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Top Medical News
A large retrospective cohort study by the University of Hong Kong (HKU) finds that postoperative prescription of opioids is associated with increased risks of new persistent opioid use, 30-day emergency department visits, 30-day readmission, and 30-day all-cause mortality.
A meta-analysis found evidence associating selfhood development with adolescent mental health.
Older adults with hypertension who are on blood pressure (BP)-lowering medications are better protected against dementia than those with untreated hypertension, and this is true across all ages in late life, according to an individual participant data meta-analysis.
Using deep brain stimulation (DBS) to target the cerebellar dentate nucleus appears to be a promising approach for treating patients with poststroke motor impairment, with a first-in-human trial showing that the intervention is safe and yields meaningful improvements in motor function when combined with physical therapy.
Brain disorders – comprising mental illness, neurologic conditions, and stroke – account for over 15 percent of global health loss (how much healthy life is lost due to early death, illness, or ability) in the Global Burden of Disease (GBD) study presented at EAN 2023.
Atrial fibrillation (AF) appears to contribute to an increased risk of rapid progresssion to mild cognitive impairment (MCI) and dementia in women, as reported in a study.
An eye-tracking device provides measures of social visual engagement that are predictive of autism in young children as shown in a new study.
Special Reports
Migraine is a debilitating neurological condition that affects millions of people worldwide, causing intense headaches, sensory disturbances, and a significant decline in quality of life. Approximately one-third of patients encounter aura, which encompasses transient focal neurological disturbances that precede the attack. [Lancet 2017;390:1211-1259; Headache 2021;61:1021-1039]
The WHO defines long COVID as a condition that occurs 3 months from COVID-19 onset, whose symptoms last ≥2 months and cannot be attributed to an alternative diagnosis. In an interview with MIMS Doctor, Professor Ghassan Dbaibo of the Center for Infectious Diseases, American University of Beirut, Beirut, Lebanon, describes the evolving attitudes towards long COVID among healthcare professionals (HCPs), some unexpected predisposing factors, potential biological mechanisms behind prolonged symptom duration and shares data on vaccination’s protective effects against long COVID.
Executive function (EF) skills in childhood predict academic success better than a child’s intelligence quotient (IQ), and are associated with better physical health, more stable careers, and higher socioeconomic status in adulthood. [Psychol Sci 2005;16:939-944; J Clin Psychiatry 2012;73:941-950; Pediatrics 2013;131:637-644] Despite this, EF is an important topic that is often overlooked. To learn more about EF, MIMS Doctor interviewed Dr Evelyn Law, a clinician scientist specialising in developmental and behavioural paediatrics. Dr Law is Assistant Professor at the National University of Singapore Yong Loo Lin School of Medicine, Singapore.
Geriatric patients with atrial fibrillation (AF) are at increased risk of blood clots that can lodge in the brain and cause fatal strokes. At a recent webinar, Professor Olivier Hanon, Head of Geriatrics Department in Broca Hospital, Paris, France, shared insights on how to optimally protect geriatric patients with AF, with a special focus on direct oral anticoagulants (DOACs), particularly rivaroxaban, for stroke prevention in AF.
A key focus in the management of atrial fibrillation (AF) in older patients is stroke prevention through oral anticoagulation. However, a significant proportion of older AF patients remain undercoagulated due to the perceived bleeding risk of oral anticoagulants (OACs). Dr Tan Vern Hsen, Senior Consultant, Department of Cardiology, Changi General Hospital, Singapore, and Dr Barbara Helen Rosario, Senior Consultant, Department of Geriatric Medicine, Changi General Hospital, Singapore, shared their respective insights into managing older AF patients for an integrated approach.
Venous thromboembolism (VTE) is a serious medical condition. It comprises deep vein thrombosis and pulmonary embolism. Left untreated, it could result in significant morbidity and mortality. Most patients with VTE receive anticoagulation therapy for 3 months or longer. For more than 50 years since the 1940s, vitamin K antagonists (VKAs) such as warfarin were the mainstay of oral anticoagulation therapy for VTE. As it has a narrow therapeutic index, VKAs require frequent coagulation monitoring with International Normalised Ratio (INR) to adjust and optimize the dose for each individual. As the peak effect for warfarin takes at least 4-5 days, in the initial stage of VTE, concurrent administration of daily subcutaneous injections of low molecular weight heparin (LMWH) is needed until INR reaches therapeutic levels. Due to numerous drug and dietary interactions with warfarin, regular INR monitoring is required to ensure therapeutic levels are maintained and to avoid under or overdosing.
Nonvalvular atrial fibrillation (NVAF) raises the risk of stroke by three to five times, particularly in older patients. Treating older patients with NVAF presents special challenges because of their elevated risks for both stroke and bleeding. This necessitates optimization of anticoagulant therapy by balancing efficacy and bleeding risk. Non-vitamin K antagonist oral anticoagulants (NOACs), such as apixaban, have shown advantages in safety and efficacy over warfarin, which has a very narrow therapeutic index. In an interview with Dr Soon Chao Yang, Cardiologist at The Heart Doctors Clinic, Mount Alvernia Hospital, Singapore, he shared insights on managing NVAF in older patients, as well as his experience with using apixaban in this special population.
Conference Reports
Brain disorders – comprising mental illness, neurologic conditions, and stroke – account for over 15 percent of global health loss (how much healthy life is lost due to early death, illness, or ability) in the Global Burden of Disease (GBD) study presented at EAN 2023.
Retinal thinning predicts disability in patients newly diagnosed with relapsing multiple sclerosis (MS), an immune-mediated disease affecting the brain and spinal cord, in a new study presented at EAN 2023.
Photobiomodulation helps to reduce the severity of chemotherapy-induced peripheral neuropathy (CIPN) and increases mobility in cancer patients as shown in a study presented at EAN 2023.
Experimental gene therapy appears to improve eyesight in patients with a severe progressive form of Leber’s hereditary optic neuropathy (LHON) in an early access programme.
Combination therapy with an anti-CGRP* monoclonal antibody (mAB) and onabotulinumtoxinA may be more effective than either therapy in patients with chronic migraine, according to a new study.
Treatment with fremanezumab – an anticalcitonin gene-related peptide (CGRP) – reduces depressive symptoms in patients with migraine and comorbid major depressive disorder (MDD) in the UNITE trial.
Eplontersen, a ligand-conjugated antisense (LICA) investigational agent designed to reduce transthyretin (TTR) production or TTR protein, ably halts neuropathy progression and improves quality of life (QoL) in patients with hereditary transthyretin-mediated amyloid polyneuropathy (ATTRv-PN) in the phase III NEURO-TTRansform trial.