The safety of using anti-VEGF: Is there strength in numbers? Curtis LH, Hammill BG, Schulman KA, Cousins SW (2010) Risks of mortality, myocardial infarction, bleeding, and stroke associated with therapies for age-related macular degeneration. Arch Ophthalmol 128(10):1273-1279

published_or_final_versionSpringer Open Choice, 21 Feb 201

Influenza-like illness among Hong Kong Chinese pregnant women

postprintWe assessed the self-reported prevalence of influenza-like illness (ILI) during pregnancy in two samples of 546 and 2764 new mothers who were pregnant during the 2009–10 and 2010–11 peak influenza seasons. During pregnancy, 11% of participants experienced an ILI. Cough, sore throat and nasal congestion were the most common reported symptoms. Only 4.6% and 9% of the participants in sample 1 and 2 had an underlying chronic illness, respectively, and 3.3% of mothers in both groups were smokers. Conducting regular surveillance on influenza prevalence during pregnancy is essential to evaluate the costs and benefits of influenza vaccination programmes

Brief education to increase uptake of influenza vaccine among pregnant women: a study protocol for a randomized controlled trial

published_or_final_versionpublished_or_final_versio

Total intravenous anaesthesia with propofol and remifentanil for elective neurosurgical procedures: An audit of early postoperative complications

Background and objectives: This was a prospective audit to assess the incidence and characteristics of early postoperative complications in the recovery room in extubated patients after elective neurosurgical procedures using propofol and remifentanil-based total intravenous anaesthesia. Methods: Vital signs (temperature, conscious level, respiratory rate, oxygen saturation, pulse and blood pressure) and postoperative complications (shivering, nausea, vomiting and cardiorespiratory) were analysed in 145 adult patients over a 1-yr period. Results: The overall shivering, postoperative nausea and vomiting and postoperative hypertension (systolic blood pressure more than 25% of the preoperative value) incidences were 30.3%, 16.6% and 35.2%, respectively. Fifty-one percent of the patients had at least one of the above complications. The complication rates were found to be widely different among various types of neurosurgery. The surgical procedures were divided into five groups: supratentorial craniotomy, posterior fossa craniotomy, intracranial vascular procedures, transphenoidal hypophysectomy and extracranial procedures. Median extubation time was similar in all groups and patients were fully conscious with no hypoxia in the recovery room. The intracranial vascular group had the highest shivering and postoperative nausea and vomiting rates (58.8% and 29.4%, respectively). In the supratentorial craniotomy group, 46% of the patients had hypertension. The overall complication rate (presence of any complications) was highest in the supratentfial craniotomy (55.4%), posterior fossa craniotomy (75%) and intracranial vascular (76.5%) groups. Shivering and overall complication rate was significantly related to the anaesthetic time (P ≤ 0.001 and 0.02, respectively). Conclusions: Despite the potential advantages of total intravenous anaesthesia in titratability, rapid return of consciousness and reduced respiratory complications, making it suitable for planned extubation at the end of neurosurgery, the postoperative complications of shivering, postoperative nausea and vomiting and hypertension were still high. © 2006 Copyright European Society of Anaesthesiology.published_or_final_versio

Group versus individual professional antenatal breastfeeding education for extending breastfeeding duration and exclusivity

Although breastfeeding initiation rates have increased substantially in many developed countries over the past several decades, breastfeeding duration and exclusivity remain suboptimal. In the antenatal period, both group and individual education interventions have been implemented to improve breastfeeding. The purpose of this review was to compare the effectiveness of group and individual antenatal professional education on breastfeeding exclusivity and duration. A systematic search of the literature was conducted using Medline (1946-June 2014), PubMed (1883-June 2014), the Cumulative Index to Nursing and Allied Health Literature (1947-June 2014), EMBASE (1947-June 2014), British Nursing Index (1994-June 2014), Google Scholar, and the Cochrane Library. Included studies were limited to health care professional-conducted education delivered to pregnant women only. Only studies reporting breastfeeding duration or exclusivity were included. Nineteen studies were included, of which 13 evaluated antenatal group education, 5 evaluated individual antenatal education, and 1 evaluated both a group and an individual antenatal education. When compared with standard care, 4 out of 12 studies supported the effectiveness of antenatal group education on breastfeeding duration or exclusivity, whereas 4 out of 6 studies supported the effectiveness of antenatal individual education. Two studies compared antenatal group education with peer-led education and neither study showed a significant difference in breastfeeding outcomes. The methodological heterogeneity and the small number of high quality studies limited our ability to draw firm conclusions about the effectiveness of either mode of antenatal education.postprin

Women's sexuality after termination of pregnancy in Hong Kong Chinese

Objective: Our aim is to determine sexuality after termination of pregnancy (TOP) in Hong Kong Chinese. Design: This was a prospective study using self-administered questionnaires given before and eight weeks after abortion. Subjects: Women over age 18 years old requesting TOP were invited to participate in the study during the period 6 December 2005 to 28 March 2006. Main outcome measures: Sexual function, couple relationship and psychological well-being like depression and post-traumatic stress disorder (PTSD) were assessed. Contraception was also reviewed. Results: No significant change in the number of women who presented with sexual dysfunctions before and after abortion. However, women reported subjective decrease in sexual functions after TOP, ranging from 9.8% for those with increased vaginal pain to 24.5% for those with decreased sexual desire. Majority of them (74.8%) suffered from at least moderate degree of post-traumatic stress symptoms and 10.2% had symptoms suggestive of the presence of a PTSD. Significant associations were seen in subjective decrease of sexual functions with post-traumatic stress symptoms after termination of pregnancy. On the other hand, 41.6% felt less depressed after abortion. There was no significant change in couple relationship after abortion. Conclusion: Termination of pregnancy did not cause sexual dysfunctions. However, significant proportion of women did suffer from decreased sexual functions subjectively which may be due to stress related to unplanned pregnancy or the TOP. The abortion itself did not cause depression and women who had completed family were less depressed after abortion. Post-traumatic stress was prevalent in those having abortion and the symptoms were associated with the subjective decrease in sexual functions.published_or_final_versio

Practices, predictors and consequences of expressed breast-milk feeding in healthy full-term infants

To investigate the prevalence and predictors of expressed breast-milk feeding in healthy full-term infants and its association with total duration of breast-milk feeding. Prospective cohort study. In-patient postnatal units of four public hospitals in Hong Kong. A total of 2450 mother–infant pairs were recruited in 2006–2007 and 2011–2012 and followed up prospectively for 12 months or until breast-milk feeding had stopped. Across the first 6 months postpartum, the rate of exclusive expressed breast-milk feeding ranged from 5·1 to 8·0 % in 2006–2007 and from 18·0 to 19·8 % in 2011–2012. Factors associated with higher rate of exclusive expressed breast-milk feeding included supplementation with infant formula, lack of previous breast-milk feeding experience, having a planned caesarean section delivery and returning to work postpartum. Exclusive expressed breast-milk feeding was associated with an increased risk of early breast-milk feeding cessation when compared with direct feeding at the breast. The hazard ratio (95 % CI) ranged from 1·25 (1·04, 1·51) to 1·91 (1·34, 2·73) across the first 6 months. Mothers of healthy term infants should be encouraged and supported to feed directly at the breast. Exclusive expressed breast-milk feeding should be recommended only when medically necessary and not as a substitute for feeding directly at the breast. Further research is required to explore mothers’ reasons for exclusive expressed breast-milk feeding and to identify the health outcomes associated with this practice.postprin

Brief Education to Promote Maternal Influenza Vaccine Uptake: A Randomized Controlled Trial

postprin

A brief group intervention using a cognitive-behavioural approach to reduce postnatal depressive symptoms: a randomised controlled trial

Key Messages: 1. Postnatal women preferred psychotherapy to pharmacotherapy for reduction of postnatal depression. ; 2. A brief, cognitive-behavioural, group intervention with 6 weekly sessions significantly reduced depressive symptoms and was well received by postnatal women. ; 3. This brief group intervention could be further tested as an integral part of postnatal care to complement existing services and reduce waiting time