Ann Acad Med Singap
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Ann Acad Med Singap · Jan 2003
Immediate and mid-term safety and efficacy of single lead VDD pacemakers for patients with atrioventricular block and normal sinus node function--a single centre experience.
Single lead atrial synchronous ventricular pacing (VDD) is increasingly being used in place of conventional dual chamber pacing (DDD) for patients with atrioventricular block and preserved sinus node function. Compared to the latter, VDD pacemakers provide similar haemodynamic benefits derived from atrial synchronous pacing, with the added benefit of an easier implant procedure. ⋯ In patients with atrioventricular block and preserved sinus node function, single lead VDD pacing is safe and effective in maintaining a physiological atrial synchronous pacing mode.
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Feeling effective as a young person depends on a capacity to draw upon one's own resources in the service of healthy living and development. In adolescent health care, there is the need to call upon the talents and creativity of young people, to introduce new and exciting experiences, and to facilitate involvement in their own care in order to nurture optimal growth and development on a physical and psychological level. While hospitalisation can represent a major crisis point in adolescence, the provision of a stimulating environment and the opportunity for creative activities offers an exciting, transformative and healing experience. ⋯ In a project called Art Injection, art students worked with adolescents to make sculptures from old hospital equipment, with startling results. More recently, the development of personal totem poles and an imaginative mosaic mural has powerfully engaged creativity and community in care. Group and individual art sessions, including the media arts project Creative Well, are offered on weekdays as part of the general hospital routine, enabling hospitalised young people to experience creativity as a daily part of their lives.
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Hypercalcaemia is a relatively common clinical problem with a wide spectrum of presentations. This review provides an overview of the diagnosis and management of hypercalcaemia, and recent developments in drug therapy. ⋯ The therapeutic approach to hypercalcaemia should be tailored to the clinical setting. Developments in the understanding of the pathophysiological processes and the increasing availability of more powerful therapeutic options would help in achieving good outcomes in the management of acute and chronic hypercalcaemia.