INTRODUCTIONSingapore has a fast-growing travel industry, but few studies have been done on travel characteristics and travel health practices. This study describes the profile and healthseeking behaviour of travellers attending a travel health clinic in Singapore.

MATERIALS AND METHODSA cross-sectional survey was conducted on travellers attending the Traveller's Health and Vaccination Centre (THVC) between September and November 2002 using a standardised questionnaire. Information obtained included individual demographic and medical information, travel patterns, vaccination status and travel health practices.

RESULTSFour hundred and ninetyfive (74%) eligible travellers seen at THVC responded to the questionnaire. Their mean age was 36 years; 77% were professionals, managers, executives, and businessmen, students, and white collar workers. Asia was the main travel destination, and most travelled for leisure and resided in hotels or hostels. The median duration of travel was 16 days. Although >90% had previously travelled overseas, only 20% had previously sought pre-travel advice. Malays were significantly underrepresented (P < 0.01); and Caucasians and Eurasians were significantly more likely (P < 0.01) to have previously sought pre-travel advice compared with Chinese, Indians and Malays. Factors associated with seeking pre-travel advice included travel outside of Asia, especially Africa and South America.

CONCLUSIONSingaporean travellers travel more often to cities rather than rural areas, compared with non-Asian travellers. Asia is the preferred destination, and travel outside of Asia is perceived as more risky and is associated with seeking pre-travel advice and vaccinations. Travel patterns and behaviours need to be taken into account when developing evidence-based travel medicine in Asia.

Adult ; Aged ; Communicable Disease Control ; organization & administration ; Community Health Centers ; utilization ; Cross-Sectional Studies ; Female ; Health Behavior ; Health Care Surveys ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Middle Aged ; Singapore ; Surveys and Questionnaires ; Travel ; statistics & numerical data ; Vaccination ; utilization

Angelica decursiva has been utilised as remedy for controlling the airway inflammatory diseases in folk medicine. We investigated whether nodakenin, columbianadin, and umbelliferone isolated from the roots of Angelica decursiva inhibit the gene expression and production of MUC5AC mucin from human airway epithelial cells. Confluent NCI-H292 cells were pretreated with nodakenin, columbianadin or umbelliferone for 30 min and then stimulated with epidermal growth factor (EGF), phorbol 12-myristate 13-acetate (PMA) or tumor necrosis factor-α (TNF-α) for 24 h. The MUC5AC mucin gene expression was measured by reverse transcription - polymerase chain reaction (RT-PCR). Production of MUC5AC mucin protein was measured by enzyme-linked immunosorbent assay (ELISA). The results were as follows: (1) Nodakenin did not affect the expression of MUC5AC mucin gene induced by EGF, PMA or TNF-α. Columbianadin inhibited the expression of MUC5AC mucin gene induced by EGF or PMA. However, umbelliferone inhibited the expression of MUC5AC mucin gene induced by EGF, PMA or TNF-α; (2) Nodakenin also did not affect the production of MUC5AC mucin protein induced by EGF, PMA or TNF-α. Columbianadin inhibited the production of MUC5AC mucin protein induced by PMA. However, umbelliferone inhibited the production of MUC5AC mucin protein induced by EGF, PMA or TNF-α. These results suggest that, among the three compounds investigated, umbelliferone only inhibits the gene expression and production of MUC5AC mucin stimulated by various inducers, by directly acting on airway epithelial cells, and the results might explain the traditional use of Angelica decursiva as remedy for diverse inflammatory pulmonary diseases.
Angelica* ; Enzyme-Linked Immunosorbent Assay ; Epidermal Growth Factor ; Epithelial Cells ; Gene Expression* ; Humans* ; Lung Diseases ; Medicine, Traditional ; Mucins* ; Necrosis ; Polymerase Chain Reaction ; Reverse Transcription

In this study, we investigated whether adenosine, adenine, uridine and homogentisic acid derived from Pinellia ternata affect the secretion, production and gene expression of MUC5AC mucin from airway epithelial cells. Confluent NCI-H292 cells were pretreated with adenosine, adenine, uridine or homogentisic acid for 30 min and then stimulated with PMA (phorbol 12-myristate 13-acetate) for 24 h. The MUC5AC mucin gene expression, mucin protein production and secretion were measured by RT-PCR and ELISA, respectively. The results were as follows: (1) Adenine and homogentisic acid decreased PMA-induced MUC5AC mucin gene expression, although adenosine and uridine did not affect the mucin gene expression; (2) Adenosine, adenine, uridine and homogentisic acid inhibited PMA-induced MUC5AC mucin production; (3) Homogentisic acid inhibited the secretion of MUC5AC mucin from NCI-H292 cells. These results suggest that, among the four compounds examined, homogentisic acid showed the regulatory effect on the steps of gene expression, production and secretion of mucin, by directly acting on airway epithelial cells.
Adenine ; Adenosine ; Biological Products* ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells* ; Gene Expression* ; Homogentisic Acid* ; Mucins* ; Pinellia* ; Uridine

Air Pollutants ; Dengue ; epidemiology ; transmission ; Disease Notification ; Humans ; Models, Theoretical ; Singapore ; epidemiology

PURPOSE: Good results of the cephalomedullary nails have been reported in proximal femoral fractures recently. Based on length of nails and shape of screws fixed in a femoral head for proximal fragment fixation, the proper nail length was in dispute. The purpose of this study was to evaluate the clinical and radiological results of a long cephalomedullary hip nail for the treatment of comminuted subtrochanteric femoral fractures. MATERIALS AND METHODS: Twenty-one consecutive patients with severe subtrochanteric femoral fractures who had undergone intramedullary fixation using long-PFNA II between March 2010 and March 2013 were followed-up for over 12 months. Their mean age was 64.8 years old (range, 43-85 years). Sixteen of 22 cases were high energy trauma. According to Seinsheimer's classification, 5 cases were type IV and 16 cases were type V. For radiological assessment, time to union, change of neck-shaft angle, sliding length, tip-apex distance (TAD) and leg length discrepancy (LLD) were measured. For clinical evaluation, a modified Koval index was investigated. RESULTS: Mean operation time was 96 minutes. An average decrease of neck-shaft angle was 4.5°. The average sliding length of the helical blade was 4.2 mm. Average LLD was 3.0 mm, and TAD was 23.0 mm. Mean modified Koval index score at final follow-up was 4.6 points. All the 21 subtrochanteric fractures healed uneventfully on an average of 24.2 weeks (range, 18-30 weeks). CONCLUSION: Long cephalomedullary hip nail provides excellent clinical and radiological outcomes in the comminuted subtrochanteric fracture.
Classification ; Dissent and Disputes ; Femoral Fractures* ; Femur ; Follow-Up Studies ; Head ; Hip Fractures ; Hip* ; Humans ; Leg

INTRODUCTIONSingapore is a transition country in Southeast Asia that is both vulnerable and receptive to the introduction and re-introduction of imported communicable diseases.

MATERIALS AND METHODSFor a 10-year period between 1998 and 2007 we studied the trend, epidemiological characteristics, proportion of imported versus local transmission of malaria, viral hepatitis (hepatitis A and E), enteric fevers (typhoid and paratyphoid), cholera, chikungunya and SARS.

RESULTSOf a total of 4617 cases of the above selected diseases notified in Singapore, 3599 (78.0%) were imported. The majority of the imported cases originated from Southeast Asia and the Indian subcontinent. Malaria constituted the largest bulk (of which 95.9% of the 2126 reported cases were imported), followed by hepatitis A (57.1% of 1053 cases imported), typhoid (87.6% of 596 cases imported), paratyphoid (87.6% of 241 cases imported), and hepatitis E (68.8% of 231 cases imported). Furthermore, there were 14 cases of imported cholera, 6 cases of imported severe acute respiratory syndrome (SARS) and 13 cases of imported chikungunya.

CONCLUSIONThis study underlines that diseases such as malaria, viral hepatitis and enteric fever occur in Singapore mainly because of importation. The main origin of importation was South and Southeast Asia. The proportion of imported diseases in relation to overall passenger traffic has decreased over the past 10 years.

Communicable Diseases ; epidemiology ; etiology ; transmission ; Disease Outbreaks ; statistics & numerical data ; Female ; Humans ; Male ; Population Surveillance ; Singapore ; epidemiology ; Travel ; Young Adult

Ectopic pregnancy is the implantation of a fertilized egg outside the uterine endometrial cavity. For women presenting to the emergency department with abdominal pain and/or vaginal bleeding, ectopic pregnancy is an important diagnostic consideration. The diagnosis is made based on laboratory values and ultrasound imaging findings. The ultrasound appearance of both normal early pregnancy and ectopic pregnancy are variable and often subtle, presenting diagnostic challenges for radiologists. This pictorial essay describes and illustrates the sonographic findings of ectopic pregnancy and reviews the differential diagnoses that can mimic ectopic pregnancy on ultrasound. With the possibility of medical management, the value of early detection and prompt initiation of treatment has increased in improving clinical outcomes and preventing the complications of ectopic pregnancy.
Abdominal Pain ; Diagnosis ; Diagnosis, Differential ; Emergencies* ; Emergency Service, Hospital ; Female ; Humans ; Methotrexate ; Pregnancy ; Pregnancy, Ectopic* ; Ultrasonography ; Uterine Hemorrhage ; Zygote

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a worldwide pandemic. The first reports of patients with COVID-19 were provided to World Health Organization on December 21, 2019 and were presumably associated with seafood markets in Wuhan, China. As of October 25, 2020, more than 42 million cases have been confirmed worldwide, with more than 1.1 million deaths. Asymptomatic transmission contributes significantly to transmission, and clinical features are non-specific to the disease. Thus, the diagnosis of COVID-19 requires specific viral RNA testing. The disease demonstrates extensive human-to-human transmissibility and has infected healthcare workers at high rates. Clinical awareness of the epidemiology and the risk factors for nosocomial transmission of COVID-19 is essential to preventing infection. Moreover, effective control measures should be further identified by comprehensive evaluation of hospital and community responses. In this review, we provide a comprehensive update on the epidemiology, presentation, transmission, risk factors, and public health measures associated with COVID-19. We also review past insights from previous coronavirus epidemics [i.e., severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS)] to suggest measures to reduce transmission.

Background: Many studies have evaluated the prevalence of different reasons for retraction in samples of retraction notices. We aimed to perform a systematic review of such empirical studies of retraction causes. Methods: The PubMed/MEDLINE database and the Embase database were searched in June 2023. Eligible studies were those containing sufficient data on the reasons for retraction across samples of examined retracted notices. Results: A 11,181 potentially eligible items were identified, and 43 studies of retractions were included in this systematic review. Studies limited to retraction notices of a specific subspecialty or country, journal/publication type are emerging since 2015. We noticed that the reasons for retraction are becoming more specific and more diverse. In a meta-analysis of 17 studies focused on different subspecialties, misconduct was responsible for 60% (95% confidence interval [CI], 53–67%) of all retractions while error and publication issues contributed to 17% (95% CI, 12–22%) and 9% (95% CI, 6–13%), respectively. The end year of the retraction period in all included studies and the proportion of misconduct presented a weak positive association (coefficient = 1.3% per year, P = 0.002). Conclusion Misconduct seems to be the most frequently recorded reason for retraction across empirical analyses of retraction notices, but other reasons are not negligible. Greater specificity of causes and standardization is needed in retraction notices.

Chronic disease rates have become more prevalent in the modern American workforce, which has negative implications for workplace productivity and healthcare costs. Offering workplace health interventions is recognized as an effective strategy to reduce chronic disease progression, absenteeism, and healthcare costs as well as improve population health. This review documents intervention and evaluation strategies used for health promotion programs delivered in workplaces. Using predetermined search terms in five online databases, we identified 1,131 published items from 1995 to 2014. Of these items, 27 peer-reviewed articles met the inclusion criteria; reporting data from completed United States-based workplace interventions that recruited at-risk employees based on their disease or disease-related risk factors. A content rubric was developed and used to catalogue these 27 published field studies. Selected workplace interventions targeted obesity (n=13), cardiovascular diseases (n=8), and diabetes (n=6). Intervention strategies included instructional education/counseling (n=20), workplace environmental change (n=6), physical activity (n=10), use of technology (n=10), and incentives (n=13). Self-reported data (n=21), anthropometric measurements (n=17), and laboratory tests (n=14) were used most often in studies with outcome evaluation. This is the first literature review to focus on interventions for employees with elevated risk for chronic diseases. The review has the potential to inform future workplace health interventions by presenting strategies related to implementation and evaluation strategies in workplace settings. These strategies can help determine optimal worksite health programs based on the unique characteristics of work settings and the health risk factors of their employee populations.
Absenteeism ; Cardiovascular Diseases ; Chronic Disease* ; Efficiency ; Health Care Costs ; Health Promotion ; Motivation ; Motor Activity ; Obesity ; Occupational Health ; Risk Factors ; Workplace*