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Comparison of two different preload targets of stroke volume variation during kidney transplantation: a randomised controlled trial. 肾移植过程中两种不同前负荷目标下每搏容量变化的比较:随机对照试验。
Pub Date : 2024-09-13 DOI: 10.4103/singaporemedj.SMJ-2023-150
Seong-Mi Yang, Seung Eun Song, Ji-Yoon Jung, Jae-Woo Ju, Jin Young Sohn, Ho-Jin Lee, Won Ho Kim

Introduction: Maintaining adequate preload during kidney transplantation (KT) is important for graft function. We evaluated whether a high or low normal target for a dynamic preload index of stroke volume variation (SVV) would impact graft function during living donor KT.

Methods: We compared haemodynamic management algorithms using two different targets of SVV: SVV6% group (n = 30) versus SVV12% group (n = 30). Crystalloids were administered to achieve SVV less than the assigned target. Neutrophil gelatinase-associated lipocalin (NGAL) level at the end of surgery was compared. We also compared the incidence of delayed graft function (DGF), daily serum creatinine level and glomerular filtration rate (GFR) until 2 weeks postoperatively.

Results: The total amount of crystalloids administered was significantly different between the SVV6% and SVV12% groups (median [interquartile range] 2,250 [1,700-3,600] vs. 1,350 [1,050-1,900], P < 0.001). There was no significant difference in NGAL level at the end of the operation between the SVV6% and SVV12% groups (395 [234-560] vs. 518 [346-654], P = 0.115). The incidence of DGF was not significantly different, and there was no significant difference in the postoperative serum creatinine levels or GFR between the groups.

Conclusions: Our randomised trial demonstrated that an SVV target of either 6% or 12% could be adequate as a preload management target for postoperative graft function during living donor KT. However, given the low incidence of DGF in living donor KT and type II error, our study should be interpreted carefully and further studies for deceased donor KT are required.

导言:肾移植(KT)期间保持足够的前负荷对移植物功能非常重要。我们评估了搏出量变化(SVV)这一动态前负荷指标的正常目标值过高或过低是否会影响活体肾移植过程中的移植物功能:我们比较了使用两种不同 SVV 目标的血流动力学管理算法:SVV6% 组(n = 30)和 SVV12% 组(n = 30)。使用晶体液使 SVV 小于指定目标。比较了手术结束时中性粒细胞明胶酶相关脂质体(NGAL)的水平。我们还比较了移植功能延迟(DGF)的发生率、每日血清肌酐水平以及术后两周前的肾小球滤过率(GFR):结果:SVV6%组和SVV12%组的晶体液总用量有显著差异(中位数[四分位距]2,250 [1,700-3,600] vs. 1,350 [1,050-1,900], P <0.001)。手术结束时,SVV6% 组和 SVV12% 组的 NGAL 水平无明显差异(395 [234-560] vs. 518 [346-654],P = 0.115)。DGF的发生率无明显差异,术后血清肌酐水平或GFR在两组间也无明显差异:我们的随机试验表明,6%或12%的SVV目标可以作为活体供体KT术后移植物功能的前负荷管理目标。然而,鉴于活体供体 KT 的 DGF 发生率较低且存在 II 型误差,因此应谨慎解释我们的研究,并需要对死亡供体 KT 进行进一步研究。
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引用次数: 0
Usage of patient portals among primary healthcare professionals: a cross-sectional study. 基层医疗保健专业人员使用患者门户网站的情况:一项横断面研究。
Pub Date : 2024-09-10 DOI: 10.4103/singaporemedj.SMJ-2023-088
Yingxian Natalie Ong, Yi Ling Eileen Koh, Ngiap Chuan Tan
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引用次数: 0
Characteristics and outcomes of reversible platypnoea-orthodeoxia syndrome in COVID-19 pneumonia. COVID-19 肺炎可逆性胸闷-缺氧综合征的特征和预后。
Pub Date : 2024-09-10 DOI: 10.4103/singaporemedj.SMJ-2023-281
Shuen-Loong Tham, Audrey Jia Yi Lee, Koh Kuan Cheryl Tan, Alfred Wai Ping Seng

Introduction: Platypnoea-orthodeoxia syndrome (POS) is an uncommon clinical entity characterised by dyspnoea and platypnoea (oxygen desaturation that follows the assumption of an upright position from recumbency). Since the coronavirus disease 2019 (COVID-19) outbreak, increasing reports of COVID-19-related POS and its associated morbidity have been reported around the world. We aimed to study the characteristics of COVID-19-related POS and orthodeoxia (including associations leading to a more prolonged orthodeoxia), and the postdischarge functional outcomes of patients with COVID-19-related POS.

Methods: An observational cohort study was conducted in a tertiary hospital that managed post-COVID-19 patients. Twenty-four participants with severe-to-critical COVID-19 disease/pneumonia and POS, who received inpatient pulmonary rehabilitation, were enrolled. Descriptive analysis of the data was performed to describe POS/orthodeoxia characteristics and functional outcomes in these participants. Correlation analyses were carried out to identify significant factors associated with a prolonged orthodeoxia.

Results: The mean duration of POS and orthodeoxia was 12.9 ± 8.3 days and 28.5 ± 14.6 days, respectively. All participants demonstrated resolution of POS and orthodeoxia by hospital discharge. On multivariable analysis, intensive care unit admission and maximal level of respiratory support were significantly associated with a prolonged duration of orthodeoxia. One participant was lost to follow-up. The remaining 23 participants achieved independence in self-care. With the exception of one patient, who was recovering from a hip fracture, the rest achieved independence in ambulation and independent community access.

Conclusion: Resolution of orthodeoxia was observed in all our participants with COVID-19-related POS. Good functional outcome can be attained with timely and effective rehabilitation interventions.

导言:呼吸困难-缺氧综合征(POS)是一种不常见的临床病症,其特征是呼吸困难和呼吸困难综合征(从腰部开始采取直立姿势后出现的血氧饱和度降低)。自 2019 年冠状病毒病(COVID-19)爆发以来,世界各地关于 COVID-19 相关 POS 及其相关发病率的报道越来越多。我们旨在研究COVID-19相关POS和正缺氧的特征(包括导致更长时间正缺氧的关联),以及COVID-19相关POS患者出院后的功能预后:在一家管理 COVID-19 后患者的三级医院开展了一项观察性队列研究。24名患有严重至危重COVID-19疾病/肺炎和POS的患者接受了住院肺康复治疗。对数据进行了描述性分析,以描述这些参与者的 POS/缺氧特征和功能结果。研究人员还进行了相关分析,以确定与长期正缺氧相关的重要因素:结果:POS 和正脱氧的平均持续时间分别为 12.9 ± 8.3 天和 28.5 ± 14.6 天。所有参与者在出院时均已解除 POS 和正位缺氧。经多变量分析,入住重症监护室和最大程度的呼吸支持与正侧位缺氧持续时间的延长显著相关。一名患者失去了随访机会。其余 23 名患者均实现了自理。除了一名从髋部骨折中恢复的患者外,其余患者都实现了独立行走和独立进入社区:结论:所有患有 COVID-19 相关 POS 的患者都能恢复正位。通过及时有效的康复干预,患者可以获得良好的功能康复效果。
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引用次数: 0
Role of cerebrospinal fluid adenosine deaminase measurement in the diagnosis of tuberculous meningitis: an updated systematic review and meta-analysis. 脑脊液腺苷脱氨酶测定在结核性脑膜炎诊断中的作用:最新系统综述和荟萃分析。
Pub Date : 2024-09-03 DOI: 10.4103/singaporemedj.SMJ-2023-155
Jinghao Nicholas Ngiam, Matthew Chung Yi Koh, Priscillia Lye, Tze Sian Liong, Lizhen Ong, Paul Anantharajah Tambyah, Jyoti Somani

Introduction: Tuberculous meningitis (TBM) can be difficult to diagnose. Elevated cerebrospinal fluid (CSF) adenosine deaminase (ADA) is often seen in TBM, but its reliability has been questioned. A previous meta-analysis in 2017 had demonstrated the diagnostic utility of CSF ADA in TBM versus non-TBM. We sought to update this meta-analysis with more recent studies, to determine whether CSF ADA could be used to aid in the early recognition of TBM.

Methods: Electronic searches were performed in PubMed and Scopus on studies published from 2016 to 2022. Ten additional studies were identified and added to 20 studies (from 2000 to 2016) from a previous meta-analysis. Meta-analysis was conducted using the random effects method, estimating the pooled diagnostic odds ratio (DOR) for elevated CSF ADA in the diagnosis of TBM.

Results: Of the 30 studies included, 16/30 (53.3%) used the Giusti method for measuring ADA. Fourteen (46.7%) studies used an ADA cut-off of 10 IU/L, and 11 (36.7%) studies used an even lower cut-off. The pooled DOR for elevated CSF ADA in the diagnosis of TBM was 45.40 (95% confidence interval [CI] 31.96-64.47, I2 = 44%). When only studies using the Giusti method were considered, DOR was 44.21 (95% CI 28.37-68.91, I2 = 40%). Among the studies that used a cut-off of 10 IU/L, DOR was 58.09 (95% CI 33.76-99.94, I2 = 41%).

Conclusion: Studies remain heterogeneous but demonstrate that CSF ADA can differentiate TBM from non-TBM. In line with most studies, CSF ADA >10 IU/L supports the diagnosis of TBM in a patient with compatible symptoms and high-risk epidemiology.

介绍:结核性脑膜炎(TBM)很难诊断。脑脊液(CSF)腺苷脱氨酶(ADA)升高经常见于TBM,但其可靠性一直受到质疑。之前在 2017 年进行的一项荟萃分析表明了 CSF ADA 在 TBM 与非 TBM 中的诊断效用。我们试图用更多的最新研究来更新这项荟萃分析,以确定 CSF ADA 是否可用于帮助早期识别 TBM:在 PubMed 和 Scopus 上对 2016 年至 2022 年发表的研究进行了电子检索。在之前的一项荟萃分析的20项研究(2000年至2016年)的基础上,又确定了10项研究。采用随机效应法进行荟萃分析,估算TBM诊断中CSF ADA升高的集合诊断几率比(DOR):在纳入的 30 项研究中,16/30(53.3%)采用朱斯蒂法测量 ADA。14项(46.7%)研究使用的 ADA 临界值为 10 IU/L,11 项(36.7%)研究使用的临界值更低。诊断 TBM 时 CSF ADA 升高的汇总 DOR 为 45.40(95% 置信区间 [CI] 31.96-64.47,I2 = 44%)。如果只考虑使用朱斯蒂方法的研究,DOR 为 44.21(95% 置信区间 28.37-68.91,I2 = 40%)。在使用 10 IU/L 临界值的研究中,DOR 为 58.09(95% CI 33.76-99.94,I2 = 41%):结论:研究结果仍不尽相同,但证明 CSF ADA 可以区分 TBM 和非 TBM。与大多数研究结果一致的是,CSF ADA >10 IU/L 可支持对症状符合且流行病学风险较高的患者进行 TBM 诊断。
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引用次数: 0
Population health research in Singapore: the experience of a research centre. 新加坡的人口健康研究:一个研究中心的经验。
Pub Date : 2024-09-03 DOI: 10.4103/singaporemedj.SMJ-2023-196
Eunice Huiying Tong, Lynn Yi-Ching Ho, Gladis Jing Lin, Chien Earn Lee, Lian Leng Low
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引用次数: 0
Myopericarditis following COVID-19 vaccination in children: a systematic review and meta-analysis. 儿童接种 COVID-19 疫苗后出现心肌炎:系统回顾和荟萃分析。
Pub Date : 2024-09-03 DOI: 10.4103/singaporemedj.SMJ-2023-081
Ashiley Annushri Thenpandiyan, Ryan Ruiyang Ling, Robert Grignani, Megan Ruien Ling, Arthena Anushka Thenpandiyan, Bee Choo Tai, Jyoti Somani, Kollengode Ramanathan, Swee Chye Quek

Introduction: Myopericarditis is a rare but serious coronavirus disease 2019 (COVID-19) vaccine-related adverse event primarily affecting adolescents. Given recent approvals for childhood vaccination, we performed a meta-analysis investigating myopericarditis following messenger ribonucleic acid COVID-19 vaccination in children aged <19 years, focusing on its overall risk and high-risk subgroups.

Methods: We searched MEDLINE via PubMed, Embase and Scopus from inception to 1 August 2022 for observational studies reporting myopericarditis in temporal relation to paediatric COVID-19 vaccination. We conducted random-effects meta-analyses (DerSimonian and Laird) on myopericarditis (primary outcome), myocarditis and pericarditis (secondary outcomes).

Results: Of 2115 studies, 12 (59,229,160 doses) studies were included in our analysis. There were 19.8 (95% confidence interval [CI]: 10.4-37.6) myopericarditis cases reported per million doses in children, compared to 23.7 (95% CI: 12.2-46.1) cases in adults (eight studies, 376,899,888 doses; P = 0.70). Compared to the second dose (34.4, 95% CI: 15.2-77.8), the number of cases post-first dose was significantly lower (9.1, 95% CI: 4.4-18.8; P = 0.017), while the number of cases post-third dose was not higher than that of post-second dose (28.4, 95% CI: 10.4-61.8; P = 0.57, global P = 0.031). Males were at higher risk of myopericarditis (67.4, 95% CI: 36.5-124.5) than females (6.9, 95% CI: 3.1-15.3; P < 0.0001). Finally, the number of cases was higher (overall P < 0.0001) among children aged ≥12 years (39.9, 95% CI: 24.1-66.0) than among children aged <12 years (3.0, 95% CI: 2.3-3.9).

Conclusion: Our meta-analysis showed 19.8 cases of myopericarditis per million doses among children, not significantly different from that of adults. Higher risk subgroups included adolescents, males, and those receiving their second dose of vaccination.

导言:心肌炎是一种罕见但严重的冠状病毒病 2019(COVID-19)疫苗相关不良事件,主要影响青少年。鉴于最近批准了儿童疫苗接种,我们对信使核糖核酸 COVID-19 疫苗接种后的心肌炎进行了荟萃分析:我们通过 PubMed、Embase 和 Scopus 在 MEDLINE 上检索了从开始到 2022 年 8 月 1 日期间报告与接种小儿 COVID-19 疫苗相关的心肌炎的观察性研究。我们对心肌炎(主要结果)、心肌炎和心包炎(次要结果)进行了随机效应荟萃分析(DerSimonian 和 Laird):在 2115 项研究中,有 12 项(59229160 剂)研究纳入了我们的分析。每百万剂量中,儿童心肌炎病例为 19.8 例(95% 置信区间 [CI]:10.4-37.6),而成人为 23.7 例(95% 置信区间 [CI]:12.2-46.1)(8 项研究,376,899,888 剂量;P = 0.70)。与第二次用药(34.4,95% CI:15.2-77.8)相比,第一次用药后的病例数显著降低(9.1,95% CI:4.4-18.8;P = 0.017),而第三次用药后的病例数并不比第二次用药后高(28.4,95% CI:10.4-61.8;P = 0.57,全局 P = 0.031)。男性患心肌炎的风险(67.4,95% CI:36.5-124.5)高于女性(6.9,95% CI:3.1-15.3;P < 0.0001)。最后,≥12 岁儿童的病例数(39.9 例,95% CI:24.1-66.0 例)高于结论年龄段的儿童(总体 P <0.0001):我们的荟萃分析显示,每百万剂量中有 19.8 例儿童患心肌炎,与成人无显著差异。风险较高的亚组包括青少年、男性和接种第二剂疫苗的儿童。
{"title":"Myopericarditis following COVID-19 vaccination in children: a systematic review and meta-analysis.","authors":"Ashiley Annushri Thenpandiyan, Ryan Ruiyang Ling, Robert Grignani, Megan Ruien Ling, Arthena Anushka Thenpandiyan, Bee Choo Tai, Jyoti Somani, Kollengode Ramanathan, Swee Chye Quek","doi":"10.4103/singaporemedj.SMJ-2023-081","DOIUrl":"https://doi.org/10.4103/singaporemedj.SMJ-2023-081","url":null,"abstract":"<p><strong>Introduction: </strong>Myopericarditis is a rare but serious coronavirus disease 2019 (COVID-19) vaccine-related adverse event primarily affecting adolescents. Given recent approvals for childhood vaccination, we performed a meta-analysis investigating myopericarditis following messenger ribonucleic acid COVID-19 vaccination in children aged <19 years, focusing on its overall risk and high-risk subgroups.</p><p><strong>Methods: </strong>We searched MEDLINE via PubMed, Embase and Scopus from inception to 1 August 2022 for observational studies reporting myopericarditis in temporal relation to paediatric COVID-19 vaccination. We conducted random-effects meta-analyses (DerSimonian and Laird) on myopericarditis (primary outcome), myocarditis and pericarditis (secondary outcomes).</p><p><strong>Results: </strong>Of 2115 studies, 12 (59,229,160 doses) studies were included in our analysis. There were 19.8 (95% confidence interval [CI]: 10.4-37.6) myopericarditis cases reported per million doses in children, compared to 23.7 (95% CI: 12.2-46.1) cases in adults (eight studies, 376,899,888 doses; P = 0.70). Compared to the second dose (34.4, 95% CI: 15.2-77.8), the number of cases post-first dose was significantly lower (9.1, 95% CI: 4.4-18.8; P = 0.017), while the number of cases post-third dose was not higher than that of post-second dose (28.4, 95% CI: 10.4-61.8; P = 0.57, global P = 0.031). Males were at higher risk of myopericarditis (67.4, 95% CI: 36.5-124.5) than females (6.9, 95% CI: 3.1-15.3; P < 0.0001). Finally, the number of cases was higher (overall P < 0.0001) among children aged ≥12 years (39.9, 95% CI: 24.1-66.0) than among children aged <12 years (3.0, 95% CI: 2.3-3.9).</p><p><strong>Conclusion: </strong>Our meta-analysis showed 19.8 cases of myopericarditis per million doses among children, not significantly different from that of adults. Higher risk subgroups included adolescents, males, and those receiving their second dose of vaccination.</p>","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of the accuracy of a single-lead adhesive electrocardiogram patch monitoring device (S-PATCH3-Cardio) in patients post-myocardial infarction: a pilot study. 评估心肌梗塞后患者使用单导联粘贴式心电图贴片监测设备(S-PATCH3-Cardio)的准确性:一项试点研究。
Pub Date : 2024-09-03 DOI: 10.4103/singaporemedj.SMJ-2022-119
Tony Yi Wei Li, Wai Chi Loh, Toon Wei Lim
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引用次数: 0
Association of intracranial large artery disease with long-term prognosis after ischaemic stroke. 颅内大动脉疾病与缺血性中风后长期预后的关系。
Pub Date : 2024-09-03 DOI: 10.4103/singaporemedj.SMJ-2023-063
Wan-Yun Sabrina Liu, Kaavya Narasimhalu, Fung Peng Woon, John Carson Allen, Deidre Anne De Silva

Introduction: Intracranial large artery disease (ICLAD) is a common cause of ischaemic stroke and is associated with the risk of recurrent vascular events in the short term. We compared the incidence of various long-term vascular outcomes between ischaemic stroke patients with and without ICLAD.

Methods: This was a longitudinal observational study of acute ischaemic stroke patients who were followed up serially for recurrent stroke, myocardial infarction or vascular death up to a median of 86 months. Transcranial colour-coded Doppler was used in the diagnosis of ICLAD.

Results: Among the 581 ischaemic stroke patients studied (median age 63 ± 11 years, male 71%), 354 (60.9%) had ICLAD. In regression analyses adjusting for covariates, patients with ICLAD were more likely to have long-term composite vascular outcomes (hazard ratio [HR] 1.44, 95% confidence interval [CI] 1.02-2.03, P = 0.041), myocardial infarction (HR 2.89, 95% CI 1.71-4.91, P < 0.001) and vascular death (HR 3.52, 95% CI 1.67-7.52, P = 0.001) but not recurrent stroke (HR 1.10, 95% CI 0.72-1.70, P = 0.652), at a median of 86 months as compared to patients without ICLAD.

Conclusion: Our findings of poor prognostic impact of ICLAD on long-term recurrent vascular events after ischaemic stroke provide evidence for the need of specific, emphasised screening and secondary prevention, especially for coronary artery disease in this high-risk group.

简介颅内大动脉疾病(ICLAD)是缺血性脑卒中的常见病因,与短期内复发血管事件的风险有关。我们比较了有和没有颅内大动脉疾病的缺血性脑卒中患者各种长期血管事件的发生率:这是一项对急性缺血性脑卒中患者进行的纵向观察研究,对患者的复发脑卒中、心肌梗死或血管性死亡进行连续随访,中位随访时间长达 86 个月。经颅彩色多普勒用于诊断 ICLAD:结果:在研究的 581 名缺血性中风患者(中位年龄为 63 ± 11 岁,男性占 71%)中,有 354 人(60.9%)患有 ICLAD。结果:在研究的 581 名缺血性中风患者中(中位年龄为 63 ± 11 岁,男性 71%),有 354 人(60.9%)患有 ICLAD。在调整协变量后进行的回归分析中,ICLAD 患者更有可能出现长期复合血管结局(危险比 [HR] 1.44,95% 置信区间 [CI] 1.02-2.03,P = 0.041)、心肌梗死(HR 2.89,95% CI 1.71-4.91,P <0.001)和血管性死亡(HR 3.52,95% CI 1.67-7.52,P =0.001),但中位卒中复发(HR 1.10,95% CI 0.72-1.70,P =0.652)不发生:我们的研究结果表明,ICLAD 对缺血性脑卒中后长期复发性血管事件的预后影响较差,这证明有必要对这一高风险人群进行专门、重点筛查和二级预防,尤其是冠状动脉疾病。
{"title":"Association of intracranial large artery disease with long-term prognosis after ischaemic stroke.","authors":"Wan-Yun Sabrina Liu, Kaavya Narasimhalu, Fung Peng Woon, John Carson Allen, Deidre Anne De Silva","doi":"10.4103/singaporemedj.SMJ-2023-063","DOIUrl":"https://doi.org/10.4103/singaporemedj.SMJ-2023-063","url":null,"abstract":"<p><strong>Introduction: </strong>Intracranial large artery disease (ICLAD) is a common cause of ischaemic stroke and is associated with the risk of recurrent vascular events in the short term. We compared the incidence of various long-term vascular outcomes between ischaemic stroke patients with and without ICLAD.</p><p><strong>Methods: </strong>This was a longitudinal observational study of acute ischaemic stroke patients who were followed up serially for recurrent stroke, myocardial infarction or vascular death up to a median of 86 months. Transcranial colour-coded Doppler was used in the diagnosis of ICLAD.</p><p><strong>Results: </strong>Among the 581 ischaemic stroke patients studied (median age 63 ± 11 years, male 71%), 354 (60.9%) had ICLAD. In regression analyses adjusting for covariates, patients with ICLAD were more likely to have long-term composite vascular outcomes (hazard ratio [HR] 1.44, 95% confidence interval [CI] 1.02-2.03, P = 0.041), myocardial infarction (HR 2.89, 95% CI 1.71-4.91, P < 0.001) and vascular death (HR 3.52, 95% CI 1.67-7.52, P = 0.001) but not recurrent stroke (HR 1.10, 95% CI 0.72-1.70, P = 0.652), at a median of 86 months as compared to patients without ICLAD.</p><p><strong>Conclusion: </strong>Our findings of poor prognostic impact of ICLAD on long-term recurrent vascular events after ischaemic stroke provide evidence for the need of specific, emphasised screening and secondary prevention, especially for coronary artery disease in this high-risk group.</p>","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Primary care management of allergic rhinitis in children. 儿童过敏性鼻炎的初级保健管理。
Pub Date : 2024-09-01 Epub Date: 2024-09-06 DOI: 10.4103/singaporemedj.SMJ-2021-382
Amanda Loke, Lee Gan Goh, Rajeev Ramachandran
{"title":"Primary care management of allergic rhinitis in children.","authors":"Amanda Loke, Lee Gan Goh, Rajeev Ramachandran","doi":"10.4103/singaporemedj.SMJ-2021-382","DOIUrl":"10.4103/singaporemedj.SMJ-2021-382","url":null,"abstract":"","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11479000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142142272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Approach to pulmonary embolism for frontline clinicians. 为一线临床医生提供的肺栓塞治疗方法。
Pub Date : 2024-09-01 Epub Date: 2024-09-06 DOI: 10.4103/singaporemedj.SMJ-2023-212
Weiling Lim, Tunn Ren Tay
{"title":"Approach to pulmonary embolism for frontline clinicians.","authors":"Weiling Lim, Tunn Ren Tay","doi":"10.4103/singaporemedj.SMJ-2023-212","DOIUrl":"10.4103/singaporemedj.SMJ-2023-212","url":null,"abstract":"","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11479001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142142270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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