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Langley JO, Ng SC, Todd EE, Porter MS. V ˙ La max: determining the optimal test duration for maximal lactate formation rate during all-out sprint cycle ergometry. Eur J Appl Physiol 2024:10.1007/s00421-024-05456-9. [PMID: 38555335 DOI: 10.1007/s00421-024-05456-9] [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] [Received: 11/15/2023] [Accepted: 02/28/2024] [Indexed: 04/02/2024]
Abstract
PURPOSE This study aimed to ascertain the optimal test duration to elicit the highest maximal lactate formation rate ( V ˙ Lamax), whilst exploring the underpinning energetics, and identifying the optimal blood lactate sampling period. METHODS Fifteen trained to well-trained males (age 27 ± 6 years; peak power: 1134 ± 174 W) participated in a randomised cross-over design completing three all-out sprint cycling tests of differing test durations (10, 15, and 30 s). Peak and mean power output (W and W.kg-1), oxygen uptake, and blood lactate concentrations were measured. V ˙ Lamax and energetic contributions (phosphagen, glycolytic, and oxidative) were determined using these parameters. RESULTS The shortest test duration of 10 s elicited a significantly (p = 0.003; p < 0.001) higher V ˙ Lamax (0.86 ± 0.17 mmol.L-1.s-1; 95% CI 0.802-0.974) compared with both 15 s (0.68 ± 0.18 mmol.L-1.s-1; 95% CI 0.596-0.794) and 30 s (0.45 ± 0.07 mmol.L-1.s-1; 95% CI 0.410-0.487). Differences in V ˙ Lamax were associated with large effect sizes (d = 1.07, d = 3.15). We observed 81% of the PCr and 53% of the glycolytic work completed over the 30 s sprint duration was attained after 10 s. BLamaxpost were achieved at 5 ± 2 min (ttest 10 s), 6 ± 2 min (ttest 15 s), and 7 ± 2 min (ttest 30 s), respectively. CONCLUSION Our findings demonstrated a 10 s test duration elicited the highest V ˙ Lamax. Furthermore, the 10 s test duration mitigated the influence of the oxidative metabolism during all-out cycling. The optimal sample time to determine peak blood lactate concentration following 10 s was 5 ± 2 min.
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Affiliation(s)
- J O Langley
- Department of Higher Education Sport, Loughborough College, Radmoor Road, Loughborough, Leicestershire, LE11 3BT, UK.
| | - S C Ng
- Department of Higher Education Sport, Loughborough College, Radmoor Road, Loughborough, Leicestershire, LE11 3BT, UK
| | - E E Todd
- Department of Higher Education Sport, Loughborough College, Radmoor Road, Loughborough, Leicestershire, LE11 3BT, UK
| | - M S Porter
- Department of Higher Education Sport, Loughborough College, Radmoor Road, Loughborough, Leicestershire, LE11 3BT, UK
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Yau YK, Su Q, Xu Z, Tang W, Ching JYL, Cheung CP, Fung M, Ip M, Chan PKS, Chan FKL, Ng SC. Faecal microbiota transplantation for patients with irritable bowel syndrome: abridged secondary publication. Hong Kong Med J 2024; 30 Suppl 1:34-38. [PMID: 38413211] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024] Open
Affiliation(s)
- Y K Yau
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
- Microbiota I-Center (MagIC), Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Q Su
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
- Microbiota I-Center (MagIC), Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Z Xu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
- Microbiota I-Center (MagIC), Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - W Tang
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
- Microbiota I-Center (MagIC), Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - J Y L Ching
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
- Microbiota I-Center (MagIC), Hong Kong SAR, China
| | - C P Cheung
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
- Microbiota I-Center (MagIC), Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - M Fung
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
- Microbiota I-Center (MagIC), Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - M Ip
- Department of Microbiology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - P K S Chan
- Department of Microbiology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - F K L Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
- Microbiota I-Center (MagIC), Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, 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 I-Center (MagIC), Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, 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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Nor Hashimah AMN, Lim AL, Mohd Zain M, Gun SC, Mohd Isa L, Chong HC, Mohamed Ismail A, Wan Mohamad Akbar SA, Ling GR, Ariff HH, Ng CR, Ng SC, Mohd A, Mageswaren E. A retrospective record review of tuberculous infections in rheumatoid arthritis patients on biologics in Malaysia. Med J Malaysia 2023; 78:870-875. [PMID: 38159920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
INTRODUCTION The aim of this study was to analyse the clinical characteristics of patients with rheumatoid arthritis receiving biologics therapy and investigate the association between types of biologics and tuberculosis (TB) infections in 13 tertiary hospitals in Malaysia. MATERIALS AND METHODS This was a retrospective study that included all RA patients receiving biologics therapy in 13 tertiary hospitals in Malaysia from January 2008 to December 2018. RESULTS We had 735 RA patients who received biologics therapy. Twenty-one of the 735 patients were diagnosed with TB infection after treatment with biologics. The calculated prevalence of TB infection in RA patients treated with biologics was 2.9% (29 per 1000 patients). Four groups of biologics were used in our patient cohort: monoclonal TNF inhibitors, etanercept, tocilizumab, and rituximab, with monoclonal TNF inhibitors being the most commonly used biologic. The median duration of biologics therapy before the diagnosis of TB was 8 months. 75% of patients had at least one co-morbidity and all patients had at least one ongoing cDMARD therapy at the time of TB diagnosis. More than half of the patients were on steroid therapy with an average prednisolone dose of 5 mg daily. CONCLUSION Although the study population and data were limited, this study illustrates the spectrum of TB infections in RA patients receiving biologics and potential risk factors associated with biologics therapy in Malaysia.
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Affiliation(s)
- A M N Nor Hashimah
- Hospital Pulau Pinang, Department of Medicine, Rheumatology Unit, Pulau Pinang, Malaysia.
| | - A L Lim
- Hospital Pulau Pinang, Department of Medicine, Rheumatology Unit, Pulau Pinang, Malaysia
| | - M Mohd Zain
- Hospital Selayang, Department of Medicine, Rheumatology Unit, Selangor, Malaysia
| | - S C Gun
- Hospital Seremban, Department of Medicine, Rheumatology Unit, Negeri Sembilan Malaysia
| | - L Mohd Isa
- Hospital Putrajaya, Department of Medicine, Rheumatology Unit, Putrajaya, Malaysia
| | - H C Chong
- Hospital Melaka, Department of Medicine, Rheumatology Unit, Melaka, Malaysia
| | - A Mohamed Ismail
- Hospital Raja Perempuan Zainab II, Department of Medicine, Rheumatology Unit, Kelantan, Malaysia
| | | | - G R Ling
- Hospital Sibu, Department of Medicine, Rheumatology Unit, Sarawak, Malaysia
| | - H H Ariff
- Hospital Queen Elizabeth, Department of Medicine, Rheumatology Unit, Sabah, Malaysia
| | - C R Ng
- Hospital Sultan Ismail, Department of Medicine, Rheumatology Unit, Johor, Malaysia
| | - S C Ng
- Hospital Sultanah Bahiyah, Department of Medicine, Rheumatology Unit, Kedah, Malaysia
| | - A Mohd
- Hospital Pakar Sultanah Fatimah, Department of Medicine, Rheumatology Unit, Johor, Malaysia
| | - E Mageswaren
- Hospital Tengku Ampuan Rahimah, Department of Medicine, Rheumatology Unit, Klang, Malaysia
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Ng SC, Chu AWH, Chan WM, Yip CCY, Leung KH, So CK, Leung JNS, To KKW, Lee CK. Re-examine the transfusion transmitted risk of SARS-CoV-2 virus during a major COVID-19 outbreak in 2022. Transfus Med 2023. [PMID: 37286528 DOI: 10.1111/tme.12981] [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] [Received: 11/22/2022] [Revised: 03/16/2023] [Accepted: 05/23/2023] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Although no case of COVID-19 transmission through transfusion has been reported, blood transfusion service (BTS) continues to implement pre-donation and post-donation measures to minimise the risk. In year 2022, when local healthcare system was badly impacted by a major outbreak, it opened an opportunity to re-examine the viraemia risk in these asymptomatic donors. MATERIALS AND METHODS Records were retrieved from blood donors who reported COVID-19 after donation and follow-up was also made for recipients who received their blood. Blood samples at donation were tested for SARS-CoV-2 viraemia by single-tube nested real-time RT-PCR assay designed to detect most SARS-CoV-2 variants including the prevailing delta and omicron variants. RESULTS From 1 January to 15 August 2022, the city with 7.4 M inhabitants recorded 1 187 844 COVID-19 positive cases and 125 936 successful blood donations were received. 781 donors reported to the BTS after donation with 701 being COVID-19 related (including close contact and symptoms respiratory tract infection). 525 COVID-19 were positive at the time of call back or follow-up. Of the 701 donations, they were processed into 1480 components with 1073 discarded upon donors' call back. For remaining 407 components, no recipient was found to have adverse event or COVID-19 positive. 510 samples from the above 525 COVID-19 positive donors were available and all tested negative for SARS-CoV-2 RNA. DISCUSSION With the negative SARS-CoV-2 RNA in blood donation samples and follow up data in transfusion recipients, the risk of transfusion transmitted COVID-19 appears negligible. However, current measures remains important in securing blood safety with ongoing surveillance of their effectiveness.
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Affiliation(s)
- S C Ng
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong, China
| | - A W H Chu
- State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - W M Chan
- State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - C C Y Yip
- State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - K H Leung
- State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - C K So
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong, China
| | - J N S Leung
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong, China
| | - K K W To
- State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - C K Lee
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong, China
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Teh JJ, Berendsen EM, Hoedt EC, Kang S, Zhang J, Zhang F, Liu Q, Hamilton AL, Wilson-O’Brien A, Ching J, Sung JJY, Yu J, Ng SC, Kamm MA, Morrison M. Novel strain-level resolution of Crohn's disease mucosa-associated microbiota via an ex vivo combination of microbe culture and metagenomic sequencing. ISME J 2021; 15:3326-3338. [PMID: 34035441 PMCID: PMC8528831 DOI: 10.1038/s41396-021-00991-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 04/07/2021] [Accepted: 04/15/2021] [Indexed: 02/03/2023]
Abstract
The mucosa-associated microbiota is widely recognized as a potential trigger for Crohn's disease pathophysiology but remains largely uncharacterised beyond its taxonomic composition. Unlike stool microbiota, the functional characterisation of these communities using current DNA/RNA sequencing approaches remains constrained by the relatively small microbial density on tissue, and the overwhelming amount of human DNA recovered during sample preparation. Here, we have used a novel ex vivo approach that combines microbe culture from anaerobically preserved tissue with metagenome sequencing (MC-MGS) to reveal patient-specific and strain-level differences among these communities in post-operative Crohn's disease patients. The 16 S rRNA gene amplicon profiles showed these cultures provide a representative and holistic representation of the mucosa-associated microbiota, and MC-MGS produced both high quality metagenome-assembled genomes of recovered novel bacterial lineages. The MC-MGS approach also produced a strain-level resolution of key Enterobacteriacea and their associated virulence factors and revealed that urease activity underpins a key and diverse metabolic guild in these communities, which was confirmed by culture-based studies with axenic cultures. Collectively, these findings using MC-MGS show that the Crohn's disease mucosa-associated microbiota possesses taxonomic and functional attributes that are highly individualistic, borne at least in part by novel bacterial lineages not readily isolated or characterised from stool samples using current sequencing approaches.
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Affiliation(s)
- J. J. Teh
- grid.1003.20000 0000 9320 7537The University of Queensland Diamantina Institute, Faculty of Medicine, University of Queensland, Woolloongabba, QLD Australia
| | - E. M. Berendsen
- grid.1003.20000 0000 9320 7537The University of Queensland Diamantina Institute, Faculty of Medicine, University of Queensland, Woolloongabba, QLD Australia ,Present Address: Wacker Biotech B.V., Amsterdam, The Netherlands
| | - E. C. Hoedt
- grid.1003.20000 0000 9320 7537The University of Queensland Diamantina Institute, Faculty of Medicine, University of Queensland, Woolloongabba, QLD Australia ,grid.413648.cPresent Address: NHMRC Centre of Research Excellence (CRE) in Digestive Health, Hunter Medical Research Institute (HMRI), Newcastle, NSW Australia
| | - S. Kang
- grid.1003.20000 0000 9320 7537The University of Queensland Diamantina Institute, Faculty of Medicine, University of Queensland, Woolloongabba, QLD Australia
| | - J. Zhang
- grid.10784.3a0000 0004 1937 0482Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Diseases, Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong, China
| | - F. Zhang
- grid.10784.3a0000 0004 1937 0482Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Diseases, Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong, China
| | - Q. Liu
- grid.10784.3a0000 0004 1937 0482Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Diseases, Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong, China
| | - A. L. Hamilton
- grid.413105.20000 0000 8606 2560Department of Gastroenterology, St Vincent’s Hospital, Melbourne, VIC Australia ,grid.1008.90000 0001 2179 088XDepartment of Medicine, The University of Melbourne, Melbourne, VIC Australia
| | - A. Wilson-O’Brien
- grid.413105.20000 0000 8606 2560Department of Gastroenterology, St Vincent’s Hospital, Melbourne, VIC Australia ,grid.1008.90000 0001 2179 088XDepartment of Medicine, The University of Melbourne, Melbourne, VIC Australia
| | - J. Ching
- grid.10784.3a0000 0004 1937 0482Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Diseases, Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong, China
| | - J. J. Y. Sung
- grid.10784.3a0000 0004 1937 0482Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Diseases, Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong, China ,grid.59025.3b0000 0001 2224 0361Present Address: Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - J. Yu
- grid.10784.3a0000 0004 1937 0482Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Diseases, Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong, China ,grid.10784.3a0000 0004 1937 0482Center for Gut Microbiota Research, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - S. C. Ng
- grid.10784.3a0000 0004 1937 0482Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Diseases, Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong, China ,grid.10784.3a0000 0004 1937 0482Center for Gut Microbiota Research, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - M. A. Kamm
- grid.413105.20000 0000 8606 2560Department of Gastroenterology, St Vincent’s Hospital, Melbourne, VIC Australia ,grid.1008.90000 0001 2179 088XDepartment of Medicine, The University of Melbourne, Melbourne, VIC Australia
| | - M. Morrison
- grid.1003.20000 0000 9320 7537The University of Queensland Diamantina Institute, Faculty of Medicine, University of Queensland, Woolloongabba, QLD Australia
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Yu PT, Ho S, Ng SC, Lo FM, Luk HM. Isolated hereditary diffuse palmoplantar keratoderma in Hong Kong Chinese patients: a case series. Hong Kong Med J 2021; 27:358-361. [PMID: 34706987 DOI: 10.12809/hkmj208902] [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: 11/05/2022] Open
Affiliation(s)
- P T Yu
- Clinical Genetic Service, Department of Health, Hong Kong
| | - S Ho
- Clinical Genetic Service, Department of Health, Hong Kong
| | - S C Ng
- Social Hygiene Clinic, Department of Health, Hong Kong
| | - F M Lo
- Clinical Genetic Service, Department of Health, Hong Kong
| | - H M Luk
- Clinical Genetic Service, Department of Health, Hong Kong
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Kuenzig E, Fung SG, Marderfeld L, Mak JW, Kaplan GG, Ng SC, Wilson DC, Cameron FL, Henderson P, Kotze PG, Benchimol EI. A25 THE RISING GLOBAL INCIDENCE OF PEDIATRIC INFLAMMATORY BOWEL DISEASE: A SYSTEMATIC REVIEW OF POPULATION-BASED STUDIES. J Can Assoc Gastroenterol 2021. [DOI: 10.1093/jcag/gwab002.024] [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
The incidence of inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), is increasing internationally, particularly in developing nations where rates were historically low. Previous reports of the incidence and prevalence of pediatric-onset IBD have identified a paucity of population-based studies.
Aims
We reviewed the global trends in incidence of pediatric IBD using evidence from population-based studies.
Methods
(PROSPERO CRD42019125193) We systematically reviewed studies indexed in MEDLINE, EMBASE, Airiti Library, and SciELO from 01/2010-02/2020 to identify population-based studies reporting the incidence of pediatric-onset IBD, CD, and UC. Included studies combined childhood and adolescent-onset IBD (onset <21y). Changes in incidence since 2000 were plotted by continent, with data from 2000–09 provided by our previous systematic review1. To depict trends, multiple times points reported in single studies were connected on graphs. When incidence was reported as an aggregated estimate over a range of years, data was plotted using the midpoint of the interval.
Results
Of 8096 abstracts screened, 74 studies described the incidence of IBD, CD, or UC in 33 countries (Figure panel A). The incidence of pediatric-onset IBD is highest in Northern Europe and North America, and lowest in Southern Europe, Asia, and the Middle East. This geographical distribution is similar in UC, while incidence of pediatric-onset CD is highest in North America and Northern Europe, followed by Australia. Trends in incidence over time, stratified by continent, are reported in Figure, panel B. Significantly increasing incidence of IBD, CD, and/or UC was reported in China, Bahrain, Canada, New Zealand, Australia, Singapore, Saudi Arabia, and most European countries. Very Early Onset (VEO) IBD significantly increased in Canada, however Saudi Arabia reported decreasing incidence of VEO-CD but stable incidence of VEO-UC.
Conclusions
Conclusion: Incidence of pediatric-onset IBD are highest in Northern Europe and North American and are increasing globally. There remains a paucity of studies from many parts of the world on the incidence pediatric IBD. Further research is needed to understand the pathogenesis of the rising incidence of pediatric IBD, including work to understand the genetic, environmental, immunological and microbiome alterations leading to the increasing rates in children.
References: 1Benchimol, Fortinsky et al. Inflamm Bowel Dis 2011;17:423–39.
Funding Agencies
None
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Affiliation(s)
- E Kuenzig
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - S G Fung
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - L Marderfeld
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - J W Mak
- Chinese University of Hong Kong, Shatin, Hong Kong
| | - G G Kaplan
- University of Calgary Cumming School of Medicine, Calgary, AB, Canada
| | - S C Ng
- Chinese University of Hong Kong, Shatin, Hong Kong
| | - D C Wilson
- University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - F L Cameron
- Alder Hey Children’s Hospital, Liverpool, Merseyside, United Kingdom
| | - P Henderson
- University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - P G Kotze
- Pontifícia Universidade Católica do Paraná (PUC-PR), Curitiba, Brazil
| | - E I Benchimol
- SickKids IBD Centre, The Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto, ON, Canada
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Keah SH, Ng SC. Basal Cell Carcinoma Surgery in general practice: Is there a role for the local General Practitioner? Malays Fam Physician 2020; 15:10-21. [PMID: 33329859 PMCID: PMC7735882] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
UNLABELLED Basal cell carcinoma (BCC) is a common disease of the skin caused principally by prolonged solar radiation exposure. It is normally a malignancy with favorable prognostic features and is potentially curable by standard excision. In White populations with high disease incidence, general practitioners (GPs) play a vital role in diagnosing and managing BCC, including surgical excision. Dedicated care at the primary care level by adequately trained GPs is conceivably cost effective for the health system and more convenient for the patient. In Asia and other parts of the world with low incidence, this valuable role of GPs may appear to be inconsequential. In this regard, any justification for the involvement of local GPs in BCC surgery is debatable. This article aims to provide a clinical update on essential information relevant to BCC surgery and advance understanding of the intricate issues of making a treatment decision at the primary care level. CASE REPORT Madam Tan, a 71-year-old Malaysian Chinese lady, otherwise healthy, presented to her local GP with a complaint of a nodule over the left cheek that had been there for more than a decade. Her concern was that the lesion was growing and had become conspicuous. She had spent most of her life as a farmer working in her orchard.Upon examination, she had an obvious dome-shaped nodule over the left cheek measuring approximately 1.8 cm in diameter. The lesion was firm, pigmented, well-demarcated, and slightly ulcerated at the top. Clinically, she was diagnosed with a pigmented nodular basal cell carcinoma of the left cheek. Examination of the systems was unremarkable.She requested that the consulting GP remove the growth. The cost for specialist treatment and waiting time at the local hospital were her concerns. CLINICAL QUESTIONS Can the basal cell skin cancer be excised safely and effectively in the local primary care setting? What are the crucial preoperative concerns?
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Affiliation(s)
- S H Keah
- MBBS(S'pore), FRACGP, FAFPM, Elizabeth Medical Centre Muar, 1-14, Jalan Arab 84000 Muar, Johore, Malaysia,
| | - S C Ng
- MBBS, MRCS (Edinburgh), GCFM, Elizabeth Medical Centre Muar, 1-14, Jalan Arab 84000 Muar, Johore, Malaysia
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10
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Ng SC, Wong HK, So CK, Lau CW, Leung JNS, Tsoi WC, Lee CK. Streptococcus bovis bacteraemia should be investigated for early detection of colorectal pathology. Hong Kong Med J 2019; 25:414. [PMID: 31761757 DOI: 10.12809/hkmj198135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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)
- S C Ng
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong
| | - H K Wong
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong
| | - C K So
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong
| | - C W Lau
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong
| | - J N S Leung
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong
| | - W C Tsoi
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong
| | - C K Lee
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong
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11
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Lui RN, Wong SH, Lau LHS, Chan TT, Cheung KCY, Li A, Chin ML, Tang W, Ching JYL, Lam KLY, Chan PKS, Wu JCY, Sung JJY, Chan FKL, Ng SC. Faecal microbiota transplantation for treatment of recurrent or refractory Clostridioides difficile infection in Hong Kong. Hong Kong Med J 2019; 25:178-182. [PMID: 31178437 DOI: 10.12809/hkmj197855] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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 Clostridioides difficile infection (CDI) is a leading cause of healthcare-associated infection globally, causing significant morbidity and mortality. Faecal microbiota transplantation (FMT) has emerged as a promising option for recurrent and refractory CDI. This study aimed to assess the safety, efficacy, and feasibility of FMT for CDI in Hong Kong. METHODS We conducted a single-centre, retrospective study for all consecutive cases of recurrent or refractory CDI who underwent FMT from 2013 to 2018. Clinical demographics, outcome, and safety parameters were collected. RESULTS A total of 24 patients with recurrent or refractory CDI (median age 70 years, interquartile range=45.0-78.3 years; 67% male) were included. Over 80% had been recently hospitalised or were long-term care facility residents. Faecal microbiota transplantation was delivered by feeding tube in 11 (45.8%), oesophagogastroduodenoscopy in eight (33.3%), and colonoscopy in six (25%) of the patients. Resolution of diarrhoea without relapse within 8 weeks was achieved in 21 out of 24 patients (87.5%) after FMT. No deaths occurred within 30 days. The FMT was well tolerated and no serious adverse events attributable to FMT were reported. CONCLUSION Our results confirm that FMT is a safe, efficacious, and feasible intervention for patients with refractory or recurrent CDI in Hong Kong. Given the increasing disease burden and the lack of effective alternatives in Hong Kong for difficult-to-treat cases of CDI, we recommend that a territory-wide FMT service be established to address increasing demand for this treatment.
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Affiliation(s)
- R N Lui
- Division of Gastroenterology and Hepatology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, Hong Kong
| | - S H Wong
- Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong.,Centre for Gut Microbiota Research, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - L H S Lau
- Division of Gastroenterology and Hepatology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, Hong Kong
| | - T T Chan
- Division of Gastroenterology and Hepatology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, Hong Kong
| | - K C Y Cheung
- Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - A Li
- Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - M L Chin
- Department of Microbiology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - W Tang
- Institute 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
| | - K L Y Lam
- Division of Gastroenterology and Hepatology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, Hong Kong
| | - P K S Chan
- Centre for Gut Microbiota Research, The Chinese University of Hong Kong, Shatin, Hong Kong.,Department of Microbiology, 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
| | - J J Y Sung
- Institute 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.,Centre for Gut Microbiota Research, 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.,Centre for Gut Microbiota Research, The Chinese University of Hong Kong, Shatin, Hong Kong
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12
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O'Flaherty D, McCartney CJL, Ng SC. Nerve injury after peripheral nerve blockade-current understanding and guidelines. BJA Educ 2018; 18:384-390. [PMID: 33456806 DOI: 10.1016/j.bjae.2018.09.004] [Citation(s) in RCA: 2] [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] [Accepted: 09/21/2018] [Indexed: 10/28/2022] Open
Affiliation(s)
- D O'Flaherty
- University College London Hospitals NHS Foundation Trust, London, UK
| | - C J L McCartney
- The Ottawa Hospital, Ottawa, ON, Canada.,University of Ottawa, Ottawa, ON, Canada
| | - S C Ng
- University College London Hospitals NHS Foundation Trust, London, UK
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13
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Mak WY, Ng SC. Editorial: ways to reduce emergency department utilisation among IBD patients. Aliment Pharmacol Ther 2018; 47:1325-1326. [PMID: 29644742 DOI: 10.1111/apt.14601] [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: 12/08/2022]
Affiliation(s)
- W Y Mak
- State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, LKS Institute of Health Science, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - S C Ng
- State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, LKS Institute of Health Science, The Chinese University of Hong Kong, Shatin, Hong Kong
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14
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Wong NS, Lee CK, Ng SC, Wong HK, Chan DPC, Lee SS. Prevalence of hepatitis C infection and its associated factors in healthy adults without identifiable route of transmission. J Viral Hepat 2018; 25:161-170. [PMID: 29032634 DOI: 10.1111/jvh.12804] [Citation(s) in RCA: 6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 09/01/2017] [Indexed: 12/20/2022]
Abstract
While hepatitis C virus (HCV) infection is long known to be associated with parenteral exposure, the specific route of transmission is not identified in a proportion of infected patients. Taking blood donors as the surrogate of healthy adults in the community in Hong Kong, we identified 91 HCV-infected donors (≤0.02% positive rate) in 2014-2016, of whom 46 were recruited in a mixed-method study to examine their transmission routes. A majority (75%) of the recruited donors were HCV RNA positive, with the predominant subtypes being 1b and 6a. From the results of the structured self-administered questionnaire and in-depth interviews, only 14 (30%) recruited donors could be traced to past history of contaminated blood transfusion (n = 9) or injection drug use (n = 5). Case-control analyses with 3 different control groups were performed to examine factors associated with HCV infection in multivariable analyses. High-risk sexual behaviour, body piercing, intramuscular injection and vaccine inoculation abroad, having lived abroad for >3 months were significantly associated with HCV in donors with otherwise nonidentifiable source of infection. While the specific route of transmission cannot be established for each person, associations with multiple parenteral exposures outside Hong Kong were observed. The World Health Organization has advocated for the global elimination of HCV by 2030. With a high proportion of HCV-infected persons who are unaware of their infections, HCV elimination could be hard to achieve.
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Affiliation(s)
- N S Wong
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - C K Lee
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong, China
| | - S C Ng
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong, China
| | - H K Wong
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong, China
| | - D P C Chan
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, China
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15
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Lung PFC, Ng SC. Editorial: challenges in the development of a magnetic resonance imaging index for fistulising Crohn's disease. Aliment Pharmacol Ther 2017; 46:696. [PMID: 28880442 DOI: 10.1111/apt.14235] [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: 12/08/2022]
Affiliation(s)
- P F C Lung
- Department of Radiology, St Mark's Hospital, Middlesex, Harrow, UK
| | - S C Ng
- Department of Medicine and Therapeutics, Institute of Digestive Disease, Chinese University of Hong Kong, Shatin, Hong Kong
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16
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Ng SC, Abu Samah F, Helmy K, Sia KK. Comparison between FEV 1/FEV 6 and FEV 1/FVC as screening of chronic obstructive pulmonary disease. Med J Malaysia 2017; 72:286-290. [PMID: 29197884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To compare FEV1/FEV6 to the standard spirometry (FEV1/FVC) as a screening tool for COPD. METHODS This cross-sectional study was conducted at Hospital Tuanku Fauziah, Perlis, Malaysia from August 2015 to April 2016. FEV1/FEV6 and FEV1/FVC results of 117 subjects were analysed. Demographic data and spirometric variables were tabulated. A scatter plot graph with Spearman's correlation was constructed for the correlation between FEV1/FEV6 and FEV1/FVC. The sensitivity, specificity, positive and negative predictive values of FEV1/FEV6 were determined with reference to the gold standard of FEV1/FVC ratio <0.70. Receiver-operator characteristic (ROC) curve analysis and Kappa statistics were used to determine the FEV1/FEV6 ratio in predicting an FEV1/FVC ratio <0.70. RESULTS Spearman's correlation with r = 0.636 (P<0.001) was demonstrated. The area under the ROC curve was 0.862 (95% confidence interval [CI]: 0.779 - 0.944, P<0.001). The FEV1/FEV6 cut-off with the greatest sum of sensitivity and specificity was 0.75. FEV1/FEV6 sensitivity, specificity, positive and negative predictive values were 93.02%, 67.74%, 88.89% and 77.78% respectively. There was substantial agreement between the two diagnostic cut-offs (κ = 0.634; 95% CI: 0.471 - 0.797, P<0.001) CONCLUSIONS: The FEV1/FEV6 ratio can be considered to be a good alternative to the FEV1/FVC ratio for screening of COPD. Larger multicentre study and better education on spirometric techniques can validate similar study outcome and establish reference values appropriate to the population being studied.
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Affiliation(s)
- S C Ng
- Hospital Tuanku Fauziah, Medical Department, Jalan Kolam, Kangar, Perlis Indera Kayangan, Malaysia.
| | - F Abu Samah
- Hospital Tuanku Fauziah, Medical Department, Jalan Kolam, Kangar, Perlis Indera Kayangan, Malaysia
| | - K Helmy
- Hospital Tuanku Fauziah, Medical Department, Jalan Kolam, Kangar, Perlis Indera Kayangan, Malaysia
| | - K K Sia
- Hospital Tuanku Fauziah, Medical Department, Jalan Kolam, Kangar, Perlis Indera Kayangan, Malaysia
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17
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Patel K, Rajendran A, Faiz O, Rutter MD, Rutter C, Jover R, Koutroubakis I, Januszewicz W, Ferlitsch M, Dekker E, MacIntosh D, Ng SC, Kitiyakara T, Pohl H, Thomas-Gibson S. An international survey of polypectomy training and assessment. Endosc Int Open 2017; 5:E190-E197. [PMID: 28299354 PMCID: PMC5348296 DOI: 10.1055/s-0042-119949] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background and study aims Colonic polypectomy is acknowledged to be a technically challenging part of colonoscopy. Training in polypectomy is recognized to be often inconsistent. This study aimed to ascertain worldwide practice in polypectomy training. Patients and methods An electronic survey was distributed to endoscopic trainees and trainers in 19 countries asking about their experiences of receiving and delivering training. Participants were also asked about whether formal polypectomy training guidance existed in their country. Results Data were obtained from 610 colonoscopists. Of these responses, 348 (57.0 %) were from trainers and 262 (43.0 %) from trainees; 6.6 % of trainers assessed competency once per year or less often. Just over half (53.1 %) of trainees had ever had their polypectomy technique formally assessed by any trainer. Approximately half the trainees surveyed (51.1 %) stated that the principles of polypectomy had only ever been taught to them intermittently. Of those trainees with the most colonoscopy experience, who had performed over 500 procedures, 48.2 % had had training on removing large polyps of over 10 mm; 46.2 % (121 respondents) of trainees surveyed held no record of the polypectomies they had performed. Only four of the 19 countries surveyed had specific guidelines on polypectomy training. Conclusions A significant number of competent colonoscopists have never been taught how to perform polypectomy. Training guidelines worldwide generally give little direction as to how trainees should acquire polypectomy skills. The learning curve for polypectomy needs to be defined to provide reliable guidance on how to train colonoscopists in this skill.
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Affiliation(s)
- K. Patel
- Wolfson Unit for Endoscopy, St Mark’s Hospital, London, UK,Imperial College, London, UK,Corresponding author Kinesh Patel St Mark’s Hospital – Wolfson Unit for EndoscopyWatford RoadLondon HA1 3UJUK+44-20-30041010
| | - A. Rajendran
- Wolfson Unit for Endoscopy, St Mark’s Hospital, London, UK,King’s College London, London, UK
| | - O. Faiz
- Wolfson Unit for Endoscopy, St Mark’s Hospital, London, UK,Imperial College, London, UK
| | - M. D. Rutter
- North Tees & Hartlepool NHS Foundation Trust, Stockton-on-Tees, UK,Durham University, Durham, Co. Durham, UK
| | - C. Rutter
- British Society of Gastroenterology, UK
| | - R. Jover
- Hospital General Universitario de Alicante, Alicante, Spain
| | | | - W. Januszewicz
- The Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland,Department of Gastroenterology and Hepatology, Medical Center for Postgraduate Education, Warsaw, Poland
| | | | - E. Dekker
- Academic Medical Center, Amsterdam, Netherlands
| | - D. MacIntosh
- Dalhousie University, Halifax, Nova Scotia, Canada
| | - S. C. Ng
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China
| | - T. Kitiyakara
- Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - H. Pohl
- Geisel School of Medicine, Dartmouth, Hanover, NH, USA
| | - S. Thomas-Gibson
- Wolfson Unit for Endoscopy, St Mark’s Hospital, London, UK,Imperial College, London, UK
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18
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Ng SC, Mythen MG. Perioperative medicine and the role of hemodynamic monitoring. ACTA ACUST UNITED AC 2016; 64:301-305. [PMID: 27938936 DOI: 10.1016/j.redar.2016.09.009] [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] [Received: 09/16/2016] [Accepted: 09/19/2016] [Indexed: 11/26/2022]
Affiliation(s)
- S C Ng
- Anaesthesia Department, University College London, Londres, Reino Unido.
| | - M G Mythen
- Anaesthesia and Critical Care, University College London, Londres, Reino Unido
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19
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Nizam AA, Ng SC, Kelleher M, Hayes N, Carton E. Knowledge, Skills and Experience Managing Tracheostomy Emergencies: A Survey of Critical Care Medicine trainees >. Ir Med J 2016; 109:471. [PMID: 28125185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Since the development of percutaneous tracheostomy, the number of tracheostomy patients on hospital wards has increased. Problems associated with adequate tracheostomy care on the wards are well documented, particularly the management of tracheostomy-related emergencies. A survey was conducted among non-consultant hospital doctors (NCHDs) starting their Critical Care Medicine training rotation in a university affiliated teaching hospital to determine their basic knowledge and skills in dealing with tracheostomy emergencies. Trainees who had received specific tracheostomy training or who had previous experience of dealing with tracheostomy emergencies were more confident in dealing with such emergencies compared to trainees without such training or experience. Only a minority of trainees were aware of local hospital guidelines regarding tracheostomy care. Our results highlight the importance of increased awareness of tracheostomy emergencies and the importance of specific training for Anaesthesia and Critical Care Medicine trainees.
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Affiliation(s)
- A A Nizam
- Department of Critical Care Medicine, Mater Misericordiae University Hospital, Eccles St, Dublin 7
| | - S C Ng
- Department of Critical Care Medicine, Mater Misericordiae University Hospital, Eccles St, Dublin 7
| | - M Kelleher
- Department of Critical Care Medicine, Mater Misericordiae University Hospital, Eccles St, Dublin 7
| | - N Hayes
- Department of Critical Care Medicine, Mater Misericordiae University Hospital, Eccles St, Dublin 7
| | - E Carton
- Department of Critical Care Medicine, Mater Misericordiae University Hospital, Eccles St, Dublin 7
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20
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Santosa A, Tan CS, Teng GG, Fong W, Lim A, Law WG, Chan G, Ng SC, Low AHL. Lung and gastrointestinal complications are leading causes of death in SCORE, a multi-ethnic Singapore systemic sclerosis cohort. Scand J Rheumatol 2016; 45:499-506. [DOI: 10.3109/03009742.2016.1153141] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- A Santosa
- Division of Rheumatology, University Medicine Cluster, National University Health System, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - CS Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - GG Teng
- Division of Rheumatology, University Medicine Cluster, National University Health System, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - W Fong
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
| | - A Lim
- Division of Rheumatology, University Medicine Cluster, National University Health System, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - WG Law
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore
| | - G Chan
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore
| | - SC Ng
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Duke-National University of Singapore, Graduate Medical School, Singapore, Singapore
| | - AHL Low
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Duke-National University of Singapore, Graduate Medical School, Singapore, Singapore
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21
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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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22
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Di K, Feng SX, Piramanayagam SN, Zhang VL, Lim HS, Ng SC, Kuok MH. Enhancement of spin-wave nonreciprocity in magnonic crystals via synthetic antiferromagnetic coupling. Sci Rep 2015; 5:10153. [PMID: 25950082 PMCID: PMC4423564 DOI: 10.1038/srep10153] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 03/31/2015] [Indexed: 11/29/2022] Open
Abstract
Spin-wave nonreciprocity arising from dipole-dipole interaction is insignificant for magnon wavelengths in the sub-100 nm range. Our micromagnetic simulations reveal that for the nanoscale magnonic crystals studied, such nonreciprocity can be greatly enhanced via synthetic antiferromagnetic coupling. The nonreciprocity is manifested as highly asymmetric magnon dispersion curves of the magnonic crystals. Furthermore, based on the study of the dependence of the nonreciprocity on an applied magnetic field, the antiparallel alignment of the magnetizations is shown to be responsible for the enhancement. Our findings would be useful for magnonic and spintronics applications.
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Affiliation(s)
- K. Di
- Department of Physics, National University of Singapore, Singapore 117551
| | - S. X. Feng
- Department of Physics, National University of Singapore, Singapore 117551
| | - S. N. Piramanayagam
- School of Physical and Mathematical Sciences, Nanyang Technological University, Singapore 637371
| | - V. L. Zhang
- Department of Physics, National University of Singapore, Singapore 117551
| | - H. S. Lim
- Department of Physics, National University of Singapore, Singapore 117551
| | - S. C. Ng
- Department of Physics, National University of Singapore, Singapore 117551
| | - M. H. Kuok
- Department of Physics, National University of Singapore, Singapore 117551
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23
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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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Sung JJY, Ng SC, Chan FKL, Chiu HM, Kim HS, Matsuda T, Ng SSM, Lau JYW, Zheng S, Adler S, Reddy N, Yeoh KG, Tsoi KKF, Ching JYL, Kuipers EJ, Rabeneck L, Young GP, Steele RJ, Lieberman D, Goh KL. An updated Asia Pacific Consensus Recommendations on colorectal cancer screening. Gut 2015; 64:121-32. [PMID: 24647008 DOI: 10.1136/gutjnl-2013-306503] [Citation(s) in RCA: 302] [Impact Index Per Article: 33.6] [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] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Since the publication of the first Asia Pacific Consensus on Colorectal Cancer (CRC) in 2008, there are substantial advancements in the science and experience of implementing CRC screening. The Asia Pacific Working Group aimed to provide an updated set of consensus recommendations. DESIGN Members from 14 Asian regions gathered to seek consensus using other national and international guidelines, and recent relevant literature published from 2008 to 2013. A modified Delphi process was adopted to develop the statements. RESULTS Age range for CRC screening is defined as 50-75 years. Advancing age, male, family history of CRC, smoking and obesity are confirmed risk factors for CRC and advanced neoplasia. A risk-stratified scoring system is recommended for selecting high-risk patients for colonoscopy. Quantitative faecal immunochemical test (FIT) instead of guaiac-based faecal occult blood test (gFOBT) is preferred for average-risk subjects. Ancillary methods in colonoscopy, with the exception of chromoendoscopy, have not proven to be superior to high-definition white light endoscopy in identifying adenoma. Quality of colonoscopy should be upheld and quality assurance programme should be in place to audit every aspects of CRC screening. Serrated adenoma is recognised as a risk for interval cancer. There is no consensus on the recruitment of trained endoscopy nurses for CRC screening. CONCLUSIONS Based on recent data on CRC screening, an updated list of recommendations on CRC screening is prepared. These consensus statements will further enhance the implementation of CRC screening in the Asia Pacific region.
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Affiliation(s)
- J J Y Sung
- Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, NT, Hong Kong
| | - S C Ng
- Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, NT, Hong Kong Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - F K L Chan
- Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, NT, Hong Kong Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - H M Chiu
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - H S Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - T Matsuda
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - S S M Ng
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - J Y W Lau
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - S Zheng
- Cancer Institute, Zhejiang University, Hanggzhou, Zhejiang, China
| | - S Adler
- Division of Gastroenterology, Bikur Holim Hospital, Jerusalem, Israel
| | - N Reddy
- Asian Healthcare Foundation, Asian Institute of Gastroenterology, Hyderabad, Andhra Pradesh, India
| | - K G Yeoh
- Department of Medicine, Asian Healthcare Foundation, National University of Singapore and Senior Consultant Gastroenterologist, Singapore
| | - K K F Tsoi
- School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - J Y L Ching
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - E J Kuipers
- Department of Medicine & Therapeutics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - L Rabeneck
- Institute of Clinical Evaluative Sciences, University of Toronto, Ontario, Canada
| | - G P Young
- Department of Gastroenterology, Flinders Medical Centre, Adelaide, South Australia, Australia
| | - R J Steele
- Department of Surgery and Molecular Oncology, University of Dundee, Dundee, UK
| | - D Lieberman
- Portland VA Medical Centre, Portland, Oregon, USA
| | - K L Goh
- Department of Gastroenterology and Hepatology, University of Malaya, Kuala Lumpur, Malaysia
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Di K, Lim HS, Zhang VL, Kuok MH, Ng SC, Cottam MG, Nguyen HT. Comment on "Physical origin and generic control of magnonic band gaps of dipole-exchange spin waves in width-modulated nanostrip waveguides". Phys Rev Lett 2013; 111:149701. [PMID: 24138279 DOI: 10.1103/physrevlett.111.149701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Indexed: 06/02/2023]
Affiliation(s)
- K Di
- Department of Physics, National University of Singapore, Singapore 117542
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Ng SC, Lam YT, Tsoi KKF, Chan FKL, Sung JJY, Wu JCY. Systematic review: the efficacy of herbal therapy in inflammatory bowel disease. Aliment Pharmacol Ther 2013; 38:854-63. [PMID: 23981095 DOI: 10.1111/apt.12464] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [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] [Received: 07/15/2013] [Revised: 08/03/2013] [Accepted: 08/03/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND Complementary and alternative medicine (CAM), particularly herbal therapy, is widely used by patients with inflammatory bowel disease (IBD) but controlled data are limited. AIM To systematically review the literature on the efficacy of herbal therapy in the treatment of ulcerative colitis (UC) and Crohn's disease (CD). METHODS Publications in English and non-English literatures (MEDLINE, EMBASE, EBM Reviews, AMED, Global Health) were searched from 1947 to 2013 for controlled clinical studies of herbal therapy in IBD. Outcome measures included response and remission rates. RESULTS Twenty-one randomised controlled trials (14 UC; 7 CD) including a total of 1484 subjects (mean age 41, 50% female) were analysed. In UC, aloe vera gel, Triticum aestivum (wheat grass juice), Andrographis paniculata extract (HMPL-004) and topical Xilei-san were superior to placebo in inducing remission or response, and curcumin was superior to placebo in maintaining remission; Boswellia serrata gum resin and Plantago ovata seeds were as effective as mesalazine, whereas Oenothera biennis (evening primrose oil) had similar relapse rates as omega-3 fatty acids in the treatment of UC. In CD, Artemisia absinthium (wormwood) and Tripterygium wilfordii were superior to placebo in inducing remission, and preventing clinical recurrence of post-operative CD respectively. CONCLUSIONS Randomised controlled trials of herbal therapy for the treatment of IBD show encouraging results but studies remain limited and heterogenous. Larger controlled studies with stricter endpoints and better-defined patient groups are required to obtain more conclusive results on the use of CAM therapies in IBD.
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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, Chinese University of Hong Kong, Shatin, Hong Kong
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27
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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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Chia FL, Ng SC, Low HL, Lateef A, Leong KH. AB0224 Treating rheumatoid arthritis to target: a singapore survey. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2547] [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: 11/03/2022]
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Ng SC. Commentary: psychiatric co-morbidity is associated with increased risk of surgery in Crohn's disease. Aliment Pharmacol Ther 2013; 37:653. [PMID: 23406406 DOI: 10.1111/apt.12224] [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] [Received: 01/07/2013] [Accepted: 01/08/2013] [Indexed: 12/08/2022]
Affiliation(s)
- S C Ng
- Department of Medicine and Therapeutics, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.
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Tan KK, Tang KZ, Putra AS, Pu X, Huang S, Lee TH, Ng SC, Tan LG. An auto-perfusing umbilical cord blood collection instrument. ISA Trans 2012; 51:420-429. [PMID: 22342030 DOI: 10.1016/j.isatra.2012.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Revised: 12/30/2011] [Accepted: 01/03/2012] [Indexed: 05/31/2023]
Abstract
In this paper, the development of an automated umbilical cord blood (UCB) collection instrument, comprising of mechanical, electronics and control components, is provided in detail. UCB from the placenta provides a rich source of highly proliferative cells for many clinical uses as it contains rich Hematopoietic Stem Cells (HSCs) which yield many benefits over traditional sources such as the bone marrow and periphery blood. Current collection of UCB uses a syringe to extract blood from placenta, which is highly limited in volume and cell numbers. This paper will present the development of an automated UCB collection instrument to yield improved performance which comprised four subsystems. First, a placenta handling system is designed to produce air pressure which can realize the emulation of the uterus compression on the placenta. Second, an auto-medium injector system is presented to enable perfusion automatically. Third, a time window widening system is developed which generates vibrations during the perfusion phase and helps the exposed end of the cord cool down to a low temperature. Finally, a control platform is used to integrate all systems working together, hosting the control algorithms which operate the instrument automatically.
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Affiliation(s)
- K K Tan
- Department of Electrical & Computer Engineering, National University of Singapore, Singapore.
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Peng GM, Wu SQ, Fang ZL, Zhang WG, Bin Zhang Z, Fan J, Zheng SR, Wu SS, Ng SC. Preparation and Chiral Separation of a Novel Immobilized Cellulose-Based Chiral Stationary Phase in High-Performance Liquid Chromatography. J Chromatogr Sci 2012; 50:516-22. [DOI: 10.1093/chromsci/bms047] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [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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Ng SC, Benjamin JL, McCarthy NE, Hedin CRH, Koutsoumpas A, Plamondon S, Price CL, Hart AL, Kamm MA, Forbes A, Knight SC, Lindsay JO, Whelan K, Stagg AJ. Relationship between human intestinal dendritic cells, gut microbiota, and disease activity in Crohn's disease. Inflamm Bowel Dis 2011; 17:2027-37. [PMID: 21910165 DOI: 10.1002/ibd.21590] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [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: 10/21/2010] [Accepted: 10/29/2010] [Indexed: 12/11/2022]
Abstract
BACKGROUND Altered intestinal dendritic cell (DC) function underlies dysregulated T-cell responses to bacteria in Crohn's disease (CD) but it is unclear whether composition of the intestinal microbiota impacts local DC function. We assessed the relationship between DC function with disease activity and intestinal microbiota in patients with CD. METHODS Surface expression of Toll-like receptor (TLR)-2, TLR-4, and spontaneous intracellular interleukin (IL)-10, IL-12p40, IL-6 production by freshly isolated DC were analyzed by multicolor flow cytometry of cells extracted from rectal tissue of 10 controls and 28 CD patients. Myeloid DC were identified as CD11c(+) HLA-DR(+lin-/dim) cells (lin = anti-CD3, CD14, CD16, CD19, CD34). Intestinal microbiota were analyzed by fluorescent in situ hybridization of fecal samples with oligonucleotide probes targeting 16S rRNA of bifidobacteria, bacteroides-prevotella, C. coccoides-E. rectale, and Faecalibacterium prausnitzii. RESULTS DC from CD produced higher amounts of IL-12p40 and IL-6 than control DC. IL-6(+) DC were associated with the CD Activity Index (r = 0.425; P = 0.024) and serum C-reactive protein (CRP) (r = 0.643; P = 0.004). DC expression of TLR-4 correlated with disease activity. IL-12p40(+) DC correlated with ratio of bacteroides: bifidobacteria (r = 0.535, P = 0.003). IL-10(+) DC correlated with bifidobacteria, and IL-6(+) DC correlated negatively with F. prausnitzii (r = -0.50; P = 0.008). The amount of TLR-4 on DC correlated negatively with the concentration of F. prausnitzii. CONCLUSIONS IL-6 production by intestinal DC is increased in CD and correlates with disease activity and CRP. Bacterially driven local IL-6 production by intestinal DC may overcome regulatory activity, resulting in unopposed effector function and tissue damage. Intestinal DC function may be influenced by the composition of the commensal microbiota.
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Affiliation(s)
- S C Ng
- Antigen Presentation Research Group, Imperial College London, St Mark's Hospital, London, UK
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Chen YC, Ng SC, Chen SL, Huang YH, Hu SW, Chen GD. Overactive bladder in Taiwanese women: re-analysis of epidemiological database of community from 1999 to 2001. Neurourol Urodyn 2011; 31:56-9. [PMID: 21826728 DOI: 10.1002/nau.21190] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Accepted: 06/23/2011] [Indexed: 11/07/2022]
Abstract
AIMS To update our previous computerized epidemiological data according to the new taxonomy, we re-evaluated and re-analyzed the data using the current definitions of lower urinary tract symptoms (LUTS) which were approved and published by the ICS in 2002 and 2010 according to patient perception. Further, we divided overactive bladder (OAB) symptoms into OAB dry and OAB wet to assess their prevalence percentages by using the current definitions. METHODS OAB syndrome in our computerized database was re-defined as having the following storage symptoms present, that is, frequency, urgency, nocturia, urgency incontinence, or stress urinary incontinence (SUI). The prevalence of OAB syndrome was determined with a different taxonomy for those five storage symptoms either singly or in combination. OAB symptoms which were probably associated with mixed incontinence were either ignored or excluded. RESULTS The prevalence of OAB syndrome varied from 34.76% to 28.33% to 20.95% using different classifications of the above five storage symptoms. The prevalence of OAB wet symptoms increased with advancing age and this finding was consistent with three different definitions. CONCLUSIONS The prevalence of OAB using the current definition is slightly higher than the result found in our previous published data using a defective classification system of OAB symptoms. The effects of mixed symptoms and probable misclassification cannot be overlooked because many women with OAB (with or without urgency incontinence) might also have SUI.
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Affiliation(s)
- Y C Chen
- School of Physical Therapy, Chung Shan Medical University, Taichung, Taiwan
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Liew NC, Sim KH, Ng SC, Suhail A, Premchandran N. New oral anticoagulants for venous thromboembolism (VTE) prophylaxis. Med J Malaysia 2011; 66:278-281. [PMID: 22111463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Venous thromboembolism is a rising concern in Asia especially among patients after surgery where this complication is readily preventable. Despite the availability of several treatment options, the acceptance of prophylaxis and usage of these methods remain low. A possible explanation to this behavior is the limitations attached to the available treatment options: narrow therapeutic window of warfarin and parenteral administration of low molecular weight as well as unfractionated heparins. Newer agents have been researched and introduced to overcome these limitations in the hope of improving the adaptation towards post surgical thromboprophylaxis. Dabigatran and rivaroxaban are two such new agents that are promising in view of efficacy and ease of administration.
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Affiliation(s)
- N C Liew
- Department of Surgery, University Putra Malaysia, Selangor
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Smith JK, Dimick J, Witkowski ER, Ragulin-Coyne E, McDade TP, Ng SC, Zhou Z, Tseng JF. Does insurance coverage affect pancreatic cancer survival? The Medicare age threshold. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.6124] [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: 11/20/2022] Open
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Witkowski ER, Smith JK, Ragulin-Coyne E, Ng SC, Shah SA, Tseng JF. Surgery for pancreatic cancer: Unnecessary or insufficient? J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14596] [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: 11/20/2022] Open
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Zhang VL, Wang ZK, Lim HS, Ng SC, Kuok MH, Jain S, Adeyeye AO. Nanostructured magnonic crystal with magnetic-field tunable bandgap. J Nanosci Nanotechnol 2011; 11:2657-2660. [PMID: 21449448 DOI: 10.1166/jnn.2011.2730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Most experimental investigations into magnonic bandgaps are based on structures composed of single-constituent magnetic materials. Here we report Brillouin and numerical studies of the spin dynamics of a bi-component magnonic crystal, viz. a one-dimensional periodic array of alternating permalloy and cobalt 150 nm-wide nanostripes. Our measurements, together with those for a similar crystal composed of 250 nm-wide nanostripes, suggest that for a stripe width ratio of 1:1, the bandgap width of such magnonic arrays increases with crystal lattice constant. The bandgap parameters are strongly dependent on external magnetic field. This magnetic-field tunability of the bandgap is expected to be a crucial property of devices based on magnonic crystals. The agreement between numerical calculations, based on finite element analysis, and the experimental data is generally good.
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Affiliation(s)
- V L Zhang
- Department of Physics, National University of Singapore, 117542, Singapore
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Lin CS, Lim HS, Wang ZK, Ng SC, Kuok MH, Adeyeye AO. Magnetic field dependence of the lowest-frequency edge-localized spin wave mode in a magnetic nanotriangle. J Nanosci Nanotechnol 2011; 11:2615-2618. [PMID: 21449438 DOI: 10.1166/jnn.2011.2708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
An understanding of the spin dynamics of nanoscale magnetic elements is important for their applications in magnetic sensing and storage. Inhomogeneity of the demagnetizing field in a non-ellipsoidal magnetic element results in localization of spin waves near the edge of the element. However, relative little work has been carried out to investigate the effect of the applied magnetic fields on the nature of such localized modes. In this study, micromagnetic simulations are performed on an equilateral triangular nanomagnet to investigate the magnetic field dependence of the mode profiles of the lowest-frequency spin wave. Our findings reveal that the lowest-frequency mode is localized at the base edge of the equilateral triangle. The characteristics of its mode profile change with the ground state magnetization configuration of the nanotriangle, which, in turn, depends on the magnitude of the in-plane applied magnetic field.
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Affiliation(s)
- C S Lin
- Department of Physics, National University of Singapore, Singapore 117542, Singapore
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Abstract
BACKGROUND Up to one-third of patients with inflammatory bowel disease (IBD) do not respond to, or are intolerant of conventional immunosuppressive drugs. Although biological agents are alternative treatments, they may not be suitable or available to some patients. AIM To review the evidence for use of nonbiological drugs in the treatment of patients with IBD refractory to corticosteroids or thiopurines. METHODS A literature search was performed using PubMed for English language publications with predetermined search criteria to identify relevant studies. RESULTS Published evidence from uncontrolled series and controlled clinical trials has been used to produce a practical approach relevant to clinical practice which incorporates the indication, optimal dose, and side effects of various therapies including tacrolimus, methotrexate, thalidomide, tioguanine, mycophenolate mofotil, leucocyte apheresis, nutritional therapy, antibiotics, probiotics, allopurinol, rectal acetarsol and ciclosporin in the treatment of patients with refractory ulcerative colitis and Crohn's disease. Approaches to optimise thiopurine efficacy are also discussed. CONCLUSIONS Patients with IBD refractory to corticosteroids or thiopurines may respond to alternative anti-inflammatory chemical molecules, but the evidence base for many of these alternatives is limited and further trials are needed.
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Affiliation(s)
- S C Ng
- Institute of Digestive Disease, Chinese University of Hong Kong, Hong Kong.
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Tasdemiroglu E, Kaya M, Yildirim CH, Lucas KG, Bao L, Bruggeman R, Specht C, Murray JC, Donahue DJ, Galliani CA, Blondin NA, Hui P, Vortmeyer A, Hasbani J, Baehring J, Jensen RL, Lee J, Lake WB, Baskaya MK, Salamat MS, Kennedy T, Abraham S, Jensen RL, Lusis EA, Scheithauer B, Yachnis AT, Chicoine MR, Paulus W, Perry A, Chan DT, Kam MK, Ma BB, Ng SC, Siu DY, Ng HK, Poon WS, Dunbar EM, Dong HJ, Liu C, Chi YY, Keeling C, Yachnis AT, Stephen JH, Sievert AJ, Resnick AC, Storm PB, Judkins AR, Santi M, Kirsch M, Stelling A, Koch E, Salzer R, Schackert G, Steiner G, Pollo B, Maderna E, Valletta L, Guzzetti S, Eoli M, Calatozzolo C, Nunziata R, Salmaggi A, Finocchiaro G, Kastenhuber ER, Campos C, Brennan CW, Mellinghoff IK, Huse JT, Zhang H, Sergey M, Estrada DK, Kay AB, Wagner AS, Khanlou N, Vinters HV, Cloughesy TF, Yong WH. Pathology. Neuro Oncol 2010. [DOI: 10.1093/neuonc/noq116.s10] [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: 11/13/2022] Open
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Abstract
Dendritic cells (DCs) play a key role in discriminating between commensal microorganisms and potentially harmful pathogens and in maintaining the balance between tolerance and active immunity. The regulatory role of DC is of particular importance in the gut where the immune system lies in intimate contact with the highly antigenic external environment. Intestinal DC constantly survey the luminal microenvironment. They act as sentinels, acquiring antigens in peripheral tissues before migrating to secondary lymphoid organs to activate naive T cells. They are also sensors, responding to a spectrum of environmental cues by extensive differentiation or maturation. Recent studies have begun to elucidate mechanisms for functional specializations of DC in the intestine that may include the involvement of retinoic acid and transforming growth factor-β. Specialized CD103(+) intestinal DC can promote the differentiation of Foxp3(+) regulatory T cells via a retinoic acid-dependent process. Different DC outcomes are, in part, influenced by their exposure to microbial stimuli. Evidence is also emerging of the close interaction between bacteria, epithelial cells, and DC in the maintenance of intestinal immune homeostasis. Here we review recent advances of functionally specialized intestinal DC and their mechanisms of antigen uptake and recognition. We also discuss the interaction of DC with intestinal microbiota and their ability to orchestrate protective immunity and immune tolerance in the host. Lastly, we describe how DC functions are altered in intestinal inflammation and their emerging potential as a therapeutic target in inflammatory bowel disease.
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Affiliation(s)
- S C Ng
- Antigen Presentation Research Group, Faculty of Medicine, Imperial College London, Northwick Park and St Mark's Campus, Harrow, UK
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Maeda Y, Ng SC, Durdey P, Burt C, Torkington J, Rao PKD, Mayberry J, Moshkovska T, Stone CD, Carapeti E, Vaizey CJ. Randomized clinical trial of metronidazole ointment versus placebo in perianal Crohn's disease. Br J Surg 2010; 97:1340-7. [PMID: 20632322 DOI: 10.1002/bjs.7121] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND The potential for metronidazole 10 per cent ointment to exert therapeutic benefit in perianal Crohn's disease, while minimizing the adverse effects found with oral metronidazole, was evaluated in a randomized placebo-controlled study. METHODS Subjects with perianal Crohn's disease were randomized to metronidazole 10 per cent ointment, 0.7 g applied perianally three times daily, or placebo ointment. The Perianal Crohn's Disease Activity Index (PCDAI) was scored at baseline and after 4 weeks of treatment. Perianal pain was assessed on a visual analogue scale. RESULTS Seventy-four subjects (33 metronidazole, 41 placebo) were evaluated. The mean(s.e.m.) reduction in PCDAI score at 4 weeks was 2.4(0.5) in the metronidazole group and 2.2(0.4) in the placebo group (P = 0.660). More subjects in the metronidazole group than the placebo group showed a reduction in PCDAI score of at least 5 points (10 of 27 versus 4 of 34; P = 0.031). Perianal discharge was reduced significantly in metronidazole-treated subjects (P = 0.012). A greater reduction in perianal pain was seen in the metronidazole group, which approached statistical significance (P = 0.059). No serious adverse events were reported. CONCLUSION Metronidazole 10 per cent ointment was not effective in the reduction of PDCAI score, but some secondary outcomes showed improvement suggestive of a treatment effect. It is well tolerated, with minimal adverse effects, and has potential as treatment for pain and discharge associated with perianal Crohn's disease. REGISTRATION NUMBER NCT00509639 (http://www.clinicaltrials.gov).
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Affiliation(s)
- Y Maeda
- Physiology Unit, St Mark's Hospital, Harrow, UK.
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Abstract
BACKGROUND Management of acute severe ulcerative colitis (UC) is a clinical challenge, with a mortality rate of approximately 1-2%. The traditional management with intravenous corticosteroids has been modified by introduction of ciclosporin and more recently, infliximab. AIM To provide a detailed and comprehensive review of the medical management of acute severe UC. METHODS PubMed and recent conference abstracts were searched for articles relating to treatment of acute severe UC. RESULTS Two-thirds of patients respond to intravenous steroids in the short term. In those who fail steroids, low-dose intravenous ciclosporin at 2 mg/kg/day is effective. Approximately 75% and 50% of patients treated with ciclosporin avoid colectomy in the short and long-terms, respectively. Long-term outcome of ciclosporin therapy is improved by introduction of azathioprine on discharge from hospital, together with oral ciclosporin as a bridging therapy. Controlled data show that infliximab is effective as rescue therapy for acute severe UC and the effect appears to be durable, although longer-term follow-up data are needed. CONCLUSIONS Both ciclosporin and infliximab have demonstrated efficacy as rescue medical therapies in patients with acute severe UC, but surgery needs to be considered if there is failure to improve or clinical deterioration.
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Wong GK, Tang BYH, Yeung JHH, Collins G, Rainer T, Ng SC, Poon WS. Traumatic intracerebral haemorrhage: is the CT pattern related to outcome? Br J Neurosurg 2010; 23:601-5. [PMID: 19922273 DOI: 10.3109/02688690902948184] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
It is believed by many neurosurgeons that in addition to age and neurological status, the CT patterns of traumatic intracerebral haemorrhages are related to outcome. The aim of this study was to find out whether this is the case. The study was conducted in a regional level I trauma centre in Hong Kong. We prospectively collected data of patients with traumatic intracerebral haematomas over a 4-year period. Of 464 patients with head injuries, traumatic intracerebral haematoma was significantly associated with inpatient mortality and one year unfavorable outcome after adjustment for age, sex, post-resuscitation GCS, and presence of acute subdural haematoma. One hundred-and-fourteen patients had traumatic intracerebral haematomas and were included for further analysis. The mean age was 49, the male to female ratio was 2 to 1, and the median Glasgow Coma Scale (GCS) score on admission was 12. Logistic regression analysis showed that age and GCS score/GCS motor component score were significant factors for inpatient mortality, one-year mortality and one-year outcome. There was an association between temporal haematomas and inpatient mortality, subdural haematomas and inpatient mortality, and bilateral haematomas and unfavourable one-year outcome. In patients with severe head injury, a traumatic haematoma of more than 50 ml was associated higher inpatient mortality. In addition to age and GCS score, the CT patterns of bilateral haematomas, temporal haematomas and associated subdural haematomas were suggestive of poor outcome or mortality.
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Affiliation(s)
- G K Wong
- Division of Neurosurgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
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Ng SC, Plamondon S, Gupta A, Burling D, Kamm MA. Prospective assessment of the effect on quality of life of anti-tumour necrosis factor therapy for perineal Crohn's fistulas. Aliment Pharmacol Ther 2009; 30:757-66. [PMID: 19575762 DOI: 10.1111/j.1365-2036.2009.04088.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [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] [Indexed: 12/18/2022]
Abstract
BACKGROUND Anti-tumour necrosis factor (TNF) therapy effectively treats Crohn's perineal fistulas (CPF); the effect on health-related quality of life (HRQoL) remains unknown. AIMS To evaluate the effect of anti-TNF therapy on the HRQoL of patients with CPF in daily clinical practice. METHODS Prospective evaluation of clinical and magnetic resonance imaging (MRI) responses, disease activity (Perianal Disease Activity Index - PDAI), and HRQoL assessment [Inflammatory Bowel Disease Questionnaire (IBDQ)] in patients receiving anti-TNF therapy for CPF treated up to 12 months. RESULTS In all, 26 patients with CPF were treated (mean age 39 years; 19 infliximab, 7 adalimumab). At baseline, 85% patients had impaired IBDQ scores (mean 137; 'normal' >170). At 12 months, mean increases in IBDQ score for infliximab and adalimumab treated patients were 40 and 41 points respectively (P < 0.05). There were significant improvements in all IBDQ subscores (bowel, emotional, systemic, social) at 12 months (all P < or = 0.003). Fourteen patients (74%) on infliximab and six on adalimumab (86%) achieved IBDQ score > or =170. Mean increase in IBDQ score was 50, 34 and 16 points in patients with clinical fistula closure (P < 0.001), clinical response (P = 0.002) and no response (n = 1) respectively. IBDQ score increased for patients with MRI healing (P < 0.001) and MRI improvement (P = 0.016), but not for those with no MRI change (n = 2). IBDQ correlated significantly with PDAI at baseline and at 12 months. CONCLUSION Anti-TNF therapy improves HRQoL in patients with CPF at 12 months and this improvement is most pronounced in patients with clinical and MRI healing.
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Affiliation(s)
- S C Ng
- Department of Gastroenterology, St Mark's Hospital, London, UK
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Ng SC, Plamondon S, Al-Hassi HO, English N, Gellatly N, Kamm MA, Knight SC, Stagg AJ. A novel population of human CD56+ human leucocyte antigen D-related (HLA-DR+) colonic lamina propria cells is associated with inflammation in ulcerative colitis. Clin Exp Immunol 2009; 158:205-18. [PMID: 19737136 DOI: 10.1111/j.1365-2249.2009.04012.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Ulcerative colitis (UC) involves inappropriate mucosal immune responses to intestinal microbiota. Gut dendritic cells (DC) are central immunoregulators of the response to commensal bacteria, and the subset of CD11c(+) cells within the human leucocyte antigen D-related (HLA-DR(+)) lineage (lin)(-/dim) population are activated in inflammatory bowel disease. We hypothesized that CD11c(-) cells within this population may also be involved in intestinal inflammation. HLA-DR(+) lin(-/dim) cells were identified in freshly isolated lamina propria mononuclear cells by multi-colour flow cytometry in 54 UC patients and 22 controls. Proportion and number of CD11c(+) and CD11c(-) cells, and surface expression of activation markers CD40, CD86, Toll-like receptor (TLR)-2, TLR-4, and CD56(+)[natural killer (NK) marker], were determined. Cytokine production was assessed by intracellular staining. Lamina propria colonic CD11c(-) HLA-DR(+) lin(-/dim) cells were increased significantly in inflamed and 'non-inflamed' UC tissue, compared with control tissue. CD11c(+) HLA-DR(+) lin(-/dim) cells were unchanged. Fewer CD11c(-) cells expressed activation markers and produced intracellular cytokines than their CD11c(+) counterparts, and they were weakly stimulatory in mixed leucocyte reactions. Few CD11c(-) cells expressed blood plasmacytoid DC markers, but a major subset expressed high levels of CD56. CD11c(-) cells decreased after inflammation resolved. Intestinal inflammation in UC is associated with the presence of cells that share phenotypic features of both DC and NK cells. This novel population of human colonic CD56(+) HLA-DR(+) cells may play a role in immune regulation or tissue repair. Their increase in quiescent UC may be a marker of subclinical inflammation.
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Affiliation(s)
- S C Ng
- Antigen Presentation Research Group, Faculty of Medicine, Imperial College London, Northwick Park and St Mark's Campus, Watford Road, Harrow, UK
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Tan KK, Tang KZ, Huang S, Putra AS, Lee TH, Ng SC, Chan JKY, Tan LG, Chong MSK. Ex utero harvest of hematopoietic stem cells from placenta/umbilical cord with an automated collection system. IEEE Trans Biomed Eng 2009; 56:2331-4. [PMID: 19497809 DOI: 10.1109/tbme.2009.2023993] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Hematopoietic stem cells (HSCs) from the human placenta and umbilical cord blood (UCB) provide a rich source of highly proliferative cells for many clinical uses with advantages over traditional sources like the bone marrow and periphery blood. However, the key current constraint with this source of HSCs is the inadequate number of HSCs cells that can be harvested in a single collection using current approaches, which render a large number of collections unusable on their own, even for pediatric patients. This paper will present the development of a device to enable more efficient harvesting of HSCs from placentas, which can be used ex utero, upon the discharge of placentas after deliveries. The device can be used to facilitate a two-fraction collection process. Results, in terms of mononucleated cells (MNCs) count, CD34+ cells count, as well as flow cytometry, will be furnished to verify the effectiveness of the developed system.
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Affiliation(s)
- K K Tan
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore 117576, Singapore.
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Abstract
The intestinal microbiota plays a fundamental role in maintaining immune homeostasis. In controlled clinical trials probiotic bacteria have demonstrated a benefit in treating gastrointestinal diseases, including infectious diarrhea in children, recurrent Clostridium difficile-induced infection, and some inflammatory bowel diseases. This evidence has led to the proof of principle that probiotic bacteria can be used as a therapeutic strategy to ameliorate human diseases. The precise mechanisms influencing the crosstalk between the microbe and the host remain unclear but there is growing evidence to suggest that the functioning of the immune system at both a systemic and a mucosal level can be modulated by bacteria in the gut. Recent compelling evidence has demonstrated that manipulating the microbiota can influence the host. Several new mechanisms by which probiotics exert their beneficial effects have been identified and it is now clear that significant differences exist between different probiotic bacterial species and strains; organisms need to be selected in a more rational manner to treat disease. Mechanisms contributing to altered immune function in vivo induced by probiotic bacteria may include modulation of the microbiota itself, improved barrier function with consequent reduction in immune exposure to microbiota, and direct effects of bacteria on different epithelial and immune cell types. These effects are discussed with an emphasis on those organisms that have been used to treat human inflammatory bowel diseases in controlled clinical trials.
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Affiliation(s)
- S C Ng
- Antigen Presentation Research Group, Imperial College London, London, UK
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Wong GK, Tang BYH, Yeung JHH, Collins G, Rainer T, Ng SC, Poon WS. Traumatic intracerebral haemorrhage: Is the CT pattern related to outcome? Br J Neurosurg 2009. [DOI: 10.1080/02688690902948184] [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: 10/20/2022]
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50
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Abstract
BACKGROUND Treatment options for ulcerative colitis (UC) are expanding with the development of novel drug formulations and dosing regimens and new chemical entities. Although the goals of medical therapy for UC remain unchanged, that is to induce and to maintain remission, focus has also centred on improving patient compliance, modifying the natural course of disease and healing the mucosa. AIM To examine novel formulations, new chemical entities and novel therapeutic approaches to the management of UC. METHODS Searches for all studies related to UC treatment in Medline and abstracts from major national and international meetings published in the last 10 years. RESULTS 5-Aminosalicylic acids (5-ASA) remain the standard first-line treatment for patients with mild to moderately active UC. New formulations with altered delivery, and new dosing regimens have demonstrated possible improvements in efficacy compared with historically available preparations and dosing patterns. Once-daily dosing, micropellet formulations,and high-dose tablets offer enhanced efficacy and improved compliance. 5-ASA is now recognized as a ligand for peroxisome proliferator activated receptor-gamma (PPAR-gamma) and it has a role as a chemo-preventive agent in long-standing UC. New colonic release corticosteroid formulations help to limit systemic toxicity; turmeric, tacrolimus and infliximab have shown promising results. New anti-inflammatory targeted therapies include an anti-CD3 antibody, selective integrin blockers, anti-IL-2 antibody and PPAR-gamma agonists. CONCLUSION The evolution of novel oral 5-ASA formulations and dosage regimens,and recent development of new molecules have expanded the therapeutic armamentarium of UC.
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Affiliation(s)
- S C Ng
- St Mark's Hospital, London, UK
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