2012 Jan-22 Risk of pulmonary embolism in patients with autoimmune disorders: a nationwide follow-up study from Sweden
Bengt Zöller, Xinjun Li, Jan Sundquist, Kristina Sundquist.The Lancet, Volume 379, Issue 9812, Pages 244 - 249, 21 January 2012 doi:10.1016/S0140-6736(11)61306-8
Background
Some autoimmune disorders have been linked to venous thromboembolism. We examined whether there is an association between autoimmune disorders and risk of pulmonary embolism.
Last Updated on Friday, 27 January 2012 23:23
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2012 Jan-22 Cardiovascular Mortality in Women With Obstructive Sleep Apnea With or Without Continuous Positive Airway Pressure Treatment: A Cohort Study
Francisco Campos-Rodriguez, Miguel A. Martinez-Garcia, Ines de la Cruz-Moron, Carmen Almeida-Gonzalez, Pablo Catalan-Serra, Josep M. Montserrat. Ann Intern Med January 17, 2012 156:115-122
Background:
Obstructive sleep apnea (OSA) is a risk factor for cardiovascular death in men, but whether it is also a risk factor in women is unknown.
Objective:
To investigate whether OSA is a risk factor for cardiovascular death in women and assess whether continuous positive airway pressure (CPAP) treatment is associated with a change in risk.
Last Updated on Friday, 27 January 2012 23:22
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2012 Jan-22 Severe Vitamin D Deficiency: A Prerequisite for COPD Responsiveness to Vitamin D Supplementation?
Diane R. Gold, MD, JoAnn E. Manson Ann Intern Med January 17, 2012 156:156-157
Chronic obstructive pulmonary disease (COPD) ranks in the top 10 causes of morbidity and mortality in the United States and in affluent and middle-income countries worldwide. According to the Global Initiative for Chronic Obstructive Lung Disease (www.goldcopd.org), extrapulmonary manifestations of COPD include muscle weakness, osteoporotic fractures, deep venous thrombosis, systemic inflammation, cardiovascular disease, and lung cancer and often contribute to disease severity and poor prognosis. Three-year follow-up in the TORCH (Towards a Revolution in COPD Health) study demonstrated that only one third of deaths were due to respiratory failure; the majority was attributed to lung cancer or cardiovascular events. Unfortunately, COPD therapies other than smoking cessation have limited efficacy in reducing COPD-associated mortality.
Last Updated on Friday, 27 January 2012 23:22
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2012 Jan-22 High Doses of Vitamin D to Reduce Exacerbations in Chronic Obstructive Pulmonary Disease A Randomized Trial
An Lehouck, Chantal Mathieu, Claudia Carremans, Femke Baeke, Jan Verhaegen, Johan Van Eldere, Brigitte Decallonne, Roger Bouillon, Marc Decramer, Wim Janssens. Ann Intern Med January 17, 2012 156:105-114;
Background:
Low serum 25-hydroxyvitamin D (25-[OH]D) levels have been associated with lower FEV1, impaired immunologic control, and increased airway inflammation. Because many patients with chronic obstructive pulmonary disease (COPD) have vitamin D deficiency, effects of vitamin D supplementation may extend beyond preventing osteoporosis.
Last Updated on Friday, 27 January 2012 23:22
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2011 Aug - A series on "self-management of chronic lung diseases" - Part II: Self-efficacy-enhancing intervention is the process
Ms Vicky Chan, OTII, KWC; Dr Bobby Ng, Senior Occupational Therapist, KCC
Introduction
Chronic disease self-management (SM) is NOT just a kind of patient education. It is about coaching the patients to solve their problems, may they be physical, psychosocial, emotional, etc. in nature, as induced by their chronic diseases. Table 1 lists some common problems encountered by patients suffering from chronic lung diseases and the potential solutions that some patients may apply1. In order to ensure success in coaching the patients to develop such problem solving ability, “self-efficacy” is an area that should be emphasized besides “knowledge and skill” (Fig 1)2. However, this aspect is sometimes neglected especially when patient education follows a traditional prescriptive and directive style.
Last Updated on Friday, 13 January 2012 20:55
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2011 Aug - Respiratory Update
From March to May 2011, fifteen publications from local authors were chosen to be shared with readers. We have missed one original article published by Siu GK et al in Jan 2011 but it is still worth putting it up here in retrospect.
Asthma and allergies
Lai CK et al investigated the relationship between asthma control status derived from the Global Initiative for Asthma (GINA), the Asthma Control Test (ACT) and urgent health-care utilization among the cohort derived from the Asthma Insights and Reality in Asia-Pacific Phase 2 (AIRIAP2). The GINA control classification and the ACT are found to be valid symptom-based measures and are significantly associated with urgent health-care utilization [1].
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2011 Jun - Prevalence of sleep-disordered breathing in dialysis patients in a renal unit of a regional hospital in Hong Kong
Dr Anthony Pak-Yuen Yau
Department of M&G, Caritas Medical Centre
Background
Sleep-disordered breathing (SDB) was being increasingly recognized as a major health issue in the general population. Several medical conditions, including end stage renal failure, were identified to be associated with sleep-disordered breathing and sleep apnoea syndrome. Previous Caucasian studies suggested that the prevalence of sleep-disordered breathing was much higher than that in the general population. There was a lack of data of the prevalence in the Chinese Population. This study investigated the prevalence of this disease in the end stage renal failure (ESRF) population in Hong Kong.
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2011 Jun - Clinical efficacy and safety of chemical pleurodesis with talc slurry: comparison between two talc preparations in two public hospitals in Hong Kong
Dr Ka-Yan Wai
Department of Medicine, Kwong Wah Hospital
Background:
Talc pleurodesis is a common procedure used in malignant pleural effusion and recurrent/ secondary pneumothorax. Recent studies suggested that the systemic complications of talc pleurodesis including fever, desaturation and ARDS are related to the use of small particle size talc. In Hong Kong, talc preparations are not standardized. Many hospitals are using mixed particle size talc which include significant fraction of small particle size talc. Kwong Wah Hospital (KWH) and Tuberculosis and Chest Unit, Wong Tai Sin Hospital (TBCU, WTSH) have changed the talc slurry preparation from mixed particle size talc to Steritalc© (a graded talc preparation of larger mean particle size with small particle size portion removed) for chemical pleurodesis since Jan 2010 because of the latest evidences .
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2011 Jun - The Clinical Course and Outcome of persistent air-leak in spontaneous pneumothorax in a regional hospital in Hong Kong
Dr Jones Hau-Chung Kwok
Department of Medicine and Geriatrics, Princess Margaret Hospital
Background and Objective
Pneumothorax is a common, yet challenging disease in respiratory medicine. Spontaneous pneumothorax (SP) is the most common type of pneumothorax in Hong Kong. A portion of patients suffers from persistent air-leak despite chest drain insertion. International guidelines advocate 5-7 days arbitrarily as persistent air-leak. Managements of the situation are diversified according to different clinical situations. The aim of this study is to examine the characteristics and timing of the persistent air leak of SP in a regional hospital, and to review the treatment modalities and complications. Knowing this challenging situation of persistent airleak would facilitate treatment planning for different patients.
Last Updated on Friday, 13 January 2012 20:42
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2011 May 26 - Bad News? Black News?
Date: 26th May 2011
Drs Wai-On TAM and Chi-Fong WONG
Tuberculosis and Chest Unit, Grantham Hospital
Case history
A 71-year-old housewife was admitted for investigation of lung shadow in January 2010. She was a non-smoker with history of hypertension and hyperuricemia which were well controlled on regular medications. She was incidentally found to have a right lower zone opacity with blurring of right heart border on chest x-ray, suggestive of right middle lobe collapse consolidation (Figure 1). She was then referred to chest clinic for further management.
Last Updated on Friday, 13 January 2012 20:24
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2011 May 26 - A Sleepness Night
Date: 26th May 2011
Drs Macy MS LUI and Jamie CM LAM
Department of Medicine, Queen Mary Hospital, Hong Kong
Case History
A 59 year-old lady was admitted to Queen Mary Hospital in May 2009 for dyspnea for one week. She also complained of cough with mucoid sputum for a few days, without any fever. There was no hemoptysis or chest pain. She did not have any wheeze, or nocturnal worsening of the symptoms. She did notice bilateral ankle swelling, which was particularly worse in the evening. Systemic enquiry was unremarkable, except that she had difficulty in falling asleep and was always sleepy during daytime.
Last Updated on Friday, 13 January 2012 20:23
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2012 Jan-8 EGFR exon 20 insertion mutations in non-small-cell lung cancer: preclinical data and clinical implication
Hiroyuki Yasuda, Susumu Kobayashi, Dr Daniel B Costa The Lancet Oncology,Volume 13, Issue 1, Pages e23 - e31, January 2012 doi:10.1016/S1470-2045(11)70129-2
Lung cancer is the leading cause of cancer-related death. The identification of epidermal growth factor receptor (EGFR) somatic mutations defined a new, molecularly classified subgroup of non-small-cell lung cancer (NSCLC). Classic EGFR activating mutations, such as inframe deletions in exon 19 or the Leu858Arg (L858R) point mutation in exon 21 are associated with sensitivity to first generation quinazoline reversible EGFR tyrosine kinase inhibitors (TKIs).
Last Updated on Tuesday, 10 January 2012 15:50
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2012 Jan-8 Antiviral resistance during the 2009 influenza A H1N1 pandemic: public health, laboratory, and clinical perspectives
Aeron C Hurt, Tawee Chotpitayasunondh Nancy J Cox , Rod Daniels , Alicia M Fry , Larisa V Gubareva, Frederick G Hayden , David S Hui, Olav Hungnes , Angie Lackenby , Wilina Lim , Adam Meijer , Charles Penn , Masato Tashiro , Timothy M Uyeki , Maria Zambon. he Lancet Infectious Diseases, Early Online Publication, 19 December 2011 doi:10.1016/S1473-3099(11)70318-8
Influenza A H1N1 2009 virus caused the first pandemic in an era when neuraminidase inhibitor antiviral drugs were available in many countries. The experiences of detecting and responding to resistance during the pandemic provided important lessons for public health, laboratory testing, and clinical management.
Last Updated on Tuesday, 10 January 2012 15:50
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2012 Jan 19 - HKTS Clinical Meeting
Date: 19th January, 2012; Venue: Ruttonjee Hospital, Hong Kong
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2011 Nov 19 - Celebratory Dinner for the 25th Anniversary of the HKTS and 15th Anniversary of the HKLF
Date: 19th November 2011; Venue: Hong Kong Club, 1 Jackson Road, Central, Hong Kong
All photos of the event are available for viewing, click Read More!
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Last Updated on Wednesday, 04 January 2012 20:32
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2011 Dec-25 Smoking and the First Amendment
Kevin Outterson, N Engl J Med 2011; 365:2351-2353December 22, 2011
On June 22, 2009, President Barack Obama signed the Family Smoking Prevention and Tobacco Control Act into law. 1 For the first time, Congress had given the Food and Drug Administration (FDA) authority to directly regulate tobacco products, with the aim of improving public health. And indeed, effective tobacco control would be a remarkable public health achievement — and might be possible if the law is allowed to stand. But on November 7, 2011, a federal judge in Washington, D.C., issued a preliminary injunction blocking some of its key provisions as unconstitutional restrictions on commercial speech, and the battle seems likely to end up in the Supreme Court.
Last Updated on Thursday, 29 December 2011 11:40
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