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
ReviewStrategies to promote better outcomes in young people with chronic illnesses.
This paper aims to provide an overview of chronic illness and disability in young people, focusing on the developmental needs of young people and the impact of chronic illness on adolescence. The emotional well-being of the young person with chronic illness is explored and strategies that promote better health outcomes for the young person through health, family and school settings are discussed. ⋯ Young people with chronic illness have the same developmental needs as other adolescents. Traditional health care is focused on disease outcomes; however, young people do not necessarily share the same focus. Improving health outcomes for young people involves health professionals having an understanding of adolescent development and broadening the medical perspective to incorporate the developmental perspective. Building competence in young people with chronic illness, strengthening connectedness within the family, school and peer group and building the capacity of the health care team in different settings will provide opportunities to enhance resilience in young people with chronic illness. In doing so, their health outcomes will hopefully also be improved.
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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.