Milk Consumption Across Life Periods in Relation to Lower Risk of Nasopharyngeal Carcinoma: A Multicentre Case-Control Study

Background: The much higher incidence of nasopharyngeal carcinoma (NPC) in men suggests sex hormones as a risk factor, and dairy products contain measurable amounts of steroid hormones. Milk consumption has greatly increased in endemic regions of NPC. We investigated the association between NPC and milk consumption across life periods in Hong Kong.Methods: A multicentre case-control study included 815 histologically confirmed NPC incident cases and 1,502 controls who were frequency-matched on age and sex at five major hospitals in Hong Kong in 2014–2017. Odds ratios (ORs) of NPC (cases vs. controls) for milk consumption at different life periods were estimated by unconditional logistic regression, adjusting for sex, age, socioeconomic status score, smoking and alcohol drinking status, exposure to occupational hazards, family history of cancer, IgA against Epstein-Barr virus viral capsid antigen, and total energy intake.Results: Compared with abstainers, lower risks of NPC were consistently observed in regular users (consuming ≥5 glasses of milk [fresh and powdered combined] per month) across four life periods of age 6–12 (adjusted OR 0.74, 95% CI 0.54–0.86), 13–18 (0.68, 0.55–0.84), 19–30 (0.68, 0.55–0.84), and 10 years before recruitment (0.72, 0.59–0.87). Long-term average milk consumption of ≤2.5, >2.5, and ≤12.5, >12.5 glasses per month yielded adjusted OR (95% CI) of 1.00 (0.80–1.26), 0.98 (0.81–1.18), 0.95 (0.76–1.18), and 0.55 (0.43–0.70), respectively (all P-values for trend < 0.05).Conclusion: Consumption of milk across life periods was associated with lower risks of NPC. If confirmed to be causal, this has important implications for dairy product consumption and prevention of NPC

Surgical treatment of carcinoma of larynx

published_or_final_versionSurgeryMasterMaster of Surger

Squamous cell carcinoma of the hypopharynx - Analysis of treatment results

The results of surgical treatment and causes of failure in 109 patients with squamous cell carcinoma of the hypopharynx were analyzed. The 5-year survival was significantly related to the stage of the disease (stage I, 74%; stage II, 63%; stage III, 32%; and stage IV, 14%) and the preoperative nodal staging (N0, 57%; N1, 28%; N2, 6%; and N3, 0%), but not related to the extent of tumor resection. The local control rate was 86% and the majority of the local recurrences occurred at the upper resection margin. There was no significant difference in the local recurrence rate between those patients who had pharyngolaryngoesophagectomy and those who had pharyngolaryngectomy. However, the resection-associated complications (bleeding, cardiac arrhythmia, pulmonary complications) were more frequent when total esophagectomy was performed. Reconstruction-associated complications such as wound infection and anastomotic leakage occurred less often after gastric pull-up reconstruction as compared with the use of myocutaneous flap, but was associated with more serious outcome after pharyngogastric anastomosis. Thirty-seven patients (34%) had neck node recurrences and these were significantly related to the preoperative nodal staging (N0, 20%; N1, 37%; N2, 48%; and N3, 83%). Additional primary cancers occurred in 17% of the patients and was a significant cause of death in those patients who survived more than 2 years.link_to_subscribed_fulltex

Pathological basis of surgery in the management of postradiotherapy cervical metastasis in nasopharyngeal carcinoma

Radical neck dissection was performed on 43 patients with nasopharyngeal carcinoma in whom persistent or recurrent cervical metastasis developed after radiotherapy. The pathologic nature of the tumor in the cervical lymph nodes was studied with step serial sectioning of the entire radical neck dissection specimen at 3-mm intervals. In 70% of patients, more tumor-harboring lymph nodes were detected in the specimen when compared with clinical examination. The extensive behavior of the tumor in the cervical metastases was reflected by the presence of extracapsular spread in 70% of the lymph nodes and the existence of isolated clusters of tumor cells in 35% of the specimens studied. Tumor tissue lying in close proximity to the spinal accessory nerve was demonstrated in 27.5% of the specimens, and 72% of the tumor-bearing lymph nodes were located in the posterior triangle. Radical neck dissection is recommended as the salvage procedure for these patients.link_to_subscribed_fulltex

Investigation of carriage and antibiotic susceptibility of pathogenic bacteria in the nose and oropharynx among students of Universiti Tunku Abdul Rahman Kampar Campus

Some members of the normal microbiota of the human upper respiratory tract can be potentially pathogenic when they overgrow or translocate to other body sites; the latter could lead to pneumonia and meningitis. The presence of these pathogens can be investigated via respiratory carriage studies, which have been recognised as a pragmatic solution to gaining large real-time epidemiological data on their carriage at the population level. This study aimed to investigate the upper respiratory carriage of Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, Staphylococcus aureus, Klebsiella pneumoniae, and Pseudomonas aeruginosa among the students of UTAR Kampar Campus. Nasal and oropharyngeal swabs from 100 students aged 18-28 years were collected and cultured onto various media, which include the chocolate agar, Columbia blood agar, MacConkey agar, mannitol salt agar, and King’s A medium. Identification of the S. aureus, K. pneumoniae, and P. aeruginosa isolates obtained was done through assessment of their growth characteristics, Gram stain, biochemical tests, and 16S rDNA sequencing. They were isolated from 39%, 12%, and 1% of subjects in this study, respectively. In the Kirby-Bauer assay, 19 S. aureus isolates were resistant to penicillin while 11 were intermediately resistant to quinupristin-dalfopristin. All the K. pneumoniae isolates were resistant to ampicillin as expected. Two S. aureus isolates were mecA-positive but only one showed methicillin resistance and was determined to be methicillin-resistant S. aureus (MRSA). Nine and two K. pneumoniae isolates were blaSHV- and blaTEM-positive in the multiplex extended-spectrum beta-lactamase (ESBL) PCR, respectively; however, these did not correspond to the findings of the combination disc test. In this study, the presence of S. pneumoniae, H. influenzae, and N. meningitidis was assessed via multiplex PCR on total DNA extracts from the chocolate agar sweeps. Among the 44 subjects screened, 9.1%, 20.5%, and 2.3% were positive for these target bacteria, respectively. All these were from the oropharyngeal swabs except for the sole N. meningitidis-positive sample, which was of nasal origin. The outcomes of this study contributed to better understanding of the respiratory carriage of bacterial pathogens, which will be of value to help inform the immunisation and antibiotic prescription policies

Use of Information and Communications Technology in Family Services and Its Perceived Benefits amid the COVID-19 Pandemic in Hong Kong—Jockey Club SMART Family-Link Project

Introduction: We examined information and communications technology (ICT) use in family services and its perceived benefits and barriers amid the COVID-19 pandemic in Hong Kong. Methods: We invited all family service social workers of 12 NGOs to complete an anonymous online questionnaire in May 2020 (Part A) and a management representative from each NGO to provide written feedback on ICT use in January 2021 (Part B). Results: In Part A, of 255 respondents (response rate: 67.3%), perceived ICT use in conducting programmes, groups, casework and preventive family programmes showed net increases of 33.9–54.5%; perceived ICT use in different work processes showed net increases of 18.8–48.6%. The three most common perceived benefits were “providing another option to service users” (74.2%), “more convenient service” (60.2%) and “maintaining normal service” (59.7%). In Part B, 12 management representatives consistently reported positive impacts of ICT use on family services. They shared actionable strategies (e.g., ICT skill-related training) and concerns about data privacy and management. Conclusions: ICT use in family services markedly increased amid the COVID-19 pandemic in Hong Kong. It helped make the services more accessible especially when the pandemic restricted face-to-face services

Use of the International Prostate Symptom Score (IPSS) in Chinese male patients with benign prostatic hyperplasia

© 2017 Informa UK Limited, trading as Taylor & Francis Group. Purpose: To test the psychometric properties of the International Prostate Symptom Score (Hong Kong Chinese version 2) (IPSS) in Chinese male patients with benign prostatic hyperplasia (BPH) under secondary care. Methods: A prospective longitudinal study was done by interviewing subjects at baseline, at 2 week after baseline for assessing testâretest reliability and at 26 week after baseline for assessing responsiveness. All subjects were interviewed to complete a structured questionnaire including IPSS, Short Form-12 Health Survey version 2 (SF-12v2) and Depression Anxiety Stress Scale (DASS). Results: The IPSS HRQOL score had weak correlations with SF-12v2 summary and DASS domain scores. For reliability analysis, Cronbachâs alpha coefficient was 0.90 for the seven symptom-related items. The intraclass correlation coefficients of the IPSS total symptom score and HRQOL score were 0.90 and 0.86, respectively. For sensitivity, statistically significant differences were detected between the subjects with BPH and those without for IPSS total symptom score (effect size = 0.68) but not the IPSS HRQOL score. The areas under ROC curves for the IPSS total symptom and HRQOL scores were 0.67 and 0.60, respectively. Conclusions: The IPSS was valid, reliable instrument in Chinese patients with BPH. The IPSS total symptom score, but not the HRQOL score, is sensitive in differentiating subgroups.Link_to_subscribed_fulltex