Ann Acad Med Singap
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Monumental advances in the field of lipid metabolism and its relationship to atherosclerotic cardiovascular disease have been achieved during the last half century. Epidemiologic studies have defined lipid disorders as highly significant independent risk factors for coronary heart disease, along with diabetes mellitus, hypertension and smoking. Primary and secondary prevention studies including the Coronary Primary Prevention Trial, Helsinki Heart Study, and the Coronary Drug Project have shown that lowering the atherogenic low density lipoproteins (LDL) and very low density lipoproteins (VLDL) whilst raising the high density lipoproteins (HDL) significantly decreases the risk for coronary disease. ⋯ Such patients merit individualized treatment. The prevalence of this syndrome may be more common in Singapore and requires further investigation. Current therapeutic guidelines emphasize the need for weight loss and dietary restriction of total and especially saturated fat (< 7% to 10% total calories), cholesterol (< 200 to 300 mg/day), and exercise. (ABSTRACT TRUNCATED)
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Ann Acad Med Singap · Jul 1997
ReviewJoint lectureship of the Royal College of Surgeons of Edinburgh and the Academy of Medicine, Singapore--accurate long-term documentation in surgical audit and evaluation of outcomes.
The purpose of a surgical audit is to allow a critical assessment of patient care, carried out among peers and in an atmosphere of learning, open discussion, free of recriminations. The results of a surgical unit will hopefully lead to improvement in the quality of care of our patients by reducing the preventable causes of mortality and morbidity. Data from surgical audit can also be used to monitor the teaching programme in a department. It may even allow us to study the cost effectiveness of certain procedures which is obviously very important in this era of diminishing resources and cost containment.