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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
Inhaled corticosteroid (ICS) should be the mainstay of long-term asthma management — such is the key message of the latest Singapore ACE* Clinical Guidance (ACG) for asthma, released in October 2020.
2 days ago
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Carvedilol yields survival gains in patients with cirrhosis, portal hypertension

30 Dec 2020

Patients with cirrhosis and portal hypertension appear to achieve lower mortality with carvedilol than with variceal band ligation (VBL), a study has found.

The study included 152 patients (73 percent had alcohol-related liver disease) treated with either VBL (n=75) or carvedilol (n=77) to prevent first variceal bleed. In total, 146 patients (96 percent) contributed mortality data and 135 (89 percent) had available long-term follow-up data (up to 20 years).

More patients in the carvedilol vs VBL arm crossed over and received the alternative treatment (32 percent vs 16 percent) during their follow-up than vice versa (p=0.02). The most common reason for crossing over was the development of variceal bleeding (54 percent) among patients originally treated with carvedilol, and intolerance to the banding programme (64 percent) among patients who originally received VBL.

In the intention‐to‐treat analysis, carvedilol was associated with significantly better survival than VBL, with median of 7.8 years as opposed to 4.2 years (p=0.03). This survival advantage persisted in the per‐protocol analysis, when patients who switched between treatment arms were excluded (p=0.02).

Transplant‐free survival, liver‐related mortality, and decompensation events did not significantly differ between the treatment arms.

The present findings point to carvedilol as an advantageous pharmacological adjunct in patients with cirrhosis with portal hypertension. Potential mechanisms underlying such a benefit include a decrease in gastrointestinal congestion and thus gut permeability, and subsequently reduced bacterial translocation leading to a lower incidence of ascites and spontaneous bacterial peritonitis. These effects are said to be independent of the drug’s effect on portal pressure. [Ann Gastroenterol 2014;27:20-26; Gut 2015;64:1111-1119]

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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
Inhaled corticosteroid (ICS) should be the mainstay of long-term asthma management — such is the key message of the latest Singapore ACE* Clinical Guidance (ACG) for asthma, released in October 2020.
2 days ago
Among patients with moderate-to-severe psoriasis, the use of biologics appears to lower the risk of being hospitalized for the novel coronavirus disease (COVID-19), a new study has found.