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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Ann Acad Med Singap · May 2001
Obstetric admissions to the intensive therapy unit of a tertiary care institution.
Between 0.1% and 0.9% of women develop pregnancy complications which require admission to an intensive therapy unit. The aim of this study was to review all obstetric admissions to the intensive therapy unit at the KK Women's and Children's Hospital from 1998 to 1999 with respect to indications for admission, interventions employed and clinical outcome. ⋯ The admission rate to the intensive therapy unit in our institution was 0.73% of all deliveries during the 2-year study period. Hypertensive disease and haemorrhage were the predominant admitting diagnoses.
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Ann Acad Med Singap · May 2001
An audit of patients with rheumatic disease requiring medical intensive care.
Medical intensive care for patients with rheumatic disease is usually complicated by significant morbidity and mortality. The aims of this study were to examine the reasons for admission, the outcomes of these patients and the possible prognostic factors in an Asian cohort. ⋯ Many of our critically-ill patients with rheumatic disease were young females with good functional status. Despite the high mortality, they should be aggressively treated because infection and acute respiratory failure are potentially reversible.
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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 Study Clinical TrialAntibiotic sensitivity of Propionibacterium acnes isolates from patients with acne vulgaris in a tertiary dermatological referral centre in Singapore.
To study the minimum inhibitory concentrations (MICs) of Propionibacterium acnes (P. acnes) isolates to selected antibiotics from patients with acne vulgaris in Singapore and determine if resistance increases with prolonged use of antibiotics. ⋯ Antibiotic resistance in P. acnes isolates in Singapore follows similar patterns to studies conducted in Europe. Resistance to erythromycin was most commonly seen, and this is associated with cross-resistance to clindamycin. Among the tetracycline group of drugs, the average MICs to tetracycline was higher than that for doxycycline, which in turn was higher than that for minocycline. Antibiotic resistance can occur with short-term antibiotic courses, and the rate of resistance increases as the duration of antibiotic consumption increases.