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Managing and preventing severe hand injuries among sugarcane juicer operators 管理和预防甘蔗榨汁机操作人员严重手部伤害
4区 医学 Q2 Medicine Pub Date : 2023-08-30 DOI: 10.47102/annals-acadmedsg.202393
Zhi Xuan Low, Sean Wei Loong Ho, Gregory Chung Tsing Chan, Dawn Sinn Yii Chia
Of all hand injuries encountered at an emergency department, 54% are sustained in the workplace,1 in part contributed by occupational injuries among food and beverage operators that caused a loss of 16,197 man-hours in 2021 alone.2 Commonplace in Singapore and in parts of South and Southeast Asia is the sugarcane juicer, a machine typically operated by sole proprietorship drink stalls within food centres and more importantly, a dangerous cause of workplace accidents. We highlight the severity of sugarcane juicer-related hand injuries that have resulted in permanent disabilities in 3 representative patients. We also review occupational health risks of such technology to understand the contributing factors involved and how they can be prevented.
在急诊部门遇到的所有手部伤害中,54%发生在工作场所,部分原因是食品和饮料操作员的职业伤害,仅在2021年就造成了16,197个工时的损失在新加坡以及南亚和东南亚的部分地区,甘蔗榨汁机很常见,这种机器通常由食品中心内的独资饮料摊位操作,更重要的是,它是造成工作场所事故的危险因素。我们强调甘蔗榨汁机相关的手部损伤的严重程度,已导致永久性残疾的3例代表性患者。我们还审查了此类技术的职业健康风险,以了解所涉及的促成因素以及如何预防这些因素。
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引用次数: 0
Poorer outcomes following COVID-19 infection for patients with depression: A cohort analysis in South Korea 韩国一项队列分析显示,抑郁症患者感染COVID-19后预后较差
4区 医学 Q2 Medicine Pub Date : 2023-08-30 DOI: 10.47102/annals-acadmedsg.202331
Su Kyoung Lee, Yohwan Lim, Seogsong Jeong, Hyun Wook Han
Introduction: It remains unknown whether patients with pre-existing depressive conditions are at high risk of severe COVID-19. Therefore, this study aims to investigate the association between patients with pre-existing depressive conditions and severe COVID-19. Method: This study is part of the Korea Disease Control and Prevention Agency-COVID19-National Health Insurance Service cohort study of an ongoing large-scale health screening survey of adults 18 years and older residing in South Korea. Pre-existing depression status was measured from 552,860 patients who participated in a biennial health screening from 2019 to 2020. Finally, 29,106 confirmed COVID-19 patients were enrolled and followed up to track any severe clinical events within 1 month of their diagnosis date. Adjusted odds ratio (AOR) and 95% confidence interval (CI) were calculated using multivariate-adjusted logistic regression analysis. Results: We identified 2868 COVID-19 patients with severe clinical events and 26,238 COVID-19 patients without severe clinical events. The moderate-to-severe depressive symptoms group showed an elevated odds of severe outcomes of COVID-19 (AOR, 1.46; 95% CI, 1.25–1.72), including those without vaccination (AOR, 1.32; 95% CI, 1.08–1.61) and those with complete vaccination (AOR, 1.76; 95% CI, 1.18–2.63). In addition, those who were diagnosed with depression along with depressive symptoms at the health screening revealed an increased risk of severe outcomes of COVID-19 (AOR, 2.22; 95% CI, 1.22–4.05). Conclusion: Moderate-to-severe depressive symptoms were associated with higher odds of severe COVID-19 events in both no and complete vaccination groups. Participants with depressive symptoms may be at higher risk of severe outcomes of COVID-19.
目前尚不清楚已有抑郁症的患者是否存在严重COVID-19的高风险。因此,本研究旨在探讨已存在抑郁症患者与严重COVID-19之间的关系。方法:本研究是韩国疾病预防控制院- covid - 19国民健康保险服务队列研究的一部分,该队列研究正在对居住在韩国的18岁及以上成年人进行大规模健康筛查调查。从2019年至2020年参加两年一次的健康筛查的552,860名患者中测量了已有的抑郁症状况。最后,研究人员招募了29106名确诊的COVID-19患者,并对其进行了随访,以跟踪其诊断日期后1个月内的任何严重临床事件。采用多变量调整logistic回归分析计算校正优势比(AOR)和95%置信区间(CI)。结果:共发现2868例有严重临床事件的新冠肺炎患者,26238例无严重临床事件的新冠肺炎患者。中重度抑郁症状组出现COVID-19严重结局的几率升高(AOR, 1.46;95% CI, 1.25-1.72),包括未接种疫苗的患者(AOR, 1.32;95% CI, 1.08-1.61)和完全接种疫苗(AOR, 1.76;95% ci, 1.18-2.63)。此外,那些在健康筛查中被诊断患有抑郁症和抑郁症状的人显示出COVID-19严重后果的风险增加(AOR, 2.22;95% ci, 1.22-4.05)。结论:在未接种疫苗组和完全接种疫苗组中,中度至重度抑郁症状与严重COVID-19事件的发生率较高相关。有抑郁症状的参与者患COVID-19严重后果的风险可能更高。
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引用次数: 0
Consensus statement on Singapore integrated 24-hour activity guide for early childhood 新加坡幼儿24小时综合活动指南共识声明
IF 5.2 4区 医学 Q2 Medicine Pub Date : 2023-06-27 DOI: 10.47102/10.47102/annals-acadmedsg.2022315
Benny Kai Guo Loo, D. Sirisena, F. Müller-Riemenschneider, M. Chia, Benedict Tan, N. Tan, O. Teoh, Ethel Jie Kai Lim, Mohammad Ashik Zainuddin, Joanne Shumin Gao, P. C. Chan, T. Tan, Nirmal Kavalloor Visruthan, V. Rajadurai, Moira Chia, Nur Adila Ahmad Hatib, S. Cai, J. Ong, J. Lo, M. Chong, Le Ye Lee, E. Chew, Ratnaporn Siriamornsarp, Miriam Lee, Aaron Sim, Chui Mae Wong, S. Sherwood, S. H. Toh, P. L. Quah, K. Ng, K. Tan, Y. Lee
Introduction: Early childhood is a critical period for growth and development. Adopting healthy lifestyle behaviours during this period forms the foundation for future well-being and offers the best protection against non-communicable diseases. Singapore studies have shown that many young children are not achieving the recommendations on physical activity, sedentary behaviour and sleep. A workgroup was set up to develop recommendations for caregivers of infants, toddlers and preschoolers (aged <7 years) on how to integrate beneficial activities within a daily 24-hour period for optimal development and metabolic health.
幼儿期是生长发育的关键时期。在此期间采取健康的生活方式行为是未来福祉的基础,并提供预防非传染性疾病的最佳保护。新加坡的研究表明,许多幼儿在体育活动、久坐行为和睡眠方面没有达到建议的水平。成立了一个工作组,为婴儿、学步儿童和学龄前儿童(7岁以下)的照顾者制定建议,说明如何在每天24小时内整合有益的活动,以实现最佳发育和代谢健康。
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引用次数: 0
Consensus statement on Singapore integrated 24-hour activity guide for early childhood 新加坡幼儿24小时综合活动指南共识声明
4区 医学 Q2 Medicine Pub Date : 2023-06-27 DOI: 10.47102/annals-acadmedsg.2022315
Benny Kai Guo Loo, Dinesh Sirisena, Falk Müller-Riemenschneider, Michael Yong Hwa Chia, Benedict Tan, Ngiap Chuan Tan, Oon Hoe Teoh, Ethel Jie Kai Lim, Mohammad Ashik Zainuddin, Joanne Shumin Gao, Poh Chong Chan, Teresa Shu Zhen Tan, Nirmal Kavalloor Visruthan, Victor Samuel Rajadurai, Moira Suyin Chia, Nur Adila Binte Ahmad Hatib, Shirong Cai, Ju Lynn Ong, June Chi Yan Lo, Mary Foong-Fong Chong, Le Ye Lee, Elaine Chu Shan Chew, Ratnaporn Siriamornsarp, Miriam Lee, Aaron Sim, Chui Mae Wong, Shelly-Anne Sherwood, Siao Hui Toh, Phaik Ling Quah, Kee Chong Ng, Kok Hian Tan, Yung Seng Lee
Introduction: Early childhood is a critical period for growth and development. Adopting healthy lifestyle behaviours during this period forms the foundation for future well-being and offers the best protection against non-communicable diseases. Singapore studies have shown that many young children are not achieving the recommendations on physical activity, sedentary behaviour and sleep. A workgroup was set up to develop recommendations for caregivers of infants, toddlers and preschoolers (aged <7 years) on how to integrate beneficial activities within a daily 24-hour period for optimal development and metabolic health. Method: The Grading of Recommendations Assessment, Development and Evaluation (GRADE)-ADOLOPMENT approach was employed for adoption, adaption or de novo development of recommendations. International and national guidelines were used as references, and an update of the literature reviews up to September 2021 was conducted through an electronic search of PubMed, Embase and Cochrane Central Register of Controlled Trials (CENTRAL) databases. Results: Four consensus statements were developed for each age group: infants, toddlers and preschoolers. The statements focus on achieving good metabolic health through regular physical activity, limiting sedentary behaviour, achieving adequate sleep and positive eating habits. The 13th consensus statement recognises that integration of these activities within a 24-hour period can help obtain the best results. Conclusion: This set of recommendations guides and encourages caregivers of Singapore infants, toddlers and preschoolers to adopt beneficial lifestyle activities within each 24-hour period.
幼儿期是生长发育的关键时期。在此期间采取健康的生活方式行为是未来福祉的基础,并提供预防非传染性疾病的最佳保护。新加坡的研究表明,许多幼儿在体育活动、久坐行为和睡眠方面没有达到建议的水平。成立了一个工作组,为婴儿、学步儿童和学龄前儿童(7岁)的照料者制定建议,说明如何在每天24小时内整合有益的活动,以实现最佳发育和代谢健康。方法:采用建议分级评估、发展和评价(GRADE)-采用方法对建议进行采纳、调整或重新制定。使用国际和国家指南作为参考,并通过PubMed、Embase和Cochrane中央对照试验注册(Central)数据库的电子检索对截至2021年9月的文献综述进行了更新。结果:四个共识声明发展为每个年龄组:婴儿,幼儿和学龄前儿童。这些声明的重点是通过定期的体育活动、限制久坐行为、获得充足的睡眠和积极的饮食习惯来实现良好的代谢健康。第13项共识声明承认,在24小时内整合这些活动有助于取得最佳结果。结论:这套建议指导和鼓励新加坡婴幼儿和学龄前儿童的照顾者在每24小时内采取有益的生活方式活动。
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引用次数: 0
Re-examining the roles of generalists and specialists in healthcare. 重新审视多面手和专家在医疗保健中的作用
IF 5.2 4区 医学 Q2 Medicine Pub Date : 2023-03-30 DOI: 10.47102/annals-acadmedsg.2022434
Priyanka Khatri, Ashna Nastar, Gim Gee Teng, Jason Phua

Increasing workload and case complexity of a multimorbid ageing population have catalysed primary care transformation for general practitioners to meet these challenges. There is also a need to re-examine the role of hospital specialists as overly disease-centric, hospital-based specialist care is no longer sustainable. A new specialist-generalist model can maximise the potential of generalists and specialists to provide person-centred care, increase cost-effectiveness, improve appropriateness of referrals, decrease length of hospital stay and lower mortality.

多发病老龄化人口的工作量和案件复杂性不断增加,促进了全科医生应对这些挑战的初级保健转型。还需要重新审视医院专家的作用,因为过度以疾病为中心、以医院为基础的专家护理不再可持续。一种新的专家-多面手模式可以最大限度地发挥多面手和专家的潜力,提供以人为本的护理,提高成本效益,提高转诊的适当性,缩短住院时间,降低死亡率。关键词:全科医生、医疗模式、医疗成本、综合护理、专家
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引用次数: 0
Approach to bradyarrhythmias: A proposed algorithm. 慢性心律失常的治疗方法:一种建议的算法。
IF 5.2 4区 医学 Q2 Medicine Pub Date : 2023-02-01 DOI: 10.47102/annals-acadmedsg.2022411
T. Yeo, F. Q. Goh, Y. N. Teo, C. Sia
Bradyarrhythmias are commonly encountered in clinical practice. While there are several electrocardiographic criteria and algorithms for tachyarrhythmias, there is no algorithm for bradyarrhythmias to the best of our knowledge. In this article, we propose a diagnostic algorithm that uses simple concepts: (1) the presence or absence of P waves, (2) the relationship between the number of P waves and QRS complexes, and (3) the regularity of time intervals (PP, PR and RR intervals). We believe this straightforward, stepwise method provides a structured and thorough approach to the wide differential diagnosis of bradyarrhythmias, and in doing so, reduces misdiagnosis and mismanagement.
心律失常在临床实践中很常见。虽然快速性心律失常有几种心电图标准和算法,但据我们所知,还没有缓慢性心律失常的算法。在本文中,我们提出了一种诊断算法,该算法使用了简单的概念:(1)P波的存在与否,(2)P波数量与QRS波群之间的关系,以及(3)时间间隔(PP、PR和RR间隔)的规律性。我们相信,这种简单、逐步的方法为缓慢性心律失常的广泛鉴别诊断提供了一种结构化和彻底的方法,并在这样做的过程中减少了误诊和管理不善。
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引用次数: 0
Through the eyes into the brain, using artificial intelligence. 通过眼睛进入大脑,使用人工智能。
IF 5.2 4区 医学 Q2 Medicine Pub Date : 2023-02-01 DOI: 10.47102/annals-acadmedsg.2022369
K. Sathianvichitr, Oriana Lamoureux, S. Nakada, Z. Tang, L. Schmetterer, Christopher L H Chen, C. Cheung, R. Najjar, D. Milea
INTRODUCTIONDetection of neurological conditions is of high importance in the current context of increasingly ageing populations. Imaging of the retina and the optic nerve head represents a unique opportunity to detect brain diseases, but requires specific human expertise. We review the current outcomes of artificial intelligence (AI) methods applied to retinal imaging for the detection of neurological and neuro-ophthalmic conditions.METHODCurrent and emerging concepts related to the detection of neurological conditions, using AI-based investigations of the retina in patients with brain disease were examined and summarised.RESULTSPapilloedema due to intracranial hypertension can be accurately identified with deep learning on standard retinal imaging at a human expert level. Emerging studies suggest that patients with Alzheimer's disease can be discriminated from cognitively normal individuals, using AI applied to retinal images.CONCLUSIONRecent AI-based systems dedicated to scalable retinal imaging have opened new perspectives for the detection of brain conditions directly or indirectly affecting retinal structures. However, further validation and implementation studies are required to better understand their potential value in clinical practice.
引言在当前人口日益老龄化的背景下,检测神经系统状况具有重要意义。视网膜和视神经头的成像是检测脑部疾病的独特机会,但需要特定的人类专业知识。我们综述了人工智能(AI)方法应用于视网膜成像检测神经和神经眼科疾病的最新结果。方法利用基于人工智能的脑部疾病患者视网膜研究,对当前和新兴的与神经系统疾病检测相关的概念进行了检查和总结。结果颅内高压引起的乳头水肿可以在人类专家水平上通过标准视网膜成像的深度学习准确识别。新兴的研究表明,通过将人工智能应用于视网膜图像,可以将阿尔茨海默病患者与认知正常的人区分开来。结论最近致力于可扩展视网膜成像的基于人工智能的系统为检测直接或间接影响视网膜结构的大脑状况开辟了新的视角。然而,还需要进一步的验证和实施研究,以更好地了解其在临床实践中的潜在价值。
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引用次数: 0
Safety and effectiveness of nitrous oxide procedural sedation in a paediatric emergency department. 儿科急诊科一氧化二氮程序性镇静的安全性和有效性。
IF 5.2 4区 医学 Q2 Medicine Pub Date : 2023-02-01
Si Qi Tan, Lai Peng Tham
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引用次数: 0
The role of PIVKA-II in hepatocellular carcinoma surveillance in an Asian population. PIVKA-II在亚洲人群肝细胞癌监测中的作用。
IF 5.2 4区 医学 Q2 Medicine Pub Date : 2023-02-01 DOI: 10.47102/annals-acadmedsg.2022351
W. Ng, Daniel Yan Zheng Lim, Silvian Tan, J. Chang, T. Krishnamoorthy, C. Lim, D. Tan, V. Ekstrom, G. Goh, M. Cheah, Rajneesh Kumar, C. Yeo, Chee‐Kiat Tan
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引用次数: 0
Reducing non-clinical working hours of junior doctors could benefit patient outcomes. 减少初级医生的非临床工作时间可能有利于患者的预后。
IF 5.2 4区 医学 Q2 Medicine Pub Date : 2023-02-01 DOI: 10.47102/annals-acadmedsg.2022234
J. Tung, Jia Long Chua, Z.M. Aribou, G. Sng
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引用次数: 0
期刊
Annals Academy of Medicine Singapore
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