Publications by authors named "Rachel Goh"

There is a new awareness of the widespread nature of metabolic dysfunction-associated steatotic liver disease (MASLD) and its connection to cardiovascular disease (CVD). This has catalyzed collaboration between cardiologists, hepatologists, endocrinologists, and the wider multidisciplinary team to address the need for earlier identification of those with MASLD who are at increased risk for CVD. The overlap in the pathophysiologic processes and parallel prevalence of CVD, metabolic syndrome, and MASLD highlight the multisystem consequences of poor cardiovascular-liver-metabolic health.

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Introduction: This systematic review and meta-analysis aimed to evaluate the effectiveness and safety of adjunct systemic corticosteroid therapy in patients admitted to the intensive care unit (ICU) with bacterial community-acquired pneumonia (CAP).

Method: We searched MEDLINE, Embase and the Cochrane Library to identify randomised controlled trials (RCTs) published from the databases' inception to February 2024. All RCTs evaluating the effect of systemic corticosteroids on mortality, compared to standard of care among adult bacterial CAP patients admitted to ICU were included.

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Background: Dementia, particularly Alzheimer's disease, is a major healthcare challenge in ageing societies.

Objective: This study aimed to investigate the efficacy and safety of a dietary compound, ergothioneine, in delaying cognitive decline in older individuals.

Methods: Nineteen subjects aged 60 or above with mild cognitive impairment were recruited for this double-blinded, randomized, and placebo-controlled study (ClinicalTrials.

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Article Synopsis
  • The study aims to project cardiovascular disease (CVD) mortality trends and risk factors from 2025 to 2050 to aid healthcare planning.
  • Using historical data and Poisson regression, projections indicate a significant increase in CVD prevalence (90%), crude mortality (73.4%), and DALYs (54.7%), with ischaemic heart disease and high blood pressure as major contributors.
  • Despite a stable age-standardized CVD prevalence, the study underscores a concerning rise in crude mortality due to an aging population, prompting the need for effective healthcare strategies.
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  • A study forecasts a 91.2% increase in crude cardiovascular disease (CVD) mortality in Asia from 2025 to 2050, despite a 23.0% decrease in the age-standardized mortality rate.
  • Ischaemic heart disease and stroke will remain the top causes of mortality, with Central Asia experiencing the highest mortality rates while high systolic blood pressure is identified as the leading risk factor across most of Asia.
  • The research highlights the need for targeted health interventions due to the significant variations in CVD burden across different regions in Asia.
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  • Malnutrition is linked to worse outcomes for patients with acute coronary syndrome (ACS), impacting their prognosis and survival rates.
  • The study reviewed various nutritional assessment tools and analyzed data from 30 studies with over 37,000 patients, revealing that about one-third were malnourished, leading to a mortality rate of 20.59% among them.
  • Results showed that malnutrition significantly increased the risk of all-cause mortality, regardless of ACS type, ethnicity, or income, highlighting the importance of addressing nutritional status in these patients.
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Introduction: Reported outcomes for parenteral nutrition (PN)-related complications in older adult patients with acute intestinal failure who are receiving PN in the acute hospital setting are limited. Our study aims to compare PN-related complications between older and younger adult patients.

Methods: A retrospective descriptive study of inpatients who were administered PN from January 1, 2019, to December 31, 2019, was performed.

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Article Synopsis
  • * Overweight/obesity is forecasted to not only be the most rapidly growing risk factor but also the leading cause of AMI-related deaths, with a staggering 294.7% increase in mortality associated with it.
  • * Disparities exist among ethnic groups, with Indian and Malay populations facing a higher burden of obesity and AMI-related mortality compared to Chinese individuals.
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Article Synopsis
  • - Recent research indicates that tirzepatide, a medication that interacts with gut hormones, effectively promotes weight loss in individuals with overweight or obesity, as shown in a systematic review and meta-analysis of clinical trials.
  • - The analysis involved approximately 5800 patients, revealing that a significant percentage achieved notable weight loss (≥5%: 78.22%, ≥10%: 55.60%, ≥15%: 32.28%) and that higher doses of tirzepatide led to greater weight loss compared to placebo and another drug, semaglutide.
  • - While there were some gastrointestinal side effects linked to tirzepatide, they were not substantially different from those experienced with semaglutide,
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Background: Epicardial adipose tissue (EAT) has garnered attention as a prognostic and risk stratification factor for cardiovascular disease. This study, via meta-analyses, evaluates the associations between EAT and cardiovascular outcomes stratified across imaging modalities, ethnic groups, and study protocols.

Methods: Medline and Embase databases were searched without date restriction on May 2022 for articles that examined EAT and cardiovascular outcomes.

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Background: Previous studies have shown that females with type 2 diabetes mellitus (T2DM) may have excess mortality risk compared to their male counterparts. An important next step to address the high global burden of T2DM and cardiovascular disease (CVD) is an umbrella review to summarize data on sex differences in cardiovascular outcomes for patients with T2DM and assess the strength of the evidence observed.

Methods And Results: Medline and Embase were searched from inception till 7 August 2022 for systematic reviews and meta-analyses studying the effects of sex on cardiovascular outcomes in T2DM patients.

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Article Synopsis
  • Health literacy and illness perception significantly impact the management of cardiometabolic diseases, with this study examining the differences in attitudes and knowledge between individuals with and without metabolic risk factors (MFs).
  • A survey of 345 participants revealed that those with MFs tended to have lower knowledge scores but higher perceived risks regarding cardiometabolic diseases like hypertension and diabetes.
  • Despite their heightened awareness of risks, individuals with MFs showed only slight increases in taking preventive actions, highlighting a critical need to bridge the gap between knowledge and actual health behaviors.
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Background: Low socioeconomic status (SES) is an important prognosticator amongst patients with acute coronary syndrome (ACS). This paper analysed the effects of SES on ACS outcomes.

Methods: Medline and Embase were searched for articles reporting outcomes of ACS patients stratified by SES using a multidimensional index, comprising at least 2 of the following components: Income, Education and Employment.

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Although most of the current evidence on myocardial infarction focuses on obesity, there is growing evidence that patients who are underweight have unfavorable prognosis. This study aimed to explore the prevalence, clinical characteristics, and prognosis of this population at risk. Embase and Medline were searched for studies reporting outcomes in populations who were underweight with myocardial infarction.

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Article Synopsis
  • Malnutrition and obesity are interconnected issues that affect global health, and trends in disability-adjusted life years (DALYs) and deaths related to both were analyzed using data from 204 countries from 2000 to 2019, with projections up to 2030.
  • In 2019, malnutrition-related DALYs were higher in Africa and low SDI countries, while obesity-related DALYs increased annually, especially in the Eastern Mediterranean and middle SDI regions.
  • The study predicts that while malnutrition-related DALYs may decrease, the burden of obesity will continue to rise significantly in the coming years, indicating a growing health crisis.
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Background: A significant proportion of premature deaths globally are related to metabolic diseases in young adults. We examined the global trends and mortality of metabolic diseases in individuals aged below 40 years using data from the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) 2019.

Methods: From 2000 to 2019, global estimates of deaths and disability-adjusted life years (DALYs) were described for metabolic diseases (type 2 diabetes mellitus [T2DM], hyperlipidemia, hypertension, obesity, non-alcoholic fatty liver disease [NAFLD]).

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Article Synopsis
  • The study investigates how common hepatic steatosis (fatty liver) and fibrosis are in patients who have experienced an acute myocardial infarction (heart attack) and looks at their impact on mortality.
  • Among 5,765 patients studied, about 24.8% had hepatic steatosis, with 41.7% of those also having advanced fibrosis, which was linked to higher death rates over an average follow-up of 2.7 years.
  • The research concludes that hepatic steatosis and fibrosis are prevalent in post-AMI patients and significantly increase the risk of mortality, suggesting they could be important factors for assessing patient risk alongside traditional factors.
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Objective: The obesity epidemic is a global health concern with Asian countries facing one of the most rapid rises in obesity rates. However, given the underwhelming long-term efficacy of weight loss strategies, especially in Asia, this review aimed to explore barriers and facilitators to weight management of patients with overweight and obesity in Asia.

Methods: Medline, CINAHL, PsycINFO, and Web of Science were searched for articles discussing barriers and facilitators of treatment to obesity from the perspectives of both health care professionals (HCPs) and patients.

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Patients undergoing transcatheter aortic valve implantation (TAVI) commonly have co-morbidities requiring anticoagulation. However, the optimal post-procedural anticoagulation regimen is not well-established. This meta-analysis investigates safety and efficacy outcomes of direct oral anticoagulants (DOACs) and Vitamin K Antagonist (VKA), with or without concomitant antiplatelet therapy.

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Background: Standard modifiable cardiovascular risk factors (SMuRF), comprising diabetes, hyperlipidemia, hypertension, and smoking, are used for risk stratification in acute coronary syndrome (ACS). Recent studies showed an increasing proportion of SMuRF-less ACS patients.

Methods: Embase, Medline and Pubmed were searched for studies comparing SMuRF-less and SMuRF patients with first presentation of ACS.

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Background & Aims: The use of standardized commercially available parenteral nutrition (SCAPN) as a starter bag to bridge to customized compounded PN offers the advantage of starting PN on the same day of consult, avoiding delays in nutrition delivery. We aim to evaluate the safety and feasibility of using SCAPN as a bridge to compounded PN in the acute hospital setting.

Methods: Retrospective review of patients on PN from Aug 2018 to Sep 2019 was performed.

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Newer generation durable polymer drug-eluting stents (DP-DES) and biodegradable polymer DES (BP-DES) have similar efficacy with dual-antiplatelet therapy (DAPT) duration of > 6 months. However, this difference in outcomes have not been well studied in shorter DAPT regime. This study compares the safety and efficacy profiles of DP-DES and BP-DES based on short-term (1-3 months), intermediate-term (4-6 months) and standard DAPT (6-12 months) durations.

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M1 and M4 muscarinic receptor (mAChR) agonists are under development for the treatment of schizophrenia, Alzheimer's and Parkinson's disease. We performed first-in-human PET imaging of mAChR with F-Fluorobenzyl-Dexetimide (FDEX) in 10 healthy participants (29.4±4.

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