A 36-year-old banker with good past health presented to our rheumatology clinic with a 6-month history of bilateral wrist pain. He initially sought medical attention in the private sector for a 2-month history of bilateral symmetrical wrist pain and swelling.
Ruptured aneurysms can be one of the most fatal medical emergencies and are dubbed as a “silent killer” given their lack of symptoms. Audrey Abella speaks with Dr Julian Wong Chi Leung, Senior Consultant at the Department of Cardiac, Thoracic and Vascular Surgery at the National University Heart Centre, Singapore, on how this potentially life-threatening condition can be aptly diagnosed and prevented in the primary care setting.
Dr. Michael Sze, Dr. Tammy Ma, Dr. Yui-Ming Lam, 20180409000000
A 47-year-old gentleman with a known history of mitral valve prolapse (MVP) and mild-to-moderate mitral regurgitation since his 30s presented to Queen Mary Hospital with sudden onset of chest pain and palpitations for 1 day.
Chronic kidney disease (CKD) has a global prevalence of 7–12 percent, with a mortality risk that has increased over the past 25 years – ranking 25th in 1990 to 17th in 2015. While there is no sufficient data reflecting the incidence of CKD in South East Asia (SEA), in Singapore, 2.3 percent of adults aged 18–69 years have been found to have renal impairment (estimated glomerular filtration rate [eGFR] of <60 mL/min/1.73m2).
Rates of burnout within the medical profession are significant. Studies from across the world quote rates of 12–80 percent, depending on which dimension of burnout is studied. Prevalence varies according to specialty, gender, age or career stage, and practice setting.
The syndrome of sensory neuronopathy and detection of anti-Hu antibody in 2010 were very strong indications of the presence of a malignant tumour. In a series of 200 patients positive for anti-Hu, 83.5 percent were found to have cancer, and 90 percent of the cancer cases were small-cell lung cancer.
The combined use of piperacillin and tazobactam does not appear to be a suitable alternative to meropenem for patients with bloodstream infections caused by ceftriaxone-resistant Escherichia coli (E. coli) or Klebsiella pneumoniae (K. pneumoniae), according to results of the MERINO* trial.
Taking oral antibiotics appears to increase the risk of nephrolithiasis, according to a recent study. Moreover, the risk seems to be compounded for individuals with recent antibiotic exposure and those who were exposed at a younger age.
Male smokers under the age of 50 years are at risk of developing ischaemic stroke, and this risk increases with the number of cigarettes smoked daily, according to data from the Stroke Prevention in Young Men Study.
Early renin-angiotensin-aldosterone system (RAAS) blockade with renin-angiotensin system inhibitors (RASI) leads to better short- and long-term renal outcomes in systemic lupus erythematosus (SLE) patients with antiphospholipid-associated nephropathy (aPLN), according to a study, adding that this renal protective effect is independent of RASI’s antihypertensive and antiproteinuric effects.