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Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa, 08 Jan 2021
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Allografts with vascularized fibula graft inlays superior to allografts alone for osseous reconstruction

19 Jul 2020

Allograft reconstruction with supplementary vascularized fibula graft (VFG) inlay is better than allografts alone for osseous reconstruction in lower extremity bone cancer, reports a recent meta-analysis.

Drawing from the databases of PubMed, Embase, and Web of Science, the researchers included 25 eligible articles, corresponding to 359 patients who received allografts alone, and 310 who underwent the allograft/VGF reconstruction. Surgeries were performed secondary to an oncological bone defect. Outcomes included nonunion, infection, fractures, explantation, and functional limb status.

The rate of nonunion was significantly higher in patients who received allografts alone than in those who were also given VFG supplementation. The resulting weighted random effect rates were 21.4 percent and 13 percent, respectively (p<0.001). Fractures (19.1 percent vs 19.6 percent; p=0.70) and infections (9 percent vs 7.9 percent; p=0.82) occurred with comparable frequency between groups.

However, when taken together, the allograft-alone group showed a significantly higher overall complication rate (50.6 percent vs 41.3 percent; p<0.001).

In addition, explantation rate was significantly lower in the allograft/VFG group than in those who underwent reconstruction with allografts alone (6.57 percent vs 18.11 percent; p<0.001). Reasons for removal included fractures, extended time of malunion or nonunion, the need for revisions, and recurrence of tumours.

Functional outcomes, most commonly assessed using the Musculoskeletal Tumour Society rating scale, were comparable between groups, and not enough studies reported on limb status to make meta-analysis possible.

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Most Read Articles
01 Dec 2020
Tetanus toxoid 5 Lf, diphtheria toxoid 2 Lf, pertussis toxoid 2.5 mcg, filamentous haemagglutinin 5 mcg, fimbriae types 2 and 3 5 mcg, pertactin 3 mcg
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.
Pearl Toh, 26 Nov 2020
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3 days ago
Daily intake of cow’s milk formula in early life helps prevent the development of cow’s milk allergy later on without competing with breastfeeding, a recent study has found.