Adapting to Change: The State of Singapore Private Enterprise in China

Academy of International Business. Southeast Asia Regional Conference 2013, December 5-7, Bali, Indonesia</h3

Genomic Dissection of Bipolar Disorder and Schizophrenia, Including 28 Subphenotypes

publisher: Elsevier articletitle: Genomic Dissection of Bipolar Disorder and Schizophrenia, Including 28 Subphenotypes journaltitle: Cell articlelink: https://doi.org/10.1016/j.cell.2018.05.046 content_type: article copyright: © 2018 Elsevier Inc

Selective serotonin reuptake inhibitors and the risk of hepatocellular carcinoma in hepatitis B virus-infected patients

Chia-Ming Chang,1&ndash;3 Ming-Shun Hsieh,1&ndash;4 Tsung-Chieh Yang,3,5 Vivian Chia-Rong Hsieh,6 Jen-Huai Chiang,7 Hsien-Hao Huang,1,3 Chorng-Kuang How,1,3 Sung-Yuan Hu,8 David Hung-Tsang Yen1,3 1Department of Emergency Medicine, Taipei Veterans General Hospital, 2Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, 3College of Medicine, National Yang-Ming University, Taipei, 4Department of Emergency Medicine, 5Division of Gastroenterology, Department of Internal Medicine, Taipei Veterans General Hospital, Taoyuan Branch, Taoyuan, 6Department of Health Services Administration, 7Management Office for Health Data, China Medical University, 8Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China Background: This study aimed to investigate the association between the use of selective serotonin reuptake inhibitors (SSRIs) and the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B virus (HBV) infection.Methods: We conducted a population-based cohort study by using claims data from the Taiwan National Health Insurance Research Database (NHIRD). The study cohort comprised 1380 newly diagnosed HBV-infected patients with SSRI use who were frequency matched by age, sex, liver cirrhosis, and index year with HBV-infected patients without SSRI use in the comparison cohort. Each patient case was followed from 2000 to 2012 to identify incident HCC cases. Cox proportional hazards regression was performed to evaluate the association between SSRI use and HCC risk. The further sensitivity analysis used case-control study design. A total of 9070 HCC subjects retrieved from NHIRD, and equal non-HCC subjects were analyzed after matching for age and sex.Results: We identified 9 and 24 HCC cases in the study and comparison cohorts during the follow-up period of 7056 and 6845 person-years, respectively. The incidence rate of HCC was 1.28 and 3.51 per 1000 person-years for SSRI and non-SSRI users, respectively. After adjusting for potential confounders, the adjusted hazard ratio (HR) for SSRI use was 0.28 (95% confidence interval [CI], 0.12&ndash;0.64; p = 0.0027). For SSRI users with a cumulative defined daily dose (cDDD) of 28&ndash;89, 90&ndash;364, and &ge;365, the adjusted HRs were 0.51, 0.22, and 0.12, respectively, (95% CI, 0.21&ndash;1.25, 0.05&ndash;0.94, and 0.02&ndash;0.90, respectively) compared with non-SSRI users (&lt;28 cDDD). The sensitivity analysis showed that the SSRI presented with a dose-response protective effect for HCC in the multivariate analysis.Conclusion: SSRIs use may possibly reduce the risk of HCC in HBV-infected patients in a dose-responsive manner. Keywords: selective serotonin reuptake inhibitors, SSRI, hepatitis B virus, HBV, hepatocellular carcinoma, HCC, depressio

Real-World Treatment and Outcomes of ALK-Positive Metastatic Non&ndash;Small Cell Lung Cancer in a Southeast Asian Country

Mau Ern Poh,1 Soon Hin How,2,3 Gwo Fuang Ho,4 Yong Kek Pang,1 Harissa H Hasbullah,5,6 Lye Mun Tho,7 Ibtisam Muhamad Nor,6 Bee Chiu Lim,3 Kean Fatt Ho,8 Muthukkumaran Thiagarajan,6 Azlina Samsudin,9 Azza Omar,10 Choo Khoon Ong,11 Sing Yang Soon,12 Justin Yu Kuan Tan,9 Muhammad Adil Zainal Abidin2 1Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia; 2Kulliyyah of Medicine, International Islamic University Malaysia, Kuantan, Pahang, Malaysia; 3Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia; 4Clinical Oncology Unit, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia; 5Faculty of Medicine, Universiti Teknologi Mara, Sungai Buloh, Selangor, Malaysia; 6Oncology and Radiotherapy Department, General Hospital Kuala Lumpur, Kuala Lumpur, Malaysia; 7Department of Clinical Oncology, Beacon Hospital, Petaling Jaya, Selangor, Malaysia; 8Mount Miriam Cancer Hospital, Tanjong Bungah, Penang, Malaysia; 9Hospital Sultanah Nur Zahirah, Kuala Terengganu, Terengganu, Malaysia; 10Respiratory Unit, Medical Department, Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan, Malaysia; 11Gleneagles Penang, George Town, Penang, Malaysia; 12Sarawak Heart Centre, Kuching, Sarawak, MalaysiaCorrespondence: Mau Ern Poh, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia, Tel +60-3-7841-4000, Email [email protected]: Anaplastic lymphoma kinase (ALK) inhibitors are associated with good overall survival (OS) for ALK-positive metastatic non–small cell lung cancer (NSCLC). However, these treatments can be unavailable or limited by financial constraints in developing countries. Using data from a nationwide lung cancer registry, the present study aimed to identify treatment patterns and clinical outcomes of ALK-positive NSCLC in Malaysia.Methods: This retrospective study examined data of patients with ALK-positive NSCLC from 18 major hospitals (public, private, or university teaching hospitals) throughout Malaysia between January 1, 2015 and December 31, 2020 from the National Cardiovascular and Thoracic Surgical Database (NCTSD). Data on baseline characteristics, treatments, radiological findings, and pathological findings were collected. Overall survival (OS) and time on treatment (TOT) were calculated using the Kaplan–Meier method.Results: There were 1581 NSCLC patients in the NCTSD. Based on ALK gene-rearrangement test results, only 65 patients (4.1%) had ALK-positive advanced NSCLC. Of these 65 patients, 59 received standard-of-care treatment and were included in the analysis. Crizotinib was the most commonly prescribed ALK inhibitor, followed by alectinib and ceritinib. Patients on ALK inhibitors had better median OS (62 months for first-generation inhibitors, not reached at time of analysis for second-generation inhibitors) compared to chemotherapy (27 months), but this was not statistically significant (P=0.835) due to sample-size limitations. Patients who received ALK inhibitors as first-line therapy had significantly longer TOT (median of 11 months for first-generation inhibitors, not reached for second-generation inhibitors at the time of analysis) compared to chemotherapy (median of 2 months; P< 0.01).Conclusion: Patients on ALK inhibitors had longer median OS and significantly longer TOT compared to chemotherapy, suggesting long-term benefit.Keywords: ALK inhibitors, chemotherapy, ALK-positive, NSCL