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  1. Article: Impact of Guideline-Based Asthma Treatment on Health Services Use in Singapore Before and During COVID-19 Outbreak.

    Lim, Laura Huey Mien / Lim, Hui Fang / Liew, Mei Fong / Chen, Wenjia

    Journal of asthma and allergy

    2023  Volume 16, Page(s) 1207–1216

    Abstract: Introduction: To date, the role of standard asthma care in reducing asthma-related health services use (HSU) during the COVID-19 pandemic remains unclear. This study examined the impact of guideline-based asthma treatment on the use of asthma-related ... ...

    Abstract Introduction: To date, the role of standard asthma care in reducing asthma-related health services use (HSU) during the COVID-19 pandemic remains unclear. This study examined the impact of guideline-based asthma treatment on the use of asthma-related emergency department (ED) visits, polyclinic visits (total visits and urgent visits characterized by nebuliser use) before and during the pandemic.
    Methods: Data from April 2017 to October 2020 was obtained from the National University Health System, one of the three healthcare clusters in Singapore. Using generalized linear models, we estimated the joint effects of the ratio of preventer to reliever dispensations (PRR) and COVID-19 on asthma-related ED visits per hospital per month, total asthma-related polyclinic visits and asthma-related urgent polyclinic visits per clinic per month.
    Results: Findings show that before the onset of COVID-19, for every 0.5 unit increase in PRR, the number of asthma-related ED visits and urgent polyclinic visits decreased by 12.9% (95% CI: -13.0% to -12.9%) and 6.8% (95% CI: -6.9% to -6.7%), respectively, whereas total asthma-related polyclinic visits increased by 1.0% (95% CI: 0.9% to 1.0%). During the pandemic, a 0.5 unit increase of PRR decreased the number of asthma-related ED visits, urgent and total polyclinic visits by 16.9% (95% CI: -17.0% to - 16.9%), 9.3% (95% CI: -9.5% to -9.2%) and 0.7% (95% CI: -0.8% to -0.7%), respectively.
    Discussion: These findings suggest that regardless of the COVID-19 pandemic, an increase in PRR consistently reduced the frequency of asthma-related urgent and emergent care, although it barely influenced routine asthma follow-up visits.
    Language English
    Publishing date 2023-10-31
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 2494877-9
    ISSN 1178-6965
    ISSN 1178-6965
    DOI 10.2147/JAA.S425342
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Making sense of a negative COVID-19 swab test.

    Ng, Qin Xiang / Liew, Mei Fong / Yeo, Wee Song

    Quantitative imaging in medicine and surgery

    2020  Volume 10, Issue 11, Page(s) 2212–2214

    Keywords covid19
    Language English
    Publishing date 2020-10-28
    Publishing country China
    Document type Journal Article
    ZDB-ID 2653586-5
    ISSN 2223-4306 ; 2223-4292
    ISSN (online) 2223-4306
    ISSN 2223-4292
    DOI 10.21037/qims-20-929
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Safe patient transport for COVID-19.

    Liew, Mei Fong / Siow, Wen Ting / Yau, Ying Wei / See, Kay Choong

    Critical care (London, England)

    2020  Volume 24, Issue 1, Page(s) 94

    MeSH term(s) Betacoronavirus ; COVID-19 ; Coronavirus Infections ; Critical Care ; Humans ; Influenza, Human ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-03-18
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 2041406-7
    ISSN 1466-609X ; 1364-8535
    ISSN (online) 1466-609X
    ISSN 1364-8535
    DOI 10.1186/s13054-020-2828-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Potentially fatal severe brady arrythmias related to Lopinavir-Ritonavir in a COVID 19 patient.

    Shree, Venkatesan / En Liew, Lydia Qi / Teo, Wei Wei / Ting, Jeanette / Liew, Mei Fong

    Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi

    2020  Volume 54, Issue 1, Page(s) 133–135

    MeSH term(s) Aged ; Antiviral Agents/adverse effects ; Antiviral Agents/therapeutic use ; Bradycardia/chemically induced ; Bradycardia/virology ; COVID-19/drug therapy ; Comorbidity ; Coronary Disease ; Drug Combinations ; Humans ; Hypertension ; Lopinavir/adverse effects ; Lopinavir/therapeutic use ; Male ; Ritonavir/adverse effects ; Ritonavir/therapeutic use
    Chemical Substances Antiviral Agents ; Drug Combinations ; lopinavir-ritonavir drug combination ; Lopinavir (2494G1JF75) ; Ritonavir (O3J8G9O825)
    Keywords covid19
    Language English
    Publishing date 2020-08-06
    Publishing country England
    Document type Case Reports ; Letter
    ZDB-ID 1497590-7
    ISSN 1995-9133 ; 1684-1182 ; 0253-2662
    ISSN (online) 1995-9133
    ISSN 1684-1182 ; 0253-2662
    DOI 10.1016/j.jmii.2020.07.015
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Preparing for COVID-19: early experience from an intensive care unit in Singapore.

    Liew, Mei Fong / Siow, Wen Ting / MacLaren, Graeme / See, Kay Choong

    Critical care (London, England)

    2020  Volume 24, Issue 1, Page(s) 83

    MeSH term(s) Betacoronavirus ; COVID-19 ; China ; Coronavirus Infections ; Critical Care ; Disease Outbreaks ; Humans ; Infections ; Intensive Care Units ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2 ; Singapore
    Keywords covid19
    Language English
    Publishing date 2020-03-09
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 2041406-7
    ISSN 1466-609X ; 1364-8535
    ISSN (online) 1466-609X
    ISSN 1364-8535
    DOI 10.1186/s13054-020-2814-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Promises and challenges of biologics for severe asthma.

    Tan, Ronnie / Liew, Mei Fong / Lim, Hui Fang / Leung, Bernard P / Wong, W S Fred

    Biochemical pharmacology

    2020  Volume 179, Page(s) 114012

    Abstract: Patients with severe asthma that remain uncontrolled incur significant medical burden and healthcare costs. Severe asthma is a heterogeneous airway disorder with complex pathophysiological mechanisms which can be broadly divided into type 2 (T2)-high and ...

    Abstract Patients with severe asthma that remain uncontrolled incur significant medical burden and healthcare costs. Severe asthma is a heterogeneous airway disorder with complex pathophysiological mechanisms which can be broadly divided into type 2 (T2)-high and T2-low inflammatory pathways. Recent advances in asthma therapeutics with the advent of biologics have heralded an era of promising targeted therapy in this group of patients. The current available biologics, including anti-IgE mAb, anti-IL-5/IL-5R mAb and anti-IL-4Rα mAb, mainly target patients with an asthma endotype characterised by T2-high inflammation. While they have delivered positive outcomes in terms of reduction in exacerbations, improving lung function and quality of life, as well as reducing the dependence on oral corticosteroids, they have not functioned as the "panacea" as a significant proportion of patients do not respond completely to these targeted therapies. In addition, there is a lack of markers that can predict treatment response and clinicians are guided only by subjective asthma symptom scores. Suboptimal treatment response is common for individual patients. There has also been a dearth of effective targeted therapy for patients with T2-low asthma and treatment options remain limited for these patients. There is a pipeline of newer biologics targeting cytokines that operate at the interface between innate and adaptive immunity (e.g. IL-17A, thymic stromal lymphopoietin (TSLP), IL-25, IL-33, IL-32 and IL-36γ) with potential of modifying and reducing the severity of asthma. This commentary provides an overview of treatment with the current biologics and highlights the limitations, challenges and unmet needs in clinical management. We also summarise up-and-coming potential targets and therapeutic biologics for severe asthma.
    MeSH term(s) Anti-Asthmatic Agents/administration & dosage ; Anti-Asthmatic Agents/therapeutic use ; Antibodies, Monoclonal, Humanized/pharmacology ; Antibodies, Monoclonal, Humanized/therapeutic use ; Asthma/drug therapy ; Asthma/metabolism ; Asthma/physiopathology ; Biological Products/administration & dosage ; Biological Products/therapeutic use ; Cytokines/metabolism ; Humans ; Immunoglobulin E/blood ; Interleukin-17/metabolism ; Interleukin-5/antagonists & inhibitors ; Interleukin-5/blood ; Molecular Targeted Therapy/methods ; Omalizumab/pharmacology ; Omalizumab/therapeutic use
    Chemical Substances Anti-Asthmatic Agents ; Antibodies, Monoclonal, Humanized ; Biological Products ; Cytokines ; IL5 protein, human ; Interleukin-17 ; Interleukin-5 ; Omalizumab (2P471X1Z11) ; Immunoglobulin E (37341-29-0) ; dupilumab (420K487FSG) ; mepolizumab (90Z2UF0E52)
    Language English
    Publishing date 2020-05-08
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 208787-x
    ISSN 1873-2968 ; 0006-2952
    ISSN (online) 1873-2968
    ISSN 0006-2952
    DOI 10.1016/j.bcp.2020.114012
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Managing COVID-19 in resource-limited settings: critical care considerations.

    Siow, Wen Ting / Liew, Mei Fong / Shrestha, Babu Raja / Muchtar, Faisal / See, Kay Choong

    Critical care (London, England)

    2020  Volume 24, Issue 1, Page(s) 167

    MeSH term(s) COVID-19 ; Coronavirus Infections/epidemiology ; Coronavirus Infections/therapy ; Critical Care ; Developing Countries ; Health Resources/supply & distribution ; Humans ; Pandemics ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/therapy
    Keywords covid19
    Language English
    Publishing date 2020-04-22
    Publishing country England
    Document type Editorial
    ZDB-ID 2041406-7
    ISSN 1466-609X ; 1364-8535
    ISSN (online) 1466-609X
    ISSN 1364-8535
    DOI 10.1186/s13054-020-02890-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Eosinophilic endotype of chronic obstructive pulmonary disease: similarities and differences from asthma.

    Li, Andrew / Chan, Hiang Ping / Gan, Phyllis X L / Liew, Mei Fong / Wong, W S Fred / Lim, Hui-Fang

    The Korean journal of internal medicine

    2021  Volume 36, Issue 6, Page(s) 1305–1319

    Abstract: Approximately 25% to 40% of patients with chronic obstructive pulmonary disease (COPD) have the eosinophilic endotype. It is important to identify this group accurately because they are more symptomatic and are at increased risk for exacerbations and ... ...

    Abstract Approximately 25% to 40% of patients with chronic obstructive pulmonary disease (COPD) have the eosinophilic endotype. It is important to identify this group accurately because they are more symptomatic and are at increased risk for exacerbations and accelerated decline in forced expiratory volume in the 1st second. Importantly, this endotype is a marker of treat ment responsiveness to inhaled corticosteroid (ICS), resulting in decreased mortality risk. In this review, we highlight differences in the biology of eosinophils in COPD compared to asthma and the different definitions of the COPD eosinophilic endotype based on sputum and blood eosinophil count (BEC) with the corresponding limitations. Although BEC is useful as a biomarker for eosinophilic COPD endotype, optimal BEC cut-offs can be combined with clinical characteristics to improve its sensitivity and specificity. A targeted approach comprising airway eosinophilia and appropriate clinical and physiological features may improve identification of subgroups of patients who would benefit from biologic therapy or early use of ICS for disease modification.
    MeSH term(s) Adrenal Cortex Hormones/therapeutic use ; Asthma/diagnosis ; Asthma/drug therapy ; Eosinophils ; Forced Expiratory Volume ; Humans ; Leukocyte Count ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Pulmonary Disease, Chronic Obstructive/drug therapy ; Sputum
    Chemical Substances Adrenal Cortex Hormones
    Language English
    Publishing date 2021-10-12
    Publishing country Korea (South)
    Document type Journal Article ; Review
    ZDB-ID 639023-7
    ISSN 2005-6648 ; 1226-3303
    ISSN (online) 2005-6648
    ISSN 1226-3303
    DOI 10.3904/kjim.2021.180
    Database MEDical Literature Analysis and Retrieval System OnLINE

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