1
|
Wu J, Chi H, Kok S, Chua JM, Huang XX, Zhang S, Mah S, Foo LX, Peh HY, Lee HB, Tay P, Tong C, Ladlad J, Tan CH, Khoo N, Aw D, Chong CX, Ho LM, Sivarajah SS, Ng J, Tan WJ, Foo FJ, Teh BT, Koh FH. Multimodal prerehabilitation for elderly patients with sarcopenia in colorectal surgery. Ann Coloproctol 2024; 40:3-12. [PMID: 37004990 PMCID: PMC10915526 DOI: 10.3393/ac.2022.01207.0172] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/14/2023] [Accepted: 01/16/2023] [Indexed: 04/04/2023] Open
Abstract
Sarcopenia, which is characterized by progressive and generalized loss of skeletal muscle mass and strength, has been well described to be associated with numerous poor postoperative outcomes, such as increased perioperative mortality, postoperative sepsis, prolonged length of stay, increased cost of care, decreased functional outcome, and poorer oncological outcomes in cancer surgery. Multimodal prehabilitation, as a concept that involves boosting and optimizing the preoperative condition of a patient prior to the upcoming stressors of a surgical procedure, has the purported benefits of reversing the effects of sarcopenia, shortening hospitalization, improving the rate of return to bowel activity, reducing the costs of hospitalization, and improving quality of life. This review aims to present the current literature surrounding the concept of sarcopenia, its implications pertaining to colorectal cancer and surgery, a summary of studied multimodal prehabilitation interventions, and potential future advances in the management of sarcopenia.
Collapse
Affiliation(s)
- Jingting Wu
- Division of Surgery, Sengkang General Hospital, Singapore
| | - Hannah Chi
- Division of Surgery, Sengkang General Hospital, Singapore
| | - Shawn Kok
- Department of Radiology, Sengkang General Hospital, Singapore
| | - Jason M.W. Chua
- Institute of Molecular and Cell Biology, Agency for Science Technology and Research, Singapore
| | - Xi-Xiao Huang
- Institute of Molecular and Cell Biology, Agency for Science Technology and Research, Singapore
| | - Shipin Zhang
- Duke-NUS Graduate Medical School, National Cancer Centre Singapore, Singapore
| | - Shimin Mah
- Department of Physiotherapy, Sengkang General Hospital, Singapore
| | - Li-Xin Foo
- Department of Physiotherapy, Sengkang General Hospital, Singapore
| | - Hui-Yee Peh
- Department of Dietetics, Sengkang General Hospital, Singapore
| | - Hui-Bing Lee
- Department of Dietetics, Sengkang General Hospital, Singapore
| | - Phoebe Tay
- Department of Dietetics, Sengkang General Hospital, Singapore
| | - Cherie Tong
- Department of Dietetics, Sengkang General Hospital, Singapore
| | - Jasmine Ladlad
- Division of Surgery, Sengkang General Hospital, Singapore
| | | | | | - Darius Aw
- Division of Surgery, Sengkang General Hospital, Singapore
| | | | | | | | - Jialin Ng
- Division of Surgery, Sengkang General Hospital, Singapore
| | | | - Fung-Joon Foo
- Division of Surgery, Sengkang General Hospital, Singapore
| | - Bin-Tean Teh
- Duke-NUS Graduate Medical School, National Cancer Centre Singapore, Singapore
| | | |
Collapse
|
2
|
Yeung WF, Chung KF, Zhang ZJ, Lao LX, Suen LKP, Ho FYY, Ho LM. Self-administered acupressure for insomnia: abridged secondary publication. Hong Kong Med J 2023; 29 Suppl 2:35-38. [PMID: 36951005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Affiliation(s)
- W F Yeung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - K F Chung
- Department of Psychiatry, The University of Hong Kong, Hong Kong SAR, China
| | - Z J Zhang
- School of Chinese Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - L X Lao
- Virginia University of Integrative Medicine Vienna, Virginia, United States
| | - L K P Suen
- School of Nursing, Tung Wah College, Hong Kong SAR, China
| | - F Y Y Ho
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - L M Ho
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| |
Collapse
|
3
|
Sabat J, Subhadra S, Ho LM, Dwibedi B. A spectrum of viral diseases in Odisha state, eastern India: An evidence-based analysis from 2010-2017. J Postgrad Med 2022; 69:81-88. [PMID: 36571329 DOI: 10.4103/jpgm.jpgm_1152_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Introduction Emerging and re-emerging viral diseases are a major threat to public health. Proper laboratory surveillance plays an important role in estimating the disease burden that helps in taking preventive measures for controlling seasonal diseases. This study focuses on the prevalence of different viral diseases in the state of Odisha, India, from 2010-2017. Material and Methods A total of 43,397 patients with clinical suspicion of viral diseases were screened for different viral etiology during 2010-2017. The laboratory diagnosis was conducted by serology (ELISA) and RealTime RT-PCR for 24 different viruses, i.e., Dengue, Chikungunya, Japanese Encephalitis, Hepatitis A Virus, Hepatitis E Virus, Hepatitis B Virus, Hepatitis C Virus, Rotavirus, Herpes Simplex Virus-1 and Herpes Simplex Virus-2, Epstein -Barr Virus & Cytomegalo Virus, and respiratory viruses. Patients were enrolled from sporadic hospital admissions and outbreaks under different categories as per clinical diagnosis like fever with rash, diarrhoea, encephalitis, jaundice, respiratory illness, and fever of unknown etiology. Results The majority of patients belonged to exanthematous group, i.e., fever with rash (32.24%). The number of males were more in all categories except fever with rash, where females (53.34%) were more. Children <16 years of age were found to be the predominant age group for suspected viral diarrhoea (85.26%), encephalitis (76.96%), fever of unknown origin (40.16%), and respiratory infections (27.23%). Conclusion Odisha being one of the coastal states in the country, reports many viral illnesses due to its typical geographical location. Initially, it was thought to be the only vector-borne disease that posed a threat to the state, but subsequently, other viral illnesses were also diagnosed and reported. This is the first report of laboratory confirmation and distribution of different viral diseases in the state of Odisha and neighboring regions, which will support public health management.
Collapse
Affiliation(s)
- J Sabat
- VRDL, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - S Subhadra
- VRDL, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - L M Ho
- VRDL, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - B Dwibedi
- Department of Pediatrics, AIIMS, Bhubaneswar, Odisha, India
| |
Collapse
|
4
|
Dwibedi B, Sabat J, Dixit S, Rathore S, Subhadra S, Panda S, Pati SS, Mandal M, Ho LM, Thakur B, Kar SK. Epidemiological and clinical profile of Influenza A(H1N1) pdm09 in Odisha, eastern India. Heliyon 2019; 5:e02639. [PMID: 31667431 PMCID: PMC6812237 DOI: 10.1016/j.heliyon.2019.e02639] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 08/07/2019] [Accepted: 10/08/2019] [Indexed: 11/09/2022] Open
Abstract
Epidemic of flu is highly contagious and it spreads through air. In 2009 H1N1 influenza virus emerged after reassortment of North American TRIG and Eurasia Avian like virus of swine and started epidemic in Mexico. The first cases were reported from Hyderabad city on 16th May 2009 in India that spread rapidly within a short span of time. During this period large population of Odisha situated at the eastern side of India was also affected and incidences of H1N1 cases were recorded through state Government surveillance system. In this study real time RT-PCR based diagnosis was conducted for the throat swabs collected from suspected H1N1 cases in Odisha during 2009–2017. A total of 2872 throat swabs were received from 23 different Government and private hospitals and 21.1% positivity was confirmed. The disease affected mostly 46–60 years age group, males (50.6%) being more affected. The clinical features had shown that fever with cough (89.6%) was the most common symptom followed by shortness of breath (72.7%). Post monsoon was the peak season in which most of the cases were reported. Neurological signs, pregnancy, diabetes and hypertension were found to be risk factors for H1N1. The case fatality rate (CFR) was 15%.
Collapse
Affiliation(s)
- B Dwibedi
- Dept. of Pediatrics, AIIMS, Bhubaneswar, Odisha, India
| | - J Sabat
- Virus Research and Diagnostic Laboratory, Regional Medical Research Centre (ICMR), Bhubaneswar, Odisha, India
| | - S Dixit
- Virus Research and Diagnostic Laboratory, Regional Medical Research Centre (ICMR), Bhubaneswar, Odisha, India
| | - S Rathore
- Virus Research and Diagnostic Laboratory, Regional Medical Research Centre (ICMR), Bhubaneswar, Odisha, India
| | - S Subhadra
- Virus Research and Diagnostic Laboratory, Regional Medical Research Centre (ICMR), Bhubaneswar, Odisha, India
| | - S Panda
- Virus Research and Diagnostic Laboratory, Regional Medical Research Centre (ICMR), Bhubaneswar, Odisha, India
| | - S S Pati
- Virus Research and Diagnostic Laboratory, Regional Medical Research Centre (ICMR), Bhubaneswar, Odisha, India
| | - M Mandal
- Virus Research and Diagnostic Laboratory, Regional Medical Research Centre (ICMR), Bhubaneswar, Odisha, India
| | - L M Ho
- Virus Research and Diagnostic Laboratory, Regional Medical Research Centre (ICMR), Bhubaneswar, Odisha, India
| | - B Thakur
- Virus Research and Diagnostic Laboratory, Regional Medical Research Centre (ICMR), Bhubaneswar, Odisha, India
| | - S K Kar
- SOA University, Bhubaneswar, Odisha, India
| |
Collapse
|
5
|
Chan YH, Ngai MC, Chen Y, Wu MZ, Yu YJ, Zhen Z, Lai K, Cheung TT, Ho LM, Chung HY, Lau CS, Tse HF, Yiu KH. 3045Role of osteogenic circulating endothelial progenitor cells in dissemination of large arterial calcification in rheumatoid arthritis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Rheumatoid arthritis is associated with both abnormal bone metabolism and atherogenesis but mechanistic links were missing.
Aim
This study aimed to investigate the role of osteocalcin (OCN)-expressing circulating endothelial progenitor cells (EPC)s in the severity and dissemination of systemic arterial calcifications in rheumatoid arthritis.
Methods
We performed flow cytometry studies in 145 consecutive patients with rheumatoid arthritis to determine osteogenic circulating levels of OCN-positive (OCN+) CD34+KDR+ and OCN+CD34+, versus conventional early EPC CD34+CD133+KDR+. Total calcium load of the thoracic aorta (ascending plus descending) and the carotid arteries were assessed by non-contrast computed tomography (CT) and contrast CT angiography.
Results
Osteogenic EPCs OCN+CD34+KDR+ (P=0.002) and OCN+CD34+ were strikingly associated with the clustered presence of aortic and carotid calcification (P=0.002 and 0.001 respectively, Figure). Multivariable analyses revealed that circulating OCN+CD34+KDR+ (B=14.4 [95% CI 4.0 to 24.8], P=0.007) and OCN+CD34+ (B=9.6 [95% CI 4.9 to 14.3], P<0.001) remained independently associated with increased aortic calcium load. OCN+CD34+ EPC (B=0.8 [95% CI 0.1 to 1.5], P=0.023), but not OCN+CD34+KDR+ EPC (B=1.2 [95% CI −0.2 to 2.6], P=0.09) was further independently associated with carotid calcium load. In comparison, conventional early EPC CD34+CD133+KDR+ had no significant association with aortic or carotid calcium load (P=0.46 and 0.88, respectively).
Conclusions
Circulating level of osteogenic EPC is associated with promulgated aortic and carotid calcification in patients with rheumatoid arthritis, suggesting a potential mechanistic role of the bone-vascular axis in pro-atherogenicity of rheumatic diseases.
Acknowledgement/Funding
General Research Fund, Hong Kong Research Grants Council
Collapse
Affiliation(s)
- Y.-H Chan
- Queen Mary Hospital, Department of Medicine, Division of Cardiology - The University of Hong Kong, Hong Kong, Hong Kong
| | - M C Ngai
- Queen Mary Hospital, Department of Medicine, Division of Cardiology - The University of Hong Kong, Hong Kong, Hong Kong
| | - Y Chen
- Queen Mary Hospital, Department of Medicine, Division of Cardiology - The University of Hong Kong, Hong Kong, Hong Kong
| | - M Z Wu
- Queen Mary Hospital, Department of Medicine, Division of Cardiology - The University of Hong Kong, Hong Kong, Hong Kong
| | - Y J Yu
- Queen Mary Hospital, Department of Medicine, Division of Cardiology - The University of Hong Kong, Hong Kong, Hong Kong
| | - Z Zhen
- Queen Mary Hospital, Department of Medicine, Division of Cardiology - The University of Hong Kong, Hong Kong, Hong Kong
| | - K Lai
- Queen Mary Hospital, Department of Medicine, Division of Cardiology - The University of Hong Kong, Hong Kong, Hong Kong
| | - T T Cheung
- Queen Mary Hospital, Department of Medicine, Division of Rheumatology, The University of Hong Kong, Hong Kong, Hong Kong
| | - L M Ho
- The University of Hong Kong, School of Public Health, Hong Kong, Hong Kong
| | - H Y Chung
- Queen Mary Hospital, Department of Medicine, Division of Rheumatology, The University of Hong Kong, Hong Kong, Hong Kong
| | - C S Lau
- Queen Mary Hospital, Department of Medicine, Division of Rheumatology, The University of Hong Kong, Hong Kong, Hong Kong
| | - H F Tse
- Queen Mary Hospital, Department of Medicine, Division of Cardiology - The University of Hong Kong, Hong Kong, Hong Kong
| | - K H Yiu
- Queen Mary Hospital, Department of Medicine, Division of Cardiology - The University of Hong Kong, Hong Kong, Hong Kong
| |
Collapse
|
6
|
Sabat J, Subhadra S, Thakur B, Panda M, Panda S, Pati SS, Ho LM, Dixit S, Rathore SK, Kar SK, Dwibedi B. Molecular and phylogenetic analysis of the dengue strains circulating in Odisha, India. Virusdisease 2019; 30:380-386. [PMID: 31803805 DOI: 10.1007/s13337-019-00544-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 07/08/2019] [Indexed: 02/02/2023] Open
Abstract
Dengue has emerged as a major public health challenge in terms of both changing clinical pattern and epidemiological features. The state of Odisha reported first dengue epidemic in the year 2010 and this continued each year in epidemic form during post monsoon period gradually becoming an endemic phenomenon. Present study depicts the changing epidemiological and clinical pattern of dengue with reference to its serotypes and genotypes. The study included 5320 suspected dengue cases from different health facilities of the state during 2010-2017. Dengue NS1 antigen and IgM antibody was done through ELISA. Serotyping was done through RTPCR by amplifying a part of core-pre-membrane gene (CprM) followed by sequencing and phylogenetic analysis. Dengue IgM antibody in 17.7% cases and NS1 antigen in 53.20% cases was detected. Dengue serotype 2 (DEN-2) was the only serotype detected in 2010 and 2011 where as all four serotypes 1, 2, 3, 4 were detected in 2012-2017, DEN-2 being dominant but in 2017 DEN-3 was found to be dominant. Phylogenetic analysis revealed genotype IV of DEN-2 and genotype III of DEN-1 and DEN-3 circulating in this region. In 6 cases involvement of DEN-2 in clinically evident encephalitis cases is an important observation in this region and needs public health attention. High prevalence of dengue was observed without any previous reported outbreaks in the state with increased number of cases from 2010 to 2012 affecting both urban and rural areas. High incidence in 2012 was due to co-circulation of more than one serotype which continued in the following years. Severity in some cases was associated with mixed infection but in most cases it was mild indicating the endemic nature of the virus in most parts of Odisha.
Collapse
Affiliation(s)
- J Sabat
- 2ICMR- Regional Medical Research Centre, Bhubaneswar, Odisha 751023 India
| | - S Subhadra
- 2ICMR- Regional Medical Research Centre, Bhubaneswar, Odisha 751023 India
| | - B Thakur
- 2ICMR- Regional Medical Research Centre, Bhubaneswar, Odisha 751023 India
| | - M Panda
- 2ICMR- Regional Medical Research Centre, Bhubaneswar, Odisha 751023 India
| | - S Panda
- 2ICMR- Regional Medical Research Centre, Bhubaneswar, Odisha 751023 India
| | - S S Pati
- 2ICMR- Regional Medical Research Centre, Bhubaneswar, Odisha 751023 India
| | - L M Ho
- 2ICMR- Regional Medical Research Centre, Bhubaneswar, Odisha 751023 India
| | - S Dixit
- 2ICMR- Regional Medical Research Centre, Bhubaneswar, Odisha 751023 India
| | - S K Rathore
- 2ICMR- Regional Medical Research Centre, Bhubaneswar, Odisha 751023 India
| | - S K Kar
- 3Directorate of Medical research, IMS & SUM Hospital, S 'O' A University, Bhubaneswar, Odisha 751030 India
| | - B Dwibedi
- 1Department of Pediatrics, AIIMS, Bhubaneswar, Odisha 751019 India
| |
Collapse
|
7
|
Wong CM, Chan WM, Yang L, Chan KP, Lai HK, Thach TQ, Ho LM, Lam TH, Peiris JSM. Effect of lifestyle factors on risk of mortality associated with influenza in elderly people. Hong Kong Med J 2014; 20 Suppl 6:16-19. [PMID: 25482965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Affiliation(s)
- C M Wong
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong
| | - W M Chan
- Department of Health, The Government of the Hong Kong Special Administrative Region
| | - L Yang
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong
| | - K P Chan
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong
| | - H K Lai
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong
| | - T Q Thach
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong
| | - L M Ho
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong
| | - T H Lam
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong
| | - J S M Peiris
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong
| |
Collapse
|
8
|
Tarrant M, Schooling CM, Leung SLS, Mak KH, Ho LM, Leung GM. Impact of breastfeeding on infectious disease hospitalisation: the children of 1997 cohort. Hong Kong Med J 2014; 20 Suppl 4:5-6. [PMID: 25224109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Affiliation(s)
- M Tarrant
- School of Nursing, The University of Hong Kong
| | - C M Schooling
- Department of Community Medicine, School of Public Health, The University of Hong Kong
| | - S L S Leung
- Family Health Service, Department of Health, Hong Kong SAR
| | - K H Mak
- Student Health Service, Department of Health, Hong Kong SAR
| | - L M Ho
- Department of Community Medicine, School of Public Health, The University of Hong Kong
| | - G M Leung
- Department of Community Medicine, School of Public Health, The University of Hong Kong
| |
Collapse
|
9
|
Schooling CM, Hui LL, Cowling BJ, Ho LM, Leung GM. Are the 2006 World Health Organization standards for infant growth applicable to Hong Kong Chinese? Universalistic standards or epidemiological transition stage-specific norms. Hong Kong Med J 2013; 19 Suppl 9:30-32. [PMID: 24473587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
1. Parental socio-economic status was positively associated with length and body mass index of Hong Kong Chinese infants at 9 months. 2. Maternal smoking in pregnancy was negatively associated with infant length at 9 months. 3. Some of the World Health Organization (WHO) criteria for an optimal nurturing environment contributed positively to growth. At 36 months, Hong Kong Chinese infants were generally shorter and fatter than the WHO growth references.
Collapse
Affiliation(s)
- C M Schooling
- Department of Community Medicine and School of Public Health, The University of Hong Kong
| | | | | | | | | |
Collapse
|
10
|
Cowling BJ, Ho LM, Riley S, Leung GM. Statistical algorithms for early detection of the annual influenza peak season in Hong Kong using sentinel surveillance data. Hong Kong Med J 2013; 19 Suppl 4:4-5. [PMID: 23775178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
In Hong Kong, influenza sentinel surveillance systems have been recently established. Methods that compare current data to data from recent weeks may be appropriate to indicate the start of peak influenza activity. These methods can produce reliable and timely alerts at the start of the annual influenza peak season.
Collapse
Affiliation(s)
- B J Cowling
- School of Public Health, The University of Hong Kong, 100 Cyberport Road, Hong Kong.
| | | | | | | |
Collapse
|
11
|
Riley S, Leung GM, Ho LM, Cowling BJ. Transmission of Japanese encephalitis virus in Hong Kong. Hong Kong Med J 2012; 18 Suppl 2:45-46. [PMID: 22311363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
1. Pigs are likely to be the main amplifying host for Japanese encephalitis virus. 2. The success of a swine vaccination programme depends on the timing of the loss of maternal antibody protection and seasonal dynamics of the vector population. 3. Vaccination may be ineffective in the face of strong natural infection because of the variability in timing of the loss of maternal antibody protection.4. Evidence in support of swine vaccination as a human health intervention was not found.
Collapse
Affiliation(s)
- S Riley
- Department of Community Medicine and School of Public Health, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China.
| | | | | | | |
Collapse
|
12
|
Leung GM, Ho LM, Lam TH, Hedley AJ. Epidemiology of SARS in the 2003 Hong Kong epidemic. Hong Kong Med J 2009; 15 Suppl 9:12-16. [PMID: 20393218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
1. The temporal and spatial evolution of the SARS epidemic in Hong Kong is described. 2. Estimates of key epidemiological distributions and their stability over the course of the epidemic are derived. 3. The characteristics of those who contracted the disease are determined including factors associated with the likelihood of mortality as a result of SARS coronavirus infection.
Collapse
Affiliation(s)
- G M Leung
- Department of Community Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China.
| | | | | | | |
Collapse
|
13
|
Leung GM, Ho LM, Lam TH, Hedley AJ, Peiris JSM. Prevalence of SARS-CoV antibody in all Hong Kong patient contacts. Hong Kong Med J 2009; 15 Suppl 9:27-29. [PMID: 20393222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
The near absence of transmission (seroprevalence=0.19%) resulting in asymptomatic infection in this representative high-risk group of close contacts indicates that the prevailing SARS-CoV strains in Hong Kong almost always led to clinically apparent disease.
Collapse
Affiliation(s)
- G M Leung
- Department of Community Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China.
| | | | | | | | | |
Collapse
|
14
|
Leung GM, Quah S, Ho LM, Ho SY, Hedley AJ, Lee HP, Lam TH. Community psycho-behavioural surveillance and related impact on outbreak control in Hong Kong and Singapore during the SARS epidemic. Hong Kong Med J 2009; 15 Suppl 9:30-34. [PMID: 20393223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
1. The promotion of personal protective health practices must take into account background perceptions of risk and psychological responses in the community-at-large. 2. Population psycho-behavioural factors in Hong Kong and Singapore are shown to be an important potential vector for the transmission of an infectious agent. 3. Comparative psycho-behavioural surveillance and analysis can yield important insights into generic versus population-specific issues that could be used to inform, design and benchmark public health infection control measures.
Collapse
Affiliation(s)
- G M Leung
- Department of Community Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China.
| | | | | | | | | | | | | |
Collapse
|
15
|
Schooling CM, Hui LL, Leung SSL, Ho LM, Mak KH, Leung GM. Short- and medium-term outcomes of accelerated infant growth in a Hong Kong Chinese birth cohort. Hong Kong Med J 2009; 15 Suppl 2:17-21. [PMID: 19258628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
1. In a large, population representative,Chinese birth cohort, higher birth weight and rapid growth, particularly at 0-3 months, were associated with higher body mass index (BMI) at 7 years. 2. Boys born heavy who had grown fast had the highest BMI, but rapid growth had the largest impact in lighter-born boys. 3. Rapid growth at 0-3 months or 3-12 months was not associated with a compensatory lower risk of serious infectious morbidity. 4. The ability to grow fast may be an embodiment of good health status, rather than fast growth being causally protective.
Collapse
Affiliation(s)
- C M Schooling
- Department of Community Medicine and School of Public Health, The University of Hong Kong, Li Ka Shing Faculty of Medicine, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China.
| | | | | | | | | | | |
Collapse
|
16
|
Kwok MK, Schooling CM, Ho LM, Leung SSL, Mak KH, McGhee SM, Lam TH, Leung GM. Early life second-hand smoke exposure and serious infectious morbidity during the first 8 years: evidence from Hong Kong's "Children of 1997" birth cohort. Tob Control 2008; 17:263-70. [DOI: 10.1136/tc.2007.023887] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
17
|
Cowling BJ, Ho LM, Leung GM. Effectiveness of control measures during the SARS epidemic in Beijing: a comparison of the Rt curve and the epidemic curve. Epidemiol Infect 2007; 136:562-6. [PMID: 17568476 PMCID: PMC2870828 DOI: 10.1017/s0950268807008722] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
One of the areas most affected by SARS was Beijing with 2521 reported cases. We estimate the effective reproductive number Rt for the Beijing SARS epidemic, which represents the average number of secondary cases per primary case on each day of the epidemic and is therefore a measure of the underlying transmission dynamics. Our results provide a quantitative assessment of the effectiveness of public health control measures. More generally, our results illustrate how changes in Rt will reflect changes in the epidemic curve.
Collapse
Affiliation(s)
- B J Cowling
- Department of Community Medicine and School of Public Health, The University of Hong Kong, Hong Kong.
| | | | | |
Collapse
|
18
|
McGhee SM, Ho LM, Lapsley HM, Chau J, Cheung WL, Ho SY, Pow M, Lam TH, Hedley AJ. Cost of tobacco-related diseases, including passive smoking, in Hong Kong. Tob Control 2006; 15:125-30. [PMID: 16565461 PMCID: PMC2563564 DOI: 10.1136/tc.2005.013292] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Costs of tobacco-related disease can be useful evidence to support tobacco control. In Hong Kong we now have locally derived data on the risks of smoking, including passive smoking. AIM To estimate the health-related costs of tobacco from both active and passive smoking. METHODS Using local data, we estimated active and passive smoking-attributable mortality, hospital admissions, outpatient, emergency and general practitioner visits for adults and children, use of nursing homes and domestic help, time lost from work due to illness and premature mortality in the productive years. Morbidity risk data were used where possible but otherwise estimates based on mortality risks were used. Utilisation was valued at unit costs or from survey data. Work time lost was valued at the median wage and an additional costing included a value of USD 1.3 million for a life lost. RESULTS In the Hong Kong population of 6.5 million in 1998, the annual value of direct medical costs, long term care and productivity loss was USD 532 million for active smoking and USD 156 million for passive smoking; passive smoking accounted for 23% of the total costs. Adding the value of attributable lives lost brought the annual cost to USD 9.4 billion. CONCLUSION The health costs of tobacco use are high and represent a net loss to society. Passive smoking increases these costs by at least a quarter. This quantification of the costs of tobacco provides strong motivation for legislative action on smoke-free areas in the Asia Pacific Region and elsewhere.
Collapse
Affiliation(s)
- S M McGhee
- Department of Community Medicine, University of Hong Kong, Hong Kong SAR, China
| | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Abstract
To describe the prevalence of erectile dysfunction (ED) and its association with smoking among the Chinese in Hong Kong, we conducted a cross-sectional study among 819 men (aged 31-60 years) who were randomly selected among the Hong Kong residents and interviewed by trained interviewers. A structured questionnaire was used for data collection. We found that current smokers who smoked 20 cigarettes or more daily had more dissatisfaction, erection difficulty and ED than never smokers. The prevalence of dissatisfaction, difficulty in erection and ED increased significantly (P<0.05) with increasing age. Compared with never-smokers, current smokers of more than 20 cigarettes daily had a greater risk of ED (age-adjusted odds ratio=1.47, 95% confidence interval: 1.00-2.16). Our results support that there are association between ED and smoking among the Chinese and suggest linking ED with smoking in the antismoking campaign and promoting smoking cessation to reduce ED among smokers.
Collapse
Affiliation(s)
- T H Lam
- Department of Community Medicine, Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | | | | | | | | |
Collapse
|
20
|
Farewell VT, Herzberg AM, James KW, Ho LM, Leung GM. SARS incubation and quarantine times: when is an exposed individual known to be disease free? Stat Med 2005; 24:3431-45. [PMID: 16237660 PMCID: PMC7169610 DOI: 10.1002/sim.2206] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2004] [Accepted: 02/01/2005] [Indexed: 12/03/2022]
Abstract
The setting of a quarantine time for an emerging infectious disease will depend on current knowledge concerning incubation times. Methods for the analysis of information on incubation times are investigated with a particular focus on inference regarding a possible maximum incubation time, after which an exposed individual would be known to be disease free. Data from the Hong Kong SARS epidemic are used for illustration. The incorporation of interval-censored data is considered and comparison is made with percentile estimation. Results suggest that a wide class of models for incubation times should be considered because the apparent informativeness of a likelihood depends on the choice and generalizability of a model. There will usually remain a probability of releasing from quarantine some infected individuals and the impact of early release will depend on the size of the epidemic.
Collapse
Affiliation(s)
- V T Farewell
- MRC Biostatistics Unit, Institute of Public Health, Cambridge, UK.
| | | | | | | | | |
Collapse
|
21
|
Ghani AC, Donnelly CA, Cox DR, Griffin JT, Fraser C, Lam TH, Ho LM, Chan WS, Anderson RM, Hedley AJ, Leung GM. Methods for estimating the case fatality ratio for a novel, emerging infectious disease. Am J Epidemiol 2005; 162:479-86. [PMID: 16076827 PMCID: PMC7109816 DOI: 10.1093/aje/kwi230] [Citation(s) in RCA: 174] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
During the course of an epidemic of a potentially fatal disease, it is important that the case fatality ratio be well estimated. The authors propose a novel method for doing so based on the Kaplan-Meier survival procedure, jointly considering two outcomes (death and recovery), and evaluate its performance by using data from the 2003 epidemic of severe acute respiratory syndrome in Hong Kong, People's Republic of China. They compare this estimate obtained at various points in the epidemic with the case fatality ratio eventually observed; with two commonly quoted, naïve estimates derived from cumulative incidence and mortality statistics at single time points; and with estimates in which a parametric mixture model is used. They demonstrate the importance of patient characteristics regarding outcome by analyzing subgroups defined by age at admission to the hospital.
Collapse
Affiliation(s)
- A C Ghani
- Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Abstract
Pneumatosis intestinalis may be idiopathic or associated with numerous conditions. Uncommonly, it has been associated with organ transplantation. We report one case of pneumatosis intestinalis after lung transplantation in an adult patient. To our knowledge, this finding has not been reported in the radiology literature.
Collapse
Affiliation(s)
- L M Ho
- Department of Radiology, Duke University Medical Center, Durham, Box 3808, NC 27710, USA.
| | | | | |
Collapse
|
23
|
Affiliation(s)
- S M McGhee
- Department of Community Medicine, University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong, China
| | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Leung GM, Yeung RYT, Lai TYY, Johnston JM, Tin KYK, Wong IOL, Woo PPS, Ho LM. Physicians' perceptions towards the impact of and willingness to pay for clinical computerization in Hong Kong. Int J Med Inform 2004; 73:403-14. [PMID: 15171982 DOI: 10.1016/j.ijmedinf.2004.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2003] [Revised: 03/22/2004] [Accepted: 03/23/2004] [Indexed: 10/26/2022]
Abstract
BACKGROUND AND OBJECTIVES We evaluated factors associated with physicians' perceptions towards the effects of computers on health care and on current levels of computerization in their practice. We also performed a contingent valuation to quantify physicians' perceived benefits from computerization in a hypothetical ambulatory, solo clinic. METHODS We surveyed 949 representative physicians in Hong Kong by post. Factor analysis was performed to summarize similar items into categories. Multivariable log-linear regression models were employed to assess the relationships between different factor scores and the number of functions computerized. We elicited their willingness-to-pay (WTP) for three defined computer systems using contingent valuation techniques. WTP values were estimated using econometric modeling by both, parametric and geometric methods. Sociodemographic, attitudinal, and practice-related predictors of WTP were estimated through regression analyses. RESULTS Factor analysis revealed a three-factor solution which explained 53% of total variance. The overall mean score (mean = 3.51 +/- 0.45) showed a generally positive attitude towards the effects of computers on health care. Respondents with a higher level of computer knowledge had significantly higher mean overall (P = 0.002) and factor scores for all three factors (P < 0.01). Higher factor scores on the effects of computers on patient care and clinicians (P = 0.006) and on the health system (P = 0.032) were associated with a higher number of functions computerized. The parametric median WTP values for computerizing administrative, clinical, and both sets of functions were HK dollars 21205 (US dollars 2719), HK dollars 34231 (US dollars 4389), and HK dollars 45720 (US dollars 5862), respectively, which were lower than the estimates obtained from demand curves using the geometric method [HK dollars 43286 (US dollars 5549), HK dollars 59570 (US dollars 7637), and HK dollars 84623 (US dollars 10849), respectively]. Doctors with higher incomes were willing to pay more to computerize the clinic, with strong dose-response gradients demonstrated. Those who worked in corporate settings were also more likely to accept higher WTP values. CONCLUSIONS Our findings confirm that better knowledge about computers is contributory to a more positive attitude towards the effects of computers on health care, which is in turn significantly associated with higher levels of actual computerization in clinical practice. WTP values represent the likelihood, in monetary terms, of translating doctors' perceived benefits from computerization into investment action.
Collapse
Affiliation(s)
- Gabriel M Leung
- Department of Community Medicine, Faculty of Medicine Building, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong, PR China.
| | | | | | | | | | | | | | | |
Collapse
|
25
|
Lam TH, Stewart SM, Leung GM, Lee PWH, Wong JPS, Ho LM. Depressive symptoms among Hong Kong adolescents: relation to atypical sexual feelings and behaviors, gender dissatisfaction, pubertal timing, and family and peer relationships. Arch Sex Behav 2004; 33:487-496. [PMID: 15305119 DOI: 10.1023/b:aseb.0000037429.79394.c6] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
A representative community sample of Hong Kong boys (n = 1,024) and girls (n = 1,403), age 14-18 years, provided information regarding same-sex attraction, gender dissatisfaction, pubertal timing, early experience with sexual intercourse, and depressive symptoms. They also rated the quality of their family and peer relationships and self-perceived attractiveness. Depressive symptoms were higher in youths reporting same-sex attraction, gender dissatisfaction, early pubertal maturation, and early sexual intercourse. Family relationships were less satisfactory for those who reported same-sex attraction, gender dissatisfaction, and early sexual intercourse, and peer relationships were also worse for those who reported gender dissatisfaction. In multivariate analyses, same-sex attraction, early sexual intercourse, and early pubertal maturation were unique and direct contributors to depressive symptoms; however, gender dissatisfaction's association with depressive symptoms was largely accounted for by shared correlations with negative family and peer relationships. The multivariate model explained 11% of the variance of depressive symptoms. These findings offer a preliminary documentation of the prevalence and correlates of atypical sexual self-assessments and behavior among adolescents in Hong Kong. Such information is important if theories of sexual identity and risk factors for depressive symptoms are to have cross-cultural utility.
Collapse
Affiliation(s)
- T H Lam
- Department of Community Medicine, University of Hong Kong, Hong Kong, People's Republic of China.
| | | | | | | | | | | |
Collapse
|
26
|
Abstract
Pancreatic cancer may present on computed tomography (CT) as an isolated cuff of tumor surrounding the superior mesenteric artery (SMA) or celiac trunk, without an identifiable pancreatic mass. We reviewed our experience with imaging-guided biopsy of the soft tissue cuff in this patient group. A retrospective review of our interventional database identified 163 patients referred for biopsy of suspected pancreatic carcinoma. Of these, eight patients underwent biopsy of an isolated cuff of soft tissue encasing the SMA (n = 6) or celiac trunk (n = 2). None of these eight patients had an identifiable pancreatic mass. The mean width of tissue cuff biopsied was 1.3 cm (range, 0.9-2.0 cm). Nine imaging-guided biopsies were performed in eight patients. Five biopsies were performed with color Doppler ultrasound and four with CT fluoroscopy. There was a median of two needle passes per procedure (range, 1-4). In six cases, a diagnosis of pancreatic adenocarcinoma was made at the first biopsy session. In one patient, ultrasound-guided biopsy was negative, but subsequent CT-guided biopsy was positive. In one additional patient with chronic pancreatitis, biopsy revealed benign fibrous tissue. There were no procedure-related complications. In patients with suspected pancreatic cancer (but without a focal parenchymal mass), imaging-guided biopsy of isolated periarterial tissue cuffs of tumor is accurate and safe.
Collapse
Affiliation(s)
- M J O'Connell
- Department of Radiology, Duke University Medical Center, Box 3808, Durham, NC 27710, USA.
| | | | | | | |
Collapse
|
27
|
Abstract
Scholars have proposed that individualistic values resulting from globalization are associated with increasing behavioral and emotional problems among youth in modernizing cultures. This study examined specific individualistic and traditional values in the context of suicidal ideation and behaviors in Hong Kong among community adolescent youths (N=2427) ages 14-18 years. Participants indicated the extent to which self-direction/independence and obedience/respect for elders were important to them. They also reported on four progressive levels of suicidality: whether in the last year they had experienced suicidal ideation, made plans for a suicide attempt, attempted suicide, and (for attemptors) made a serious attempt requiring medical attention. After controlling for quality of family relationships and depressive symptoms, at least one of the values predicted suicidality at all but the highest level. There were sex-specific associations between values and suicidality. In general, endorsement of self-direction was correlated with reduced risk of suicidality for boys and was irrelevant to girls. In contrast, traditional emphases on obedience and respect for elders were more frequently protective against suicidality for girls and were inconsistent predictors for boys. The relationship between values and suicidality was generally independent of the effect of family relationships and depressive symptoms. Thus, values were associated with adolescent suicidality, but not consistently in the direction predicted by some theorists, and the association depended upon the adolescent's sex.
Collapse
Affiliation(s)
- T H Lam
- The University of Hong Kong, Hong Kong S.A.R., China.
| | | | | | | | | | | | | |
Collapse
|
28
|
Abstract
AIMS To estimate the prevalence of passive smoking at work in the whole workforce in Hong Kong (population 6.8 million), the characteristics of the passive smokers, any extra use of health care among passive smokers, and who pays for that health care. METHODS A random sample of 14,325 households was contacted by telephone; 6,186 responding adults who worked full time were asked about their employment, their most recent use of health care and the cost of that care, their medical benefits, and their exposure to secondhand smoke in the workplace. After weighting the sample for sex, age, household size, and income, 4,739 subjects were included in the analysis. RESULTS Of 1,961 full time workers who did not smoke, 47.5% were exposed to secondhand smoke in the workplace compared with only 26% exposed at home. Exposure at work was associated with being younger, male, married, less educated, and having a lower income. Those exposed at work were 37% more likely to report having visited a doctor for a respiratory illness in the previous 14 days. Employers were paying 28% of the cost of these visits, the government paid 8%, and the individuals paid 63%. If extrapolated to the 3 million workers in the Hong Kong population, employers would pay just over US$9 million per year, while the affected workers would pay around US$20 million. CONCLUSION As well as the costs of active smoking, the cost of extra health care utilisation associated with passive smoking is an additional cost being paid by those employers who have not established smoke free workplaces and by their employees.
Collapse
Affiliation(s)
- S M McGhee
- Department of Community Medicine, University of Hong Kong, 5th Floor, University of Hong Kong Medical Centre, 21 Sassoon Road, Hong Kong.
| | | | | |
Collapse
|
29
|
Lam TH, Shi HJ, Ho LM, Stewart SM, Fan S. Timing of pubertal maturation and heterosexual behavior among Hong Kong Chinese adolescents. Arch Sex Behav 2002; 31:359-366. [PMID: 12187549 DOI: 10.1023/a:1016228427210] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
This study presents a cross-sectional examination of the independent contribution of pubertal maturation timing to heterosexual activity among Chinese adolescents. A standardized self-administered questionnaire was designed to obtain information on a spectrum of physical heterosexual behaviors from dating to sexual intercourse, age at first nocturnal ejaculation in boys, age at menarche in girls, and several psychosocial variables that might be associated with sexual behavior in adolescents. A total of 4,116 students aged from 14 to 18 years (2,175 boys and 1,941 girls) were recruited in the Youth Sexuality Survey of the Hong Kong Family Planning Association in 1996-97. When groups were defined as "early," "average," and "late maturers," among boys, early maturers were youngest to report dating and to have sexual intercourse, followed by average and late maturers. Among girls, late maturers were slower to date and have sexual intercourse, but early maturers showed no difference from average maturers. Age of maturation was significantly lower for those reporting all heterosexual behaviors for both sexes. Our findings illustrate culture's moderation of the expression of biological differences.
Collapse
Affiliation(s)
- T H Lam
- Department of Community Medicine, The University of Hong Kong, 5/F Academic and Administration Block, Faculty of Medicine Building, 21 Sassoon Road, People's Republic of China.
| | | | | | | | | |
Collapse
|
30
|
Abstract
PURPOSE To report on the prevalence and correlates of smoking and sexual activity in a community sample of Hong Kong Chinese adolescents. METHODS Participants (N = 4116) aged 13 to 18 years were surveyed regarding smoking and physical heterosexual activity, relationships with family members, family involvement, social support, school performance and emotional adjustment. Data were analyzed using logistic regression analyses. RESULTS About 30% of participants reported ever smoking and 3.5% reported sexual intercourse. Current smoking was correlated with age, school performance and quality of relationship with mother. Sexual intercourse was correlated with age, gender, family involvement and social support. Smoking and sexual activity were significantly correlated with each other. Smoking and increasing levels of heterosexual physical contact were negatively correlated with emotional adjustment, even after controlling for common predictors to health-endangering behaviors and emotional adjustment. CONCLUSIONS Smoking and sexual activity among adolescents are far less common in Hong Kong than in the West and their presence in a Hong Kong adolescent should alert the health practitioner to the possibility of significant psychosocial stress and maladjustment.
Collapse
Affiliation(s)
- T H Lam
- Department of Community Medicine, the University of Hong Kong, Pokfulam, Hong Kong, China
| | | | | |
Collapse
|
31
|
Abstract
Young adults (n = 964; never married; age, 18-27 years) in Hong Kong were surveyed to obtain information about their smoking habits and sexual behaviors. Current smokers (15% of the entire sample) and those who had ever had sexual intercourse (28%) were more likely to be male, to have ended their education at secondary school, and to report less life satisfaction. After controlling for demographic and psychosocial correlates, sexual intercourse was associated with smoking status for both males and females. Among those who were sexually active, those who had multiple sexual partners, had their first sexual experience prior to age 18 years, and (for males) reported visiting massage parlors were more likely to have a history of smoking. Our findings extend those of our previous study with community adolescents in Hong Kong and suggest that smoking may be a marker for other high-risk behaviors among young Chinese adults.
Collapse
Affiliation(s)
- T H Lam
- Department of Community Medicine, University of Hong Kong, Hong Kong, China.
| | | | | |
Collapse
|
32
|
Abstract
BACKGROUND High cesarean birth rates are an issue of international public health concern. The purpose of this paper was to examine the annual incidence and secular trend of cesarean births in Hong Kong and to correlate these rates with socioeconomic, demographic, and health indicators for the population since 1987. METHODS This was a descriptive and ecologic study. Annual population rates of cesarean sections were estimated for 1987 from a population-based survey, and for 1993 through 1999 from government data sources. The number of excess cesarean sections was calculated for each year using the 15 percent upper limit as proposed by the World Health Organization. RESULTS From 1987 to 1999 the overall annual cesarean section rate rose steadily from 16.6 to 27.4 per 100 hospital deliveries, resulting in a 65 percent increase over 12 years. The mean difference in rates of surgical delivery between public (mean(public) = 16.0%) and private (mean(private) = 43.4%) institutions was 27.4 percent (95% confidence interval (CI) = 24.1, 30.7; p < 0.001). CONCLUSIONS This is the first systematic report of secular variations of cesarean delivery rates in Asia. The high rates and increasing trend represent an unnecessary excess risk for mothers and their infants. Various strategies combating high cesarean rates have been proposed and have succeeded elsewhere. Concerted action from health care professionals, public health authorities, the general population, and the media is urgently required to implement solutions to reduce the rate of cesarean delivery.
Collapse
Affiliation(s)
- G M Leung
- Department of Community Medicine, The University of Hong Kong, Patrick Manson Building, 7 Sassoon Road, Pokfulam, Hong Kong, China
| | | | | | | | | |
Collapse
|
33
|
Wong MK, Ho LM, Zheng YS, Ho CY, Yang D. Asymmetric epoxidation of olefins catalyzed by chiral iminium salts generated in situ from amines and aldehydes. Org Lett 2001; 3:2587-90. [PMID: 11483067 DOI: 10.1021/ol016260i] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
[reaction: see text] A new approach for catalytic asymmetric epoxidation of olefins was developed that utilized chiral iminium salts, generated in situ from chiral amines and aldehydes, as catalysts. Epoxidation reactions can be conducted with 20 mol % of amines and aldehydes. The enantioselectivity of epoxides can be up to 65%. This modular approach obviates the difficulties inherent in the preparation and isolation of unstable exocyclic iminium salts.
Collapse
Affiliation(s)
- M K Wong
- Department of Chemistry, The University of Hong Kong, Pokfulam Road, Hong Kong
| | | | | | | | | |
Collapse
|
34
|
Abstract
Both keyboard-based and pen-based devices for data input have advantages and disadvantages. The suitability of the two input devices for entering different types of clinical data into computers remains unclear. This study aimed to determine the usefulness of different types of technology for nurses' data entry by comparing the utility and efficiency of keyboard and pen-based data input for clinical tasks. The study was conducted in the six largest specialties of an acute care hospital. In each specialty, several wards were randomly selected, and all nurses working in these wards were invited to participate. The input prototype was designed according to the type of text that was to be entered into the system. Task 1 mainly consisted of structured data, Task 2 contained equal amount of structured and textual data, and Task 3 was mainly in textual form. Each nurse was asked to complete the three simulations of nursing records (Tasks 1, 2 and 3). Preliminary findings showed that nurses found the pen-based interface easier to use than the keyboard for completing Tasks 1 and 2, but not Task 3. In terms of accuracy, the nurses preferred the keyboard to the pen when the data were more structured. The pen-based device is not a panacea for all kinds of user interface, and more importantly, the choice of input device should depend on the amount of structured and textual data.
Collapse
Affiliation(s)
- P M Young
- Department of Community Medicine and Unit for Behavioural Sciences, University of Hong Kong, Hong Kong
| | | | | | | |
Collapse
|
35
|
Abstract
The objective of this study was to assess the current level of computerization in clinical practice in Hong Kong through a population-based, physician survey conducted in 2000.A self-completed, 20-question, postal questionnaire was sent to 4850 randomly selected doctors in Hong Kong. We received 897 completed responses. Over one-third of doctors in the overall sample were already recording patient summaries, processing laboratory results and specialist reports, and preparing referral notes electronically. Patient registration (52.2%), billing systems (40.2%), appointment scheduling (39.9%), and payroll (36.9%), were the commonest administrative functions to have been computerized. Seventy per cent of doctors in solo or small-group ('individual') practices did not yet have any clinical function computerized compared with only 30.7% for those working in large, corporate organizations. Similarly, approximately two-thirds of administrative tasks in 'individual' clinics were not computerized, while corporate physicians reported a corresponding percentage of 39.3%. Younger age, male gender, specialist qualifications, more computers in the practice, higher numbers of administrative tasks already computerized, higher levels of knowledge about and positive attitudes towards computer applications in clinical practice were all positively associated with more clinical tasks already computerized in the practice. The present study has systematically documented the extent of clinical computer use in Hong Kong and identified areas for improvement as well as specific groups of physicians who might benefit from targeted efforts promoting computerization in practice.
Collapse
Affiliation(s)
- G M Leung
- Department of Community Medicine, 7 Sassoon Road, Patrick Manson Building, University of Hong Kong, Pokfulam, Hong Kong, China.
| | | | | | | | | |
Collapse
|
36
|
Abstract
OBJECTIVE To examine the effects of environmental tobacco smoke (ETS) on health services use in Chinese infants with nonsmoking mothers. DESIGN Prospective, population-based birth cohort. SETTING General population of Hong Kong in 1997-1998. PARTICIPANTS A total of 8327 parent-infant pairs who were followed up for 18 months. MAIN OUTCOME MEASURES Doctor consultations and hospitalizations. Results. After adjusting for the age, education level, and employment status of mothers-as well as infants' birth weight, method of delivery, breastfeeding status, and birth order-ETS exposure through the mother in utero was positively associated with higher consultation (adjusted odds ratio [OR]: 1.26; 95% confidence interval [CI]: 1.14, 1.39) and hospitalization (OR: 1.18; 95% CI: 1.05, 1.31) use in infants with nonsmoking mothers attributable to any illness. In addition, postnatal exposure to ETS at home was linked to higher rates of hospitalizations for any illness compared with nonexposed infants (OR: 1.12; 95% CI: 1.00, 1.25), although the relationship did not hold for outpatient consultation visits. The OR for higher hospital use in infants exposed to 2 or more smokers at home was 1.30 (95% CI: 1.08, 1.58). CONCLUSIONS The use of tobacco products by household members, even among nonsmoking mothers, has an enormous adverse impact on the health of children, as well as increases health services use and cost. The present data support the revision of public policy to reflect an evidence-based approach to the promotion of smoking cessation in all household members during and after pregnancy. environmental tobacco smoke, health services, infants.
Collapse
Affiliation(s)
- T H Lam
- Department of Community Medicine, University of Hong Kong Medical Center, Pokfulam, Hong Kong
| | | | | |
Collapse
|
37
|
Affiliation(s)
- C M Gaskin
- Duke University Medical Center, Durham, NC 27710, USA
| | | | | |
Collapse
|
38
|
Abstract
The aim of the study was to determine whether there were significant 'seasonal' variations in the rhythm of sperm parameters (i.e. semen volume and sperm density) of men who reside in the tropics. A total of 7656 semen analysis results from the department of obstetrics and gynaecology of a tertiary general hospital was analysed. These samples were obtained as part of an initial screening for male partners of couples with problems trying to conceive who were attending a fertility clinic from 1991 to 1995. The subjects' mean semen volume and sperm density of 2.9 ml and 26.9x10(6)/ml respectively were within the World Health Organization reference values. There were no significant month-to-month variations in the adjusted (for age of subject, year of test and technologist who performed the analysis by analysis of co-variance, ANCOVA) mean semen volume and sperm density over the 5 year period. Variations in semen volume and density observed in the temperate climates are not seen in this study, which was conducted in subjects staying in the tropics. This observation may be related to relative constant temperature and hours of light exposure among men who reside in the tropics. As this study is, so far, published data from only one country, Singapore, it may not truly reflect the actual situation for individuals who are residing in the tropics.
Collapse
Affiliation(s)
- S E Chia
- Department of Community, Occupational & Family Medicine, National University of Singapore, Singapore
| | | | | | | |
Collapse
|
39
|
Abstract
Laboratory methods give more accurate measurement of blood loss in the postpartum period than visual estimation. In order to evaluate a laboratory method used to quantify blood loss postpartum, blood lost at gynecological operations was collected in a measuring bottle. The measured amount of blood (50-1,000 ml) was then poured onto absorbent paper towels and sanitary pads, in order to mimic conditions when measuring blood loss in clinical trials in the postpartum period. The amount of blood absorbed onto the absorbent paper and sanitary pads was measured by a rapid method of automatic extraction and photometric measurement of alkaline hematin. The study shows that the method provides a reliable and accurate means of measuring blood loss. The error in each case was less than 10% with an intraclass correlation coefficient of almost 1.
Collapse
Affiliation(s)
- S Chua
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore, Singapore
| | | | | | | | | | | |
Collapse
|
40
|
Abstract
It is increasingly common in Hong Kong and elsewhere for employers to contract directly with physician networks to provide medical services to employees. These contracts are known in Hong Kong as contract medicine arrangements. In other countries and areas, managed care organizations are generally required by regulation or legislation to ensure that services of adequate quality are provided to patients who are locked in to network providers. There are no such requirements in Hong Kong and concerns have been raised about potential quality and cost trade-offs in contract medicine arrangements. Satisfaction surveys were sent to contract medicine enrollees in one large company in Hong Kong. The response rate was 30% and analysis of non-respondent data shows that respondents were representative of their group. Comparison of satisfaction using logistic regression showed that risk-bearing networks paid by capitation had consistently lower satisfaction ratings across all major dimensions including access, interpersonal care, communication with the doctor, choice of doctor, and outcomes. These findings suggest that quality, at least as perceived by the patient, may be lower in these networks. The issue is of concern in Asia where infrastructures and data systems are not well developed to adequately monitor quality of care or protect patient interests. This study highlights the need to structure pre-paid provider networks and managed care organizations so that quality of care is not compromised. At a time when managed care concepts are being applied throughout Asia, we believe attention needs to be drawn to this problem.
Collapse
Affiliation(s)
- C Brudevold
- University of Hong Kong, Department of Community Medicine, Pok Fu Lam, People's Republic of China.
| | | | | |
Collapse
|
41
|
Abstract
STUDY OBJECTIVE To estimate the impact of passive smoking at work on use of health care services and absenteeism. DESIGN Cross sectional survey. SETTING A workforce in Hong Kong. PARTICIPANTS 5142 never-smoking police officers in a total sample of 9926. MAIN RESULTS A consistently strong association was found among men between length of time exposed to passive smoking at work and self reported consultations with a doctor, use of medicines and time off work. Results for women were similar but most were not statistically significant. CONCLUSIONS The exposure of healthy adults to passive smoking at work is related to utilisation of health care services and extra time off work. This results in costs to the health services, to employers and to those exposed.
Collapse
Affiliation(s)
- S M McGhee
- Department of Community Medicine, University of Hong Kong, 7 Sassoon Road, Pokfulam, Hong Kong.
| | | | | | | | | | | | | |
Collapse
|
42
|
Choo WL, Chua S, Chong YS, Vanaja K, Oei PL, Ho LM, Roy AC, Arulkumaran S. Correlation of change in uterine activity to blood loss in the third stage of labour. Gynecol Obstet Invest 2000; 46:178-80. [PMID: 9736799 DOI: 10.1159/000010028] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In 47 women, the change in the uterine activity after the administration of a uterotonic agent was correlated with the amount of blood loss during the same period of time. Uterine activity was measured by a Gaeltec catheter-tipped pressure transducer inserted transcervically within 5 min of delivery of the placenta. A uterotonic agent (either intravenous syntocinon, intramuscular syntometrine or oral misoprostol) was given after the insertion of the intrauterine pressure catheter and pressure recorded for another 90 min. Blood loss over the same 2-hour period was collected with absorbent paper which was then assessed by colorimetric measurement of the haemoglobin content in the sample. Our results show that the change in uterine activity is associated with the total blood loss. However, there is a poor linear correlation between the two variables probably because of the biological variation in myometrial activity and differences in coagulation mechanisms in normal women.
Collapse
Affiliation(s)
- W L Choo
- Department of Obstetrics and Gynaecology, National University of Singapore National University Hospital, Singapore
| | | | | | | | | | | | | | | |
Collapse
|
43
|
Abstract
CONTEXT Few epidemiological studies have examined the relationship between chronic respiratory symptoms and exposure to environmental tobacco smoke (ETS) at work in adults, and none have shown clear dose-response relationships. OBJECTIVE To examine the respiratory effects of ETS exposure at home and at work among never-smoking adults. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional, self-administered questionnaire survey conducted in December 1995 and January 1996 among 4468 male and 728 female police officers in Hong Kong who were never-smokers. MAIN OUTCOME MEASURES Respiratory symptoms and physician consultation in the previous 14 days for such symptoms by presence and amount of ETS exposure at work. RESULTS Eighty percent of both men and women reported ETS exposure at work. Significant odds ratios (ORs) for respiratory symptoms were found among men with ETS exposure at work (for any respiratory symptoms, difference in absolute rate, 20.4%; OR, 2.33; 95% confidence interval [CI], 1.97-2.75; attributable risk, 57%) and physician consultation (difference in absolute rate, 4.5%; OR, 1.30; 95% CI, 1. 05-1.61; attributable risk, 23%). Trends were similar among women for any respiratory symptoms (difference in absolute rate, 15.4%; OR, 1.63; 95% CI, 1.04-2.56; attributable risk, 39%) and for physician consultation (difference in absolute rates, 2.8%; OR, 1.45; 95% CI, 0.87-2.41; attributable risk, 31%). Positive dose-response relationships with number of coworkers smoking nearby and amount of ETS exposure in the work place were found. CONCLUSIONS This study provides further evidence of the serious health hazards associated with ETS exposure at work. The findings support a ban on smoking in the workplace to protect all workers in both developed and developing countries. JAMA. 2000;284:756-763
Collapse
Affiliation(s)
- T H Lam
- Department of Community Medicine, University of Hong Kong, Patrick Manson Building South Wing, 7 Sassoon Rd, Hong Kong, China.
| | | | | | | | | | | | | |
Collapse
|
44
|
Pereira Arias-Bouda LM, Nguyen LN, Ho LM, Kuijper S, Jansen HM, Kolk AH. Development of antigen detection assay for diagnosis of tuberculosis using sputum samples. J Clin Microbiol 2000; 38:2278-83. [PMID: 10834989 PMCID: PMC86781 DOI: 10.1128/jcm.38.6.2278-2283.2000] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The rising incidence of tuberculosis worldwide means an increasing burden on diagnostic facilities, so tests simpler than Ziehl-Neelsen staining are needed. Such tests should be objective, reproducible, and have at least as good a detection limit as 10(4) bacteria/ml. A capture enzyme-linked immunosorbent assay (ELISA) was developed for detection of lipoarabinomannan (LAM) in human sputum samples. As a capture antibody, we used a murine monoclonal antibody against LAM, with rabbit antiserum against Mycobacterium tuberculosis as a source of detector antibodies. The sensitivity of the capture ELISA was evaluated by using purified LAM and M. tuberculosis whole cells. We were able to detect 1 ng of purified LAM/ml and 10(4) M. tuberculosis whole cells/ml. LAM could also be detected in culture filtrate of a 3-week-old culture of M. tuberculosis. The culture filtrate contained approximately 100 microgram of LAM/ml. The detection limit in sputum pretreated with N-acetyl-L-cysteine and proteinase K was 10(4) M. tuberculosis whole cells per ml. Thirty-one (91%) of 34 sputum samples from 18 Vietnamese patients with tuberculosis (32 smear positive and 2 smear negative) were positive in the LAM detection assay. In contrast, none of the 25 sputum samples from 21 nontuberculous patients was positive. This specific and sensitive assay for the detection of LAM in sputum is potentially useful for the diagnosis of tuberculosis.
Collapse
|
45
|
Chia SE, Ong CN, Chua LH, Ho LM, Tay SK. Comparison of zinc concentrations in blood and seminal plasma and the various sperm parameters between fertile and infertile men. J Androl 2000; 21:53-7. [PMID: 10670519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
The aim of the study was to examine the relationships between concentrations of zinc in blood and seminal plasma and sperm quality among infertile and fertile men. One hundred seven male (infertile group) partners of couples who were undergoing investigation for infertility with no known cause for the infertility and 103 men (fertile group) whose wives were pregnant at the time of the study were recruited. The subjects' blood and seminal plasma concentration of zinc were determined by atomic absorption spectroscopy. Except for semen volume, all the other semen parameters for the infertile men were significantly lower than those for the fertile group. The geometric means of the seminal plasma zinc concentration were significantly lower in the infertile group compared with those in the fertile group; 183.6 mg/L (range, 63-499) versus 274.6 mg/L (range, 55-420). There were no significant differences in the geometric means of the blood zinc concentration between the 2 groups. Seminal plasma zinc concentration was significantly correlated with sperm density (r = 0.341, P < .0001), motility (r = 0.253, P < .0001), and viability (r = 0.286, P < .0001). On the basis of the findings of this study and those of other reports, zinc may contribute to fertility through its positive effect on spermatogenesis.
Collapse
Affiliation(s)
- S E Chia
- Department of Community, Occupational and Family Medicine, the National University of Singapore, Republic of Singapore.
| | | | | | | | | |
Collapse
|
46
|
Low VH, Ho LM, Freed KS. Vaginal opacification during defecography: direction of vaginal migration aids in diagnosis of pelvic floor pathology. Abdom Imaging 1999; 24:565-8. [PMID: 10525808 DOI: 10.1007/s002619900564] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND To determine whether direction of vaginal displacement during defecography aids in diagnosing pelvic floor pathology. METHODS Ninety patients underwent defecography over a 2-year period. Each study was retrospectively reviewed by three radiologists who recorded whether the vagina was displaced cephalad, caudad, or nondisplaced in relation to the urogenital hiatus. This information was then correlated with radiologic diagnosis rendered for the study. RESULTS Of the 26 patients with normal defecograms, 19 (73%; p < 0. 001) demonstrated no vaginal displacement during the procedure. Comparatively, 10 (83%; p < 0.001) of the 12 patients with cystoceles showed caudad vaginal displacement, and no patients with cystoceles showed cephalad displacement of the vagina. Of the 17 patients with rectoceles, 10 (58%) showed cephalad displacement, one (6%) showed caudad displacement, and six (35%) patients showed no vaginal displacement. Thirteen (46%) of 28 patients with enteroceles showed cephalad vaginal displacement, nine (32%) showed no vaginal displacement, and six (21%) demonstrated caudad displacement. CONCLUSIONS Caudad displacement of the opacified vagina suggests the presence of a cystocele. Cephalad vaginal displacement is suggestive of the presence of an enterocele or rectocele.
Collapse
Affiliation(s)
- V H Low
- Department of Radiology, Duke University Medical Center, Box 3808, Erwin Road, Durham, NC 27710, USA
| | | | | |
Collapse
|
47
|
Abstract
We evaluated the value of placement of a folded gauze square into the urogenital introitus to improve vaginal opacification in 90 patients who underwent defecography. Of the 50 patients who retained the gauze in the introitus, 96% demonstrated excellent or good vaginal opacification. By contrast, only 75% of the 40 patients who lost the gauze during the study were able to achieve the same level of opacification. This difference was shown to be statistically significant (p < 0.002), suggesting that placement of a folded gauze square in the introitus limits loss of contrast from the vagina, which improves vaginal opacification.
Collapse
Affiliation(s)
- L M Ho
- Department of Radiology, Duke University Medical Center, Box 3808, Erwin Road, Durham, NC 27710, USA
| | | | | |
Collapse
|
48
|
Abstract
The present computer system is the first of its kind based on problem-oriented medical record (POMR) design developed and operated in a hospital in Hong Kong. It went live in May 1996 with two workstations installed in the medical record office (MRO). Doctors have no direct access to it. They dictate medical notes on tape using either structured or free dictation format, and the tape is brought to the MRO for processing. The principal aim of this study is to study the impact of the computer system on patient care. Retrospective review of medical records and in-depth interviews were conducted to study the quality of medical records and doctor's opinions. A total of 400 manual and 398 computerized patient records were randomly selected for review. The completeness of the manual notes and computerized notes using free dictation format were about the same. The computerized records using structured dictation format may be more complete than those using free dictation format. The in-depth interview shows that most doctors preferred structured medical records but some disagreed with too detailed a level of structuring. They were not familiar with POMR, and some even thought that breaking down the record by problem was not possible. All felt that the present system would not directly affect patient care, but some said that it would facilitate research. In conclusion, since the utility of the information mainly depends on the doctors' efforts, commitment to the agreed structure and subsequent routine audit of computerized medical records are essential to make sure that diagnoses are accurately coded and information is correctly structured.
Collapse
Affiliation(s)
- L M Ho
- Department of Community Medicine, The University of Hong Kong, Hong Kong
| | | | | | | |
Collapse
|
49
|
Yu SL, Ho LM, Lim BC, Sim ML. Urinary deoxypyridinoline is a useful biochemical bone marker for the management of postmenopausal osteoporosis. Ann Acad Med Singap 1998; 27:527-9. [PMID: 9791660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Most medical treatment of postmenopausal osteoporosis are inhibitors of bone resorption and urinary deoxypyridinoline (D-Pyr) has been shown to be a reliable indicator of bone resorption. Fifty-one healthy women were divided into four groups. Group A: premenopausal women (n = 10), Group B: postmenopausal women, no osteoporosis, not on hormone replacement therapy (HRT) (n = 14), Group C: postmenopausal women, osteoporotic, not on HRT (n = 12), and Group D: postmenopausal women on HRT (n = 15). Fasting urine was collected and sampled for D-Pyr using Pyrilinks-D Kit-(Metra Biosystems). Urinary D-Pyr was calculated in nM/creatinine mM. There was a significant difference between premenopausal and postmenopausal urinary D-Pyr showing a higher value of D-Pyr during menopause. Urinary D-Pyr results of postmenopausal women on HRT and premenopausal women showed no difference. Hence D-Pyr may be useful for the monitoring of hormonal treatment of postmenopausal bone loss.
Collapse
Affiliation(s)
- S L Yu
- Department of Obstetrics and Gynaecology, Singapore General Hospital
| | | | | | | |
Collapse
|
50
|
Affiliation(s)
- L M Ho
- Department of Radiology, University of Virginia Health Sciences Center, Charlottesville 22908, USA
| | | |
Collapse
|