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Top Medical News
Patients with chronic coronary (CAD) or peripheral artery disease (PAD) treated with the combination of rivaroxaban and aspirin are at greater risk of bleeding than those treated with aspirin alone, according to a study. Major bleeding usually occurs during the first year of treatment, arises in the gastrointestinal (GI) tract and can be managed using conventional supportive therapies.
A large case series of enucleations has shown a low rate of implant exposure, which indicates that absence of wrapping material around hydroxyapatite orbital implants does not compromise surgical outcomes. It has also reduced surgical time and prevented complications from wrapping materials.
The once-daily fixed-dose combination of candesartan plus rosuvastatin reduces systolic blood pressure and low-density lipoprotein cholesterol at the same time with no major safety issues, according to the results of a phase III trial. This drug represents a convenient treatment option for patients with coexistent essential hypertension and hypercholesterolaemia.
In autoimmune hepatitis (AIH) patients receiving induction therapy with prednisone or prednisolone, the dose to induce remission may be lowered without compromising efficacy, as reported in a recent study. Specifically, 0.50 mg/kg/day is enough and hence reduces unnecessary exposure to the drugs in this population.
The 40-item Frailty Index and the Comprehensive Geriatric Assessment are similarly predictive of 1-year mortality in elderly adults undergoing colorectal surgery, a recent study has found.
Mindfulness-based interventions effectively alleviate psychological distress among cancer patients and survivors, reports a recent meta-analysis.
Overweight, postmenopausal women who eat two whole eggs per day show a significant increase in cholesterol efflux capacity, according to a study. This increase occurs without changes in apolipoprotein A1 (ApoA1), total cholesterol (TC), low- (LDL) or high-density lipoprotein (HDL) cholesterol.
Special Reports
At the recent 10th Malaysian Endocrine and Metabolic Society (MEMS) Annual Congress(MAC) held in Hilton Kuala Lumpur, Dr Wong Ming, a consultant endocrinologist from Sunway Medical Centre, spoke on the role of non–high-density lipoprotein cholesterol (non–HDL-c) as an emerging marker and treatment target for cardiovascular (CV) disease. Additionally, she also highlighted the role of fenofibrate in delaying and preventing diabetic retinopathy (DR).
Chronic hepatitis B (CHB) remains a major public health concern because of its worldwide distribution and potential adverse sequelae, including cirrhosis and hepatocellular carcinoma (HCC). At a recent symposium held during the GIHep Singapore 2019, Professor Vincent Wong from the Chinese University of Hong Kong and Professor Ray Kim from the Stanford University School of Medicine, Stanford, California, US, discussed antiviral treatments for CHB, with a focus on the novel agent tenofovir alafenamide (Vemlidy®). Dr Tan Poh Seng from the National University Hospital, Singapore, chaired the symposium.
Major trials have demonstrated the benefits of beta-blockers in the treatment of hypertension.1 At a recent symposium held during the Asian Pacific Society of Cardiology 2019 Congress in Manila, Philippines, experts discussed the latest guidelines on hypertension treatment, with a focus on the role of the 3rd generation beta-blocker, nebivolol. The symposium was chaired by Dr Dante D. Morales, Clinical Associate Professor at the University of the Philippines College of Medicine, and featured renowned cardiologists Prof Rafael R. Castillo and Dr Hyo Seung Ahn.
The cost of hospitalization for complications associatedwith influenza can be reduced significantly through theprevention of influenza infection.5 Cost savings mayincrease exponentially if one considers the control ofinfluenza outbreaks, especially in the aged care homesetting.
Renal cell carcinoma (RCC) is the most common primary tumour arising from the kidney, constituting approximately 80–85% of primary renal neoplasms. According to the Malaysian National Cancer Registry Report 2007–2011, RCC accounts for 62.8% of all kidney cancers nationwide. RCC typically occurs approximately 50% more commonly in men compared with women, and predominantly occurs in the sixth to eighth decade of life.
In an environment where children can interact openly, highly infectious diseases, such asinfluenza, have the potential to spread among childrenand those they come in contact with. Once infected,parents or siblings may have to take time off work or school to recover and to avoid spreading the disease to other healthy individuals.
Coenzyme Q10 (CoQ10, ubiquinone) is a fat-soluble, potent physiological antioxidant that is required for the production of cellular adenosine triphosphate (ATP). CoQ10 can be obtained through tissue synthesis and diet, and it has been widely studied in patients with cardiovascular (CV) risk factors. The effects of oral CoQ10 supplementation in different patient subgroups are presented here.
Conference Reports
The mortality rate for patients who undergo percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) for de-novo three-vessel disease or left main coronary artery disease (CAD) is comparable at 10 years. However, CABG may be preferable for those with three-vessel disease, according to the SYNTAX Extended Survival (SYNTAXES) study, a 10-year follow-up of the SYNTAX* trial.
Subgroup evaluations of the GLOBAL LEADERS trial demonstrated the anti-ischaemic efficacy of long-term ticagrelor monotherapy relative to aspirin monotherapy in patients who had percutaneous coronary intervention (PCI). However, this occurred at the expense of bleeding in the elderly.
The potent P2Y12 inhibitor prasugrel significantly reduced the incidence of death, myocardial infarction (MI), or stroke in patients with acute coronary syndrome (ACS) with or without ST-segment elevation (STE) compared with ticagrelor, according to the results of the ISAR-REACT* 5 trial presented at ESC Congress 2019. Moreover, the improved anti-ischaemic efficacy of prasugrel was not accompanied by an increased bleeding risk.
A single testing of cardiac troponin I using a high-sensitivity assay can effectively rule out myocardial infarction (MI) without compromising safety, according to the HiSTORIC* study presented at the ESC 2019 Congress.
A newly developed clinical risk score can identify patients with type 2 diabetes (T2D) at greatest risk for hospitalization for heart failure (HHF) who would derive the most benefit from treatment with dapagliflozin, according to a study presented at ESC 2019.
Prof Deepak Bhatt gives a rundown of the findings from THEMIS and THEMIS-PCI
Podcast: Prof Derek Chew explains the importance of a 1-hour troponin T protocol in suspected ACS as discussed in the RAPID-TnT trial
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