2.Risk-based screening programmes for cancer diagnosis: A systematic review with narrative synthesis.
Yong Yi TAN ; Sara TASNIM ; Mohammad Fahmy Bin FADZIL ; Xin Rong NG ; Sabrina Kw WONG ; Jo-Anne Elizabeth MANSKI-NANKERVIS ; Joseph Jao-Yiu SUNG ; Joanne NGEOW
Annals of the Academy of Medicine, Singapore 2025;54(10):644-663
INTRODUCTION:
Risk-based screening (RBS) has emerged as a promising alternative to age-based cancer screening. However, evidence regarding real-world implementation outcomes remains fragmented. Thus, a systematic review was conducted to evaluate the implementation metho-dologies and outcomes of RBS programmes across different cancer types.
METHODS:
MEDLINE, Embase, CINAHL, Web of Science, Cochrane Central Register of Controlled Trials and Scopus were systematically searched from their respective dates of inception up to 8 July 2024. Prospective and rando-mised controlled trials (RCTs), which implement the RBS of cancer in an asymptomatic population, or studies retrospectively evaluating the outcomes of the same were included. Geographic distribution, population characteristics, RBS methodology, diagnostic accuracy and clinical outcomes were narratively synthesised.
RESULTS:
Among the 33 included studies (i.e. 21 prospective cohort, 8 RCTs, 3 retrospective and 1 non-RCT), sample sizes ranged from 102 to 1,429,890 participants. Most RBS trials were conducted in China (n=7, 21.2%), followed by the Netherlands (n=4, 12.1%) then the US, Australia and Sweden (n=3, 9.8%). Studies predominantly examined colorectal (27.3%), breast (21.2%) and prostate cancer (18.2%). Three main stratification approaches emerged: algorithmic (48.5%), validated risk models (39.4%) and physician assessment (9.1%). Implementation outcomes showed higher uptake in moderate-risk (75.4%) compared to high-risk (71.3%) and low-risk groups (67.9%). Five studies demonstrated cost-effectiveness with increased quality-adjusted life years, while 12 studies showed superior or non-inferior cancer detection rates compared to traditional screening.
CONCLUSION
The RBS of cancer has the potential to optimise healthcare resource allocation while minimising harm and increasing receptiveness for patients. More work is needed to evaluate long-term outcomes prior to the scaling of RBS programmes.
Humans
;
Early Detection of Cancer/methods*
;
Neoplasms/diagnosis*
;
Risk Assessment
;
Mass Screening/methods*
4.Role of bilastine in the management of allergic rhinitis and urticaria: an Asia-Pacific consensus statement
Ralph MÖSGES ; Dennis Lip Yen LEE ; Jovilia ABONG ; Bella SIASOCO ; Steven KW CHOW ; Jern Lin LEONG ; Harvinder SINGH ; S KULJIT ; Benjamin CAMPOMANES
Asia Pacific Allergy 2016;6(1):56-66
The prevalence of allergic diseases is increasing globally, most particularly in middle- to low-income countries. This article examines the burden of allergic rhinitis and chronic urticaria in the Asia-Pacific region, unmet clinical needs, and the potential role of bilastine in the management of these conditions. An International Advisory Group meeting was convened in association with the Asian Pacific Society of Respirology Annual Congress in November 2014, followed by a literature review, and consensus-based outcomes from the meeting and literature review are described. Regional estimates of the prevalence of allergic rhinitis range from 10% to 50%, while little is known regarding the burden of urticaria in the Asia-Pacific region. A survey of allergy patients in the region identified fast, complete, and long-lasting symptom relief as the medication attributes most important to patients. International treatment guidelines for allergic rhinitis and urticaria advocate the first-line use of second-generation, no-sedating H1-antihistamines, such as bilastine, over their first-generation counterparts and a range of these agents are available to Asia-Pacific patients. The newer agents possess many of the properties of an "ideal" antihistamine (once daily administration, rapid and complete symptom relief, limited potential for drug-drug interactions, minimal side effects). The burgeoning prevalence of allergic diseases in the Asia-Pacific region and the uncontrolled symptoms that these patients experience demand a new antihistamine that offers the highest number of positive features according to the international guidelines.
Asia
;
Asian Continental Ancestry Group
;
Consensus
;
Group Processes
;
Histamine Antagonists
;
Humans
;
Hypersensitivity
;
Prevalence
;
Rhinitis, Allergic
;
Urticaria
5.Laboratory bioefficacy of nine commercial formulations of temephos against larvae of Aedes aegypti (L.), Aedes albopictus Skuse and Culex quinquefasciatus Say.
Chen CD ; Lee HL ; Chan CK ; Ang CL ; Azahari AH ; Lau KW ; Sofian Azirun M
Tropical Biomedicine 2009;26(3):360-365
The bioefficacy of nine commercial formulations of temephos against Aedes aegypti, Aedes albopictus and Culex quinquefasciatus larvae were evaluated in the laboratory. WHO larval bioassay with operational dosage of temephos at 1 mg/L was performed. The larval mortality was recorded every 5 minutes until complete mortality was achieved. All formulations of temephos exhibited various toxicity level against Ae. aegypti, Ae. albopictus and Cx. quinquefasciatus. Generally, larvae of Cx. quinquefasciatus was susceptible to all formulations of temephos, followed by Ae. aegypti and Ae. albopictus.
6.Predation on pupa of Chrysomya rufifacies (Marquart) (Diptera: Calliphoridae) by parasitoid, Exoristobia philippinensis Ashmead (Hymenoptera: Encyrtidae) and Ophyra spinigera larva (Diptera: Muscidae).
Heo CC ; Nazni WA ; Lee HL ; Jeffery J ; Baharudin O ; Chen CD ; Lau KW ; Sofian Azirun M
Tropical Biomedicine 2009;26(3):369-372
A forensic entomological study was conducted using monkey carcasses (Macaca fascicularis Raffles) that were placed in either an outdoor or indoor environment at a coastal area in Tanjung Sepat, Selangor, Malaysia during May until August 2008. We collected pupae of Chrysomya rufifacies (Marquart) from the carcasses and kept them individually. The emergence of 13 parasitic microhymenopteran, from one of the pupae occurring within a week were identified as Exoristobia philippinensis Ashmead (Hymenoptera: Encyrtidae). Another observation was made whereby a pupa of C. rufifacies was predated by a muscid larva, Ophyra spinigera (Stein). The larva squeezed into the pupa and consumed the contents. This paper report C. rufifacies as a new host record for E. philippinensis in Malaysia and highlighted the predatory behavior of O. spinigera larva in natural environment.
7.Human thermoregulation and measurement of body temperature in exercise and clinical settings.
Chin Leong LIM ; Chris BYRNE ; Jason Kw LEE
Annals of the Academy of Medicine, Singapore 2008;37(4):347-353
This review discusses human thermoregulation during exercise and the measurement of body temperature in clinical and exercise settings. The thermoregulatory mechanisms play important roles in maintaining physiological homeostasis during rest and physical exercise. Physical exertion poses a challenge to thermoregulation by causing a substantial increase in metabolic heat production. However, within a non-thermolytic range, the thermoregulatory mechanisms are capable of adapting to sustain physiological functions under these conditions. The central nervous system may also rely on hyperthermia to protect the body from "overheating." Hyperthermia may serve as a self-limiting signal that triggers central inhibition of exercise performance when a temperature threshold is achieved. Exposure to sub-lethal heat stress may also confer tolerance against higher doses of heat stress by inducing the production of heat shock proteins, which protect cells against the thermolytic effects of heat. Advances in body temperature measurement also contribute to research in thermoregulation. Current evidence supports the use of oral temperature measurement in the clinical setting, although it may not be as convenient as tympanic temperature measurement using the infrared temperature scanner. Rectal and oesophagus temperatures are widely accepted surrogate measurements of core temperature (Tc), but they cause discomfort and are less likely to be accepted by users. Gastrointestinal temperature measurement using the ingestible temperature sensor provides an acceptable level of accuracy as a surrogate measure of Tc without causing discomfort to the user. This form of Tc measurement also allows Tc to be measured continuously in the field and has gained wider acceptance in the last decade.
Body Temperature
;
physiology
;
Body Temperature Regulation
;
physiology
;
Exercise
;
physiology
;
Humans
;
Monitoring, Physiologic
;
methods
8.Sensitive Balance Parameters in Detecting Age-related Changes of Balance Control in Elderly.
Heedong PARK ; Ji Hye HWANG ; Peter KW LEE ; Young keun WOO ; Nam Gyun KIM
Journal of the Korean Academy of Rehabilitation Medicine 2006;30(6):595-603
OBJECTIVE: To determine stability parameters in clinical balance tests and posturography that can assess age-related changes in posture control sensitively METHOD: Thirty nine healthy elderly people over 60 years old and twenty young controls were recruited. Elderly people were subdivided into 3 groups by age (aged 60~69, 70~79, over 80). Subjects were evaluated with clinical balance tests and posturography. In posturography, center of pressure (COP) parameters were obtained as total path distance, sway area, mean frequency of sway in comfortable standing. Visual feedback system (VFS) was added to posturography and then subjects were asked to move their COP into the target circle on monitor with active movement on force plate. In VFS, time to get in the circle, total path of deviation, time in the circle were measured. RESULTS: Time in the circle assessed by posturography with VFS showed significant difference between age groups (p<0.05). Significant correlations between time in the circle and clinical balance tests were also found (p<0.01). CONCLUSION: A posturography with VFS was considered to have clinical usefulness in sensitive evaluation of age-related change of balance control in healthy elderly people.
Aged*
;
Feedback, Sensory
;
Humans
;
Middle Aged
;
Postural Balance
;
Posture
9.Effect of Characteristics of Joint Motion of Lower Extremity according to Aging on Balance in Elderly.
Young Keun WOO ; Ji Hye HWANG ; Juha AN ; Heedong PARK ; Yun Hee KIM ; Peter KW LEE ; Nam Gyun KIM
Journal of the Korean Academy of Rehabilitation Medicine 2005;29(1):109-118
OBJECTIVE: To investigate the effect and the correlation of characteristics of joint motion of lower extremity according to aging on balance in elderly. METHOD: There were thirty nine healthy elderly subjects aged 60 and older. The subjects were divided into 3 groups by their age. Each group was measured with joint motion of bilateral lower extremities by goniometer. The subjects were evaluated with clinical balance tests [(Berg balance scale (BBS), Functional reach test (FRT), Tinetti's performance oriented mobility assessment (POMA), and one leg standing (OLS)]. RESULTS: The flexibilities of lower extremities were decreased according to the increase in age. The balance ability was also decreased according to the increase in age by tested clinical balance scores. The flexibility of the ankle joints showed the strongest correlation with clinical balance scores (BBS, FRT, POMA and OLS) according to the increase in age, and the flexibility of hip joints also correlated with clinical balance scores (POMA and OLS). CONCLUSION: Among clinically validated balance tests, the decline of balance performance related with aging. Correlation exists between ankle ROM and balance in healthy elderly people. Additional research is needed to add the ankle ROM to reflect the excise for balance tests and balance ability.
Aged*
;
Aging*
;
Ankle
;
Ankle Joint
;
Hip Joint
;
Humans
;
Joints*
;
Leg
;
Lower Extremity*
;
Pliability
;
Range of Motion, Articular
10.Nonaka Myopathy: A case report.
Peter KW LEE ; Eun Jin KIM ; Chang Seok KI ; Jong Won KIM
Journal of the Korean Academy of Rehabilitation Medicine 2004;28(3):288-291
Nonaka myopathy (NM) or distal myopathy with rimmed vacuoles was an autosomal recessive muscle disease with preferential involvement of the tibialis anterior and sparing quadriceps muscles in young adulthood. Patients with NM usually showed slightly elevated serum creatine kinase (CK) levels and characteristic rimmed vacuoles in muscle biopsy. Recently, the UDP-N-acetylglucosamine-2-epimerase/N-ace-tylmannosamine kinase (GNE) gene was identified as the identified as the causative gene for NM. Here we reported a NM patient carrying homozygous mutations (V572L) of the GNE gene. To the best of our knowledge, this was the first report of genetically confirmed NM in Korea and NM should be included in the differential diagnosis of slowly progressive weakness of distal legs.
Biopsy
;
Creatine Kinase
;
Diagnosis, Differential
;
Distal Myopathies
;
Humans
;
Korea
;
Leg
;
Muscular Diseases*
;
Phosphotransferases
;
Quadriceps Muscle
;
Vacuoles

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