Singapore medical journal最新文献_第5页

Paediatric one-day admission: why and is it necessary? 儿科一日入院：为什么需要？

IF 1.7 4区医学

Singapore medical journal Pub Date : 2025-01-01 Epub Date: 2023-02-15 DOI: 10.4103/singaporemedj.SMJ-2021-117

Jing Zhan Lock, Zi Xean Khoo, Jen Heng Pek

{"title":"Paediatric one-day admission: why and is it necessary?","authors":"Jing Zhan Lock, Zi Xean Khoo, Jen Heng Pek","doi":"10.4103/singaporemedj.SMJ-2021-117","DOIUrl":"10.4103/singaporemedj.SMJ-2021-117","url":null,"abstract":"Introduction: Paediatric patients admitted to the inpatient units from the emergency department (ED) are increasing, but the mean length of stay has fallen significantly. We aimed to determine the reasons behind paediatric one-day admissions in Singapore and to assess their necessity.Methods: A retrospective study involving paediatric patients who were admitted from a general ED of an adult tertiary hospital to a paediatric tertiary hospital between 1 August 2018 and 30 April 2020. One-day admission was defined as an inpatient stay of less than 24 h from the time of admission to discharge. An unnecessary admission was defined as one with no diagnostic test ordered, intravenous medication administered, therapeutic procedure performed or specialty review made in the inpatient unit. Data were captured in a standardised form and analysed.Results: There were 13,944 paediatric attendances - 1,160 (8.3%) paediatric patients were admitted. Among these, 481 (41.4%) were one-day admissions. Upper respiratory tract infection (62, 12.9%), gastroenteritis (60, 12.5%) and head injury (52, 10.8%) were the three most common conditions. The three most common reasons for ED admissions were inpatient treatment (203, 42.2%), inpatient monitoring (185, 38.5%) and inpatient diagnostic investigations (32, 12.3%). Ninety-six (20.0%) one-day admissions were unnecessary.Conclusion: Paediatric one-day admissions present an opportunity to develop and implement interventions targeted at the healthcare system, the ED, the paediatric patient and their caregiver, in order to safely slow down and perhaps reverse the trend of increased hospital admissions.","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"15-19"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9363620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Gastrointestinal transit time of radiopaque ingested foreign bodies in children: experience of two paediatric tertiary centres. 儿童摄入不透射线的异物的胃肠道传递时间：两个儿科三级中心的经验。

IF 1.7 4区医学

Singapore medical journal Pub Date : 2025-01-01 Epub Date: 2023-04-25 DOI: 10.4103/singaporemedj.SMJ-2021-408

Chen Xiang Ang, Win Kai Mun, Marion Margaret Aw, Diana Lin, Shu-Ling Chong, Lin Yin Ong, Shireen Anne Nah

{"title":"Gastrointestinal transit time of radiopaque ingested foreign bodies in children: experience of two paediatric tertiary centres.","authors":"Chen Xiang Ang, Win Kai Mun, Marion Margaret Aw, Diana Lin, Shu-Ling Chong, Lin Yin Ong, Shireen Anne Nah","doi":"10.4103/singaporemedj.SMJ-2021-408","DOIUrl":"10.4103/singaporemedj.SMJ-2021-408","url":null,"abstract":"Introduction: Foreign body (FB) ingestion is a common paediatric emergency. While guidelines exist for urgent intervention, less is known of the natural progress of FBs passing through the gastrointestinal tract (GIT). We reviewed these FB transit times in an outpatient cohort.Methods: A retrospective review was performed on all children (≤18 years) treated for radiopaque FB ingestion at two major tertiary paediatric centres from 2015 to 2016. Demographic data, FB types, outcomes and hospital visits (emergency department [ED] and outpatient) were recorded. All cases discharged from the ED with outpatient follow-up were included. We excluded those who were not given follow-up appointments and those admitted to inpatient wards. We categorised the outcomes into confirmed passage (ascertained via abdominal X-ray or reported direct stool visualisation by patients/caregivers) and assumed passage (if patients did not attend follow-up appointments).Results: Of the 2,122 ED visits for FB ingestion, 350 patients who were given outpatient follow-up appointments were reviewed (median age 4.35 years [range: 0.5-14.7], 196 [56%] male). The largest proportion (16%) was aged 1-2 years. Coins were the most common ingested FB, followed by toys. High-risk FB (magnets or batteries) formed 9% of cases ( n =33). The 50 th centile for FB retention was 8, 4 and 7 days for coins, batteries and other radiopaque FBs, respectively; all confirmed passages occurred at 37, 7 and 23 days, respectively. Overall, 197 (68%) patients defaulted on their last given follow-up.Conclusion: This study provides insight into the transit times of FB ingested by children, which helps medical professionals to decide on the optimal time for follow-up visits and provide appropriate counsel to caregivers.","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"24-27"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9439943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Use of metallic ureteric stents for chronic ureteric obstruction and its association with value-based care. 使用金属输尿管支架治疗慢性输尿管梗阻及其与价值导向型护理的关系。

IF 1.7 4区医学

Singapore medical journal Pub Date : 2025-01-01 Epub Date: 2023-02-01 DOI: 10.4103/singaporemedj.SMJ-2021-418

Yu Xi Terence Law, Ang Zhou, David Terrence Consigliere, Benjamin Yen Seow Goh, Ho Yee Tiong

{"title":"Use of metallic ureteric stents for chronic ureteric obstruction and its association with value-based care.","authors":"Yu Xi Terence Law, Ang Zhou, David Terrence Consigliere, Benjamin Yen Seow Goh, Ho Yee Tiong","doi":"10.4103/singaporemedj.SMJ-2021-418","DOIUrl":"10.4103/singaporemedj.SMJ-2021-418","url":null,"abstract":"Introduction: We aimed to compare the real-world data and our clinical experience with metallic stents (MSs) and conventional polymeric stents (PSs) in the management of both malignant and benign chronic ureteric obstruction (CUO), in terms of clinical outcomes and costs.Methods: Clinical data from our institution, including outcomes for all ureteric stents inserted for long-term management of CUO from all causes from 2014 to 2017, were retrospectively reviewed and compared between the MS and PS episodes.Results: A total of 247 stents were placed in 63 patients with CUO over the 4-year study period. Of these, 45 stents were MSs. There was no significant difference in all baseline characteristics between the MS and PS groups, except for the aetiology of obstructive cause. Mean indwelling stent duration was significantly greater for MS than for PS (228.6 ± 147.0 vs. 146.1 ± 66.0 days, P < 0.001), thereby leading to lower average number of stent changes per year in the MS group compared to the PS group (1.4 vs. 6.3 times, respectively). Despite the higher unit cost of MS compared to PS, there was no significant mean cost difference overall (cost per dwelling day SGD 7.82 ± SGD 10.44 vs. SGD 8.23 ± SGD 20.50, P = 0.888).Conclusion: Resonance MS is a better option than PS to manage CUO from malignant and benign causes because its significantly longer indwelling time mitigates the higher unit cost of the stent. It potentially reduces the number of procedures and operations in patients. Thus, it should be considered for all patients with CUO requiring long-term ureteric drainage.","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"28-32"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9237884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical predictors of acute kidney injury in children with acute post-streptococcal glomerulonephritis: a tertiary centre experience. 链球菌感染后急性肾小球肾炎患儿急性肾损伤的临床预测因素：一家三级中心的经验。

IF 1.7 4区医学

Singapore medical journal Pub Date : 2025-01-01 Epub Date: 2023-01-06 DOI: 10.4103/singaporemedj.SMJ-2021-092

Wan Adlina Wan Yusof, Najib Majdi Yaacob, Ariffin Nasir, Surini Yusoff, Mohamad Ikram Ilias

引用次数: 0

Efficacy and safety of echinocandins versus triazoles or amphotericin B in the treatment of invasive fungal infections in paediatric patients: a systematic review. 棘白菌素与三唑或两性霉素B治疗儿科患者侵袭性真菌感染的疗效和安全性：一项系统综述。

IF 1.7 4区医学

Singapore medical journal Pub Date : 2025-01-01 Epub Date: 2023-08-23 DOI: 10.4103/singaporemedj.SMJ-2021-173

Lu Lu Htet, Lay Nee Wang, Yi Xin Liew

引用次数: 0

Does the COVID-19 XBB Omicron subvariant signal the beginning of the end of the pandemic? COVID-19 XBB Omicron 子变体是否预示着大流行开始结束？

IF 1.7 4区医学

Singapore medical journal Pub Date : 2024-12-01 Epub Date: 2022-12-01 DOI: 10.4103/singaporemedj.SMJ-2022-180

Jinghao Nicholas Ngiam, Abdurrahmaan Al-Mubaarak, Sebastian Maurer-Stroh, Paul Anantharajah Tambyah

引用次数: 0

Localised swelling at sites of dermal filler injections following administration of Covid-19 vaccines: a systematic review. 注射Covid-19疫苗后皮肤填充物部位局部肿胀：一项系统综述

IF 1.7 4区医学

Singapore medical journal Pub Date : 2024-12-01 Epub Date: 2023-04-13 DOI: 10.4103/singaporemedj.SMJ-2021-157

Chew Lip Ng, Evelyn Yuxin Tay, Alwyn Ray D'Souza

{"title":"Localised swelling at sites of dermal filler injections following administration of Covid-19 vaccines: a systematic review.","authors":"Chew Lip Ng, Evelyn Yuxin Tay, Alwyn Ray D'Souza","doi":"10.4103/singaporemedj.SMJ-2021-157","DOIUrl":"10.4103/singaporemedj.SMJ-2021-157","url":null,"abstract":"Introduction: Localised swelling at sites of filler injections has been reported in the Moderna mRNA-1273 coronavirus disease 2019 (COVID-19) vaccine trial.Methods: We conducted a review of the existing data and literature on the potential pathophysiology for this adverse event and its potential management.Results: Data from the Moderna and Pfizer COVID-19 vaccine Phase 3 trial and one case series were available. Three out of 30,400 subjects developed possible filler reaction in the Moderna trial. Two other cases were reported after emergency use authorisation. Reactions occurred at a mean of 1.4 days post-vaccination. Fillers were injected at a mean of 14.1 months before vaccination. Areas involved included lips, infraorbital areas and tear troughs. Treatment included observation, corticosteroids, antihistamine, hyaluronidase and 5-fluorouracil.Conclusion: Rare, self-limiting adverse reactions to dermal fillers have been reported following COVID-19 vaccination. Clinicians should be aware of this clinical phenomenon and its management, as vaccination is carried out globally.","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"665-668"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11698283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9383468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pityriasis alba secondary to prolonged use of face mask. 因长期使用面膜而继发的白癣。

IF 1.7 4区医学

Singapore medical journal Pub Date : 2024-12-01 Epub Date: 2023-01-06 DOI: 10.4103/singaporemedj.SMJ-2021-005

Gabriel Hong Zhe Wong, Mark Jean Aan Koh

引用次数: 0

COVID-19 vaccination strategy in Singapore: perspectives and lessons from primary care. 新加坡COVID-19疫苗接种战略：初级保健的观点和经验教训。

IF 1.7 4区医学

Singapore medical journal Pub Date : 2024-12-01 Epub Date: 2023-03-02 DOI: 10.4103/singaporemedj.SMJ-2021-405

Sky Wei Chee Koh, Victor Loh, Yiyang Liow, Choon Kit Leong, Doris Young

引用次数: 0

Dermatophytosis in Singapore children. 新加坡儿童的皮肤癣菌病。

IF 1.7 4区医学

Singapore medical journal Pub Date : 2024-12-01 Epub Date: 2023-01-06 DOI: 10.4103/singaporemedj.SMJ-2020-279

Celine Shuen Yin Yoong, Chrystie Wan Ning Quek, Yee Wah Foong, Mark Jean Aan Koh

引用次数: 0