1,739 results match your criteria: "Khoo Teck Puat hospital[Affiliation]"

Characterization and individual-level prediction of cognitive state in the first year after 'mild' stroke.

PLoS One

August 2024

Occupational Therapy, School of Allied Health, Human Services and Sport, College of Science Health and Engineering, La Trobe University, Melbourne, Australia.

Background: Mild stroke affects more than half the stroke population, yet there is limited evidence characterizing cognition over time in this population, especially with predictive approaches applicable at the individual-level. We aimed to identify patterns of recovery and the best combination of demographic, clinical, and lifestyle factors predicting individual-level cognitive state at 3- and 12-months after mild stroke.

Methods: In this prospective cohort study, the Montreal Cognitive Assessment (MoCA) was administered at 3-7 days, 3- and 12-months post-stroke.

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Effective feedback is crucial for educating health professions students. This systematic review investigates the impact of extrinsic feedback on health professions students, encompassing medical, dental, and nursing fields. Through meticulous gathering and analysis of 37 studies, this review highlights verbal and visual feedback as predominant forms, often delivered immediately by instructors and supplemented by peer or simulated input.

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Purpose: The purpose of this study was to evaluate longitudinal changes in choroidal vascular characteristics in childhood, and their relationship with eye growth and refractive error.

Methods: Analysis of high-resolution optical coherence tomography (OCT) scans, collected over an 18-month period as part of the Role of Outdoor Activity in Myopia (ROAM) study, was conducted in 101 children (41 myopic, 60 non-myopic, age 10-15 years). OCT images were automatically analyzed and binarized using a deep learning software tool.

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The existence and function of Lgr5 cells within the developing esophagus remains unknown. Here, we document multiple discrete Lgr5 populations in the developing mouse esophagus, predominantly within nascent epithelial and external muscle layers. Lgr5 expression initially emerges in the developing proximal embryonic epithelium, but progressively extends distally and persists within the distal epithelium of neonates.

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Purpose: Distal femur fractures comprise approximately 4% of all femoral fractures, with lateral plating being a common fixation technique. In recent years, dual plating with an additional medial plate has shown added benefit for Arbeitsgemeinschaft für Osteosynthesefragen C-type fractures, comminuted, osteoporotic distal femur fractures and non-union or malunion complications postsingle lateral plating. However, to our knowledge, there is no commercially available distal femur medial plate for fracture fixation.

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Association of major candidate protein biomarkers and long-term diabetic kidney disease progression among Asians with young-onset type 2 diabetes mellitus.

Diabetes Res Clin Pract

October 2024

Clinical Research Unit, Khoo Teck Puat Hospital, Singapore; Diabetes Centre, Admiralty Medical Centre, Singapore; Saw Swee Hock School of Public Heath, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore. Electronic address:

Aims: We aim to determine the association of seven major candidate protein biomarkers and diabetic kidney disease (DKD) progression among Asians with young-onset type 2 diabetes mellitus (T2DM).

Methods: 824 T2DM patients (onset ≤ 40 years old) were classified as DKD progressors based on yearly estimated glomerular filtration rate (eGFR) decline of >3 ml/min/1.73 m or >40 % from baseline.

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Lacquer cracks in pathological myopia: a clinical review.

Eye (Lond)

October 2024

Department of Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, SG, Singapore.

Lacquer cracks, described as breaks in the Bruch's membrane, are unique lesions in the spectrum of fundus changes associated with pathological myopia. Lacquer cracks are generally believed to be relatively innocuous lesions by themselves; however, progression to other features of myopic macular degeneration, such as patchy chorioretinal atrophy and choroidal neovascularization, may result in irreversible visual impairment. With the rising prevalence of pathological myopia to epidemic proportions, particularly in the Asian countries, ophthalmologists expect to encounter lacquer cracks more frequently in clinical practice.

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Lymph node status is a key prognostic factor in penile cancer. The European Association of Urology (EAU) recommends intermediate-risk (pT1a, Grade 2) or high-risk (pT1b or greater) penile cancer patients with clinically non-palpable inguinal lymph node (cN0) to undergo either an invasive bilateral modified inguinal lymph node dissection (ILND) or dynamic sentinel node biopsy (DSNB). DSNB has been reported to have acceptable false negative rates, and lower rates of long-term morbidity compared to ILND.

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A pancreatic pseudocyst is defined as an encapsulated fluid collection with a well-defined inflammatory wall with minimal or no necrosis. The diagnosis cannot be made prior to 4 wk after the onset of pancreatitis. The clinical presentation is often nonspecific, with abdominal pain being the most common symptom.

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Objectives: To provide an updated summary of published anchor-based Minimally Important Difference (MID) estimates for the EQ-5D index and EQ visual analog scale (EQ VAS) scores and identify factors influencing those estimates.

Study Design And Setting: We systematically searched eight electronic databases from January 1990 to March 2023. We examined the association of baseline score, type of score change (improvement/worsening), data source, value set, disease/condition, treatment type (surgical/non-surgical), and type of anchor (clinical vs.

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Identifying the evolving needs of patients with advanced heart failure (AdHF) and triaging those at high risk of death can facilitate timely referrals to palliative care and advance patient-centered individualized care. There are limited models specific for patients with end-stage HF. We aim to identify risk factors associated with up to three-year all-cause mortality (ACM) and describe prognostic models developed or validated in AdHF populations.

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Background: Cardiocerebral infarction (CCI), which is concomitant with acute myocardial infarction (AMI) and acute ischemic stroke (AIS), is a rare but severe presentation. However, there are few data on CCI, and the treatment options are uncertain. We investigated the characteristics and outcomes of CCI compared with AMI or AIS alone.

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Proteomics profiling and association with cardiorenal complications in type 2 diabetes subtypes in Asian population.

Diabetes Res Clin Pract

August 2024

Clinical Research Unit, Khoo Teck Puat Hospital, Singapore; Lee Kong Chian School of Medicine, Nanyang Technology University, Singapore; Diabetes Centre, Admiralty Medical Centre, Singapore; Saw Swee Hock School of Public Heath, Singapore. Electronic address:

Aim: Among multi-ethnic Asians, type 2 diabetes (T2D) clustered in three subtypes; mild obesity-related diabetes (MOD), mild age-related diabetes with insulin insufficiency (MARD-II) and severe insulin-resistant diabetes with relative insulin insufficiency (SIRD-RII) had differential cardio-renal complication risk. We assessed the proteomic profiles to identify subtype specific biomarkers and its association with diabetes complications.

Methods: 1448 plasma proteins at baseline were measured and compared across the T2D subtypes.

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BACKGROUND Visual hallucinations occur in a variety of clinical settings and may be extremely troubling to individuals experiencing them. We report a case of delayed-onset visual hallucinations 20 years after initiation of medical therapy to highlight the importance of considering iatrogenic causes when managing such patients. CASE REPORT An 88-year-old woman presented with recurring hypnopompic formed visual hallucinations for the past 20 years.

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Family caregivers living with patients with dementia (PwD) face psychological challenges due to care burden. Technology-delivered psychosocial interventions (TPIs) have played a promising role in improving health outcomes among family caregivers living with PwD. This review aims to synthesise evidence of the effectiveness of TPIs on primary (burden and depression) and secondary outcomes (self-efficacy, stress and anxiety) for family caregivers living with PwD.

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Cost-effectiveness analysis of a 'Termination of Resuscitation' protocol for the management of out-of-hospital cardiac arrest.

Resuscitation

September 2024

Health Services and Systems Research, Duke-NUS Medical School, 8 College Rd, Singapore 169857, Singapore. Electronic address:

Article Synopsis
  • A 'Termination of Resuscitation' (TOR) protocol was introduced in Singapore in 2019, allowing emergency responders to pronounce death on-scene for out-of-hospital cardiac arrests (OHCA), rather than transporting patients to hospitals.
  • A Markov model evaluated the cost-effectiveness of three approaches: No TOR, Observed TOR, and Full TOR, demonstrating that Full TOR resulted in fewer costs and QALYs (quality-adjusted life years).
  • The study concluded that implementing the TOR protocol was cost-effective, suggesting its sustainable adoption can be justified based on economic evaluations.
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We systematically reviewed the literature on the effects of the coronavirus disease 2019 (COVID-19) pandemic on the progression, prevalence, and incidence of myopia. A comprehensive literature search was performed on PubMed, Cochrane Central Register of Controlled Trials, and Scopus databases. Studies included in the review assessed myopia progression, prevalence, and/or incidence as the primary outcome.

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Background: Iliacus muscle abscess is an uncommon but potentially life-threatening condition that can present with nonspecific symptoms, posing diagnostic challenges. This case report highlights the importance of considering iliopsoas abscess in patients presenting with fever and hip pain, especially in the absence of obvious risk factors or penetrating trauma. The novelty of this case lies in its atypical presentation mimicking a respiratory viral infection and musculoskeletal injury, impeding accurate diagnosis and appropriate management.

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Health-related quality of life with comprehensive geriatric assessment guided care versus usual care in older adults with cancer: A systematic review and meta-analysis of randomized trials.

Crit Rev Oncol Hematol

September 2024

Department of Radiation Oncology, National University Cancer Institute, Singapore, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Article Synopsis
  • The study examined whether comprehensive geriatric assessment (CGA)-guided care enhances health-related quality of life (HRQL) in older cancer patients compared to standard care.
  • Meta-analyses showed a potential moderate improvement in HRQL scores at 3 months, though results were not definitive and depended on the size and type of trials.
  • Overall, findings suggested that larger RCTs and those requiring CGA before cancer treatment were more likely to show better HRQL outcomes.
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Background: Door-to-balloon time (DTBT) for ST-elevation myocardial infarction (STEMI) is a performance metric by which primary percutaneous coronary intervention (PPCI) services are assessed.

Methods: Consecutive patients presenting with STEMI undergoing PPCI between January 2007 to December 2019 from the Singapore Myocardial Infarction Registry were included. Patients were stratified based on DTBT (≤60 min, 61-90 min, 91-180 min) and Killip status (I-III vs.

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Machine learning (ML) methods are increasingly used to assess variable importance, but such black box models lack stability when limited in sample sizes, and do not formally indicate non-important factors. The Shapley variable importance cloud (ShapleyVIC) addresses these limitations by assessing variable importance from an ensemble of regression models, which enhances robustness while maintaining interpretability, and estimates uncertainty of overall importance to formally test its significance. In a clinical study, ShapleyVIC reasonably identified important variables when the random forest and XGBoost failed to, and generally reproduced the findings from smaller subsamples (n = 2500 and 500) when statistical power of the logistic regression became attenuated.

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