Three-dimensional glenohumeral relationship in cuff tear arthropathy and its correlation with the type of cuff tear.

Objective: The main purpose of this study is to evaluate 1) the three-dimensional (3D) glenohumeral relationship in cuff tear arthropathy (CTA) and 2) the correlation between different types of rotator cuff tears (RCTs) and the 3D glenohumeral relationship.

Method: A total of 124 patients with CTA and 60 control patients were included in this study. 3D models of computed tomography images of the shoulder were reconstructed to evaluate the position of the humerus in relation to the scapula using a Cartesian coordinate system.

Antibiotic resistance in the microbiota of periodontitis patients: an update of current findings.

Systemic antibiotics are an effective adjunct in the treatment of periodontitis, but their judicious use is necessary as antimicrobial resistance is a growing global concern. This review aims to explore the current understanding and insight related to antibiotic resistance in the subgingival microbiota of periodontitis patients. A search of MEDLINE (PubMed) was carried out from 1 January 2012 to 25 November 2021 for studies related to antibiotic resistance in periodontitis patients.

Limited value of current shoulder arthroplasty registries in evidence-based shoulder surgery: a review of 7 national registries.

National shoulder arthroplasty registries are currently used to assess incidence, indication, type of prosthesis and revision, but they seem to lack sufficient information to lead to evidence based decision-making in shoulder surgery. There appears to be a large difference in registered parameters and outcome measurement per country. First we investigated whether existing registries have sufficient common datasets to enable pooling of data.

Managing a Renal Transplant Programme During the COVID-19 Pandemic: Practical Experience from a Singapore Transplant Centre.

Introduction: Coronavirus Disease 2019 (COVID-19) has significantly affected the way healthcare is delivered in Singapore. Healthcare services such as renal transplantation had to rapidly adjust and meet the needs to (1) protect patients and staff, (2) ramp up, conserve or redeploy resources while (3) ensuring that critical services remained operational. This paper aims to describe the experience of the renal transplant programme at the Singapore General Hospital (SGH) in responding to the risks and constraints posed by the pandemic.

Teaching hip surgery to orthopaedic residents: what's new?

Purpose: The purpose of this study is to provide an overview of the published literature on the existing educational methods used to teach surgical skills, with a specific focus on hip surgery, to orthopaedic residents.

Methods: A total of 31 articles were selected from a PubMed literature search on the topic of teaching surgical skills to orthopaedic residents, and 9 articles on hip surgery are included in this review.

Results: Although several methods are included in the published literature to teach orthopaedic residents, only arthroscopy of the knee and shoulder joint is well described.

Analysis of failures after the Bristow-Latarjet procedure for recurrent shoulder instability.

Purpose: Despite good clinical results and low recurrence rates, post-operative complications of coracoid process transfer procedures are not well understood. This study aims to evaluate the underlying failure mechanism in cases requiring major open revision surgery after prior Bristow or Latarjet stabilization.

Methods: Between January 2006 and January 2017, 26 patients underwent major open revision after primary Bristow or Latarjet procedure.

An Unusual Case of a Parturient with Uncorrected Pentalogy of Fallot Presenting for Elective Cesarean Section Delivery of Twins.

We present a 31-year-old primigravida with uncorrected pentalogy of Fallot, pregnant with monochorionic-diamniotic twins, undergoing elective lower segment cesarean section at 36 weeks gestation. Preoperative workup included a transthoracic echocardiogram which revealed a large ventricular septal defect of 1.8 cm with bidirectional shunting, a moderate size atrial septal defect of 1.

Combined heart-liver transplantation with extended cardiopulmonary bypass.

We report a case of combined heart and liver transplantation for familial amyloid polyneuropathy. This is the first such combined transplant performed in Asia, and differs from previously described cases, in that cardiopulmonary bypass was continued at partial flow during liver transplantation in our case. This was done in order to provide haemodynamic support to the cardiac graft and to protect it from the impending reperfusion insult that frequently accompanies liver transplantation.

Ropinirole-induced symptomatic sinus node dysfunction.

Restless legs syndrome is a neurological disorder that can be treated with ropinirole. We report the case of a patient who presented with syncope during treatment with ropinirole due to prolonged sinus pauses. The treatment was discontinued and the patient remained asymptomatic.

[Transient left ventricular apical ballooning or tako-tsubo syndrome: 14 cases].

Introduction: Tako-tsubo syndrome is a new diagnostic entity, still little known. Also called transient left ventricular apical ballooning, stress cardiomyopathy, and neurogenic myocardial stunning, it mimics myocardial infarction, combining chest pain with electrocardiographic changes and a moderate rise in the serum markers of necrosis. Angiography of the coronary artery is normal while that of the left ventricle shows ballooning and basal hyperkinesis.

The effects of remifentanil and thoracic epidural on oxygenation and pulmonary shunt fraction during one-lung ventilation.

Objective: To compare the effects of remifentanil and thoracic epidural analgesia on the hemodynamic changes and pulmonary shunt fraction during one-lung ventilation (OLV) for thoracotomy.

Design: Prospective, single crossover design.

Setting: Tertiary care hospital.

In vitro behavior of HVOF sprayed calcium phosphate splats and coatings.

Hydroxyapatite (HA) coatings and splats deposited by high velocity oxy-fuel (HVOF) spray technique was investigated in vitro. HA coatings prepared from two different HA powder size range (30+/-5 and 50 +/-5 microm) were immersed in a simulated body fluid with various incubation periods of maximum 6 weeks. The dissolution/precipitation behavior was studied and the degradation of HA coatings caused by in vitro ageing was demonstrated by measuring the changes in flexural modulus through a 3-point bend test.

Outpatient general anaesthesia for oral surgery.

Outpatient general anaesthesia (GA) is administered for extraction of carious teeth in children and straightforward dento-alveolar surgery such as removal of impacted teeth, cyst enucleation and dental implantology in adults. Although oral surgery is often performed under local anaesthesia, GA is indicated in conditions when local anaesthesia is ineffective and in uncooperative patients because of age, fear or anxiety, mental impairment or physical disability. Outpatient GA for oral surgery yields a high satisfaction score from the patients.

Total intravenous anaesthesia using 3-in-1 mixture of propofol, alfentanil and mivacurium.

Introduction: To avoid errors and confusion associated with 3 separate infusions, we conducted a feasibility study of total intravenous anaesthesia (TIVA) using 1 electrically-powered syringe pump to deliver a 3-in-1 mixture containing fixed proportions of propofol, alfentanil and mivacurium.

Materials And Methods: The 3-in-1 mixture was obtained by mixing 200 mg propofol, 1 mg alfentanil, 20 mg mivacurium, and making up to 40 mL with 5% dextrose solution. Electrical zone sensing sizer and light microscopy were used to compare emulsion instability of the 3-in-1 with control mixtures.

Bone marrow harvesting using EMLA (eutectic mixture of local anaesthetics) cream, local anaesthesia and patient-controlled analgesia with alfentanil.

Bone marrow harvesting (BMH) was performed on 40 consecutive allogeneic or autologous donors using EMLA (eutectic mixture of local anaesthetics), local anaesthesia (LA) and patient-controlled analgesia with alfentanil (PCA-A). The effect of alkalinizing the LA solution on reducing pain during LA infiltration in the presence of EMLA was also investigated. EMLA 10 g with occlusive dressing was applied to the harvest sites at least 60 min before BMH.

Simulations of the erythrocyte cytoskeleton at large deformation. II. Micropipette aspiration.

Coarse-grained molecular models of the erythrocyte membrane's spectrin cytoskeleton are presented in Monte Carlo simulations of whole cells in micropipette aspiration. The nonlinear chain elasticity and sterics revealed in more microscopic cytoskeleton models (developed in a companion paper; Boey et al., 1998.

Simulations of the erythrocyte cytoskeleton at large deformation. I. Microscopic models.

Three variations of a polymer chain model for the human erythrocyte cytoskeleton are used in large deformation simulations of microscopic membrane patches. Each model satisfies an experimental observation that the contour length of the spectrin tetramers making up the erythrocyte cytoskeleton is roughly square root of 7 times the end-to-end distance of the tetramer in vivo. Up to modest stress, each brushy cytoskeletal network behaves, consistently, like a low-temperature, planar network of Hookean springs, with a model-dependent effective spring constant, keff, in the range of 20-40 kBT/s(o)2, where T is the temperature and s(o) is the force-free spring length.

[Malignant cardiac lymphoma. Diagnosis by echocardiography].

The authors report a case of cardiac malignant non-Hodgkin lymphoma. The initial clinical presentation suggested recurrent angina in a patient who had undergone angioplasty of the left anterior descending artery two years previously. Echocardiography showed severe left ventricular dysfunction with apical and septal akinesia and also allowed visualisation of two oval masses in the right ventricle without dilatation of the right heart chambers.

Preoperative prediction of intra and postoperative red blood cell transfusion in surgical patients.

Anaesthetists were asked to predict the need for intra and postoperative red blood cell transfusion in 1706 patients before surgery. Each prediction was made using only the individual patient's medical history and physical examination, the results of routine preoperative laboratory investigations, and knowledge of the proposed surgical procedure. Only 159 patients (9.

A two-year experience of an acute pain service in Singapore.

The first anaesthesia-based acute pain service in Singapore is described. The benefits, risks and resource implications of such a service during its first two years are reviewed. One thousand two hundred and sixty-eight (1,268) post-operative patients were treated with either patient-controlled analgesia (310 patients) or epidural opioid analgesia (958 patients).

Bone marrow harvesting using local anaesthesia and PCA-alfentanil: a feasible alternative to general or regional anaesthesia.

We examined the feasibility of combined use of local anaesthesia (LA) and patient-controlled analgesia with alfentanil (PCA-alfentanil) for bone marrow harvesting (BMH) in 16 consecutive in-patient donors (nine allogeneic and seven autologous). A loading dose of alfentanil 15 micrograms/kg was delivered at the time of skin preparation followed by a background infusion of alfentanil 0.05 microgram/kg/min.