Kwok J.M.F.,St Theresas Hospital |
Ma C.C.H.,King's College London |
Ma S.,Hong Kong Baptist Hospital
Vascular Pharmacology | Year: 2013
Statins, inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA), are important lipid-lowering agents. After two decades of laboratory and clinical studies, their pleiotropic effects appear well-established. One of these effects is through the regulation of Rac1 and NADPH oxidases. Relatively few human trials have been carried out with regards to the action of statins on Rac1 and NADPH oxidases, but similar positive effects were also observed in blood vessels and myocardium of participants in the trials. Besides, more specific biomarkers for the antioxidation effects of statins have been developed in the recent two years; both monitoring of the progress of disease and the effects of medical therapy will be possible. Further development of the potency and specificity of statin may enhance their therapeutic potential on cardiovascular disease. © 2012 Elsevier Inc.
Seto W.H.,Hong Kong Baptist Hospital |
Yuen S.W.S.,Hong Kong Baptist Hospital |
Cheung C.W.Y.,Hong Kong Baptist Hospital |
Ching P.T.Y.,Hong Kong Baptist Hospital |
And 2 more authors.
American Journal of Infection Control | Year: 2013
Campaign fatigue was evident in a large hospital in Hong Kong when hand hygiene compliance remained just above 50% after 4 years of aggressive and varied promotional activities. A new innovative strategy was developed that directly involved the infection control link nurses both in formulating the strategy and in implementing the various proposed programs. The new strategy was successful in increasing hand hygiene compliance to 83%. © 2013 by the Association for Professionals in Infection Control and Epidemiology, Inc.
Seto W.H.,Hong Kong Baptist Hospital |
Cowling B.J.,University of Hong Kong |
Cheung C.W.Y.,Hong Kong Baptist Hospital |
Wong C.Y.Y.,Hong Kong Baptist Hospital |
And 3 more authors.
American Journal of Infection Control | Year: 2015
Staff of a large hospital in Hong Kong attempted and set the first Guinness World Record for the most participants in a hand sanitizing relay in May 2014. After this event, average compliance with hand hygiene increased from 72% (95% CI, 70%-74%) in 2013 to 85% (95% CI, 83%-87%) in June-July 2014, and the conceptual understanding of good hand hygiene practices improved. © 2015 Association for Professionals in Infection Control and Epidemiology, Inc.
Liu F.X.,Baxter Healthcare Corporation |
Gao X.,Pharmerit International |
Inglese G.,Hollister Incorporated |
Chuengsaman P.,Banphaeo Hospital |
And 2 more authors.
Peritoneal Dialysis International | Year: 2015
Given the ever-increasing burden of end-stage renal disease (ESRD) in a global milieu of limited financial and health resources, interested parties continue to search for ways to optimize dialysis access. Government and payer initiatives to increase access to renal replacement therapies (RRTs), particularly peritoneal dialysis (PD) and hemodialysis (HD), may have meaningful impacts from clinical and health-economic perspectives; and despite similar clinical and humanistic outcomes between the two dialysis modalities, PD may be the more convenient and resource-conscious option. This review assessed country-specific PD-First/Favored policies and their associated background, implementation, and outcomes. It was found that barriers to policy-implementation are broadly associated with government policy, economics, provider or healthcare professional education, modality-related factors, and patient-related factors. Notably, the success of a given country’s PD-Favored policy was inversely associated with the extent of HD infrastructure. It is hoped that this review will provide a foundation across countries to share lessons learned during the development and implementation of PD-First/Favoredpolicies. © 2015 International Society for Peritoneal Dialysis.
Chan L.C.,Prince of Wales Hospital |
Chiu S.K.W.,Hong Kong Baptist Hospital |
Chan S.L.,Chinese University of Hong Kong
Hong Kong Medical Journal | Year: 2011
Objective To evaluate the efficacy and toxicities of stereotactic radiotherapy for unresectable hepatocellular carcinoma. Design Retrospective study. Setting Prince of Wales Hospital, Hong Kong. Main outcome measures Treatment outcome and toxicities. Patients During the period of 2000 to 2004, 16 patients with hepatocellular carcinoma treated with stereotactic radiotherapy were reviewed. Results Of the 16 patients, 11 had assessable responses. For local control, there were two complete and three partial responses, five with stable disease and one with progressive disease, giving a local response rate of 45% and control rate of 91%. The median survival was 23 months. The 1-year and 3-year overall survival rates were 62% and 28%, respectively. The most frequent site of recurrence was intrahepatic but outside the irradiated field. Two patients with Child-Pugh B cirrhosis developed radiation-induced liver disease. No other grade 3/4 toxicities were recorded. Conclusion Stereotactic radiotherapy gives high local control rates and has the potential to prolong survival in patients with hepatocellular carcinoma. It is safe and tolerable in Child-Pugh A patients. © 1995-2011 HKAM.
Chiang V.C.L.,Hong Kong Polytechnic University |
Leung S.S.K.,University of Hong Kong |
Chui C.Y.Y.,Hong Kong Baptist Hospital |
Leung A.Y.M.,University of Hong Kong |
Mak Y.W.,Hong Kong Polytechnic University
Nurse Education Today | Year: 2013
Background: Life-long learning involves the development of skills in critical thinking (CT), effective group process (GP), and self-directedness (SDL). Recent studies have shown that small group learning with active interactions is effective in enabling students to develop themselves as independent learners beyond graduation. With a view to integrative learning, the purpose of this study was to evaluate life-long learning outcomes through the work of small group teaching and learning for a class of undergraduate nursing freshmen during one academic year. Methods: A mixed-methods approach was used to evaluate the CT, GP and SDL of 99 freshmen with a self-assessment questionnaire before and after their learning activities in three nursing courses, and to identify themes from a total of six focus group interviews with the students and teachers. Results: The CT, GP and SDL results obtained from self-assessment did not indicate significant differences. Four themes emerged from the qualitative analysis. Discussion: Many factors contributed to the results on life-long learning skill development of students in this study. The qualitative analysis provided good insights for future teaching and learning development. Conclusions: With a developmental perspective, life-long learning may be better developed and evaluated over a longer period of time in the nursing program. © 2012 Elsevier Ltd.
Luk K.D.K.,University of Hong Kong |
Cheung W.-Y.,University of Hong Kong |
Wong Y.,Hong Kong Baptist Hospital |
Cheung K.M.C.,University of Hong Kong |
And 2 more authors.
Spine | Year: 2012
Study Design: A prospective cohort study of Cobb angles (CA) and apical vertebral rotations (AVR) in 25 patients who had adolescent idiopathic scoliosis. Objective: To assess in vivo the concomitant vertebral derotation occurring with correction of scoliosis deformity as a result of coupling effect by using the fulcrum bending radiograph and to assess whether the fulcrum bending radiograph can predict the amount of postoperative apical derotation when no additional intraoperative apical derotation maneuver is used. Summary of Background Data: Adolescent idiopathic scoliosis (AIS) is a 3-dimensional coupling deformity. Various studies have reported vertebral derotational effects, using different implant constructs and surgical techniques for AIS. However, none of them have considered the spontaneous coupling effect on vertebral derotation produced by correction of the coronal deformity, in particular, using the predictive capacity of the preoperative fulcrum bending radiograph. METHOD.: Twenty-five patients with flexible Lenke type 1 AIS with CA greater than 45°who underwent posterior spinal fusion with instrumentation, without direct apical derotation were prospectively assessed. CA and AVR in standing, supine, and fulcrum bending positions preoperatively and in supine position postoperatively were assessed on radiographs and computed tomographic scans. Results: The study entailed 80% adolescent girls and 20% adolescent boys (mean age, 15.5 years). The mean AVR values on preoperative standing, supine, and fulcrum bending positions and postoperation were 24.2°, 17.7°, 9.8°, and 8.1°respectively. The preoperative AVR highly correlated with the preoperative CA (R = 0.75). The postoperative AVR was correlated with the postoperative CA (r = 0.82) and the change in curve magnitude (r = -0.49), correction rate (r = -0.83), and fulcrum bending correction index (r = -0.45) (P < 0.05). There was no significant difference in AVR between preoperative fulcrum bending and postoperative assessment. Conclusion: Correction of scoliosis deformity produces spontaneous reduction of rotational deformity through coupling. The amount of spontaneous apical vertebral derotation with fulcrum bending can be used to assess the flexibility of the rotational deformity. In flexible curves, it also predicts the amount of apical derotation achievable with surgery. These should be considered when assessing the derotational effect of different implants and surgical strategies. Copyright © 2012 Lippincott Williams & Wilkins.
Ma S.,Hong Kong Baptist Hospital |
Ma C.C.-H.,NHS Dumfries & Galloway
Vascular pharmacology | Year: 2014
Since the discovery of the importance of nitric oxide (NO) to the human body three decades ago, numerous laboratory and clinical studies have been done to explore its potential therapeutic actions on many organs. In the cardiovascular system, NO works as a volatile signaling molecule regulating the vascular permeability and vascular tone, preventing thrombosis and inflammation, as well as inhibiting the smooth muscle hyperplasia. Thus, NO is important in the prevention and treatment of cardiovascular disease. NO is synthesized by NO synthase (NOS) with tetrahydrobiopterin (BH4) as the crucial cofactor. Many studies have been done to form nitric oxide donors so as to deliver NO directly to the vessel walls. In addition, NO moieties have been incorporated into existing therapeutic agents to enhance the NO bioavailability, including statins. Statins are inhibitors of 3-hydroxy-3-methylglutaryl-coenzyme (HMG-CoA), the rate-limiting enzyme of the mevalonate pathway. By inhibiting this pathway, statins lower blood cholesterol and exert their pleiotropic effects through activity in reaction cascades, such as Rho/ROCK and Rac 1/NADPH oxidase pathways. Statins have also been observed to implement their non-lipid effects by promoting BH4 synthesis with increase of NO bioavailability. Furthermore, NO-donating statins in laboratory studies have demonstrated to produce better therapeutic effects than their parent's drugs. They offer better anti-inflammatory, anti-proliferative and antithrombotic actions on cardiovascular system. They also cause better revascularization in peripheral ischemia and produce greater enhancement in limb reperfusion and salvage. In addition, it has been shown that NO-donating statin caused less myotoxicity, the most common side effect related to treatment with statins. The initial studies have demonstrated the superior therapeutic effects of NO-donating statins while producing fewer side effects. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.
Yan C.M.,Hong Kong Baptist Hospital
Hong Kong Medical Journal | Year: 2010
The laparoscopic management of three rare types of ectopic pregnancy, including rudimentary horn pregnancy, caesarean scar pregnancy, and interstitial pregnancy is described. All were managed with little morbidity. When the appropriate facilities and skills are available, laparoscopic surgery is the surgical treatment of choice for the various types of ectopic pregnancy.
PubMed | Chong Hua Hospital, Cho Ray Hospital, Asan Medical Center, MacKay Memorial Hospital and 7 more.
Type: | Journal: Antimicrobial resistance and infection control | Year: 2016
This document is an executive summary of the APSIC Guide for Prevention of Central Line Associated Bloodstream Infections (CLABSI). It describes key evidence-based care components of the Central Line Insertion and Maintenance Bundles and its implementation using the quality improvement methodology, namely the Plan-Do-Study-Act (PDSA) methodology involving multidisciplinary process and stakeholders. Monitoring of improvement over time with timely feedback to stakeholders is a key component to ensure the success of implementing best practices. A surveillance program is recommended to monitor outcomes and adherence to evidence-based central line insertion and maintenance practices (compliance rate) and identify quality improvement opportunities and strategically targeting interventions for the reduction of CLABSI.