Biomedical subjects

B C C Lam

Publications and source records attributed to B C C Lam.

4 recordsLinked to original sources

PubMed2006

Splenic rupture in a premature neonate.

Splenic injuries are very rare in neonates. We report a case of splenic injury in a premature neonate, highlighting the importance of a high-index suspicion in early recognition of this rare but potentially fatal intra-abdominal injury. We also review the literature on possible aetiologies and mechanism of splenic injury, as well as its management. This is the first reported case of a very low-birth-weight neonate with splenic rupture who survived with intact neurology.

Cesarean Section↗

PubMed2006

Newborn hearing screening in Hong Kong.

OBJECTIVES: To review studies on newborn hearing screening in Hong Kong and the current evidence on the cost-effectiveness of universal newborn hearing screening programmes and to determine their value and the best model for such a programme in Hong Kong. DATA SOURCE: Medline literature search (1985-2004), local reports and abstracts available to the author. STUDY SELECTION: Literature and data on newborn hearing screening strategies, screening devices, cost-effectiveness study of universal newborn hearing screening programmes. DATA EXTRACTION: Relevant information and data were reviewed by the author. DATA SYNTHESIS: A universal newborn hearing screening programme with a high coverage rate is essential to enable early diagnosis and intervention before 6 months of age. This ensures good language and cognitive outcomes in hearing impaired children. A cost-effective universal newborn hearing screening programme should be hospital-based to achieve a high coverage rate, use modern screening devices with high sensitivity and specificity that enable early diagnosis, and be acceptable to parents. CONCLUSIONS: Increasing evidence supports the cost-effectiveness and long-term benefits of universal newborn hearing screening programmes. The medical community in Hong Kong should work towards the development and implementation of a well-coordinated, collaborative, multidisciplinary, cost-effective, and sustainable territory-wide universal newborn hearing screening programme coupled with interventions for the next generation of hearing impaired children.

Cost-Benefit Analysis↗

PubMed2004

Feasibility of implementing a universal neonatal hearing screening programme using distortion product otoacoustic emission detection at a university hospital in Hong Kong.

OBJECTIVE: To assess the feasibility of implementing a universal neonatal hearing screening programme using distortion product otoacoustic emission detection at a major teaching hospital in Hong Kong. DESIGN: Descriptive study and questionnaire. SETTING. Teaching hospital, Hong Kong. METHODS: A total of 1064 infants, together with their mothers, were successfully recruited for the study. The participation rate was 99.3%. A three-stage hearing screening protocol using distortion product otoacoustic emission detection was adopted. Each of the participating infants was screened on three separate occasions (day 1-4, day 5-14, and day 21-30 after birth), irrespective of the test results. A questionnaire was administered to 364 randomly selected mothers to determine whether as consumers of the hearing screening service, mothers would find screening desirable. RESULTS: Results of the screening demonstrated an incidence of permanent bilateral hearing loss (>or=40 dB in the better ear) of 0.28%. The results also showed that 3.5% of the screened infants were referred for subsequent diagnostic audiological assessment, including those suspected with unilateral as well as bilateral hearing loss. Data obtained were comparable to other reported results obtained using multi-stage screening protocols. Taking both the false positive rate and the default rate into consideration, the most appropriate time for screening in this hospital setting appeared to be around day 5 to 14 when infants returned to the hospital's day centre as out-patients for routine medical follow-up. Since this day centre service is not generally provided by all maternity hospitals in Hong Kong, an alternative time for screening would be around day 21 to 30 when infants could return as out-patients solely for the hearing test. The results of the questionnaire suggested that most mothers thought a neonatal hearing screening would be desirable (91.35%). The majority (81.70%) indicated a preference for screening either within a few days of birth at the maternity ward prior to discharge from the hospital, or between 5 and 30 days when returning to the hospital as an out-patient. CONCLUSION: It was concluded that a universal neonatal hearing screening programme could be readily implemented in a maternity hospital setting in Hong Kong.

Clinical Protocols↗

PubMed2003

MRI of neonatal encephalopathy.

We present the magnetic resonance imaging (MRI) findings in neonatal encephalopathy, including hypoxic-ischaemic encephalopathy, perinatal/neonatal stroke, metabolic encephalopathy from inborn errors of metabolism, congenital central nervous system infections and birth trauma. The applications of advanced MRI techniques, such as diffusion-weighted imaging and magnetic resonance spectroscopy are emphasized.

Birth Injuries↗