Educational outcomes of simulation-based training in regional anaesthesia: a scoping review.

Background: Structured training in regional anaesthesia includes pretraining on simulation-based educational platforms to establish a safe and controlled learning environment before learners are provided clinical exposure in an apprenticeship model. This scoping review was designed to appraise the educational outcomes of current simulation-based educational modalities in regional anaesthesia.

Methods: This review conformed to PRISMA-ScR guidelines.

A systematic review and meta-analysis on the effect of goal-directed fluid therapy on postoperative outcomes in renal transplantation surgeries.

Introduction: This systematic review and meta-analysis investigated the impact of intraoperative goal-directed therapy (GDT) compared with conventional fluid therapy on postoperative outcomes in renal transplantation recipients, addressing this gap in current literature.

Method: A systematic search of patients aged ≥18 years who have undergone single-organ primary renal transplantations up to June 2022 in PubMed, Embase, Scopus and CINAHL Plus was performed. Primary outcome examined was postoperative renal function.

Spotlighting 'Medical Collegiality'.

'Collegiality' comes from the Latin term 'Collegium', which essentially refers to a community of individuals bounded by their collective pursuit of a common goal. The concept has historical roots in both organised religion and academia, with its use subsequently extended to various industrial and corporate settings including healthcare. Nowadays, 'collegiality' has become a common buzzword adopted by the medical fraternity - often deemed as having a polite and respectful demeanour, maintaining cordial work relationships and being a team player who demonstrates willingness to help others and avoid speaking ill of fellow colleagues.

Factors associated with international humanitarian aid appeal for disasters from 1995 to 2015: A retrospective database study.

Introduction: International humanitarian aid during disasters should be needs-based and coordinated in response to appeals from affected governments. We identify disaster and population factors associated with international aid appeal during disasters and hence guide preparation by international humanitarian aid providers.

Methods: In this retrospective database analysis, we searched the Emergency Events Database for all disasters from 1995 to 2015.

Nocturnal Oxygen Desaturation Index Correlates with Respiratory Depression in Post-Surgical Patients Receiving Opioids - A Post-Hoc Analysis from the Prediction of Opioid-Induced Respiratory Depression in Patients Monitored by Capnography (PRODIGY) Study.

Purpose: Postoperative monitoring of respiratory status on general care wards typically consists of intermittent checks of oxyhemoglobin saturation and respiratory rate, allowing substantial unmonitored time for severe opioid induced respiratory depression (RD) to develop unnoticed. Oxygen desaturation index (ODI) can be computed solely by continuous pulse oximetry monitoring. In this post-hoc analysis, we evaluate whether nocturnal ODI correlates with RD.

Association Between Race and Opioid-Induced Respiratory Depression: An International Post Hoc Analysis of the Prediction of Opioid-induced Respiratory Depression In Patients Monitored by Capnography Trial.

Background: Opioid-induced respiratory depression (OIRD) is common on the medical and surgical wards and is associated with increased morbidity and health care costs. While previous studies have investigated risk factors for OIRD, the role of race remains unclear. We aim to investigate the association between race and OIRD occurrence on the medical/surgical ward.

Factors reducing inappropriate attendances to emergency departments before and during the COVID-19 pandemic: A multicentre study.

Introduction: Inappropriate attendances (IAs) to emergency departments (ED) create an unnecessary strain on healthcare systems. With decreased ED attendance during the COVID-19 pandemic, this study postulates that there are less IAs compared to before the pandemic and identifies factors associated with IAs.

Methods: We performed a retrospective review of 29,267 patient presentations to a healthcare cluster in Singapore from 7 April 2020 to 1 June 2020, and 36,370 patients within a corresponding period in 2019.

Direct Measurement of Creatinine Clearance over a Short Interval in Intensive Care Settings.

Background: The definition of acute kidney injury (AKI), based on serum creatinine and urine output, bears significant limitations in intensive care units (ICUs). Serum creatinine has significant lag-time as it needs to be accumulated and stabilized at a new level whereas urine output is affected by diuresis, antidiuresis, and antinatriuresis. Direct measurement of creatinine clearance (CrCl = urine creatinine × urine flow rate/serum creatinine) over a short interval (3-6 hours) was explored to identify patients with AKI.

Changes of Drug Pharmacokinetics in Patients with Short Bowel Syndrome: A Systematic Review.

Background And Objectives: Short bowel syndrome is a clinical condition defined by malabsorption of nutrients and micronutrients, most commonly following extensive intestinal resection. Due to a loss of absorptive surfaces, the absorption of orally administered drugs is also often affected. The purpose of this study was to systematically review the published literature and examine the effects of short bowel syndrome on drug pharmacokinetics and clinical outcomes.

Undertreatment of osteoporosis following hip fracture: a retrospective, observational study in Singapore.

Unlabelled: Undertreatment of osteoporosis after hip fracture increases the risk of death, disability, recurrent osteoporotic fractures, and financial burden. Only half were compliant with osteoporosis medications. Elderly patients were less persistent and compliant to treatment.

A BEME systematic review of teaching interventions to equip medical students and residents in early recognition and prompt escalation of acute clinical deteriorations: BEME Guide No. 62.

Current educational interventions and teaching for acute deteriorations seem to address acute care learning in discreet segments. Technology enhanced and team training methodologies are in vogue though well studied in the nursing profession, teaching avenues for junior 'doctors in training' seem to be a lacuna. The BEME systematic review was designed to (1) appraise the existing published evidence on educational interventions that are intended for 'doctors in training' to teach early recognition and prompt escalation in acute clinical deteriorations (2) to synthesise evidence & to evaluate educational effectiveness.

Causes and prognosis of symptomatic pericardial effusions treated by pericardiocentesis in an Asian academic medical centre.

Introduction: This study aimed to investigate the causes, clinical management and outcomes of clinically significant pericardial effusions, and evaluate the practice of pericardiocentesis within an academic medical centre in Singapore, a multiethnic country in Southeast Asia.

Methods: Consecutive patients undergoing pericardiocentesis at a single Asian academic medical centre were identified. Patient demographics, echocardiographic findings, investigations, pericardiocentesis procedural details and clinical progress were tracked using a comprehensive electronic medical records system.

Neurologic and cognitive outcomes associated with the clinical use of xenon: a systematic review and meta-analysis of randomized-controlled trials.

Background: Xenon has been shown to have positive neurologic effects in various pre-clinical models. This study systematically reviewed the randomized-controlled trials (RCTs) investigating neurologic and cognitive outcomes associated with the clinical use of xenon.

Methods: We searched PubMed, CENTRAL, EMBASE, CINAHL, elibrary.

Posttraumatic Growth After Motor Vehicle Crashes.

The relationship between sub-dimensions of posttraumatic growth (PTG) and distress was investigated for survivors of motor vehicle crashes (MVC). PTG and symptoms of posttraumatic stress disorder (PTSD) for 1045 MVC survivors who attended the Accident and Emergency Services were examined with the Chinese versions of the Posttraumatic Growth Inventory (PTGI) and the Impact of Event Scale-Revised 1 week after the experience of a MVC. A factor structure, which was different from both the original English version of the PTGI and the Chinese version of PTGI for cancer survivors, was identified.

Xenon Anesthesia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background: Xenon anesthesia has been studied for decades. However, no meta-analysis of randomized controlled trials (RCTs) on xenon anesthesia has been conducted. The aim of this study was to systematically review all available evidence from RCTs comparing xenon and other inhaled and IV anesthetics on anesthetic outcomes.

Paravertebral Block for Inguinal Herniorrhaphy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background: Paravertebral block (PVB) is a safe and effective anesthetic technique for thoracotomy and mastectomy. However, no systematic review or meta-analysis has focused on PVB for inguinal herniorrhaphy. Our study compares PVB with general anesthesia/systemic analgesia, neuraxial blocks, and other peripheral nerve blocks.

Optimizing pain management to facilitate Enhanced Recovery After Surgery pathways.

Purpose: The optimal management of postoperative pain using multimodal analgesia is a key component of Enhanced Recovery After Surgery (ERAS). Pain has adverse clinical implications on postoperative recovery, including prolonging the time to recovery milestones and length of hospital stay. Moreover, the ubiquity of opioids in postoperative analgesic regimens results in adverse effects, such as sedation, postoperative nausea and vomiting, urinary retention, ileus, and respiratory depression, which can delay discharge.

Lidocaine patch for acute pain management: a meta-analysis of prospective controlled trials.

Background: Local anesthetic is one of the cornerstones of multimodal analgesia. We investigated the efficacy of the lidocaine patch for acute pain management.

Methods: We searched MEDLINE, CINAHL, Scopus, and the Cochrane Controlled Trials Register for published prospective controlled clinical trials that evaluated the analgesic effect of the lidocaine patch for acute or postoperative pain management (1966--2014).

Combined use of serum adiponectin and tumor necrosis factor-alpha receptor 2 levels was comparable to 2-hour post-load glucose in diabetes prediction.

Background: Adipose tissue inflammation and dysregulated adipokine secretion are implicated in obesity-related insulin resistance and type 2 diabetes. We evaluated the use of serum adiponectin, an anti-inflammatory adipokine, and several proinflammatory adipokines, as biomarkers of diabetes risk and whether they add to traditional risk factors in diabetes prediction.

Methods: We studied 1300 non-diabetic subjects from the prospective Hong Kong Cardiovascular Risk Factor Prevalence Study (CRISPS).

Psychometric analysis of the Chinese version of the Posttraumatic Growth Inventory with cancer patients in Hong Kong and Taiwan.

Objective: Cancer patients in Hong Kong and Taiwan share traditional Chinese as a written form of language, but each region has its own sociocultural background. This study examined if the four-factor model (self, spiritual, life orientation, and interpersonal) of the Chinese version of the Posttraumatic Growth Inventory (PTGI-C), developed for Hong Kong cancer survivors, could be applied to cancer survivors in Taiwan.

Methods: Multisample confirmatory factor analyses (MS-CFA) were used to examine the factorial invariance of the PTGI-C among cancer survivors in Taiwan (n = 217) and Hong Kong (n = 223).