Surveillance of acute flaccid paralysis in Hong Kong: 1997 to 2002

Objectives. To describe the characteristics of patients reported with acute flaccid paralysis between 1997 and 2002, and to evaluate the performance of the acute flaccid paralysis surveillance system using indicators recommended by the World Health Organization. Design. Retrospective study. Setting. Department of Health, Hong Kong. Participants. Children aged younger than 15 years who were reported to the Department of Health between 1997 and 2002 with acute flaccid paralysis. Results. Of 120 children with acute flaccid paralysis reported between 1997 and 2002, 42% were younger than 5 years of age. None of the cases were acute poliomyelitis or polio-compatible. A neurological cause was identified in 67.5% of cases, of which the most common was Guillain-Barré syndrome (42%), followed by transverse myelitis (15%). All except one of the performance indicators consistently met World Health Organization requirements and thus demonstrated the effectiveness of the acute flaccid paralysis surveillance programme. The acute flaccid paralysis notification rate consistently exceeded 1.0 per 100 000 population below 15 years of age. The requirement for adequate stool investigation was the single indicator that did not satisfy World Health Organization requirements. This highlighted the importance of maintaining physicians' awareness of acute flaccid paralysis surveillance. Conclusion. Hong Kong should remain vigilant for acute flaccid paralysis. The effective surveillance system and its evaluation may serve as a model for surveillance of other infectious diseases.published_or_final_versio

The Hong Kong mental morbidity survey: background and study design

Mental disorders are highly prevalent conditions with immense disease burden. To inform health and social services policy formulation, local psychiatric epidemiological data are required. The Hong Kong Mental Morbidity Survey is a 3-year population-based study in which 5700 community-dwelling Chinese adults aged between 16 and 75 years were interviewed with the aim of evaluating the prevalence, co-morbidity, functional impairment, physical morbidity, and social determinants of significant mental disorders in the population. This paper describes the background and design of the survey, and is the first territory-wide psychiatric epidemiological study in Hong Kong. 精神障礙非常普遍，且對社會造成巨大的疾病負擔。收集本地精神病流行病學資料，對計劃相關的衛生及社會服務政策至為重要。香港精神健康調查是一個為期3年，以人口為基礎的大型研究，透過對5700名介乎16歲至75歲之華裔市民進行精神健康評估，檢視重要的精神障礙的現患率、共病、功能障礙、身體疾病以及社會決定因素。本文闡述這項首個全港大型精神病流行病研究的背景和設計。published_or_final_versio

A case-study in Technology-enhanced Collaborative Learning

Main Theme: E-Learning in a Changing Landscape of Emerging Technologies and Pedagogie

What does recovery from psychosis mean? Perceptions of young first-episode patients

Background: This study explored the experience of first-episode psychosis from the patients' perspective and the meanings they attach to the illness and their recovery.Method: A qualitative methodology was used based on a focus group. Audio tapes were transcribed verbatim and three researchers participated in a content analysis that identified four major themes: the meaning of psychosis and psychotic experience; the meaning of recovery; stigma; and having an optimistic view of recovery.Discussion: Participants' view of recovery was broader than that often held by psychiatrists, extending beyond symptom control and medication compliance, and they identified positive features that the experience of illness had brought. Their concerns included the side effects of medication and the fear of their illness being disclosed (to employers, university authorities, acquaintances, etc.) in the face of societal stigma.Conclusion: Ideas about what constitutes recovery need to take account of patients' views and experience in order to emphasize therapeutic optimism rather than pessimism, and to inform treatment contexts and the views of medical staff. © 2011 SAGE Publications.link_to_subscribed_fulltex

Effects of 20 PBDE metabolites on steroidogenesis in the H295R cell line

Polybrominated diphenyl ethers (PBDEs) are additive flame retardants that have been found in the environment as well as human tissues. Environmental concentrations of these compounds have been increasing in many parts of the world in recent years. Due to their structural similarity, PBDEs are believed to have similar toxicity to PCBs, but their toxicological properties are still being determined. In this study, the steroidogenic effects of hydroxylated, methoxylated and/or chlorinated derivatives of PBDEs were assessed at both the gene and enzyme/hormone levels in the H295R human adrenocortical carcinoma cell line. The expression levels of 10 steroidogenic genes were measured using quantitative real-time PCR (Q-RT-PCR). Aromatase activity in the cells and sex steroid (testosterone (T) and 17β-estradiol (E2)) concentrations in the culture medium were also measured. CYP11B2, which regulates the synthesis of aldosterone, was the most sensitive gene and was induced by most of the compounds tested in this study. CYP19 gene expression, aromatase activity, and E2 production were also affected by several metabolites, but no consistent relationship was observed between these endpoints. Several PBDE metabolites showed some potential ability to interfere with steroidogenesis, including 5-Cl-6-OH-BDE-47, a biologically relevant BDE-47 metabolite, which significantly decreased aromatase activity and E2 production at a concentration of 10 μM. The results of this study indicate that PBDE metabolites affect steroidogenesis in vitro and that they may have the potential to affect steroidogenesis and reproduction in whole organisms. © 2007 Elsevier Ireland Ltd. All rights reserved.link_to_subscribed_fulltex

Effects of 20 PBDE metabolites on steroidogenesis in the H295R cell line

Polybrominated diphenyl ethers (PBDEs) are additive flame retardants that have been found in the environment as well as human tissues. Environmental concentrations of these compounds have been increasing in many parts of the world in recent years. Due to their structural similarity, PBDEs are believed to have similar toxicity to PCBs, but their toxicological properties are still being determined. In this study, the steroidogenic effects of hydroxylated, methoxylated and/or chlorinated derivatives of PBDEs were assessed at both the gene and enzyme/hormone levels in the H295R human adrenocortical carcinoma cell line. The expression levels of 10 steroidogenic genes were measured using quantitative real-time PCR (Q-RT-PCR). Aromatase activity in the cells and sex steroid (testosterone (T) and 17β-estradiol (E2)) concentrations in the culture medium were also measured. CYP11B2, which regulates the synthesis of aldosterone, was the most sensitive gene and was induced by most of the compounds tested in this study. CYP19 gene expression, aromatase activity, and E2 production were also affected by several metabolites, but no consistent relationship was observed between these endpoints. Several PBDE metabolites showed some potential ability to interfere with steroidogenesis, including 5-Cl-6-OH-BDE-47, a biologically relevant BDE-47 metabolite, which significantly decreased aromatase activity and E2 production at a concentration of 10 μM. The results of this study indicate that PBDE metabolites affect steroidogenesis in vitro and that they may have the potential to affect steroidogenesis and reproduction in whole organisms. © 2007 Elsevier Ireland Ltd. All rights reserved.link_to_subscribed_fulltex

Effects of PCBs and MeSO2-PCBs on adrenocortical steroidogenesis in H295R human adrenocortical carcinoma cells

Some endocrine disrupting chemicals (EDCs) in the environment have been shown to exert their biological effects through interference with steroidogenesis. In this study, the potential effects of four selected polychlorinated biphenyl (PCB) congeners (PCB101, PCB110, PCB126 and PCB149) as well as several of their environmentally-relevant methylsulfonyl-(MeSO2-) PCB metabolites (3′-MeSO2-CB101, 4′-MeSO2-CB101, 4′-MeSO2-CB110, 3′-MeSO2-CB149 and 4′-MeSO2-CB149) on adrenocortical steroidogenesis were evaluated by in vitro bioassay based on the human adrenocortical carcinoma H295R cell line. The PCBs included in the study represented different structures and potential mechanisms of action. Cells were exposed for 48 h to 10 μM of each PCB congener in the presence or absence of 20% (w/w) of their corresponding MeSO2-PCB metabolite(s). After the chemical treatments, changes in mRNA expression of 11 steroidogenic genes (CYP11A, CYP11B1, CYP11B2, CYP17, CYP19, CYP21, 3β-HSD1, 3β-HSD2, 17β-HSD1, StAR and HMGR) were quantified using molecular beacon-based real-time RT-PCR. Genes coding for enzymes involved in the later or final steps of steroid production (CYP11B1, CYP11B2, CYP19, 3β-HSD1, 3β-HSD2 and 17β-HSD1) were up-regulated to various extents by most PCBs. The greatest transcriptional activations (2.8-29.9-fold) were elicited by PCB110 on CYP11B1, CYP11B2, 3β-HSD2 and CYP19, and PCB149 on CYP11B1, 3β-HSD1 and 17β-HSD1. Increased expression of these steroidogenic genes might ultimately lead to a change in hormonal balance through excessive production of steroid hormones including aldosterone, cortisol and estradiol. In addition, co-treatment with 3′- and 4′-MeSO2-PCB149 resulted in a significant decrease in PCB149-induced 3β-HSD1 and 17β-HSD1 expression. This result indicates that some PCB congeners and their MeSO2-metabolites may affect steroidogenesis via different mechanisms. Overall, these findings suggest that PCBs and PCB metabolites can affect regulation of adrenocortical steroidogenesis. © 2005 Elsevier Ltd. All rights reserved.link_to_subscribed_fulltex