Neurological disorders in pregnancy

Pregnant women can present with a wide variety of neurological conditions. Patient data from 1 January 1985 through 31 December 1994 for all deliveries at the Tsan Yuk and Queen Mary hospitals were reviewed to determine the local frequency of various neurological conditions during pregnancy. Conditions including epilepsy, eclampsia, facial nerve palsy, pituitary tumour, cerebrovascular disorders, myasthenia gravis, multiple sclerosis, and non-pituitary intracranial tumours were encountered, in descending order of frequency. The limitations of this retrospective analysis are acknowledged. This paper reviews the current concepts of these conditions and outlines appropriate management.published_or_final_versio

Gastrointestinal bleeding in patients on novel oral anticoagulants: Risk, prevention and management

Novel oral anticoagulants (NOACs), which include direct thrombin inhibitor (dabigatran) and direct factor Xa inhibitors (rivaroxaban, apixaban and edoxaban), are gaining popularity in the prevention of embolic stroke in non-valvular atrial fibrillation as well as in the prevention and treatment of venous thromboembolism. However, similar to traditional anticoagulants, NOACs have the side effects of bleeding, including gastrointestinal bleeding (GIB). Results from both randomized clinical trials and observations studies suggest that high-dose dabigatran (150 mg b.i.d), rivaroxaban and high-dose edoxaban (60 mg daily) are associated with a higher risk of GIB compared with warfarin. Other risk factors of NOAC-related GIB include concomitant use of ulcerogenic agents, older age, renal impairment, Helicobacter pylori infection and a past history of GIB. Prevention of NOAC-related GIB includes proper patient selection, using a lower dose of certain NOACs and in patients with renal impairment, correction of modifiable risk factors, and prescription of gastroprotective agents. Overt GIB can be managed by withholding NOACs followed by delayed endoscopic treatment. In severe bleeding, additional measures include administration of activated charcoal, use of specific reversal agents such as idarucizumab for dabigatran and andexanent alfa for factor Xa inhibitors, and urgent endoscopic management.published_or_final_versio

Concerns on installing long-throw sprinklers in tall halls

There are concerns over long-throw sprinkler installation in halls with high ceilings which are likely to store large amount of combustible materials. These concerns will be addressed in this paper. At the moment, it is unknown whether such sprinkler installation can protect high-ceiling halls which store large amount of combustibles. The concept should be further explored with in-depth research through full-scale burning experiments with big fires.published_or_final_versio

Hif-αs fine-tune Sox9-dependent Extracellular Matrix Production in Chondrocytes

INTRODUCTION: An avascular milieu is a hallmark feature of articular cartilage and therefore the expression of chondrocyte-specific matrix protein is orchestrated under hypoxic condition. Physiological responses under hypoxia are regulated by the ...postprin

A multi-material virtual prototyping system for biomedical applications

This paper describes a multi-material virtual prototyping (MMVP) system for modelling and digital fabrication of discrete and functionally graded multi-material objects for biomedical applications. The MMVP system consists of a DMMVP module, an FGMVP module, and a virtual reality (VR) simulation module. The DMMVP module is used for design and process planning of discrete multi-material (DMM) objects, while the FGMVP module is for functionally graded multimaterial (FGM) objects. The VR simulation module integrates these two modules to perform digital fabrication of multimaterial objects, which can be subsequently visualized and analyzed in a virtual environment to optimize MMLM processes for fabrication of product prototypes. Using the MMVP system, two biomedical objects, including a human dextrocardic heart made of discrete multi-materials and a hip joint assembly of FGM are modelled and digitally fabricated for visualization and analysis in a VR environment. These studies show the MMVP system is a practical tool for modelling, visualization, process planning, and subsequent fabrication of biomedical objects of discrete and functionally graded multi-materials for biomedical applications. ©2009 IEEE.published_or_final_versionThe IEEE International Conference on Virtual Environments, Human-Computer Interfaces and Measurements Systems (VECIMS) 2009, Hong Kong, 11-13 May 2009. In Proceedings of the IEEE International Conference on Virtual Environments, Human-Computer Interfaces and Measurements Systems, 2009, p. 73-7

Peritoneal implantation of ureter in cadaveric renal transplant

Case reportWe report here a case of complication of peritoneal implantation of ureter in cadaveric renal transplant. The patient presented with anuria and delayed graft function. The diagnosis was suspected upon physical examination and radiological investigation. The complication was managed with reimplantation of the ureter into the bladder and the patient recovered with good graft function. We discuss this case, review the literature on this rare complication, and share our suggestions on how it can be prevented.published_or_final_versio

ACE (Angiotensin-Converting Enzyme) Inhibitors/Angiotensin Receptor Blockers Are Associated With Lower Colorectal Cancer Risk: A Territory-Wide Study With Propensity Score Analysis

Whether ACE (angiotensin-converting enzyme) inhibitors and angiotensin receptor blockers modify colorectal cancer risk remains controversial. We aimed to determine association between their use and colorectal cancer risk after a negative baseline colonoscopy. This is a territory-wide retrospective cohort study recruiting patients aged ≥40 who had undergone colonoscopy between 2005 and 2013. Exclusion criteria included colorectal cancer detected 3years (adjusted hazard ratio, 1.18 [95% CI, 0.88-1.57]); every single year increase in the drug use was associated with 5% reduction in adjusted hazard ratio risk. ACE inhibitors/angiotensin receptor blocker were associated with a lower colorectal cancer risk in a duration-response manner

Impurity induced disordering produced lateral optical confinement in AIGaAs/GaAs quantum well wavegu

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Prevalence of alarms in intensive care units, and its relationship with nursing staff levels

Background The average number of alarms per patient on each day in Intensive Care Unit (ICU) was very high with poor specificity, high sensitivity and high false positive rate. The large number of false alarms has caused healthcare professionals to turn down the volume of audible signals, adjust the alarm setting beyond limits that are safe and appropriate for the patient, and ignore or even deactivate alarms, resulting in sentinel events and patient deaths. The objectives of the present study were to examine the prevalence of ICU cardiac and technical alarms and the relationship between that prevalence and available nursing staff levels. Methods The study collected all cardiac and technical alarm data from the bedside physiological monitor through the central monitoring system at the nurses' station, over a five-week period. The prevalence of these alarms and the correlation with different shifts of duty was analysed. The relationship between nursing staff levels and the number of these alarms was also analysed. Results There was a positive correlation between the number of cardiac and technical alarms per bed per hour in three different shifts (Night and Morning, Morning and Afternoon, and, Afternoon and Night: All p-value < 0.001). The effect of these alarms on the present shift will affect the number of alarms in the subsequent three shifts. Besides, the number of cardiac and technical alarms is not related to the nursing staff levels. Conclusions This study describes the prevalence of cardiac and technical alarms from a different perspective, by examining the prevalence of physiological monitor cardiac and technical alarms in ICUs (but not their sound amplitude) and its relationship with nursing staff levels, the finding against many people thinking that the cardiac and technical alarms should be fewer when the nursing staffing level is high in the unit.published_or_final_versio

16S rDNA PCR detection of Actinobacillus actinomycetemcomitans from periodontitis-free plaque

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