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McNally DR, Ravichandran H, Tam W, Steidl C, Scott DW, Melnick A, Elemento O. HIGHLY MULTIPLEX TISSUE IMAGING OF DLBCL IDENTIFIES NOVEL PATHOLOGICAL FEATURES PREDICTIVE OF OVERALL SURVIVAL. Hematol Oncol 2021. [DOI: 10.1002/hon.7_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Lai G, Nahar R, Lim T, Kwang X, Liew P, Lim J, Aung Z, Takano A, Lim W, Lau D, Tan W, Ang M, Toh C, Tan B, Devanand A, Too C, Gogna A, Ong B, Koh T, Kanesvaran R, Ng Q, Jain A, Yuan J, Lim T, Lim A, Hillmer A, Zhai W, Iyer G, Tan E, Tam W, Tan D. OA 09.07 Clonality of c-MET Copy Number Gain as a Determinant of Primary TKI Resistance in EGFR-Mutant NSCLC. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Lo K, Tam W. Reply to comment on: waist-to-height ratio, body mass index and waist circumference for screening pediatric cardio-metabolic risk factors: a meta-analysis. Obes Rev 2016; 17:1342-1343. [PMID: 27749998 DOI: 10.1111/obr.12473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 09/05/2016] [Indexed: 11/27/2022]
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Lo K, Wong M, Khalechelvam P, Tam W. Waist-to-height ratio, body mass index and waist circumference for screening paediatric cardio-metabolic risk factors: a meta-analysis. Obes Rev 2016; 17:1258-1275. [PMID: 27452904 DOI: 10.1111/obr.12456] [Citation(s) in RCA: 157] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 06/17/2016] [Accepted: 06/29/2016] [Indexed: 02/01/2023]
Abstract
Waist-to-height ratio (WHtR) is superior to body mass index and waist circumference for measuring adult cardio-metabolic risk factors. However, there is no meta-analysis to evaluate its discriminatory power in children and adolescents. A meta-analysis was conducted using multiple databases, including Embase and Medline. Studies were included that utilized receiver-operating characteristics curve analysis and published area under the receiver-operating characteristics curves (AUC) for adiposity indicators with hyperglycaemia, elevated blood pressure, dyslipidemia, metabolic syndrome and other cardio-metabolic outcomes. Thirty-four studies met the inclusion criteria. AUC values were extracted and pooled using a random-effects model and were weighted using the inverse variance method. The mean AUC values for each index were greater than 0.6 for most outcomes including hypertension. The values were the highest when screening for metabolic syndrome (AUC > 0.8). WHtR did not have significantly better screening power than other two indexes in most outcomes, except for elevated triglycerides when compared with body mass index and high metabolic risk score when compared with waist circumference. Although not being superior in discriminatory power, WHtR is convenient in terms of measurement and interpretation, which is advantageous in practice and allows for the quick identification of children with cardio-metabolic risk factors at an early age.
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Béguelin W, Sawh S, Chambwe N, Chan FC, Jiang Y, Choo JW, Scott DW, Chalmers A, Geng H, Tsikitas L, Tam W, Bhagat G, Gascoyne RD, Shaknovich R. IL10 receptor is a novel therapeutic target in DLBCLs. Leukemia 2015; 29:1684-94. [PMID: 25733167 DOI: 10.1038/leu.2015.57] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 02/16/2015] [Accepted: 02/19/2015] [Indexed: 12/30/2022]
Abstract
Diffuse large B-cell lymphoma (DLBCL) is a biologically and clinically heterogeneous disease with marked genomic instability and variable response to conventional R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) chemotherapy. More clinically aggressive cases of DLBCLs have high level of circulating interleukin 10 (IL10) cytokine and evidence of activated intracellular STAT3 (signal transducer and activator of transcription 3) signaling. We investigated the role of IL10 and its surface receptor in supporting the neoplastic phenotype of DLBCLs. We determined that IL10RA gene is amplified in 21% and IL10RB gene in 10% of primary DLBCLs. Gene expression of IL10, IL10RA and IL10RB was markedly elevated in DLBCLs. We hypothesized that DLBCLs depend for their proliferation and survival on IL10-STAT3 signaling and that blocking the IL10 receptor (IL10R) would induce cell death. We used anti-IL10R blocking antibody, which resulted in a dose-dependent cell death in all tested activated B-cell-like subtype of DLBCL cell lines and primary DLBCLs. Response of germinal center B-cell-like subtype of DLBCL cell lines to anti-IL10R antibody varied from sensitive to resistant. Cells underwent cell cycle arrest, followed by induction of apoptosis. Cell death depended on inhibition of STAT3 and, to a lesser extent, STAT1 signaling. Anti-IL10R treatment resulted in interruption of IL10-IL10R autostimulatory loop. We thus propose that IL10R is a novel therapeutic target in DLBCLs.
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Visco C, Li Y, Xu-Monette ZY, Miranda RN, Green TM, Li Y, Tzankov A, Wen W, Liu WM, Kahl BS, d'Amore ESG, Montes-Moreno S, Dybkær K, Chiu A, Tam W, Orazi A, Zu Y, Bhagat G, Winter JN, Wang HY, O'Neill S, Dunphy CH, Hsi ED, Zhao XF, Go RS, Choi WWL, Zhou F, Czader M, Tong J, Zhao X, van Krieken JH, Huang Q, Ai W, Etzell J, Ponzoni M, Ferreri AJM, Piris MA, Møller MB, Bueso-Ramos CE, Medeiros LJ, Wu L, Young KH. Erratum: Comprehensive gene expression profiling and immunohistochemical studies support application of immunophenotypic algorithm for molecular subtype classification in diffuse large B-cell lymphoma: a report from the International DLBCL Rituximab-CHOP Consortium Program Study. Leukemia 2014. [DOI: 10.1038/leu.2014.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Giulino-Roth L, Reichel J, Teruya-Feldstein J, Tam W, Tam Y, Roshal M, Cesarman E. Beta-2 Microglobulin (B2 M) Genomic Alterations and Absent Protein Expression in Pediatric and Adolescent Classical Hodgkin Lymphoma. KLINISCHE PADIATRIE 2014. [DOI: 10.1055/s-0034-1371104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Singh R, Sathananthan D, Tam W, Ruszkiewicz A. Endocytoscopy for Diagnosis of Gastrointestinal Neoplasia: The Expert's Approach. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/s2212-0971(13)70009-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Wong GHY, Hui CLM, Wong DY, Tang JYM, Chang WC, Chan SKW, Lee EHM, Xu JQ, Lin JJX, Lai DC, Tam W, Kok J, Chung DWS, Hung SF, Chen EYH. Developments in early intervention for psychosis in Hong Kong. East Asian Arch Psychiatry 2012; 22:100-104. [PMID: 23019282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The year 2011 marked the 10-year milestone of early intervention for psychosis in Hong Kong. Since 2001, the landscape of early psychosis services has changed markedly in Hong Kong. Substantial progress has been made in the areas of early intervention service implementation, knowledge generation, and public awareness promotion. Favourable outcomes attributable to the early intervention service are supported by solid evidence from local clinical research studies; early intervention service users showed improved functioning, ameliorated symptoms, and decreased hospitalisation and suicide rates. Continued development of early intervention in Hong Kong over the decade includes the introduction and maturation of several key platforms, such as the Hospital Authority Early Assessment Service for Young People with Psychosis programme, the Psychosis Studies and Intervention Unit by the University of Hong Kong, the Hong Kong Early Psychosis Intervention Society, the Jockey Club Early Psychosis Project, and the postgraduate Psychological Medicine (Psychosis Studies) programme. In this paper, we reviewed some of the major milestones in local service development with reference to features of the Hong Kong mental health system. We describe chronologically the implementation and consolidation of public early intervention services as well as recent progresses in public awareness work that are tied in with knowledge generation and transfer, and outline the prospects for early intervention in the next decade and those that follow.
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Lim K, Tam W, Worthley C, Nguyen NQ. Education and Imaging. Hepatobiliary and pancreatic: pancreatic vascular malformations in hereditary hemorrhagic telangiectasia. J Gastroenterol Hepatol 2012; 27:989. [PMID: 22515811 DOI: 10.1111/j.1440-1746.2012.07099.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
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Visco C, Li Y, Xu-Monette ZY, Miranda RN, Green TM, Li Y, Tzankov A, Wen W, Liu WM, Kahl BS, d'Amore ESG, Montes-Moreno S, Dybkær K, Chiu A, Tam W, Orazi A, Zu Y, Bhagat G, Winter JN, Wang HY, O'Neill S, Dunphy CH, Hsi ED, Zhao XF, Go RS, Choi WWL, Zhou F, Czader M, Tong J, Zhao X, van Krieken JH, Huang Q, Ai W, Etzell J, Ponzoni M, Ferreri AJM, Piris MA, Møller MB, Bueso-Ramos CE, Medeiros LJ, Wu L, Young KH. Comprehensive gene expression profiling and immunohistochemical studies support application of immunophenotypic algorithm for molecular subtype classification in diffuse large B-cell lymphoma: a report from the International DLBCL Rituximab-CHOP Consortium Program Study. Leukemia 2012; 26:2103-13. [PMID: 22437443 DOI: 10.1038/leu.2012.83] [Citation(s) in RCA: 255] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Gene expression profiling (GEP) has stratified diffuse large B-cell lymphoma (DLBCL) into molecular subgroups that correspond to different stages of lymphocyte development-namely germinal center B-cell like and activated B-cell like. This classification has prognostic significance, but GEP is expensive and not readily applicable into daily practice, which has lead to immunohistochemical algorithms proposed as a surrogate for GEP analysis. We assembled tissue microarrays from 475 de novo DLBCL patients who were treated with rituximab-CHOP chemotherapy. All cases were successfully profiled by GEP on formalin-fixed, paraffin-embedded tissue samples. Sections were stained with antibodies reactive with CD10, GCET1, FOXP1, MUM1 and BCL6 and cases were classified following a rationale of sequential steps of differentiation of B cells. Cutoffs for each marker were obtained using receiver-operating characteristic curves, obviating the need for any arbitrary method. An algorithm based on the expression of CD10, FOXP1 and BCL6 was developed that had a simpler structure than other recently proposed algorithms and 92.6% concordance with GEP. In multivariate analysis, both the International Prognostic Index and our proposed algorithm were significant independent predictors of progression-free and overall survival. In conclusion, this algorithm effectively predicts prognosis of DLBCL patients matching GEP subgroups in the era of rituximab therapy.
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Cheng LT, Foss RP, Meredith GR, Tam W, Zumsteg FC. Quadratic Nonlinear Optical Properties of Polymeric Organic Materials. ACTA ACUST UNITED AC 2011. [DOI: 10.1557/proc-247-27] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
ABSTRACTWe discuss our rational approach to incorporate optically nonlinear molecules into polymeric and cross-linked materials through the use of isocyanate-hydroxy coupling chemistry. Thin film fabrication, optical loss, poling, second harmonic generation, and electro-optic properties are discussed.
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Chen Yi Mei SG, Tam W, Nind G, Singh R. Endoscopic removal of migrating silastic band after vertical banding gastroplasty. Endoscopy 2010; 42 Suppl 2:E253. [PMID: 20931468 DOI: 10.1055/s-0030-1255643] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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Singh R, Nind G, Tucker G, Nguyen N, Holloway R, Bate J, Shetti M, George B, Tam W. Narrow-band imaging in the evaluation of villous morphology: a feasibility study assessing a simplified classification and observer agreement. Endoscopy 2010; 42:889-94. [PMID: 21072704 DOI: 10.1055/s-0030-1255708] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND STUDY AIMS To determine the utility of narrow-band imaging with optical magnification (NBI-Z) in the evaluation of villous morphology. PATIENTS AND METHODS Patients considered at risk of having celiac disease were invited. After standard endoscopy, they underwent further evaluation with NBI-Z which was digitally recorded. Targeted biopsies of each area videoed with NBI-Z were performed and tissue sent for histopathological analysis. Two expert endoscopists then selected the best representative videos (developmental phase). Next, 41 representative images of these videos were classified as follows: villous patterns present (N) or absent (A). Images showing absence of villi were then classified as cerebriform (C) or flat (F), corresponding to partial or total villous atrophy respectively. Three NBI-Z-naïve endoscopists then graded the videos. They underwent an interactive training session (learning phase) with video and images from a digital library before embarking on the actual assessment. To test for reproducibility, all videos were randomly reordered and graded again after a week. RESULTS Forty-one videos (10 celiac disease, 31 normal) from 21 patients (3 celiac disease, 18 normal) were analyzed. The overall sensitivity and specificity in correctly distinguishing the presence or absence of villi were 93.3% and 97.8% respectively, with interobserver and intraobserver agreement (kappa, κ) at 0.82 and 0.86. The sensitivity and specificity in differentiating partial from total villous atrophy were 83.3% and 100%, κ at 0.73 and 0.68 respectively. CONCLUSIONS Using a simplified classification, we demonstrated the feasibility of using NBI-Z to detect villous atrophy in patients presenting with suspected celiac disease.
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Abu-Sneineh A, Tam W, Schoeman M, Fraser R, Ruszkiewicz AR, Smith E, Drew PA, Dent J, Holloway RH. The effects of high-dose esomeprazole on gastric and oesophageal acid exposure and molecular markers in Barrett's oesophagus. Aliment Pharmacol Ther 2010; 32:1023-30. [PMID: 20937048 DOI: 10.1111/j.1365-2036.2010.04428.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Acid reflux is often difficult to control medically. AIM To assess the effect of 40 mg twice daily esomeprazole (high-dose) on gastric and oesophageal pH and symptoms, and biomarkers relevant to adenocarcinoma, in patients with Barrett's oesophagus (BO). METHODS Eighteen patients, treated with proton pump inhibitors as prescribed by their treating doctor, had their therapy increased to high-dose esomeprazole for 6 months. RESULTS At entry into the study, 9/18 patients had excessive 24-h oesophageal acid exposure, and gastric pH remained <4 for >16 h in 8/18. With high-dose esomeprazole, excessive acid exposure occurred in 2/18 patients, and gastric pH <4 was decreased from 38% of overall recording time and 53% of the nocturnal period to 15% and 17%, respectively (P < 0.001). There was a reduction in self-assessed symptoms of heartburn (P = 0.0005) and regurgitation (P < 0.0001), and inflammation and proliferation in the Barrett's mucosa. There was no significant change in p53, MGMT or COX-2 expression, or in aberrant DNA methylation. CONCLUSIONS High-dose esomeprazole achieved higher levels of gastric acid suppression and control of oesophageal acid reflux and symptoms, with significant decreases in inflammation and epithelial proliferation. There was no reversal of aberrant DNA methylation.
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Singh R, Shetti MP, Nind G, Tam W. Education and imaging. Gastrointestinal: Dysphagia caused by erosion of a laparoscopic adjustable gastric band. J Gastroenterol Hepatol 2009; 24:928. [PMID: 19646020 DOI: 10.1111/j.1440-1746.2009.05887.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
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Chuang G, Mao S, Tam W, Tam G, Tam C. Survey of biological active molecule in the Chinese herbal formula‐ Suan Zao Ren Tang in treating insomnia. FASEB J 2009. [DOI: 10.1096/fasebj.23.1_supplement.902.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Mao S, Chuang G, Tam W, Tam G, Tam C. Survey of biological active molecules in the Chinese traditional herbal formula Liu Wei Di Huang Wan for the treatment of Type II Diabetes. FASEB J 2009. [DOI: 10.1096/fasebj.23.1_supplement.900.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Chadburn A, Hyjek EM, Tam W, Liu Y, Rengifo T, Cesarman E, Knowles DM. Immunophenotypic analysis of the Kaposi sarcoma herpesvirus (KSHV; HHV-8)-infected B cells in HIV+ multicentric Castleman disease (MCD). Histopathology 2009; 53:513-24. [PMID: 18983461 DOI: 10.1111/j.1365-2559.2008.03144.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
AIMS Kaposi sarcoma herpesvirus (KSHV) is aetiologically related to Kaposi sarcoma, classical and extracavitary primary effusion lymphoma (PEL; EC-PEL) and multicentric Castleman disease (MCD), entities preferentially occurring in HIV-infected individuals. Characterization of HIV-associated PELs/EC-PELs suggests that the KSHV-infected malignant cells originate from a pre-terminal stage of B-cell differentiation. However, only limited phenotypic studies have been performed on HIV+ MCD, including for PR domain containing 1 with zinc finger domain/B lymphocyte-induced maturation protein 1 (PRDM1/BLIMP1), a key regulator of terminal B-cell differentiation. The aim was to characterize KSHV-infected cells in 17 cases of HIV+ MCD. METHODS AND RESULTS Double immunohistochemistry and immunohistochemistry-in situ hybridization were used to characterize the KSHV-infected cells in MCD; the results were compared with the phenotypic profiles of 39 PELs/EC-PELs and seven PEL cell lines. Whereas the immunophenotype of KSHV-infected cells in MCD and malignant KSHV+ PEL cells was similar (PAX5, Bcl-6-; PRDM1/BLIMP1, IRF4/MUM1+; Ki67+), the MCD KSHV-infected cells differed, as they expressed OCT2, cytoplasmic lambda immunoglobulin; variably expressed CD27; lacked CD138; and were Epstein-Barr virus negative. CONCLUSIONS Although both PEL and MCD originate from KSHV-infected pre-terminally differentiated B cells, these findings, with previously reported genetic studies, indicate HIV+ MCD may arise from extrafollicular B cells, whereas PELs may originate from cells that have traversed the germinal centre.
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Sally C, David TR, Chau PC, Tam W, Chiu IW. Effects of Multisensory Therapy on Behaviour of Adult Clients with Developmental Disabilities. ACTA ACUST UNITED AC 2009; 7:309-353. [PMID: 27819918 DOI: 10.11124/01938924-200907090-00001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES The objective of this review was to present the best available evidence on the effect of multisensory therapy in adult clients with developmental disabilities on the frequency of challenging behaviour, the frequency of stereotypic self-stimulating behaviour, and the frequency of relaxing behaviour INCLUSION CRITERIA: The review summarised all the relevant studies relating to the multisensory therapy intervention. TYPES OF PARTICIPANTS Trials which included adult clients (aged 18-60) diagnosed with mental retardation according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders: IV Classification or those with an Intelligence Quotient < 70 and who stayed in institutions.Types of interventions: Multisensory therapy/ multisensory environment/ SnoezelenTypes of outcomes measures: Outcome measures of interest were challenging behaviour, stereotypic self-stimulating behaviour and relaxing behaviour.Types of studies: This study considered any randomized or quasi-randomized controlled trials that investigated the effectiveness of multisensory therapy on adult clients with developmental disabilities. Due to a limited number of high quality RCT's on this subject, papers using other experimental or observational designs were also included. SEARCH STRATEGY Electronic databases were used to search for primary publications. The reference lists and bibliographies of retrieved articles were reviewed to identify research not located through other search strategies. CRITICAL APPRAISAL Two reviewers assessed all identified abstracts and full reports were retrieved for all studies that met the inclusion criteria of the review. Studies identified from bibliography searches were assessed on the study title. Methodological quality was assessed by two reviewers using a checklist. Disagreements between reviewers were resolved by discussion with a third reviewer. DATA EXTRACTION Data were extracted independently by two reviewers using a data extraction tool. A third reviewer dealt with disagreements. DATA SYNTHESIS In all studies percentages of clients in each category and/or change in group mean score for outcomes were reported. If appropriate, results from comparable groups of studies were pooled in statistical meta-analysis using Review Manager Software from the Cochrane Collaboration. Odds ratio (for categorical outcome data) or weighted mean differences (for continuous data) and their 95% confidence intervals were calculated for each analysis. Heterogeneity between combined studies was tested using standard chi-square test. For the purpose of this review, where possible, intention to treat and/or completer analysis were performed. Where statistical pooling was not appropriate or possible, the findings were summarised in narrative form. RESULTS 130 publications were identified through the various database searches and review of reference list and bibliographies. However, only 15 English publications were included in the review. The present evidence showed that multisensory therapy promoted participants' positive emotions and they reported being happier and more relaxed. Evidence also indicated that participants' had displayed more positive emotions and less negative emotions after therapy sessions. CONCLUSIONS This systematic review demonstrated a beneficial effect of multisensory therapy in promoting participants' positive emotions. Out of the 15 reviewed studies, 12 studies had a single treatment group only. While the reviewers acknowledge the difficulty in carrying out randomised controlled trial in people with developmental disabilities and challenging behaviour, the lack of trial-derived evidence makes it difficult to produce a strong conclusion to show the effectiveness of the multisensory therapy.
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Zschau N, Nguyen N, Tam W, Schoeman M. Intestinal perforation: a rare complication of percutaneous endoscopic jejunostomy removal. Endoscopy 2008; 40 Suppl 2:E178. [PMID: 18668465 DOI: 10.1055/s-2007-995808] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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Ko FWS, Woo J, Tam W, Lai CKW, Ngai J, Kwok T, Hui DSC. Prevalence and risk factors of airflow obstruction in an elderly Chinese population. Eur Respir J 2008; 32:1472-8. [PMID: 18684847 DOI: 10.1183/09031936.00058708] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
It is common practice to use a forced expiratory volume in one second (FEV(1))/ forced vital capacity (FVC) ratio of <70% as evidence of airflow obstruction. As the FEV(1)/FVC ratio falls with age, the lower limit of normal range (LLN), defined as the bottom 5% in a health reference population, of FEV(1)/FVC ratio has been suggested as a better index to reduce over-diagnosis of chronic obstructive pulmonary disease (COPD), particularly in the elderly. However, there are no large scale studies that focus on the diagnosis of COPD in the elderly based on these definitions. The present prospective epidemiological study involved 1,149 elderly subjects aged > or =60 yrs in the community. Detailed questionnaires, pre- and post-bronchodilator spirometry were performed. In total, 1,008 subjects (mean age 74.2+/-6.4 yrs; 271 males) completed satisfactory spirometry testing. Airflow obstruction was present in 25.9% as defined by the post-bronchodilator FEV(1)/FVC ratio of <70% and in 12.4% defined by the LLN of FEV(1)/FVC ratio. Moderate COPD, at least, was found in 14.0% of patients according to the post-bronchodilator FEV(1)/FVC ratio of <70% and in 8.5% of patients according to LLN of FEV(1)/FVC ratio. In the present elderly Chinese population (mostly females, with low education level and previous exposure to biomass during formative years), the prevalence of chronic obstructive pulmonary disease varied markedly depending on definitions adopted. Further longitudinal studies are needed to determine the precise definition of chronic obstructive pulmonary disease.
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Chapman MJ, Fraser RJ, Bryant LK, Vozzo R, Nguyen NQ, Tam W, Zacharakis B, Davidson G, Butler R, Horowitz M. Gastric emptying and the organization of antro-duodenal pressures in the critically ill. Neurogastroenterol Motil 2008; 20:27-35. [PMID: 18069967 DOI: 10.1111/j.1365-2982.2007.00984.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The motor dysfunctions underlying delayed gastric emptying (GE) in critical illness are poorly defined. Our aim was to characterize the relationship between antro-duodenal (AD) motility and GE in critically ill patients. AD pressures were recorded in 15 mechanically ventilated patients and 10 healthy volunteers for 2 h (i) during fasting, (ii) following an intragastric nutrient bolus with concurrent assessment of GE using the (13)C-octanoate breath test and (iii) during duodenal nutrient infusion. Propagated waves were characterized by length and direction of migration. Critical illness was associated with: (i) slower GE (GEC: 3.47 +/- 0.1 vs 2.99 +/- 0.2; P = 0.046), (ii) fewer antegrade (duodenal: 44%vs 83%, AD: 16%vs 83%; P < 0.001) and more retrograde (duodenal: 46%vs 12%, AD: 38%vs 4%; P < 0.001) waves, (iii) shorter wave propagation (duodenal: 4.7 +/- 0.3 vs 6.0 +/- 0.4 cm; AD: 7.7 +/- 0.6 vs 10.9 +/- 0.9 cm; P = 0.004) and (iv) a close correlation between GE with the percentage of propagated phase 3 waves that were antegrade (r = 0.914, P = 0.03) and retrograde (r = -0.95, P = 0.014). In critical illness, the organization of AD pressure waves is abnormal and associated with slow GE.
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Ko FWS, Tam W, Wong TW, Lai CKW, Wong GWK, Leung TF, Ng SSS, Hui DSC. Effects of air pollution on asthma hospitalization rates in different age groups in Hong Kong. Clin Exp Allergy 2007; 37:1312-9. [PMID: 17845411 DOI: 10.1111/j.1365-2222.2007.02791.x] [Citation(s) in RCA: 130] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS To assess the relationship between levels of ambient air pollutants and hospitalization rates for asthma in Hong Kong (HK). METHODS This is a retrospective ecological study. Data of daily emergency hospital admissions to 15 major hospitals in HK for asthma and indices of air pollutants [sulphur dioxide (SO(2)), nitrogen dioxide (NO(2)), ozone (O(3)), particulates with an aerodynamic diameter of <10 microm particulate matter (PM(10)) and 2.5 microm (PM(2.5))] and meteorological variables from January 2000 to December 2005 were obtained from several government departments. Analysis was performed by the generalized additive models with Poisson distribution. The effects of time trend, season, other cyclical factors, temperature and humidity were adjusted. Autocorrelation and overdispersion were corrected. RESULTS Altogether, 69 716 admissions were assessed. Significant associations were found between hospital admissions for asthma and levels of NO(2), O(3), PM(10) and PM(2.5). The relative risks (RR) for hospitalization for every 10 microg/m(3) increase in NO(2), O(3), PM(10) and PM(2.5) were 1.028, 1.034, 1.019 and 1.021, respectively, at a lag day that ranged from cumulative lag 0-4 to 0-5. In a multi-pollutant model, O(3) was significantly associated with increased admissions for asthma. The younger age group (0-14 years) tended to have a higher RR for each 10 microg/m(3) increase in pollutants than those aged 15-65 years. The elderly (aged >/=65 years) had a shorter 'best' lag time to develop asthma exacerbation following exposure to pollutants than those aged <65 years. CONCLUSION Adverse effects of ambient concentrations of air pollutants on hospitalization rates for asthma are evident. Measures to improve air quality in HK are urgently needed.
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Aithal GP, Anagnostopoulos GK, Tam W, Dean J, Zaitoun A, Kocjan G, Ragunath K, Pereira SP. EUS-guided tissue sampling: comparison of "dual sampling" (Trucut biopsy plus FNA) with "sequential sampling" (Trucut biopsy and then FNA as required). Endoscopy 2007; 39:725-30. [PMID: 17620230 DOI: 10.1055/s-2007-966400] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND STUDY AIMS Both endoscopic ultrasound- (EUS-) guided tissue sampling techniques, fine-needle aspiration (FNA) and Trucut biopsy, have advantages and limitations. The aim of this study was to develop a strategy of combining these two EUS-guided sampling techniques in order to maximize the diagnostic accuracy and minimize duplication. PATIENTS AND METHODS In this multicenter study we performed "dual sampling" (i. e. with both FNA and Trucut biopsy) in 95 patients during phase 1 of the study and "sequential sampling" (i. e. performing FNA only when Trucut biopsy tissue cores were macroscopically inadequate) in 72 patients during phase 2. RESULTS During the study period, 167/401 patients referred for EUS-guided sampling were eligible for the study; only solid lesions were included. In 143/167 patients (86 %), sampling was performed via the transesophageal or transgastric routes. When the dual sampling strategy was used, an accurate diagnosis was achieved in 78/95 patients by FNA, compared with 85/95 by Trucut biopsy ( P = 0.21). The combined accuracy of the dual sampling strategy was higher than FNA alone (88/95 vs. 78/95, P = 0.048), but was not significantly higher than Trucut biopsy alone (88/95 vs. 85/95, P = 0.61). Using the sequential sampling strategy, an accurate diagnosis was achieved in 66/72 patients (92 %) compared with 88/95 (93 %) for dual sampling ( P = 1.0), and 8/72 patients (11 %) had to undergo FNA after Trucut biopsy failed to obtain an adequate sample. One patient with mediastinal tuberculosis developed a cold abscess following Trucut biopsy. CONCLUSION A sequential sampling strategy, in which EUS-guided Trucut biopsy is attempted first, and FNA performed only when Trucut biopsy fails to obtain a macroscopically adequate sample, achieves a diagnostic accuracy of 92 %, with 11 % of patients requiring both sampling procedures.
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