Biomedical subjects

Kam-lun Ellis Hon

Publications and source records attributed to Kam-lun Ellis Hon.

7 recordsLinked to original sources

PubMed2006

Air versus ground transportation of artificially ventilated neonates: comparative differences in selected cardiopulmonary parameters.

OBJECTIVE: To assess if cardiopulmonary interventions and abnormal CO2 tension are more likely in intubated neonates transported by air versus ground. METHODS: We reviewed the transport records of all ventilated neonates retrieved to a pediatric teaching hospital in the United States within a 12-month period. Demographic data, underlying diagnosis, pretransport and posttransport ventilation settings and blood gas data, and transport data were recorded. RESULTS: Seventy-five intubated neonates were transported by ground (n = 43), helicopter (n = 29) and by fixed-wing aircraft (n = 3). Thirty-nine patients (52%) received interventions, including adjustments of ventilator settings (36 patients) and increase in the rate of dopamine infusion or boluses infusion (volume expanders or sodium bicarbonate) in 9 patients. There were no overt pneumothoraces, endotracheal tube complications, arrhythmias, or cardiopulmonary resuscitation en route. The posttransport blood gas analysis revealed 7 patients with hypercapnia greater than 55 mm Hg and 17 patients with hypocapnia of less than 30 mm Hg. When compared with patients with Pco2 30 to 55 mm Hg, all patients with posttransport Pco2 greater than 55 mm Hg had interventions en route (P = 0.01). No significant difference between the mode of transport and stabilization time, return time, diagnostic groups, interventions, or the occurrence of hypercapnia and hypocapnia was identified. Additional adjustments of ventilatory settings were retrospectively considered necessary in many of these patients with Pco2 greater than 55 mm Hg or less than 30 mm Hg. CONCLUSIONS: There were no cardiopulmonary disasters (such as overt pneumothoraces, endotracheal tube complications, arrhythmias, or cardiopulmonary resuscitation en route) in the various modes of neonatal transport. Adjustments of ventilation, inotropes, and volume infusion are often required for stabilization of patients during the dynamic process of transport. When compared with ground transport, there is no increase in the risk of cardiopulmonary interventions or abnormal CO2 tension in air transport of intubated neonates. Additional adjustments of ventilatory settings were retrospectively considered necessary in many of these patients with significant hypercapnia or hypocapnia.

Ambulances↗

PubMed2006

Neurologic and radiologic manifestations of three girls surviving acute carbon monoxide poisoning.

We report the neurologic and radiologic manifestations of three adolescent girls with acute carbon monoxide poisoning. The girls were found collapsed and unconscious in a bathroom where liquid petroleum gas was being used as heating fuel. As hyperbaric oxygen therapy was not available locally, they only received oxygen supplementation via nasal cannula (4 L/minute) as treatment in the first 2 days. On transfer to a tertiary center in Hong Kong, evolving neurologic manifestations of visual acuity and field deficits, confusion, and focal motor weaknesses were observed. Focal infarctions were evident in cerebral computed tomography in one patient and cortical lesions on magnetic resonance imaging in all three patients. [18F]Fluorodeoxyglucose (FDG) positron emission tomography (PET) revealed additional decreased metabolism in the basal ganglia in two patients, which was typical of carbon monoxide poisoning. The neurologic deficits resolved completely at 3 weeks after the exposure, but psychologic symptoms succeeded. This report serves to alert clinicians to the varied neuro-ophthalmologic manifestations and psychologic impairment even with the same duration of carbon monoxide poisoning. PET might be more sensitive in detecting cerebral injuries specific for carbon monoxide poisoning.

Acute Disease↗

PubMed2006

Chinese nursing students' attitudes toward traditional Chinese medicine.

In this study, we examined Chinese nursing students' attitudes toward and use of traditional Chinese medicine (TCM). Survey questionnaires were distributed to 439 nursing students, 263 of whom (60%) returned them. Of the respondents, 92% had used TCM, while 48% had used TCM at least once during the previous year. Forty-five percent of respondents reported positive attitudes toward TCM use, 52% had neutral attitudes, and only 3% reported negative attitudes. The majority of respondents (76%) reported no change in their attitude toward TCM after studying nursing. Mean scores related to the adequacy of the current curriculum in TCM training and the state of respondents' TCM knowledge were generally low. Of the respondents who had used TCM during the past year, the most common use was for upper respiratory tract infection. The most common type of TCM used by respondents was herbal tea or soup. Final-year nursing students were more likely to have used TCM during the previous year, report they would like more courses on TCM, and consult Western medicine physicians before using TCM; they were also less likely to develop more negative attitudes toward TCM after studying nursing.

Adult↗

PubMed2006

A malignant itch.

We report an unusual presentation of a previously healthy three-year-old Chinese girl with a four-week history of apparently unexplained generalized intense itch. She had no past history of atopy or xerosis. Despite the severe itch, she had only minimal scratch marks on her right gluteal region but no flexural involvement. The girl was treated as having scabies and eczema and with oral antihistamines by various dermatologists without much improvement. She subsequently presented to a regional hospital with right hip pain and fever. Radiological and histopathological investigations confirmed that she had a peripheral T-cell lymphoma. The itch pattern prior to and following chemotherapy, as documented by the DigiTrac wrist-held movement monitor, showed a dramatic reduction of her nocturnal itch. The pattern was also very different from that of atopic dermatitis in that the scratching was of much higher intensity but lower frequency. Intractable pruritus associated with a peripheral T-cell lymphoma has not been previously reported in the pediatric literature. This report serves to alert clinicians of the gold paradigm that in a patient with an unexplained generalized itch, lymphoma and other malignancies must be considered.

Child, Preschool↗

PubMed2005

Oral sildenafil for treatment of severe pulmonary hypertension in an infant.

We report the use of oral sildenafil in a 5-month-old preterm infant with severe bronchopulmonary dysplasia and pulmonary arterial hypertension refractory to inhaled nitric oxide treatment, maximal ventilatory support and conventional vasodilator therapy. Sildenafil was prepared as a liquid suspension by the method of trituration and administered via an orogastric tube to the patient. Forty-eight hours after sildenafil treatment, echocardiography revealed that the tricuspid incompetence was substantially diminished and the contractility of both ventricles improved, indicating a marked reduction in pulmonary arterial pressure. Oral sildenafil treatment was continued for 6 months until complete resolution of pulmonary arterial hypertension, and oxygen supplement was weaned off. There was no adverse effect during the treatment period. Oral sildenafil may be useful in reducing pulmonary vascular resistance and can be considered for treatment of severe pulmonary arterial hypertension secondary to bronchopulmonary dysplasia.

Administration, Oral↗

PubMed2005

Hyperventilation at referring hospitals is common before transport in intubated children with neurological diseases.

OBJECTIVE: To assess if cardiopulmonary complications and abnormal carbon dioxide tension are more likely in intubated children with neurological diseases undergoing transport. METHODS: We reviewed the transport records of all ventilated children retrieved to a pediatric teaching hospital in the United States within a 12-month period. RESULTS: Twenty-seven children were transported by ground (n = 11), helicopter (n = 10), and fixed-wing aircraft (n = 6). Adjustments of ventilator settings were made in 17 (63%). There were no pneumothoraces, endotracheal tube complications, arrhythmias, or cardiopulmonary resuscitation en route. Twelve patients (44%) had a primary neurological condition. In the neurological category, the pretransport blood gases revealed 7 patients with hyperventilation (Pco2, 20-29 mm Hg), and the posttransport blood gases showed 4 patients with hyperventilation (Pco2, 15-28 mm Hg). In the nonneurological category, hyperventilation occurred only in one patient before and another after transport. No significant difference between the mode of transport, stabilization time, return time, and the occurrence of hypercapnia and hypocapnia was identified. Patients who had a neurological condition were more likely to be hyperventilated at the referring hospitals (P = 0.007). Additional maneuvers were considered necessary in 3 of the 6 neurological patients and 2 of the 5 nonneurological patients with DeltapH greater than +/-0.1, whereas the management of all but one patient with DeltapH less than +/-0.1 was considered appropriate (DeltapH defined as the difference between posttransport and pretransport pH values). CONCLUSION: There is no cardiopulmonary disaster in the various modes of pediatric transport. When compared with ground transport, there is no significant increase in the risk for cardiopulmonary complications or abnormal CO2 tension in air transport of intubated children. DeltapH, in conjunction with clinical data and PCO2 values, may be a simple index for evaluation of cardiopulmonary management during transport.

Adolescent↗

PubMed2005

A survey of attitudes toward homosexuality in Hong Kong chinese medical students.

BACKGROUND: Homosexuality is now considered an alternative lifestyle occurring with some regularity as a variant of human sexuality, rather than a pathological disorder. It is important to understand the attitudes of medical professionals toward homosexuality, as their attitudes may influence their approach to gay men and lesbians as patients. It is also important to understand the current attitudes of medical students who will be the future generation of health care providers. PURPOSE: To study Chinese medical students' attitudes toward and personal experiences with homosexuality. METHODS: A cross-sectional study was conducted at a university medical school. Medical students were asked 16 questions according to an anonymous survey questionnaire. RESULTS: Of the 780 medical students (42% male, 49% female, 10% sex anonymous) who received the questionnaire, 627 (80%) returned it. Of these students, 72% were age 18 to 22 years; 38% reported that they had homosexual friends. Only 16 students described themselves as homosexuals and 20 as bisexuals. A total of 249 students (40%) reported that they had a religion; 542 (86%) reported that they would accept their friends to be homosexuals. Two thirds thought that homosexual and heterosexual partners should have equal legal rights in terms of marriage, whereas slightly less than half (46%) thought they should have equal legal rights in adopting children. With regard to learning or working abilities, 93% thought homosexuals are not any different from heterosexuals. Two thirds thought homosexuals are not different from heterosexuals in terms of sexual behaviour such as promiscuity or loyalty. One fourth thought homosexuality is a psychological disorder that requires therapy. These findings did not differ significantly with seniority, but students with a religion held different attitudes than those without, and were more likely to believe that homosexuality is a psychological disorder, odds ratio (OR) = 2.33, 95% confidence interval (CI) = 1.59 .43, p < .001. Female students were more likely to have homosexual friends, OR = 1.72, 95% CI = 1.20 .48, p = .003, and more accepting attitudes, OR = 1.78, 95% CI = 1.24 .57, p = .002. CONCLUSIONS: The attitudes and experiences do not vary significantly between the 5 classes of medical students, but religious beliefs and gender might influence these attitudes. These findings can help medical teachers to be more sensitive in terms of educating their students.

Adolescent↗