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Mpox clade I outbreak: how should Asia prepare and respond? Mpox I支链疫情爆发:亚洲应如何准备和应对?
Pub Date : 2024-09-01 Epub Date: 2024-09-06 DOI: 10.4103/singaporemedj.SMJ-2024-186
Poh Lian Lim, Wilnard Yeong Tze Tan, Shawn Vasoo
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引用次数: 0
A multivariate analysis on characteristics of hand and wrist tumours: a multiethnic study. 手部和腕部肿瘤特征的多变量分析:一项多种族研究。
Pub Date : 2024-08-22 DOI: 10.4103/singaporemedj.SMJ-2023-001
Pamela Qin Yi Chong, Muntasir Mannan Choudhury, Sze Ryn Chung, Robert Tze Jin Yap, Dawn Sinn Yi Chia, Jackson Kian Hong Jiang, Andrew Yuan Hui Chin, Duncan Angus McGrouther

Introduction: Hand tumours are frequently encountered in clinical practice. However, large-scale epidemiological data of soft tissue tumours in the hand are infrequently published. Epidemiological data provide diagnostic cues to guide the workup and management of hand tumours. Assessing significant independent demographic factors and tumour characteristics associated with hand tumours is essential in health care.

Methods: A retrospective review of patients who underwent excision of hand tumours in Singapore General Hospital between 2004 and 2015 was conducted. The data collected included age, gender, ethnicity, histological diagnosis, malignancy and location of tumour. Generalised linear latent and mixed models (GLLAMM) analyses were performed.

Results: A total of 4476 tumours were identified from 4226 patients with a mean age of 51.3 (range 8-101) years and male to female ratio of 1 to 1.15. Most patients were Chinese (75%), followed by Malay (9%), Indian (8%) and others (8%). The most common hand tumours excised were ganglions (43%) (majority in the wrist), followed by giant cell tumours (9%) (commonly in the digits). Most soft tissue tumours were benign (97%), with only 3% of malignant cases. The GLLAMM analyses revealed further potential factors on the status of malignancy, tumour origin and tumour location.

Conclusion: Most soft tissue tumours in the hand and wrist are benign. This can guide workup and counselling of patients before the operation. While malignant tumours are uncommon, they have the potential for significant morbidity and mortality if not appropriately evaluated or treated. The application of GLLAMM analyses showed that age, ethnicity and gender were significant predictors of malignancy.

简介手部肿瘤是临床上经常遇到的疾病。然而,有关手部软组织肿瘤的大规模流行病学数据却很少公布。流行病学数据可提供诊断线索,指导手部肿瘤的检查和治疗。评估与手部肿瘤相关的重要独立人口学因素和肿瘤特征对医疗保健至关重要:方法:对2004年至2015年间在新加坡中央医院接受手部肿瘤切除术的患者进行了回顾性研究。收集的数据包括年龄、性别、种族、组织学诊断、恶性程度和肿瘤位置。对这些数据进行了广义线性潜在混合模型(GLLAMM)分析:共从 4226 名患者中识别出 4476 个肿瘤,平均年龄为 51.3 岁(8-101 岁不等),男女比例为 1:1.15。大多数患者为华人(75%),其次是马来人(9%)、印度人(8%)和其他人(8%)。最常见的手部肿瘤是神经节瘤(43%)(多数位于手腕),其次是巨细胞瘤(9%)(常见于手指)。大多数软组织肿瘤是良性的(97%),只有 3% 是恶性的。GLLAMM分析进一步揭示了恶性程度、肿瘤来源和肿瘤位置的潜在因素:结论:大多数手部和腕部软组织肿瘤都是良性的。结论:大多数手部和腕部软组织肿瘤都是良性的,这可以为患者手术前的检查和咨询提供指导。虽然恶性肿瘤并不常见,但如果不进行适当的评估或治疗,有可能会导致严重的发病率和死亡率。应用 GLLAMM 分析表明,年龄、种族和性别是恶性肿瘤的重要预测因素。
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引用次数: 0
Scapular dyskinesia with focal impingement of the hypertrophied serratus anterior muscle in a competitive swimmer. 一名竞技游泳运动员因肥大的前锯肌局灶性撞击而出现肩胛运动障碍。
Pub Date : 2024-08-03 DOI: 10.4103/singaporemedj.SMJ-2024-011
Kay Yi Low, Le Roy Chong, Hui Yin Lim, Ivy Lim, Aik Khien Victor Tan
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引用次数: 0
Clinics in diagnostic imaging (220). 影像诊断诊所(220)。
Pub Date : 2024-08-01 Epub Date: 2024-08-10 DOI: 10.4103/singaporemedj.SMJ-2022-171
Aric Lee, Yi-Xiu Chua
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引用次数: 0
Poststroke shoulder pain. 中风后肩部疼痛
Pub Date : 2024-08-01 Epub Date: 2024-08-10 DOI: 10.4103/singaporemedj.SMJ-2021-360
Pei Ling Tan, Tze Chao Wee, Ang Tee Lim
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引用次数: 0
Development of a needs-based digital portal to support maternal and child health in Singapore. 开发基于需求的数字门户网站,为新加坡的母婴健康提供支持。
Pub Date : 2024-07-19 DOI: 10.4103/singaporemedj.SMJ-2022-029
Usha Chandraseharan, Priyanka Rajendram, Vasuki Utravathy, Vijaya Karuppiah, Shyamala Thilagaratnam
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引用次数: 0
Deploying artificial intelligence in the detection of adult appendicular and pelvic fractures in the Singapore emergency department after hours: efficacy, cost savings and non-monetary benefits. 在新加坡急诊科下班后采用人工智能检测成人阑尾和骨盆骨折:疗效、成本节约和非货币收益。
Pub Date : 2024-07-19 DOI: 10.4103/singaporemedj.SMJ-2023-170
John Jian Xian Quek, Oliver James Nickalls, Bak Siew Steven Wong, Min On Tan

Introduction: Radiology plays an integral role in fracture detection in the emergency department (ED). After hours, when there are fewer reporting radiologists, most radiographs are interpreted by ED physicians. A minority of these interpretations may miss diagnoses, which later require the callback of patients for further management. Artificial intelligence (AI) has been viewed as a potential solution to augment the shortage of radiologists after hours. We explored the efficacy of an AI solution in the detection of appendicular and pelvic fractures for adult radiographs performed after hours at a general hospital ED in Singapore, and estimated the potential monetary and non-monetary benefits.

Methods: One hundred and fifty anonymised abnormal radiographs were retrospectively collected and fed through an AI fracture detection solution. The radiographs were re-read by two radiologist reviewers and their consensus was established as the reference standard. Cases were stratified based on the concordance between the AI solution and the reviewers' findings. Discordant cases were further analysed based on the nature of the discrepancy into overcall and undercall subgroups. Statistical analysis was performed to evaluate the accuracy, sensitivity and inter-rater reliability of the AI solution.

Results: Ninety-two examinations were included in the final study radiograph set. The AI solution had a sensitivity of 98.9%, an accuracy of 85.9% and an almost perfect agreement with the reference standard.

Conclusion: An AI fracture detection solution has similar sensitivity to human radiologists in the detection of fractures on ED appendicular and pelvic radiographs. Its implementation offers significant potential measurable cost, manpower and time savings.

导言:放射科在急诊科(ED)的骨折检测中发挥着不可或缺的作用。下班后,由于放射科报告医生较少,大多数放射照片都由急诊科医生判读。这些判读中的少数可能会漏诊,从而需要回访患者以进一步处理。人工智能(AI)被认为是解决下班后放射科医生短缺问题的潜在方法。我们探讨了人工智能解决方案在新加坡一家综合医院急诊室下班后对成人放射照片进行阑尾和骨盆骨折检测的功效,并估算了潜在的货币和非货币收益:方法:回顾性收集了 150 张匿名的异常 X 光片,并将其输入人工智能骨折检测解决方案。由两名放射科医生审查员重新读片,并将他们的共识作为参考标准。根据人工智能解决方案与审片专家结论的一致性对病例进行分层。根据差异的性质,将不一致的病例进一步分析为高估和低估亚组。进行统计分析以评估人工智能解决方案的准确性、灵敏度和评审员之间的可靠性:最终的研究放射照片集包括 92 张检查照片。人工智能解决方案的灵敏度为 98.9%,准确度为 85.9%,与参考标准几乎完全一致:人工智能骨折检测解决方案在 ED 阑尾和骨盆 X 光片上检测骨折的灵敏度与人类放射医师相似。该方案的实施可节省大量可衡量的潜在成本、人力和时间。
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引用次数: 0
Pregnancy and perinatal outcomes of women with SARS-CoV-2 infection during pregnancy. 妊娠期感染 SARS-CoV-2 的妇女的妊娠和围产期结局。
Pub Date : 2024-07-19 DOI: 10.4103/singaporemedj.SMJ-2023-083
Choi Wah Kong, William Wing Kee To

Introduction: This study aimed to compare the pregnancy and perinatal outcomes of women with and without severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy.

Methods: Women who delivered in an obstetric unit from March 2022 to October 2022 were recruited. The history of vaccination and SARS-CoV-2 infection during pregnancy was recorded. The pregnancy and perinatal outcomes of women with and without SARS-CoV-2 infection were compared.

Results: A total of 1015 women were recruited - 41.5% had SARS-CoV-2 infection during pregnancy and 25.2% were unvaccinated. The incidences of preeclampsia, gestational diabetes mellitus and caesarean section were similar between the two groups. There were more preterm deliveries (9.0% vs 5.1%, P = 0.01) and more late preterm deliveries of between 33 and 36 + 6 weeks (6.2% vs. 3.7%, P = 0.03) in the SARS-CoV-2 infection group. There were no statistically significant differences between the two groups in perinatal outcomes, including birthweight, incidence of small for gestational age, low Apgar scores, and neonatal intensive care or special care baby unit admissions. There were no differences in pregnancy and perinatal outcomes between women infected in the first/second trimester and those infected in the third trimester, except for lower mean birthweight (3180 g vs. 3292 g, P = 0.04). There were no major differences in pregnancy outcome between vaccinated and unvaccinated women.

Conclusion: The pregnancy and perinatal outcomes of women who were infected with SARS-CoV-2 during gestation appear favourable.

引言本研究旨在比较孕期感染和未感染严重急性呼吸系统综合征冠状病毒2(SARS-CoV-2)的妇女的妊娠和围产期结局:招募了 2022 年 3 月至 2022 年 10 月期间在产科分娩的妇女。记录孕期疫苗接种史和 SARS-CoV-2 感染史。比较感染和未感染 SARS-CoV-2 的妇女的妊娠和围产期结果:共招募了 1015 名妇女,其中 41.5% 在怀孕期间感染了 SARS-CoV-2,25.2% 未接种疫苗。两组孕妇子痫前期、妊娠糖尿病和剖腹产的发生率相似。SARS-CoV-2 感染组的早产率更高(9.0% 对 5.1%,P = 0.01),33 至 36 + 6 周的晚期早产率更高(6.2% 对 3.7%,P = 0.03)。在围产期结果方面,包括出生体重、胎龄小发生率、低Apgar评分、新生儿重症监护室或特殊护理婴儿室入院率,两组之间没有统计学意义上的差异。除了平均出生体重较低(3180 克对 3292 克,P = 0.04)外,第一/第二孕期感染的妇女与第三孕期感染的妇女在妊娠和围产期结果方面没有差异。接种疫苗和未接种疫苗的妇女在妊娠结局方面没有重大差异:结论:在妊娠期间感染了 SARS-CoV-2 的妇女的妊娠和围产期结局似乎是好的。
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引用次数: 0
Trends in electrocardiographic and cardiovascular manifestations of patients hospitalised with COVID-19. COVID-19 住院患者的心电图和心血管表现趋势。
Pub Date : 2024-07-19 DOI: 10.4103/singaporemedj.SMJ-2023-179
Jinghao Nicholas Ngiam, Tze Sian Liong, Matthew Chung Yi Koh, Wilson Goh, Meng Ying Sim, Srishti Chhabra, Nicholas Wen Sheng Chew, Jayagowtham Krishan Annadurai, Sandi Myo Thant, Ping Chai, Tiong-Cheng Yeo, Kian Keong Poh, Paul Anantharajah Tambyah, Ching-Hui Sia

Introduction: Early in the coronavirus disease 2019 (COVID-19) pandemic, a low incidence of cardiovascular complications was reported in Singapore. Little was known about the trend of cardiovascular complications as the pandemic progressed. In this study, we examined the evolving trends in electrocardiographic and cardiovascular manifestations in patients hospitalised with COVID-19.

Methods: We examined the first 1781 consecutive hospitalised patients with polymerase chain reaction-confirmed COVID-19. We divided the population based on whether they had abnormal heart rate (HR) or electrocardiography (ECG) or normal HR and ECG, comparing the baseline characteristics and outcomes. Cardiovascular complications were defined as acute myocardial infarction, stroke, pulmonary embolism, myocarditis and mortality.

Results: The 253 (14.2%) patients who had abnormal HR/ECG at presentation were more likely to be symptomatic. Sinus tachycardia was commonly observed. Troponin I levels (97.0 ± 482.9 vs. 19.7 ± 68.4 ng/L, P = 0.047) and C-reactive protein levels (20.1 ± 50.7 vs. 13.9 ± 24.1 μmol/L, P = 0.003) were significantly higher among those with abnormal HR/ECGs, with a higher prevalence of myocarditis (2.0% vs. 0.5%, P = 0.019), pulmonary embolism (2.0% vs. 0.3%, P = 0.008) and acute myocardial infarction (1.2% vs. 0.1%, P = 0.023). After adjusting for age and comorbidities, abnormal HR/ECG (adjusted odds ratio 4.41, 95% confidence interval 2.21-8.77; P < 0.001) remained independently associated with adverse cardiovascular complications. Over time, there was a trend towards a higher proportion of hospitalised patients with cardiovascular complications.

Conclusion: Cardiovascular complications appear to be increasing in proportion over time among hospitalised patients with COVID-19. A baseline ECG and HR measurement may be helpful for predicting these complications.

导言:2019 年冠状病毒病(COVID-19)大流行初期,新加坡报告的心血管并发症发病率较低。随着疫情的发展,人们对心血管并发症的趋势知之甚少。在这项研究中,我们研究了 COVID-19 住院患者心电图和心血管表现的演变趋势:我们对经聚合酶链反应确诊为 COVID-19 的首批 1781 名连续住院患者进行了研究。我们根据患者的心率(HR)或心电图(ECG)是否异常或心率和心电图是否正常对患者进行了分类,并对基线特征和结果进行了比较。心血管并发症定义为急性心肌梗死、中风、肺栓塞、心肌炎和死亡率:发病时心率/心电图异常的 253 名患者(14.2%)更有可能出现症状。窦性心动过速很常见。肌钙蛋白 I 水平(97.0 ± 482.9 vs. 19.7 ± 68.4 ng/L,P = 0.047)和 C 反应蛋白水平(20.1 ± 50.7 vs. 13.9 ± 24.1 μmol/L,P = 0.003),心肌炎(2.0% vs. 0.5%,P = 0.019)、肺栓塞(2.0% vs. 0.3%,P = 0.008)和急性心肌梗死(1.2% vs. 0.1%,P = 0.023)的发病率更高。对年龄和合并症进行调整后,HR/ECG 异常(调整后的几率比为 4.41,95% 置信区间为 2.21-8.77;P<0.001)仍与不良心血管并发症密切相关。随着时间的推移,心血管并发症住院患者的比例呈上升趋势:结论:随着时间的推移,COVID-19住院患者中出现心血管并发症的比例似乎在增加。基线心电图和心率测量可能有助于预测这些并发症。
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引用次数: 0
Barriers to postpartum diabetes mellitus screening among mothers with a recent history of gestational diabetes mellitus: a cross-sectional study. 近期有妊娠糖尿病史的母亲进行产后糖尿病筛查的障碍:一项横断面研究。
Pub Date : 2024-07-15 DOI: 10.4103/singaporemedj.SMJ-2023-136
Yen Siong Andrew Tan, Li Ping Marianne Tsang, Seen Hang Smily Lock, Kayshini Vijakumar, Xin Yi Cassandra Ho, Ai Choo Seah, Pei Pei Gong, Yi Ling Eileen Koh, Ngiap Chuan Tan
{"title":"Barriers to postpartum diabetes mellitus screening among mothers with a recent history of gestational diabetes mellitus: a cross-sectional study.","authors":"Yen Siong Andrew Tan, Li Ping Marianne Tsang, Seen Hang Smily Lock, Kayshini Vijakumar, Xin Yi Cassandra Ho, Ai Choo Seah, Pei Pei Gong, Yi Ling Eileen Koh, Ngiap Chuan Tan","doi":"10.4103/singaporemedj.SMJ-2023-136","DOIUrl":"10.4103/singaporemedj.SMJ-2023-136","url":null,"abstract":"","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617894","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
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Singapore medical journal
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