No Author listed.
Breast Neoplasms* ; Breast*

Background: Critical illness refers to a wide spectrum of life-threatening medical or surgical conditions usually requiring an intensive care unit level of care. In most of these patients a common pathophysiological process is often present, namely infection, trauma, or major surgery. These factors initiate an inflammatory cascade leading to activation of regulatory mechanisms in order to control the intensity of the inflammatory response. The prognosis of critically ill patients usually depends on illness severity, intensity of the biological inflammatory response and nutritional status. Objective and Methodology: This analytical cross-sectional study of 82 mechanically ventilated critically-ill patients with hypoalbiminemia admitted in the ICU and NCCU of St. Luke’s Medical Center from January 1 to December 31, 2008, aimed at determining the odds ratio between hypoalbuminemia and those with albumin >3mg/dl in terms of failure in weaning. Also it seeks to determine the prevalence of hypoalbuminemia among mechanically ventilated patients in the ICU; characterize the patients involved in the study in terms of age, sex, APACHE II score, and co-morbidities/ underlying illness; and to determine the manner of serum albumin correction. A 2x2 table analysis was computed to measure the odds ratio. Chi-Square for qualitative dichotomous variables and unpaired t-test for continuous variables are the statistical tools employed to interpret the present data. Results: Eighty-two of the 109 of patients had hypoalbuminemia, giving a prevalence of 0.75. Of the 82 hypoalbuminemic patients, 26 subjects failed to be weaned off mechanical ventilator support compared to two subjects of 27 patients with no hypoalbuminemia. An odds ratio of 5.8 was obtained. Patient’s demographics of both groups did not significantly differ except for hypertension. The biochemical parameters prior to weaning (hemoglobin, sodium, potassium, calcium and magnesium) were not significantly different between hypoalbuminemic and non hypoalbuminemic patients. From our results, 22.6% of the patients were started on albumin IV infusion at a level of <2.4g/dL. The rest did their correction through diet. Conclusion: Hypoalbuminemia with a serum albumin level of <3mg/dl is associated with negative outcome of weaning from mechanical ventilation. The odds that a patient will have failure in weaning was 6 times more likely in subjects with serum albumin <3 mg/dl.

BACKGROUND: Cardiovascular disease remains one of the leading causes of death and major causes of disability and loss of productivity in adults worldwide. Inflammation is a key feature of atherosclerosis and its clinical manifestations. Because inflammation plays a key role in atherosclerosis and its end results, discovering new biomarkers of inflammation becomes important to help diagnostic accuracy and provide prognostic information about coronary artery disease (CAD). The eosinophil count and eosinophil-to-leukocyte ratio (ELR), in particular, have become novel biomarkers for risk assessment in patients with CAD. The current study aimed to evaluate the association of ELR with presence of CAD. OBJECTIVES: The aim of this study was to investigate the prognostic value and predictive performance of ELR in patients with suspected CAD. Furthermore, if proven of value, this study aims to use ELR as a biomarker for screening patients at risk for CAD for early prevention and intervention. METHODS: This is a retrospective cohort study involving a chart review of CAD suspects 40 years or older who underwent elective coronary angiogram from January 2019 to December 2019. Eosinophil-to-leukocyte ratio was calculated by dividing the number of eosinophils by the number of leukocytes. RESULTS: A total of 436 patients were included in this study. With an optimal cutoff value of 0.5 (area under the curve, 0.9911; sensitivity, 96.63%; specificity, 95.27%), ELR demonstrated efficiency in detecting CAD. CONCLUSION Patients with CAD has a higher ELR than those without CAD in the control group. Furthermore, this study supports the positive association of ELR in predicting CAD.
coronary artery disease

There is a lack of representative samples to provide reliable and accurate seroprevalence of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) as well as behavioural information among men who have sex with men (MSM) in Singapore. We used respondent driven sampling (RDS) to recruit MSM. Participants completed a survey used by Asian Internet MSM Sex Survey (AIMSS) and were tested for HIV and syphilis. We compared the characteristics of the RDS participants with STI diagnosis against those who did not have any STI diagnosis in the past 6 months. We compared RDS participants with AIMSS participants. Of 72 MSM recruited, 1 was positive for HIV (1.3%) and 4 (5.5%) tested positive for syphilis. Median age was 30 years and majority was Chinese (69.4%). RDS participants who had any STI diagnosis reported to have more use of recreational drugs (P = 0.006), and lower condom use (P = 0.054). Comparing RDS participants (n = 72) with the AIMSS participants (n = 2075), RDS respondents had ≥1 male partner in the past 6 months (P = 0.003), more casual sex partners (P = 0.012) and more STI symptoms (P = 0.019). There was no difference in terms of HIV testing and recreational drug use. The HIV and syphilis seroprevalence rates from our study are similar to previous reports conducted in high-risk MSM. In contrast to other settings, RDS did not work well among MSM in Singapore. The public health implications of our study highlight the challenges in obtaining data for HIV surveillance in assessing prevalence and risk behaviours among MSM.
Adult ; HIV Infections ; diagnosis ; epidemiology ; psychology ; Health Literacy ; methods ; Health Surveys ; Homosexuality, Male ; psychology ; statistics & numerical data ; Humans ; Male ; Middle Aged ; Prevalence ; Risk-Taking ; Seroepidemiologic Studies ; Sexual Behavior ; Sexual Partners ; psychology ; Singapore ; epidemiology ; Syphilis ; diagnosis ; epidemiology ; psychology

INTRODUCTION: Stable distal radius fractures in children are frequently treated by immobilisation with a cast and heal readily without complications. This randomised clinical trial aimed to assess patient satisfaction and casting-related clinical outcomes when using polyolefin cast, a new cast material, compared to the conventional fibreglass cast. METHODS: A total of 80 patients (age range 7-16 years) with radiograph-confirmed stable distal radius fractures were recruited. They were randomised to either the fibreglass group or polyolefin group, with short arm cast immobilisation for 20-30 days. After cast removal, the incidence of skin rash, growth of hair and cast breakage was recorded along with the administration of patient satisfaction questionnaires. Mann-Whitney U test or Fisher's exact test was applied to compare results. RESULTS: Overall, 34 patients from the fibreglass group and 31 patients from the polyolefin group were included in the final analysis. Significantly fewer patients from the polyolefin group reported itchiness during the casting period (p = 0.038). However, significantly more cast breakages were observed for the polyolefin group in the palmar bar region (p = 0.009). Patients from the polyolefin group were overall more satisfied (fibreglass group = 3.15/5 vs. polyolefin group = 3.74/5; p = 0.002). CONCLUSION Polyolefin cast reduces itchiness during casting and provides higher overall patient satisfaction during the treatment of stable distal radius fractures in children in tropical climates. However, patients should be counselled regarding potential cast breakage, which did not compromise safety, and the higher costs involved.