Ann Acad Med Singap
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Ann Acad Med Singap · May 2014
ReviewThe golden hours in paediatric septic shock-current updates and recommendations.
Paediatric sepsis is a global health problem. It is the leading cause of mortality in infants and children worldwide. Appropriate and timely initial management in the first hours, often termed as the "golden hours", has great impact on survival. The aim of this paper is to summarise the current literature and updates on the initial management of paediatric sepsis. ⋯ The use of early goal-directed therapy has had significant impact on patient outcomes and protocolised resuscitation of children in septic shock is recommended.
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Ann Acad Med Singap · May 2014
Use of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of granulomatous mediastinal lymphadenopathy.
This study assessed the clinical utility of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for the diagnosis of suspected granulomatous mediastinal lymphadenopathy. ⋯ EBUS-TBNA can be useful in the diagnosis of suspected granulomatous mediastinal lymphadenopathy with sensitivities and accuracies of >60%.
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Ann Acad Med Singap · May 2014
ReviewAnticoagulation needs in asians with atrial fibrillation: a mythbuster.
Atrial fibrillation (AF) has long been known to increase the risk of stroke. As a result, relevant international guidelines recommend that measures to reduce the risk of thrombus formation should be considered in all patients presenting with AF. ⋯ Evidence from the Global Anticoagulant Registry in the Field (GARFIELD) registry shows that major deviation from guidelines is due in large part to physicians' decision-making. In this brief narrative review, we address some of the frequent reasons cited by physicians why the guidelines are disregarded for Asian patients.