The rehabilitation of a 19-year-old male with a congenital ventricular septal defect who suffered a haemorrhagic stroke from a ruptured mycotic aneurysm, secondary to infective endocarditis is described in this case study. This case study illustrates the application of the International Classification of Functioning, Disability and Health (ICF) model, and Kawa model in the structuring of a holistic, interdisciplinary team management. Application of both models provide clear communication within the interdisciplinary team and aids the team to understand the contextual factors in the interaction of the patient's rehabilitation journey.

A case study highlighting the complexity in the management of newly diagnosed atrial fibrillation in an elderly female with recurrent falls and a lack of mental capacity. This demonstrates a delicate balance between reducing thromboembolic phenomenon and bleeding risks.

This is a case study of a 58-year-old lady with metastatic nasopharyngeal carcinoma (NPC) who suffered a left neck of femur fracture. Unfortunately, there was an unexpected and rapid cancer progression, requiring her goals of care to transit from rehabilitation after her fracture to palliation. The case brings to light the need for family physicians to be poised to manage cancer patients at the end of life in the community, and work together with other stakeholders to deliver compassionate and supportive care.

This is a case study of a 22-year-old National Serviceman presenting with the main complaint of insomnia. This case demonstrates possible gaps in the integration of care between public and National Service healthcare. We illustrate a pathway which primary physicians may use to improve communication with National Service healthcare.

OBJECTIVE: To investigate the effectiveness of radiographic parameters on segmental instability in the lumbar spine using Kinetic magnetic resonance imaging (MRI). METHODS: Segmental motion, defined as excessive (more than 3 mm) translational motion from flexion to extension, was investigated in 309 subjects (927 segments) using Kinetic MRI. Radiographic parameters which can help indicate segmental instability include disc degeneration (DD), facet joint osteoarthritis (FJO), and ligament flavum hypertrophy (LFH). These three radiographic parameters were simultaneously evaluated, and the combinations corresponding to significant segmental instability at each level were determined. RESULTS: The overall incidence of segmental instability was 10.5% at L3-L4, 16.5% at L4-L5, and 7.3% at L5-S1. DD and LFH at L3-L4 and FJO and LFH at L4-L5 were individually associated with segmental instability (p<0.05). At L4-L5, the following combinations had a higher incidence of segmental instability (p<0.05) when compared to other segments : (1) Grade IV DD with grade 3 FJO, (2) Grade 2 or 3 FJO with the presence of LFH, and (3) Grade IV DD with the presence of LFH. At L5-S1, the group with Grade III disc and Grade 3 FJO had a higher incidence of segmental instability than the group with Grade I or II DD and Grade 1 FJO. CONCLUSION: This study showed that the presences of either Grade IV DD or grade 3 FJO with LFH at L4-L5 were good indicators for segmental instability. Therefore, using these parameters simultaneously in patients with segmental instability would be useful for determining candidacy for surgical treatment.
Humans ; Hypertrophy ; Incidence ; Intervertebral Disc Degeneration ; Ligaments ; Magnetic Resonance Imaging ; Osteoarthritis ; Spine ; Zygapophyseal Joint