Pok Oi Hospital

Objective: Eosinophilic granulomatosis with polyangiitis (EGPA) is a form of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis. Data among Chinese patients is sparse. This multicenter retrospective study aims to assess the presentation, treatment strategies, and outcomes of EGPA in Hong Kong. Methods: Patients with newly diagnosed EGPA who presented to eight participating hospitals in Hong Kong between January 1, 2013 and December 31, 2023 were identified. Clinical history and laboratory parameters were collected and analyzed. Outcomes, including mortality, relapse, and complications from disease and treatment, were assessed. Results: Seventy-six patients were identified. The annual incidence of EGPA was estimated at 1.9 per million population. Regarding the presentation, neurological symptoms (71.1%) were most frequently observed, followed by cutaneous (54%) and pulmonary symptoms (52.6%). The presence of anti-myeloperoxidase antibody (anti-MPO) correlated with a higher Birmingham Vasculitis Activity Score (BVAS) on presentation, more renal involvement, and absence of asthma. While anti-PR3 was associated with cardiovascular manifestations. Treatment mainly involved corticosteroids and cyclophosphamide as induction and azathioprine as maintenance. Biologics were used for induction in 18.4% of cases and for maintenance in 7.9%. Infective complications occurred in 29% of patients; a starting prednisolone dose [Formula: see text] 40 mg daily and a history of diabetes mellitus were identified as risk factors. Relapses occurred in 26.3% of subjects; the mean time to relapse was 39.5 months. Multivariate survival analysis revealed that a history of smoking [Formula: see text] 1 year (HR 20.63, 95% CI 2.76–154.37, [Formula: see text] = 0.03), absence of asthma (HR 0.13, 95% CI 0.02–0.96, [Formula: see text] = 0.045), and absence of neurological involvement on presentation (HR 0.06, 95% CI 0.01–0.45, [Formula: see text] = 0.006) were associated with mortality. Conclusion: This study underscored the heterogeneity of EGPA in the Chinese population and supports categorization based on anti-MPO status. Smoking history and absence of asthma or neurological symptoms were associated with mortality. The findings aim to inform clinical practice and direct future research efforts in managing this complex disease.

Maqolada leksik takrorning “Xoldorxon” dostonidagi o‘rni haqida so‘z yuritiladi. Ushbu maqolada Go‘ro‘g‘li turkumiga mansub “Xoldorxon” dostonidagi leksik-semantik takroriy shakllarning lingvopoetik xususiyatlari tahlil qilinadi. Tadqiqot davomida epanalepsis, sinonimik va antonimik takror, halqasimon takror kabi birliklarning badiiy matndagi funksional o‘rni o‘rganildi. Takror san’ati doston nutqining musiqiyligi, ritmik uyg‘unligi va emotsional ta’sirchanligini ta’minlashda muhim vosita ekanligi asoslab berildi. Takror tushunchasi tilda ma’noni kuchaytirish, ta’kidlash, ta’sirchanlikni oshirish maqsadida ba’zi so‘z va unsurlarning qayta qo‘llanishiga nisbatan ishlatiladi. Takror va takroriylik adabiy matn tashqarisida, bizni qurshab turgan olamdagi jismlararo munosabatlarda ham mavjud. Hatto hayotimizning har qirrasida muntazamlikni ta’minlovchi, murakkablikni bartaraf qiluvchi beminnat vosita sifatida duch kelamiz. Takror keng ma’noda odam va olam bilan bog‘liq tushuncha va mavjudlikning nomi hisoblanadi. Dostondagi takrorlar orqali qahramonlar xarakteri, yaxshilik va yomonlik qarama-qarshiligi, jang manzaralarining dinamikasi kuchaytiriladi. “Xoldorxon” dostonining nasriy va she’riy qismlarida takrorlar o‘ziga xos stilistik yukni bajarib, epik nutqning badiiy-estetik qimmatini oshiradi. Tadqiqot natijalariga ko‘ra, leksik-semantik takroriy birliklar doston kompozitsiyasining uzviy qismi bo‘lib, folklor nutqining ritmik-intonatsion yaxlitligini ta’minlashga xizmat qiladi.

Abstract Background Sarcopenia is an important prognostic marker affecting 25% ambulatory HF patients, predicting poor activity tolerance, cardiac function and even mortality of HF patients. On the other hand, the pathophysiology of HF involving the metabolic, endocrine, vascular and inflammatory synergistic responses cause a pathological level of catabolism, which further aggravates the skeletal muscle loss and results in secondary sarcopenia.5 Resistance training is the guideline-based recommendation for sarcopenia. Yet, the exercise principles of "specificity," "overload," and "progression" have seldom integrated to stimulate muscle anabolism.9 Besides, the exercise format which can sustain the patient’s self-practice was least investigated. Purposes This pilot RCT investigated the effects of an elastic band-based progressive resistance training program (EB-PRT) on muscle mass, grip strength, physical function, symptoms and health-related quality of life (HRQL) of HF patients. Methods We randomized 58 HF patients[mean age=70.7 (8.9); NYHA classification: I/II 55.2%/44.8], who fulfilled the Asian Working Group of Sarcopenia (AWGS) 2019 criteria of sarcopenia, from the outpatient cardiac clinic to receive the 14-week EB-PRT program or usual care. The 12-week EB-PRT (Fig 2) was designed according to the principles of "specificity," "overload," and "progression". A trained RA with background in physical education delivered the program via hybrid in-person, tele and face-time visits. The outcomes included the ASMI by the bioimpedance analysis (BIA) using Inbody machine; hand grip strength; Short Physical Performance Battery, Memorial Symptom Assessment Scale-Heart Failure (MSAS-HF); and e Minnesota Living with Heart Failure Questionnaire (MLHFQ) at baseline (T0), posttest-14th week (T1), 26th week (T2). Results After adjusting the socio-demographic characteristics, two-way ANOVA analysis showed that the EB-PRT group reported significantly greater improvement in HF symptoms by MSAS-HF [β(95%CI)=-19.55 (-32.08 to -7.03), p=0.002 at T1; -15.10 (-28.54 to -1.66), p=0.028 at T2] and HRQL [MLHFQ [β(95%CI) =--6.17 (-11.78 to -0.55), p=0.031 at T1 only]. This pilot study also identified a non-significant trend of greater improvement in muscle mass and physical performance which reaching a medium effect size [BIA analysis [Adjusted mean difference (95% CI): ASMI=0.17(-0.05-0.38), Cohen’s d=0.403; right arm muscle=0.09(-0.02-0.20), Cohen’s d=0.449; left leg muscle=0.26(-0.04-0.56), Cohen’s d=0.473SBBP=0.16(-0.18-1.54), Cohen’s d=0.421]. Conclusions This pilot study highlights the high feasibility of using elastic band to engage the HF patients in RT. Based on the promising preliminary effects of EB-PRT on the criteria markers of sarcopenia, HF symptom control and HRQL, a full-scale trail to investigate the effects and mechanism is warranted.

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract and usually present as submucosal gastric lesions. Atypical morphologies, such as exophytic or cystic growth, are uncommon and can lead to lesions being mistaken for hepatic, pancreatic, or splenic origin. We report a case of a 63-year-old woman referred for evaluation of unexplained weight loss. Imaging revealed a 4 cm lobulated lesion adjacent to the spleen with peripheral cystic changes. The mass enhanced similarly to splenic tissue and was initially interpreted as splenosis. Final pathology revealed a GIST with cystic degeneration, negative margins, and no evidence of metastasis. This case highlights the diagnostic challenges posed by atypical GISTs and emphasizes the importance of endoscopic ultrasound (EUS) with tissue acquisition for accurate diagnosis when cross-sectional imaging is inconclusive.

Older patients are vulnerable to complications from hospitalisation, particularly during the COVID-19 pandemic.We report four cases of complications (psychological distress, deconditioning and pressure injuries, delirium, and poor feeding) that occurred during the stay in the community treatment facility.These complications are common and tend to be overlooked during the pandemic because of the isolation policy with decreased contact between healthcare workers and patients, increased patient load, and shortage of healthcare manpower.The usual preventive measure should be implemented despite the difficulties during the pandemic.Early mobilisation with decreased bedrest and early discharge arrangement should be considered once medical condition stabilised and isolation period completed.

Breast cancer is the most common cancer in reproductive age women. The aim of this study is to assess the knowledge, attitude and intention on fertility preservation among women diagnosed to have breast cancer. This is a multi-centre cross-sectional questionnaire study. Reproductive age women diagnosed with breast cancer attending Oncology, Breast Surgery and Gynaecology Clinics and support groups were invited to participate. Women filled in paper or electronic form of the questionnaire. 461 women were recruited and 421 women returned the questionnaire. Overall, 181/410 (44.1%) women had heard of fertility preservation. Younger age and higher education level were significantly associated with increased awareness of fertility preservation. Awareness and acceptance of the different fertility preservation methods in reproductive age women with breast cancer was suboptimal. However, 46.1% women felt that their fertility concerns affected their decision for cancer treatment in some way.