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

Prevalence of antibiotic-resistant intestinal flora in patients undergoing transrectal ultrasonography-guided prostate biopsy (TRUS-Bx) and its implication for clinical practice: preliminary results

Oral (Free Paper) Session I - Prostate Cancer: Diagnosis to Treatment: OP.1-2香港泌尿外科學會OBJECTIVE: An important factor determining the choice of antibiotic for TRUS-Bx prophylaxis and treatment of post-biopsy infection is the prevalence of quinolone-resistant and ESBL-producing organisms in the rectum of patients undergoing this procedure. We aim to determine these prevalence values in patients undergoing TRUS-Bx and to study their correlation with the microbiological data of patients ...published_or_final_versionThe 17th Annual Scientific Meeting of the Hong Kong Urological Association, Hong Kong, 6 November 2011. In Program Book, 2011, p. 3

The Chinese version of the pelvic pain and urgency / frequency symptom scale: a useful assessment tool for street-ketamine abusers with lower urinary tract symptoms

OBJECTIVE: To investigate the use of a translated Chinese version of the pelvic pain and urgency/frequency symptom scale as an assessment and prognostic tool to evaluate the severity of street-ketamine-associated lower urinary tract symptoms and their reversibility after abstinence. DESIGN: Cross-sectional study. SETTING: A special designated out-patient clinic in a regional hospital in Hong Kong. PARTICIPANTS: There were 50 patients with street-ketamine-associated lower urinary tract symptoms and 20 healthy individuals. MAIN OUTCOME MEASURES: Reliability and validity of the questionnaire; frequency of individual lower urinary tract symptoms, cystoscopic, urodynamic and radiological abnormalities, and their correlation with pelvic pain and the urgency/frequency score. RESULTS: The test-retest reliability coefficient was 0.755 (P<0.001). Cronbach's alpha was 0.974. Mann-Whitney U test proved the discriminatory ability of the questionnaire (P<0.001). Patients with specific lower urinary tract symptoms had a higher mean pelvic pain and urgency/frequency total score compared to those without them: frequency (23.8 vs 17.3), nocturia (22.4 vs 14.0), urgency (22.5 vs 15.1), dysuria (22.7 vs 13.3), and haematuria (24.8 vs 16.2). The number of daytime voids and nocturia episodes correlated well with pelvic pain and urgency/frequency scores. With an increasing score, the likelihood of having cystitis changes, urodynamic abnormalities and hydronephrosis increased, while the cystometrically determined bladder capacity decreased. None of the patients with a score of 16 or below had urodynamic abnormality or hydronephrosis. The mean score change in the abstinence group was -4.33, versus +3.33 in their counterparts. CONCLUSIONS: The Chinese version of the pelvic pain and urgency/frequency questionnaire is reliable and valid for assessment in patients with street-ketamine-associated lower urinary tract symptoms. The pelvic pain and urgency/frequency score correlates well with symptom severity as well as endoscopic, urodynamic and radiological abnormalities in patients with street-ketamine-associated lower urinary tract symptoms. A cut-off total pelvic pain and urgency/frequency score of 17 may suggest more serious urological sequelae from ketamine abuse. Abstinence from ketamine reduced lower urinary tract symptoms, but the extent of reversibility of urinary tract damage is yet to be evaluated.published_or_final_versio

Doping of GaN by Mg diffusion

published_or_final_versio

Subcapsular hematoma after ureteroscopy and laser lithotripsy

published_or_final_versio

Long-term hearing results and otological complications of nasopharyngeal carcinoma patients: comparison between treatment with conventional two-dimensional radiotherapy and intensity-modulated radiotherapy

OBJECTIVE: To assess the long-term audiological outcome and otological complications of nasopharyngeal carcinoma patients who have received intensity-modulated radiotherapy (IMRT) versus conventional two-dimensional radiotherapy (2 DRT). STUDY DESIGN: Prospective study on the audiological outcome and otological complications 5-9 years after radiotherapy. METHODOLOGY: Patients had pure-tone audiogram before radiotherapy and 5 years after radiotherapy. Otological examination was performed 5-9 years after radiotherapy by an otolaryngologist. RESULTS: There is a significant deterioration of the hearing threshold 5 years after radiotherapy but there is no statistically significant difference in the deterioration of hearing between IMRT and 2 DRT. Six patients in the 2 DRT group and 1 patient in the IMRT group had osteoradionecrosis of the external auditory canal (p = 0.042). CONCLUSION: There are fewer incidences of osteoradionecrosis of the external auditory canal in patients treated with IMRT. There is no difference in bone conduction threshold in patients treated with IMRT or 2 DRT.postprin

Clinical significance of hepatic derangement in severe acute respiratory syndrome

Aim: Elevation of alanine aminotransferase (ALT) level is commonly seen among patients suffering from severe acute respiratory syndrome (SARS). We report the progression and clinical significance of liver derangement in a large cohort of SARS patient. Methods: Serial assay of serum ALT was followed in patients who fulfilled the WHO criteria of SARS. Those with elevated ALT were compared with those with normal liver functions for clinical outcome. Serology for hepatitis B virus (HBV) infection was checked. Adverse outcomes were defined as oxygen desaturation, need of intensive care unit (ICU) and mechanical ventilation and death. Results: Two hundred and ninety-four patients were included in this study. Seventy (24%) patients had elevated serum ALT on admission and 204 (69%) patients had elevated ALT during the subsequent course of illness. Using peak ALT >5×ULN as a cut-off and after adjusting for potential confounding factors, the odds ratio of peak ALT >5× ULN for oxygen desaturation was 3.24 (95%CI 1.23-8.59, P = 0.018), ICU care was 3.70 (95%CI 1.38-9.89, P = 0.009), mechanical ventilation was 6.64 (95%CI 2.22-19.81, P = 0.001) and death was 7.34 (95%CI 2.28-24.89, P = 0.001). Ninety-three percent of the survived patients had ALT levels normalized or were on the improving trend during follow-up. Chronic hepatitis B was not associated with worse clinical outcomes. Conclusion: Reactive hepatitis is a common complication of SARS-coronavirus infection. Those patients with severe hepatitis had worse clinical outcome. © 2005 The WJG Press and Elsevier Inc. All rights reserved.published_or_final_versio

Utilisation of geriatric assessment in oncology - a survey of Australian medical oncologists

© 2018 Elsevier Inc. Introduction: Geriatric assessment (GA) is a multidimensional health assessment of the older person to evaluate their physical and cognitive function, comorbidities, nutrition, medications, psychological state, and social supports. GA may help oncologists optimise care for older patients with cancer. The aim of this study was to explore the views of Australian medical oncologists regarding the incorporation of geriatric screening tools, GA and collaboration with geriatricians into routine clinical practice. Methods: Members of the Medical Oncology Group of Australia were invited to complete an online survey that evaluated respondent demographics, practice characteristics, treatment decision-making factors, use of GA, and access to geriatricians. Results: Sixty-nine respondents identified comorbidities, polypharmacy, and poor functional status as the most frequent challenges in caring for older patients with cancer. Physical function, social supports and nutrition were the most frequent factors influencing treatment decision-making. The majority of respondents perceived value in GA and geriatrician review, although access was a barrier for referral. Such services would need to be responsive, providing reports within two weeks for the majority of respondents. Conclusion: Despite an emerging evidence base for the potential benefits of GA and collaboration with geriatricians, medical oncologists reported a lack of access but a desire to engage with these services

Robot-assisted ureteral reimplantation in children with vesico-ureteral reflux

香港泌尿外科學會Moderated Poster (Free Paper) Session II - Upper Tract and Robotic Surgery: MP.2-4OBJECTIVE: We report our initial experience on robot-assisted ureteral reimplanation in children with vesico-ureteral reflux (VUR) …published_or_final_versionThe 17th Annual Scientific Meeting of the Hong Kong Urological Association, Hong Kong, 6 November 2011. In Program Book, 2011, p. 6