Inhaled steroids and bone metabolism in clinical perspective

Inhaled corticosteroids have become the mainstay of maintenance treatment in asthma adults, and they are also being advocated for early use in children. The systemic side effects of inhaled steroids are much less than those from systemic steroids needed for comparable asthma control. Long term use of systemic corticosteroids is known to cause osteoporosis, and the risks from inhaled therapy are currently under study. There are reports of changes in biochemical parameters of bone metabolism due to inhaled corticosteroids, suggesting depression of bone formation and increase in bone resorption. However, the significance of biochemical changes in relation to bone mass and architecture is not known. Cross-sectional studies of bone mass suggest that dosages of more than 1 mg daily in adults may be associated with a decrease in bone mineral density. Longitudinal studies are needed to confirm the findings and define more clearly the profile and risk factors of bone loss. Current data in children show that inhaled corticosteroid in the usual therapeutic dose range has no detrimental effect on long term statural growth, while effects of peak bone mass are not yet known. The magnitude of measurable adverse effects were found to be dose-dependent, hence, the use of a minimum effective dose is recommended. Patients on inhaled corticosteroid therapy should maintain optimal intake of calcium and vitamin D. Physical activity should be encouraged and oestrogen replacement therapy in postmenopausal women considered.published_or_final_versio

Lymphangioleimyomatosis: the Hong Kong experience

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Measuring the Interdependence of Banks in Hong Kong

This paper assesses systemic linkages among banks in Hong Kong using the risk measure "CoVaR" derived from quantile regression. The CoVaR measure captures the co-movements of banks¡¯ default risk by taking into account their nonlinear relationship when the banks are in distress. Based on equity price information, our estimation results show that the default risks of the banks were interdependent during the recent crisis. Although local banks are generally smaller, their systemic importance is found to be similar to their international and Mainland counterparts, which may be due to a higher degree of commonality in the risk profile of local banks. Regarding the impact of external shocks on the banks, international banks are more likely to be affected by the equity price fall in the US market, while local banks are relatively more responsive to funding liquidity risk.Value-at-Risk, Systemic Risk, Risk Spillovers, Quantile Regression

Mallampati score is a good and independent predictive factor for obstructive sleep apnoea (OSA)

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The combined use of gemcitabine and ifosfamide in patients with Stage III or IV non-small cell lung cancer (NSCLC)

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Combination of paclitaxel and carboplatin in advanced non-small cell lung cancer (NSCLC)

Session - Respiratory & Critical Care Medicine: no. G-RC-13published_or_final_versio

Oral coriolus versicolor polysaccharide peptide is beneficial by slowing the progression of lung cancer

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Chemotherapy for advanced non-small-cell lung cancer: Role of paclitaxel and gemcitabine

Objective. To review the role of chemotherapy in advanced non-small-cell lung cancer, focusing on cisplatin-based regimens and two new drugs: paclitaxel and gemcitabine. Data sources. Medline search of the relevant English literature. Study selection. Open and randomised comparative (phases II and III) studies, and meta-analyses of cytotoxic drugs/regimens used to treat advanced non-small-cell lung cancer. Data extraction. The following factors were studied and compared: symptomatic response rates; tumour response rates; median survival time and 1-year survival rates; and side effects of cisplatin-, paclitaxel-, and gemcitabine-based regimens. Data synthesis. Using cisplatin-based chemotherapy achieves significant relief of disease-related symptoms of advanced non-small-cell lung cancer and a slight improvement in the median survival time (by approximately 1.5 months). New cytotoxic drugs that are effective and have good safety profiles include paclitaxel and gemcitabine. When used as single agents, these two drugs give response rates of approximately 25%. When used with cisplatin/carboplatin, response rates increase to 45% to 62% and 1-year survival rates increase to 40% to 60%. Conclusion. Paclitaxel, gemcitabine, and other drugs such as decetaxel and vinorelbine are promising new chemotherapeutic agents in the treatment of advanced non-small-cell lung cancer. These drugs can palliate disease symptoms and improve the median survival time. The optimal dose and treatment schedules, however, are yet to be defined.published_or_final_versio

Gastro-oesophageal reflux in bronchiectasis

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Efficacy and safety profiles of a combination of gemcitabine and ifosfamide on Chinese patients with advanced non-small cell lung cancer

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