Hong Kong Medical Journal最新文献

Disabilities and professional training: a tripartite consensus statement by the Hong Kong Academy of Medicine and the two medical schools in Hong Kong.

IF 3.1 4区医学

Hong Kong Medical Journal Pub Date : 2024-12-20 DOI: 10.12809/hkmj245174

G K K Leung

引用次数: 0

Artificial intelligence-based computer-aided diagnosis for breast cancer detection on digital mammography in Hong Kong.

IF 3.1 4区医学

Hong Kong Medical Journal Pub Date : 2024-12-19 DOI: 10.12809/hkmj2310920

S M Yu, C Y M Young, Y H Chan, Y S Chan, C Tsoi, M N Y Choi, T H Chan, J Leung, W C W Chu, E H Y Hung, H H L Chau

{"title":"Artificial intelligence-based computer-aided diagnosis for breast cancer detection on digital mammography in Hong Kong.","authors":"S M Yu, C Y M Young, Y H Chan, Y S Chan, C Tsoi, M N Y Choi, T H Chan, J Leung, W C W Chu, E H Y Hung, H H L Chau","doi":"10.12809/hkmj2310920","DOIUrl":"https://doi.org/10.12809/hkmj2310920","url":null,"abstract":"Introduction: Research concerning artificial intelligence in breast cancer detection has primarily focused on population screening. However, Hong Kong lacks a population-based screening programme. This study aimed to evaluate the potential of artificial intelligence-based computer-assisted diagnosis (AI-CAD) program in symptomatic clinics in Hong Kong and analyse the impact of radio-pathological breast cancer phenotype on AI-CAD performance.Methods: In total, 398 consecutive patients with 414 breast cancers were retrospectively identified from a local, prospectively maintained database managed by two tertiary referral centres between January 2020 and September 2022. The full-field digital mammography images were processed using a commercial AI-CAD algorithm. An abnormality score <30 was considered a false negative, whereas a score of ≥90 indicated a high-score tumour. Abnormality scores were analysed with respect to the clinical and radio-pathological characteristics of breast cancer, tumour-to-breast area ratio (TBAR), and tumour distance from the chest wall for cancers presenting as a mass.Results: The median abnormality score across the 414 breast cancers was 95.6; sensitivity was 91.5% and specificity was 96.3%. High-score cancers were more often palpable, invasive, and presented as masses or architectural distortion (P<0.001). False-negative cancers were smaller, more common in dense breast tissue, and presented as asymmetrical densities (P<0.001). Large tumours with extreme TBARs and locations near the chest wall were associated with lower abnormality scores (P<0.001). Several strengths and limitations of AI-CAD were observed and discussed in detail.Conclusion: Artificial intelligence-based computer-assisted diagnosis shows potential value as a tool for breast cancer detection in symptomatic setting, which could provide substantial benefits to patients.","PeriodicalId":48828,"journal":{"name":"Hong Kong Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Atypical imaging manifestations in non-alcoholic Wernicke's encephalopathy: a potentially reversible neurological condition not to be missed. 非酒精性韦尼克脑病的非典型影像学表现：不容错过的潜在可逆性神经疾病。

IF 3.1 4区医学

Hong Kong Medical Journal Pub Date : 2024-12-18 DOI: 10.12809/hkmj2310911

C C Y Chan, K K F Fung, E Y L Kan

引用次数: 0

Public fertility preservation programme for cancer patients in Hong Kong.

IF 3.1 4区医学

Hong Kong Medical Journal Pub Date : 2024-12-17 DOI: 10.12809/hkmj2311060

D T Y Chan, J K Y Ko, K K W Lam, Y W Tong, E Wong, H H Y Cheng, S S F Yung, R H W Li, E H Y Ng

{"title":"Public fertility preservation programme for cancer patients in Hong Kong.","authors":"D T Y Chan, J K Y Ko, K K W Lam, Y W Tong, E Wong, H H Y Cheng, S S F Yung, R H W Li, E H Y Ng","doi":"10.12809/hkmj2311060","DOIUrl":"https://doi.org/10.12809/hkmj2311060","url":null,"abstract":"Introduction: Fertility preservation (FP) offers cancer patients the opportunity to have biological children after completing treatment. This study was performed to review the experience and changes in service demand since the implementation of a public FP programme for cancer patients in Hong Kong.Methods: This retrospective study included men and women who attended an assisted reproduction unit for public FP services before cancer treatment from August 2020 to February 2023. Their medical records were reviewed and the results were compared with findings from our previous study to evaluate trends in service demand.Results: During the study period, there were 48 consultations for female FP, compared with 72 women who presented for FP from 2010 to 2020 prior to establishment of the public FP programme. The median time from referral to consultation was 3 days (interquartile range [IQR]=2-5). Eighteen women (37.5%) underwent 19 cycles of ovarian stimulation for oocyte or embryo cryopreservation. Thirty women (62.5%) received gonadotropin-releasing hormone agonists during cancer treatment. There were 58 consultations for male FP during the study period, compared with 265 men who presented for sperm cryopreservation from 2005 to 2020. The median time from referral to consultation was 4 days (IQR=2-7). Fifty-five men (94.8%) attempted sperm cryopreservation, and 49 (84.5%) successfully preserved sperm.Conclusion: Since the establishment of a public FP programme for cancer patients, there has been an increase in the demand for FP services at our centre. Regular review of FP services is warranted to assess changes in demand and identify areas for improvement.","PeriodicalId":48828,"journal":{"name":"Hong Kong Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Consolidated and updated ultrasonographic fetal biometry and estimated fetal weight references for the Hong Kong Chinese population. 综合并更新香港中国人口的超声胎儿生物测量和估计胎儿体重参考值。

IF 3.1 4区医学

Hong Kong Medical Journal Pub Date : 2024-12-16 DOI: 10.12809/hkmj2310910

F Liu, J Lu, A H W Kwan, Y K Yeung, L Wong, C P H Chiu, L C Y Poon, D S Sahota

{"title":"Consolidated and updated ultrasonographic fetal biometry and estimated fetal weight references for the Hong Kong Chinese population.","authors":"F Liu, J Lu, A H W Kwan, Y K Yeung, L Wong, C P H Chiu, L C Y Poon, D S Sahota","doi":"10.12809/hkmj2310910","DOIUrl":"https://doi.org/10.12809/hkmj2310910","url":null,"abstract":"Introduction: This study aimed to construct consolidated and updated ultrasonographic fetal biometry and estimated fetal weight (EFW) references for the Hong Kong Chinese population and evaluate the extent of under- and overdiagnosis of small-for-gestational-age (SGA) and large-for-gestational-age (LGA) using these new references.Methods: Fetal biometry and EFW references were constructed using the Generalised Additive Model for Location, Scale, and Shape, based on data from 1679 singleton pregnancies in non-smoking Chinese women. Ultrasound scans were performed at 12 to 40 weeks of gestation to measure biparietal diameter, head circumference, abdominal circumference (AC), and femur length, following standardised protocols. The rates of SGA and LGA diagnoses using the existing and updated Hong Kong fetal biometry references were compared in an independent cohort of 10 229 pregnancies.Results: The median number of scans per gestational week between 20 and 39 weeks was 75 (interquartile range=67-83). Compared with existing references, the new AC reference would significantly (P<0.001) increase the proportions of SGA fetuses with AC measurements at <3rd and <10th percentiles from 1.7% and 6.1% to 3.4% and 10.0%, respectively. Conversely, it would significantly decrease (P<0.001) the proportions of LGA fetuses with AC at >90th and >97th percentiles from 15.0% and 4.9% to 11.5% and 3.5%, respectively.Conclusion: Adoption of the new references, particularly for AC, may lead to increased identification of SGA cases and decreased identification of LGA cases. The proportions of these cases will be more consistent with their intended diagnostic thresholds. Further studies are needed to determine how these references impact pregnancy outcomes.","PeriodicalId":48828,"journal":{"name":"Hong Kong Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Incidence of 30-day readmission after total knee arthroplasty and its associated factors in Hong Kong.

IF 3.1 4区医学

Hong Kong Medical Journal Pub Date : 2024-12-05 DOI: 10.12809/hkmj2310733

O W K Tsui, P K Chan, J H Y Leung, A Cheung, V W K Chan, M H Luk, M H Cheung, H Fu, K Y Chiu

{"title":"Incidence of 30-day readmission after total knee arthroplasty and its associated factors in Hong Kong.","authors":"O W K Tsui, P K Chan, J H Y Leung, A Cheung, V W K Chan, M H Luk, M H Cheung, H Fu, K Y Chiu","doi":"10.12809/hkmj2310733","DOIUrl":"https://doi.org/10.12809/hkmj2310733","url":null,"abstract":"Introduction: Total knee arthroplasty (TKA) is one of the most commonly performed orthopaedic procedures worldwide, due to the increased prevalence of osteoarthritis associated with an ageing global population. Although many studies have focused on the causes of readmission among TKA patients within 30 days post-surgery, none have been conducted in Hong Kong. This study investigated the 30-day readmission rate, causes, and risk factors among TKA patients in Hong Kong.Methods: This retrospective review included patients who underwent TKA at a local university-affiliated hospital between 2001 and 2020. Eligible patients were identified using the Clinical Data Analysis and Reporting System and electronic patient records. Their data were analysed to determine the 30-day readmission rate, risk factors, and underlying causes.Results: Among the 3827 TKA patients included, the male-to-female ratio was 1:2.78 (1012:2815) and the mean age (±standard deviation) was 71.11±8.82 years. Of these patients, 3.4% underwent unplanned readmission to hospitals through the Accident and Emergency Department within 30 days of TKA. The most common causes of readmission were knee pain (33.1%), knee swelling (26.2%), and gastrointestinal-related conditions (8.5%). Age ≥80 years (odds ratio [OR]=1.63; P=0.01) and hypertension (OR=2.08; P<0.001) were risk factors for readmission. Bilateral simultaneous TKA (OR=0.42; P=0.005) was associated with lower risk of readmission.Conclusion: The readmission rate in this study was 3.4%, comparable to rates in previous reports. Enhanced patient education and optimised perioperative pain management are needed to minimise hospital readmissions. Fall prevention, cautious painkiller prescribing, and improved nursing care are recommended to prevent readmission.","PeriodicalId":48828,"journal":{"name":"Hong Kong Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

2024 Hong Kong College of Obstetricians and Gynaecologists Guidelines for cervical cancer prevention and screening.

IF 3.1 4区医学

Hong Kong Medical Journal Pub Date : 2024-12-03 DOI: 10.12809/hkmj2411547

S F Ngu, A N Y Cheung, K K Jong, J Y P Law, A Y Lee, J H S Lee, W H Li, V Ma, G C Y Wong, R W C Wong, K K L Chan

{"title":"2024 Hong Kong College of Obstetricians and Gynaecologists Guidelines for cervical cancer prevention and screening.","authors":"S F Ngu, A N Y Cheung, K K Jong, J Y P Law, A Y Lee, J H S Lee, W H Li, V Ma, G C Y Wong, R W C Wong, K K L Chan","doi":"10.12809/hkmj2411547","DOIUrl":"https://doi.org/10.12809/hkmj2411547","url":null,"abstract":"Primary prevention of cervical cancer is best achieved by vaccinating girls with a prophylactic human papillomavirus (HPV) vaccine. Despite the high efficacy of such vaccines, cervical cancer screening remains necessary because current vaccines do not offer full protection. Secondary prevention via cervical screening should target all women from age 25 years or at the onset of sexual activity, whichever occurs later, until age 64 years. Screening is recommended at 3-year intervals after two consecutive normal annual cytology results, or at 5-year intervals using HPV-based testing (either HPV co-test with cytology or HPV stand-alone). Women who have undergone hysterectomy with cervix removal for benign disease and have no prior history of cervical dysplasia can discontinue screening. Women with HPV-positive, cytology-negative co-test results should either undergo repeat co-testing in 12 months or immediate HPV16/18 genotyping. Immediate referral of women with positive stand-alone HPV test results for colposcopy without further triage is not recommended. A second triage test using cytology, genotyping for HPV16/18, or p16/Ki-67 dual-stain should be conducted to accurately identify women at high risk for high-grade lesions who thus require colposcopy referral. Women with HPV-positive, cytology-positive co-test results, or high-grade abnormal cytology results should be referred for colposcopy. Treatment with a loop electrosurgical excision procedure is recommended for women with high-grade squamous intraepithelial lesions (HSILs). After HSIL treatment, long-term follow-up with HPV-based testing over 25 years is preferred. When cytology results show atypical glandular cells, colposcopy and sampling of the endocervix and endometrium are recommended.","PeriodicalId":48828,"journal":{"name":"Hong Kong Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Use of burosumab in two young children with X-linked hypophosphataemic rickets in Hong Kong: two case reports. 在香港两名患有 X 连锁低磷血症佝偻病的幼儿中使用布罗苏单抗：两份病例报告。

IF 3.1 4区医学

Hong Kong Medical Journal Pub Date : 2024-11-26 DOI: 10.12809/hkmj2311184

J Y L Tung, S Wong, Q W S See, J Chan, E Kuong

引用次数: 0

Mask-associated changes in ocular surface parameters. 与面具相关的眼表参数变化。

IF 3.1 4区医学

Hong Kong Medical Journal Pub Date : 2024-11-18 DOI: 10.12809/hkmj2311140

V T T Chan, K W Kam, W W K Yip, A L Young

引用次数: 0

Aggressive renal angiomyolipoma with renal vein and inferior vena cava thrombus: a case report. 伴有肾静脉和下腔静脉血栓的侵袭性肾血管肌脂肪瘤：病例报告。