Ann Acad Med Singap
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Ann Acad Med Singap · Jan 2000
Endobronchial stenting in patients requiring mechanical ventilation for major airway obstruction.
To examine the value of therapeutic rigid bronchoscopy on subsequent ventilator weaning in ventilated patients with major airway obstruction. ⋯ Therapeutic rigid bronchoscopy is effective in the acute management of respiratory distress from central airway obstruction. Dramatic improvements in ventilatory status following therapeutic rigid bronchoscopy allow ventilator liberation in a select group of patients with an otherwise good performance status.
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Ann Acad Med Singap · Jan 2000
Fibre-optic aided bougie (FAB) for simulated difficult tracheal intubation.
Difficult intubation remains a key problem and the value of the gum elastic bougie as a first approach is well recognised. ⋯ The fibre-optic assisted bougie (FAB) offers a promising technique in patients who may be difficult to intubate but who can be ventilated. Further developments are required to achieve a faster intubation time but oxygenation may be achieved by jetting down the hollow bougie.
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Neonatal lupus erythematosus (NLE) presents clinically with either cutaneous lesions or cardiac involvement and is related to the transplacental passage of anti-Ro antibodies from mother to foetus. We report a series of 10 cases seen at the National Skin Centre between 1990 and 1998 including a pair of siblings. ⋯ The rash resolved spontaneously by 3 to 6 months of age.
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Ann Acad Med Singap · Nov 1999
Comparative Study Clinical Trial Controlled Clinical TrialUse of EMLA cream or alfentanil for analgesia during ophthalmic nerve blocks.
This prospective double-blind study compared the effectiveness of EMLA with alfentanil and placebo in reducing the overall pain during ophthalmic nerve blocks. Seventy-five patients scheduled for cataract surgery were divided into three groups. ⋯ Patients then received facial nerve blocks and retrobulbar block by the same surgeon. Pain scores by patients and independent observers were significantly lower in the EMLA and alfentanil groups compared to placebo (P < 0.005) with no significant difference between the EMLA and alfentanil groups.
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This study aims to examine the feasibility of applying the focused ultrasound examination (FAST) in the initial assessment of the trauma patient. Its advantage over diagnostic peritoneal lavage lies in the speed in which it can be performed, its non-invasiveness and repeatability. Over the period January 1997 to July 1998, the FAST examination (Acuson 128XP/10, 3.5 MHz probe) was used to assess the presence of haemopericardium or haemoperitoneum in 38 multi-trauma patients admitted to the Singapore General Hospital. ⋯ Overall sensitivity was 67% and specificity 97%. Although the FAST examination missed the small amount of free fluid seen in the CT scan of 2 patients, these patients did not have to undergo laparotomy as their abdominal examination was normal. We conclude that the FAST examination is feasible and should be part of a general surgeon's armamentarium in the initial assessment of trauma.