Ann Acad Med Singap
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Ann Acad Med Singap · May 2003
Case ReportsBoerhaave's syndrome presenting as a right-sided pleural effusion.
Boerhaave's syndrome is an uncommon condition where there is oesophageal rupture following forceful vomiting, subsequent mediastinitis and is associated with high mortality and morbidity in the absence of therapy. We present a case of Boerhaave's syndrome in a 79-year-old woman who developed a right-sided effusion, an unusual presentation. ⋯ Physicians should have a high index of suspicion of oesophageal rupture when patients present with Meckler's triad of symptoms and especially when pleural fluid cultures grow bacteria native to the gastrointestinal tract.
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Ann Acad Med Singap · May 2003
Editorial Historical ArticleSevere acute respiratory syndrome (SARS)--150 days on.
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The incidence of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) in children has risen steadily over the years and has become an increasing cause of morbidity and mortality during childhood. More than 90% of all children with HIV infection acquired their infection at birth from HIV-infected mothers. With increasing evidence of heterosexual HIV transmission, the number of infected women and consequently their children is increasing. ⋯ There are at least 7 million people living with HIV/AIDS in the Asia-Pacific region. The numbers of HIV-infected women and children are increasing at an alarming rate. Over 1 million children are HIV-infected; in the year 2000 alone, 600,000 children acquired HIV infection.
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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.