnosis and management across various primary and speciality care settings. Real-world population health data is needed to identify care gaps and inform policies.

Patients And Methods: This retrospective, longitudinal cohort study assessed real-world data from adults (aged ≥18 years) with asthma in the SingHealth Chronic Obstructive Pulmonary Disease and Asthma Data Mart, an integrated database of electronic medical records of patients who attended primary and/or speciality care clinics in the SingHealth Regional Health System 01/01/2015-12/31/2020.

Lower limb nodules with angioinvasive Phaeoacremonium spp. fungus in an immunocompetent host.

Phaeohyphomycosis has been described to cause a variety of cutaneous manifestations in both immunocompetent and immunocompromised hosts. We report an unexpected case where an immunocompetent elderly female developed a rare angioinvasive fungal cutaneous infection. She had no known history of inoculation, and her lesions resolved without treatment.

ADAR1-regulated cytoplasmic dsRNA-sensing pathway is a novel mechanism of lenalidomide resistance in multiple myeloma.

Immunomodulatory agents (IMiDs) are a major class of drugs for treating multiple myeloma (MM); however, acquired resistance to IMiDs remains a significant clinical challenge. While alterations in cereblon (CRBN) and its pathway are known to contribute to IMiD resistance, they account for only 20-30% of cases, and the underlying mechanisms in the majority of the resistance cases remain unclear. Here, we identified ADAR1 as a novel driver of lenalidomide resistance in MM.

Late radiation-related lymphopenia after prostate stereotactic body radiation therapy plus or minus supplemental pelvic irradiation.

Introduction: Prior studies suggest lymphopenia following radiation therapy may impact toxicity and cancer control. Chronic radiation-related lymphopenia (RRL) has been noted in prostate cancer patients treated with conventionally fractionated pelvic radiation therapy. The impact of utilizing hypofractionated high integral dose therapies such as stereotactic body radiation therapy (SBRT) on RRL is less well characterized.

Sputum metagenomics reveals a multidrug resistant Pseudomonas-dominant severe asthma phenotype in an Asian population.

Background And Objective: While the lung microbiome in severe asthma has been studied, work has employed targeted amplicon-based sequencing approaches without functional assessment with none focused on multi-ethnic Asian populations. Here we investigate the clinical relevance of microbial phenotypes of severe asthma in Asians using metagenomics.

Methods: Prospective assessment of clinical, radiological, and immunological measures were performed in a multi-ethnic Asian severe asthma cohort (N = 70) recruited across two centres in Singapore.

Lessons from Recent Measles Post-Campaign Coverage Surveys Worldwide.

Background: Measles elimination strategies include supplementary immunization activities (SIAs) to rapidly fill immunity gaps. Post-campaign coverage surveys (PCCSs) are recommended to assess SIA coverage. We characterized selected PCCSs performed following recent SIAs, highlighting specific challenges and strengths, and provide recommendations for improvement.

Resistance to immunomodulatory drugs in multiple myeloma: the cereblon pathway and beyond.

Acquired resistance to immunomodulatory drugs (IMiDs) remains a significant unmet need in the treatment landscape of multiple myeloma (MM). CRBN pathway-dependent mechanisms are known to be vital contributors to IMiD resistance; however, they may account for only a small proportion. Recent research has unveiled additional mechanisms of acquired IMiD resistance that are independent of the CRBN pathway.

Unmet educational needs and expectations among tracheostomy recipients.

Objective: This study seeks to better understand unmet educational needs and treatment expectations in individuals with a tracheostomy.

Study Design: Retrospective, cross-sectional survey.

Methods: A survey was distributed to individuals who received a tracheostomy at a tertiary care center in the last five years as well as in Facebook support groups for tracheostomy and head and neck cancer patients.

Shwachman-Diamond Syndrome Presenting as Neonatal Ichthyosis.

Shwachman-Diamond syndrome (SDS) is a rare inherited bone marrow failure syndrome characterized by the triad of exocrine pancreatic dysfunction, cytopenia, and skeletal abnormalities. We report a 5-month-old boy with SDS who presented with generalized ichthyosis in the neonatal period that evolved into more eczematous skin eruptions, accompanied by severe failure to thrive. This report highlights the importance of including SDS as a differential diagnosis in patients who present with early ichthyosis, failure-to-thrive, gastrointestinal symptoms and cytopenia.

Report from the World Health Organization's immunization and vaccines-related implementation research advisory committee (IVIR-AC) meeting, virtual gathering, 10-13 September 2024.

The Immunization and Vaccines-related Implementation Research Advisory Committee (IVIR-AC) is the primary advisory body of the World Health Organization conducting independent reviews of immunization-related implementation research, with a primary focus on transmission and economic modeling analyses that estimate the value and impact of vaccines. From 10 to 13th September 2024, IVIR-AC convened virtually for its second of two semi-annual meetings to provide feedback and recommendations across six sessions including: pneumococcal vaccination strategies that rely on indirect protection; vaccine impact modeling for chikungunya; The Lancet Commission on strengthening the use of epidemiological modeling of emerging and pandemic infectious diseases; methods for immunization coverage estimation; setting immunization research priorities in the South-East Asian Region; and modeling evidence related to typhoid conjugate vaccine schedules. This report summarizes the sessions, proceedings, and recommendations from that meeting.

Temporal Trends in Knowledge of Human Papillomavirus and Associated Oropharyngeal Cancer Following Expanded Vaccination Eligibility.

Objective: Human papillomavirus (HPV) is a significant driver of elevated risk for oropharyngeal squamous cell carcinoma (OPSCC). In 2018, HPV vaccination eligibility was expanded to men and women aged 27 to 45. We evaluated changes in awareness of HPV, its association with OPSCC, and HPV vaccination among all US adults between 2018 and 2020, focusing on those aged 27 to 45.

Asthma prescribing trends, inhaler adherence and outcomes: a Real-World Data analysis of a multi-ethnic Asian Asthma population.

Inhaled corticosteroid (ICS) is the mainstay therapy for asthma, but general adherence is low. There is a paucity of real-world inhaler prescribing and adherence data from Asia and at the population level. To address these gaps, we performed a real-world data analysis of inhaler prescribing pattern and adherence in a multi-ethnic Asian asthma cohort and evaluated the association with asthma outcomes.

Safety and early efficacy of involved-field SBRT for nodal oligo-recurrent prostate cancer.

Purpose: Following treatment for localized prostate cancer, a subset of men will develop recurrent disease in the abdominopelvic nodes. For radiation therapy (RT), the optimal treatment volume, fractionation schedule, and dose remain unanswered questions. We report early outcomes for patients treated with involved-field stereotactic body radiation therapy (SBRT) (IF-SBRT) for nodal oligo-recurrent (NOR) prostate cancer.

Disease Burden and Access to Biologic Therapy in Patients with Severe Asthma, 2017-2022: An Analysis of the International Severe Asthma Registry.

Introduction: Patients with severe asthma may be prescribed biologic therapies to improve disease control. The EVEREST study aimed to characterize the global disease burden of patients with severe asthma without access to biologics and those who have access but do not receive biologics, as well as the remaining unmet need despite use of these therapies.

Methods: This was a historical cohort study of patients with severe asthma (aged ≥18 years) in the International Severe Asthma Registry receiving Global Initiative for Asthma (GINA) 2018 step 5 treatment, or with uncontrolled disease at GINA step 4.

Biologics in congenital ichthyosis: are they effective?

Background: Congenital ichthyoses (CI) comprise a heterogeneous group of genetic diseases requiring lifelong treatment and having a major effect on quality of life. Conventional treatments reduce scaling and skin discomfort; however, they usually have little or no effect on erythema and pruritus. The identification of cytokine alterations in CI raised the possibility of repurposing available biologics.