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3.
Cardiol Young ; 28(2): 175-181, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28851468

RESUMO

Persistence of the embryonic "fifth aortic arch" in postnatal life is a rare, enigmatic - and at times controversial - condition, with variable anatomical forms and physiological consequences. First described in humans over 40 years ago by Van Praagh, the condition was labelled the "great pretender" by Gerlis 25 years later, because of its apparent propensity to mimic anatomically similar structures. Despite many subsequent case reports citing the condition, the true developmental origin of these structures remains unresolved, and has been the subject of debate among embryologists for more than a century. A persistent fifth aortic arch has been defined as an extrapericardial structure, arising from the ascending aorta opposite or proximal to the brachiocephalic artery, and terminating in the dorsal aorta or pulmonary arteries via a persistently patent arterial duct. This description may therefore encompass various anatomical forms, such as a unilateral double-lumen aortic arch, an unrestrictive aortopulmonary shunt, or a critical vascular channel for either the systemic or pulmonary circulation. The physiological properties of these vessels, such as their response to prostaglandins, may also be unpredictable. In this article, we demonstrate a number of cases that fulfil the contemporary definition of "persistent fifth aortic arch" while acknowledging the embryological controversies associated with this term. We also outline the key diagnostic features, particularly with respect to the use of new cross-sectional imaging techniques.


Assuntos
Aorta Torácica/anormalidades , Doenças da Aorta/congênito , Malformações Vasculares/diagnóstico , Aorta Torácica/diagnóstico por imagem , Doenças da Aorta/diagnóstico , Ecocardiografia , Humanos , Imageamento Tridimensional , Tomografia Computadorizada por Raios X
4.
Hong Kong Med J ; 23(4): 365-73, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28684648

RESUMO

INTRODUCTION: There has been limited research on the knowledge of and attitudes about herpes zoster in the Hong Kong population. This study aimed to investigate the knowledge, attitude, and practice of patients aged 50 years or above towards herpes zoster and its vaccination. METHODS: This was a cross-sectional study in the format of a structured questionnaire interview carried out in Sai Ying Pun Jockey Club General Outpatient Clinic in Hong Kong. Knowledge of herpes zoster and its vaccination was assessed, and patient attitudes to and concerns about the disease were evaluated. Factors that affected a decision about vaccination against herpes zoster were investigated. RESULTS: A total of 408 Hong Kong citizens aged 50 years or above were interviewed. Multiple regression analysis revealed that number of correct responses regarding knowledge about herpes zoster was positively correlated with educational attainment (B=0.313, P=0.026) and history of herpes zoster (B=0.408, P=0.038), and negatively correlated with age (B= -0.042, P<0.001) and male gender (B= -0.396, P=0.029). Answers to several questions revealed a sizable number of misconceptions about the disease. Among all respondents, 35% stated that they were worried about getting the disease, and 17% would consider vaccination against herpes zoster. CONCLUSIONS: Misconceptions about herpes zoster were notable in this study. More health education is needed to improve the understanding and heighten awareness of herpes zoster among the general public. Although the majority of participants indicated that herpes zoster would have a significant impact on their health, a relatively smaller proportion was actually worried about getting the disease. Further studies on this topic should be encouraged to gauge the awareness and knowledge of herpes zoster among broader age-groups.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Vacina contra Herpes Zoster/uso terapêutico , Herpes Zoster/psicologia , Pacientes Ambulatoriais/psicologia , Vacinação/psicologia , Idoso , Estudos Transversais , Feminino , Herpes Zoster/prevenção & controle , Hong Kong , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
6.
J Adv Nurs ; 72(8): 1766-73, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27380764

RESUMO

AIMS: To examine the accuracy and acceptability of capillary blood glucose monitoring using the earlobe. BACKGROUND: In current practice, blood samples for capillary blood glucose monitoring are obtained from the fingertip. Because obtaining blood samples from the fingertip is sometimes contraindicated, it is necessary to identify an alternative site for the procedure. DESIGN: A single-patient design with repeated measurements. METHODS: Patients from an outpatient clinic and four medical wards were recruited to the study, in 2014, if they met one of the following criteria: (i) were in a relatively stable glycaemic state; (ii) were currently receiving intravenous infusion; (iii) had been diagnosed with chronic renal impairment or (iv) were aged 65 years or above and bedbound. Blood samples were obtained from the fingertip and the earlobe consecutively for blood glucose monitoring. Participants were asked to rate the respective pain level caused by the procedures. Intra-class correlation coefficient was calculated to demonstrate the level of absolute agreement between the two blood glucose readings. The Wilcoxon signed rank test was used to compare the pain levels. RESULTS: A total of 120 patients participated in the study between February - December 2014. The intra-class correlation coefficient between the readings at the two sampling sites was significantly high, except in a hypoglycaemic state. Participants generally reported a significantly lower level of pain when the earlobe rather than fingertip was pricked. CONCLUSION: The earlobe is to be recommended as a safe alternative site for capillary blood glucose monitoring unless the patient is in a suspected hypoglycaemic state.


Assuntos
Glicemia/análise , Orelha , Dor , Idoso , Capilares , Feminino , Humanos , Hipoglicemia/diagnóstico , Masculino
7.
Fam Pract ; 33(4): 401-7, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27142313

RESUMO

BACKGROUND: In Hong Kong, fasting plasma glucose (FPG) is the most popular screening test for diabetes mellitus (DM) in primary care. Individuals with impaired fasting glucose (IFG) are commonly encountered. OBJECTIVES: To explore the determinants of regression to normoglycaemia among primary care patients with IFG based on non-invasive variables and to establish a nomogram for the prediction of regression from IFG. METHODS: This cohort study consisted of 1197 primary care patients with IFG. These subjects were invited to repeat a FPG test and 75-g 2-hour oral glucose tolerance test (2h-OGTT) to determine the glycaemia change. Normoglycaemia was defined as FPG <5.6 mmol/L and 2h-OGTT <7.8 mmol/L. Stepwise logistic regression model was developed to predict the regression to normoglycaemia with non-invasive variables, using a randomly selected training dataset (810 subjects). The model was validated on the remaining testing dataset (387 subjects). Area under the receiver operating characteristic curve (AUC) and Hosmer-Lemeshow test were used to evaluate discrimination and calibration of the model. A nomogram was constructed based on the model. RESULTS: After a mean follow-up period of 6.1 months, 180 subjects (15.0%) had normoglycaemia based on the repeated FPG and 2h-OGTT results at follow-up. Subjects without central obesity or hypertension, with moderate-to-high-level physical activity and a lower baseline FPG level, were more likely to regress to normoglycaemia. The prediction model had acceptable discrimination (AUC = 0.705) and calibration (P = 0.840). CONCLUSION: The simple-to-use nomogram could facilitate identification of subjects with low risk of progression to DM and thus aid in clinical decision making and resource prioritization in the primary care setting.


Assuntos
Glicemia/análise , Tomada de Decisão Clínica/métodos , Intolerância à Glucose/diagnóstico , Nomogramas , Idoso , Estudos de Coortes , Diabetes Mellitus/diagnóstico , Jejum/sangue , Feminino , Teste de Tolerância a Glucose , Hong Kong , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Atenção Primária à Saúde , Curva ROC
8.
Drug Alcohol Depend ; 164: 47-54, 2016 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-27177803

RESUMO

OBJECTIVE: To investigate the association between reported alcohol drinking and mental health problems in Hong Kong adolescents. METHODS: In a school-based questionnaire survey in 2012-13 on 4620 Secondary one (US Grade seven) to six students (mean age 14.5, SD 1.6 years; 53.4% boys), alcohol drinking was classified as never drinking (reference), experimental, former, less-than-weekly and weekly drinking. Binge drinking was defined as drinking at least five drinks on one occasion. Mental health was assessed using the Strengths and Difficulties Questionnaire (SDQ) with five subscales (emotional symptoms, conduct problems, hyperactivity, peer relationship problems and prosocial activity) and the total difficulties score (sum of the first four subscales). Multilevel regression was used to analyse the associations of mental health problems with drinking frequency and binge drinking, adjusting for potential confounders. RESULTS: Compared with never drinking, higher total difficulties scores were associated with less-than-weekly drinking (adjusted odds ratio AOR 1.39, 95% CI 1.01-1.91), weekly drinking (AOR 3.21, 95% CI 2.18-4.70), and binge drinking (AOR 2.18, 95% CI 1.42-3.32). Weekly drinking was most strongly associated with hyperactivity (AOR 6.27, 95% CI 1.42-3.32) among all subscales. Girls were more likely than boys to report emotional problems (AOR 3.36 vs 1.47) and hyperactivity (AOR 19.2 vs 2.31) related to weekly alcohol drinking (both P for interaction <0.05). CONCLUSIONS: In Hong Kong adolescents, less-than-weekly, weekly, and binge drinking are associated with higher risks of mental health problems based on self-reported data. Prospective studies are warranted to explore the causality between alcohol drinking and mental health problems.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Grupo com Ancestrais do Continente Asiático/psicologia , Transtornos Mentais/epidemiologia , Estudantes/psicologia , Adolescente , Consumo de Bebidas Alcoólicas/psicologia , Feminino , Hong Kong/epidemiologia , Humanos , Masculino , Transtornos Mentais/psicologia , Razão de Chances , Grupo Associado , Instituições Acadêmicas , Autorrelato , Inquéritos e Questionários
9.
Oncogene ; 35(17): 2197-207, 2016 04 28.
Artigo em Inglês | MEDLINE | ID: mdl-26257057

RESUMO

Enhanced sensitivity to Wnts is an emerging hallmark of a subset of cancers, defined in part by mutations regulating the abundance of their receptors. Whether these mutations identify a clinical opportunity is an important question. Inhibition of Wnt secretion by blocking an essential post-translational modification, palmitoleation, provides a useful therapeutic intervention. We developed a novel potent, orally available PORCN inhibitor, ETC-1922159 (henceforth called ETC-159) that blocks the secretion and activity of all Wnts. ETC-159 is remarkably effective in treating RSPO-translocation bearing colorectal cancer (CRC) patient-derived xenografts. This is the first example of effective targeted therapy for this subset of CRC. Consistent with a central role of Wnt signaling in regulation of gene expression, inhibition of PORCN in RSPO3-translocated cancers causes a marked remodeling of the transcriptome, with loss of cell cycle, stem cell and proliferation genes, and an increase in differentiation markers. Inhibition of Wnt signaling by PORCN inhibition holds promise as differentiation therapy in genetically defined human cancers.


Assuntos
Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/genética , Compostos Heterocíclicos de 4 ou mais Anéis/administração & dosagem , Proteínas de Membrana/genética , Proteínas Wnt/genética , Aciltransferases , Animais , Linhagem Celular Tumoral , Neoplasias Colorretais/patologia , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Humanos , Proteínas de Membrana/antagonistas & inibidores , Camundongos , Processamento de Proteína Pós-Traducional , Células-Tronco/efeitos dos fármacos , Proteínas Wnt/antagonistas & inibidores , Via de Sinalização Wnt/efeitos dos fármacos , Ensaios Antitumorais Modelo de Xenoenxerto
10.
Br J Anaesth ; 117(4): 512-520, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28077540

RESUMO

BACKGROUND: The efficacy of opioids typically decreases after long-term use owing to the development of tolerance. Glial activation and the upregulation of proinflammatory cytokines are related to the induction of tolerance. We investigated the effect of leukemia inhibitory factor (LIF) on morphine analgesia and tolerance. METHODS: LIF concentrations in rat spinal cords were measured by polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA) after morphine administration. LIF distribution was examined using confocal microscopy. To evaluate the effects of LIF on morphine analgesia and tolerance, LIF was intrathecally administered 30 min before morphine injection. The analgesic effect of morphine was evaluated by measuring tail-flick latency. Human LIF concentrations from the cerebrospinal fluid (CSF) of opioid tolerant patients were also determined by specific ELISA. RESULTS: Chronic morphine administration upregulated LIF concentrations in rat spinal cords. Intrathecal injection of LIF potentiated the analgesic action of morphine. Patch clamp recording of spinal cord slices showed that LIF enhanced DAMGO ([D-Ala2, N-MePhe4, Gly-ol]-enkephalin)-induced outward potassium current. The development of tolerance was markedly suppressed by exogenous LIF, whereas neutralizing the endogenously released LIF with anti-LIF antibodies accelerated the tolerance induction. Moreover, LIF concentrations in the CSF of opioid-tolerant patients were higher than those in the opioid-naive controls. CONCLUSIONS: Intrathecal administration of LIF potentiated morphine antinociceptive activity and attenuated the development of morphine tolerance. Upregulation of endogenously released LIF by long-term use of opioids might counterbalance the tolerance induction effects of other proinflammatory cytokines. LIF might be a novel drug candidate for inhibiting opioid tolerance induction.


Assuntos
Analgésicos Opioides/farmacologia , Fator Inibidor de Leucemia/fisiologia , Morfina/farmacologia , Animais , Citocinas/análise , Tolerância a Medicamentos , Humanos , Masculino , Ratos , Ratos Sprague-Dawley
11.
Fam Pract ; 32(6): 631-8, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26467644

RESUMO

BACKGROUND: HbA1c ≥ 6.5% has been recommended as a diagnostic criterion for the detection of diabetes mellitus (DM) since 2010 because of its convenience, stability and significant correlation with diabetic complications. Nevertheless, the accuracy of HbA1c compared to glucose-based diagnostic criteria varies among subjects of different ethnicity and risk profile. OBJECTIVES: This study aimed to evaluate the accuracy of HbA1c for diagnosing DM compared to the diagnosis by oral glucose tolerance test (OGTT) and the optimal HbA1c level to diagnose DM in primary care Chinese patients with impaired fasting glucose (IFG). METHODS: A cross-sectional study was carried out in three public primary care clinics in Hong Kong. About 1128 Chinese adults with IFG (i.e. FG level between 5.6 and 6.9 mmol/l in the past 18 months) were recruited to receive paired OGTT and HbA1c tests. Sensitivities and specificities of HbA1c at different threshold levels for predicting DM compared to the diagnosis by OGTT were evaluated. A receiver operating characteristic (ROC) curve was used to determine the optimal cut-off level. RESULTS: Among the 1128 subjects (mean age 64.2±8.9 year, 48.8% male), 229 (20.3%) were diagnosed to have DM by OGTT. The sensitivity and specificity of HbA1c ≥6.5% were 33.2% and 93.5%, respectively, for predicting DM diagnosed by OGTT. The area under the ROC curve was 0.770, indicating HbA1c had fair discriminatory power. The optimal cut-off threshold of HbA1c was 6.3% for discriminating DM from non-DM, with sensitivity and specificity of 56.3% and 85.5%, respectively. HbA1c ≥ 5.6% has the highest sensitivity and negative predictive value of 96.1% and 94.5%, respectively. CONCLUSIONS: HbA1c ≥ 6.5% is highly specific in identifying people with DM, but it may miss the majority (66.8%) of the DM cases. An HbA1c threshold of <5.6% is more appropriate to be used for the exclusion of DM. OGTT should be performed for the confirmation of DM among Chinese patients with IFG who have an HbA1c between 5.6% and 6.4%.


Assuntos
Diabetes Mellitus/diagnóstico , Jejum/sangue , Intolerância à Glucose , Teste de Tolerância a Glucose/métodos , Hemoglobina A Glicada/análise , Idoso , Glicemia/metabolismo , Estudos Transversais , Diabetes Mellitus/sangue , Feminino , Hong Kong , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade
13.
Animal ; 9(6): 952-7, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25556532

RESUMO

This study was conducted by two trials to investigate effects of sequential feeding with low- and high-protein diets on growth traits and plasma metabolites in geese. In Trial I, the effect of sequential feeding under time-restricted feeding system was investigated. Seventy-two White Roman goslings were randomly allotted into either sequential feeding (S1) or control feeding (C1) group. All goslings were fed for 1 h at morning and at evening, respectively, from 2 to 8 weeks of age. S1 group was offered 13% CP diet at morning and 19% CP diet at evening. C1 group was offered the same diet (16% CP; mixed equally with the two diets mentioned above) at both morning and evening. Blood samples were hourly collected for 4 h after feeding at both morning and evening for the determination of the postprandial plasma levels of glucose, triacylglycerol and uric acid at the end of experiment. Results showed that BW, average daily gain (ADG), and daily feed intake (FI) were not different between groups, but the feed efficiency (FE) in S1 group was significantly higher than that in C1 group (P<0.05). The areas under curve (AUC) of plasma postprandial levels of glucose, triacylglycerol and uric acid were not affected by treatment, but the AUC of triacylglycerol and uric acid in morning were lower than those in evening (P<0.05). In Trial II, the effect of sequential feeding under ad libitum feeding system was investigated. Twenty-four goslings were randomly allotted into either sequential feeding (S2) or control feeding (C2) group. Diets were altered at 0600 and 1800 h, respectively, and geese were fed ad libitum from 4 to 8 weeks of age. S2 group was offered 14% CP diet at morning and 20% CP diet at evening. C2 group was supplied the same diet (mixed with the two diets according to the ratio of diets consumed by S2 group on the preceded day) at both morning and evening. Results showed that the ADG in S2 group was higher than those in C2 group (P<0.05). Summarized data from both trials showed that sequential feeding improves daily gain and FE in growing geese.


Assuntos
Ração Animal/análise , Dieta/veterinária , Gansos/fisiologia , Ganho de Peso , Animais , Análise Química do Sangue/veterinária , Dieta com Restrição de Proteínas/veterinária , Feminino , Gansos/crescimento & desenvolvimento , Masculino , Distribuição Aleatória
14.
Br J Dermatol ; 173(1): 146-54, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25511692

RESUMO

BACKGROUND: Few studies have examined the association between psoriasis and glomerulonephritis (GN) as well as chronic kidney disease (CKD). OBJECTIVES: To determine the risk of CKD in patients with psoriasis and evaluate the impact of the severity of psoriasis, comorbidities and concomitant drugs on the risk of GN and CKD in patients with psoriasis. METHODS: We identified 4344 patients with psoriasis for the study cohort and randomly selected 13,032 subjects as a control cohort. Each subject was individually followed for up for 5 years to identify those who subsequently developed GN and CKD. RESULTS: After adjustment for traditional CKD risk factors, psoriasis was found to be independently associated with an increased risk of CKD during the follow-up period [hazard ratio (HR) 1.28; 95% confidence interval (CI) 1.14-1.44]. The increased incidence of GN in patients with psoriasis (HR 1.50, 95% CI 1.24-1.81) may contribute to the positive association between psoriasis and CKD. Patients with mild and severe psoriasis had an increased risk of CKD and GN compared with the control cohort; the risk increased with severity. Patients with psoriasis and arthritis exhibited a higher risk of CKD than patients without arthritis (HR 1.62 vs. 1.26). Among drugs, nonsteroidal anti-inflammatory drugs (NSAIDs) have the strongest association with CKD in patients with psoriasis (adjusted odds ratio 1.69, 95% CI 1.14-2.49). CONCLUSIONS: Psoriasis was associated with a higher risk of developing CKD and GN. High severity, psoriatic arthritis involvement and concomitant NSAIDs use further increased the risk of CKD in patients with psoriasis.


Assuntos
Glomerulonefrite/etiologia , Psoríase/complicações , Insuficiência Renal Crônica/etiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Anti-Inflamatórios não Esteroides/efeitos adversos , Métodos Epidemiológicos , Feminino , Glomerulonefrite/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Psoríase/epidemiologia , Insuficiência Renal Crônica/epidemiologia , Fatores Socioeconômicos , Taiwan/epidemiologia , Adulto Jovem
15.
Animal ; 8(3): 395-400, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24387980

RESUMO

This study comprises two trials that investigated the effects of feeding time and time-restricted feeding on the fattening traits and plasma metabolite levels of White Roman geese. In Trial I, 24 geese aged 8 weeks of each sex were allowed free access to a fattening diet for 1 h either in the morning (morning-feeding group) or afternoon (afternoon-feeding group). At 12 weeks of age, blood samples were collected hourly for 4 h, beginning 1 h after feeding to determine the plasma levels of glucose, triacylglycerols and uric acid. The results showed a lower (P<0.05) daily feed intake (DFI) and daily gain (DG) and higher (P<0.05) feed efficiency (FE) for the morning-feeding group compared with those of the afternoon-feeding group. In addition, the postprandial plasma levels of glucose, triacylglycerols and uric acid did not differ (P>0.05) between groups. In Trial II, 12 geese aged 8 weeks of each sex were randomly assigned to either the ad libitum feeding group (control group) or time-restricted feeding group (restricted group). The geese in the control group were fed a fattening diet ad libitum, whereas those in the restricted group were allowed access to the diet for 2 h every morning. All geese were killed at 13 weeks of age and their carcass traits were evaluated. The results showed a lower DFI and DG and higher FE for the restricted group compared with those of the control group (P<0.05). In addition, the restricted group exhibited lower visceral and abdominal fat and higher empty digestive tract and liver weights than those of the control group (P<0.05). The results showed that time-restricted feeding in the morning resulted in superior DG and FE compared with feeding in the afternoon. Moreover, time-restricted feeding implemented in the morning during the fattening period reduced DFI and increased FE in geese compared with ad libitum feeding.


Assuntos
Gansos/fisiologia , Ração Animal/análise , Animais , Dieta , Feminino , Masculino , Distribuição Aleatória
16.
Hong Kong Med J ; 19 Suppl 4: 39-41, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23775186

RESUMO

1. Reliable and valid interviewer-administered questionnaires were developed to investigate associations of perceived neighbourhood attributes of Hong Kong older adults with their walking for transportation and recreation. 2. Access to and availability of different types of services and destinations, provision of facilities for resting/sitting in the neighbourhood, and easy access to/from residential buildings may help maintain an active lifestyle by facilitating walking for transport in the neighbourhood. 3. Access to services, indoor places for walking, environmental aesthetics, low traffic, and absence of physical barriers may promote recreational walking..


Assuntos
Estilo de Vida , Características de Residência , Transportes , Caminhada/fisiologia , Idoso , Idoso de 80 Anos ou mais , Planejamento Ambiental , Feminino , Hong Kong , Humanos , Masculino , Projetos Piloto , Recreação , Inquéritos e Questionários
17.
Hong Kong Med J ; 19 Suppl 4: 45-7, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23775188

RESUMO

1. Onset of obesity is related to age, gender, pubertal stage, dietary habits, and parental occupation. Targeting the high riskgroups may help curb obesity in children. 2. Obesity may lead to poor self-esteem and potential psychosocial risk. The psychosocial impact of obesity could be more pronounced in girls than boys. 3. The association between obesity and psychosocial health could be bi-directional. Improving psychosocial health could be beneficial in weight management for normal-weight and obese children. 4. Obesity is associated with higher blood pressures.


Assuntos
Saúde Mental , Obesidade/epidemiologia , Autoimagem , Pressão Sanguínea , Criança , Estudos de Coortes , Feminino , Hong Kong/epidemiologia , Humanos , Masculino , Obesidade/etiologia , Obesidade/psicologia , Avaliação de Resultados em Cuidados de Saúde , Pais , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais
18.
Int J Obes (Lond) ; 36(7): 925-30, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22234278

RESUMO

OBJECTIVE: An association between weight gain and breakfast skipping has been reported, but breakfast location was rarely considered. We investigated the prospective associations between breakfast location, breakfast skipping and body mass index (BMI) change in a large cohort of Chinese children. DESIGN: Our baseline cohort consisted of 113,457 primary 4 (US grade 4) participants of the Hong Kong Department of Health Student Health Service in 1998-2000. Of these, 68,606 (60.5%) had complete records and were successfully followed-up 2 years later. Data on breakfast consumption and location were collected at both time points along with other lifestyle characteristics. BMI was derived from objectively measured height and weight. Associations between breakfast habits and BMI change were assessed by multivariable linear regression, adjusting for demographic, socioeconomic and lifestyle characteristics. RESULTS: At baseline, 85.3, 9.4 and 5.2% of children had breakfast at home, away from home and skipped breakfast, respectively. Prospectively, having breakfast away from home (vs at home) predicted a greater BMI increase over two years (ß = 0.15; 95% CI: 0.11-0.18). Breakfast skipping had a comparable, slightly smaller effect (0.13; 0.09-0.18). CONCLUSION: Both breakfast skipping and eating breakfast away from home predict greater increases in BMI during childhood, the effect being slightly stronger in the latter. Having breakfast, particularly at home, could have important implications for weight management and reducing obesity in children. Further research is required to gain insight into potential underlying mechanisms.


Assuntos
Índice de Massa Corporal , Fenômenos Fisiológicos da Nutrição Infantil , Dieta , Comportamento Alimentar , Obesidade/epidemiologia , Análise de Variância , Criança , Estudos de Coortes , Feminino , Hong Kong/epidemiologia , Humanos , Masculino , Valor Nutritivo , Obesidade/prevenção & controle , Estudos Prospectivos , Distribuição por Sexo , Fatores Socioeconômicos , Inquéritos e Questionários , Ganho de Peso
19.
Ultrasound Obstet Gynecol ; 39(2): 196-202, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21638368

RESUMO

OBJECTIVE: To compare the capability of three-dimensional (3D) reconstructed images produced by high-resolution episcopic microscopy (HREM) with that of in-vivo four-dimensional high-resolution transvaginal sonography (4D-HRTVS) to discern morphological features of the first-trimester human fetal heart. METHODS: This was a prospective study of fetal hearts between 9 and 14 weeks' gestation. For ex-vivo 3D analysis, 30 human fetal hearts (at 9 + 0 to 14 + 6 weeks) were retrieved from surgical terminations of pregnancy. The specimens were embedded in resin and episcopic ('block-face') imaging was used to obtain a digital volume dataset (HREM) using 3-micron slicing. 4D-HRTVS was performed in 28 separate pregnancies at 10 + 2 to 14 + 0 weeks using a Voluson E8 ultrasound machine with volumetric transvaginal RIC 6-12-MHz transducers. Heart volumes obtained by both methods were compared to assess their ability to demonstrate first-trimester cardiac morphology. Comparisons were made in the transverse and sagittal planes, and using volume rendering. RESULTS: All hearts were structurally normal, although abdominal situs was not examined in the isolated hearts that underwent HREM. 4D-HRTVS demonstrated each of the complete five transverse cardiac views in 32-86% of cases. HREM showed four features unique to the first-trimester human heart: prominent atrial appendages, spiral ventricular arrangement, prominent coronary arteries and thickened arterial walls. 4D-HRTVS could demonstrate the first two, but ultrasound resolution was too poor to quantify wall thickness and demonstrate coronary arteries in the 3-5-mm diameter heart. CONCLUSIONS: 4D-HRTVS showed limited morphological features of the first-trimester fetal heart compared with HREM. HREM provides a gold standard of ex-vivo imaging against which developments in ultrasound resolution could be compared.


Assuntos
Ecocardiografia Quadridimensional/métodos , Coração Fetal/diagnóstico por imagem , Microscopia/métodos , Ultrassonografia Pré-Natal , Feminino , Coração Fetal/anormalidades , Coração Fetal/anatomia & histologia , Ventrículos do Coração/anormalidades , Ventrículos do Coração/anatomia & histologia , Ventrículos do Coração/diagnóstico por imagem , Humanos , Processamento de Imagem Assistida por Computador , Gravidez , Primeiro Trimestre da Gravidez , Estudos Prospectivos , Ultrassonografia Pré-Natal/métodos , Vagina
20.
Fam Pract ; 29(2): 196-202, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21890842

RESUMO

BACKGROUND: Little is known about the quality of care for patients with Type 2 diabetes in primary care setting in Hong Kong. OBJECTIVES: To investigate the quality of care for patients with Type 2 diabetes in Hong Kong primary care setting and potential disparities by patient characteristics and clinics. METHODS: Cross-sectional study in three general outpatient clinics (GOPCs; public primary care clinics) in Hong Kong involving 1970 patients. Main outcome measures were achievement rates of seven process measures and three intermediate outcome targets and adjusted odds ratios of age, sex, socio-economic status and clinic on the quality measures. RESULTS: The achievement rates for the recording of HbA1c, blood pressure (BP), cholesterol, body mass index, smoking status, nephropathy screening and retinopathy screening in the previous 12 months were 92.8%, 99.9%, 91.0%, 47.9%, 91.3%, 69.0% and 38.0%, respectively. A total of 58.0%, 38.2% and 36.4% of patients achieved the glycaemic, BP and cholesterol targets, respectively. Older patients were less likely to have records of process measures and more likely to achieve the HbA1c target. Women were less likely to have smoking status recorded and to achieve the HbA1c target. Patients of lower socio-economic status were less likely to have records of process measures and to achieve the BP target. Family medicine training practices had better achievements of the quality measures. CONCLUSIONS: There is scope for improvement in the quality of diabetes care in the GOPCs. Variations in the quality of care were observed. Family medicine training may enhance the health care quality.


Assuntos
Diabetes Mellitus Tipo 2/terapia , Atenção Primária à Saúde/normas , Qualidade da Assistência à Saúde , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Disparidades em Assistência à Saúde , Hong Kong , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Indicadores de Qualidade em Assistência à Saúde , Qualidade da Assistência à Saúde/normas , Fatores Sexuais , Fatores Socioeconômicos
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