Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease with undetermined etiology that primarily involves the motor neurons in the cerebral cortex, brainstem and spinal cord.
There is no cure and the mean duration of survival is 2-5 years without tracheostomy and ventilator support.
Clinical hallmarks of ALS are: presence of upper & lower motor neuron features involving the brainstem and spinal cord and progressive limb weakness, respiratory insufficiency, spasticity, hyperreflexia, and bulbar symptoms such as dysarthria and dysphagia.
Jackson M, Lladó J, Rothstein JD. Therapeutic developments in the treatment of amyotrophic lateral sclerosis. Expert Opin Investig Drugs. 2002 Oct;11(10):1343-1364. PMID: 12387699
Andersen PM, Borasio GD, Dengler R, et al. EFNS Task Force on Management of Amyotrophic Lateral Sclerosis: guidelines for diagnosing and clinical care of patients and relatives. Eur J Neurol. 2005 Dec;12(12):921-938. PMID: 16324086
Miller RG, Jackson CE, Kasarskis EJ, et al. Practice parameter update: the care of the patient with amyotrophic lateral sclerosis: multidisciplinary care, symptom management and cognitive/behavioral impairment (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2009 Oct;73(15):1227-1233. PMID: 19822873
Quality Standard Subcommittee of the American Academy of Neurology. Practice advisory on the treatment of amyotrophic lateral sclerosis with riluzole: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 1997 Sep;49(3):657-659. PMID: 9305318
Swash M. An algorithm for ALS diagnosis and management. Neurology. 1999;53(8)(Suppl 5):S58-S62. PMID: 10560641
Elman LB, McCluskey L. Diagnosis of amyotrophic lateral sclerosis and other forms of motor neuron disease. UpToDate. http://www.uptodate.com. Feb 2011. Accessed 01 Oct 2011
Galvez-Jimenez N. Symptom-based management of amyotrophic lateral sclerosis. UpToDate. http://www.uptodate.com. Feb 2011. Accessed 01 Oct 2011.
Choudry RB, Galvez-Jimenez N, Cudkowicz ME. Pharmacologic treatment of amyotrophic lateral sclerosis. UpToDate. http://www.uptodate.com. Jun 2011. Accessed 01 Oct 2011
Brooks BR, Miller RG, Swash M; World Federation of Neurology Research Group on Motor Neuron Diseases. El Escorial revisited: revised criteria for the diagnosis of amyotrophic lateral sclerosis. A consensus conference at Airlie House, Warrenton. http://www.wfnals.org/guidelines/1998elescorial/elescolrial1998.htm. Apr 1998
Hardiman O, van den Berg LH, Kiernan MC. Clinical diagnosis and management of amyotrophic lateral sclerosis. Nat Rev Neurol. 2011;7:639-649. doi: 10.1038/nrneurol.2011.153 . Accessed 16 Feb 2015. PMID: 21989247
Rusina R, Ridzon P, Keller O, et al. Relationship between ALS and the degree of cognitive impairment, markers of neurodegenration and predictors of poor outcome: a prospective study. Eur J Neurol. 2010 Jan;17(1):23-30. doi: 10.1111/j.1468-1331.2009.02717.x. PMID: 19572947
Salvioni CC, Stanich P, Almeida CS, et al. Nutritional care in motor neurone disease/amyotrophic lateral sclerosis. Arq Neuropsiquiatr. 2014 Feb;72(2):157-163. doi: 10.1590/0004-282X20130185. PMID: 24604371
Choudry RB, Galvez-Jimenez N, Cudkowicz ME. Disease modifying treatment of amyotrophic lateral sclerosis. UpToDate. http://www.uptodate.com. Jun 2017.
Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa,
08 Jan 2021
Antimicrobial resistance has become increasingly dire as the rapid emergence of drug resistance, especially gram-negative pathogens, has outpaced the development of new antibiotics. At a recent virtual symposium, Dr Hsu Li Yang, Vice Dean (Global Health) and Programme Leader (Infectious Diseases), NUS Saw Swee Hock School of Public Health, presented epidemiological data on multidrug-resistant (MDR) gram-negative bacteria (GNB) in Asia, while Dr Tan Thuan Tong, Head and Senior Consultant, Department of Infectious Diseases, Singapore General Hospital (SGH), focused on the role of ceftazidime-avibactam in MDR GNB infections. Dr Andrea Kwa, Assistant Director of Research, Department of Pharmacy, SGH, joined the panel in an interactive fireside chat, to discuss challenges, practical considerations, and solutions in MDR gram-negative infections. This Pfizer-sponsored symposium was chaired by Dr Ng Shin Yi, Head and Senior Consultant of Surgical Intensive Care, SGH.