Ann Acad Med Singap
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Ovarian cancer is predominantly a disease of postmenopausal women which presents at a late stage and has an overall 5-year survival of less than 30%. If detected at stage I, survival is dramatically increased and this would suggest that screening for ovarian cancer may reduce mortality. However, the inaccessibility of the ovaries and the absence of a confirmed premalignant condition make screening for preclinical disease difficult. ⋯ Multimodal screening using tumour markers and ultrasound in combination gives high sensitivity and specificity and is also the most cost-effective potential screening strategy. The sensitivity and specificity of these techniques are sufficient to warrant large-scale clinical trials of ovarian cancer screening. Three such trials are currently underway and, in due course, will establish whether any screening strategy will ultimately reduce mortality from ovarian cancer.
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Despite advances in antimicrobial therapy and medical support, septic shock remains a leading cause of death. Emerging adjunctive therapy for septic shock can be divided into those directed against bacterial components, those directed against host-derived inflammatory-mediators and those designed to limit tissue damage. ⋯ Therapies against endotoxin, tumour necrosis factor, interleukin-1 and platelet activating factor did not reduce mortality. Future effective therapies will probably use combination of agents depending upon the nature of the infection and the type of patient.
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The Polarprobe is a portable non invasive electronic device designed for the detection of cervical precancer and cancer. It measures both electrical and optical properties of cervical tissue to allow a real time comparison with a databank of previously determined cervical tissue types. ⋯ Indeed it has been shown to be associated with less pain and anxiety than the smear and has the capability of encouraging women to attend for screening. Some of the preliminary clinical trials on the Polarprobe are reported as well as the ongoing developments and modifications to the device.
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Ann Acad Med Singap · Jul 1998
Comparative StudyDay hospital rehabilitation for the elderly: a retrospective study.
Alexandra Hospital has the first day hospital for rehabilitation of the elderly in Singapore. To determine if functional skills and mobility improved significantly with a Day Hospital rehabilitation programme, and the factors influencing the outcome, a pre-test/post-test study was conducted on 30 male and 34 female patients discharged from the programme between 1 October 1995 and 30 June 1996. The Barthel Index was used to assess functional status and the Elderly Mobility Scale was used to assess mobility. ⋯ Improvement in functional skills and mobility were both inversely correlated with age. Multiple linear regression analysis showed that age and Barthel Index on admission were significant independent determinants of the Barthel Index at discharge, while age, Barthel Index and Elderly Mobility Score on admission significantly determined the Elderly Mobility Scale at discharge. This study showed that functional skills and mobility improved with rehabilitation in the elderly population, but younger and less severely disabled individuals tended to fare better.
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Ann Acad Med Singap · Jul 1998
Review Case ReportsA case series of ocular disease as the primary manifestation in sarcoidosis.
Sarcoidosis is an idiopathic, systemic, non-caseating, granulomatous disease with protean clinical manifestations. This disease is highly prevalent in the southern states of United States of America, especially among African-Americans, but uncommon among Asians. Though sarcoidosis concerns physicians of virtually all specialties, it is particularly important to ophthalmologists since a significant number of patients will seek initial medical examination because of ocular disease. ⋯ We report here 4 patients with active sarcoidosis who presented to us with ocular symptoms as the first and primary manifestation of the disease. All 4 patients developed symptoms and signs of systemic sarcoidosis at a later date. The ocular manifestations included simultaneous bilateral chronic granulomatous iridocyclitis, intermediate uveitis, posterior uveitis characterised by vasculitis with candle wax drippings, and optic nerve head granuloma.