OBJECTIVES. To evaluate the accuracy of gadolinium-enhanced magnetic resonance angiography in assessing renal artery stenosis compared to catheter digital subtraction angiography.

DESIGN. Retrospective study.

SETTING. Singapore General Hospital.

PATIENTS. Records of patients who underwent magnetic resonance angiography as well as digital subtraction angiography for assessment of renal artery stenosis from January 2003 to December 2005 were reviewed.

RESULTS. There were 27 patients (14 male, 13 female) with a mean age of 62 (range, 44-77) years. There were 10 patients with renal transplants; their native renal arteries were not evaluated. Each of the two experienced interventional and body magnetic resonance radiologists, who were blinded to the results, reviewed the digital subtraction angiography and magnetic resonance angiography images respectively. Digital subtraction angiography was used as the standard of reference. A total of 39 renal arteries from these 27 patients were evaluated. One of the arteries was previously stented and could not be assessed with magnetic resonance angiography due to severe artefacts. Of the remaining 38 renal arteries, two were graded as normal, seven as having mild stenosis (<50%), eight as having moderate stenosis (>=50% but <75%), and 21 as having severe stenosis (>=75%). Magnetic resonance angiography and digital subtraction angiography were concordant in 89% of the arteries; magnetic resonance angiography overestimated the degree of stenosis in 8% and underestimated it in 3% of them. In the evaluation of clinically significant renal artery stenosis (>=50%) with magnetic resonance angiography, the overall sensitivity, specificity, positive predictive value, and negative predictive value were 97%, 67%, 90%, and 86% respectively. The sensitivity and specificity of magnetic resonance angiography in transplant renal artery stenosis was 100%.

CONCLUSION. Our experience suggested that gadolinium-enhanced magnetic resonance angiography is a sensitive non-invasive modality useful in the assessment of clinically significant renal artery stenosis.

Key words: Angiography, digital subtraction; Gadolinium; Magnetic resonance angiography; Renal artery obstruction; Sensitivity and specificity

View this abstract indexed in MEDLINE:

OBJECTIVE. To determine the association of Mycoplasma genitalium and Ureaplasma urealyticum in symptomatic male patients presenting with non-gonococcal urethritis in a sexually transmitted infection clinic in Hong Kong.

DESIGN. Cross-sectional study.

SETTING. A sexually transmitted infection clinic, Department of Health, Centre for Health Protection, Hong Kong.

PATIENTS. A cohort of consecutive new male patients attending the government sexually transmitted infection clinic.

MAIN OUTCOME MEASURES. Prevalence of Mycoplasma genitalium and Ureaplasma urealyticum among symptomatic male patients with non-gonococcal urethritis and asymptomatic patients without non-gonococcal urethritis.

RESULTS. Specimens of 22 and 10 patients tested positive by polymerase chain reaction for Ureaplasma urealyticum and Mycoplasma genitalium respectively, among the symptomatic non-gonococcal urethritis group (n=98). In the asymptomatic control group (n=236), corresponding patient numbers whose specimens tested positive were 47 and 5. There was no statistically significant difference between the two groups, in terms of the proportion of patients infected with Mycoplasma genitalium (P=0.799) or Ureaplasma urealyticum (P=0.535).

CONCLUSIONS. In our study, demonstration of Mycoplasma genitalium and Ureaplasma urealyticum by polymerase chain reaction was not associated with symptomatic non-gonococcal urethritis in male patients attending a Hong Kong government clinic for sexually transmitted infections.

Key words: Mycoplasma infections; Polymerase chain reaction; Sexually transmitted diseases; Ureaplasma infections; Urethritis

View this abstract indexed in MEDLINE:

OBJECTIVE. To provide an understanding of Hong Kong registered nurses' personal and professional use of complementary and alternative medicine.

DESIGN. Cross-sectional questionnaire study.

PARTICIPANTS. Registered nurses who were members of the Hong Kong College of Nursing were invited to participate.

MAIN OUTCOME MEASURES. Demographic data of the respondents, prevalence of personal and professional use of complementary and alternative medicines, including their use for detailed clinical conditions.

RESULTS. A total of 187 nurses participated in this study. Nearly four fifths (80%; 95% confidence interval, 74-86%) of the participants had used at least one form of complementary/alternative medicine. In addition to the personal use of such treatment, over two fifths (41%; 95% confidence interval, 34-48%) had recommended at least one form of complementary/alternative medicine to their patients. These included bone-setting (20%), Chinese remedial massage (tuina, 19%), and meditation (19%). Specifically, registered nurses recommended acupuncture or acupressure to patients with musculoskeletal disorders, chronic pain, or headaches/migraines.

CONCLUSIONS. Personal use and professional recommendations for complementary and alternative medicine by registered nurses in Hong Kong is substantial. Registered nurses played an active role in advising such treatment for their patients based on their personal knowledge of perceived benefit in specific conditions. Further investigations with a larger sample size should focus on registered nurses??educational needs in respect of complementary and alternative medicine and the advice they recommended.

Key words: Complementary therapies; Health personnel; Medicine, Chinese traditional; Nurses; Utilization review

View this abstract indexed in MEDLINE:

OBJECTIVE. To report the clinical profile of children with mental retardation and developmental delay diagnosed by the Child Assessment Service.

DESIGN. Retrospective study.

SETTING. Child Assessment Service, Department of Health, Hong Kong.

PARTICIPANTS. Data pertaining to the children with mental retardation and developmental delay were drawn from an in-house clinical information system in the year 2004.

MAIN OUTCOME MEASURES. Clinical profiles including: sources, reasons and age of referral, diagnosis, gender ratio, co-morbidities, and socio-economic background.

RESULTS. In 2004, 23% (1463 of 6439) of Child Assessment Service referrals were diagnosed to have mental retardation or developmental delay. The Family Health Service was the major source of referral (64%). The majority (93%) of children were referred before the age of 6 years. The most common reason for referral was language delay (39%). More boys were affected (3 boys: 1 girl). The two most common co-morbidities were autistic spectrum disorders (33% in mental retardation and 19% in developmental delay) and discrepant language delay (17% in mental retardation and 47% in developmental delay). The socio-economic status of these families was higher than those in the general population.

CONCLUSION. The data presented here provide information on the descriptive epidemiology of mental retardation and developmental delay among Hong Kong children. Since mental retardation and developmental delay are common developmental disabilities in Hong Kong, public health education to promote and ensure early screening and identification of cases is an important prelude to early training and guidance for families with children having these conditions.

Key words: Mental retardation; Developmental disabilities; Health services needs and demand

View this abstract indexed in MEDLINE:

OBJECTIVE. To study clinical perspectives pertaining to chronic sclerosing sialadenitis, which is also known as Kuttner's tumour.

DESIGN. Retrospective medical chart review.

SETTING. Regional hospital, Hong Kong.

PATIENTS. From February 2005 to February 2007, nine cases with Kuttner's tumour were identified from our hospital electronic database.

INTERVENTIONS. They underwent submandibular sialadenectomy under either local (n=6) or general (n=3) anaesthesia.

MAIN OUTCOME MEASURES. The results of preoperative ultrasonography, fine-needle aspiration cytology, and intra-operative frozen section examination were correlated with the final diagnosis. Operative morbidity was also evaluated.

RESULTS. The mean age of the patients at diagnosis was 61 years; three were females. Three had bilateral submandibular swellings. Following preoperative ultrasonography in six of the patients, tumours were suspected in two, an enlarged lymph node in one, and diffuse enlargement was visualised in the other three. Six patients had preoperative fine-needle aspiration cytology; five yielded scanty acini with normal-looking ductal cells, variable degrees of infiltration by chronic inflammatory cells without granuloma admixing fibrosis. In the sixth patient, only bland-looking epithelial cells, indicative of ductal differentiation suspicious of neoplasm were noted. Intra-operative frozen section examination was conducted in three patients: chronic inflammation without evidence of carcinoma was visualised in each. Operations performed under local anaesthesia were well tolerated; only one patient endured a transient, marginal facial nerve palsy.

CONCLUSIONS. Kuttner's tumour is by no means rare. When supported by ultrasonography and fine-needle aspiration cytology, an accurate diagnosis can be made preoperatively and surgery can be reserved for symptomatic cases. Submandibular sialadenectomy is a safe and effective means of treating Kuttner's tumour, and can be accomplished under local anaesthesia.

Key words: Autoimmune diseases; Sclerosis; Sialadenitis; Submandibular gland

View this abstract indexed in MEDLINE: