Pub Date : 2023-09-27DOI: 10.47102/annals-acadmedsg.2022385
Mingzhe Cai, Piea Peng Lee, Pei Leng Chong, Fiona Teng Teng Peh, Sachin Mathur
According to the latest Utstein-style consensus, drowning is defined as the primary respiratory impairment resulting from submersion or immersion in a liquid medium.1 Patients may experience hypothermia, acute respiratory distress syndrome and shock.1 The pathophysiology is poorly understood, but could relate to physiological responses to temperature, water swallowing and electrolyte disturbances.2 Globally, more than 500,000 deaths from drowning are reported every year.3 Poor prognostic factors include low Glasgow Coma Scale (GCS) score and cardiorespiratory arrest. Treatment is largely supportive. Most preventative measures are centred on aquatic safety education and swimming lessons. Based on the National Sport Participation Survey 2018–2022, swimming has consistently ranked among the 5 most popular sports in Singapore.4 This study aimed to describe the outcomes of patients admitted for drowning.
{"title":"Outcomes of patients admitted for drowning","authors":"Mingzhe Cai, Piea Peng Lee, Pei Leng Chong, Fiona Teng Teng Peh, Sachin Mathur","doi":"10.47102/annals-acadmedsg.2022385","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2022385","url":null,"abstract":"According to the latest Utstein-style consensus, drowning is defined as the primary respiratory impairment resulting from submersion or immersion in a liquid medium.1 Patients may experience hypothermia, acute respiratory distress syndrome and shock.1 The pathophysiology is poorly understood, but could relate to physiological responses to temperature, water swallowing and electrolyte disturbances.2 Globally, more than 500,000 deaths from drowning are reported every year.3 Poor prognostic factors include low Glasgow Coma Scale (GCS) score and cardiorespiratory arrest. Treatment is largely supportive. Most preventative measures are centred on aquatic safety education and swimming lessons. Based on the National Sport Participation Survey 2018–2022, swimming has consistently ranked among the 5 most popular sports in Singapore.4 This study aimed to describe the outcomes of patients admitted for drowning.","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135579616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Intensive care unit (ICU) resources are scarce and expensive, and deciding if intensive care is suitable for older patients involves complex clinical reasoning, ethical challenges and cost considerations. Although some studies show that ICU mortality increases with age, others suggest that age alone is not predictive of poor prognosis, and other factors such as frailty, premorbid functional status and comorbidities could be important.
{"title":"Impact of an ageing population on the intensive care unit","authors":"Sharlene Ho, Hwee Pin Phua, Wei-Ye Lim, Niranjana Mahalingam, Jin Wen Sennen Lew","doi":"10.47102/annals-acadmedsg.202315","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.202315","url":null,"abstract":"Intensive care unit (ICU) resources are scarce and expensive, and deciding if intensive care is suitable for older patients involves complex clinical reasoning, ethical challenges and cost considerations. Although some studies show that ICU mortality increases with age, others suggest that age alone is not predictive of poor prognosis, and other factors such as frailty, premorbid functional status and comorbidities could be important.","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135579614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-30DOI: 10.47102/annals-acadmedsg.2023275
Boon Wee Teo, Xiaoli Peng
Chronic kidney disease (CKD) is a structural and functional disorder of the kidney caused by many diseases, such as diabetes, hypertension and glomerular disease.1 There are many factors that contribute to the development and progression of CKD, and often, we do not look at the exposure of heavy metals as a risk factor for the development and accelerant of CKD.2 Heavy metals, such as cadmium, mercury, arsenic and lead, can enter the body through various sources, including contaminated water, food, air pollution, occupational exposure and certain medications. Prolonged or excessive exposure to these metals can lead to their accumulation in the kidneys and cause nephrotoxicity. The kidney has the ability to reabsorb and concentrate divalent ions and metals. The renal proximal tubules are responsible for the reabsorption of essential substances from the glomerular filtrate. Heavy metals in the blood can bind to metallothionein and glutathione in inert forms, and the conjugates are then released into the blood through the liver and kidneys. These substances are then reabsorbed through the endocytic process in the S1 segment of the proximal tubule, which may eventually lead to chronic inflammation, renal fibrosis and renal failure.
{"title":"Micronutrients and kidney health","authors":"Boon Wee Teo, Xiaoli Peng","doi":"10.47102/annals-acadmedsg.2023275","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2023275","url":null,"abstract":"Chronic kidney disease (CKD) is a structural and functional disorder of the kidney caused by many diseases, such as diabetes, hypertension and glomerular disease.1 There are many factors that contribute to the development and progression of CKD, and often, we do not look at the exposure of heavy metals as a risk factor for the development and accelerant of CKD.2 Heavy metals, such as cadmium, mercury, arsenic and lead, can enter the body through various sources, including contaminated water, food, air pollution, occupational exposure and certain medications. Prolonged or excessive exposure to these metals can lead to their accumulation in the kidneys and cause nephrotoxicity. The kidney has the ability to reabsorb and concentrate divalent ions and metals. The renal proximal tubules are responsible for the reabsorption of essential substances from the glomerular filtrate. Heavy metals in the blood can bind to metallothionein and glutathione in inert forms, and the conjugates are then released into the blood through the liver and kidneys. These substances are then reabsorbed through the endocytic process in the S1 segment of the proximal tubule, which may eventually lead to chronic inflammation, renal fibrosis and renal failure.","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136240596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Chronic kidney disease (CKD) is a condition defined as a persistent change in kidney structure or function, or both, that compromises human health. Environmental exposure to heavy metals (e.g. cadmium, lead, arsenic and mercury) is common, and high exposure levels are known to cause nephrotoxicity. Micronutrients such as selenium and zinc are positively associated with better kidney function and renal outcomes. This study determined the associations between CKD and heavy metal exposures measured in blood or urine within a community-dwelling population, and assessed whether and how selenium and zinc modified the associations. Method: Data were extracted from 4 cycles of the US National Health and Nutrition Examination Survey (NHANES) database (2011–2012, 2013–2014, 2015–2016 and 2017–2018). Results: Univariate analysis showed that higher quartiles of plasma lead and cadmium concentration were more likely associated with CKD than the lowest quartile, and along with folate, were linked to greater odds of CKD. Conversely, as plasma selenium and serum zinc increased, the odds of CKD decreased. Multivariate analysis had similar results after adjusting for relevant confounders. Higher plasma cadmium quartiles were associated with higher odds of CKD. Associations between higher quartiles of plasma selenium and serum zinc were significantly associated with lower odds of CKD. Conclusion: Elevated blood levels of heavy metals increase CKD, whereas elevated concentrations of plasma selenium and serum zinc decrease CKD. A high serum zinc concentration appears to interact with low-toxicity heavy metals to reduce CKD risk. This study suggests that increased selenium and zinc in the body along with avoidance of heavy metal exposures could protect against CKD.
{"title":"Plasma selenium and zinc alter associations between nephrotoxic metals and chronic kidney disease: Results from NHANES database 2011–2018","authors":"Cheng-Jui Lin, Hong-Mou Shih, Pei-Chen Wu, Chi-Feng Pan, Yun Hsi Lin, Chih-Jen Wu","doi":"10.47102/annals-acadmedsg.202357","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.202357","url":null,"abstract":"Introduction: Chronic kidney disease (CKD) is a condition defined as a persistent change in kidney structure or function, or both, that compromises human health. Environmental exposure to heavy metals (e.g. cadmium, lead, arsenic and mercury) is common, and high exposure levels are known to cause nephrotoxicity. Micronutrients such as selenium and zinc are positively associated with better kidney function and renal outcomes. This study determined the associations between CKD and heavy metal exposures measured in blood or urine within a community-dwelling population, and assessed whether and how selenium and zinc modified the associations. Method: Data were extracted from 4 cycles of the US National Health and Nutrition Examination Survey (NHANES) database (2011–2012, 2013–2014, 2015–2016 and 2017–2018). Results: Univariate analysis showed that higher quartiles of plasma lead and cadmium concentration were more likely associated with CKD than the lowest quartile, and along with folate, were linked to greater odds of CKD. Conversely, as plasma selenium and serum zinc increased, the odds of CKD decreased. Multivariate analysis had similar results after adjusting for relevant confounders. Higher plasma cadmium quartiles were associated with higher odds of CKD. Associations between higher quartiles of plasma selenium and serum zinc were significantly associated with lower odds of CKD. Conclusion: Elevated blood levels of heavy metals increase CKD, whereas elevated concentrations of plasma selenium and serum zinc decrease CKD. A high serum zinc concentration appears to interact with low-toxicity heavy metals to reduce CKD risk. This study suggests that increased selenium and zinc in the body along with avoidance of heavy metal exposures could protect against CKD.","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136162036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-30DOI: 10.47102/annals-acadmedsg.2022472
Abhiram Kanneganti, Arundhati Tushar Gosavi, Mei Xian Karen Lim, Wei Ling Sarah Li, Dawn AK Chia, Mahesh Arjandas Choolani, Ching Kit Chen, Arijit Biswas
Objective: To determine the distribution of major fetal congenital heart diseases (CHDs) diagnosed antenatally during routine second-trimester obstetric anatomical scans in an unselected population at a single tertiary centre and to characterise and stratify risk factors, genetic diagnosis and long-term health at 4 years old. Method: A single-centre cohort study of all major fetal CHDs detected on routine obstetric fetal anatomical ultrasound scans between January 2014 and December 2017 was performed in an unselected population. Demographic details, fetal echocardiogram reports, genetic test results, delivery outcomes and postnatal progress were stratified by CHD subtype. Results: Of 20,031 screened pregnancies, 109 pregnancies (0.53%) had major fetal CHDs. The most common subtypes were coarctation of aorta (17.4%), transposition of great arteries (16.5%), and tetralogy of Fallot and univentricular hearts (13.8% each). Of the 60.5% that underwent confirmatory genetic testing—mostly conventional karyotyping and testing for 22q11 microdeletion—about a quarter had abnormalities, of which 22q microdeletion was the most common. We had complete obstetric data in 85 pregnancies (78%), of which 76.5% progressed to live birth. Among these, 92.1% of postnatal echocardiograms concurred with antenatal ones. At 4 years old, 43.2% of offspring had no medical or developmental issues, 20.0% had mild medical or developmental issues, 21.5% had major medical or developmental issues, and 12.3% had deceased. Conclusion: Fetal echocardiograms accurately diagnose CHDs. Future studies should evaluate the roles of chromosomal microarray and next-generation sequencing in diagnosing CHD.
{"title":"Fetal congenital heart diseases: Diagnosis by anatomical scans, echocardiography and genetic tests","authors":"Abhiram Kanneganti, Arundhati Tushar Gosavi, Mei Xian Karen Lim, Wei Ling Sarah Li, Dawn AK Chia, Mahesh Arjandas Choolani, Ching Kit Chen, Arijit Biswas","doi":"10.47102/annals-acadmedsg.2022472","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2022472","url":null,"abstract":"Objective: To determine the distribution of major fetal congenital heart diseases (CHDs) diagnosed antenatally during routine second-trimester obstetric anatomical scans in an unselected population at a single tertiary centre and to characterise and stratify risk factors, genetic diagnosis and long-term health at 4 years old. Method: A single-centre cohort study of all major fetal CHDs detected on routine obstetric fetal anatomical ultrasound scans between January 2014 and December 2017 was performed in an unselected population. Demographic details, fetal echocardiogram reports, genetic test results, delivery outcomes and postnatal progress were stratified by CHD subtype. Results: Of 20,031 screened pregnancies, 109 pregnancies (0.53%) had major fetal CHDs. The most common subtypes were coarctation of aorta (17.4%), transposition of great arteries (16.5%), and tetralogy of Fallot and univentricular hearts (13.8% each). Of the 60.5% that underwent confirmatory genetic testing—mostly conventional karyotyping and testing for 22q11 microdeletion—about a quarter had abnormalities, of which 22q microdeletion was the most common. We had complete obstetric data in 85 pregnancies (78%), of which 76.5% progressed to live birth. Among these, 92.1% of postnatal echocardiograms concurred with antenatal ones. At 4 years old, 43.2% of offspring had no medical or developmental issues, 20.0% had mild medical or developmental issues, 21.5% had major medical or developmental issues, and 12.3% had deceased. Conclusion: Fetal echocardiograms accurately diagnose CHDs. Future studies should evaluate the roles of chromosomal microarray and next-generation sequencing in diagnosing CHD.","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136239618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-30DOI: 10.47102/annals-acadmedsg.202337
Yie Hui Lau, Andrew Y Li, Shir Lynn Lim, Kai Lee Woo, Kollengode Ramanathan, Horng-Ruey Chua, Akalya K, Addy YH Tan, Jason Phua, Jonathan JE Tan, Ser Hon Puah, Yew Woon Chia, Sean CH Loh, Faheem Ahmed Khan, Somnath Chatterjee, Manish Kaushik, Kay Choong See
Introduction: Anticoagulation is recommended during continuous kidney replacement therapy (CKRT) to prolong the filter lifespan for optimal filter performance. We aimed to evaluate the effect of anticoagulation during CKRT on dialysis dependence and mortality within 90 days of intensive care unit (ICU) admission. Method: Our retrospective observational study evaluated the first CKRT session in critically ill adults with acute kidney injury (AKI) in Singapore from April to September 2017. The primary outcome was a composite of dialysis dependence or death within 90 days of ICU admission; the main exposure variable was anticoagulation use (regional citrate anticoagulation [RCA] or systemic heparin). Multivariable logistic regression was performed to adjust for possible confounders: age, female sex, Acute Physiology and Chronic Health Evaluation (APACHE II) score, liver dysfunction, coagulopathy (international normalised ratio[INR] >1.5) and platelet counts of less than 100,000/uL). Results: The study cohort included 276 patients from 14 participating adult ICUs, of whom 176 (63.8%) experienced dialysis dependence or death within 90 days of ICU admission (19 dialysis dependence, 157 death). Anticoagulation significantly reduced the odds of the primary outcome (adjusted odds ratio [AOR] 0.47, 95% confidence interval [CI] 0.27–0.83, P=0.009). Logistic regression analysis using anticoagulation as a 3-level indicator variable demonstrated that RCA was associated with mortality reduction (AOR 0.46, 95% CI 0.25–0.83, P=0.011), with heparin having a consistent trend (AOR 0.51, 95% CI 0.23–1.14, P=0.102). Conclusion: Among critically ill patients with AKI, anticoagulation use during CKRT was associated with reduced dialysis or death at 90 days post-ICU admission, which was statistically significant for regional citrate anticoagulation and trended in the same direction of benefit for systemic heparin anticoagulation. Anticoagulation during CKRT should be considered whenever possible.
导读:推荐在持续肾脏替代治疗(CKRT)期间抗凝治疗，以延长过滤器的使用寿命，以获得最佳的过滤器性能。我们的目的是评估CKRT期间抗凝治疗对透析依赖和重症监护病房(ICU)入院90天内死亡率的影响。方法:我们的回顾性观察性研究评估了2017年4月至9月新加坡重症急性肾损伤(AKI)成人的首次CKRT疗程。主要转归是透析依赖或ICU入院90天内死亡的综合转归;主要暴露变量是抗凝使用(局部柠檬酸抗凝[RCA]或全身肝素)。采用多变量logistic回归来调整可能的混杂因素:年龄、女性性别、急性生理和慢性健康评估(APACHE II)评分、肝功能障碍、凝血功能障碍(国际正常化比率[INR] >1.5)和血小板计数小于100,000/uL)。结果:研究队列包括来自14个成人ICU的276例患者，其中176例(63.8%)在ICU入院90天内出现透析依赖或死亡(19例透析依赖，157例死亡)。抗凝显著降低了主要结局的几率(调整优势比[AOR] 0.47, 95%可信区间[CI] 0.27-0.83, P=0.009)。采用抗凝作为3水平指标变量的Logistic回归分析显示，RCA与死亡率降低相关(AOR 0.46, 95% CI 0.25-0.83, P=0.011)，肝素与RCA相关(AOR 0.51, 95% CI 0.23-1.14, P=0.102)。结论:在重症AKI患者中，CKRT期间抗凝治疗与icu入院后90天透析减少或死亡相关，局部柠檬酸盐抗凝治疗具有统计学意义，与全身肝素抗凝治疗的获益趋势相同。在CKRT期间应尽可能考虑抗凝。
{"title":"Association of anticoagulation use during continuous kidney replacement therapy and 90-day outcomes: A multicentre study","authors":"Yie Hui Lau, Andrew Y Li, Shir Lynn Lim, Kai Lee Woo, Kollengode Ramanathan, Horng-Ruey Chua, Akalya K, Addy YH Tan, Jason Phua, Jonathan JE Tan, Ser Hon Puah, Yew Woon Chia, Sean CH Loh, Faheem Ahmed Khan, Somnath Chatterjee, Manish Kaushik, Kay Choong See","doi":"10.47102/annals-acadmedsg.202337","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.202337","url":null,"abstract":"Introduction: Anticoagulation is recommended during continuous kidney replacement therapy (CKRT) to prolong the filter lifespan for optimal filter performance. We aimed to evaluate the effect of anticoagulation during CKRT on dialysis dependence and mortality within 90 days of intensive care unit (ICU) admission. Method: Our retrospective observational study evaluated the first CKRT session in critically ill adults with acute kidney injury (AKI) in Singapore from April to September 2017. The primary outcome was a composite of dialysis dependence or death within 90 days of ICU admission; the main exposure variable was anticoagulation use (regional citrate anticoagulation [RCA] or systemic heparin). Multivariable logistic regression was performed to adjust for possible confounders: age, female sex, Acute Physiology and Chronic Health Evaluation (APACHE II) score, liver dysfunction, coagulopathy (international normalised ratio[INR] >1.5) and platelet counts of less than 100,000/uL). Results: The study cohort included 276 patients from 14 participating adult ICUs, of whom 176 (63.8%) experienced dialysis dependence or death within 90 days of ICU admission (19 dialysis dependence, 157 death). Anticoagulation significantly reduced the odds of the primary outcome (adjusted odds ratio [AOR] 0.47, 95% confidence interval [CI] 0.27–0.83, P=0.009). Logistic regression analysis using anticoagulation as a 3-level indicator variable demonstrated that RCA was associated with mortality reduction (AOR 0.46, 95% CI 0.25–0.83, P=0.011), with heparin having a consistent trend (AOR 0.51, 95% CI 0.23–1.14, P=0.102). Conclusion: Among critically ill patients with AKI, anticoagulation use during CKRT was associated with reduced dialysis or death at 90 days post-ICU admission, which was statistically significant for regional citrate anticoagulation and trended in the same direction of benefit for systemic heparin anticoagulation. Anticoagulation during CKRT should be considered whenever possible.","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":"154 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136163006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-30DOI: 10.47102/annals-acadmedsg.2023105209
Mona P Tan, Clement Luck Khng Chia, Chang Yi Woon, Serene Si Ning Goh, Lin Seong Soh, Chloe Fu Cui Yeo, Marc Weijie Ong, Benjamin Wong, Joelle Hoi Ting Leong, Jerry Tiong Thye Goo
I read with interest the article by Woon et al. published in a recent issue of the Annals on the reduction of re-excision rates with the use of intraoperative frozen section (FS) analysis.1 This certainly has the potential to improve patient outcomes after surgery as their study has demonstrated. It is also likely that a decrease in re-operation rates would have a positive influence on patients choice to undergo breast conservation treatment (BCT) rather than mastectomy.
{"title":"Breast conservation treatment and frozen section analysis of margins","authors":"Mona P Tan, Clement Luck Khng Chia, Chang Yi Woon, Serene Si Ning Goh, Lin Seong Soh, Chloe Fu Cui Yeo, Marc Weijie Ong, Benjamin Wong, Joelle Hoi Ting Leong, Jerry Tiong Thye Goo","doi":"10.47102/annals-acadmedsg.2023105209","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2023105209","url":null,"abstract":"I read with interest the article by Woon et al. published in a recent issue of the Annals on the reduction of re-excision rates with the use of intraoperative frozen section (FS) analysis.1 This certainly has the potential to improve patient outcomes after surgery as their study has demonstrated. It is also likely that a decrease in re-operation rates would have a positive influence on patients choice to undergo breast conservation treatment (BCT) rather than mastectomy.","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136239621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-30DOI: 10.47102/annals-acadmedsg.2023215
Meng Sha, Yong-bing Qian, Qiang Xia
The outbreak of the COVID-19 virus in 2019 had rapidly developed into a global pandemic, causing more than 6.8 million deaths and impacting the lives of billions of individuals around the world.1 Public healthcare around the work have mainly focused on the clinical manifestations and treatment of the deadly respiratory disease. As the pandemic progressed, it became clear that the psychological distress—arising from anxiety, depression and self-isolation; leading even to some suicides—had negatively impacted people’s mental health.2 However, whether pre-existing mental disorder has an influence on COVID-19 outcomes remains unknown.
{"title":"Impact of pre-existing depression on severe COVID-19 outcomes","authors":"Meng Sha, Yong-bing Qian, Qiang Xia","doi":"10.47102/annals-acadmedsg.2023215","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2023215","url":null,"abstract":"The outbreak of the COVID-19 virus in 2019 had rapidly developed into a global pandemic, causing more than 6.8 million deaths and impacting the lives of billions of individuals around the world.1 Public healthcare around the work have mainly focused on the clinical manifestations and treatment of the deadly respiratory disease. As the pandemic progressed, it became clear that the psychological distress—arising from anxiety, depression and self-isolation; leading even to some suicides—had negatively impacted people’s mental health.2 However, whether pre-existing mental disorder has an influence on COVID-19 outcomes remains unknown.","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136162030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-30DOI: 10.47102/annals-acadmedsg.202372
Benjamin Liang Jun Lui, Chris Lixian Tan
Cryotherapy is a cost-effective treatment that can be performed by non-dermatologists for viral warts, which are very common.1,2 The National University Hospital, Singapore runs a nurse-led wart clinic where nurses are trained to administer cryotherapy. This study reviewed eradication rates and side effects in patients treated at the nurse-led wart clinic.
冷冻疗法是一种经济有效的治疗方法，可以由非皮肤科医生对非常常见的病毒性疣进行治疗。1,2新加坡国立大学医院(National University Hospital)开设了一家由护士领导的疣诊所，在那里护士接受过冷冻治疗的培训。本研究回顾了在护士领导的疣诊所治疗的患者的根除率和副作用。
{"title":"Outcomes of nurse-led cryotherapy treatment for viral warts","authors":"Benjamin Liang Jun Lui, Chris Lixian Tan","doi":"10.47102/annals-acadmedsg.202372","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.202372","url":null,"abstract":"Cryotherapy is a cost-effective treatment that can be performed by non-dermatologists for viral warts, which are very common.1,2 The National University Hospital, Singapore runs a nurse-led wart clinic where nurses are trained to administer cryotherapy. This study reviewed eradication rates and side effects in patients treated at the nurse-led wart clinic.","PeriodicalId":50774,"journal":{"name":"Annals Academy of Medicine Singapore","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136163004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-30DOI: 10.47102/annals-acadmedsg.202355
Junjie Huang, Wing Sze Pang, Yuet Yan Wong, Samantha Ko, Shadow SL Yip, Florence SW Chan, Clement SK Cheung, Wing Nam Wong, Ngai Tseung Cheung, Martin CS Wong
In Hong Kong, the eHealth App was launched in January 2021, as part of Stage Two development of the Electronic Health Record Sharing System. It provides the healthcare recipients, that is, those who have registered in the system, a series of functions to manage their health, such as accessing electronic health records and self-inputting health information.1 We conducted a study to evaluate how the general population adopted the eHealth App and identify the contributing factors that may influence its adoption.
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