Safely navigating kidney transplantation during the COVID-19 pandemic: the Singapore General Hospital's experience.

Background: The coronavirus disease 2019 (COVID-19) pandemic curtailed transplant activities worldwide, driven by concerns about increased COVID-19-related mortality among kidney transplant recipients (KTRs), infections originating from donors, and decreased availability of surgical and intensive care resources as healthcare resources are reallocated for pandemic response. We examined the outcomes of KTRs at our center before and during the COVID-19 pandemic.

Methods: We conducted a retrospective single-center cohort study examining the characteristics and outcomes of patients undergoing kidney transplantation during two periods January 1, 2017 to December 31, 2019 (pre-COVID-19 era) and January 1, 2020 to June 30, 2022 (COVID-19 era).

Knowledge of COVID-19 and associated factors among kidney transplant recipients and donors in Singapore.

Background: Effective interventions during the coronavirus disease 2019 (COVID-19) pandemic require an understanding of patients' knowledge and perceptions that influence their behaviour. Our study assessed knowledge of COVID-19 among kidney transplant recipients and donors, hitherto unevaluated.

Methods: We conducted a cross-sectional survey among 325 kidney transplant recipients and 172 donors between 1 May 2020 and 30 June 2020.

Psychological distress and associated factors among kidney transplant recipients and living kidney donors during COVID-19.

Background: The coronavirus disease 2019 (COVID-19) pandemic has caused significant psychological distress globally. Our study assessed the prevalence of psychological distress and associated factors during COVID-19 pandemic among kidney transplant recipients and kidney donors.

Methods: A cross-sectional survey of 497 participants (325 recipients and 172 donors) was conducted from 1st May to 30th June 2020 in Singapore.

Same-day discharge following the Nuss repair: A comparison.

Purpose: Intercostal Nerve Cryoablation (INC) has significantly improved pain control following the Nuss repair of pectus excavatum (PE). This study sought to evaluate patients undergoing the Nuss repair with INC compared to the Nuss repair with an ERAS protocol, INC, and intercostal nerve blocks (INB).

Methods: In June 2020, a new protocol was implemented involving surgery, anesthesia, nursing, physical therapy, and child life with the goal of safe same day discharge for patients undergoing the Nuss repair.

Same day discharge for pectus excavatum-is it possible?

Purpose: The use of intercostal nerve cryoablation (INC) has been an effective modality for treating pain in patients undergoing pectus excavatum (PE) repair. This study sought to evaluate if PE patients undergoing Nuss procedures with INC and intercostal nerve block (INB) could safely be discharged the same day of surgery.

Methods: A prospective study with IRB approval of 15 consecutive patients undergoing PE Nuss repair with INC, INB, and an enhanced recovery after surgery (ERAS) protocol was conducted.

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.

Can fecal continence be predicted in patients born with anorectal malformations?

Purpose: The purpose of this study was to identify factors associated with attaining fecal continence in children with anorectal malformations (ARM).

Methods: We performed a multi-institutional cohort study of children born with ARM in 2007-2011 who had spinal and sacral imaging. Questions from the Baylor Social Continence Scale were used to assess fecal continence at the age of ≥4 years.

Screening practices and associated anomalies in infants with anorectal malformations: Results from the Midwest Pediatric Surgery Consortium.

Background: This study evaluates screening practices and the incidence of associated anomalies in infants with anorectal malformations (ARM).

Methods: We performed a multi-institutional retrospective cohort study of children born between 2007 and 2011 who underwent surgery for ARM at 10 children's hospitals. ARM type was classified based on the location of the distal rectum, and all screening studies were reviewed.

Effect of cilostazol prescribed in a pragmatic treatment program for intermittent claudication.

Background: Controlled trials of cilostazol for claudication demonstrate improvements in walking distance and quality of life. Without the structure of a study environment, it is not certain that cilostazol has similar efficacy.

Method: Retrospective review of patients prescribed cilostazol for claudication was undertaken.

Emergency ulcer surgery.

The rate of elective surgery for peptic ulcer disease has been declining steadily over the past 3 decades. During this same period, the rate of emergency ulcer surgery rose by 44%. This means that the gastrointestinal surgeon is likely to be called on to manage the emergent complications of peptic ulcer disease without substantial experience in elective peptic ulcer disease surgery.

Arch debranching versus elephant trunk procedures for hybrid repair of thoracic aortic pathologies.

Background: We compared outcomes of arch debranching (AD) and elephant trunk (ET) techniques when used with thoracic endovascular aortic repair.

Methods: A review was performed of consecutive patients with proximal thoracic aortic pathologies repaired with a hybrid approach.

Results: Between 2005 and 2009, 58 patients underwent first-stage ET (n = 21) or AD (n = 37).

Outcomes of treatment of childhood achalasia.

Purpose: The optimal management of achalasia in children and adolescents remains unclear. The aim of this study was to review a single institution's experience with endoscopic and surgical interventions in children with achalasia.

Methods: A retrospective review was conducted of the medical records of children treated for achalasia from 1978 to 2008.

Development and initial validation of a virtual reality haptically augmented surgical knot-tying trainer for the Autosuture ENDOSTITCH instrument.

The Autosuture Endostitch device (Covidien, CT) is difficult to learn. In particular, the handle requires the use of a toggle which is unique in this instrument. We have developed a virtual reality trainer for the device that offers the use of the actual instrument handle while creating a visible virtual instrument tip complete with virtual needle and suture on a monitor.

Identification of Entamoeba histolytica thiol-specific antioxidant as a GalNAc lectin-associated protein.

Entamoeba histolytica is a human intestinal parasite that causes amebic dysentery. A cell surface amebic adhesin, the galactose and N-acetyl-D-galactosamine inhibitable (GalNAc) lectin mediates amebic adherence to and contact-dependent killing of host cells. Previous work has suggested that the GalNAc lectin transduces signals via protein interactions with its short cytoplasmic domain.