Singap Med J
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The lesions at and around the superior glenolabral junction of the shoulder have gained considerable attention since its description in 1990. A 31-year-old Chinese woman with a superior labral anterior-posterior (SLAP) tear is reported. The MR arthrogram findings were confirmed at surgery. The classification and mechanisms of SLAP lesions, and the role of MR arthrography in the diagnosis of glenolabral lesions are discussed.
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Cerebrovascular accident (CVA) is a leading cause of death and disability in many countries. Diffusion-weighted (DW) magnetic resonance (MR) imaging has been reported to be useful in the detection of acute strokes and as an investigative tool evaluating the therapeutic effects of neuroprotective and thrombolytic agents. The objectives of this study are to share our experience using the commercially available isotropic DW scan in imaging of acute stroke, assess its usefulness over conventional T2-weighted (T2W) scans in a busy clinical radiology unit and highlight it pitfalls. ⋯ However, there are potential pitfalls in the evaluation of small hyperacute posterior fossa strokes and venous infarcts. The major strength of this MR technique lies in its ability to diagnose hyperacute strokes and thence the potential for therapeutic thrombolysis, but unfortunately patients qualifying for the "therapeutic window" were a minority. More efforts need to be focused on public education in order for this powerful imaging modality to find its true value and contribute to viability of an effective thrombolytic programme.
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For centuries, physicians have been allowed to interfere and overrule patient's preferences with the aim of securing patient benefit or preventing harm. With the radical rise in emphasis on individual control and freedom, medical paternalism no longer receives unquestioned acceptance by society as the dominant mode for decision-making in health care. ⋯ This can be achieved through a model for shared decision making, acknowledging that though the final choices reside ultimately in patients, only through physician beneficence can the patient be empowered to make meaningful decisions that serve them best. For such a model to function effectively, the restoration of trust in doctor-patient relationship and the adoption of patient-centred communication are both crucial.
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Age has been cited as a predictor of mortality in the intensive care unit (ICU) and suggested as a criterion for rationing resources. We investigated the association of age with both ICU mortality and hospital mortality. ⋯ We did not find a statistically significant association between age and mortality. We recommend that age should not be used as a criterion for admission.
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To study the efficacy and complications from Unipulse CO2 laser resurfacing system (Nidek, California) for the treatment of scars and wrinkles in patients with Type III and IV skin type. ⋯ CO2 laser resurfacing provides minimal to moderate improvements for scars and wrinkles among Asians with darker skin type. Erythema fades over six months after resurfacing. Post-inflammatory pigmentation is common but tends to clear over six months.