The records from 12 Chinese adult patients with scleredema, who had attended the Social Hygiene Service of the Hong Kong Department of Health between 22 January 1990 and 19 March 1996, were retrieved and analysed. The neck was the commonest site of involvement (75%), followed by the back (42%), and the shoulder (17%). The vast majority (83%) of scleredema cases were associated with diabetes mellitus; half of these were insulin-dependent. Most of the patients (92%) had hypertension for which medical treatment was needed. No cases of skin disease were preceded by acute infection, and none had any associated paraproteinaemia. The degree of skin involvement did not affect the daily activities of most of the patients. This study revealed differences between the disease in our locality and those described in the western literature.

Sleep-related breathing disorder is a prevalent medical condition that remains underdiagnosed in the community. This disorder has social, behavioural and neuropsychological impact, deleterious haemodynamic effects during sleep, and is associated with increased cardiovascular morbidity. This review aims to describe the current evidence for the association of sleep-related breathing disorder with hypertension, ischaemic heart disease, heart failure, and stroke, based on the knowledge of its haemodynamic effects during sleep.

Intermittent claudication is a common symptom. It is a marker of generalised antherosclerotic disease and may herald other cardiovascular catastrophes. The aim of management is to reduce the total cardiovascular morbidity and mortality. The functional status and quality of life of severely affected patients can be improved by endovascular and surgical interventions.

Published data were used to determine the rate of occurrence of cleft lip and /or palate in the Chinese population. The rate of occurrence ranged from 1.33 to 2.23 per 1000 live and stillbirths. Most studies were performed in communities with mixed racial groups, and only three obtained data from multiple sources. Half of the studies included live and still births. The majority of the studies reported pooled figures for subjects with and without other malformations. Furthermore, three different classifications of clefts were used by the authors. Clefts involving the lip and palate had the highest occurrence rate in most studies. Unfortunately, the differences in the rate of occurrence may reflect differences in the technique used for data collection rather than real differences.

This paper reviews the evidence that with early retinal photocoagulation, blindness as a complication of diabetes mellitus is preventable and the new evidence that high blood sugar levels play a major role in the development of the microvascular complications of diabetes mellitus. The screening methods used to detect diabetes mellitus and diabetic retinopathy and the cost-effectiveness of diabetic retinopathy screening are also discussed. The Early Treatment Diabetic Retinopathy Study demonstrates that severe visual loss can be nearly eliminated when proliferative diabetic retinopathy and macular oedema are detected early and treated in a timely manner. The Diabetes Control and Complications Trial and the recently published 10-year follow up report of the Wisconsin Epidemiologic Study of Diabetic Retinopathy strongly suggest that microvascular complications can be prevented when near-normal levels of blood sugar are maintained in patients with insulin-dependent diabetes mellitus and non-insulin-dependent diabetes mellitus. Good management of diabetes mellitus requires a medical screening system and public awareness education. The early diagnosis, proper treatment, and reduction of risk factors can prevent disease complications. Treatment of the severe complications of diabetes mellitus is expensive in terms of health care dollars and the increased morbidity and mortality of patients affected by the disease. Health care dollars would be better spent by developing a system for the early diagnosis of retinopathy and the education of patients in the effective management of their disease. The expensive and catastrophic complications of diabetes mellitus could thereby be prevented.