Singap Med J
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Comparative Study
Hip hemiarthroplasty for femoral neck fractures in end-stage renal disease patients on dialysis compared to patients with late-stage chronic kidney disease.
Hip fractures in patients with end-stage renal disease (ESRD) are associated with frequent complications and poorer outcomes. Patients on chronic dialysis are at additional risk of dialysis-related complications such as myocardial infarction and early osteolysis. We analysed the complications and implant survivorship of hemiarthroplasty in patients with femoral neck fractures with late-stage chronic kidney disease with and without pre-existing dialysis. ⋯ Patients with ESRD on chronic dialysis were more likely to develop cardiopulmonary complications and implant loosening after hemiarthroplasty for femoral neck fractures. Hyperparathyroidism should be optimised, as it may prevent loosening. Our study did not show any difference in complications or outcomes for cemented fixation.
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Variability of blood pressure (BP) has been reported to be related to worse cardiovascular outcomes. We examined the impact of daytime systolic BP variability on left ventricular (LV) function and arterial stiffness in hypertensive patients. ⋯ Increased BP variability was associated with LV mass and dysfunction, as well as arterial stiffness, suggesting that BP variability may be an important determinant of target organ damage in hypertensive patients.
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Associated factors of blood transfusion for Caesarean sections in pure placenta praevia pregnancies.
This study aimed to evaluate associated factors of blood transfusion for Caesarean sections in pure placenta praevia pregnancies. ⋯ Previous Caesarean section, anterior placentation, major placenta praevia, preoperative bleeding of more than 250 mL, preoperative anaemia and emergency Caesarean section were independent factors that increased the risk of blood transfusion for Caesarean section in pure placenta praevia pregnancies.
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Parkinson's disease (PD) is associated with cognitive decline but little is known about frontal-subcortical and posterior cortical cognitive functioning in patients with PD. The present study was designed to: (a) compare frontal and posterior cognitive functioning between patients with PD and healthy controls; (b) determine the effect of levodopa (L-dopa) on frontal-subcortical and posterior cortical cognitive functions; and (c) identify predictors of cognitive functions in patients with PD. ⋯ L-dopa medication improves frontal-subcortical and posterior cortical cognitive functioning in patients with PD. Disease duration is a marker of cognitive decline in PD.
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Antimicrobial resistance (AMR) results in drug-resistant infections that are harder to treat, subsequently leading to increased morbidity and mortality. In 2008, we reviewed the problem of AMR in Singapore, limiting our discussion to the human healthcare sector. ⋯ The role of antibiotic use and AMR in food animals and the environment - and the link to human health - is better understood today. This issue of AMR encompasses both human health as well as animal/food safety, and efforts to control it will need to continually evolve to maintain or improve on current gains.