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Biomedical subjects

I K Cheng

Publications and source records attributed to I K Cheng.

117 records · Page 7Linked to original sources

Treatment of urinary tract infections in Hong Kong: a comparative study of norfloxacin and co-trimoxazole.

The study compared the efficacy and safety of norfloxacin to those of co-trimoxazole in the treatment of urinary tract infections (UTI). A total of 172 adults, 42 men and 130 women were recruited and randomly allocated to norfloxacin or co-trimoxazole using a double-blind study design. Patients with lower UTI received norfloxacin 200 mg or co-trimoxazole (160 mg of trimethoprim plus 800 mg of sulphamethoxazole) b.i.d. for seven days. In patients with upper UTI, the norfloxacin dose was 400 mg b.i.d. for seven days. Eleven to 14 days after treatment, the bacteriological cure rates were 96.8% and 83.3% and the clinical cure rates were 96.9% and 89.9% for norfloxacin and co-trimoxazole, respectively. A few patients complained of gastrointestinal symptoms but there were few other side-effects and the treatments were well tolerated. In conclusion, both norfloxacin and co-trimoxazole were well tolerated but norfloxacin gave higher cure rates.

Adult↗

Cyclosporin A in steroid-sensitive nephrotic syndrome with frequent relapses.

Eight patients with steroid-sensitive nephrotic syndrome which frequently relapsed despite cyclophosphamide treatment were given cyclosporin A (7.5 mg/kg/day to 10 mg/kg/day) for 8 to 12 weeks. Six had minimal change glomerulonephritis and two had focal segmental glomerulonephritis. Cyclosporin A was given to 5 patients when their nephrotic syndrome was in relapse and to 3 patients when the nephrotic syndrome was in remission. Cyclosporin A induced a transient remission in only one patient.

Adult↗

Continuous ambulatory peritoneal dialysis (CAPD): experience with the first 100 patients in a Hong Kong centre.

We treated 100 Chinese patients age 16 to 83 years by CAPD, using three 2-litre exchanges per day. The treatment was self-financed in 69 patients, by charitable organisations in 25 patients, and by government funds in 6 patients. Satisfactory biochemistry was maintained and there was no gross hyperlipidaemia, renal osteodystrophy, or loss of ultrafiltration capacity of the peritoneum. Rehabilitation was good and 62% of patients returned to full-time employment. The average duration of hospitalization was 11.3 days per patient year. Peritonitis usually due to Staphylococcus pyogenes occurred at a frequency of one episode per 12.3 patient-months. Sixteen patients were transplanted and had a 2-year graft survival of 78.5%. The cumulative patient survival was 97% at 1 year and 84% at 2 years. The corresponding technique survival rates were 87% and 76% respectively.

Adolescent↗

Lymphocyte subsets in Heymann nephritis.

Altered ratios of T lymphocyte subsets have recently been reported in some forms of glomerulonephritis, including membranous glomerulonephritis. Heymann nephritis is a model of membranous glomerulonephritis that can be induced in susceptible strains of rat by a single subcutaneous injection of renal tubular antigen in Freund's complete adjuvant. Monoclonal antibodies were used to identify cytotoxic/suppressor and helper/inducer T cells in the blood, spleen, peripheral lymph nodes, and, where relevant, the lymph node draining the antigen injection site in susceptible and nonsusceptible rat strains before and after immunization with renal tubular antigen. A marked interstrain variation in the proportions of T lymphocyte subsets was found, but this did not segregate strains that are susceptible to Heymann nephritis induction from those that are resistant. Neither the development of Heymann nephritis in susceptible strains or immunization of resistant strains with renal tubular antigen was associated with any specific alteration in the T lymphocyte subpopulations.

Animals↗

A randomized prospective comparison of oral levofloxacin plus intraperitoneal (IP) vancomycin and IP netromycin plus IP vancomycin as primary treatment of peritonitis complicating CAPD.

OBJECTIVE: To compare the therapeutic efficacy of daily oral levofloxacin plus intermittent intraperitoneal (IP) vancomycin (group 1) versus daily IP netromycin and intermittent IP vancomycin (group 2) in the primary treatment of peritonitis complicating continuous ambulatory peritoneal dialysis (CAPD). DESIGN: A randomized multicenter prospective open-label comparative clinical study. SETTING: University and Hospital Authority hospitals in Hong Kong. PATIENTS: All CAPD patients who developed bacterial or culture-negative peritonitis beyond 28 days of a previous episode and without evidence of septicemia, associated tunnel infection, or known sensitivity to trial medications were accepted into the clinical trial. RESULTS: A total of 101 patients entered the trial. The primary cure rate was 74.5% for group 1 and 73.6% for group 2. Baseline culture results appeared to influence the clinical outcome: the primary cure rate for culture-negative, gram-positive, and gram-negative episodes was 83.3%, 78.6%, and 42.9% for group 1 and 69.1%, 76.9%, and 71.3% for group 2, respectively. The primary cure rate also varied considerably among individual centers and was particularly noticeable in group 1. In the latter group, it correlated closely with in vitro levofloxacin resistance which in turn correlated closely with previous exposure to fluoroquinolones. CONCLUSION: Oral levofloxacin in combination with intermittent IP vancomycin has comparable efficacy to IP netromycin combined with intermittent IP vancomycin as primary treatment in CAPD peritonitis, but is simpler and more cost-effective to administer. It may be recommended as primary therapy in centers with relatively low exposure and, therefore, low background resistance to fluoroquinolones.

Administration, Oral↗

Relationship between adequacy of dialysis and nutritional status, and their impact on patient survival on CAPD in Hong Kong.

OBJECTIVE: Superior patient survival on continuous ambulatory peritoneal dialysis (CAPD) with 3 x 2-L exchanges has been reported from Hong Kong. This study examined the relationship between indices of dialysis adequacy and nutrition and patient survival on CAPD in Hong Kong. DESIGN: A cross-sectional study on prevalent CAPD patients. Patients were assessed for indices of dialysis adequacy and nutritional status with a composite nutritional index (CNI). Patients were then followed for 24 months. Survival data were analyzed according to adequacy indices and nutritional status. SETTING: All prevalent CAPD patients in nine dialysis centers in Hong Kong as of 1 April 1996. MAIN OUTCOME MEASURE: Mortality. RESULTS: 937 patients were assessed: 68.2% were using 3 x 2-L exchanges per day; mean age was 54.6 +/- 13 years. Mean total Kt/V was 1.83 +/- 0.42 and total creatinine clearance was 55.6 +/- 19.5 L/week/1.73 m2. 19% of patients were moderately to severely malnourished according to the CNI. There was no significant correlation between indices of adequacy and serum albumin or CNI. The 1- and 2-year patient survival from the time of assessment was 90.9% and 79.8%. There was a trend toward better survival in patients with Kt/V greater than 2.0, but it was not statistically significant. Peritoneal Kt/V did not impact survival in anuric patients. Malnourished patients had poorer survival than patients who were better nourished (p = 0.0259). After adjusting for age and diabetes, CNI was predictive of mortality but Kt/V and creatinine clearance were not. CONCLUSIONS: This study demonstrates the importance of nutritional status over adequacy indices in predicting patient survival. There was a lack of correlation between nutritional status and conventional indices of dialysis adequacy.

Adult↗