Hong Kong Medical Journal最新文献_第9页

Hong Kong consensus recommendations on the management of pancreatic ductal adenocarcinoma. 关于胰腺导管腺癌治疗的香港共识建议。

IF 2.7 4区医学

Hong Kong Medical Journal Pub Date : 2024-04-01 Epub Date: 2024-04-09 DOI: 10.12809/hkmj2210476

S L Chan, C L Chiang, K S H Chok, A S Lee, R S Y Tang, F M Y Lim, K F Lee, A Y P Tai, S W M Lee, R C L Lo, A W H Chan, F P T Mok

{"title":"Hong Kong consensus recommendations on the management of pancreatic ductal adenocarcinoma.","authors":"S L Chan, C L Chiang, K S H Chok, A S Lee, R S Y Tang, F M Y Lim, K F Lee, A Y P Tai, S W M Lee, R C L Lo, A W H Chan, F P T Mok","doi":"10.12809/hkmj2210476","DOIUrl":"https://doi.org/10.12809/hkmj2210476","url":null,"abstract":"This project was undertaken to develop the first set of consensus statements regarding the management of pancreatic ductal adenocarcinoma (PDAC) in Hong Kong, with the goal of providing guidance to local clinicians. A multidisciplinary panel of experts discussed issues surrounding current PDAC management and reviewed evidence gathered in the local context to propose treatment recommendations. The experts used the Delphi approach to finalise management recommendations. Consensus was defined as ≥80% acceptance among all expert panel members. Thirty-nine consensus statements were established. These statements cover all aspects of PDAC management, including diagnosis, resectability criteria, treatment modalities according to resectability, personalised management based on molecular profiling, palliative care, and supportive care. This project fulfils the need for guidance regarding PDAC management in Hong Kong. To assist clinicians with treatment decisions based on varying levels of evidence and clinical experience, treatment options are listed in several consensus statements.","PeriodicalId":48828,"journal":{"name":"Hong Kong Medical Journal","volume":"30 2","pages":"147-162"},"PeriodicalIF":2.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873023","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

Stevens-Johnson syndrome and toxic epidermal necrolysis in Hong Kong. 香港的史蒂文斯-约翰逊综合征和中毒性表皮坏死症。

IF 2.7 4区医学

Hong Kong Medical Journal Pub Date : 2024-04-01 Epub Date: 2024-03-26 DOI: 10.12809/hkmj2210131

C M T Cheung, M M Chang, J J X Li, A W S Chan

{"title":"Stevens-Johnson syndrome and toxic epidermal necrolysis in Hong Kong.","authors":"C M T Cheung, M M Chang, J J X Li, A W S Chan","doi":"10.12809/hkmj2210131","DOIUrl":"10.12809/hkmj2210131","url":null,"abstract":"Introduction: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) [hereafter, SJS/TEN] are uncommon but severe mucocutaneous reactions. Although they have been described in many populations worldwide, data from Hong Kong are limited. Here, we explored the epidemiology, disease characteristics, aetiology, morbidity, and mortality of SJS/TEN in Hong Kong.Methods: This retrospective cohort study included all hospitalised patients who had been diagnosed with SJS/TEN in Prince of Wales Hospital from 1 January 2004 to 31 December 2020.Results: There were 125 cases of SJS/TEN during the 17-year study period. The annual incidence was 5.07 cases per million. The mean age at onset was 51.4 years. The mean maximal body surface area of epidermal detachment was 23%. Overall, patients in 32% of cases required burns unit or intensive care unit admission. Half of the cases involved concomitant sepsis, and 23.2% of cases resulted in multiorgan failure or disseminated intravascular coagulation. The mean length of stay was 23.9 days. The cause of SJS/TEN was attributed to a drug in 91.9% of cases, including 84.2% that involved anticonvulsants, allopurinol, antibiotics, or analgesics. In most cases, patients received treatment comprising either best supportive care alone (35.2%) or combined with intravenous immunoglobulin (43.2%). The in-hospital mortality rate was 21.6%. Major causes of death were multiorgan failure and/or fulminant sepsis (81.5%).Conclusion: This study showed that SJS/TEN are uncommon in Hong Kong but can cause substantial morbidity and mortality. Early recognition, prompt withdrawal of offending agents, and multidisciplinary supportive management are essential for improving clinical outcomes.","PeriodicalId":48828,"journal":{"name":"Hong Kong Medical Journal","volume":" ","pages":"102-109"},"PeriodicalIF":2.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140295035","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

Acute chorioamnionitis following amnioreduction for polyhydramnios in placental chorioangioma complicating pregnancy: a case report. 妊娠并发胎盘绒毛膜血管瘤患者因多羊水而羊水减量后出现急性绒毛膜羊膜炎：病例报告。

IF 2.7 4区医学

Hong Kong Medical Journal Pub Date : 2024-04-01 Epub Date: 2024-04-11 DOI: 10.12809/hkmj2310668

J T C Leung, W Y Lok, W W K To, C W Kong

引用次数: 0

The challenge of detecting monoclonal protein in POEMS syndrome: two case reports. 检测 POEMS 综合征中单克隆蛋白的挑战：两份病例报告。

IF 2.7 4区医学

Hong Kong Medical Journal Pub Date : 2024-04-01 Epub Date: 2024-04-15 DOI: 10.12809/hkmj2210439

Y N Mew, Y O Lam, T H Luk, K F Hui, W C Fong

引用次数: 0

Multisystem inflammatory syndrome in adults in Hong Kong: two case reports. 香港成人多系统炎症综合征：两份病例报告。

IF 2.7 4区医学

Hong Kong Medical Journal Pub Date : 2024-04-01 Epub Date: 2024-04-16 DOI: 10.12809/hkmj2310676

A J Y Chan, J S Y Yu, A W T Yeung, H P Shum, K C Lung

引用次数: 0

Impact of a novel pre-hospital stroke notification programme on acute stroke care key performance indicators in Hong Kong: a multicentre prospective cohort study with historical controls. 新型院前卒中通报计划对香港急性卒中救治关键绩效指标的影响：一项多中心前瞻性队列研究与历史对照。

IF 2.7 4区医学

Hong Kong Medical Journal Pub Date : 2024-04-01 Epub Date: 2024-04-05 DOI: 10.12809/hkmj2210413

K Y Cheng, E L M Yu, T Yamamoto, J C L Kwong, Y K Ho, H K Ngan, W H Lin, J M T Lau, C H Cheung, G P C Lee, L H Siu, B Sheng, W W Y Wong, W Y Man, C C C Cheung, C T Tse

{"title":"Impact of a novel pre-hospital stroke notification programme on acute stroke care key performance indicators in Hong Kong: a multicentre prospective cohort study with historical controls.","authors":"K Y Cheng, E L M Yu, T Yamamoto, J C L Kwong, Y K Ho, H K Ngan, W H Lin, J M T Lau, C H Cheung, G P C Lee, L H Siu, B Sheng, W W Y Wong, W Y Man, C C C Cheung, C T Tse","doi":"10.12809/hkmj2210413","DOIUrl":"https://doi.org/10.12809/hkmj2210413","url":null,"abstract":"Introduction: Early identification and initiation of reperfusion therapy is essential for suspected acute ischaemic stroke. A pre-hospital stroke notification (PSN) protocol using FASE (facial drooping, arm weakness, speech difficulties, and eye palsy) was implemented to improve key performance indicators (KPIs) in acute stroke care delivery. We assessed KPIs and clinical outcomes before and after PSN implementation in Hong Kong.Methods: This prospective cohort study with historical controls was conducted in the Accident and Emergency Departments of four public hospitals in Hong Kong. Patients were screened using the PSN protocol between August 2021 and February 2022. Suspected stroke patients between August 2020 and February 2021 were included as historical controls. Door-to-needle (DTN) and door-to-computed tomography (DTC) times before and after PSN implementation were compared. Clinical outcomes including National Institutes of Health Stroke Scale score at 24 hours and modified Rankin Scale score at 3 months after intravenous recombinant tissue-type plasminogen activator (IV-rtPA) were also assessed.Results: Among the 715 patients (266 PSN and 449 non-PSN) included, 50.8% of PSN patients and 37.7% of non-PSN patients had a DTC time within 25 minutes (P<0.001). For the 58 PSN and 134 non-PSN patients given IV-rtPA, median DTN times were 67 and 75.5 minutes, respectively (P=0.007). The percentage of patients with a DTN time within 60 minutes was higher in the PSN group than in the non-PSN group (37.9% vs 21.6%; P=0.019). No statistically significant differences in clinical outcomes were observed.Conclusion: Although the PSN protocol shortened DTC and DTN times, clinical outcomes did not significantly differ.","PeriodicalId":48828,"journal":{"name":"Hong Kong Medical Journal","volume":"30 2","pages":"94-101"},"PeriodicalIF":2.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860557","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

Comparison of clinical characteristics between ACOSOG Z0011-eligible cohort and sentinel lymph node-positive breast cancer patients in Hong Kong. 符合 ACOSOG Z0011 标准的香港乳腺癌患者与前哨淋巴结阳性患者临床特征的比较。

IF 2.7 4区医学

Hong Kong Medical Journal Pub Date : 2024-04-01 Epub Date: 2024-03-25 DOI: 10.12809/hkmj2210286

V Man, A Kwong

{"title":"Comparison of clinical characteristics between ACOSOG Z0011-eligible cohort and sentinel lymph node-positive breast cancer patients in Hong Kong.","authors":"V Man, A Kwong","doi":"10.12809/hkmj2210286","DOIUrl":"10.12809/hkmj2210286","url":null,"abstract":"Introduction: The American College of Surgeons Oncology Group (ACOSOG) Z0011 trial resulted in de-escalation of axillary surgery among early-stage breast cancer patients with low-volume sentinel lymph node (SLN) disease undergoing breast-conserving surgery and radiation therapy. Nevertheless, the mastectomy rate in the Chinese population remains high. This study compared the clinical characteristics of the ACOSOG Z0011-eligible cohort with SLN-positive breast cancer patients in Hong Kong.Methods: This retrospective analysis of a prospectively maintained database at a university-affiliated breast cancer centre in Hong Kong was performed from June 2014 to May 2019. The database included all patients with clinical tumour (T) stage T1 or T2 invasive breast carcinoma, no palpable adenopathy, one or two positive SLNs on histological examination, and no prior neoadjuvant systemic treatment. Comparisons were made between the mastectomy and breast-conserving treatment groups in our cohort, along with the sentinel-alone arm in the ACOSOG Z0011 trial.Results: One hundred and seventy-one patients met the inclusion criteria: 112 underwent mastectomy and 59 underwent breast-conserving treatment. Our mastectomy group had higher prevalences of T2 tumours (P<0.001), lymphovascular invasion (P<0.001), and SLN macrometastases (P=0.004) compared with the ACOSOG Z0011 cohort. However, in our patient population, mean pathological size slightly differed between the mastectomy and breast-conserving treatment groups (2.2 cm vs 1.8 cm; P=0.005). Other histopathological features were similar.Conclusion: This study demonstrated that clinicopathological features were comparable between SLN-positive breast cancer patients undergoing mastectomy and those undergoing breast-conserving treatment. Low-risk SLN-positive mastectomy patients may safely avoid completion axillary lymph node dissection.","PeriodicalId":48828,"journal":{"name":"Hong Kong Medical Journal","volume":" ","pages":"139-146"},"PeriodicalIF":2.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140207990","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

A smallpox vaccination certificate. 天花疫苗接种证书。

IF 3.1 4区医学

Hong Kong Medical Journal Pub Date : 2024-04-01 DOI: 10.12809/hkmj-hkmms202404

W P Mak, T W Wong

引用次数: 0

2024 OSHK Guideline for Clinical Management of Postmenopausal Osteoporosis in Hong Kong. 2024 OSHK 香港绝经后骨质疏松症临床治疗指南。

IF 3.1 4区医学

Hong Kong Medical Journal Pub Date : 2024-04-01

Tai-Pang Ip, Chun-Hong Alan Lee, Tak-Wai David Lui, Ronald Man Yeung Wong, Ching-Lung Cheung, Ka-Chun Patrick Chiu, Siu-Lun Eddie Chow, Cheuk-Wah Flora Ho, Tze-Kwan Carmen Ho, Yiu-Yan Andrew Ho, Ka-Kui Lee, Hang-Wun Raymond Li, Kin-Cheung Mak, Koon-Kiu David Ng, Sze-Ling Iris Ngai, Ching-Yin Grace Wong, Siu-Him Janus Wong, Sze-Hung Wong, Tin-Wai Wong

引用次数: 0

Prioritising the psychosocial needs of young oncology patients: a call for comprehensive care. 优先考虑年轻肿瘤患者的社会心理需求：呼吁全面护理。

IF 2.7 4区医学

Hong Kong Medical Journal Pub Date : 2024-04-01 Epub Date: 2024-04-10 DOI: 10.12809/hkmj2311405

C Y Wong, H Y Au, K Y Chan, H Gill

引用次数: 0