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Yau T.,University of Hong Kong | Cheng P.N.,Bio Cancer Treatment International Ltd | Chan P.,Ruttonjee Hospital | Chan W.,University of Hong Kong | And 5 more authors.
Investigational New Drugs | Year: 2013

Summary: Background Hepatocellular carcinoma (HCC) cells are auxotrophic for arginine, depletion of which leads to tumour regression. The current study evaluated safety, pharmacokinetics (PK)/ pharmacodynamics (PD) parameters, and potential anti-tumor activity of pegylated recombinant human arginase 1 (peg-rhArg1) in advanced HCC patients. Methods Eligibility criteria included advanced HCC with measurable lesions, Child-Pugh A or B, and adequate organ function. Initial single IV bolus was followed by weekly doses of peg-rhArgI escalated from 500 U/kg to 2500 U/kg in a 3 + 3 design. Results Fifteen patients were enrolled at weekly doses of 500 U/kg (n = 3), 1000 U/kg (n = 3), 1600 U/kg (n = 3) and 2500 U/kg (n = 6). The median age was 57 years (33-74); 87% were hepatitis B carriers and 47% had prior systemic treatment. The most commonly reported drug-related non-haematological adverse events (AEs) were diarrhea (13.3%), abdominal discomfort (6.7%) and nausea (6.7%). No drug-related haematological AEs were seen. Only 1 of the six patients that received 2500U/kg peg-rhArg1 experienced DLT (grade 4 bilirubin elevation) and thus the maximum tolerated dose was 2500 U/kg. PK and PD analysis indicated that peg-rhArg1 was efficacious in inducing arginine depletion in a dose-dependent manner. Adequate arginine depletion dose was achieved in the 1,600-2,500 U/kg range and therefore the optimal biological dose was at 1600 U/kg, which was chosen as the recommended dose. The best response was stable disease for >8 weeks in 26.7% of the enrolled patients. Conclusion Peg-rhArg1 has manageable safety profile and preliminary evidence of activity in advanced HCC patients. © 2012 The Author(s).

Yu T.K.K.,Ruttonjee Hospital
CME Journal Geriatric Medicine | Year: 2010

Advances in telecommunication technology can provide new ways of caring for older people. This article will review specific areas of geriatric services where telemedicine may be useful and specific geriatric diseases where telemedicine may be of benefit. © 2010 Rila Publications Ltd.

Cheung K.W.,Ruttonjee Hospital | Mak Y.W.,Hong Kong Polytechnic University
International Journal of Environmental Research and Public Health | Year: 2016

It is common for elderly people and those with such chronic disorders as respiratory diseases to suffer severe complications from influenza, a viral infection. The voluntary uptake of vaccination is vital to the effectiveness of influenza prevention efforts. The Health Belief Model (HBM) is the most commonly used framework in the field of vaccination behavior to explain the decision that people make to accept or refuse vaccination. In addition, psychological flexibility is considered helpful in causing people to be open to adopting new practices that are consistent with their values. This study examined the role of psychological flexibility and health beliefs in predicting the uptake of influenza vaccination among people in Hong Kong. Eligible participants were Hong Kong permanent residents aged 18 years or above with a history of chronic respiratory diseases (CRD). A convenience sample of 255 patients was recruited to participate in a cross-sectional survey in which HBM components and factors of psychological flexibility were assessed. The following variables were found to be significant predictors of vaccination: age, smoking status, comorbidity, previous hospitalization, perceived susceptibility, perceived severity, and psychological flexibility. Enhancing psychological flexibility might be a potential new direction for motivating people to accept influenza vaccination. © 2016 by the authors; licensee MDPI, Basel, Switzerland.

Ip T.P.,Tung Wah Eastern Hospital | Ip T.P.,University of Hong Kong | Leung J.,Ruttonjee Hospital | Kung A.W.C.,University of Hong Kong
Osteoporosis International | Year: 2010

Hip fracture is associated with high morbidity, mortality, and economic burden worldwide. It is also a major risk factor for a subsequent fracture. A literature search on the management of osteoporosis in patients with hip fracture was performed on the Medline database. Only one clinical drug trial was conducted in patients with a recent hip fracture. Further studies that specifically address post-fracture management of hip fracture are needed. The efficacy of anti-osteoporosis medication in older individuals and those at high risk of fall is reviewed in this paper. Adequate nutrition is vital for bone health and to prevent falls, especially in malnourished patients. Protein, calcium, and vitamin D supplementation is associated with increased hip BMD and a reduction in falls. Fall prevention, exercise, and balance training incorporated in a comprehensive rehabilitation program are essential to improve functional disability and survival. Exclusion of secondary causes of osteoporosis and treatment of coexistent medical conditions are also vital. Such a multidisciplinary team approach to the management of hip fracture patients is associated with a better clinical outcome. Although hip fracture is the most serious of all fractures, osteoporosis management should be prioritized to prevent deterioration of health and occurrence of further fracture. © 2010 The Author(s).

Introduction: Establishing intravenous access is a common procedure being performed in the emergency department. Ultrasound guidance is useful for difficult intravenous cannulation. We compared a commercially available Blue Phantom™ and a self-made pork meat model for suitability of simulation based training. Methods: We recruited emergency physicians from two public regional hospitals in our locality. We also recruited Myanmar emergency physicians from an ultrasound course. They were given a 30-minute handson practice on both phantoms. Questionnaires, which asked about the practical feeling and overall impression of both phantoms, were distributed afterwards. Results: Thirty-nine emergency physicians with varied experience in ultrasound guided intravenous catheterisation enrolled in the study. The median score were 4 (i.e. agree) in seven out of eight pairs of questions. The practical feeling and overall personal impression were very similar between Blue Phantom™ and pork meat model. Conclusions: The suitability of self-made pork meat model was similar to Blue Phantom™ for the training of ultrasound guided IV catheterisation. Pork meat model can used as an alternative training tool. © 2016, Medcom Limited. All rights reserved.

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