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  1. Article ; Online: Long-term effectiveness and persistence rate of ustekinumab dose intensification in a South East Asian inflammatory bowel disease center.

    Lim, Chong-Teik / Tay, Shu-Wen / Elangovan, Sakktivel / Ong, Wan-Chee / Lim, Gek-Hsiang / Salazar, Ennaliza / Chan, Webber P W / Tan, Malcolm T K

    Journal of gastroenterology and hepatology

    2024  

    Abstract: Background and aims: Ustekinumab (UST) is an effective biologic for treatment of inflammatory bowel disease (IBD). However, some patients treated with UST have suboptimal clinical response with standard dosing. The aims of this study were to determine ... ...

    Abstract Background and aims: Ustekinumab (UST) is an effective biologic for treatment of inflammatory bowel disease (IBD). However, some patients treated with UST have suboptimal clinical response with standard dosing. The aims of this study were to determine the effectiveness of UST dose intensification (DI), identify factors associated with DI, cumulative incidence of DI and persistence of UST among treated patients.
    Methods: Clinical data of patients with Crohn's disease (CD) and ulcerative colitis (UC) who received UST from September 2017 to October 2022 in Singapore General Hospital were collected. Primary outcome was defined as achieving corticosteroid-free clinical remission, biochemical remission, endoscopic healing and/or transmural healing (CD). Statistical analysis was performed to identify factors, which are predictive of UST DI and effectiveness of UST DI.
    Results: Forty-two patients (34 CD and 8 UC) underwent UST DI to either 6-weekly (n = 19, 45.2%) or 4-weekly (n = 23, 35.9%) and the median time to intensification was 31.1 weeks (17.8-65.7). Presence of perianal disease in CD (HR 4.9; 1.47-16.4) was associated with DI. After DI, 16 (38%) patients achieved primary outcome by week 52. The overall drug persistence rates at 1 year and 2 years were 75.7% (95% CI 62.9-84.6) and 63.5% (95% CI 49.9-74.3), respectively.
    Conclusion: Two third of IBD patients underwent DI while on UST treatment and the median time to DI was about 6 months after induction. CD patients with perianal disease is more likely to undergo DI. More than one third of dose-intensified patients achieved remission by week 52.
    Language English
    Publishing date 2024-04-28
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 632882-9
    ISSN 1440-1746 ; 0815-9319
    ISSN (online) 1440-1746
    ISSN 0815-9319
    DOI 10.1111/jgh.16562
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  2. Article ; Online: Ulcerative colitis: STRIDE-ing beyond symptoms with new standards.

    Tay, Shu Wen / Teh, Kevin Kim Jun / Ang, Tiing-Leong / Tan, Malcolm

    Singapore medical journal

    2021  Volume 65, Issue 2, Page(s) 99–105

    Abstract: The landscape of ulcerative colitis has changed in the last two decades. Advancements in pharmacotherapeutics have heralded the introduction of new treatment options, with many agents in development. Better clinical outcomes are seen with tighter disease ...

    Abstract The landscape of ulcerative colitis has changed in the last two decades. Advancements in pharmacotherapeutics have heralded the introduction of new treatment options, with many agents in development. Better clinical outcomes are seen with tighter disease control, made possible with greater understanding of inflammatory pathways and their blockade with drugs. There has been a resultant shift in treatment targets, beyond symptoms to endoscopic and histological healing. Controlling the burden of disease activity also lowers the risk of developing colorectal cancer. Colorectal cancer screening now requires the use of dye-based agents and high-definition colonoscopy to improve the detection of colonic neoplasms.
    MeSH term(s) Humans ; Colitis, Ulcerative/diagnosis ; Colitis, Ulcerative/drug therapy ; Colitis, Ulcerative/pathology ; Colonoscopy ; Colonic Neoplasms ; Colorectal Neoplasms/diagnosis ; Wound Healing
    Language English
    Publishing date 2021-11-26
    Publishing country India
    Document type Journal Article
    ZDB-ID 604319-7
    ISSN 2737-5935 ; 0037-5675
    ISSN (online) 2737-5935
    ISSN 0037-5675
    DOI 10.11622/smedj.2021173
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  3. Article ; Online: Diet and cancer of the esophagus and stomach.

    Tay, Shu Wen / Li, James Weiquan / Fock, Kwong Ming

    Current opinion in gastroenterology

    2020  Volume 37, Issue 2, Page(s) 158–163

    Abstract: Purpose of review: Dietary factors have been linked to cancers. This review focuses on several nutrients, which have strong evidence showing increase in cancer risks in the esophagus and stomach.: Recent findings: Obesity is an important risk factor ... ...

    Abstract Purpose of review: Dietary factors have been linked to cancers. This review focuses on several nutrients, which have strong evidence showing increase in cancer risks in the esophagus and stomach.
    Recent findings: Obesity is an important risk factor in upper gastrointestinal cancers. High sugar content in food and sugary drinks are the main drivers of obesity. Proinflammatory diet is another dietary factor, which is increasingly recognized as being associated with esophageal and gastric cancer.
    Summary: Cancer has been predicted to be the leading cause of death in this century. Cancers of the esophagus and stomach are the six and third most common cause of death worldwide. Although Helicobacter pylori infection is a known cause of gastric cancer, obesity is a leading contributor to esophageal adenocarcinoma. Epidemiological data have shown that dietary factors are associated with the two cancers. Observational, case control, animal and recent large cohort studies have identified associations between dietary factors and upper gastrointestinal cancer. Data are also emerging from studies, which look at dietary patterns, such as reduction in the Dietary Inflammatory Index, as well as adherence to a modified Mediterranean diet, and its association with the incidence of esophageal and gastric cancer.
    MeSH term(s) Diet ; Esophageal Neoplasms/epidemiology ; Esophageal Neoplasms/etiology ; Helicobacter Infections/complications ; Helicobacter Infections/epidemiology ; Helicobacter pylori ; Humans ; Risk Factors ; Stomach Neoplasms/epidemiology ; Stomach Neoplasms/etiology
    Language English
    Publishing date 2020-12-14
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 632571-3
    ISSN 1531-7056 ; 0267-1379
    ISSN (online) 1531-7056
    ISSN 0267-1379
    DOI 10.1097/MOG.0000000000000700
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Impact of COVID-19: perspectives from gastroenterology.

    Tay, Shu Wen / Teh, Kevin Kim Jun / Wang, Lai Mun / Ang, Tiing Leong

    Singapore medical journal

    2020  Volume 61, Issue 9, Page(s) 460–462

    MeSH term(s) Betacoronavirus ; COVID-19 ; China ; Coronavirus ; Coronavirus Infections ; Gastroenterology ; Humans ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-04-13
    Publishing country Singapore
    Document type Journal Article ; Comment
    ZDB-ID 604319-7
    ISSN 0037-5675
    ISSN 0037-5675
    DOI 10.11622/smedj.2020051
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  5. Article ; Online: Challenges encountered by pharmacy staff in using prescription medication labels during medication counselling with older adults and solutions employed: A mixed-methods study.

    Suppiah, Sumithra Devi / Tan, Yi Wen / Tay, Sarah Siew Cheng / Tan, Valerie Shu Ying / Tan, Ngiap Chuan / Tang, Wern-Ee / Chan, Alexandre / Koh, Gerald Choon-Huat / Malhotra, Rahul

    Exploratory research in clinical and social pharmacy

    2023  Volume 9, Page(s) 100226

    Abstract: Background: Prescription medication labels (PMLs) predominantly dispensed in English, are an important adjunct to medication counselling. PMLs are routinely used by pharmacy staff to counsel older adults about their medications. This study sought to ... ...

    Abstract Background: Prescription medication labels (PMLs) predominantly dispensed in English, are an important adjunct to medication counselling. PMLs are routinely used by pharmacy staff to counsel older adults about their medications. This study sought to identify challenges that pharmacy staff observe older adults face in using their PMLs, and to identify and quantify solutions employed by pharmacy staff during medication counselling to address such challenges.
    Methods: Ten in-depth interviews were done with primary care pharmacy staff to gather the range of challenges and solutions. Subsequently, a quantitative survey, informed by the qualitative findings, was administered to 121 pharmacy staff to assess if the reported solutions were commonly used.
    Results: The two main challenges were incongruity between PML language (English) and older adults' language proficiency, and poor PML legibility. The solutions, classified under three themes, were simplifying medication information on PMLs, supplementing PMLs with additional medication information and mitigating poor readability.
    Conclusions: Pharmacy staff observed challenges faced by older adults in using PMLs during medication counselling. Ad-hoc improvisations by pharmacy staff to PMLs were pervasive. System-level PML improvements, such as provision of legible bilingual medication instructions, pharmaceutical pictograms and additional medication information, through patient information leaflets or using quick response (QR) codes on PMLs, should be considered. This will facilitate patient-provider communication, especially in settings with language dissonance between PMLs and patients.
    Language English
    Publishing date 2023-01-20
    Publishing country United States
    Document type Journal Article
    ISSN 2667-2766
    ISSN (online) 2667-2766
    DOI 10.1016/j.rcsop.2023.100226
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  6. Article ; Online: Severe Symptomatic Hypophosphataemia as a Complication of Parenteral Iron Replacement.

    Teh, Kevin Kim-Jun / Chuah, Matthew Bingfeng / Tay, Shu-Wen / Lim, Amanda Yuan-Ling / Khoo, Joan Joo-Ching

    European journal of case reports in internal medicine

    2020  Volume 7, Issue 11, Page(s) 1860

    Abstract: Parental iron replacement is given to patients with severe iron deficiency or intolerance to oral iron. Hypophosphataemia has been reported to occur as a complication of parental iron replacement, and is postulated to be related to the carbohydrate ... ...

    Abstract Parental iron replacement is given to patients with severe iron deficiency or intolerance to oral iron. Hypophosphataemia has been reported to occur as a complication of parental iron replacement, and is postulated to be related to the carbohydrate moieties used in the parenteral preparations. Hypophosphataemia is under-diagnosed as symptoms such as fatigue, muscle weakness and poor effort tolerance mimic anaemia. Severe hypophosphataemia (<0.32 mmol/l) can result in significant complications such as confusion, rhabdomyolysis and arrhythmias. We report a patient with recurrent admissions for non-specific symptoms attributed to iron deficiency anaemia who received multiple doses of parenteral ferric carboxymaltose (FCM). He was found to have severe hypophosphataemia, with further evaluation showing increased renal phosphate wasting and elevated serum levels of fibroblast-growth-factor 23 (FGF23). FCM was stopped and he was given high-dose oral iron supplementation, with no further episodes of hypophosphataemia.
    Learning points: The carbohydrate moieties used in parenteral iron preparations are different, and may have a dose-dependent relationship with the development of hypophosphataemia.The mechanism by which hypophosphataemia occurs after parenteral iron replacement is related to increased serum levels of FGF23, which increases renal phosphate wasting.The serum phosphate levels of patients receiving parenteral iron replacement (especially ferric carboxymaltose or iron polymaltose) should be routinely monitored for hypophosphataemia, which is an under-diagnosed complication.
    Language English
    Publishing date 2020-08-20
    Publishing country Italy
    Document type Journal Article
    ISSN 2284-2594
    ISSN (online) 2284-2594
    DOI 10.12890/2020_001860
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  8. Article ; Online: A High Daptomycin Dose Is Associated with Better Bacterial Clearance in Infections Caused by Vancomycin-Resistant Enterococcus faecium Regardless of Daptomycin Minimum Inhibitory Concentration in a Rat Infective Endocarditis Model.

    Wang, Jann-Tay / Yang, Chia-Jui / Yang, Jia-Ling / Lin, Shu-Wen / Chuang, Yu-Chung / Sheng, Wang-Huei / Chen, Yee-Chun / Chang, Shan-Chwen

    Microbiology spectrum

    2022  Volume 10, Issue 5, Page(s) e0255122

    Abstract: A high daptomycin dose has been suggested for treating vancomycin-resistant Enterococcus faecium (VREf) infections. However, even a 12 mg/kg daptomycin dose might be insufficient for treating VREf with high daptomycin minimum inhibitory concentrations ( ... ...

    Abstract A high daptomycin dose has been suggested for treating vancomycin-resistant Enterococcus faecium (VREf) infections. However, even a 12 mg/kg daptomycin dose might be insufficient for treating VREf with high daptomycin minimum inhibitory concentrations (MICs). Additionally, animal pharmacodynamic and infection models to confirm the efficacy of 12 mg/kg daptomycin are lacking. Male Wistar rats were used for pharmacokinetic profiling and for the development of an infective endocarditis (IE) model. Daptomycin-susceptible dose-dependent VREf (DSE) (MIC of 0.5 mg/L) and daptomycin nonsusceptible VREf (DNSE) (MIC of 8 mg/L) were used for the IE models. The bacterial load of vegetation was the primary outcome and was evaluated after 3 days of daptomycin treatment. Daptomycin administered subcutaneously (s.c.) at 45 and 90 mg/kg, which corresponded to maximum serum concentrations (
    MeSH term(s) Humans ; Male ; Rats ; Animals ; Daptomycin/therapeutic use ; Daptomycin/pharmacokinetics ; Enterococcus faecium ; Vancomycin/therapeutic use ; Vancomycin/pharmacokinetics ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Rats, Wistar ; Microbial Sensitivity Tests ; Endocarditis, Bacterial/drug therapy ; Endocarditis, Bacterial/microbiology ; Vancomycin-Resistant Enterococci ; Endocarditis ; Gram-Positive Bacterial Infections/drug therapy ; Gram-Positive Bacterial Infections/microbiology
    Chemical Substances Daptomycin (NWQ5N31VKK) ; Vancomycin (6Q205EH1VU) ; Anti-Bacterial Agents
    Language English
    Publishing date 2022-10-03
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2807133-5
    ISSN 2165-0497 ; 2165-0497
    ISSN (online) 2165-0497
    ISSN 2165-0497
    DOI 10.1128/spectrum.02551-22
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Pyrazinamide related prolonged drug-induced liver injury: A case report.

    Wang, Yeh-Chin / Chen, Kai-Hsiang / Chen, Yen-Lin / Lin, Shu-Wen / Liu, Wang-Da / Wang, Jann-Tay / Hung, Chien-Ching

    Medicine

    2022  Volume 101, Issue 39, Page(s) e30955

    Abstract: Rationale: Drug induced liver injury (DILI) is a common side effect causing treatment discontinuation during tuberculosis (TB) treatment, and pyrazinamide (PZA) usually leads to a delayed and prolonged abnormal liver function of the 4 standard anti- ... ...

    Abstract Rationale: Drug induced liver injury (DILI) is a common side effect causing treatment discontinuation during tuberculosis (TB) treatment, and pyrazinamide (PZA) usually leads to a delayed and prolonged abnormal liver function of the 4 standard anti-tuberculosis regimens. However, a prolonged hepatitis lasting more than 4 months is rarely reported.
    Patient concerns: A 78-year-old man presented with general weakness and poor appetite on his seventh week of anti-TB treatment for tuberculosis lymphadenitis.
    Diagnosis: Drug induced liver injury, PZA-related. NAT2 slow acetylator phenotype was accidentally found during workup of DILI.
    Intervention: A liver biopsy was performed and PZA-related DILI was suspected. All anti-TB medications were therefore discontinued.
    Outcome: After withholding all anti-TB medications for 4 months, the elevations of aminotransferases and hyperbilirubinemia completely resolved. Anti-TB therapy was switched to ethambutol and levofloxacin for 15 months without adverse events. Long-term ultrasound follow-up was performed and cervical lymphadenopathy completely resolved.
    Conclusion: Our patient presents with PZA related prolonged DILI resolved after drug discontinuation for 4 months. NAT2 slow acetylator phenotype may be related to this condition through unknown mechanisms.
    MeSH term(s) Antitubercular Agents/therapeutic use ; Arylamine N-Acetyltransferase/genetics ; Chemical and Drug Induced Liver Injury/diagnosis ; Chemical and Drug Induced Liver Injury/drug therapy ; Chemical and Drug Induced Liver Injury/etiology ; Ethambutol/adverse effects ; Humans ; Levofloxacin ; Pyrazinamide/adverse effects ; Transaminases ; Tuberculosis, Lymph Node/drug therapy
    Chemical Substances Antitubercular Agents ; Pyrazinamide (2KNI5N06TI) ; Levofloxacin (6GNT3Y5LMF) ; Ethambutol (8G167061QZ) ; Arylamine N-Acetyltransferase (EC 2.3.1.5) ; NAT2 protein, human (EC 2.3.1.5) ; Transaminases (EC 2.6.1.-)
    Language English
    Publishing date 2022-09-30
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 80184-7
    ISSN 1536-5964 ; 0025-7974
    ISSN (online) 1536-5964
    ISSN 0025-7974
    DOI 10.1097/MD.0000000000030955
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Correction: Chromatin Rewiring by Mismatch Repair Protein MSH2 Alters Cell Adhesion Pathways and Sensitivity to BET Inhibition in Gastric Cancer.

    Nargund, Amrita M / Xu, Chang / Mandoli, Amit / Okabe, Atsushi / Chen, Gao Bin / Huang, Kie Kyon / Sheng, Taotao / Yao, Xiaosai / Teo, Jia Ming Nickolas / Sundar, Raghav / Kok, Yee Jiun / See, Yi Xiang / Xing, Manjie / Li, Zhimei / Yong, Chern Han / Anand, Aparna / Bin Adam Isa, Zul Fazreen / Poon, Lai Fong / Ng, Michelle Shu Wen /
    Koh, Javier Yu Peng / Ooi, Wen Fong / Tay, Su Ting / Ong, Xuewen / Tan, Angie Lay Keng / Smoot, Duane T / Ashktorab, Hassan / Grabsch, Heike I / Fullwood, Melissa J / Teh, Bin Tean / Bi, Xuezhi / Kaneda, Atsushi / Li, Shang / Tan, Patrick

    Cancer research

    2023  Volume 83, Issue 5, Page(s) 804

    Language English
    Publishing date 2023-03-02
    Publishing country United States
    Document type Published Erratum
    ZDB-ID 1432-1
    ISSN 1538-7445 ; 0008-5472
    ISSN (online) 1538-7445
    ISSN 0008-5472
    DOI 10.1158/0008-5472.CAN-22-4060
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