Ann Acad Med Singap
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Ann Acad Med Singap · Mar 2005
ReviewMesenchymal stem cells in musculoskeletal tissue engineering: a review of recent advances in National University of Singapore.
A key factor in the tissue engineering approach to tissue repair and regeneration is the use of appropriate cells. Mesenchymal stem cells (MSCs) are derived from bone marrow stroma or connective tissues and they have the potential to differentiate into various mesenchymal cell lines in vitro and in vivo. ⋯ This review is based mainly on the work which has been done in the National University of Singapore on the use of MSCs for engineering cartilage, growth plate, bone and tendon/ligament as well as the clinical trail of autologous chondrocyte implantation. It can help to shape future research on musculoskeletal tissue engineering.
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Ann Acad Med Singap · Mar 2005
Incidence, risk factors of retinopathy of prematurity among very low birth weight infants in Singapore.
To determine the incidence, risk factors and need for surgery for retinopathy of prematurity (ROP) among very-low-birth-weight (VLBW) infants. ⋯ The incidence of ROP among VLBW infants was 29.2%. ROP was strongly associated with smaller, more immature and sicker infants. The median age of onset of ROP was 35 weeks (range, 31 to 40 weeks) postmenstrual age. Infants <30 weeks of GA and/or infant with BW <1000 g are at considerable risk for threshold ROP. The main risk factors for development of threshold ROP by regression analysis are maternal preeclampsia, birth weight, and presence of pulmonary haemorrhage, duration of ventilation and continuous positive pressure ventilation. We suggest that both immaturity and compromised pulmonary function are both important aetiological factors in the development of ROP. Prevention of prematurity, control of preeclampsia, judicious use of ventilation and oxygen therapy are the only promising factors that may reduce the incidence and severity of ROP in this high-risk infant.
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Ann Acad Med Singap · Mar 2005
The relationship between postoperative complications and outcomes after hip fracture surgery.
We studied the prevalence of postoperative complications in a series of consecutive patients who received surgery for hip fractures in a major public hospital in Singapore. We also studied the predictors for the occurrence of complications and the impact of these complications on patient outcomes. ⋯ Postoperative complications are common after surgery for hip fractures and result in significantly longer hospitalisation periods. Significant predictors for such complications include being of female gender and pre-fracture mobility. Age, in itself, does not result in a higher risk of complications and should not preclude older hip fracture patients from surgical management.
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Ann Acad Med Singap · Jan 2005
ReviewInfectious respiratory illnesses and their impact on healthcare workers: a review.
Respiratory illnesses are increasingly recognised as a growing concern for healthcare workers (HCWs) and patients. The recent hospital-based outbreak of Severe Acute Respiratory Syndrome (SARS) has once again highlighted the vulnerability of HCWs. The new epidemic of the 21st century resulted in tremendous economic and psychological impact with its high rates of mortality and nosocomial transmission. ⋯ We need to be better armed to deal with future potential outbreaks and biohazardous situations. The importance of safeguarding the health of our medical staff and the community cannot be over-emphasised. In this paper, we review the incidence, transmission and various preventive strategies of respiratory illnesses in HCWs, in particular, new diagnostic tools, infection control management strategies, personal protective equipments, vaccination programmes and post-exposure prophylaxis.
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Patients want doctors who are competent, respectful, honest and able to communicate with them. This is patient-centred professionalism. In the United Kingdom, it is being embedded into practice by the General Medical Council (GMC) through medical regulation in a partnership between the public and doctors. ⋯ The results of these annual appraisals will be submitted to the GMC for a revalidation decision every 5 years. Where doctors' performance or conduct gives cause for concern, they may have to undergo a further searching assessment under the GMC's Fitness to Practise Procedures. Under these procedures the GMC can order a doctor to retrain or, if circumstances warrant it, to stop practising.