Singapore medical journal最新文献_第5页

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。

Singapore medical journal 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

{"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":"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.","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。

Singapore medical journal Pub Date : 2024-09-01 Epub Date: 2024-09-06 DOI: 10.4103/singaporemedj.SMJ-2021-382

Amanda Loke, Lee Gan Goh, Rajeev Ramachandran

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。

Singapore medical journal Pub Date : 2024-09-01 Epub Date: 2024-09-06 DOI: 10.4103/singaporemedj.SMJ-2023-212

Weiling Lim, Tunn Ren Tay

引用次数: 0

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？

Singapore medical journal 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

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。

Singapore medical journal 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

{"title":"A multivariate analysis on characteristics of hand and wrist tumours: a multiethnic study.","authors":"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","doi":"10.4103/singaporemedj.SMJ-2023-001","DOIUrl":"https://doi.org/10.4103/singaporemedj.SMJ-2023-001","url":null,"abstract":"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.","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142038159","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

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。

Singapore medical journal 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

引用次数: 0

Clinics in diagnostic imaging (220). 影像诊断诊所（220）。

Singapore medical journal Pub Date : 2024-08-01 Epub Date: 2024-08-10 DOI: 10.4103/singaporemedj.SMJ-2022-171

Aric Lee, Yi-Xiu Chua

引用次数: 0

Poststroke shoulder pain. 中风后肩部疼痛

Singapore medical journal 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

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。

Singapore medical journal Pub Date : 2024-07-19 DOI: 10.4103/singaporemedj.SMJ-2022-029

Usha Chandraseharan, Priyanka Rajendram, Vasuki Utravathy, Vijaya Karuppiah, Shyamala Thilagaratnam

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。

Singapore medical journal 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

{"title":"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.","authors":"John Jian Xian Quek, Oliver James Nickalls, Bak Siew Steven Wong, Min On Tan","doi":"10.4103/singaporemedj.SMJ-2023-170","DOIUrl":"https://doi.org/10.4103/singaporemedj.SMJ-2023-170","url":null,"abstract":"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.","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141728464","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