Singapore medical journal最新文献_第7页

Gradually, then suddenly: Singapore’s journey towards sustainable medicine 渐进，然后突然：新加坡迈向可持续发展医学之路

Singapore medical journal Pub Date : 2024-04-01 DOI: 10.4103/singaporemedj.smj-2024-061

Nick Watts, Alston Zhao Yi Ng, Amanda Zain

引用次数: 1

Clinical challenges in the management of hepatic sarcoidosis. 肝肉瘤病治疗中的临床挑战。

Singapore medical journal Pub Date : 2024-04-01 DOI: 10.4103/singaporemedj.SMJ-2022-067

Ram Prasad Sinnanaidu, T. Jayaraman, R. Rajaram, Zhiqin Wong, S. Mahadeva

引用次数: 0

Approach to nocturnal enuresis in children 治疗儿童夜尿症的方法

Singapore medical journal Pub Date : 2024-04-01 DOI: 10.4103/singaporemedj.smj-2021-273

Li Ming Ong, Joel Meng Fai Chan, Gabrielle Eloise Ming Yen Koh, Pamela E-Wei Gopal, E. H. Leow, Yong Hong Ng

引用次数: 0

Healthcare in the era of climate change and the need for environmental sustainability. 气候变化时代的医疗保健和环境可持续性需求。

Singapore medical journal Pub Date : 2024-04-01 DOI: 10.4103/singaporemedj.SMJ-2024-035

Nicholas Chin Hock Tee, Jo-Anne Yeo, Mahesh Choolani, K. Poh, T. Ang

引用次数: 1

Advanced care planning among persons living with haemodialysis: a qualitative study. 血液透析患者的晚期护理规划：一项定性研究。

Singapore medical journal Pub Date : 2024-04-01 DOI: 10.4103/singaporemedj.SMJ-2021-463

Radha Maniam, Maw Pin Tan, Mei Chan Chong, Pathmawathi Subramanian

引用次数: 0

Going green in Singapore: insights and challenges in working towards achieving net zero in anaesthesia 新加坡的绿色行动：努力实现麻醉零净值的启示与挑战

Singapore medical journal Pub Date : 2024-04-01 DOI: 10.4103/singaporemedj.smj-2023-256

Danella Yaoxin Foo, Pei Kee Poh, Eugene H. Liu, Andrea Yap

引用次数: 1

Preventing perioperative hypothermia in children through implementation of customised guidelines. 通过实施定制指南预防儿童围手术期体温过低。

Singapore medical journal Pub Date : 2024-03-13 DOI: 10.4103/singaporemedj.SMJ-2023-021

Shu Ying Lee, Rehena Sultana, John Carson Allen, Choon Looi Bong

{"title":"Preventing perioperative hypothermia in children through implementation of customised guidelines.","authors":"Shu Ying Lee, Rehena Sultana, John Carson Allen, Choon Looi Bong","doi":"10.4103/singaporemedj.SMJ-2023-021","DOIUrl":"10.4103/singaporemedj.SMJ-2023-021","url":null,"abstract":"Introduction: Perioperative hypothermia (PH) is common in children and associated with adverse clinical outcomes. Guidelines to prevent PH are mainly developed for adults and differ among institutions. We aimed to evaluate the effectiveness of customised guidelines in reducing PH in our paediatric population and the impact of cost considerations on physician practice.Methods: Patients aged ≤16 years undergoing general anaesthesia in our tertiary paediatric hospital were prospectively recruited in this cohort study. Patient demographics, surgical procedures, anaesthesia details and temperature control measures were recorded. Data collection occurred over four phases: Phases 1 and 2 comprised standard management, while Phases 3 and 4 occurred following guidelines implementation. Sensors for continuous core temperature monitoring were provided free to patients during Phases 1 and 3, but were charged during Phases 2 and 4. The main outcome was occurrence of PH, defined as core temperature <36°C at any point from induction of anaesthesia to discharge from the postanaesthetic care unit. The impact of guidelines implementation and cost considerations influencing physician practice on PH outcomes was also analysed.Results: Data from 3917 patients was analysed (1766 in Phase 1, 679 in Phase 2, 706 in Phase 3 and 766 in Phase 4). Guidelines implementation decreased PH incidence from 11.0% to 6.79% (odds ratio [OR] 0.63, 95% confidence interval [CI] 0.50-0.80, P = 0.0002). Free sensors increased the odds of detecting PH (OR 1.48, 95% CI 1.17-1.88, P = 0.001). With guidelines implementation, there was greater reduction in PH with free sensors (OR 0.64, 95% CI 0.47-0.88, P = 0.0055) compared to chargeable sensors (OR 0.75, 95% CI 0.50-1.11, P = 0.1471).Conclusions: Customised guidelines facilitated a sustained reduction of hypothermia in our paediatric surgical patients, although its impact was reduced by cost considerations.","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140121769","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

Association of postpartum depression with child growth and developmental outcomes: a community-based study. 产后抑郁与儿童生长发育结果的关系：一项基于社区的研究。

Singapore medical journal Pub Date : 2024-03-13 DOI: 10.4103/singaporemedj.SMJ-2023-107

Moira Suyin Chia, Nur Adila Binte Ahmad Hatib, Elaine Chu Shan Chew, Shu-Ling Chong, Rehena Sultana, Ade Xin Ning Tan, Xiaoxuan Guo, David Chee Chin Ng, Padmini Sita Yeleswarapu, Pratibha Keshav Agarwal, Helen Yu Chen, Yoke Hwee Chan

引用次数: 0

Disaster medicine in Singapore: past, present, future. 新加坡的灾难医学：过去、现在和未来。

Singapore medical journal Pub Date : 2024-03-13 DOI: 10.4103/singaporemedj.SMJ-2023-019

Li Juan Joy Quah, Jen Heng Pek, Lenard Cheng, Chan Yu Lee, David Kuan Peng Teng, Mathew Yi Wen Yeo, Venkataraman Anantharaman

引用次数: 0

Diagnostic threshold and performance of anion gap in screening for high anion gap metabolic acidosis. 阴离子间隙在筛查高阴离子间隙代谢性酸中毒中的诊断阈值和性能。

Singapore medical journal Pub Date : 2024-03-13 DOI: 10.4103/singaporemedj.SMJ-2023-009

Chang Yin Chionh, Carolyn Shan-Yeu Tien, Wenxiang Yeon

{"title":"Diagnostic threshold and performance of anion gap in screening for high anion gap metabolic acidosis.","authors":"Chang Yin Chionh, Carolyn Shan-Yeu Tien, Wenxiang Yeon","doi":"10.4103/singaporemedj.SMJ-2023-009","DOIUrl":"https://doi.org/10.4103/singaporemedj.SMJ-2023-009","url":null,"abstract":"Introduction: The anion gap (AG) is commonly used to screen for acid-base disorders. It was proposed that the cut-off for high anion gap metabolic acidosis (HAGMA) may be lower with current laboratory techniques, although modern laboratory equipment are still calibrated to familiar reference ranges established with earlier techniques. The appropriate cut-off for HAGMA is unclear. This study aimed to assess the performance of AG as a screening test for HAGMA and to determine the optimal diagnostic threshold of AG for HAGMA.Methods: This was a retrospective analysis of a large, anonymised dataset extracted by computerised protocol from 2017 to 2019. All inpatients with blood samples taken for organic acids (lactate, ketone or salicylate) paired with a metabolic panel were included. The target condition was HAGMA secondary to elevated blood lactate, ketone and/or salicylate. Sensitivity for HAGMA was explored at various AG cut-off levels.Results: Of 16,475 patients, 2,621 had organic acidosis. Median age was 65 years, and median estimated glomerular filtration rate was 70 mL/min/1.73 m2. With organic acidosis, the median AG was 23 (interquartile range [IQR] 20-29) mEq/L, while without organic acidosis, the median AG was 16 (IQR 14-19) mEq/L. The area under the curve-receiver operating characteristic of AG for HAGMA was 0.873. Desired sensitivity for HAGMA was set at ≥95%, and this was found with an AG threshold of ≥15 mEq/L (sensitivity 98.1%, specificity 34.0%).Conclusion: The recommended AG threshold value is ≥15 mEq/L with a high sensitivity for HAGMA. The AG should always be interpreted with the clinical context, and it should be repeated as the clinical picture evolves.","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140121766","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