Sarcopenia, which is characterized by progressive and generalized loss of skeletal muscle mass and strength, has been well described to be associated with numerous poor postoperative outcomes, such as increased perioperative mortality, postoperative sepsis, prolonged length of stay, increased cost of care, decreased functional outcome, and poorer oncological outcomes in cancer surgery. Multimodal prehabilitation, as a concept that involves boosting and optimizing the preoperative condition of a patient prior to the upcoming stressors of a surgical procedure, has the purported benefits of reversing the effects of sarcopenia, shortening hospitalization, improving the rate of return to bowel activity, reducing the costs of hospitalization, and improving quality of life. This review aims to present the current literature surrounding the concept of sarcopenia, its implications pertaining to colorectal cancer and surgery, a summary of studied multimodal prehabilitation interventions, and potential future advances in the management of sarcopenia.

Autoantibodies ; COVID-19 ; Humans ; Singapore/epidemiology*

The aim of this systematic review is to compare the vaginalerosion rates in different synthetic materials used insuburethral slings in Tension Free Vaginal Tape (TVT-O/TOT) procedures in management of female stress urinaryincontinence.Methods: PRISMA 2009 framework was adopted for studydesign. Scholarly literature search was done usingMEDLINE, EMBASE, the Cochrane Library and ClinicalTrials.gov using selected keywords. Five articles fulfilled theinclusion and exclusion criteria. Our main outcome ofinterest is to review the ideal properties of the suburethralsling, procedure of insertion and post-surgical complicationfollowing the sling insertion primarily vaginal erosion.Results were compared using one way-ANOVA test andindependent T- test.Results: Total of 1725 subjects were available for analysisin the five studies. Monofilament polypropylene constituted92.5% of the total sample size from one study alone.Polyester (n= 16/51) causes higher incidence rate of vaginalerosion compared to monofilament polypropylene (31.4 vs.,4.7; p = 0.01). There was no difference in the vaginal erosionrate between monofilament polypropylene and multifilamentpolypropylene (4.7 vs, 14.1; p=0.055) as well as betweenmultifilament polypropylene and polyester (14.1 vs, 31.4;p=0.068). Although there was a marginally lower rate ofvaginal erosion in TVT-O over TVT, the difference was notsignificant. (5.6 vs., 6.4, p=0.468). Common presentations ofvaginal erosion were vaginal discharge, perineal pain anddyspareunia. Conclusion: Given the limited sample size, polyester slingmaterial appears to cause higher rates of vaginal erosion.No difference in erosion rate was seen between TVT andTVT-O.

INTRODUCTIONVictims of out-of-hospital cardiac arrests require timely cardiopulmonary resuscitation (CPR) and early defibrillation. Callers to emergency medical services are asked to provide dispatcher-guided responses until an ambulance arrives. Knowing what to expect in such circumstances should reduce both delay and confusion.

METHODSThis study was conducted among schoolchildren aged 11-17 years using ten-item pre- and post-training surveys. We aimed to observe any knowledge and attitude shifts regarding CPR and automated external defibrillator (AED) use subsequent to the training.

RESULTSA total of 1,196 students across five schools completed the pre- and post-training surveys. Survey questions tested basic CPR knowledge and attitudes towards CPR and AED use. The overall response rate was 80.8% and 81.5% in the pre- and post-training surveys, respectively. There was a statistically significant improvement in the students' CPR knowledge. The number of students who selected all the correct answers for the knowledge-based questions in the post-training survey increased by 64.7% (95% confidence interval 61.9%-67.5%; p < 0.001). There was also an improvement in their willingness to administer CPR (likely/very likely to administer CPR pre-training vs. post-training: 13.0% vs. 71.0%; p < 0.001) and use AED (likely/very likely to administer AED pre-training vs. post-training: 11.7% vs. 78.0%; p < 0.001) after training.

CONCLUSIONThe training programme imparted new information and skills, and improved attitudes towards providing CPR and using AED. However, some concerns persisted about hurting the victim while performing CPR.

INTRODUCTIONThere is a need for a simple-to-use and easy-to-carry CPR feedback device for laypersons. We aimed to determine if a novel CPRcard™ feedback device improved the quality of chest compressions.

METHODSWe compared participants' chest compression rate and depth with and without feedback. Compression data was captured through the CPRcard™ or Resusci Anne's SimPad® SkillReporter™. Compression quality was defined based on 2010 international guidelines for rate, depth and flow fraction.

RESULTSOverall, the CPRcard group achieved a better median compression rate (CPRcard 117 vs. control 122, p = 0.001) and proportion of compressions within the adequate rate range (CPRcard 83% vs. control 47%, p < 0.001). Compared to the no-card and blinded-card groups, the CPRcard group had a higher proportion of adequate compression rate (CPRcard 88% vs. no-card 46.8%, p = 0.037; CPRcard 73% vs. blinded-card 43%, p = 0.003). Proportion of compressions with adequate depth was similar in all groups (CPRcard 52% vs. control 48%, p = 0.957). The CPRcard group more often met targets for compression rate of 100-120/min and depth of at least 5 cm (CPRcard 36% vs. control 4%, p = 0.022). Chest compression flow fraction rate was similar but not statistically significant in all groups (92%, p = 1.0). Respondents using the CPRcard expressed higher confidence (mean 2.7 ± 2.4; 1 = very confident, 10 = not confident).

CONCLUSIONUse of the CPRcard by non-healthcare workers in simulated resuscitation improved the quality of chest compressions, thus boosting user confidence in performing compressions.