Evidence for treatment of lower limb in-stent restenosis with drug eluting balloons

INTRODUCTION: Restenosis by myointimal hyperplasia after peripheral arterial angioplasty or stenting often limits long term patency. Drug-eluting balloons (DEBs) which inhibit the proliferation of neo-intimal growth of vascular smooth muscle cells may prevent restenosis. The aim of this paper was to examine the evidence in published literature on the use of DEBs in the treatment of peripheral arterial in-stent restenosis (ISR). EVIDENCE ACQUISITION: A systematic literature review was undertaken of all published literature on the treatment of peripheral ISR with drug eluting balloon using Medline and cross-referenced. All published papers on the use of DEBs in peripheral arterial disease (PAD) were used. Cochrane Central Register of Controlled Trials and electronic databases were also searched for on-going studies. EVIDENCE SYNTHESIS: There were no level 1 or 2 evidence published on this subject. The number of high-quality publications is few, and consequently a sufficient analysis is not possible. Recently data from non-randomized cohort studies showed encouraging results with DEB as treatment modality for ISR, whether used alone or as combined strategies. CONCLUSIONS: Evidence from the published literature suggests that DEBs are safe in preventing peripheral ISR. Despite strong corporate pressure for the use of DEBs, there is only circumstantial evidence that this is a useful modality for ISR. Results from on-going studies may allow further meta-analysis for efficiency and cost-effectiveness.link_to_subscribed_fulltex

Problems with Wednesbury Unreasonableness in Contract Law: Lessons from Public Law

This article identifies three key problems with the English courts’ current use of Wednesbury unreasonableness to control the exercise of discretion in contract law. First, there are misconceptions about the nature of Wednesbury review in contract law. Second, the intensity with which courts should apply Wednesbury unreasonableness is unclear. Finally, the contents of Wednesbury unreasonableness have been considered vague, leading to uncertainty in its application. This article proposes solutions to each of these problems by examining the jurisprudence and discourse on Wednesbury unreasonableness in public law

Hong Kong’s Film Industry Reconstituted: Pathways to China after the Golden Age

This chapter examines the factors underpinning the vicissitudes of Hong Kong’s film industry since the 1980s. It explores the industry’s competitive edge and discusses Hong Kong’s contributions to the growth of the Chinese film market in the context of the regional integration of the Chinese movie value chain. The analysis is organized in four sections. The first provides an overview of the Hong Kong film industry from a historical perspective. The second describes the structure and the production system of Hong Kong’s film industry in its golden age of the 1980s. The third illuminates the causes of the Hong Kong film industry’s collapse since the mid-1990s. The final section reflects critically on the recent and future development of Hong Kong’s film industry against the backdrop of its integration with the Chinese market. The chapter concludes with a discussion of the broader implications of this study for developing a sociological perspective on the Hong Kong economy

Epidemiological updates of venous thromboembolism in a Chinese population

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Mindfulness Practice in Medical Education

Undergraduate medical education aims to prepare students to become doctors who provide quality health care. It is a rigorous and demanding endeavour that necessarily requires medical students to be attuned to themselves, their work and their surroundings, in order to succeed academically, to interact effectively and empathetically with patients, and equally importantly, to care for themselves. Mindfulness practice is an approach that helps to relieve stress, but also trains the important clinical skill of being “fully present” whether it is in class, or in clinic with a patient. We consider the evidence for mindfulness meditation, a particular aspect of mindfulness practice, in medical education and share the results of several different approaches undertaken to implement mindfulness practice in the medical curriculum at the University of Hong Kong. We discuss and reflect on the impact and outcomes of these different approaches