Left ventricular assist devices (LVADs) improve survival and quality of life (QoL) in patients with advanced heart failure (HF). At the National Heart Centre Singapore (NHCS), a mechanical cardiac support (MCS) programme in place since 2001 has shown a 2-year survival rate of 100 percent with the use of continuous flow pumps.
Tolvaptan improves dyspnoea, increases sodium levels and reduces body weight in patients with acute heart failure (HF) with or without hyponatraemia, but no significant effect is seen in mortality or rehospitalization, according to a recent meta-analysis.
A left ventricular ejection fraction (LVEF) cut-off of 60 percent may identify patients with heart failure (HF) with mid-range or preserved ejection fraction (mrEF or pEF) who could benefit from drug therapy.
Early use of mTOR inhibitors for primary immunosuppression may attenuate the progression of cardiac allograft vasculopathy (CAV) and reduce mortality after heart transplantation (HTX), while noninvasive assessments may become promising alternatives to endomyocardial biopsy for diagnosis of allograft rejection, recent studies have shown.
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Macrolide antibiotics are derived from the Streptomycesspecies. These contain either 14-membered (erythromycin [ERM],clarithromycin [CAM], roxithromycin [RXM]), 15-membered(azithromycin [AZM]) or 16-membered (spiramycin, josamycin,midecamycin) macrocyclic lactone rings. They inhibit proteinsynthesis by reversibly binding to the 23S ribosomal RNA (rRNA)in the 50s subunit of the bacterial ribosome. Traditionally,macrolides are used as first-line agents in respiratory, skin,soft tissue, and urogenital infections, and they are also activeagainst gram-positive cocci and atypical pathogens.
Nonsmall cell lung cancer (NSCLC) patients harbouring sensitive EGFR mutations may fare well with the third-generation tyrosine kinase inhibitor osimertinib as an upfront therapy, with the results of a network meta-analysis showing that the drug tops other currently available options in terms of progression-free survival and tolerability.
Pneumonia is a common infection– affecting around 3,200 people inSingapore in 2016 – making it the thirdmost common cause of hospitalisation inthe country. Its common complications,especially with delayed or inappropriatetreatment, include bacteraemia andseptic shock, lung abscesses, pleuraleffusions, empyema, pleurisy, respiratoryfailure and renal failure.