Multidisciplinary | Special Reports

A patient with treatment-resistant depression and suicidality achieving remission with an intranasal NMDA receptor antagonist

Dr. Chun Lam, 20230914080000

A 25-year-old female school teacher with treatment-resistant depression (TRD), who was otherwise healthy with a strong family history of depression, was referred to our clinic in April 2023 by a general practitioner (GP) due to suicidal ideation – a psychiatric emergency.

Novel oral non-statin lipid-lowering therapy for patients with high and very high CV risk

Prof. Ulrich Laufs, 20230914080000

Statins have remained the cornerstone of lipid-lowering therapy for several decades. However, a substantial proportion of patients fail to achieve guideline-recommended LDL-cholesterol targets, while one in 10–12 patients have statin intolerance. At the 31^st Annual Scientific Congress of the Hong Kong College of Cardiology (HKCC ASC 2023), Professor Ulrich Laufs of the Department of Cardiology, Leipzig University Hospital, Germany, presented evidence on bempedoic acid, a novel, first-in-class treatment for statin-intolerant patients at high risk of cardiovascular (CV) events, which is available as a single agent or as a fixed-dose combination (FDC) with ezetimibe.

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First-generation TRK inhibitor in a patient with highly aggressive caecal and gastric adenocarcinoma with lung metastases

Dr. Kirsty Lee, 20230908080000

A 75-year-old male with shortness of breath and mild chronic cough was admitted to hospital in September 2022. He had multiple comorbidities, including diabetes, fatty liver, hypertensive nephropathy, postinfectious pulmonary fibrosis, and haemolytic anaemia (managed with azathioprine). Upon admission, the patient was not experiencing anorexia or weight loss, and his Eastern Cooperative Oncology Group performance status (ECOG PS) was 0. (Table 1)

Switching treatment from ACEI to ARNI in a patient with ischaemic cardiomyopathy and severe HFrEF secondary to triple vessel disease

Dr. Ka-Hung Lau, 20230816061533

A 67-year-old male former smoker with a history of organizing pneumonia presented with symptoms of heart failure (HF), including exertional dyspnoea, orthopnoea, and ankle oedema for a few months, and was hospitalized in July 2019.

Latest EULAR recommendations in SLE and lupus nephritis

Dr. Dimitrios Boumpas, 20230815080000

The new European Alliance of Associations for Rheumatology (EULAR) recommendations for systemic lupus erythematosus (SLE) and lupus nephritis (LN) have adopted a more proactive treatment approach that focuses on early use of biologics to enable faster steroid tapering and preservation of renal function, as well as to minimize the risk of flares and organ damage progression. At European Congress of Rheumatology 2023 (EULAR 2023), Dr Dimitrios Boumpas, Chair of the EULAR Task Force on SLE, presented key changes in the new guidelines and discussed the established efficacy and safety of belimumab, a biologic indicated for SLE and LN.

Emerging trends in BoNT-A resistance: Implications and risk mitigation strategies

Dr. Wilson Ho, 20230815080000

Botulinum neurotoxin A (BoNT-A) is widely used in aesthetic and medical treatments. As clinical applications of BoNT-A continue to expand, concerns have emerged regarding BoNT-A resistance. In an interview with MIMS Doctor, Dr Wilson Ho, Specialist in Plastic Surgery in Hong Kong and Panellist of the Aesthetic Council for Ethical Use of Neurotoxin Delivery (ASCEND), discussed challenges of growing BoNT-A resistance in the Asia Pacific region, and highlighted key messages from the ASCEND consensus statements, best practices and risk mitigation strategies.

In-hospital initiation of SGLT2 inhibitors in acute heart failure: Why?

Prof. Christiane Angermann, 20230814080000

Patients hospitalized for acute heart failure (HF) have high risks of readmission and mortality in the first few months after discharge. At Advances in Medicine (AIM) 2023, Professor Christiane Angermann of Comprehensive Heart Failure Centre, University Hospital of Würzburg, Würzburg, Germany, discussed recent evidence supporting in-hospital initiation of guideline-directed medical therapies (GDMT) in patients hospitalized for acute HF, focusing on clinical benefits of a sodium-glucose cotransporter 2 (SGLT2) inhibitor, empagliflozin, demonstrated in the EMPULSE trial.