Antithrombotic treatment of atrial fibrillation in a regional hospital in Hong Kong.

OBJECTIVE: To measure the use, appropriateness, and safety of antithrombotic therapy in Hong Kong Chinese patients with atrial fibrillation. DESIGN: Retrospective review. SETTING: Regional hospital, Hong Kong. SUBJECTS AND METHODS: Medical records of all patients with atrial fibrillation admitted to acute internal medicine wards in April 2000 and between July and October 2001 were reviewed for details of antithrombotics given, results of international normalised ratio monitoring for patients receiving warfarin, side-effects, and additional risk factors for complications of atrial fibrillation. Statistical analysis was undertaken to assess factors predictive of antithrombotic use. RESULTS: A total of 207 patients with chronic atrial fibrillation were included in the study. Of these, 44.0% of patients with non-valvular atrial fibrillation without contra-indications for warfarin use were receiving warfarin, 34.1% were receiving aspirin, and 22.0% were receiving no antithrombotic therapy. The majority of patients (69.1%) were treated appropriately according to the American College of Chest Physicians guidelines. The major side-effect rates for warfarin and aspirin were 2.14% and 1.72% per patient-year, respectively, which were comparable with western studies of usual clinical practice. The ischaemic stroke rate for patients taking warfarin or aspirin were 1.40% and 6.02% per patient-year, respectively. The median international normalised ratio was 1.96. The median frequency of international normalised ratio measurement was 45.58 days. CONCLUSIONS: This study found that antithrombotic use in a Hong Kong regional hospital for patients with atrial fibrillation was similar to that reported from western institutions. Complication and stroke rates were also comparable to the western data relating to usual clinical practice.

Genotype distribution of hepatitis C virus infection in Taiwan.

To investigate the prevalence of genotype distribution of hepatitis C virus (HCV) infection in Taiwan, genotypes were identified in 122 (36 anti-HCV-positive blood donors, 44 anti-HCV-positive aborigines, 28 hemodialysis patients, and 14 patients with chronic liver diseases) of 280 subjects, using polymerase chain reaction by Okamoto's type-specific primer method. Type II was the dominant (66.7%) type among anti-HCV-positive blood donors, followed by type III and type IV with the same percentages (16.7%), while none of type I was detected. The prevalence of genotype distribution were 75.0%, 81.1%, and 64.3% for type II, 4.6%, 17.9%, and 21.4% for type III, 13.6%, 0%, and 7.1% for type IV, for the aborigines, hemodialysis, and chronic liver diseases groups, respectively. Four subjects revealed mixed infections by two different genotypes: two cases of II and III; and each one case of II and IV, and III and IV. Diverse genotype distributions in two hemodialysis groups disclose the existence of obvious regional differences even within a region. The results reveal the highest prevalence of type II as in Japan. However, there is a higher prevalence rate of type IV than in Japan.

[Diagnostic value of serum total bile acid in hepatobiliary diseases].

The purpose of this study was to evaluate the clinical diagnostic value of serum total bile acid (STBA) in hepatobiliary diseases. Fasting STBA was measured using the enzymatic colorimetric method in 44 normal control cases and 153 cases of hepatobiliary disease, and then abnormal rates were compared to other conventional liver function tests. These 153 cases of hepatobiliary diseases included acute viral hepatitis (10 cases), chronic persistent hepatitis (32 cases), chronic active hepatitis (16 cases), liver cirrhosis (15 cases), alcoholic hepatitis (11 cases), alcoholic fatty liver (23 cases), alcoholic cirrhosis (17 cases), chronic liver diseases with slight fatty changes (10 cases) and hepatocellular carcinoma (6 cases). Except for 8 cases of acute viral hepatitis, the above cases were verified by liver biopsy. There were also 13 cases of biliary tract diseases. Fasting STBA and other conventional liver function tests were used in the above hepatobiliary diseases during the acute, exacerbated or decompensated stage, and the stable or compensated stage, and their abnormal rates compared. The results of this study revealed that the concentration of STBA is raised in various hepatobiliary diseases, which is related to the degree of hepatic cell injury and the various stages of liver. The concentration of STBA was higher in the acute, exacerbated or decompensated stage than in the convalescent, stable or compensated stage of liver diseases. When the abnormal rates of STBA were compared to other conventional liver function tests, the abnormal rates of STBA were not inferior to r-GT, GOT and GPT, and were more accurate than the other liver function tests.(ABSTRACT TRUNCATED AT 250 WORDS)