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Wong W, Singh AK. Urinary cytokines: clinically useful markers of chronic renal disease progression? Curr Opin Nephrol Hypertens 2001; 10:807-11. [PMID: 11706309 DOI: 10.1097/00041552-200111000-00012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Many factors that drive glomerular and tubulointerstitial fibrogenesis have been identified. These include hemodynamic factors, chemokines, inflammatory mediators, cytokines, and lipids. These strides in knowledge are important in identifying those patients at increased risk of progressive renal disease as well as in developing targets for therapeutic interventions. Identifying 'progressors' is crucial since the distribution of the slope of the glomerular filtration rate of patients with chronic kidney disease is not normal. Some patients appear to progress very rapidly, such as those with diabetes, whereas other patients fail to progress at all. Developing strategies targeted at identifying the fast from the slow progressors is therefore of paramount importance if we are to deploy resources rationally in the management of patients with chronic kidney disease. The use of urinary cytokine markers as predictors of progression of renal disease is reviewed in this paper.
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Wong W. Ambulatory blood pressure in twin children. Am J Hypertens 2001. [DOI: 10.1016/s0895-7061(01)01925-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Wong W, Coward RJ, Morris MC. Ibuprofen induced acute renal failure in an infant. THE NEW ZEALAND MEDICAL JOURNAL 2001; 114:431. [PMID: 11700753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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Thrupp J, Wong W, Charles J. Primary anconeal fracture in a boxer. Aust Vet J 2001; 79:611-2. [PMID: 11702931 DOI: 10.1111/j.1751-0813.2001.tb10778.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A 14-month-old speyed female Boxer was presented with acute non-weight-bearing lameness in the right forelimb. Radiography revealed separation of the anconeal process, which was thence surgically removed. Histological examination of the anconeal process confirmed a primary fracture. Isolated unilateral anconeal process fracture in the dog is rare and this report includes histopathological findings of a primary anconeal fracture.
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Ng JS, Wong W, Law RW, Hui J, Wong EN, Lam DS. Ocular complications of paediatric patients with nephrotic syndrome. Clin Exp Ophthalmol 2001; 29:239-43. [PMID: 11545423 DOI: 10.1046/j.1442-9071.2001.00426.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate ocular complications arising from nephrotic syndrome and/or its treatments in children. METHODS A cross-sectional study was conducted in a teaching hospital. A total of 31 paediatric patients with nephrotic syndrome were studied. Comprehensive ophthalmic assessments on best-corrected visual acuity, intraocular pressure, slit-lamp and fundus examination were taken. Information regarding histological diagnosis of nephrotic syndrome and its treatment regimen in each patient was reviewed and analysed. RESULTS Bilateral posterior subcapsular cataracts were detected in three of 29 patients (10.3%) who received steroid therapy. Two had normal vision while one had visual acuity reduced to 6/15 in both eyes. The age of onset of the nephrotic syndrome in these three patients was 2 years, which was significantly younger than those without cataract (5.4 +/- 3.2 years, P < 0.001). Three patients (9.7%) had isolated asymptomatic fundal findings of tortuous and dilated retinal vessels. Hypertensive retinopathy was found in one patient (3.2%). No steroid-induced glaucoma, uveitis, ocular infection, or other eye complications related to the use of steroids or other immunosuppressive agents were noted. CONCLUSIONS Children who have nephrotic syndrome often require prolonged, intermittent high dose of systemic corticosteroid therapy. Paediatricians should be aware of the potential risk of developing steroid-related complications, especially posterior subcapsular cataract. It appears to have a higher risk when steroid therapy is used in very young patients. Early detection would help to prevent amblyopia development, particularly in the group of immature eyes.
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Abstract
Tongue acupuncture is an innovative technique in traditional Chinese medicine. We have demonstrated that specific tongue acupoints are related to various functional domains. This study aimed to assess the efficacy of tongue acupuncture in children with neurologic disability who had severe drooling problems. We conducted an intent-to-treat study in a cohort of 10 children. A continuous course of tongue acupuncture was performed daily to five acupoints in the tongue for a total of 30 sessions. Standardized outcome measures of drooling were evaluated by a blinded assessor to study the efficacy at baseline and after a course of treatment. Statistically significant improvement was noted in the following outcome measures: (1) mean visual analog scale (VAS) decreased from 6.6 (pre-TAC) to 4.67 (post-TAC) (P = 0.002); (2) mean drooling quotient (DQ) decreased from 14.016% (pre-TAC) to 8.335% (post-TAC) (P = 0.0078); and (3) mean drooling score (DS) decreased from 7.4 (pre-TAC) to 4.4 (post-TAC) (P = 0.002). This study demonstrated the efficacy of tongue acupuncture as an adjunctive or alternative treatment for patients with drooling problems and can be integrated as part of the oromotor stimulation program, drooling program, and behavioral modification program before subjecting the patient to invasive surgical procedures on the salivary glands.
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El-Gazzaz G, Wong W, El-Hadary MK, Gunson BK, Mirza DF, Mayer AD, Buckels JA, McMaster P. Outcome of liver resection and transplantation for fibrolamellar hepatocellular carcinoma. Transpl Int 2001; 13 Suppl 1:S406-9. [PMID: 11112043 DOI: 10.1007/s001470050372] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Fibrolamellar hepatocellular carcinoma (FL HCC) is an uncommon variant of hepatocellular carcinoma occurring usually in non-cirrhotic livers. Hepatic resection or transplantation offers the only chance of cure. We reviewed our experience of surgery for FL HCC from 1985-1998. Twenty patients with FL HCC (13 females and 7 males) median age 27 years (range 12-69) were treated either by hepatic resection [n = 11; extended right hepatectomy (5), extended left hepatectomy (1), right hemihepatectomy (2), left hemihepatectomy (2), left lateral segmentectomy (1)] or, if the disease was non-resectable, by transplantation (n = 9). The median follow up was 25 months (1-63). The prognostic factors analysed included size [less than 5 cm (3 patients), more than 5 cm (17 patients)], number [solitary (16 patients), multiple (4 patients)], capsular invasion (6 patients), vascular invasion (11 patients) and lymph node invasion (6 patients). The overall survival at 1, 3 and 5 years was 89.5, 75 and 50%, respectively. The liver resection survival was better than liver transplantation survival at 3 years 100 vs 76%, respectively (P < 0.025). Although all prognostic factors analysed did not show a significant difference, there is tendency that tumour stage was the most significant for prognosis. Most of the patients in this study are young and presented without specific symptoms, with normal liver function range and had no tumour marker to help in diagnosis. As a result most of our patients were diagnosed late. However the outcome of surgical intervention was favourable.
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Ng PC, So KW, Fung KS, Lee CH, Fok TF, Wong E, Wong W, Cheung KL, Cheng AF. Randomised controlled study of oral erythromycin for treatment of gastrointestinal dysmotility in preterm infants. Arch Dis Child Fetal Neonatal Ed 2001; 84:F177-82. [PMID: 11320044 PMCID: PMC1721258 DOI: 10.1136/fn.84.3.f177] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
AIM To evaluate the effectiveness of oral erythromycin as a prokinetic agent for the treatment of moderately severe gastrointestinal dysmotility in preterm very low birthweight infants. METHODS A prospective, double blind, randomised, placebo controlled study in a tertiary referral centre of a university teaching hospital was conducted on 56 preterm infants (< 1500 g) consecutively admitted to the neonatal unit. The infants were randomly allocated by minimisation to receive oral erythromycin (12.5 mg/kg, every six hours for 14 days) or an equivalent volume of placebo solution (normal saline) if they received less than half the total daily fluid intake or less than 75 ml/kg/day of milk feeds by the enteral route on day 14 of life. The times taken to establish half, three quarters, and full enteral feeding after the drug treatment were compared between the two groups. Potential adverse effects of oral erythromycin and complications associated with parenteral nutrition were assessed as secondary outcomes. RESULTS Twenty seven and 29 infants received oral erythromycin and placebo solution respectively. The times taken to establish half, three quarters, and full enteral feeding after the drug treatment were significantly shorter in the group receiving oral erythromycin than in those receiving the placebo (p < 0.05, p < 0.05 and p < 0.0001 respectively). There was also a trend suggesting that more infants with prolonged feed intolerance developed cholestatic jaundice in the placebo than in the oral erythromycin group (10 v 5 infants). None of the infants receiving oral erythromycin developed cardiac dysrhythmia, pyloric stenosis, or septicaemia caused by multiresistant organisms. CONCLUSIONS Oral erythromycin is effective in facilitating enteral feeding in preterm very low birthweight infants with moderately severe gastrointestinal dysmotility. Treated infants can achieve full enteral feeding 10 days earlier, and this may result in a substantial saving on hyperalimentation. However, until the safety of erythromycin has been confirmed in preterm infants, this treatment modality should remain experimental. Prophylactic or routine use of this medication for treatment of mild cases of gastrointestinal dysmotility is probably not warranted at this stage.
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Popoola J, Marconell MH, Wood KJ, Sacks SH, Wong W. Natural killer cell regulatory receptor changes following tolerance induction. Transplant Proc 2001; 33:448. [PMID: 11266903 DOI: 10.1016/s0041-1345(00)02087-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Gourishankar S, Wong W, Dorval M. Meta-analysis of prophylaxis of CMV disease in solid organ transplantation: is Ganciclovir a superior agent to Acyclovir? Transplant Proc 2001; 33:1870-2. [PMID: 11267547 DOI: 10.1016/s0041-1345(00)02730-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Runge VM, Armstrong MR, Barr RG, Berger BL, Czervionke LF, Gonzalez CF, Halford HH, Kanal E, Kuhn MJ, Levin JM, Low RN, Tanenbaum LN, Wang AM, Wong W, Yuh WT, Zoarski GH. A clinical comparison of the safety and efficacy of MultiHance (gadobenate dimeglumine) and Omniscan (Gadodiamide) in magnetic resonance imaging in patients with central nervous system pathology. Invest Radiol 2001; 36:65-71. [PMID: 11224753 DOI: 10.1097/00004424-200102000-00001] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
RATIONALE AND OBJECTIVES The safety and diagnostic efficacy of MultiHance (gadobenate dimeglumine) in the central nervous system (CNS) were evaluated in a double-blind, multicenter, phase III clinical trial. METHODS Two hundred five patients highly suspected of having a CNS lesion (by previous imaging exam) were enrolled at 16 sites in the United States. Patients were randomized to one of three incremental dosing regimens. Magnetic resonance imaging with Omniscan (gadodiamide) at doses of 0.1 and 0.3 mmol/kg was compared with MultiHance (gadobenate dimeglumine) at doses of 0.05 and 0.15 mmol/kg and at 0.1 and 0.2 mmol/kg. RESULTS Compared with predose images alone, efficacy was demonstrated in each of the gadobenate dimeglumine and gadodiamide groups (single and cumulative doses) as indicated by the level of diagnostic information, number of lesions detected, and contrast-to-noise ratio measurements. The level of diagnostic information from gadobenate dimeglumine at 0.1 mmol/kg was equivalent to that with gadodiamide at the same dose. One of the two blinded reviewers found equivalence between the gadobenate dimeglumine 0.05 mmol/kg dose and gadodiamide at 0.1 mmol/kg. Both reviewers found the level of diagnostic information to be equivalent after the second dose of contrast for all three dosing regimens. The cumulative doses of gadobenate dimeglumine were well tolerated and as safe as gadodiamide. CONCLUSIONS Gadobenate dimeglumine is comparable to gadodiamide in terms of safety and efficacy for imaging of CNS lesions, with a possible advantage in imaging applications owing to enhanced T1 relaxivity.
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Li AM, Wong W, Chan MH, Ma KC, Law LK, van Zwieten R, Lam CW, Fok TF. Normal pulse oximeter reading in a cyanotic infant. J Paediatr Child Health 2001; 37:94-5. [PMID: 11168881 DOI: 10.1046/j.1440-1754.2001.00614.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A newborn infant who presented with central cyanosis was found to have hereditary methaemoglobinaemia. The pulse oximeter readings and physical findings were incompatible. Clinical assessment remains an important part in the management of such cases.
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Ho AM, Wong W, Ling E, Chung DC, Tay BA. Airway difficulties caused by improperly applied cricoid pressure. J Emerg Med 2001; 20:29-31. [PMID: 11165834 DOI: 10.1016/s0736-4679(00)00285-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Cricoid pressure, when properly applied, may prevent gastric regurgitation and may improve the view of laryngoscopy. When improperly applied, however, it can impede laryngoscopy and mask-ventilation. When faced with a "cannot intubate" or "cannot mask-ventilate" situation, clinicians should reevaluate the manner with which the assistant is applying cricoid pressure and must be prepared to adjust or even to release it.
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Keith M, Norwich KH, Wong W, Jeejeebhoy KN. The tissue distribution of tumor necrosis factor-alpha in rats: a compartmental model. Metabolism 2000; 49:1309-17. [PMID: 11079821 DOI: 10.1053/meta.2000.9525] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Tumor necrosis factor (TNF) is widely accepted to be the mediator of the cascade of metabolic abnormalities associated with both critical and chronic illness. TNF binding to cell surface receptors mediates its physiologic actions, although the exact mechanism of TNF action is unknown. Therefore, this study was designed to investigate the in vivo metabolism of TNF using a mathematical model to examine tissue uptake and loss of TNF over time. Two distinct patterns of TNF uptake were observed. Muscle tissues were found to accumulate TNF over the entire experimental period, whereas the visceral organs were found to have a rapid initial accumulation of TNF followed by a rapid loss of TNF back to the plasma or out into the bile or the urine. These patterns of TNF binding and retention may reflect the number of TNF receptors or their affinity for TNF, as well as the balance between cell surface and soluble TNF receptors. Furthermore, TNF binding patterns provide insight into the biologic action of TNF at these sites.
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Ng PC, Lee CH, Fok TF, Chui K, Wong W, Cheung KL, So KW. Central nervous system candidiasis in preterm infants: limited value of biochemical markers for diagnosis. J Paediatr Child Health 2000; 36:509-10. [PMID: 11036812 DOI: 10.1046/j.1440-1754.2000.00520.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Two rare cases of isolated central nervous system (CNS) candidiasis in preterm infants have been diagnosed in a tertiary neonatal centre over the past 6 years. Despite the life-threatening nature of the disease, biochemical infection markers were not useful for the early identification of localized fungal infection. Because the infection was likely to have been blood borne, we postulated that the initial fungal load was probably low and that the organisms were rapidly eliminated from the circulation after a few had been deposited in the CNS. Hence, the absence of fungaemia or systemic involvement precluded the activation of cytokines and cellular markers. Clinicians should be aware of the limitation of biochemical infection markers so that diagnosis and treatment of fungal infection will not be delayed.
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Irizarry K, Kustanovich V, Li C, Brown N, Nelson S, Wong W, Lee CJ. Genome-wide analysis of single-nucleotide polymorphisms in human expressed sequences. Nat Genet 2000; 26:233-6. [PMID: 11017085 DOI: 10.1038/79981] [Citation(s) in RCA: 108] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Single-nucleotide polymorphisms (SNPs) have been explored as a high-resolution marker set for accelerating the mapping of disease genes. Here we report 48,196 candidate SNPs detected by statistical analysis of human expressed sequence tags (ESTs), associated primarily with coding regions of genes. We used Bayesian inference to weigh evidence for true polymorphism versus sequencing error, misalignment or ambiguity, misclustering or chimaeric EST sequences, assessing data such as raw chromatogram height, sharpness, overlap and spacing, sequencing error rates, context-sensitivity and cDNA library origin. Three separate validations-comparison with 54 genes screened for SNPs independently, verification of HLA-A polymorphisms and restriction fragment length polymorphism (RFLP) testing-verified 70%, 89% and 71% of our predicted SNPs, respectively. Our method detects tenfold more true HLA-A SNPs than previous analyses of the EST data. We found SNPs in a large fraction of known disease genes, including some disease-causing mutations (for example, the HbS sickle-cell mutation). Our comprehensive analysis of human coding region polymorphism provides a public resource for mapping of disease genes (available at http://www.bioinformatics.ucla.edu/snp).
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Wong W. Advancing breastfeeding. THE CANADIAN NURSE 2000; 96:10-1. [PMID: 11865518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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Wong W. Long-term care. No justice, no peace. NURSING TIMES 2000; 96:32-3. [PMID: 11963010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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Wong W, Howes L. Angiotensin receptor antagonists. AUSTRALIAN FAMILY PHYSICIAN 2000; 29:653-5, 658. [PMID: 10914449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
BACKGROUND Angiotensin receptor antagonists are a relatively new class of cardiovascular drugs for which the clinical application has not yet been completely defined. OBJECTIVE This article reviews the pharmacology of the various angiotensin receptor antagonists available in Australia, including their mode of action, side effects and potential drug interactions. DISCUSSION Angiotensin receptor antagonists are effective drugs for the treatment of mild to moderate hypertension which have a side effect profile similar to placebo. Their role in the management of hypertension remains to be defined, but they are of particular use to patients who are intolerant of ACE inhibitors because of cough. It is uncertain at the present time whether the benefits of ACE inhibition in other disorders such as congestive heart failure and following myocardial infarction will be similar for angiotensin receptor blockers.
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Wong W, Tang NL, Lau TK, Wong TW. A new recommendation for maternal weight gain in Chinese women. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 2000; 100:791-6. [PMID: 10916517 DOI: 10.1016/s0002-8223(00)00230-3] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To characterize the distribution of maternal weight gain in Chinese women living in a well-nourished community, to recommend target weight gains from quartile values derived from women with good pregnancy outcomes, and to quantify the risk for adverse pregnancy outcomes encountered among subjects with weight gain outside these recommendations. DESIGN A retrospective study on maternal anthropometry and pregnancy outcomes was conducted among Chinese women who delivered a singleton pregnancy in a university hospital in Hong Kong. SUBJECTS Nine hundred eight women who delivered during the study period were identified. Among them, 754 (83%) had complete anthropometry data. The normative distribution of maternal weight gain was derived from 504 women who had a good pregnancy outcome. STATISTICS Analysis of variance was used to compare total weight gain among women of different prepregnancy weight. Fisher exact test was used in the univariate analysis of the association between risk factors and corresponding adverse pregnancy outcomes. Adjusted odds ratios for adverse outcomes were determined by multiple logistic regression models controlling for the following factors: maternal age, duration of gestation, prepregnancy body mass index (BMI), height, parity, and smoking. RESULTS A maternal weight-gain chart and recommendations for total weight gains in Chinese women were derived from the distribution of weight gain in subjects with good pregnancy outcomes. The recommended total weight gain was 13 to 16.7 kg, 11 to 16.4 kg, and 7.1 to 14.4 kg respectively for women of low (BMI < 19), moderate (BMI: 19 to 23.5), and high (BMI > 23.5) prepregnancy BMI. Women who did not achieve the lower quartile value had more than twice the risk of having low-birth-weight infants. Those with excessive weight gain were at risk for needing assisted delivery. APPLICATIONS As maternal anthropometry differs across ethnic groups, different recommendations should be made for specific populations.
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Chopko BW, Kerber C, Wong W, Georgy B. Transcatheter snare removal of acute middle cerebral artery thromboembolism: technical case report. Neurosurgery 2000; 46:1529-31. [PMID: 10834659 DOI: 10.1097/00006123-200006000-00046] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE AND IMPORTANCE We describe the case of a patient in whom a snare designed for the removal of foreign bodies was successfully used to retrieve a thromboembolism from the middle cerebral artery. This technique can be used to reestablish blood flow when maximal pharmacological therapies have failed. CLINICAL PRESENTATION A 38-year-old man with scrotal squamous cell carcinoma presented with the abrupt onset of left hemiparesis and numbness. Computed tomography of the head showed no hemorrhage or hypodensity, and right middle cerebral artery thrombosis was suspected. INTERVENTION Cerebral angiography demonstrated a near-total occlusion of the right middle cerebral artery at the M1-M2 junction. The administration of intra-arterial urokinase, systemic heparin, and systemic abciximab, and mechanical maceration failed to lyse the clot. A 4-mm goose-neck snare was guided through a microcatheter, and the clot was snared and withdrawn. Immediate postoperative angiography demonstrated the reconstitution of normal flow. Pathological examination of the snared material was consistent with clot. By postoperative Day 5, the patient had regained full strength, except for the fingers of the left hand, which remained moderately weak. Computed tomography demonstrated a right insular and extreme capsular infarct. CONCLUSION To our knowledge, this is the first reported use of a snare to remove clot in the setting of thromboembolic stroke. As the use of intra-arterial thrombolysis increases, transcatheter snare removal of pharmacologically resistant clot may be considered as a salvage strategy.
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Leung TF, Ng PC, Fok TF, Wong MC, Wong W, Cheung KL, So KW. Pneumocystis carinii pneumonia in an immunocompetent infant with congenital cytomegalovirus infection. Infection 2000; 28:184-6. [PMID: 10879648 DOI: 10.1007/s150100050078] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The case of a term infant with congenital cytomegalovirus (CMV) infection who developed Pneumocystis carinii pneumonia (PCP) at 4 months of age is reported. Our patient suffered from severe malnutrition and zinc deficiency secondary to necrotizing enterocolitis since the age of 2 months. There was no evidence of human immunodeficiency virus infection. Qualitative and quantitative in vitro leukocyte functions were also normal. This case highlights the fact that PCP can occur in apparently immunocompetent term infants. Malnourished infants with zinc deficiency or congenital CMV infection are at increased risk of developing PCP.
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Nemoto T, Aoki B, Huang K, Morris A, Le MN, Nguyen H, Ching A, Wong W. HIV risk behaviors among Asian drug users in San Francisco. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2000; 12:126-140. [PMID: 10833038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
This study identified patterns of drug use and HIV risk behaviors in relation to cultural factors among Asian drug users in San Francisco. A sample of 92 Asian drug users (35 Chinese, 31 Filipino, 26 Vietnamese) who were not currently enrolled in drug treatment programs were recruited through targeted sampling methods and interviewed using a questionnaire with open-ended questions. The study evaluated responses of the participants based on content analyses. Compared with Chinese and Vietnamese, Filipino drug users had engaged in riskier behaviors in terms of injection drug use, having sex while on drugs, and having sex with injection drug users (IDUs). Cultural factors such as stigma of injection drug use and fear of needles were cited as reasons for not injecting drugs. Among IDUs, half cited trust as a reason for having shared needles. AIDS prevention programs targeting Asian drug users should consider specific cultural factors among high-risk groups (i.e., Filipinos, immigrants, women, and IDUs).
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