Notes

New record of Cyrtonotula Uvarov, 1939 (Blaberidae, Epilamprinae) through Tiongkok, together with 3 new varieties based on morphological and also COI data.
033); patients with diabetes mellitus on metformin had the best prognosis. Metformin use was associated with significantly lower DSS (p = 0.042). Other oral hypoglycaemic agents, insulin or statins were not associated with disease recurrences or progression.

Metformin use was associated with improved oncological outcomes in patients with non-muscle invasive bladder cancer treated with intravesical BCG. Prospective studies with larger patient populations are needed to validate the role of metformin as potential therapy for bladder cancer.
Metformin use was associated with improved oncological outcomes in patients with non-muscle invasive bladder cancer treated with intravesical BCG. Prospective studies with larger patient populations are needed to validate the role of metformin as potential therapy for bladder cancer.
Unmet psychosocial concerns are associated with emotional distress among cancer patients. This longitudinal study aimed to identify specific psychosocial concern profiles and trajectories of emotional distress, and examine their association among newly diagnosed adult cancer patients across the first year of diagnosis.

Adult patients aged 21-64 years were screened to determine eligibility for this study. Psychosocial concerns and psychological distress were measured with the Problem List (PL) and the Distress Thermometer (DT), respectively (n = 221). Latent transition mixture analysis was used to determine specific psychosocial concern profiles and trajectories of emotional distress, and examine associations with adjustments made for demographic and medical variables.

Two classes of psychosocial concerns were identified low (81%) and high (19%) concerns. Two trajectories of distress were identified low stable (69%) and high stable (31%) trajectories. Patients in the high concerns class were significantly more likely to demonstrate the high stable trajectory of distress.

The findings highlight the importance of concurrent assessment of multiple psychosocial concerns and screening of emotional distress throughout a cancer patient's treatment journey. Such assessments can effectively guide interventions to address individual concerns and alleviate emotional distress among newly diagnosed cancer patients.
The findings highlight the importance of concurrent assessment of multiple psychosocial concerns and screening of emotional distress throughout a cancer patient's treatment journey. Such assessments can effectively guide interventions to address individual concerns and alleviate emotional distress among newly diagnosed cancer patients.
General anaesthesia is associated with higher maternal morbidity and mortality, when compared with regional anaesthesia, related mainly to failure of intubation, hypoxia and aspiration. The aim of this retrospective review was to define the incidence of failed and difficult intubation in parturients undergoing general anaesthesia for caesarean delivery at a high-volume obstetric hospital in Singapore.

All parturients who underwent caesarean delivery under general anaesthesia in 2013-2016 were identified and medical records reviewed to extract pertinent data. Difficult intubation was defined as those "requiring more than one attempt at intubation, or documented as such, based on the opinion of the anaesthetist." A failed intubation was defined as "the inability to intubate the trachea, with subsequent abandonment of intubation as a means of airway management."

Records of 660 caesarean sections under general anaesthesia were extracted. Mean age of parturients was 32.1 ± 5.5 years and median body mass index was 27.5 (interquartile range 24.6-31.1) kg/m2. Rapid sequence induction with cricoid pressure was employed for all patients, with thiopentone and succinylcholine being administered for 91.2% and 98.1% of patients, respectively. There were 33 difficult intubations among 660 patients, giving an incidence of 5.0%. Junior trainees performed 90% of all intubations and 28 of 33 (84.8%) difficult intubations. Repeat intubations were performed by senior residents/fellows (57.1%) and consultants (15.0%). No instance of failed intubation was reported.

The local incidence of difficult obstetric intubation was 1 in 20. learn more There was no failure of intubation.
The local incidence of difficult obstetric intubation was 1 in 20. There was no failure of intubation.
It is unclear which advanced airway device has better placement success and fewer adverse events in out-of-hospital cardiac arrests (OHCAs). This study aimed to evaluate the efficacy of the VBM laryngeal tube (LT) against the laryngeal mask airway (LMA) in OHCAs managed by emergency ambulances in Singapore.

This was a real-world, prospective, cluster-randomised crossover study. All OHCA patients above 13 years old who were suitable for resuscitation were randomised to receive either LT or LMA. The primary outcome was placement success. Per-protocol analysis was performed and association between outcomes and airway device group was compared using multivariate binomial logistic regression analysis.

Of 965 patients with OHCAs from March 2016 to January 2018, 905 met the inclusion criteria, of which 502 (55.5%) were randomised to receive LT while 403 (44.5%) were randomised to receive LMA. Only 174 patients in the LT group actually received the device due to noncompliance. Placement success for LT was lower than for LMA (adjusted odds ratio [OR] 0.52, 95% confidence interval [CI] 0.31-0.90). Complications were more likely when using LT (OR 2.82,0 95% CI 1.64-4.86). Adjusted OR for prehospital return of spontaneous circulation (ROSC) was similar in both groups. A modified intention-to-treat analysis showed similar outcomes to the per-protocol analysis between the groups.

LT was associated with poorer placement success and higher complication rates than LMA. The likelihood of prehospital ROSC was similar between the two groups. Familiarity bias and a low compliance rate to the LT were the main limitations of this study.
LT was associated with poorer placement success and higher complication rates than LMA. The likelihood of prehospital ROSC was similar between the two groups. Familiarity bias and a low compliance rate to the LT were the main limitations of this study.
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