The knowledge, perceptions, and attitudes toward vaccination in pregnancy, pertussis, and pertussis vaccination during pregnancy among pregnant women in Hong Kong.

AIMS: The Centre for Health Protection of Hong Kong has issued a recommendation on pertussis vaccination during pregnancy to protect infants against pertussis. This study aimed to explore the knowledge, perceptions, and attitudes toward pertussis vaccination during pregnancy among pregnant women in Hong Kong. METHODS: This was a cross-sectional study conducted over a 6-week period from August 17 to September 30 2019 among pregnant women in an obstetrics department in a regional public hospital in Hong Kong. Information on participants' demographics, medical, and immunization history, their knowledge, perception and attitudes, toward pertussis vaccination during pregnancy were gathered. Point-biserial correlation coefficients were used to determine correlation between variables. RESULTS: Only 112 (24.6%) women knew that pertussis vaccination can be given during pregnancy and 53 (11.6%) recognized that antenatal pertussis vaccination should be given in each pregnancy. Despite poor knowledge on the vaccination, over 80% of women showed an intention to receive pertussis vaccination during pregnancy. Fifty-two (71.3%) women expressed that recommendations by healthcare professionals may alter their decision on vaccination uptake. The score in the knowledge section and the perception to the vaccination positively correlated with the intention to be vaccinated. Those who were given advice by healthcare professionals were more likely to indicate an intention to receive the vaccination. CONCLUSION: Pregnant women in Hong Kong are likely to accept antenatal pertussis vaccination despite the poor knowledge on vaccination in pregnancy and antenatal pertussis vaccination. Recommendations by healthcare professionals are a key factor affecting women's decision on vaccination uptake.

A case series of appendicitis and pseudo-appendicitis in a paediatric intensive care unit.

INTRODUCTION: Appendicitis is a common childhood condition that can be diagnostically challenging. Severe cases may necessitate support in the critical or intensive care unit. These "critical appendicitis diagnoses" have rarely been described. CASE DESCRIPTION: We retrospective reviewed the PICU database of the Hong Kong Children's Hospital and identified cases of suspected and confirmed appendicitis. Clinical features, radiologic findings and final diagnosis of each case were summarized and reported in this case series. We review six anonymized cases of appendicitis managed in a paediatric intensive care unit (PICU) to illustrate the different age spectrum and clinical manifestations of the condition. Rupture of the inflamed appendix, peritonitis and pancreatitis were some of the complications encountered. Crohn disease was found in one case as an underlying diagnosis. Also, one girl clinically diagnosed with appendicitis was found to be a case of ruptured hepatoblastoma with no appendicitis (i.e., pseudoappendicitis). CONCLUSION: Prompt diagnosis, surgical removal of the inflamed appendix, and use of appropriate antimicrobials when indicated are essential in reducing mortality and morbidity associated with severe appendicitis. Significant premorbid conditions such as acute myeloid leukemia, mitochondrial encephalopathy lactic acidosis syndrome (MELAS), inflammatory bowel disease and complications may be present in patients needing intensive care as is illustrated in the present cases. Pseudoappendicitis is an important differential diagnosis. Imaging is crucial and useful in establishing and confirming the diagnosis of appendicitis and pseudo-appendicitis in these PICU cases.

Cell-free circulating tumor RNAs in plasma as the potential prognostic biomarkers in colorectal cancer.

Background: Cell free RNA (cfRNA) contains transcript fragments from multiple cell types, making it useful for cancer detection in clinical settings. However, the pathophysiological origins of cfRNAs in plasma from colorectal cancer (CRC) patients remain unclear. Methods: To identify the tissue-specific contributions of cfRNAs transcriptomic profile, we used a published single-cell transcriptomics profile to deconvolute cell type abundance among paired plasma samples from CRC patients who underwent tumor-ablative surgery. We further validated the differentially expressed cfRNAs in 5 pairs of CRC tumor samples and adjacent tissue samples as well as 3 additional CRC tumor samples using RNA-sequencing. Results: The transcriptomic component from intestinal secretory cells was significantly decreased in the in-house post-surgical cfRNA. The HPGD, PACS1, and TDP2 expression was consistent across cfRNA and tissue samples. Using the Cancer Genome Atlas (TCGA) CRC datasets, we were able to classify the patients into two groups with significantly different survival outcomes. Conclusions: The three-gene signature holds promise in applying minimal residual disease (MRD) testing, which involves profiling remnants of cancer cells after or during treatment. Biomarkers identified in the present study need to be validated in a larger cohort of samples in order to ascertain their possible use in early diagnosis of CRC.