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1.
J Otolaryngol Head Neck Surg ; 49(1): 30, 2020 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-32414407

RESUMO

The 2019 novel coronavirus disease (COVID-19) epidemic originated in Wuhan, China and spread rapidly worldwide, leading the World Health Organization to declare an official global COVID-19 pandemic in March 2020. In Hong Kong, clinicians and other healthcare personnel collaborated closely to combat the outbreak of COVID-19 and minimize the cross-transmission of disease among hospital staff members. In the field of otorhinolaryngology-head and neck surgery (OHNS) and its various subspecialties, contingency plans were required for patient bookings in outpatient clinics, surgeries in operating rooms, protocols in wards and other services. Infected patients may shed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) particles into their environments via body secretions. Therefore, otolaryngologists and other healthcare personnel in this specialty face a high risk of contracting COVID-19 and must remain vigilant when performing examinations and procedures involving the nose and throat. In this article, we share our experiences of the planning and logistics undertaken to provide safe and efficient OHNS practices over the last 2 months, during the COVID-19 pandemic. We hope that our experiences will serve as pearls for otolaryngologists and other healthcare personnel working in institutes that serve large numbers of patients every day, particularly with regard to the sharing of clinical and administrative tasks during the COVID-19 pandemic.


Assuntos
Infecções por Coronavirus/transmissão , Controle de Infecções/normas , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Otolaringologia/normas , Pandemias , Assistência ao Paciente/normas , Pneumonia Viral/transmissão , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Cabeça/cirurgia , Educação em Saúde , Hong Kong , Hospitalização , Humanos , Controle de Infecções/organização & administração , Pescoço/cirurgia , Otolaringologia/organização & administração , Ambulatório Hospitalar/organização & administração , Ambulatório Hospitalar/normas , Pandemias/prevenção & controle , Assistência ao Paciente/métodos , Pneumonia Viral/prevenção & controle , Telemedicina
5.
Lancet Public Health ; 5(5): e279-e288, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32311320

RESUMO

BACKGROUND: A range of public health measures have been implemented to suppress local transmission of coronavirus disease 2019 (COVID-19) in Hong Kong. We examined the effect of these interventions and behavioural changes of the public on the incidence of COVID-19, as well as on influenza virus infections, which might share some aspects of transmission dynamics with COVID-19. METHODS: We analysed data on laboratory-confirmed COVID-19 cases, influenza surveillance data in outpatients of all ages, and influenza hospitalisations in children. We estimated the daily effective reproduction number (Rt) for COVID-19 and influenza A H1N1 to estimate changes in transmissibility over time. Attitudes towards COVID-19 and changes in population behaviours were reviewed through three telephone surveys done on Jan 20-23, Feb 11-14, and March 10-13, 2020. FINDINGS: COVID-19 transmissibility measured by Rt has remained at approximately 1 for 8 weeks in Hong Kong. Influenza transmission declined substantially after the implementation of social distancing measures and changes in population behaviours in late January, with a 44% (95% CI 34-53%) reduction in transmissibility in the community, from an estimated Rt of 1·28 (95% CI 1·26-1·30) before the start of the school closures to 0·72 (0·70-0·74) during the closure weeks. Similarly, a 33% (24-43%) reduction in transmissibility was seen based on paediatric hospitalisation rates, from an Rt of 1·10 (1·06-1·12) before the start of the school closures to 0·73 (0·68-0·77) after school closures. Among respondents to the surveys, 74·5%, 97·5%, and 98·8% reported wearing masks when going out, and 61·3%, 90·2%, and 85·1% reported avoiding crowded places in surveys 1 (n=1008), 2 (n=1000), and 3 (n=1005), respectively. INTERPRETATION: Our study shows that non-pharmaceutical interventions (including border restrictions, quarantine and isolation, distancing, and changes in population behaviour) were associated with reduced transmission of COVID-19 in Hong Kong, and are also likely to have substantially reduced influenza transmission in early February, 2020. FUNDING: Health and Medical Research Fund, Hong Kong.


Assuntos
Infecções por Coronavirus/prevenção & controle , Vírus da Influenza A Subtipo H1N1 , Influenza Humana/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Adulto , Betacoronavirus/isolamento & purificação , Criança , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Hong Kong/epidemiologia , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Influenza Humana/epidemiologia , Influenza Humana/terapia , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Medição de Risco
7.
Asia Pac J Ophthalmol (Phila) ; 9(2): 67-77, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32349113

RESUMO

The Coronavirus Disease 2019 (COVID-19), caused by severe acute respiratory coronavirus-2, was first reported in December 2019. The World Health Organization declared COVID-19 a pandemic on March 11, 2020 and as of April 17, 2020, 210 countries are affected with >2,000,000 infected and 140,000 deaths. The estimated case fatality rate is around 6.7%. We need to step up our infection control measures immediately or else it may be too late to contain or control the spread of COVID-19. In case of local outbreaks, the risk of infection to healthcare workers and patients is high. Ophthalmic practice carries some unique risks and therefore high vigilance and special precautions are needed. We share our protocols and experiences in the prevention of infection in the current COVID-19 outbreak and the previous severe acute respiratory syndrome epidemic in Hong Kong. We also endeavor to answer the key frequently asked questions in areas of the coronaviruses, COVID-19, disease transmission, personal protection, mask selection, and special measures in ophthalmic practices. COVID-19 is highly infectious and could be life-threatening. Using our protocol and measures, we have achieved zero infection in our ophthalmic practices in Hong Kong and China. Preventing spread of COVID-19 is possible and achievable.


Assuntos
Infecções por Coronavirus/prevenção & controle , Controle de Infecções/métodos , Máscaras , Oftalmologia/normas , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/prevenção & controle , Betacoronavirus , China , Higiene das Mãos , Hong Kong , Humanos , Ventiladores Mecânicos
8.
BMC Infect Dis ; 20(1): 299, 2020 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-32321442

RESUMO

BACKGROUND: Sexualized drug use (SDU) refers to use of any psychoactive substance before/during sexual intercourse. Chemsex is a subset of SDU, which is defined as the use of some specific psychoactive substances (methamphetamine, mephedrone, γ-hydroxybutyrate, ketamine and cocaine) before/during sexual intercourse. SDU and chemsex are prevalent among gay, bisexual and other men who have sex with men (GBMSM). This study investigated uptake and willingness to use pre-exposure prophylaxis (PrEP) among a sample of GBMSM in Hong Kong with experience of SDU in the past year. METHODS: A total of 600 GBMSM were recruited by convenient sampling through outreaching in gay venues, online recruitment and peer referral. Participants completed a cross-sectional anonymous telephone interview. This study was based on a subsample of 580 GBMSM self-reported as HIV negative/unknown sero-status. RESULTS: Of the participants, 82 (14.1%) and 37 (6.4%) had experience of SDU and chemsex in the past year. The prevalence of PrEP uptake was 4.0% among all participants and 14.6% among those with experience of SDU in the past year. Among GBMSM with experience of SDU in the past year who were not on PrEP (n = 70), 67.1% were willing to use daily oral PrEP in the next 6 months. Multivariate logistic regression models showed that positive attitudes toward PrEP (AOR: 2.37, 95%CI: 1.47, 3.82), perceived support from significant others to use PrEP (AOR: 9.67, 95%CI: 2.95, 31.71), and perceived behavioral control of using PrEP (AOR: 19.68, 95%CI: 5.44, 71.26) were significantly associated with higher willingness to use PrEP. CONCLUSION: GBMSM with experience of recent SDU are potentially good candidates of PrEP implementation. This group of GBMSM reported high prevalence of uptake and willingness to use PrEP. Perceptions related to PrEP based on the Theory of Planned Behavior were significantly associated with willingness to use PrEP.


Assuntos
Homossexualidade Masculina/estatística & dados numéricos , Participação do Paciente/estatística & dados numéricos , Profilaxia Pré-Exposição/métodos , Psicotrópicos/uso terapêutico , Minorias Sexuais e de Gênero/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/prevenção & controle , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Volição , Adolescente , Adulto , Atitude Frente a Saúde , Bissexualidade/psicologia , Bissexualidade/estatística & dados numéricos , China/epidemiologia , Estudos Transversais , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Homossexualidade Masculina/psicologia , Hong Kong/epidemiologia , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Profilaxia Pré-Exposição/estatística & dados numéricos , Prevalência , Comportamento Sexual/fisiologia , Comportamento Sexual/estatística & dados numéricos , Minorias Sexuais e de Gênero/psicologia , Doenças Sexualmente Transmissíveis/epidemiologia , Inquéritos e Questionários , Volição/fisiologia , Adulto Jovem
10.
Int J Infect Dis ; 94: 156-163, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32251790

RESUMO

Hong Kong has been recently attacked by the coronavirus disease-2019 (COVID-19). In late January 2020, it's shown a steadily increasing trend of confirmed cases. There is a 257 in total infected cases confirmed including 4 deaths until 20th of March 2020. To prevent further outbreak of COVID-19, this article discusses the current understanding of COVID-19 and compares with the outbreak of SARS-CoV-2 in 2003 of Hong Kong from the causes, transmission, symptoms, diagnosis, treatments and preventions to study for an applicable measurement to control COVID-19.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Vírus da SARS , Síndrome Respiratória Aguda Grave , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Infecções por Coronavirus/transmissão , Surtos de Doenças/prevenção & controle , Pessoal de Saúde , Hong Kong , Humanos , Exposição Ocupacional , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Pneumonia Viral/transmissão , Síndrome Respiratória Aguda Grave/epidemiologia , Síndrome Respiratória Aguda Grave/terapia , Síndrome Respiratória Aguda Grave/transmissão
12.
J Environ Manage ; 264: 110484, 2020 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-32250909

RESUMO

With the integration of the global economy and increased international trade, CO2 emissions embodied in trade have attracted broad attention. In this study, we examined Taiwan's CO2 emissions embodied in its imports and exports with its 167 trade partners from 1970 to 2015 using the emissions embodied in bilateral trade (EEBT) method. The results show that since the mid-1990s, Taiwan has shifted to being a net CO2 emissions exporter. The share of Taiwan's CO2 emissions exported to developed countries has decreased. However, the share exported to Mainland China, Hong Kong special administrative region and many developing countries in Southeast Asia has increased. The results of a structural decomposition analysis show that emissions intensity changes were the main driving force for Taiwan's exported CO2 emissions during 1970-1996, while increased export volumes were the largest driving force for Taiwan's exported CO2 emissions during 1996-2015. Emissions intensity changes and population growth are the main driving factors for Taiwan's CO2 emissions produced and consumed by itself increases. Based on the SDA results, environmentally friendly policies, such as energy efficiency and industrial structure optimization, are suggested to help Taiwan shift towards a sustainable economy.


Assuntos
Dióxido de Carbono , Comércio , China , Hong Kong , Internacionalidade , Taiwan
13.
Euro Surveill ; 25(16)2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32347198

RESUMO

BackgroundCOVID-19, caused by SARS-CoV-2, first appeared in China and subsequently developed into an ongoing epidemic. Understanding epidemiological factors characterising the transmission dynamics of this disease is of fundamental importance.AimsThis study aimed to describe key epidemiological parameters of COVID-19 in Hong Kong.MethodsWe extracted data of confirmed COVID-19 cases and their close contacts from the publicly available information released by the Hong Kong Centre for Health Protection. We used doubly interval censored likelihood to estimate containment delay and serial interval, by fitting gamma, lognormal and Weibull distributions to respective empirical values using Bayesian framework with right truncation. A generalised linear regression model was employed to identify factors associated with containment delay. Secondary attack rate was also estimated.ResultsThe empirical containment delay was 6.39 days; whereas after adjusting for right truncation with the best-fit Weibull distribution, it was 10.4 days (95% CrI: 7.15 to 19.81). Containment delay increased significantly over time. Local source of infection and number of doctor consultations before isolation were associated with longer containment delay. The empirical serial interval was 4.58-6.06 days; whereas the best-fit lognormal distribution to 26 certain-and-probable infector-infectee paired data gave an estimate of 4.77 days (95% CrI: 3.47 to 6.90) with right-truncation. The secondary attack rate among close contacts was 11.7%.ConclusionWith a considerable containment delay and short serial interval, contact-tracing effectiveness may not be optimised to halt the transmission with rapid generations replacement. Our study highlights the transmission risk of social interaction and pivotal role of physical distancing in suppressing the epidemic.


Assuntos
Busca de Comunicante , Infecções por Coronavirus , Monitoramento Epidemiológico , Pandemias , Pneumonia Viral , Adulto , Idoso , Betacoronavirus/genética , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Feminino , Hong Kong/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Isolamento de Pacientes , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Encaminhamento e Consulta , Fatores de Tempo , Adulto Jovem
14.
Bone Joint J ; 102-B(4): 519-523, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32228070

RESUMO

AIMS: The purpose of this study was to evaluate the incidence and analyze the trends of surgeon-reported complications following surgery for adolescent idiopathic scoliosis (AIS) over a 13-year period from the Scoliosis Research Society (SRS) Morbidity and Mortality database. METHODS: All patients with AIS between ten and 18 years of age, entered into the SRS Morbidity and Mortality database between 2004 and 2016, were analyzed. All perioperative complications were evaluated for correlations with associated factors. Complication trends were analyzed by comparing the cohorts between 2004 to 2007 and 2013 to 2016. RESULTS: Between 2004 and 2016, a total of 84,320 patients were entered into the database. There were 1,268 patients associated with complications, giving an overall complication rate of 1.5%. Death occurred in 12 patients (0.014%). The three most commonly reported complications were surgical site infection (SSI) (441 patients; 0.52%), new neurological deficit (293; 0.35%), and implant-related complications (172; 0.20%). There was a statistically significant but weak correlation between the occurrence of a SSI and the magnitude of the primary curve (r = 0.227; p < 0.001), and blood loss in surgery (r = 0.111; p = 0.038), while the occurrence of a new neurological deficit was correlated statistically significantly but weakly with age at surgery (r = 0.147; p = 0.004) and magnitude of the primary curve (r = 0.258; p < 0.001). The overall complication rate decreased from 4.95% during 2004 to 2007 to 0.98% during 2013 to 2016 (p = 0.023). CONCLUSION: An overall complication rate of 1.5% was found in our series after surgery for AIS, with a reduction of complication rates found in the second period of the analysis. Cite this article: Bone Joint J 2020;102-B(4):519-523.


Assuntos
Complicações Pós-Operatórias/etiologia , Escoliose/cirurgia , Adolescente , Criança , Bases de Dados Factuais , Feminino , Hong Kong/epidemiologia , Humanos , Incidência , Masculino , Complicações Pós-Operatórias/epidemiologia , Próteses e Implantes/efeitos adversos , Escoliose/epidemiologia , Traumatismos da Medula Espinal/epidemiologia , Traumatismos da Medula Espinal/etiologia , Fusão Vertebral/efeitos adversos , Fusão Vertebral/instrumentação , Raízes Nervosas Espinhais/lesões , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/etiologia , Infecção da Ferida Cirúrgica/microbiologia
17.
Infect Control Hosp Epidemiol ; 41(5): 493-498, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32131908

RESUMO

OBJECTIVE: To describe the infection control preparedness measures undertaken for coronavirus disease (COVID-19) due to SARS-CoV-2 (previously known as 2019 novel coronavirus) in the first 42 days after announcement of a cluster of pneumonia in China, on December 31, 2019 (day 1) in Hong Kong. METHODS: A bundled approach of active and enhanced laboratory surveillance, early airborne infection isolation, rapid molecular diagnostic testing, and contact tracing for healthcare workers (HCWs) with unprotected exposure in the hospitals was implemented. Epidemiological characteristics of confirmed cases, environmental samples, and air samples were collected and analyzed. RESULTS: From day 1 to day 42, 42 of 1,275 patients (3.3%) fulfilling active (n = 29) and enhanced laboratory surveillance (n = 13) were confirmed to have the SARS-CoV-2 infection. The number of locally acquired case significantly increased from 1 of 13 confirmed cases (7.7%, day 22 to day 32) to 27 of 29 confirmed cases (93.1%, day 33 to day 42; P < .001). Among them, 28 patients (66.6%) came from 8 family clusters. Of 413 HCWs caring for these confirmed cases, 11 (2.7%) had unprotected exposure requiring quarantine for 14 days. None of these was infected, and nosocomial transmission of SARS-CoV-2 was not observed. Environmental surveillance was performed in the room of a patient with viral load of 3.3 × 106 copies/mL (pooled nasopharyngeal and throat swabs) and 5.9 × 106 copies/mL (saliva), respectively. SARS-CoV-2 was identified in 1 of 13 environmental samples (7.7%) but not in 8 air samples collected at a distance of 10 cm from the patient's chin with or without wearing a surgical mask. CONCLUSION: Appropriate hospital infection control measures was able to prevent nosocomial transmission of SARS-CoV-2.


Assuntos
Betacoronavirus , Técnicas de Laboratório Clínico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Controle de Infecções , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/transmissão , Pessoal de Saúde , Hong Kong , Humanos , Controle de Infecções/métodos , Técnicas de Diagnóstico Molecular , Pneumonia Viral/transmissão , Fatores de Tempo
18.
J Environ Manage ; 261: 110230, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32148300

RESUMO

In recent years, considerable efforts have been devoted to minimizing the environmental consequences from building industry globally, as the industry is notorious for its significant resource consumption and environmental emissions. However, due to a lack of data representativeness in many parts of the world, considerable variations were observed among studies, and thus makes life cycle assessment (LCA) results difficult for the decision-making purpose. In addition, the selection of low impact materials and the management of end-of-life building waste are the most important concern. By considering several strategies including data representativeness, low carbon material, and end-of-life building waste management, this study aimed to enhance the accuracy of such assessment and sustainability performance of building. An integrated LCA framework is proposed for implementing those strategies through a case specific high-rise residential building in Hong Kong. Based on case-specific/regional data, carbon emission of building was evaluated with a cradle-to-construction system boundary with the functional unit of 1 m2 of gross floor area using the IMPACT 2002+ method, and then compared to that of selecting generic databases under different scenarios. The results demonstrate that the application of case-specific and generic data would significantly influence the outcomes of the case study, as the deviations of certain magnitudes were mostly derived from different building materials that it can lead to an underestimation of carbon emissions of up to 28%. Along with using alternative materials, the adoption of the proposed materials cycling and resource recovery approach at the end-of-life building could lead to a reduction of 14% of the total emissions (i.e. excluding the use and renovation of building). The results would support data selection for accuracy of evaluation which can be used as benchmark where recognized database is not available and promote sustainability performance of buildings locally, while the proposed framework could be adopted for comprehensive evaluation globally.


Assuntos
Indústria da Construção , Gerenciamento de Resíduos , Materiais de Construção , Hong Kong
19.
Lancet ; 395(10227): 868-869, 2020 03 14.
Artigo em Inglês | MEDLINE | ID: mdl-32171408
20.
Lancet ; 395(10227): 869, 2020 03 14.
Artigo em Inglês | MEDLINE | ID: mdl-32171409
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