Sensitization to Blomia tropicalis and dermatophagoides pteronyssinus-a comparative study between Singapore and Taiwan.
(25/1776)
Blomia tropicalis (Bt) and Dermatophagoides pteronyssinus (Dp) are the predominant domestic mites species in Singapore and Taiwan. This study aims to characterize and compare the mite sensitization profiles in both countries. Skin prick tests were performed on 203 Singaporeans with Dp and Bt crude extracts. In vitro IgE and IgG4 reactivity to extracts and specific allergens (Der p 1, Der p 2 Der p 5 and Blo t 5) were determined by immunoassays. Approximately 91% of the tested Singaporeans were skin test positive for both Bt and Dp. Both populations share similar frequencies of in vitro IgE reactivity to all the allergens tested, but they differ in the pattern and magnitude of allergen sensitization. Although Der p 1, Der p 2 and Blo t5 are major sensitizing allergens in both countries, Blo t 5 is a more potent one in Singapore, probably reflecting the high level of exposure to Bt. The unique major Bt and Dp allergens should be included for precise diagnosis and effective immuno-therapeutic treatment of mite allergy in both countries. (+info)
Food allergy in children-the Singapore story.
(26/1776)
The study of food allergy in Singaporean children is still in its infancy. Confusion and misunderstanding is common among the public. Even so, we have found certain unique features regarding food allergy among Singaporean children. "Bird's nest" has been shown to be the most common cause of anaphylaxis requiring medical attention. This allergen has not been described before. Peanuts and tree nuts are extremely uncommon causes of anaphylaxis, unlike the West. However, the pattern of sensitization to foods in children as shown by skin prick test is similar to other Western populations. The reasons for the difference between the profile foods responsible for anaphylactic reactions in our population and those of the western population, despite the similarity in sensitization profiles, are still unclear. (+info)
Contact allergy in Singapore.
(27/1776)
Contact allergy, viz. allergic contact dermatitis, photo-allergic contact dermatitis and contact urticaria, is a well-studied sub-specialty of dermatology in Singapore. Over the years, numerous studies and anecdotal reports on the subject have been published in both international and local refereed journals. This article reviews the epidemiological data on patch testing and photo-patch testing in Singapore. It also summarizes published clinical reports on important contact allergens that are found in both non-occupational and occupational setting. (+info)
APC mutation and phenotypic spectrum of Singapore familial adenomatous polyposis patients.
(28/1776)
Familial adenomatous polyposis (FAP) is a familial form of colon cancer caused by mutation of the adenomatous polyposis coli (APC) gene. Although the APC gene has been extensively studied in the Caucasian population, it has not been previously described in the Chinese population. In the present study, we investigated APC mutation and phenotypic spectrum in the Singapore FAP families who are predominantly Chinese. The protein truncation test (PTT) was used to screen the entire APC gene for germline mutations in 28 unrelated families. Fifteen different mutations were identified in 22 families. Eight mutations were 1-11 basepair deletions or insertions; three involved deletions of whole exons and four were nonsense mutations. Nine of the mutations, including two complex rearrangements, are novel. Eight families including three de novo cases have the same (AAAGA) deletion at codon 1309, indicating that like the Western families, codon 1309 is also the mutation 'hot spot' for Singapore FAP families. In contrast, we did not find any mutation in codon 1061, the second hot spot for the Western population. Congenital hypertrophy of the retinal pigment epithelium (CHRPE) is consistently associated with the prescribed domain (codons 463 to 1387) and is the only phenotype with no intra-family variation. Other than CHRPE, differences in the type and frequency of extracolonic manifestations within the FAP families suggest the influence of modifying genes and environmental factors. (+info)
Nipah viral encephalitis or Japanese encephalitis? MR findings in a new zoonotic disease.
(29/1776)
BACKGROUND AND PURPOSE: An epidemic of suspected Japanese encephalitis occurred in Malaysia in 1998-1999 among pig farmers. In neighboring Singapore, an outbreak occurred among pig slaughterhouse workers. It was subsequently established that the causative agent in the outbreak was not the Japanese encephalitis virus but a previously unknown Hendra-like paramyxovirus named Nipah virus. METHODS: The brain MR images of eight patients with Nipah virus infection were reviewed. All patients tested negative for acute Japanese encephalitis virus. Seven patients had contrast-enhanced studies and six had diffusion-weighted examinations. RESULTS: All patients had multiple small bilateral foci of T2 prolongation within the subcortical and deep white matter. The periventricular region and corpus callosum were also involved. In addition to white matter disease, five patients had cortical lesions, three had brain stem involvement, and a single thalamic lesion was detected in one patient. All lesions were less than 1 cm in maximum diameter. In five patients, diffusion-weighted images showed increased signal. Four patients had leptomeningeal enhancement and four had enhancement of parenchymal lesions. CONCLUSION: The brain MR findings in patients infected with the newly discovered Nipah paramyxovirus are different from those of patients with Japanese encephalitis. In a zoonotic epidemic, this striking difference in the appearance and distribution of lesions is useful in differentiating these diseases. Diffusion-weighted imaging was advantageous in increasing lesion conspicuity. (+info)
Improved outcome for haemodialysis patients treated with high-flux membranes.
(30/1776)
Improved survival for haemodialysis patients has been reported for synthetic, high-flux biocompatible membranes. The reported data fail to answer the question whether improved survival is related to an effect of enhanced biocompatibility or to increased clearance of larger molecular species of putative uraemic toxins. A retrospective analysis of 715 patients treated by continuous haemodialysis for up to 5 years was undertaken. Low-flux polysulfone dialysis was used exclusively for 252 patients and 463 patients were exposed for at least 3 months to high-flux polysulfone dialysis. Patients treated with high-flux dialysis had a lower mortality (21 vs 36 per 1000 years) and significantly lower standardized mortality ratio. For non-diabetic patients the 5-year probability of survival was significantly greater for high-flux patients (Kaplan-Meier: 92% vs 69%; P=0.036). High-flux dialysis significantly reduced the adverse effect of age on survival. In a Cox proportional hazard model membrane flux (high vs low) was one of the covariates with strong predictor value for reduction of death risk in non-diabetic patients. Although other variables may explain the better survival of patients exposed to high-flux dialysis the data reported here suggest that higher membrane flux, implying higher clearance of larger molecular species and independent of biocompatibility, is associated with improved survival for haemodialysis patients. (+info)
Mammographic parenchymal patterns and risk of breast cancer at and after a prevalence screen in Singaporean women.
(31/1776)
BACKGROUND: The objective of this study was to assess the effect of mammographic parenchymal patterns on risk of breast cancer detected at first screen or in the period following a negative screen. METHODS: The study utilizes a nested case-control design with 132 breast cancer patients detected at first screen (from a total of 29 193 screened) and 42 breast cancer patients detected in the period following the first screen. These patients were matched to 348 screened-negative controls. The mammograms were classified according to Tabar's classification for parenchymal pattern and statistical analysis was done by conditional logistic regression. RESULTS: The risk of breast cancer for women with Tabar pattern IV was significantly high when compared to the remaining patterns (odds ratio 2.59). Risk factors for Tabar pattern IV coincided largely with established risk factors for breast cancer. CONCLUSION: The study confirms the increased risk of breast cancer associated with Tabar pattern IV (approximately Wolfe pattern P2), in an Asian population. This pattern is associated with nulliparity and high educational status and is strongly associated with grade 3 cancers. (+info)
Season of birth in schizophrenia: no latitude at the equator.
(32/1776)
BACKGROUND: If the established winter excess in births of people who subsequently develop schizophrenia is an effect of 'seasonality', this would be testable by examining the pattern of births in an equatorial region with no formal seasons. AIMS: To investigate whether there is any variation in month of birth among patients from equatorial Singapore with a diagnosis of schizophrenia. METHOD: All 9655 patients discharged from Singapore's national psychiatric hospital with a diagnosis of schizophrenia were included (year of birth range 1930-1984). We analysed aggregated data, as well as the data of subsamples grouped according to birth-year periods, in order to examine secular trends. One patient subsample (those born 1960-84) allowed exact matching against the general population data set and close testing of any seasonal influence. RESULTS: Monthly variation in births was evident for both patients and controls; the patterns were very similar, apart from the patient sample showing a trough in March-April. CONCLUSIONS: In an equatorial region, where 'seasons' are absent, no seasonal excess in births of those later developing schizophrenia was evident. (+info)