BackgroundTo assess the knowledge of Singaporean youth regarding corneal donation and gauge their willingness to donate their corneas.MethodsWe conducted a cross-sectional study among 500 students from five tertiary institutions in Singapore. All students answered self-administered questionnaires which included seven questions that tested knowledge and three questions that determined willingness to donate corneas.ResultsAmong 500 Singaporean youth aged 18 to 25, most students (73.2 %) answered 3 or fewer of the 7 questions about corneal donation correctly. With regards to the willingness to donate, 155 (31 %) were willing to donate their corneas, 111 (22.2 %) were not willing to donate their corneas, and 234 (46.8 %) were undecided. Willingness to donate corneas was associated with an older age group (21 to 25 years old), those who are non-Muslims, and have good basic knowledge. Particularly, students with good basic knowledge were 1.71 times more likely to willingly donate their corneas.ConclusionThe knowledge of the Singaporean youth regarding corneal donation and transplantation is poor. Since insufficient information was cited as the most common reason for being undecided in regards to corneal donation, specific and tailored programs to increase knowledge and awareness are needed to convince the youth to support corneal donation.Electronic supplementary materialThe online version of this article (doi:10.1186/s40662-016-0049-3) contains supplementary material, which is available to authorized users.
Background and Aims:The SingHealth Anaesthesiology Residency Program is a 5-year postgraduate training programme whose curriculum covers clinical and academic training, through research and educational activities. This study aimed to describe the needs of the residents in promoting research participation during residency.Methods:After obtaining ethics committee approval, we conducted an online anonymous survey among all residents in the Residency Program. The questionnaire comprised questions of demographic data, levels of research interest, areas of interest, the obstacles to research and the potential areas where help can be improved. SAS (version 9.4, 2017; SAS Institute Inc.) was used for descriptive analysis and logistic regression.Results:Sixty-seven of the 79 residents (84.8%) in the Program responded with 58 (73.4%) completing the survey. Fifty-six of the 62 (90%) expressed some level of interest in research. The top two areas of research interest were clinical research and medical education research. The top obstacles to research were lack of time (due to competing clinical time and work–life balance) and lack of mentorship. The top three areas of research support needed by residents were supervised research protected time, departmental research manpower support and mentorship with topic expertise. Senior Residents were more likely to have higher research interest, self-initiated research participation and consideration for research as part of career progression, compared with junior residents.Conclusion:Residents faced many obstacles in doing research during residency training. Our findings also highlighted some of the needs for research support reported by the residents during their specialty training.
Background: Cytomegalovirus (CMV) infection remains a cause of morbidity and mortality in patients who have undergone allogeneic hematopoietic cell transplantation (HSCT) despite pre-emptive antiviral therapy. Available treatments have clinically significant toxic effects. Valacyclovir is well tolerated, and limited evidence suggests that Valacyclovir is effective in preventing CMV disease when given as prophylactic treatment. We investigated the efficacy and safety of high dose Valacyclovir compared with Valganciclovir or Foscarnet in the pre-emptive therapy of CMV antigenemia. Methods: In a retrospective single-center study, 61 allogeneic HSCT recipients with an initial episode of CMV antigenemia received pre-emptive therapy with either Valacyclovir (n=15), Valganciclovir (n=16), or Foscarnet (n=30). Patients were treated with either Valacyclovir at 2 g twice-daily, Valganciclovir at 900 mg twice-daily, or Foscarnet at 90 mg/kg twice-daily, with appropriate renal dose adjustments for each drug. Patients were assessed weekly using the pp65 antigenemia assay. Endpoints analyzed include viremia clearance at day 14 and 28, and rates of recurrent antigenemia. Neutrophil counts and creatinine levels were monitored during treatment. Results: Overall, 60/61 (98%) of cases achieved CMV antigenemia clearance by day 28, and no patient developed CMV disease. Valacyclovir achieved similar clearance of CMV viremia compared to Valganciclovir and Foscarnet, at rates of 93.3%, 77.5%, and 79.5% respectively at 14 days (p=0.054; log rank test). After adjusting for age, sex, CMV serological status, donor type, CMV antigen level, GVHD therapy, and conditioning regimen, there were no significant differences in the odds of viral clearance at day 14 in patients who received Valganciclovir (odds ratio (OR) 0.16, 95% confidence interval (CI) 0.01 to 2.14, p=0.17) and Foscarnet (OR 0.21, 95% CI 0.02 to 2.39, p=0.21), compared to Valacyclovir (assigned OR 1.00). Recurrent CMV antigenemia by day 180 after clearance of the initial episode occurred in 34/61 (56%) of patients. Use of Acyclovir was not associated with an increased odds of CMV recurrence, compared to Valganciclovir or Foscarnet, after adjusting for the same covariates in logistic regression models. Foscarnet significantly increased creatinine levels (p=0.009), while Valganciclovir significantly reduced neutrophil counts (p=0.012). Laboratory evaluation revealed no hematopoietic or renal toxicity in patients on Valacyclovir treatment. Conclusion: Pre-emptive treatment with Valganciclovir, Foscarnet and Valacyclovir led to similar clearance of CMV antigenemia and rates of recurrence. High dose Valacyclovir is a potential alternative for pre-emptive CMV treatment in allogeneic HSCT recipients, with an acceptable safety profile. Table 1.Response to preemptive cytomegalovirus therapyAll(n=61)Valacyclovir(n=15)Valganciclovir(n=16)Foscarnet(n=30)P Median viral load (No. of CMV positive cells per million leukocytes, range)3 (1-750)3 (1-140)3 (2-181)3.5 (1-750)0.772 Clearance, N (%)0.054Cleared by day 735 (58.3)12 (80.0)11 (68.8)12 (41.4)Cleared by day 1414 (23.3)2 (13.3)2 (12.5)10 (34.5)Cleared by day 218 (13.3)1 (6.7)3 (18.8)4 (13.3)Cleared by day 283 (5.0)0 (0)0 (0)3 (10.3) Recurrent antigenemia, N (%)34 (55.8)7 (46.7)11 (68.8)16 (53.3)0.434 Median days to recurrence43.5 (11-173)59 (27-173)42 (14-94)38 (11-163)0.081 Disclosures Off Label Use: Valacyclovir use for CMV pre-emptive therapy in allogeneic HSCT recipients. Goh:Novartis Pte Ltd: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Jannsen Pharmaceuticals Inc: Research Funding; Bristol-Myres Squibb: Membership on an entity's Board of Directors or advisory committees; Gilead Sciences: Honoraria, Membership on an entity's Board of Directors or advisory committees; Hospira Inc: Honoraria, Membership on an entity's Board of Directors or advisory committees.
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