Silver containing hydrofiber dressing promotes wound healing in paediatric patients with partial thickness burns

Introduction: Burn injury is one of the most common reasons for admission in paediatric population. There is currently no international consensus on the best wound dressing material. Aquacel Ag, a new silver containing hydrofiber dressing material has been reported to produce good clinical results. Yet, only a limited number of studies exist in the paediatric population. This study aims to review our experience of burn management over the past 5 years and to evaluate the effectiveness of Aquacel Ag in the management of partial thickness burns. Methods: A retrospective review of all patients admitted for burn injury between January 2010 and December 2014 was conducted. Patients’ demographics, mechanism of injury, body surface areas involved, treatment applied, and clinical outcomes were analyzed. Patients with superficial injury, full thickness burns that required surgical debridement, burn area less than 2 % or more than 25 % of total body surface area, or incomplete clinical data were excluded from the comparative study. Results: A total of 119 patients were identified. 114 (96 %) was due to domestic injury, of which 108 (91 %) was food-related. The most commonly affected areas were limbs (n = 89, 74.8 %), followed by trunk (n = 62, 74.8). 84 patients fulfilled the inclusion criteria and were recruited into the study. 31 patients received Aquacel Ag dressing and 53 patients received standard paraffin gauze dressing. The two groups showed no statistical difference in age, sex, percentage of total body surface area involved, and infection rate. Outcomes of patients treated with Aquacel Ag were compared with patients treated with standard dressing. The mean hospital stay was significantly shorter for the Aquacel Ag group (14.26 vs 23.45, p = 0.045). Aquacel Ag group required much less frequent dressing change (5.67 vs 20.59, p = 0.002). 5 patients in standard dressing group developed hypertrophic scar and required prolonged pressure garment, whereas only one hypertrophic scar was observed in the Aquacel Ag group. Conclusion: Aquacel Ag appears to promote early burn wound healing with less hypertrophic scar formation. © 2016, Springer-Verlag Berlin Heidelberg.postprin

A theory on the ventilation over hypothetical urban areas

Urban roughness is one of the major factors affecting the flows and turbulence structures in the bottom of the atmospheric boundary layer (ABL). Whereas, our understanding of their relation is limited. In this paper, we attempt to examine the interaction among aerodynamic resistance (friction factor f), ventilation (air exchange rate ACH), and pollutant removal (pollutant removal rate PCH). Using the method of characteristic, analytical solution shows that the turbulent ventilation of a hypothetical urban area is directly proportional to the square root of friction factor (ACH? f1-2) regardless of the building geometry. Next, a series of computational fluid dynamics (CFD) sensitivity tests are performed to verify the theory. In addition to the commonly employed rectangular building mod...published_or_final_versio

Persistent hypocalcaemia in a Chinese girl due to a novel de-novo activating mutation of the calciumsensing receptor gene

A significant proportion of patients formerly diagnosed with idiopathic hypoparathyroidism actually have activating mutation of the calcium-sensing receptor (CaSR) gene. Awareness of the possibility of activating mutation of CaSR gene in patients with sporadic idiopathic hypoparathyroidism is important because of its relevance to clinical management. This report is of a novel activating mutation of the CaSR gene identified in a 10-year-old Chinese girl who was initially diagnosed as having idiopathic hypoparathyroidism at 6 years of age after presenting with seizures. Her serum calcium level was difficult to maintain near the lower limit of normal despite treatment with high-dose calcitriol. Treatment with calcitriol produced significantly elevated urinary calcium-to-creatinine ratio. Direct sequencing of the CaSR gene showed a novel heterozygous mutation (p.Q735P (c.2204A>C)). Molecular genetic analysis of her parents demonstrated that both parents did not harbour the child's mutation, indicating that her mutation had arisen de novo. © 1995-2011 HKAM.published_or_final_versio

Timely thoracoscopic decortication promotes the recovery of paediatric parapneumonic empyema

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Thoracoscopic operations in children

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How can the R.E.N.A.L. nephrometry scoring system aid management of a solid renal mass?

OBJECTIVES. To investigate use of the R.E.N.A.L. nephrometry score in relation to the choice of treatment and postoperative complications for renal masses. DESIGN. Case series. SETTING. A tertiary referral hospital in Hong Kong. PATIENTS. Data of patients undergoing nephrectomy were collected retrospectively from a clinical database and analysed. A R.E.N.A.L. nephrometry score was allocated to each renal tumour by a blinded qualified radiologist, utilising computerised imaging systems. Patient demographics, choice of surgery (radical vs partial), and approaches (open vs minimally invasive) were analysed with respect to their R.E.N.A.L. score. RESULTS. In all, 74 patients were included during the study period, of which 38 underwent partial nephrectomy and 36 underwent radical nephrectomy. No differences between the groups were found with respect to patient demographics. There were significant differences between the partial and radical nephrectomy groups in terms of their mean nephrometry score (6.9 vs 9.3, P<0.001). The mean nephrometry sum was also significantly different in the open approach versus the minimally invasive approach in patients having partial nephrectomy (7.8 vs 6.0, P=0.001). There was no difference in the postoperative 90-day morbidity and mortality in the partial nephrectomy and radical nephrectomy groups. CONCLUSIONS. The R.E.N.A.L. nephrometry score of a renal mass correlated significantly with our choice of surgery (partial vs radical) and our approach to surgery (open vs minimally invasive surgery), particularly in the partial nephrectomy group. It does not, however, correlate with postoperative complications. The nephrometry score provides a useful tool for objectively describing renal mass characteristics and enhancing better communication for the operative planning directed at renal masses.published_or_final_versio

Development of metal-containing polymers for optoelectronic applications

Most of the work in organic electroluminescent polymers has been focused on organic conjugated polymers. However, polymers attached with transition metal complex have received relatively less attention. We have synthesized and studied the light emitting properties of some metal containing polymers based on the polypyridine complexes of rhenium and ruthenium. These complexes exhibit long-lived excited states caused by the metal to ligand charge transfer transitions. By varying the structure of the ligand and/or the transition metal, we are able to fine-tune the electronic properties of the resulting metal complexes.We have synthesized a series of poly(phenylenevinylene) (PPV) derivatives which are functionalized with ruthenium polypyridine complexes at the polymer mainchain or side chain. These complexes are able to act as photosensitizers which enhance the photoconductivity of these polymers at longer wavelength. Both the conjugatedbackbone and the metal complex can emit light upon excitation. As a result, it is possible to tune the color by loading different amount of ruthenium complex to the polymer. Luminescence studies showed that the ruthenium complex could quench the emission of the conjugated backbone in some polymers, which suggests an energy transfer processbetween the backbone and the metal complexes. It was also found that the presence of metal complexes could enhance the charge carrier mobilities of the polymers, as the metal and/or ligands can act as extra charge carriers in the charge transport process.published_or_final_versio

The impact of environmental and human factors on urban heat and microclimate variability

Urbanization is known to cause noticeable changes in the properties of local climate. Studies have shown that urban areas, compared to rural areas with less artificial surfaces, register higher local temperatures as a result of Urban Heat Islands (UHIs). Hong Kong is one of the most densely populated cities in the world and a high proportion of its population residing in densely built high-rise buildings are experiencing some degrees of thermal discomfort. This study selected Mong Kok and Causeway Bay, two typical urban communities in Hong Kong, to gather evidence of microclimate variation and sources of thermal discomfort. UHIs were estimated from 58 logging sensors placed at strategic locations to take temperature and humidity measurements over 17 consecutive days each in the summer/hot and winter/cool periods. By employing geographic information and global positioning systems, these measurements were geocoded and plotted over the built landscape to convey microclimate variation. The empirical data were further aligned with distinct environmental settings to associate possible factors contributing to UHIs. This study established the existence and extent of microclimate variation of UHI within urban communities of different environmental configuration and functional uses. The findings provided essential groundwork for further studies of UHI effects to inform sources of local thermal discomfort and better planning design to safeguard environmental health in public areas.postprin

Decreased dopamine activity predicts relapse in methamphetamine abusers.

Studies in methamphetamine (METH) abusers showed that the decreases in brain dopamine (DA) function might recover with protracted detoxification. However, the extent to which striatal DA function in METH predicts recovery has not been evaluated. Here we assessed whether striatal DA activity in METH abusers is associated with clinical outcomes. Brain DA D2 receptor (D2R) availability was measured with positron emission tomography and [(11)C]raclopride in 16 METH abusers, both after placebo and after challenge with 60 mg oral methylphenidate (MPH) (to measure DA release) to assess whether it predicted clinical outcomes. For this purpose, METH abusers were tested within 6 months of last METH use and then followed up for 9 months of abstinence. In parallel, 15 healthy controls were tested. METH abusers had lower D2R availability in caudate than in controls. Both METH abusers and controls showed decreased striatal D2R availability after MPH and these decreases were smaller in METH than in controls in left putamen. The six METH abusers who relapsed during the follow-up period had lower D2R availability in dorsal striatum than in controls, and had no D2R changes after MPH challenge. The 10 METH abusers who completed detoxification did not differ from controls neither in striatal D2R availability nor in MPH-induced striatal DA changes. These results provide preliminary evidence that low striatal DA function in METH abusers is associated with a greater likelihood of relapse during treatment. Detection of the extent of DA dysfunction may be helpful in predicting therapeutic outcomes

Is vocal cord asymmetry seen on transcutaneous laryngeal ultrasonography a significant predictor of voice quality changes after thyroidectomy?

Background: Vocal cord asymmetry (VCA) on laryngoscopic examination (LE) may suggest voice impairment after thyroidectomy, but LE may cause patient discomfort. We aimed to correlate the presence of postoperative VCA assessed by noninvasive transcutaneous laryngeal ultrasonography (TLUSG) with voice quality changes after thyroidectomy. Methods: A total of 169 patients scheduled for thyroidectomy completed two validated voice symptoms questionnaires - the GRBAS (grade, roughness, breathiness, asthenia, strain) scale and the voice impairment score (VIS) - and underwent TLUSG and LE at 1 day before and 7-10 days after thyroidectomy. Postoperative VCA was apparent in 51 patients on TLUSG (group I), whereas there was no VCA in the other 118 patients (group II, controls). The GRBAS scale and VIS results were compared between the groups. Results: Before operation, the two groups had comparable preoperative GRBAS and VIS status. After operation, the "grade" and "roughness" components on the GRBAS scale were significantly worse in group I than in group II: 0.24 versus 0.07 (p = 0.016) and 0.33 versus 0.14 (p = 0.022), respectively. "Grade" and "roughness" in the GRBAS scale significantly worsened after the operation in group I: from 0.04 to 0.24 (p = 0.008) and from 0.02 to 0.33 (p = 0.001), respectively. They did not change in group II. Also, the overall VIS was significantly worse after thyroidectomy in group I: 4.97 versus 12.97 (p < 0.001). Conclusions: VCA seen on TLUSG significantly correlated with "grade" and "roughness" components on the GRBAS scale and the overall VIS. Thus, VCA might be used as a surrogate of postoperative voice changes. © 2013 Société Internationale de Chirurgie.postprin