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INTRODUCTION@#Advanced breast cancer (ABC) remains common in Singapore. In 2019, 22.1% of breast cancer patients presented with ABC in our institution. Despite increasing affluence and the advent of national mammographic screening, the incidence of ABC has not changed significantly. This suggests inherent differences in women who present late. We aim to explore the socio-economic background, knowledge and attitudes of women who present with ABC.@*METHODS@#Between December 2013 and July 2015, 100 patients who presented consecutively with ABC in a tertiary institution in Singapore were recruited to participate in an interviewer-led questionnaire exploring psychosocial and economic issues.@*RESULTS@#Among the 100 patients, 63 and 37 presented with stages 3 and 4 breast cancer respectively. Median age was 57 (27-86), 52% had at least secondary education, 53% had no formal employment and 71% were married; 88% were aware of breast cancer symptoms, 82% were aware that mammography can help detect cancer, 82% believed that current treatment modality for breast cancer is effective, 96% had never undergone a mammography and 52.9% felt mammograms were unnecessary. A total of 64% presented symptomatic from the breast tumour, with a median duration of 3 months. Many of the patients were aware of breast cancer symptoms and the utility of mammography. However, a group of patients did not comply with screening. This may be due to poor understanding about breast screening and detection in its asymptomatic phase.@*CONCLUSION@#Further public education to improve understanding of breast cancer and screening mammography may help to improve rates for earlier detection of breast cancer.
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Objective To study the characteristics of fluid intake and central venous pressure (CVP) within 4 days after birth in very low birth weight (VLBW) premature infants complicated with bronchopulmonary dysplasia (BPD).Method From February 2015 to March 2019,VLBW preterm infants without serious complications were enrolled in two hospitals.Their CVP were measured every 4 ～ 6 hours after birth.They were assigned into BPD group and non-BPD group,and the fluid intake and CVP within 4 days after birth were compared between these two groups.Result A total of 45 VLBW preterm infants were included,including 17 in the BPD group and 28 in the non-BPD group.The fluid intake in the BPD group showed no significant difference with the non-BPD group within 4 days after birth (P ＞ 0.05).No significant correlation existed between the mean liquid intake and the mean CVP in 1 ～ 4 days after birth (r =0.093,P=0.542).From day1 to day4,the CVPs of the BPD group were (3.97 ± 0.68),(4.49 ± 0.75),(4.55 ± 0.66),(4.02 ± 1.05) cmH2O,and the non-BPD group were (3.66 ± 1.09),(3.96 ±0.76),(3.81 ± 0.69),(3.91 ± 0.65) cmH2O.The differences between the BPD group and the nonBPD group were statistically significant (P ＜ 0.05).The CVP of the BPD group was increasing from day 2 to day 3 (P ＜ 0.05).Conclusion VLBW premature infants complicated with BPD may have higher CVP at the early stage of life,which may not be related with the fluid intake.
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Objective To study the range of central venous pressure (CVP) in very low birth weight (VLBW) infants within the first week after birth.Method From February 2014 to February 2018,50 VLBW infants without serious diseases during the first 7 days of life received umbilical venous catheters were prospectively enrolled.CVPs were measured every 4～6 h.The trend of CVP and the correlation of CVP (within 24 h) and birth weight,gestational age were analyzed.Result A total of 50 VLBW infants and 1 291 CVP measurements were included.The CVP increased slightly within 48 h after birth,and then declined.The 95％CI of CVPs were 3.67～4.21,4.03～4.49,3.90～4.33,3.67～4.19,3.29～3.97,3.14～3.94 and 2.64～ 3.55 cmH2O from day 1 to day 7.No significant correlation existed between CVP in the first day and birth weight,nor gestational age (r=-0.267,P=0.073;r=0.106,P=0.762).Conclusion The CVP of VLBW infants increased slightly within 48 h after birth,and then declined.There was no significant correlation between CVP in the first day and birth weight,nor CVP and gestational age.
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Objective To probe the application of umbilical vein catheterization among the verylow-birth-weight or the low-birth-weight children.Methods In this retrospective study,the clinical condition of the very-low-birth-weight or the low-birth-weight infants in neonatal intensive care unit who had umbilical vein catheterization from June 2011 to January 2013 was concluded.Results Sixty-three cases were successfully catheterized,of which 41 cases were catheterized in inferior vena cava(65.1％).The retention time was 4 to 21 days,with an average of 12.9 days.Eleven cases suffered unplanned extubation of the indwelling catheters,and eight of them were located in the umbilical vein.There were statistically significant differences of unplanned extubation rates among different location of the catheters (x2 =8.38,P ＜ 0.01).All cases were intubated within 36 hours after birth,and the intubation time was not positively correlated to the success rate of catheterization in the inferior vena cava (x2 =0.223,P ＞ 0.1).Suspected catheter-related infections occurred in 5 cases and the infection rate was 6.2/1000 per intravascular catheter day.After extubation,bacterial cultures of the tips of the catheters and blood were arranged.The results suggest that the bacterial culture of the catheter tip was positive in only 1 case(1.6％),and yeast-like fungus was positive in 1 case (1.6％),while the retention time and incidence of catheter-related infection had no significant corelation(x2 =0.075,P ＞ 0.95).Conclusion Umbilical vein catheterization could be used at the early stage in preterm (very) low-birth-weight infants.