Ann Acad Med Singap
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Ann Acad Med Singap · Mar 2004
Randomized Controlled Trial Clinical TrialImpact of a pharmacist consult clinic on a hospital-based geriatric outpatient clinic in Singapore.
We study the impact of a pharmacist consult clinic on the care of elderly outpatients based on the Health Belief Model that the perceived benefits (improvement in medication knowledge, clinical status and perception) and attached barriers (cost and number of medication and adverse drug reactions) can influence health behaviour (medication compliance). ⋯ The addition of a pharmacist consult clinic to the management of selected geriatric outpatients can improve compliance, with the attendant benefits of improving medication knowledge, cost avoidance and reducing residual adverse drug reactions.
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Ann Acad Med Singap · Mar 2004
Septic arthritis after arthroscopic anterior cruciate ligament reconstruction.
A retrospective review of postoperative infected anterior cruciate ligament (ACL) reconstruction was done on 472 consecutive cases in one institution. The purpose was to assess the incidence, diagnosis, treatment and outcome factors. ⋯ Four patients had acute infection (<2 weeks), 3 had subacute infection (2 weeks to 2 months) and none had late infection (>2 months). All were admitted within 24 hours of onset of symptoms and underwent immediate arthroscopic lavage, incision and drainage of abscess, debridement with graft retention and intravenous (8 to 31 days) followed by oral (4 to 6 weeks) antibiotics. Staphylococcus aureus was present in 4 patients, Peptostreptococcus in 3, Klebsiella in 1, and Enterobacter in 1. The patients underwent an average of 1.4 arthroscopic procedures (range, 1 to 3 procedures), with an average hospital stay of 17.3 days per patient. All were evaluated at an average of 11.7 months (range, 5 to 26 months). In all cases, the infection resolved with stable knees and with all grafts and implants retained. Although rare, early diagnosis and prompt treatment of infection can result in successful eradication without sacrificing the graft.