Ann Acad Med Singap
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Ann Acad Med Singap · May 2001
Clinical TrialThe role of early tracheostomy in critically ill neurosurgical patients.
To determine the value of early tracheostomy (within 7 days) in ventilated neurosurgical patients. ⋯ Early tracheostomy in selected neurosurgical patients with poor GCS scores was associated with reduced incidence of tracheobronchial colonisation by multiple pathogens, improvement in chest infections, and rapid weaning from ventilatory support.
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Abdominal complications after cardiac surgery are associated with a high mortality rate. Due to the absence of early specific clinical signs, diagnosis is often delayed. The present study seeks to determine predictive risk factors for subsequent gastrointestinal complications after cardiosurgical procedures. ⋯ A number of predictive factors has been described to contribute to the development of abdominal complications subsequently after cardiac surgery on cardiopulmonary bypass. Knowledge of these factors may lead to earlier identification of patients at increased risk and may allow for more efficient and earlier interventions.
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Ann Acad Med Singap · May 2001
The practice of foregoing life support in the critically ill "old old": a Singapore perspective.
To study the practice of foregoing life support (FLS) therapy between the young old and the old old. ⋯ Illness severity, as reflected by the APACHE II(M) score and the presence of a high-risk diagnosis, rather than age, predicted FLS orders.
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Ann Acad Med Singap · Mar 2001
ReviewA case series of six children with primary pulmonary hypertension.
Primary pulmonary hypertension is an uncommon but serious disease in children. Management is difficult despite recent advances in pharmacotherapy. ⋯ This condition is irreversible and progressive with a high mortality rate. A better understanding of, and research into, the pathogenesis would hopefully lead to the formulation of improved therapeutic strategies for this condition.
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Ann Acad Med Singap · Jan 2001
Comparative StudyA prospective evaluation of surgeon performed sonography as a screening test in blunt abdominal trauma.
Sonography has found a role in the evaluation of patients with abdominal injury. However, the accuracy of sonography as performed by non-radiologists remains controversial. This study aims to determine the accuracy of focused abdominal sonography for trauma when performed by surgeons. ⋯ In conclusion, our initial experience suggests that local surgeons can perform a focused sonographic examination for trauma with acceptable accuracy. Although sonography lacks the sensitivity of diagnostic peritoneal lavage and the accuracy of CT scan, the diagnostic algorithm for abdominal trauma should include sonography as a screening test.