Introduction: Achieving optimal glycated hemoglobin (HbA1c), blood pressure (BP), and LDLCholesterol (LDL-C) in patients mitigates macro- and micro-vascular complications, which is the key treatment goal in managing type 2 diabetes mellitus (T2DM). This study aimed to determine the proportion of patients in an urban community with T2DM and the above modifiable conditions attaining triple vascular treatment goals based on current practice guidelines. Methods: A questionnaire was distributed to adult Asian patients with dyslipidemia at two primary care clinics (polyclinics) in northeastern Singapore. The demographic and clinical data for this sub-population with both T2DM and dyslipidemia were collated with laboratory and treatment information retrieved from their electronic health records. The combined data was then analyzed to determine the proportion of patients who attained triple treatment goals, and logistic regression analysis was used to identify factors associated with this outcome. Results: 665 eligible patients [60.5% female, 30.5% Chinese, 35% Malays, and 34.4% Indians] with a mean age of 60.6 years were recruited. Of these patients, 71% achieved LDL-C ≤2.6 mmol/L, 70.4% had BP <140/90 mmHg, and 40.9% attained HbA1c ≤7%. Overall, 22% achieved the triple treatment goals for glycemia, BP, and LDL-C control. The major determinants were the number of diabetic medications and intensity of statin therapy. Conclusion: Eight in ten patients with T2DM failed to achieve concurrent glycemic, BP, and LDL-C treatment goals, subjecting them to risks of vascular complications. Primary healthcare professionals can mitigate these risks by optimizing therapeutic treatment to maximize glycemia, dyslipidemia, and BP control.

No abstract available.
Hair* ; Microscopy, Electron

A choledochocele is a benign cyst-like herniation of the intramural segment of the distal common bile duct protruding into the duodenal lumen. Cholangiography is essential to demonstrate a choledochocele. Because choledochoceles are often associated with characteristic structual alterations of the papilla of Vater and the peripapillary area, ERCP is helpful in demonstrating a choledochocele. We present the clinical, endoscopic and radiographic (ERCP) findings in a patient with choledochocele.
Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Choledochal Cyst* ; Common Bile Duct ; Humans

A choledochocele is a benign cyst-like herniation of the intramural segment of the distal common bile duct protruding into the duodenal lumen. Cholangiography is essential to demonstrate a choledochocele. Because choledochoceles are often associated with characteristic structual alterations of the papilla of Vater and the peripapillary area, ERCP is helpful in demonstrating a choledochocele. We present the clinical, endoscopic and radiographic (ERCP) findings in a patient with choledochocele.
Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Choledochal Cyst* ; Common Bile Duct ; Humans

Purpose: This study was conducted to develop the contents of disaster nursing education in community health nursing at universities. Methods: To validate contents, the Delphi method was used. We categorized two domains(indirect disaster management and direct disaster management) and developed 48 draft items. This study applied two round surveys and 23 experts participated in this study. The content validity was calculated using content validity ratio and coefficient of variation. Results: Indirect disaster management domain was composed of three categories including 12 items: 1) Understanding of the disaster, 2) disaster management system, and 3) response by disaster stage and recovery. Direct disaster management domain was composed of nine categories including 30 items: 1) Ethical considerations, 2) communication in disasters, 3) nursing activity by disaster stage, 4) emergency nursing in disasters, 5) patient severity classification in disasters, 6) disaster nursing for vulnerable groups, 7) disaster nursing for victims, 8) psychosocial nursing and health in disasters, and 9) cases of disaster nursing in communities. Conclusion This Delphi study identified the contents of disaster nursing education curriculum, and confirmed the validity for disaster education program in community health nursing. Based on the results, it will be helpful for training the disaster nursing and improving the competency on disaster nursing of the nursing students.

Whole body magnetic resonance imaging (WB MRI) has become feasible and enables fast scan throughout the body. This technique is based on a real-time gradient-echo imaging and sliding table platform (rolling table concept, which eliminates time-consuming repositioning of patients and surface coils). MRI scanners of the latest generation use high field MRI units of >1.5 Tesla (T), and are reported to have upgraded capabilities in terms of temporal and spatial resolution due to improved signal-to-noise ratios (SNRs) under high magnetic-field strength conditions. The diagnostic accuracy of the whole-body staging strategies of PET/CT and MRI are established. As a start of tumor staging through whole body imaging, PET/CT showed superior performances in T and N staging than WB MRI using 1.5T MR system. But, both imaging procedures showed a similar performance in detecting distant metastases. In a recent report on staging of non-small cell lung cancer (NSCLC), whole body MR imaging proved to be effective as much as PET/CT in T, N, and M staging. In addition, there were organs of strength for each modality in the detection of metastasis. Therefore, whole-body MRI/ PET would be suggested as a future diagnostic procedure of choice for the whole-body imaging with synergistic effects and reduced radiation exposure.
Carcinoma, Non-Small-Cell Lung ; Humans ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Neoplasm Staging ; Signal-To-Noise Ratio ; Whole Body Imaging

Diffuse interstitial lung diseases (DILD) are a group of chronic disorders showing varying degrees of active inflammation and established fibrosis mainly involving the interstitium of the lungs. DILD can be classified into two groups in an etiologic aspect; idiopathic and DILD with known-cause, such as connective tissue diseases associated with DILD. Although there had been complexity and variability in the classification of idiopathic interstitial pneumonia (IIP), an international standard was established for the classification of IIPs including seven clinicalradiologic-pathologic entities; idiopathic pulmonary fibrosis (IPF), nonspecific interstitial pneumonia (NSIP), cryptogenic organizing pneumonia (COP), acute interstitial pneumonia (AIP), respiratory bronchiolitis-associated interstitial lung disease (RB-ILD), desquamative interstitial pneumonia (DIP), and lymphoid interstitial pneumonia (LIP). The prognosis of fibrotic NSIP and IPF is much poorer compared to those of other spectrum of IIPs, such as COP, RB-ILD, DIP, and LIP. Therefore, fibrotic NSIP and IPF can be considered separately as a group of fibrotic IIPs. Trying to predict the prognosis of IIPs, there has been an effort to differentiate inflammationpredominant lesions from fibrosis-predominant lesions in patients with fibrotic IIPs. Radiologic features of low fibrotic scores at high-resolution CT and early enhancement patterns at dynamic enhancement of MRI can be useful prognostic determinants for the prediction of disease improvement in patients with fibrotic IIPs.
Connective Tissue Diseases ; Cryptogenic Organizing Pneumonia ; Fibrosis ; Humans ; Idiopathic Interstitial Pneumonias ; Idiopathic Pulmonary Fibrosis ; Inflammation ; Lip ; Lung ; Lung Diseases, Interstitial ; Prognosis

No abstract available.
Diagnosis* ; Exanthema* ; Lymphadenitis* ; Scrub Typhus*