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Yan BPY, Lau KK, Luk AOY, Wong MCS. Call to action: Bridging gaps in lipid management in Hong Kong. Hong Kong Med J 2024; 30:90-93. [PMID: 38594968 DOI: 10.12809/hkmj245158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024] Open
Affiliation(s)
- B P Y Yan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - K K Lau
- Division of Neurology, Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - A O Y Luk
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - M C S Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Editor-in-Chief, Hong Kong Medical Journal
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2
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Affiliation(s)
- M C S Wong
- Editor-in-Chief, Hong Kong Medical Journal
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3
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Wang HHX, Li YT, Huang J, Zhang H, Huang W, Wong MCS. COVID-19: emerging trends, healthcare practice, artificial intelligence-assisted decision support, and implications for service innovation. Hong Kong Med J 2024; 30:7-9. [PMID: 38385214 DOI: 10.12809/hkmj245155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Affiliation(s)
- H H X Wang
- Editors, Hong Kong Medical Journal
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
- Young Cadre Branch, Guangdong Primary Healthcare Association, Guangzhou, China
| | - Y T Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - J Huang
- Editors, Hong Kong Medical Journal
- Centre for Health Education and Health Promotion, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - H Zhang
- Department of Cardiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - W Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - M C S Wong
- Centre for Health Education and Health Promotion, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Editor-in-Chief, Hong Kong Medical Journal
- School of Public Health, Fudan University, Shanghai, China
- The Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- School of Public Health, Peking University, Beijing, China
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Lin WYY, Wong MCS, Huang J, Bai Y, Ng SC, Chan FKL. Dietary habits and physical activity during the third wave of the COVID-19 pandemic: associated factors, composite outcomes in a cross-sectional telephone survey of a Chinese population, and trend analysis. Hong Kong Med J 2024; 30:33-43. [PMID: 38369958 DOI: 10.12809/hkmj2210265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024] Open
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic created many challenges for Hong Kong residents attempting to maintain healthy lifestyle habits. This study aimed to measure the prevalences of unhealthy dietary habits and physical inactivity levels in Hong Kong Chinese, identify associated factors, and conduct a time trend analysis during the third wave of the COVID-19 pandemic. METHODS A cross-sectional telephone survey was conducted in Hong Kong by simple random sampling. The survey comprised socio-demographic characteristics, clinical information, the Hong Kong Diet Score (HKDS), smoking and alcohol consumption, and a Chinese version of the International Physical Activity Questionnaire Short Form. The composite outcome was low HKDS, physical inactivity, smoking, and alcohol consumption. We used 14 Health Behaviour Survey reports from 2003 to 2019 to establish a trend analysis regarding fruit and vegetable consumption, physical activity level, smoking, and alcohol consumption. RESULTS We performed 1500 complete telephone surveys with a response rate of 58.8%. Most participants were older adults (≥65 years, 66.7%), women (65.6%), and married (77.9%). The HKDS was significantly lower in men, single individuals, low-income participants, alcohol drinkers, and patients with diabetes mellitus or renal disease. Participants who were single, undergoing long-term management of medical diseases, or had diabetes or renal diseases exhibited greater likelihood of physical inactivity. CONCLUSION Prevalences of unhealthy lifestyle habits were high among men, single individuals, and chronic disease patients during the third wave of the COVID-19 pandemic in Hong Kong. The adoption of physical activity habits tended to decrease in the past two decades.
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Affiliation(s)
- W Y Y Lin
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
- Microbiota Innovation Center, Hong Kong SAR, China
| | - M C S Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - J Huang
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Y Bai
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - S C Ng
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
- Microbiota Innovation Center, Hong Kong SAR, China
- State Key Laboratory of Digestive Disease and Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - F K L Chan
- Microbiota Innovation Center, Hong Kong SAR, China
- Centre for Gut Microbiota Research, The Chinese University of Hong Kong, Hong Kong SAR, China
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Leung E, Lee A, Tsang H, Wong MCS. Data-driven service model to profile healthcare needs and optimise the operation of community-based care: A multi-source data analysis using predictive artificial intelligence. Hong Kong Med J 2023; 29:484-486. [PMID: 38088134 DOI: 10.12809/hkmj235154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Affiliation(s)
- E Leung
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - A Lee
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Rehabilitation Science, Hong Kong Polytechnic University, Hong Kong SAR, China
- Centre for Health Education and Health Promotion, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - H Tsang
- Department of Rehabilitation Science, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - M C S Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Health Education and Health Promotion, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
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6
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Wang A, Zhu B, Huang J, Wong MCS, Xue H. Quality of primary healthcare in China: challenges and strategies. Hong Kong Med J 2023; 29:372-374. [PMID: 37794614 DOI: 10.12809/hkmj235149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Affiliation(s)
- A Wang
- School of Economics and Management, Xidian University, Xi'an, China
| | - B Zhu
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
| | - J Huang
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Editor-in-Chief, Hong Kong Medical Journal
| | - M C S Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Editor-in-Chief, Hong Kong Medical Journal
- School of Public Health, Fudan University, Shanghai, China
- The Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- School of Public Health, Peking University, Beijing, China
| | - H Xue
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, United States
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7
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Wang HHX, Li YT, Huang J, Huang W, Wong MCS. Advances and opportunities in the new digital era of telemedicine, e-health, artificial intelligence, and beyond. Hong Kong Med J 2023; 29:380-382. [PMID: 37880812 DOI: 10.12809/hkmj235152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023] Open
Affiliation(s)
- H H X Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
- Department of General Practice, The Second Hospital of Hebei Medical University, Shijiazhuang, China
- Usher Institute, Deanery of Molecular, Genetic and Population Health Sciences, The University of Edinburgh, Scotland, United Kingdom
| | - Y T Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - J Huang
- Centre for Health Education and Health Promotion, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - W Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - M C S Wong
- Centre for Health Education and Health Promotion, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Editor-in-Chief, Hong Kong Medical Journal
- School of Public Health, Fudan University, Shanghai, China
- The Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- School of Public Health, Peking University, Beijing, China
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Wang HHX, Li YT, Zhang H, Li JB, Huang W, Wong MCS. Reforming education and pedagogy in medicine and health with digital innovations to enhance learning practices and outcomes. Hong Kong Med J 2023; 29:192-194. [PMID: 37349136 DOI: 10.12809/hkmj235147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Affiliation(s)
- H H X Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
- Department of General Practice, The Second Hospital of Hebei Medical University, Shijiazhuang, China
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Y T Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - H Zhang
- Department of Cardiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - J B Li
- Department of Clinical Research, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - W Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - M C S Wong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Health Education and Health Promotion, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Editor-in-Chief, Hong Kong Medical Journal
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9
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Mok A, Mui OOY, Tang KP, Lee WY, Ng CF, Wong SH, Wong MCS, Teoh JYC. Public awareness of preventive measures against COVID-19: an infodemiology study. Hong Kong Med J 2023; 29:214-223. [PMID: 37349138 DOI: 10.12809/hkmj219556] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic has led to an increase in global awareness of relevant public health preventive measures. This awareness can be explored using online search trends from major search engines, such as Google Trends. We investigated the relationship between public awareness of preventative measures and progression of the COVID-19 pandemic. METHODS Search data for five queries ('mask', 'hand washing', 'social distancing', 'hand sanitizer', and 'disinfectant') were extracted from Google Trends in the form of relative search volume (RSV). Global incidence data for COVID-19 were obtained from 1 January to 30 June 2020. These data were analysed and illustrated using a global temporal RSV trend diagram, a geographical RSV distribution chart, scatter plots comparing geographical RSV with average number of daily cases, and heat maps comparing temporal trends of RSV with average number of daily cases. RESULTS Global temporal trends revealed multiple increases in RSV, associated with specific COVID-19-related news events. The geographical distribution showed top regions of interest for various preventive measures. For the queries 'mask', 'hand washing', 'hand sanitizer', and 'disinfectant', heat maps demonstrated patterns of early RSV peaks in regions with lower average number of daily cases, when the temporal element was incorporated into the analysis. CONCLUSION Early public awareness of multiple preventive measures was observed in regions with lower average number of daily cases. Our findings indicate optimal public health communication regarding masks, hand washing, hand sanitiser, and disinfectant in the general population during early stages of the COVID-19 pandemic. Early public awareness may facilitate future disease control efforts by public health authorities.
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Affiliation(s)
- A Mok
- SH Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - O O Y Mui
- SH Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - K P Tang
- SH Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - W Y Lee
- SH Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - C F Ng
- SH Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - S H Wong
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - M C S Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Health Education and Health Promotion, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - J Y C Teoh
- SH Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Office of Global Engagement, The Chinese University of Hong Kong, Hong Kong SAR, China
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10
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Chan VWS, Rahman L, Ng HHL, Tang KP, Mok A, Tang A, Liu JPH, Ho KSC, Chan SM, Wong S, Teoh AYB, Chan A, Wong MCS, Yuan Y, Teoh JYC. Mitigation of COVID-19 transmission in endoscopic and surgical aerosol-generating procedures: a narrative review of early-pandemic literature. Hong Kong Med J 2023. [PMID: 37217445 DOI: 10.12809/hkmj209089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023] Open
Affiliation(s)
- V W S Chan
- School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - L Rahman
- School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - H H L Ng
- School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - K P Tang
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - A Mok
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - A Tang
- School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - J P H Liu
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - K S C Ho
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - S M Chan
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - S Wong
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - A Y B Teoh
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - A Chan
- Department of Anaesthesia and Intensive Care, Prince of Wales Hospital, Hong Kong SAR, China
| | - M C S Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Y Yuan
- Department of Medicine, McMaster University, Hamilton, Canada
| | - J Y C Teoh
- SH Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
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11
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Wang HHX, Li YT, Zhang Y, Wong MCS. Revisiting primary healthcare and looking ahead. Hong Kong Med J 2023; 29:96-98. [PMID: 36740222 DOI: 10.12809/hkmj235139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- H H X Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou, China.,Department of General Practice, The Second Hospital of Hebei Medical University, Shijiazhuang, China.,Usher Institute, Deanery of Molecular, Genetic and Population Health Sciences, The University of Edinburgh, Scotland, United Kingdom
| | - Y T Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Y Zhang
- Department of General Practice, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - M C S Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.,Editor-in-Chief, Hong Kong Medical Journal
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12
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Wang HHX, Li YT, Duan H, Wong MCS. Physician motivation and satisfaction matter in healthcare. Hong Kong Med J 2023; 29:8-10. [PMID: 36810236 DOI: 10.12809/hkmj235142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Affiliation(s)
- H H X Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou, China.,School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China.,Usher Institute, Deanery of Molecular, Genetic and Population Health Sciences, The University of Edinburgh, Scotland, United Kingdom
| | - Y T Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - H Duan
- Department of General Practice, Henan Provincial People's Hospital, Zhengzhou, China
| | - M C S Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.,Editor-in-Chief, Hong Kong Medical Journal
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13
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Irwin MG, Wong MCS. Perspective: a new article type for the Hong Kong Medical Journal. Hong Kong Med J 2023; 29:15. [PMID: 36731885 DOI: 10.12809/hkmj235138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- M G Irwin
- Senior Editor, Hong Kong Medical Journal
| | - M C S Wong
- Editor-in-Chief, Hong Kong Medical Journal
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14
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Hui CKM, Hung IFN, Lam B, Lin AWC, So TMK, Wong ATY, Wong MCS. The role of a single-shot higher-valency pneumococcal vaccine in overcoming challenges regarding invasive pneumococcal disease in Hong Kong. Hong Kong Med J 2023; 29:11-14. [PMID: 36751099 DOI: 10.12809/hkmj235141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Affiliation(s)
| | - I F N Hung
- Queen Mary Hospital, The University of Hong Kong, Hong Kong.,Gleneagles Hospital Hong Kong, Hong Kong
| | - B Lam
- Hong Kong Sanatorium & Hospital, Hong Kong
| | | | - T M K So
- Virtus Medical Centre, Hong Kong
| | | | - M C S Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.,Editor-in-Chief, Hong Kong Medical Journal
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15
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Kwok CCH, Wong WH, Chan LL, Wong SPY, Wang F, Wong MCS, Tse SLA. Effects of primary granulocyte-colony stimulating factor prophylaxis on neutropenic toxicity and chemotherapy dose delivery in Chinese patients with breast cancer who received adjuvant docetaxel plus cyclophosphamide chemotherapy: a retrospective cohort study. Hong Kong Med J 2022; 28:438-446. [PMID: 36261264 DOI: 10.12809/hkmj219439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION This study was performed to examine the effects of primary granulocyte-colony stimulating factor (G-CSF) prophylaxis on neutropenic toxicity, chemotherapy delivery, and hospitalisation among Chinese patients with breast cancer in Hong Kong. METHODS This retrospective study included patients with breast cancer who received adjuvant docetaxel plus cyclophosphamide chemotherapy from November 2007 to October 2013 at Princess Margaret Hospital. Data were collected regarding the usage of G-CSF prophylaxis; incidences of grade 3 or 4 neutropenia, febrile neutropenia, non-neutropenic fever, and infection; hospital admissions, and chemotherapy dose delivery. Patients who began to receive G-CSF prophylaxis during the first cycle of chemotherapy and continued such prophylaxis in subsequent cycles were regarded as the primary G-CSF prophylaxis group. RESULTS In total, 231 female Chinese patients with breast cancer were included in the analysis. Overall, 193 (83.5%) patients received primary G-CSF prophylaxis. The demographics and tumour characteristics were comparable between patients with and without primary G-CSF prophylaxis. Primary G-CSF prophylaxis significantly reduced febrile neutropenia incidence from 31.6% to 14.5% (relative risk=0.45, 95% confidence interval=0.25-0.81). Primary G-CSF prophylaxis also significantly reduced the incidence of grade 3 or 4 neutropenia from 57.9% to 24.7% (relative risk=0.43, 95% confidence interval=0.30-0.62) and the incidence of febrile neutropenia-related hospital admission from 31.6% to 12.4% (P=0.025). Finally, it enabled more patients to receive adequate chemotherapy dose delivery. CONCLUSION Primary G-CSF prophylaxis effectively reduced the incidences of grade 3 or 4 neutropenia and febrile neutropenia, while enabling adequate chemotherapy dose delivery and reducing hospital admissions among Chinese patients with breast cancer who received adjuvant docetaxel plus cyclophosphamide chemotherapy.
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Affiliation(s)
- C C H Kwok
- Department of Oncology, Princess Margaret Hospital, Hong Kong
| | - W H Wong
- Department of Oncology, Princess Margaret Hospital, Hong Kong
| | - L L Chan
- Department of Oncology, Princess Margaret Hospital, Hong Kong
| | - S P Y Wong
- Department of Surgery, Princess Margaret Hospital, Hong Kong
| | - F Wang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - M C S Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - S L A Tse
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
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16
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Huang J, Wang HHX, Zheng ZJ, Wong MCS. Impact of the COVID-19 pandemic on cancer care. Hong Kong Med J 2022; 28:427-429. [PMID: 36523118 DOI: 10.12809/hkmj215136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- J Huang
- Editor, Hong Kong Medical Journal.,The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.,Centre for Health Education and Health Promotion, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | | | - Z J Zheng
- International Editorial Advisory Board, Hong Kong Medical Journal.,Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - M C S Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.,Centre for Health Education and Health Promotion, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.,Department of Global Health, School of Public Health, Peking University, Beijing, China.,Editor-in-Chief, Hong Kong Medical Journal
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17
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Chan EOT, Chan VWS, Tang TST, Cheung V, Wong MCS, Yee CH, Ng CF, Teoh JYC. Systematic review and meta-analysis of ketamine-associated uropathy. Hong Kong Med J 2022; 28:466-474. [PMID: 36464318 DOI: 10.12809/hkmj209194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION This systematic review and meta-analysis focused on the literature regarding ketamine-associated uropathy to summarise its clinical manifestations, the results of urological assessments, and current management. METHODS A literature search was conducted using keywords and MeSH terms related to ketamine abuse, urinary tracts, and urological examinations. Databases including Embase, MEDLINE, and the Cochrane Central Register of Controlled Trials were searched up to 26 June 2020. RESULTS In total, 1365 articles were retrieved; 45 articles (4921 patients) were included in the analysis of patient demographics, clinical manifestations, examination results, and treatments. Frequency was the most common manifestation (pooled prevalence 77.1%, 95% confidence interval [CI]=56.9%-92.2%), followed by urgency (69.9%, 95% CI=48.8%-87.3%) and suprapubic pain (60.4%, 95% CI=35.3%-82.9%). Upper urinary tract involvement was less common; the pooled prevalence of hydronephrosis was 30.2% (95% CI=22.0%-39.2%). Further workup revealed a pooled functional bladder capacity of 95.23 mL (95% CI=63.57-126.88 mL), pooled voided volume of 113.31 mL (95% CI=59.44- 167.19 mL), and pooled maximum urine flow rate of 8.69 mL/s (95% CI=5.54-11.83 mL/s). Cystoscopic examinations and bladder biopsy revealed frequent urothelial denudation, inflammatory changes, and inflammatory cell infiltration. Treatments included oral medications for symptomatic relief, intravesical therapy, and surgery (eg, hydrodistension and bladder reconstruction), but ketamine abstinence was necessary for improvement. CONCLUSION Ketamine-associated uropathy frequently involves frequency, urgency, and suprapubic pain; upper urinary tract involvement is less common. Affected patients showed reductions in bladder capacity and urine flow rate. Endoscopic and histological analyses often revealed cystitis. Despite variations in treatment, ketamine abstinence is important for all patients with ketamine-associated uropathy.
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Affiliation(s)
- E O T Chan
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | - V W S Chan
- Division of Surgery and Interventional Sciences, University College London, London, United Kingdom.,Royal Derby Hospital, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, United Kingdom.,Leeds Institute of Medical Research, University of Leeds, Leeds, United Kingdom
| | - T S T Tang
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | - V Cheung
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | - M C S Wong
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - C H Yee
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | - C F Ng
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | - J Y C Teoh
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong
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18
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Wang HHX, Li YT, Wong MCS. Strengthening attributes of primary care to improve patients' experiences and population health: from rural village clinics to urban health centres. Hong Kong Med J 2022; 28:282-284. [PMID: 35989432 DOI: 10.12809/hkmj215133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Affiliation(s)
- H H X Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
- Department of General Practice, The Second Hospital of Hebei Medical University, Shijiazhuang, China
- Usher Institute, Deanery of Molecular, Genetic and Population Health Sciences, The University of Edinburgh, Scotland, United Kingdom
| | - Y T Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - M C S Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
- Editor-in-Chief, Hong Kong Medical Journal
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19
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Lai CKC, Lam W, Tsang KY, Cheng FWT, Wong MCS. COVID-19 pandemic after Omicron. Hong Kong Med J 2022; 28:196-198. [PMID: 35765729 DOI: 10.12809/hkmj215130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Affiliation(s)
- C K C Lai
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - W Lam
- Chiron Medical, Hong Kong
| | - K Y Tsang
- Specialist in Infectious Disease, Private Practice, Hong Kong
| | - F W T Cheng
- Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong
| | - M C S Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
- Editor-in-Chief, Hong Kong Medical Journal
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20
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Yan BP, Wong MCS. Cardiovascular complications of COVID-19: a future public health burden requiring intensive attention and research. Hong Kong Med J 2022; 28:199-200. [PMID: 35765730 DOI: 10.12809/hkmj215131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Affiliation(s)
- B P Yan
- Division of Cardiology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
| | - M C S Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
- Editor-in-Chief, Hong Kong Medical Journal
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21
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Sit RWS, Law SW, Lam CY, Wong MCS. Management of chronic musculoskeletal pain in Hong Kong. Hong Kong Med J 2022; 28:201-203. [PMID: 35765731 DOI: 10.12809/hkmj215129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Affiliation(s)
- R W S Sit
- The JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - S W Law
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong
- The Hong Kong College of Orthopaedic Surgeons, Hong Kong
| | - C Y Lam
- Department of Orthopaedics and Traumatology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - M C S Wong
- The JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
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22
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Tsang THF, Wong KH, Allen K, Chan KKL, Chan MCM, Chao DVK, Cheung AN, Fan CYM, Hui EP, Ip DKM, Lam KO, Law CK, Law WL, Loong HHF, Wong KH, Wong MCS, Yeung RMW, Ying ACH, Ho RKW. Update on the Recommendations on Breast Cancer Screening by the Cancer Expert Working Group on Cancer Prevention and Screening. Hong Kong Med J 2022; 28:161-168. [PMID: 35400644 DOI: 10.12809/hkmj219622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Breast cancer (BC) is the most common cancer among women in Hong Kong. The Food and Health Bureau commissioned The University of Hong Kong (HKU) to conduct the Hong Kong Breast Cancer Study (HKBCS) with the aim of identifying relevant risk factors for BC in Hong Kong and developing a locally validated BC risk assessment tool for Hong Kong Chinese women. After consideration of the most recent international and local scientific evidence including findings of the HKBCS, the Cancer Expert Working Group on Cancer Prevention and Screening (CEWG) has reviewed and updated its BC screening recommendations. Existing recommendations were preserved for women at high risk and slightly changed for women at moderate risk. The following major updates have been made concerning recommendations for other women in the general population: Women aged 44 to 69 with certain combinations of personalised risk factors (including presence of history of BC among first-degree relative, a prior diagnosis of benign breast disease, nulliparity and late age of first live birth, early age of menarche, high body mass index and physical inactivity) putting them at increased risk of BC are recommended to consider mammography screening every 2 years. They should discuss with their doctors on the potential benefits and harms before undergoing mammography screening. A risk assessment tool for local women (eg, one developed by HKU) is recommended to be used for estimating the risk of developing BC with regard to the personalised risk factors described above.
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Affiliation(s)
- T H F Tsang
- Hong Kong College of Community Medicine, Hong Kong
| | - K H Wong
- Centre for Health Protection, Department of Health, Hong Kong
| | - K Allen
- World Cancer Research Fund International, United Kingdom
| | - K K L Chan
- The Hong Kong College of Obstetricians and Gynaecologists, Hong Kong
| | | | - D V K Chao
- The Hong Kong College of Family Physicians, Hong Kong
| | - A N Cheung
- The Hong Kong College of Pathologists, Hong Kong
| | - C Y M Fan
- Professional Development and Quality Assurance Service, Department of Health, Hong Kong
| | - E P Hui
- Hong Kong College of Physicians, Hong Kong
| | - D K M Ip
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - K O Lam
- Department of Clinical Oncology, The University of Hong Kong, Hong Kong
| | - C K Law
- Hong Kong College of Radiologists, Hong Kong
| | - W L Law
- The College of Surgeons of Hong Kong, Hong Kong
| | - H H F Loong
- Department of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong
| | - K H Wong
- Hong Kong Cancer Registry, Hospital Authority, Hong Kong
| | - M C S Wong
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - R M W Yeung
- Hospital Authority (Clinical Oncology), Hong Kong
| | - A C H Ying
- The Hong Kong Anti-Cancer Society, Hong Kong
| | - R K W Ho
- Centre for Health Protection, Department of Health, Hong Kong
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23
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Leung WC, Lo R, Teoh JYC, Cheng A, Wong MCS, Leung GKK. Well-being of Academy Fellows and specialty trainees: what is the problem? Hong Kong Med J 2021; 27:324-325. [PMID: 34607971 DOI: 10.12809/hkmj215123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- W C Leung
- Honorary Secretary, Hong Kong Academy of Medicine
| | - R Lo
- Honorary Advisor, Task Force on Well-being, Hong Kong Academy of Medicine
| | - J Y C Teoh
- Chair, Young Fellows Chapter, Hong Kong Academy of Medicine
| | - A Cheng
- Chief Executive Officer, Hong Kong Academy of Medicine
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24
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Wang HHX, Chen L, Ding H, Huang J, Wong MCS. Scientific research on COVID-19 conducted in Hong Kong in 2020. Hong Kong Med J 2021; 27:244-246. [PMID: 34393111 DOI: 10.12809/hkmj215121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- H H X Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou, China.,JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - L Chen
- Department of General Practice, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - H Ding
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - J Huang
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - M C S Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.,Editor-in-Chief, Hong Kong Medical Journal
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25
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Chan HLY, Wong GLH, Wong VWS, Wong MCS, Chan CYK, Singh S. Questionnaire survey on knowledge, attitudes, and behaviour towards viral hepatitis among the Hong Kong public. Hong Kong Med J 2021; 28:45-53. [PMID: 34294603 DOI: 10.12809/hkmj219463] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION We aimed to identify gaps in knowledge, attitudes, and behaviours towards viral hepatitis among the Hong Kong public and provide insights to optimise local efforts towards achieving the World Health Organization's viral hepatitis elimination target. METHODS A descriptive, cross-sectional, self-reported web-based questionnaire was administered to 500 individuals (aged ≥18 years) in Hong Kong. Questionnaire items explored the awareness and perceptions of viral hepatitis-related liver disease(s) and associated risk factors in English or traditional Chinese. RESULTS The majority (>80%) were aware that chronic hepatitis B and/or C could increase the risks of developing liver cirrhosis, cancer, and/or failure. Only 55.8% had attended health screenings in the past 2 years, and 67.6% were unaware of their family's history of liver diseases. Misperceptions surrounding the knowledge and transmission risks of viral hepatitis strongly hint at the presence of social stigmatisation within the community. Many misperceived viral hepatitis as airborne or hereditary, and social behaviours (casual contact or dining with an infected person) as a transmission route. Furthermore, 62.4% were aware of hepatitis B vaccination, whereas 19.0% knew that hepatitis C cannot be prevented by vaccination. About 70% of respondents who were aware of mother-to-child transmission were willing to seek medical consultation in the event of pregnancy. Gaps in knowledge as well as the likelihood of seeking screening were observed across all age-groups and education levels. CONCLUSIONS Comprehensive hepatitis education strategies should be developed to address gaps in knowledge among the Hong Kong public towards viral hepatitis, especially misperceptions relevant to social stigmatisation and the importance of preventive measures, including vaccination and screening, when exposed to risk factors.
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Affiliation(s)
- H L Y Chan
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.,Department of Internal Medicine, Union Hospital, Hong Kong
| | - G L H Wong
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.,Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.,Medical Data Analytic Centre (MDAC), The Chinese University of Hong Kong, Hong Kong.,Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
| | - V W S Wong
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.,Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.,Medical Data Analytic Centre (MDAC), The Chinese University of Hong Kong, Hong Kong.,Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
| | - M C S Wong
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.,JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
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26
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Affiliation(s)
- P K S Chan
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - M C S Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - E L Y Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
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27
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Huang J, Xu W, Zheng Z, Wong MCS. Importance of sustaining non-pharmaceutical interventions for COVID-19 until herd immunity. Hong Kong Med J 2021; 27:95-96. [PMID: 33879626 DOI: 10.12809/hkmj215112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- J Huang
- Editor, Hong Kong Medical Journal
| | - W Xu
- International Editorial Advisory Board, Hong Kong Medical Journal.,School of Public Health, Fudan University, Shanghai, China
| | - Z Zheng
- International Editorial Advisory Board, Hong Kong Medical Journal.,Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - M C S Wong
- Editor-in-Chief, Hong Kong Medical Journal.,The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
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28
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Ching RCT, Mak SP, Wong MCS, Lam M, Chan WM, Wong MFY, Liang R, Lam TH. Response to the World Health Organization's working document for the development of a global action plan to reduce alcohol-related harm: Position Statement of the Hong Kong Alliance for Advocacy Against Alcohol. Hong Kong Med J 2021; 27:4-6. [PMID: 33518532 DOI: 10.12809/hkmj215109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- R C T Ching
- Hong Kong Alliance for Advocacy Against Alcohol
| | - S P Mak
- Hong Kong Alliance for Advocacy Against Alcohol
| | - M C S Wong
- Hong Kong Alliance for Advocacy Against Alcohol
| | - M Lam
- Hong Kong Alliance for Advocacy Against Alcohol
| | - W M Chan
- Hong Kong Alliance for Advocacy Against Alcohol
| | - M F Y Wong
- Hong Kong Alliance for Advocacy Against Alcohol
| | - R Liang
- Hong Kong Alliance for Advocacy Against Alcohol
| | - T H Lam
- Hong Kong Alliance for Advocacy Against Alcohol
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29
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Huang J, Wang HHX, Zheng Z, Wong MCS. Medication adherence among the older adults: challenges and recommendations. Hong Kong Med J 2020; 26:476-478. [PMID: 33350963 DOI: 10.12809/hkmj205108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023] Open
Affiliation(s)
- J Huang
- Editor, Hong Kong Medical Journal
| | | | - Z Zheng
- International Editorial Advisory Board, Hong Kong Medical Journal
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - M C S Wong
- Editor-in-Chief, Hong Kong Medical Journal
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
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30
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Lau JTF, Chan JCN, Pong SOL, Chung HHY, Ozaki R, Wong MCS, Leung EFL, Mui LWH, Choi KC. Promoting physical activity among physically inactive people with impaired glucose tolerance and/or impaired fasting glucose: a clustered randomised controlled trial (abridged secondary publication). Hong Kong Med J 2020; 26 Suppl 8:38-40. [PMID: 33504677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023] Open
Affiliation(s)
- J T F Lau
- School of Public Health and Primary Care, The Chinese University of Hong Kong
| | - J C N Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong
| | | | - H H Y Chung
- Yao Chung Kit Diabetes Assessment Centre, The Chinese University of Hong Kong
| | - R Ozaki
- Division of Diabetes and Endocrinology, The Chinese University of Hong Kong
| | - M C S Wong
- School of Public Health and Primary Care, The Chinese University of Hong Kong
| | - E F L Leung
- Physical Education Unit, The Chinese University of Hong Kong
| | - L W H Mui
- School of Public Health and Primary Care, The Chinese University of Hong Kong
| | - K C Choi
- The Nethersole School of Nursing, The Chinese University of Hong Kong
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31
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Huang J, Wang HHX, Ma ESK, Wong MCS. Contributions of physicians to government-subsidised disease prevention programmes: an appeal for active participation. Hong Kong Med J 2020; 26:364-366. [PMID: 33089784 DOI: 10.12809/hkmj205105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023] Open
Affiliation(s)
- J Huang
- Editor, Hong Kong Medical Journal
| | | | - E S K Ma
- Epidemiology Adviser, Hong Kong Medical Journal
| | - M C S Wong
- Editor-in-Chief, Hong Kong Medical Journal
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
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32
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Affiliation(s)
- M C S Wong
- Editor-in-Chief, Hong Kong Medical Journal.,Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - J Huang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - A P S Kong
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
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33
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Wong MCS, Teoh JYC. Launch of the HKMJ Expert Advisory Panel on Social Media: enhancing reach, timeliness, and efficient sharing of medical literature. Hong Kong Med J 2020; 26:174-175. [PMID: 32554816 DOI: 10.12809/hkmj205098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- M C S Wong
- Editor-in-Chief, Hong Kong Medical Journal.,School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - J Y C Teoh
- Chair, Expert Advisory Panel on Social Media, Hong Kong Medical Journal.,Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
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34
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Affiliation(s)
- M C S Wong
- Editor-in-Chief, Hong Kong Medical Journal.,Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong
| | - J Huang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong
| | - D Weller
- Centre for Population Health Science, The University of Edinburgh, Edinburgh, United Kingdom
| | - R Jones
- School of Population Health and Environmental Science, King's College London, London, United Kingdom
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35
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Wong MCS, Huang J, Xu W, Chen P, Wang S, Zhang L, Zheng Z. Research for health issues in mainland China-a growing need unaddressed. Hong Kong Med J 2020; 26:4-5. [PMID: 32077859 DOI: 10.12809/hkmj195092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- M C S Wong
- Editor-in-Chief, Hong Kong Medical Journal.,Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - J Huang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - W Xu
- School of Public Health, Fudan University, Shanghai, China
| | - P Chen
- Department of Gastroenterology, Ruijin Hospital North, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - S Wang
- Department of Gastroenterology, Jiading District Hospital, Shanghai, China
| | - L Zhang
- School of Public Health, Peking Union Medical College, The Chinese Academy of Medical Sciences, Beijing, China.,Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Z Zheng
- Department of Global Health, School of Public Health, Peking University, Beijing, China
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36
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Lee KP, Wong C, Chan D, Kung K, Luk L, Wong MCS, Chao D, Leung V, Chan CW, Ko W, Leung TF, Chan YH, Fung HT, Lee MK, Wong SYS. Family medicine vocational training and career satisfaction in Hong Kong. BMC Fam Pract 2019; 20:139. [PMID: 31630674 PMCID: PMC6800987 DOI: 10.1186/s12875-019-1030-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 09/24/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND Postgraduate vocational training in family medicine (FM) is essential for physicians to build capacity and develop quality primary care. Inadequate standards in training and curriculum development can contribute to poor recruitment and retention of doctors in primary care. This study aimed to investigate: 1) the satisfaction level of doctors regarding vocational training in family medicine and associated demographics; and 2) the satisfaction level of doctors regarding their family medicine career and associated factors. METHOD This is a cross sectional study of all family medicine physicians across all government-funded primary care clinics (GOPCs). The study questionnaire consisted of items from a standardized and validated physician survey named the Physician Worklife Survey (PWS) (Konrad et al., Med Care, 1999). We selected three scales (7 items) relating to global job satisfaction, global career satisfaction and global specialty (family medicine) satisfaction with additional items on training and demographics. All significant variables in bivariate analyses were further examined using stepwise logistic regression. RESULTS Out of 424 eligible family medicine physicians, 368 physicians successfully completed the questionnaire. The response rate was 86.8%. Most participants were male (52.6%), were aged between 35 and 44 years (55.5%), were FM specialists (42.4%), graduated locally (86.2%), and had postgraduate qualifications. Eighty-two percent (82%) of participants were satisfied with their training. Having autonomy and protected time for training were associated with satisfaction with FM training. Satisfaction with family medicine as a career was correlated with physicians' satisfaction with their current job. Doctors who did not enroll in training (p < 0.001) and physicians who were older (p = 0.023) were significantly less satisfied. Stepwise multivariate regression showed that doctors who subjectively believed their training as "broad and in depth' had higher career satisfaction (p < 0.001). CONCLUSION Overall, the satisfaction level of physicians on current family medicine training in Hong Kong was high. Having autonomy and protected time for training is associated with higher training satisfaction levels. Perceiving FM training as "broad and in-depth" is associated with higher family medicine career satisfaction.
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Affiliation(s)
- K P Lee
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - C Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong.
| | - D Chan
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - K Kung
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - L Luk
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - M C S Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - D Chao
- Hospital Authority, Hospital Authority Building, 147B Argyle Street, Kowloon, Hong Kong
| | - V Leung
- Hospital Authority, Hospital Authority Building, 147B Argyle Street, Kowloon, Hong Kong
| | - C W Chan
- Hospital Authority, Hospital Authority Building, 147B Argyle Street, Kowloon, Hong Kong
| | - W Ko
- Hospital Authority, Hospital Authority Building, 147B Argyle Street, Kowloon, Hong Kong
| | - T F Leung
- Hospital Authority, Hospital Authority Building, 147B Argyle Street, Kowloon, Hong Kong
| | - Y H Chan
- Hospital Authority, Hospital Authority Building, 147B Argyle Street, Kowloon, Hong Kong
| | - H T Fung
- Hospital Authority, Hospital Authority Building, 147B Argyle Street, Kowloon, Hong Kong
| | - M K Lee
- Hospital Authority, Hospital Authority Building, 147B Argyle Street, Kowloon, Hong Kong
| | - S Y S Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong
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37
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Li KH, Ho J, Xu Z, Lakhani I, Bazoukis G, Liu T, Wong WT, Cheng SH, Chan MTV, Gin T, Wong MCS, Wong I, Wu WKK, Zhang Q, Tse G. P5014The NPAC score for predicting survival after incident acute myocardial infarction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Risk stratification in acute myocardial infarction (AMI) is important for guiding clinical management. Current risk scores are mostly derived from clinical trials with stringent patient selection. We aimed to establish and evaluate a composite scoring system to predict short-term mortality after index episodes of AMI, independent of electrocardiography (ECG) pattern, in a large real-world cohort.
Methods
Using electronic health records, patients admitted to our regional teaching hospital (derivation cohort, n=2127) and an independent tertiary care center (validation cohort, n=1276) with index acute myocardial infarction between January 2013 and December 2017 as confirmed by principal diagnosis and laboratory findings, were identified retrospectively.
Results
Univariate logistic regression was used as the primary model to identify potential contributors to mortality. Stepwise forward likelihood ratio logistic regression revealed that neutrophil-to-lymphocyte ratio, peripheral vascular disease, age, and serum creatinine (NPAC) were significant predictors for 90-day mortality (Hosmer-Lemeshow test, P=0.21). Each component of the NPAC score was weighted by beta-coefficients in multivariate analysis. The C-statistic of the NPAC score was 0.75, which was higher than the conventional Charlson's score (C-statistic=0.63). Application of a deep learning model to our dataset improved the accuracy of classification with a C-statistic of 0.81.
Multivariate binary logistic regression Variable β Adjusted Odds ratio (95% CI) P-value Points Age ≥65 years 1.304 3.68 (2.63–5.17) <0.001 2 Peripheral vascular disease 1.109 3.03 (1.52–6.04) 0.002 2 NLRt ≥9.51 1.100 2.73 (2.12–3.51) <0.001 1 Creatinine≥109 μmol/L 1.003 3.00 (2.35–3.85) <0.001 2
NPAC deep learning model
Conclusions
The NPAC score comprised of four items from routine laboratory parameters and basic clinical information and can facilitate early identification of cases at risk of short-term mortality following index myocardial infarction. Deep learning model can serve as a gate-keeper to provide more accurate prediction to facilitate clinical decision making.
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Affiliation(s)
- K H Li
- Newcastle University, Newcastle upon Tyne, United Kingdom
| | - J Ho
- The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Z Xu
- The Chinese University of Hong Kong, Institute of Digestive Disease, Li Ka Shing Institute of Health Sciences, Hong Kong, Hong Kong
| | - I Lakhani
- The Chinese University of Hong Kong, Shatin, Hong Kong
| | - G Bazoukis
- Evangelismos General Hospital of Athens, Cardiology, Athens, Greece
| | - T Liu
- 2nd Hospital of Tianjin Medical University, Cardiology, Tianjin, China
| | - W T Wong
- The Chinese University of Hong Kong, Shatin, Hong Kong
| | - S H Cheng
- The Chinese University of Hong Kong, Shatin, Hong Kong
| | - M T V Chan
- The Chinese University of Hong Kong, Shatin, Hong Kong
| | - T Gin
- The Chinese University of Hong Kong, Shatin, Hong Kong
| | - M C S Wong
- The Chinese University of Hong Kong, Shatin, Hong Kong
| | - I Wong
- The University of Hong Kong, Hong Kong, Hong Kong
| | - W K K Wu
- The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Q Zhang
- The Chinese University of Hong Kong, Shatin, Hong Kong
| | - G Tse
- The Chinese University of Hong Kong, Shatin, Hong Kong
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38
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Chan AMW, Au WWY, Chao DVK, Choi K, Choi KW, Choi SMY, Chow Y, Fan CYM, Ho PL, Hui EMT, Kwong KH, Kwong BYS, Lam TP, Lam ETK, Lau KW, Lui L, Ng KHL, Wong MCS, Wong TY, Yeung CF, You JHS, Yung RWH. Antibiotic management of acute pharyngitis in primary care. Hong Kong Med J 2019; 25:58-63. [PMID: 30713150 DOI: 10.12809/hkmj187544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The Centre for Health Protection of the Department of Health has convened the Advisory Group on Antibiotic Stewardship Programme in Primary Care (the Advisory Group) to formulate guidance notes and strategies for optimising judicious use of antibiotics and enhancing the Antibiotic Stewardship Programme in Primary Care. Acute pharyngitis is one of the most common conditions among out-patients in primary care in Hong Kong. Practical recommendations on the diagnosis and antibiotic treatment of acute streptococcal pharyngitis are made by the Advisory Group based on the best available clinical evidence, local prevalence of pathogens and associated antibiotic susceptibility profiles, and common local practice.
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Affiliation(s)
| | - A M W Chan
- Hong Kong College of Family Physicians, Hong Kong
| | - W W Y Au
- Infection Control Branch, Centre for Health Protection, Department of Health, Hong Kong
| | - D V K Chao
- Department of Family Medicine and Primary Health Care, United Christian Hospital, Hospital Authority, Hong Kong
| | - K Choi
- Hong Kong Medical Association, Hong Kong
| | - K W Choi
- Hong Kong Society for Infectious Diseases, Hong Kong
| | - S M Y Choi
- Primary Care Office, Department of Health, Hong Kong
| | - Y Chow
- Quality HealthCare Medical Services Limited, Hong Kong
| | - C Y M Fan
- Professional Development and Quality Assurance, Department of Health, Hong Kong
| | - P L Ho
- IMPACT Editorial Board, Reducing bacterial resistance with IMPACT, 5th edition, Hong Kong
| | - E M T Hui
- Department of Family Medicine, New Territories East Cluster, Hospital Authority, Hong Kong
| | - K H Kwong
- Human Health Holdings Limited, Hong Kong
| | - B Y S Kwong
- Chief Pharmacist's Office, Hospital Authority, Hong Kong
| | - T P Lam
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
| | - E T K Lam
- Centre for Health Protection Infection Control Branch, Department of Health, Hong Kong
| | - K W Lau
- Centre for Health Protection Infection Control Branch, Department of Health, Hong Kong
| | - L Lui
- Centre for Health Protection Infection Control Branch, Department of Health, Hong Kong
| | - K H L Ng
- Centre for Health Protection Infection Control Branch, Department of Health, Hong Kong
| | - M C S Wong
- Hong Kong Academy of Medicine, Hong Kong
| | - T Y Wong
- Centre for Health Protection Infection Control Branch, Department of Health, Hong Kong
| | | | - J H S You
- School of Pharmacy, The Chinese University of Hong Kong, Hong Kong
| | - R W H Yung
- Hong Kong Sanatorium & Hospital, Hong Kong
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39
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Lim MK, Ha SCN, Luk KH, Yip WK, Tsang CSH, Wong MCS. Update on the Hong Kong Reference Framework for Hypertension Care for Adults in Primary Care Settings-review of evidence on the definition of high blood pressure and goal of therapy. Hong Kong Med J 2019; 25:64-7. [PMID: 30648830 DOI: 10.12809/hkmj187701] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The Hong Kong Reference Framework for Hypertension Care for Adults in Primary Care Settings is updated regularly to ensure it reflects the latest medical development and best practice. In 2017, guidelines from the United States included a major change, adopting the lower blood pressure values of 130/80 mm Hg in defining hypertension, in contrast to the prevailing international consensus of 140/90 mm Hg. After thorough review of the literature and international guidelines, the Advisory Group on Hong Kong Reference Framework for Care of Diabetes and Hypertension in Primary Care Settings (Advisory Group) recommends that the definition of hypertension adopted in the Reference Framework should remain unchanged as a blood pressure of ≥140/90 mm Hg, as there is currently inadequate evidence and lack of general consensus to support such change in Hong Kong. The Advisory Group agrees on individualised treatment goals, and recommends that the initial blood pressure goal for individuals with uncomplicated hypertension should be <140/90 mm Hg; for those who can tolerate it, the goal should be ≤130/80 mm Hg. A lower blood pressure is advisable for young or overweight/obese patients, smokers, and patients with other cardiovascular risk factors.
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Affiliation(s)
- M K Lim
- Primary Care Office, Department of Health, Hong Kong
| | - S C N Ha
- Primary Care Office, Department of Health, Hong Kong
| | - K H Luk
- Primary Care Office, Department of Health, Hong Kong
| | - W K Yip
- Primary Care Office, Department of Health, Hong Kong
| | - C S H Tsang
- Primary Care Office, Department of Health, Hong Kong
| | - M C S Wong
- Advisory Group on Hong Kong Reference Framework for Care of Diabetes and Hypertension in Primary Care Settings, Hong Kong
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40
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Li KHC, Ho JCS, Recaldin B, Gong M, Ho J, Li G, Liu T, Wu WKK, Wong MCS, Xia Y, Dong M, Tse G. Acute Cellular Rejection and Infection Rates in Alemtuzumab vs Traditional Induction Therapy Agents for Lung and Heart Transplantation: A Systematic Review and Meta-analysis. Transplant Proc 2018; 50:3723-3731. [PMID: 30577263 DOI: 10.1016/j.transproceed.2018.08.044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 08/14/2018] [Accepted: 08/29/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND OBJECTIVES Heart and lung transplantation is a high-risk procedure requiring intensive immunosuppressive therapy for preventing organ rejection. Alemtuzumab, a CD52-specific monoclonal antibody, is increasingly used for induction therapy compared with conventional agents. However, there has been no systematic review comparing its efficacy with traditional therapeutic drugs. METHODS PubMed and EMBASE were searched to October 1, 2017, for articles on alemtuzumab in cardiothoracic transplant surgery. Of the 433 studies retrieved, 8 were included in the final meta-analysis. RESULTS In lung transplantation, alemtuzumab use was associated with lower odds of acute cellular rejection compared with antithymocyte globulin (odds ratio [OR], 0.21; 95% CI, 0.11-0.40; P < .001), lower acute rejection rates (OR, 0.12; 95% CI, 0.03-0.55; P < .01), and infection rates (OR, 0.69; 95% CI, 0.35-1.36; P = .33) when compared with basiliximab. Multivariate meta-regression analysis found that mean age, male sex, single lung transplant, double lung transplant, cytomegalovirus or Epstein-Barr virus status, idiopathic pulmonary fibrosis, cystic fibrosis, and mean ischemic time did not significantly influence acute rejection outcomes. For heart transplantation, alemtuzumab use was associated with lower acute rejection rates when compared with tacrolimus (OR, 0.44; 95% CI, 0.30-0.66; P < .001). CONCLUSIONS Alemtuzumab use was associated with lower rejection rates when compared with conventional induction therapy agents (antithymocyte globulin, basiliximab, and tacrolimus) in heart and lung transplantation. However, this was based on observational studies. Randomized controlled trials are needed to verify its clinical use.
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Affiliation(s)
- K H C Li
- Faculty of Medicine, Newcastle University, Newcastle Upon Tyne, United Kingdom; Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China; Li Ka Shing Institute of Health Sciences, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - J C S Ho
- Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - B Recaldin
- Faculty of Medicine, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - M Gong
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - J Ho
- Department of Anesthesia and Intensive Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - G Li
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - T Liu
- Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - W K K Wu
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - M C S Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Y Xia
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - M Dong
- Department of Cardiology, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai, Shandong Province, China.
| | - G Tse
- Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China; Li Ka Shing Institute of Health Sciences, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China.
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Tse G, Li CKH, Gong M, Lakhani I, Bazoukis G, Letsas KP, Wu WKK, Wong SH, Li G, Wong MCS, Xia Y, Liu T. P4826Catheter ablation for atrial fibrillation in heart failure patients: a systematic review and meta-analysis of randomized controlled trials. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- G Tse
- The Chinese University of Hong Kong, Department of Medicine and Therapeutics; Li Ka Shing Institute of Health Sciences, Hong Kong, Hong Kong SAR People's Republic of China
| | - C K H Li
- The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR People's Republic of China
| | - M Gong
- 2nd Hospital of Tianjin Medical University, Tianjin, China People's Republic of
| | - I Lakhani
- The Chinese University of Hong Kong, Department of Medicine and Therapeutics; Li Ka Shing Institute of Health Sciences, Hong Kong, Hong Kong SAR People's Republic of China
| | - G Bazoukis
- Evangelismos General Hospital of Athens, Athens, Greece
| | - K P Letsas
- Evangelismos General Hospital of Athens, Athens, Greece
| | - W K K Wu
- The Chinese University of Hong Kong, Department of Anaesthesia and Intensive Care; Li Ka Shing Institute of Health Sciences, Hong Kong, Hong Kong SAR People's Republic of China
| | - S H Wong
- The Chinese University of Hong Kong, Department of Medicine and Therapeutics; Li Ka Shing Institute of Health Sciences, Hong Kong, Hong Kong SAR People's Republic of China
| | - G Li
- 2nd Hospital of Tianjin Medical University, Tianjin, China People's Republic of
| | - M C S Wong
- The Chinese University of Hong Kong, JC School of Public Health, Hong Kong, Hong Kong SAR People's Republic of China
| | - Y Xia
- First Affiliated Hospital of Dalian Medical University, Dalian, China People's Republic of
| | - T Liu
- 2nd Hospital of Tianjin Medical University, Tianjin, China People's Republic of
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Abstract
Background Recent terrorist attacks with biological and chemical weapons have caused much concern for the public. The purpose of this study was to assess emergency doctors' preparedness in handling Chemical, Biological, Radiological, Nuclear and Explosive (CBRNE) incidents. Methods This is a cross sectional survey of all emergency doctors working in public emergency departments (ED) in Hong Kong. Apart from the experience and confidence to handle these events, data on participants' willingness to participate in CBRNE incidents and training motivations were also analysed. Results Biological and radiological events were found to be the least commonly encountered. Few respondents reported they were confident to manage biological events (10.6% to 29.8%), despite 66% of respondents reported having prior training in CBRNE management. Conclusions This study demonstrates ED doctors' low confidence in managing specific CBRNE incidents. Current strengths identified include the good awareness of hospital emergency plans and high motivation to get more training.
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Affiliation(s)
- KKC Hung
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
- Accident & Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - ECC Lam
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - MCS Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - TW Wong
- Accident & Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
- Pamela Youde Nethersole Eastern Hospital, Accident & Emergency Department, 3 Lok Man Road, Chaiwan, Hong Kong
| | - EYY Chan
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - CA Graham
- Accident & Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
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43
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Hirai HW, Tsoi KKF, Chan JYC, Wong SH, Ching JYL, Wong MCS, Wu JCY, Chan FKL, Sung JJY, Ng SC. Systematic review with meta-analysis: faecal occult blood tests show lower colorectal cancer detection rates in the proximal colon in colonoscopy-verified diagnostic studies. Aliment Pharmacol Ther 2016; 43:755-64. [PMID: 26858128 DOI: 10.1111/apt.13556] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 11/12/2015] [Accepted: 01/18/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND The performance of faecal occult blood tests (FOBTs) to screen proximally located colorectal cancer (CRC) has produced inconsistent results. AIM To assess in a meta-analysis, the diagnostic accuracy of FOBTs for relative detection of CRC according to anatomical location of CRC. METHODS Diagnostic studies including both symptomatic and asymptomatic cohorts assessing performance of FOBTs for CRC were searched from MEDINE and EMBASE. Primary outcome was accuracy of FOBTs according to the anatomical location of CRC. Bivariate random-effects model was used. Subgroup analyses were performed to evaluate test performance of guaiac-based FOBT (gFOBT) and immunochemical-based FOBT (iFOBT). RESULTS Thirteen studies, with 17 cohorts, reporting performance of FOBT were included; a total of 26 342 patients (mean age 58.9 years; 58.1% male) underwent both colonoscopy and FOBT. Pooled sensitivity, specificity, positive likelihood ratio and negative likelihood ratio of FOBTs for CRC detection in the proximal colon were 71.2% (95% CI 61.3-79.4%), 93.6% (95% CI 90.7-95.7%), 11.1 (95% CI 7.8-15.8) and 0.3 (95% CI 0.2-0.4) respectively. Corresponding findings for CRC detection in distal colon were 80.1% (95% CI 70.9-87.0%), 93.6% (95% CI 90.7-95.7%), 12.6 (95% CI 8.8-18.1) and 0.2 (95% CI 0.1-0.3). The area-under-curve for FOBT detection for proximal and distal CRC were 90% vs. 94% (P = 0.0143). Both gFOBT and iFOBT showed significantly lower sensitivity but comparable specificity for the detection of proximally located CRC compared with distal CRC. CONCLUSION Faecal occult blood tests, both guaiac- and immunochemical-based, show better diagnostic performance for the relative detection of colorectal cancer in the distal colon than in the proximal bowel.
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Affiliation(s)
- H W Hirai
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong.,Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Shatin, Hong Kong.,Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - K K F Tsoi
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong.,Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - J Y C Chan
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - S H Wong
- Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong.,Department of Medicine and Therapeutics, LKS Institute of Health Science, State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - J Y L Ching
- Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - M C S Wong
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong.,Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - J C Y Wu
- Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong.,Department of Medicine and Therapeutics, LKS Institute of Health Science, State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - F K L Chan
- Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong.,Department of Medicine and Therapeutics, LKS Institute of Health Science, State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - J J Y Sung
- Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong.,Department of Medicine and Therapeutics, LKS Institute of Health Science, State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - S C Ng
- Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong.,Department of Medicine and Therapeutics, LKS Institute of Health Science, State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong
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Wang HHX, Wong SYS, Wong MCS, Wang JJ, Wei XL, Li DKT, Tang JL, Griffiths SM. Attributes of primary care in community health centres in China and implications for equitable care: a cross-sectional measurement of patients' experiences. QJM 2015; 108:549-60. [PMID: 25524909 DOI: 10.1093/qjmed/hcu248] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND China has been undergoing a health-care reform, and community health centres (CHCs) are being established as primary care provider across urban areas. AIM To evaluate primary care attributes in CHCs by measuring patients' experiences. DESIGN Cross-sectional surveys of 3360 adult service users with multistage cluster sampling. METHODS We developed a short assessment tool consisting of 33 items derived from the short version of the original Primary Care Assessment Tool-Adult Edition (PCAT-AE). The reliability and validity of the instrument were evaluated. Score distributions were assessed using descriptive statistics with 95% confidence interval (CI). The overall PCAT scores were categorized into three quantile groups (lower score, medium score and optimal score). Ordinal logistic regression analysis was performed to explore patient characteristics associated with optimal score after controlling for demographic, socio-economic, health conditions and health-care utilization characteristics. RESULTS One-third (33.4%, 95% CI: 31.0-35.9%) of subjects had optimal overall PCAT scores, while the majority (83.4%) reported medium-to-lower score in the community orientation scale. Patients' characteristics with respect to health-care utilization had major effects on PCAT scores. Subjects with the presence of social medical insurance had higher odds of having greater experience in most primary care attributes and tended to report optimal primary care experience (aOR 2.30, 95% CI: 1.92-2.75) compared with those without social medical insurance. CONCLUSIONS Equitable primary care is yet to be strengthened with regard to the community orientation attribute, and particularly among patients without social medical insurance, as they tend to have inferior experiences in the primary care sector.
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Affiliation(s)
- H H X Wang
- From the JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, P.R. China, General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 9LX, UK, School of Public Health, Guangzhou Medical University, Guangzhou 510182, P.R. China and Bauhinia Foundation Research Centre, Hong Kong From the JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, P.R. China, General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 9LX, UK, School of Public Health, Guangzhou Medical University, Guangzhou 510182, P.R. China and Bauhinia Foundation Research Centre, Hong Kong From the JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, P.R. China, General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 9LX, UK, School of Public Health, Guangzhou Medical University, Guangzhou 510182, P.R. China and Bauhinia Foundation Research Centre, Hong Kong
| | - S Y S Wong
- From the JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, P.R. China, General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 9LX, UK, School of Public Health, Guangzhou Medical University, Guangzhou 510182, P.R. China and Bauhinia Foundation Research Centre, Hong Kong
| | - M C S Wong
- From the JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, P.R. China, General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 9LX, UK, School of Public Health, Guangzhou Medical University, Guangzhou 510182, P.R. China and Bauhinia Foundation Research Centre, Hong Kong
| | - J J Wang
- From the JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, P.R. China, General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 9LX, UK, School of Public Health, Guangzhou Medical University, Guangzhou 510182, P.R. China and Bauhinia Foundation Research Centre, Hong Kong
| | - X L Wei
- From the JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, P.R. China, General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 9LX, UK, School of Public Health, Guangzhou Medical University, Guangzhou 510182, P.R. China and Bauhinia Foundation Research Centre, Hong Kong
| | - D K T Li
- From the JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, P.R. China, General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 9LX, UK, School of Public Health, Guangzhou Medical University, Guangzhou 510182, P.R. China and Bauhinia Foundation Research Centre, Hong Kong
| | - J L Tang
- From the JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, P.R. China, General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 9LX, UK, School of Public Health, Guangzhou Medical University, Guangzhou 510182, P.R. China and Bauhinia Foundation Research Centre, Hong Kong
| | - S M Griffiths
- From the JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, P.R. China, General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 9LX, UK, School of Public Health, Guangzhou Medical University, Guangzhou 510182, P.R. China and Bauhinia Foundation Research Centre, Hong Kong
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45
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Ng SC, Ching JYL, Chan VCW, Wong MCS, Tang R, Wong S, Luk AKC, Lam TYT, Gao Q, Chan AWH, Wu JCY, Chan FKL, Lau JYW, Sung JJY. Association between serrated polyps and the risk of synchronous advanced colorectal neoplasia in average-risk individuals. Aliment Pharmacol Ther 2015; 41:108-15. [PMID: 25339583 DOI: 10.1111/apt.13003] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 09/12/2014] [Accepted: 10/06/2014] [Indexed: 12/16/2022]
Abstract
BACKGROUND Serrated polyps of the colorectum have distinct histological features and malignant potential. AIM To assess the association between the presence of serrated polyps and synchronous advanced colorectal neoplasia. METHODS Among 4989 asymptomatic Chinese individuals aged 50-70 years who underwent screening colonoscopy, 281 cases with advanced neoplasia (adenoma ≥1 cm, with tubulovillous/villous histology, with high-grade dysplasia, or invasive adenocarcinoma) were compared with 4708 controls without advanced neoplasia for age, sex, smoking history, body mass index, family history of colorectal cancer and the presence of serrated polyps. Independent predictors of advanced neoplasia were determined by multivariate logistic regression analysis. RESULTS The prevalence of advanced neoplasia and serrated polyps (excluding small distal hyperplastic polyps) was 5.7% and 5.6%, respectively. 3.7% and 0.4% subjects had proximal and large (≥10 mm) serrated polyps, respectively. Independent predictors of synchronous advanced colorectal neoplasia were the presence of sessile serrated adenomas (OR: 4.52; 95% CI: 2.40-8.49), proximal serrated polyps (OR: 2.23, 95% CI: 1.38-3.60), large serrated polyps (OR: 59.25; 95% CI: 18.85-186.21), hyperplastic polyps (OR: 1.66; 95% CI: 1.03-2.67), three or more serrated polyps (OR: 4.86; 95% CI: 1.24-19.15) and one or more non-advanced tubular adenomas (OR: 3.58, 95% CI: 2.59-4.96). CONCLUSION Detection of proximal, sessile and/or large serrated polyps at screening colonoscopy is independently associated with an increased risk for synchronous advanced neoplasia.
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Affiliation(s)
- S C Ng
- Department of Medicine and Therapeutics, Institute of Digestive Disease, Li Ka Shing Institute of Health Science, State Key Laboratory of Digestive Diseases, Chinese University of Hong Kong, Shatin, Hong Kong, China
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46
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Wong MCS, Wang HHX, Leung MCM, Tsang CSH, Lo SV, Griffiths SM. The rising prevalence of self-reported hypertension among Chinese subjects: a population-based study from 121 895 household interviews. QJM 2015; 108:9-17. [PMID: 24939188 DOI: 10.1093/qjmed/hcu129] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Hypertension is one of the most important public health issues worldwide. AIM We assessed the prevalence rates of self-reported hypertension in Hong Kong between 2001 and 2008 and evaluated factors associated with its prevalence. DESIGN Serial cross-sectional surveys. METHODS Territory-wide Household surveys in the Hong Kong population in the years 2001, 2002, 2005 and 2008 were included. Population-adjusted prevalence of self-reported hypertension were compared across calendar years. The independent association of these variables with hypertension was evaluated by multivariate regression analysis with self-reported hypertension as a binary outcome. RESULTS There were 121 895 subjects interviewed, among which 103 367 were adults aged ≥15 years. The age- and gender-adjusted prevalence of self-reported hypertension in 2001, 2002, 2005 and 2008 among male adults was 4.73, 6.68, 7.96 and 9.82%, respectively, and among female adults, the prevalence was 6.13, 8.28, 10.00 and 11.58%, respectively. Advanced age (adjusted odds ratios [AOR]: 47.1, 95% CI 33.6-66.0 for the age group 40-65 years; AOR 256.2, 95% CI 182.4-360.0 for the age group 66-100 years; referent 0-39 years), female gender (AOR 0.81, 95% CI 0.74-0.88 for male) and a low median household income (AOR 1.56, 95% CI 1.31-1.85 for income ≤ US$1289; referent ≥ US$6444) were significantly associated with hypertension (all P < 0.001). CONCLUSIONS This is the first study to show differences between socioeconomic groups in this Chinese population with higher rates among women and the less affluent. Similarly, it is the first to show gender differences with higher rates among women.
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Affiliation(s)
- M C S Wong
- From the School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China and Food and Health Bureau, The Government of the Hong Kong Special Administrative Region, Hong Kong, China
| | - H H X Wang
- From the School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China and Food and Health Bureau, The Government of the Hong Kong Special Administrative Region, Hong Kong, China
| | - M C M Leung
- From the School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China and Food and Health Bureau, The Government of the Hong Kong Special Administrative Region, Hong Kong, China
| | - C S H Tsang
- From the School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China and Food and Health Bureau, The Government of the Hong Kong Special Administrative Region, Hong Kong, China
| | - S V Lo
- From the School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China and Food and Health Bureau, The Government of the Hong Kong Special Administrative Region, Hong Kong, China
| | - S M Griffiths
- From the School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China and Food and Health Bureau, The Government of the Hong Kong Special Administrative Region, Hong Kong, China
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Wang F, Zhang L, Zhang Y, Zhang B, He Y, Xie S, Li M, Miao X, Chan EYY, Tang JL, Wong MCS, Li Z, Yu ITS, Tse LA. Meta-analysis on night shift work and risk of metabolic syndrome. Obes Rev 2014; 15:709-20. [PMID: 24888416 DOI: 10.1111/obr.12194] [Citation(s) in RCA: 174] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 04/30/2014] [Accepted: 04/30/2014] [Indexed: 12/30/2022]
Abstract
This study aims to quantitatively summarize the association between night shift work and the risk of metabolic syndrome (MetS), with special reference to the dose-response relationship with years of night shift work. We systematically searched all observational studies published in English on PubMed and Embase from 1971 to 2013. We extracted effect measures (relative risk, RR; or odd ratio, OR) with 95% confidence interval (CI) from individual studies to generate pooled results using meta-analysis approach. Pooled RR was calculated using random- or fixed-effect model. Downs and Black scale was applied to assess the methodological quality of included studies. A total of 13 studies were included. The pooled RR for the association between 'ever exposed to night shift work' and MetS risk was 1.57 (95% CI = 1.24-1.98, pheterogeneity = 0.001), while a higher risk was indicated in workers with longer exposure to night shifts (RR = 1.77, 95% CI = 1.32-2.36, pheterogeneity = 0.936). Further stratification analysis demonstrated a higher pooled effect of 1.84 (95% CI = 1.45-2.34) for studies using the NCEP-ATPIII criteria, among female workers (RR = 1.61, 95% CI = 1.10-2.34) and the countries other than Asia (RR = 1.65, 95% CI = 1.39-1.95). Sensitivity analysis confirmed the robustness of the results. No evidence of publication bias was detected. The present meta-analysis suggested that night shift work is significantly associated with the risk of MetS, and a positive dose-response relationship with duration of exposure was indicated.
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Affiliation(s)
- F Wang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China; CUHK Centre for Public Health and Primary Care (Shenzhen), Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China
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Ng SC, Ching JYL, Chan V, Wong MCS, Suen BY, Hirai HW, Lam TYT, Lau JYW, Ng SSM, Wu JCY, Chan FKL, Sung JJY. Diagnostic accuracy of faecal immunochemical test for screening individuals with a family history of colorectal cancer. Aliment Pharmacol Ther 2013; 38:835-41. [PMID: 23957462 DOI: 10.1111/apt.12446] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 06/13/2013] [Accepted: 07/19/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND The role of a faecal immunochemical test (FIT) in screening individuals with a positive family history of colorectal cancer (CRC) is not clear. AIM To assess the diagnostic accuracy of FIT using colonoscopy findings as the gold standard in identifying colorectal neoplasms. METHODS We analysed data from 4539 asymptomatic subjects aged 50-70 years who had both colonoscopy and FIT (Hemosure; W.H.P.M., Inc, El Monte, CA, USA) at our bowel cancer screening centre between 2008 and 2012. A total of 572 subjects (12.6%) had a family history of CRC. Our primary outcome was the sensitivity of FIT in detecting advanced neoplasms and cancers in subjects with a family history of CRC. A family history of CRC was defined as any first-degree relative with a history of CRC. RESULTS Among 572 subjects with a family history of CRC, adenoma, advanced neoplasm and cancer were found at screening colonoscopy in 29.4%, 6.5% and 0.7% individuals, respectively. The sensitivity of FIT in detecting adenoma, advanced neoplasm and cancer was 9.5% [95% confidence interval (CI), 5.7-15.3], 35.1% (95% CI, 20.7-52.6) and 25.0% (95% CI, 1.3-78.1), respectively. Among FIT-negative subjects who have a family history of CRC, adenoma was found in 152 (29.6%), advanced neoplasm in 24 (4.7%) and cancer in 3 (0.6%) individuals. CONCLUSION Compared with colonoscopy, FIT is more likely to miss advanced neoplasms or cancers in individuals with a family history of CRC.
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Affiliation(s)
- S C Ng
- Institute of Digestive Disease, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
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Liu Y, Pan L, Zhang ZN, Shi ZH, Wang Y, Jing ZC, Lee WY, Chan MC, Cheun TK, So KH, Yu CM, Lee WY, Pang TY, Kong WY, Chan KH, Kwok LM, Chan SW, Ko SSW, Tam CWY, Fok BSP, Hu M, Yin OQP, Chow MSS, Tomlinson B, Guo ZR, Wu M, Zhang LJ, Luo WS, Liu JC, Ding Y, Zhu QR, Chen Q, Chan SSW, Ahmad I, Graham CA, Rainer TH, Berdina ON, Madaeva IM, Dolgikh VV, Xie MX, Li YM, Gao X, Wang GY, Wang AL, Xu T, Tong WJ, Zhang YH, Pogodina AV, Dolgikh VV, Moretzkaya IS, Nawaz SK, Xu JB, Zhang YL, Liu Y, Huang G, Zhang TJ, Huang XB, Ou YLY, Chan SSW, Tse MM, Chan CPY, Graham CA, Rainer TH, Wong MCS, Yan B, Tam WWS, Wang HHX, Liu KSD, Liu KQ, Cheung CSK, Tong ELH, Sek ACH, John GK, Cheung NT, Yu CM, Leeder S, Griffiths S, Wang HHX, Wong MCS, Yan B, Tang JL, Wang JJ, Yu CM, Griffiths S, Wong MCS, Yan B, Tam WWS, Wang HHX, Liu KSD, Liu KQ, Cheung CSK, Tong ELH, Sek ACH, Cheung NT, Yu CM, Leeder S, Griffiths S, Shin SH, Woo SI, Kim DH, Park KS, Kwan J, Liu KQL, Wong MCS, Wang HHX, Liu KSD, Yan B, Yu CM, Griffiths S, Borumand H, Cheang IN, Law TC, Choi SKV, Chung LH, Chan SLD, Li YC, Choy PS, Hung YKS, Cheung YHK, Chan LH, Chan KHK. P077 * Evaluation of two-dimensional strain echocardiography in quantifying right ventricular function in patients with pulmonary hypertension. Eur Heart J Suppl 2012. [DOI: 10.1093/eurheartj/sur028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Lee WY, Tam CS, Yan PY, Lam YY, Duchatelet S, Peat RA, Denjoy I, Itoh H, Berthet M, Crotti L, Ohno S, Pedrazzini M, Klug D, Schwartz PJ, Shimizu W, Horie M, Tregouet DA, Guicheney P, Tiong WN, Hwang SS, Fong AYY, Wee CC, Lai LYH, Tiong LL, Chang BC, Ong TK, Garg P, Ashraffi R, Chuah S, Baho H, Draz S, Mously F, Atta J, Kouatly A, Hussian A, Abu zeid H, Courtney A, Hamilton-Craig C, Strugnell W, Slaughter R, Luis CR, Habibian M, Luis SA, Raffel OC, Tung TH, Hsiung MC, Wei J, Clements IP, Hodge DO, Scott CG, Chai SC, Liew M, Leong G, Peng H, Ding J, Peng Y, Zhang Q, Xu Y, Chao X, Tian H, Zhang Y, Liu Y, Tong WJ, Liu YY, Wang J, Zhang YH, Wong MCS, Yan B, Tam WWS, Wang HHX, Liu KSD, Liu KQ, Cheung CSK, Tong ELH, Sek ACH, Cheung NT, Yu CM, Leeder S, Griffiths S, Poon KKC, Wong HL, Ng SH, Kwok WT, Yeung CL, Yu SY, Wan YP, Wan S, Underwood MJ, Chan PH, Alegria-Barrero E, Price S, Kelleher A, Moat N, Mario CD, Franzen O, Zhang YC, Lee AP, Lin QS, Fang F, Wan S, Underwood M, Yu CM, Mirhoseini SJ, Frouzannia SK, Mostafavi Pour Manshadi SMY, Naderi N, Sayegh S, Dandekar PG, Verma Y. A001 * Barriers of warfarin use for atrial fibrillation patients in Hong Kong. Eur Heart J Suppl 2012. [DOI: 10.1093/eurheartj/sur021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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