Central Nervous System Inflammatory Demyelinating Disorders in the Hong Kong Chinese

Central nervous system inflammatory demyelinating disorders (CNS IDD) include classical multiple sclerosis, neuromyelitis optica (NMO) spectrum disorders, a single attack of/recurrent acute disseminated encephalomyelitis, a single attack of idiopathic acute transverse myelitis, optic neuritis (ON) and brainstem encephalitis. CNS IDD are potentially serious disorders with risks of mortality and significant disability. Typical relapsing forms of CNS IDD are relapsing remitting multiple sclerosis and relapsing NMO. Relapsing NMO is typified by recurrent longitudinally extensive transverse myelitis and severe unilateral or bilateral ON. Early diagnosis of CNS IDD is important as long-term treatment for different forms varies. Recognition of clinical, radiological and serological characteristics of different forms of CNS IDD facilitates early diagnoses. A significant proportion of NMO patients are seropositive for autoantibodies against aquaporin-4, the most abundant water channel in the CNS; this supports the hypothesis that NMO is an autoimmune disorder. Is NMO an autoantibody-mediated disorder sharing similar pathogenesis with myasthenia gravis (MG), a classical autoantibody-mediated autoimmune disease? An interesting observation is that paraneoplastic NMO associated various tumours is recognised recently, suggesting similarity with MG which is associated with thymoma in about 15 to 20% of patients.published_or_final_versio

Plasma amyloid beta peptides and oligomers antibodies in Alzheimer's disease

INTRODUCTION: Various forms of amyloid beta (Aβ) including Aβ peptides, oligomers, protofibrils and fibrils are thought to be pathogenic in Alzheimer’s disease (AD). The exact pathophysiological role of endogenous Aβ autoantibodies (Ab) in healthy subjects and AD patients are uncertain. Potential protective role ...published_or_final_versio

Brainstem encephalitis in neuromyelitis optica spectrum disorders

Poster: abstract no. 41published_or_final_versionThe 17th Medical Research Conference (MRC), Department of Medicine, the University of Hong Kong, Hong Kong, 14 january 2012. In Hong Kong Medical Journal, 2012, v. 18 suppl. 1, p. 3

Cerebral involvement in neuromyelitis optica spectrum disorders among Hong Kong Chinese

published_or_final_versionThe 16th Medical Resarch Conference (MRC), The University of Hong Kong, Hong Kong, China, 22 January 2011. In Hong Kong Medical Journal, 2011, v. 17, suppl. 1, p. 55, abstract no. 8

Adiponectin is protective against oxidative stress-induced cytotoxicity in amyloid-beta neurotoxicity

Oral PresentationBeta-amyloid (Aβ) neurotoxicity is important in Alzheimer’s disease (AD) pathogenesis. Aβ neurotoxicity causes oxidative stress, inflammation, and mitochondrial damage resulting in neuronal degeneration and death. Oxidative stress, inflammation, and mitochondrial failure are also pathophysiological mechanisms of type 2 diabetes mellitus (T2DM) which is characterised by insulin resistance. Interestingly, T2DM increases risk to develop AD which is associated with reduced neuronal insulin sensitivity (central insulin resistance). We studied the potential protective effect of adipon…published_or_final_versio

Cognitive impairment in adiponectin-knockout mice

Oral Presentationpublished_or_final_versio

Influenza vaccine effectiveness against influenza A(H3N2) hospitalizations in children in Hong Kong in a prolonged season, 2016/17.

Background: Influenza A(H3N2) viruses circulated for 12 consecutive months in Hong Kong in 2016-2017, peaking in late June and July 2017. The objective of our study was to estimate the effectiveness of influenza vaccination in preventing hospitalizations in children in Hong Kong. Methods: We conducted a test-negative study between September 1 2016 and August 31 2017, enrolling children 6 months to 17 years of age hospitalized for an acute respiratory infection. Influenza was diagnosed by PCR on nasopharyngeal aspirates. Results: We enrolled 5514 children, including 3608 children between 6 months to 2 years, 1600 children 3-5 years, and 1206 children 6-17 years of age. Influenza-associated hospitalizations occurred throughout the study year but time of vaccination of these children was also wide-spread, from September 2016 to May 2017. Influenza vaccine effectiveness (VE) was 39.7% (95% CI: 14.7, 57.3%) against laboratory-confirmed influenza A(H3N2). In analyses stratified by time since vaccination, the VE against influenza A(H3N2) was 52.8% (17.1%, 73.2%) within 3 months of vaccination, and 31.2% (-6.6%, 55.6%) 4-6 months after vaccination. Conclusions: Influenza vaccination was effective in preventing hospitalizations in children in Hong Kong

Interim estimate of influenza vaccine effectiveness in hospitalised children, Hong Kong, 2017/18

We conducted a hospital-based test-negative study in Hong Kong to estimate influenza vaccine effectiveness (VE) for the winter of 2017/18. The interim analysis included data on 1,078 children admitted between 4 December 2017 and 31 January 2018 with febrile acute respiratory illness and tested for influenza. We estimated influenza VE at 66% (95% confidence interval (CI): 43–79) overall, and 65% (95% CI: 40–80) against influenza B, the dominant virus type (predominantly B/Yamagata).published_or_final_versio

Omicron variant susceptibility to neutralizing antibodies induced in children by natural SARS-CoV-2 infection or COVID-19 vaccine

The novel SARS-CoV-2 Omicron variant may increase the risk of re-infection and vaccine breakthrough infections as it possesses key mutations in the spike protein that affect neutralizing antibody response. Most studies on neutralization susceptibility were conducted using specimens from adult COVID-19 patients or vaccine recipients. However, since the paediatric population has an antibody response to SARS-CoV-2 infection that is distinct from the adult population, it is critical to assess the neutralization susceptibility of pediatric serum specimens. This study compared the neutralization susceptibility of serum specimens collected from 49 individuals of <18 years old, including 34 adolescent BNT162b2 (Pfizer-BioNTech) vaccine recipients, and 15 recovered COVID-19 patients aged between 2 and 17. We demonstrated that only 38.2% of BNT162b2 vaccine recipients and 26.7% of recovered COVID-19 patients had their serum neutralization titre at or above the detection threshold in our live virus microneutralization assay. Furthermore, the neutralizing antibody titer against the Omicron variant was substantially lower than those against the ancestral virus or the Beta variant. Our results suggest that vaccine recipients and COVID-19 patients in the pediatric age group will likely be more susceptible to vaccine breakthrough infections or reinfections due to the Omicron variant than previous variants

Competências não técnicas do enfermeiro instrumentista

Relatório de Estágio apresentado para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Enfermagem PerioperatóriaO presente relatório de estágio enquadra-se no 1º Curso de Mestrado em Enfermagem Perioperatória, da Escola Superior de Saúde do Instituto Politécnico de Setúbal. Foi redigido segundo a metodologia de projeto, focando-se na integração de conhecimentos e competências adquiridas durante o curso, no domínio da enfermagem perioperatória. Tem como objetivos estabelecidos: (1) reflexão crítica acerca das atividades realizadas em contexto de estágio; (2) desenvolvimento de um projeto acerca das competências não técnicas do enfermeiro instrumentista; (3) reflexão crítica acerca do desenvolvimento de competências de mestre em enfermagem perioperatória. De forma a responder aos objetivos propostos organizou-se a estrutura deste relatório por três capítulos distintos: Capítulo I – onde consta o enquadramento concetual, considerando a teoria do autocuidado de Dorothea Elizabeth Orem; e enquadramento teórico, acerca do conceito de competência em enfermagem perioperatória. Capítulo II – corresponde ao enquadramento metodológico, onde é fundamentado o método seguido para a construção do projeto, exposto o tipo de estudo conduzido, o trabalho de campo desenvolvido, bem como os processos de colheita e tratamento de dados, considerando sempre as questões éticas do processo de investigação. Capítulo III – é realizada a reflexão sobre o estágio realizado, assim como a aquisição do perfil de competências de mestre em enfermagem perioperatória. A realização deste relatório de estágio permitiu a aquisição de conhecimentos no domínio da enfermagem perioperatória. Com os contributos da investigação elaborada, foi possível a compreensão e aplicação destes saberes para a resolução de problemas, em ambiente clinico multidisciplinar, consciente das implicações científicas, éticas, deontológicas e jurídicas.This internship report is part of the 1st Master in Perioperative Nursing, taken in Escola Superior de Saúde do Instituto Politécnico de Setúbal. It has been drafted according to project methodology, focusing on the integration of knowledge and skills acquired during the course in the field of perioperative nursing. Its stated objetives are: (1) critical analysis of the activities undertaken in the stage context; (2) project development for scrub nurses non-technical skills; (3) critical assessment on the development master competencies in perioperative nursing. In order to meet the proposed objetives, this report is organized by three chapters: Chapter I – with the conceptual framework, considering the self-care theory of Dorothea Elizabeth Orem; and theoretical framework of competence in perioperative nursing. Chapter II - corresponds to the methodological framework, which is based the method followed for the construction of the project, stated the type of study conducted, the field work and the procedures for collection and processing of data, always considering ethical issues in research process. Chapter III - is held to assess the internship stage, as well as the acquisition of master skills profile in perioperative nursing. The completion of this internship report allowed the acquisition of knowledge in the field of perioperative nursing. With the contributions of elaborate investigation, it was possible the understanding and application of this knowledge to solve problems in a multidisciplinary clinical environment, aware of the scientific, ethical, ethical and legal implications