Singap Med J
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Anaesthetic modality and post-surgical oncological outcomes for paediatric tumours: is there a link?
Children with solid organ tumours often present for curative surgery. Even with the best surgical technique, micrometastases can occur. Preclinical studies support the postulation that neuraxial anaesthesia maintains the body's immune and inflammatory milieu against metastasis. However, human retrospective adult studies showed varying results, and no study has been done in children. We aimed to find out if intraoperative epidural, perioperative opioid and volatile dose are associated with relapse-free survival (RFS) in children with solid organ tumours. ⋯ Our study demonstrated some clinically meaningful associations, especially in paediatric sarcoma patients. Overall, however, there was no statistically significant association between epidural use and an improved RFS.
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Randomized Controlled Trial
Evaluation of a group family-based intervention programme for adolescent obesity: the LITE randomised controlled pilot trial.
This study aimed to evaluate the LITE (Lifestyle Intervention for TEenagers) group programme, a family-based behavioural lifestyle intervention for overweight and obese adolescents. ⋯ The LITE programme showed feasibility and short-term clinical effectiveness in improving some clinical outcomes and improved adolescents' perception of family support.
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Many institutions still perform routine chest radiography (CXR) after tube thoracostomies despite current guidelines suggesting that this is not necessary for simple cases. We aimed to evaluate the usefulness of routine CXR following ultrasonography-guided catheter thoracostomies for the detection of complications of symptomatic pleural effusions in hospitalised patients. ⋯ Routine use of CXR after tube thoracostomy did not significantly change patient management, which was concordant with recent guidelines. Instead, adverse clinical outcomes or procedural factors should guide investigations.