An Uncommon Potentially Fatal Complication in a Patient without Predisposing Factor Following Oral Bowel Preparation Commonly Used for Colonoscopy

published_or_final_versio

Prevalence of drugged drivers among non-fatal driver casualties presenting to a trauma centre in Hong Kong

OBJECTIVE: To investigate the prevalence and characteristics of abusive drug exposure among non-fatal motor vehicle driver casualties presenting to a designated trauma centre in Hong Kong. DESIGN: Cross-sectional study. SETTING: Designated trauma centre/regional accident and emergency department in Hong Kong. SUBJECTS: Non-fatal motor vehicle driver casualties who presented to the trauma centre from 1 January 2007 to 31 December 2007. MAIN OUTCOME MEASURES: Screening of abusive drug exposure using commercial bedside urine immunoassay kits. RESULTS: Drug screening was performed in 395 injured drivers, 10% of whom tested positive for the drugs of interest. Ketamine was the most commonly detected abusive substance (found in 45% of the subjects). A significantly higher proportion of young drivers (aged <25 years) screened positive (odds ratio=2.3; 95% confidence interval, 1.0-5.2; P=0.04), with the rate being 21%. The presence of these drugs in urine was related to the time of occurrence of the crash; those occurring between midnight and dawn revealed a trend towards a higher proportion of casualties testing drug-positive (odds ratio=2.2; 95% confidence interval, 0.9-5.3; P=0.07). There were no significant differences in the frequency of persons testing positive for the screened drugs with respect to gender, class of motor vehicle driven, or the day of the week on which the crash occurred. CONCLUSIONS: The prevalence of drugged driving among non-fatal casualties in our series of Hong Kong drivers was 10%. The frequency of such drivers testing positive for drugs was significantly higher in persons aged less than 25 years. These findings indicate a need to amend existing laws and implement on-site drug screening for suspected drugged drivers.published_or_final_versio

Changes in Staff Expectations, Competence, and Confidence in Providing EOL Care after Launching a 2-year End-of-life Care Pilot Project in Care and Attention Home

Conference Theme: Clinical, Legal and Administrative ChallengesFree Paper Presentation Ipublished_or_final_versio

在香港護理安老院舍推行生命晚期照護服務–成本效益分析

Conference Theme: Ageing at Home-Mobilizing Community Participation for Long Term Care of Elderlypostprin

Sociodemographic Trends in National Ambulatory Care Visits for Hepatitis C Virus Infection

Poor and non-white patients are disproportionately infected with the hepatitis C virus (HCV). The objective of this research is to determine sociodemographic patterns of HCV-related ambulatory care visits over time. Data from the National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey-Outpatient (NHAMCS-OPD) for the years 1997–2005 were analyzed in 3-year intervals. Demographic and other variables were compared for each period, and multivariable logistic regression was performed to examine whether the likelihood of a visit being HCV-related (versus non-HCV) was independently associated with (1) race and/or (2) Medicaid status over time. The total number of HCV-related ambulatory visits more than doubled from 3,583,585 during the years 1997–1999 to 8,027,166 during 2003–2005. During this time, the proportion of non-whites and Medicaid recipients presenting for HCV-related visits approximately doubled (non-whites: 16% vs. 33%, P = 0.04; Medicaid recipients: 10% vs. 25%, P = 0.07). In 2003–2005, HCV-related visits were more than twice as likely to occur among non-white patients vs. white patients (OR = 2.49; 95% CI: 1.60–3.86) and patients on Medicaid vs. non-Medicaid (3.49; 1.79–6.80). Our results show that HCV-associated ambulatory care visits are increasing, with a greater proportion of visits occurring among non-white patients and Medicaid recipients

Intramuscular midazolam, olanzapine, or haloperidol for the management of acute agitation: A multi-centre, double-blind, randomised clinical trial

© 2021 The Authors Background: The safety and effectiveness of intramuscular olanzapine or haloperidol compared to midazolam as the initial pharmacological treatment for acute agitation in emergency departments (EDs) has not been evaluated. Methods: A pragmatic, randomised, double-blind, active-controlled trial was conducted from December 2014 to September 2019, in six Hong Kong EDs. Patients (aged 18–75 years) with undifferentiated acute agitation requiring parenteral sedation were randomised to 5 mg intramuscular midazolam (n = 56), olanzapine (n = 54), or haloperidol (n = 57). Primary outcomes were time to adequate sedation and proportion of patients who achieved adequate sedation at each follow-up interval. Sedation levels were measured on a 6-level validated scale (ClinicalTrials.gov Identifier: NCT02380118). Findings: Of 206 patients randomised, 167 (mean age, 42 years; 98 [58·7%] male) were analysed. Median time to sedation for IM midazolam, olanzapine, and haloperidol was 8·5 (IQR 8·0), 11·5 (IQR 30·0), and 23·0 (IQR 21·0) min, respectively. At 60 min, similar proportions of patients were adequately sedated (98%, 87%, and 97%). There were statistically significant differences for time to sedation with midazolam compared to olanzapine (p = 0·03) and haloperidol (p = 0·002). Adverse event rates were similar across the three arms. Dystonia (n = 1) and cardiac arrest (n = 1) were reported in the haloperidol group. Interpretation: Midazolam resulted in faster sedation in patients with undifferentiated agitation in the emergency setting compared to olanzapine and haloperidol. Midazolam and olanzapine are preferred over haloperidol's slower time to sedation and potential for cardiovascular and extrapyramidal side effects. Funding: Research Grants Council, Hong Kong

Edge-Magnetoplasmon Wave-Packet Revivals in the Quantum Hall Effect

The quantum Hall effect is necessarily accompanied by low-energy excitations localized at the edge of a two-dimensional electron system. For the case of electrons interacting via the long-range Coulomb interaction, these excitations are edge magnetoplasmons. We address the time evolution of localized edge-magnetoplasmon wave packets. On short times the wave packets move along the edge with classical E cross B drift. We show that on longer times the wave packets can have properties similar to those of the Rydberg wave packets that are produced in atoms using short-pulsed lasers. In particular, we show that edge-magnetoplasmon wave packets can exhibit periodic revivals in which a dispersed wave packet reassembles into a localized one. We propose the study of edge-magnetoplasmon wave packets as a tool to investigate dynamical properties of integer and fractional quantum-Hall edges. Various scenarios are discussed for preparing the initial wave packet and for detecting it at a later time. We comment on the importance of magnetoplasmon-phonon coupling and on quantum and thermal fluctuations.Comment: 18 pages, RevTex, 7 figures and 2 tables included, Fig. 5 was originally 3Mbyte and had to be bitmapped for submission to archive; in the process it acquired distracting artifacts, to upload the better version, see http://physics.indiana.edu/~uli/publ/projects.htm

Study on Resistance Switching Properties of Na0.5Bi0.5TiO3Thin Films Using Impedance Spectroscopy

The Na0.5Bi0.5TiO3(NBT) thin films sandwiched between Au electrodes and fluorine-doped tin oxide (FTO) conducting glass were deposited using a sol–gel method. Based on electrochemical workstation measurements, reproducible resistance switching characteristics and negative differential resistances were obtained at room temperature. A local impedance spectroscopy measurement of Au/NBT was performed to reveal the interface-related electrical characteristics. The DC-bias-dependent impedance spectra suggested the occurrence of charge and mass transfer at the interface of the Au/NBT/FTO device. It was proposed that the first and the second ionization of oxygen vacancies are responsible for the conduction in the low- and high-resistance states, respectively. The experimental results showed high potential for nonvolatile memory applications in NBT thin films

Tumor necrosis factor-inducible gene 6 promotes liver regeneration in mice with acute liver injury

INTRODUCTION: Tumor necrosis factor-inducible gene 6 protein (TSG-6), one of the cytokines released by human mesenchymal stem/stromal cells (hMSC), has an anti-inflammatory effect and alleviates several pathological conditions; however, the hepatoprotective potential of TSG-6 remains unclear. We investigated whether TSG-6 promoted liver regeneration in acute liver failure. METHODS: The immortalized hMSC (B10) constitutively over-expressing TSG-6 or empty plasmid (NC: Negative Control) were established, and either TSG-6 or NC-conditioned medium (CM) was intraperitoneally injected into mice with acute liver damage caused by CCl(4). Mice were sacrificed at 3 days post-CM treatment. RESULTS: Higher expression and the immunosuppressive activity of TSG-6 were observed in CM from TSG-6-hMSC. The obvious histomorphological liver injury and increased level of liver enzymes were shown in CCl(4)-treated mice with or without NC-CM, whereas those observations were markedly ameliorated in TSG-6-CM-treated mice with CCl(4). Ki67-positive hepatocytic cells were accumulated in the liver of the CCl(4) + TSG-6 group. RNA analysis showed the decrease in both of inflammation markers, tnfα, il-1β, cxcl1 and cxcl2, and fibrotic markers, tgf-β1, α-sma and collagen α1, in the CCl(4) + TSG-6 group, compared to the CCl(4) or the CCl(4) + NC group. Protein analysis confirmed the lower expression of TGF-β1 and α-SMA in the CCl(4) + TSG-6 than the CCl(4) or the CCl(4) + NC group. Immunostaining for α-SMA also revealed the accumulation of the activated hepatic stellate cells in the livers of mice in the CCl(4) and CCl(4) + NC groups, but not in the livers of mice from the CCl(4) + TSG-6 group. The cultured LX2 cells, human hepatic stellate cell line, in TSG-6-CM showed the reduced expression of fibrotic markers, tgf-β1, vimentin and collagen α1, whereas the addition of the TSG-6 antibody neutralized the inhibitory effect of TSG-6 on the activation of LX2 cells. In addition, cytoplasmic lipid drops, the marker of inactivated hepatic stellate cell, were detected in TSG-6-CM-cultured LX2 cells, only. The suppressed TSG-6 activity by TSG-6 antibody attenuated the restoration process in livers of TSG-6-CM-treated mice with CCl(4). CONCLUSIONS: These results demonstrated that TSG-6 contributed to the liver regeneration by suppressing the activation of hepatic stellate cells in CCl(4)-treated mice, suggesting the therapeutic potential of TSG-6 for acute liver failure. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13287-015-0019-z) contains supplementary material, which is available to authorized users