PubMed Health⌕ Search

Biomedical subjects

Y K Wing

Publications and source records attributed to Y K Wing.

At least 19 recordsLinked to original sources
PubMed2006

Validation of a questionnaire instrument for prediction of obstructive sleep apnea in Hong Kong Chinese children.

To develop and validate a questionnaire scale that can be used as a screening tool to investigate for the presence of childhood obstructive sleep apnea syndrome (OSAS) in Hong Kong Chinese children. Subjects suspected to have OSAS and controls were recruited. Parents completed a Hong Kong children sleep questionnaire (HK-CSQ) and all recruited subjects underwent at least one overnight polysomnographic study (PSG). An obstructive apnea index (OAI) >or= 1/h was diagnostic of OSAS. Receiver-operating characteristics (ROC) curve was constructed to determine optimal sensitivity and specificity. Reliability and validity of the questionnaire scale were also assessed. Two hundred twenty-nine children (149 boys and 80 girls) with a mean age of 10.0 years (SD = 2.1) were recruited. Their mean body mass index (BMI) and OAI were 19.8 (SD = 5.1) and 2.6 (SD = 7.6), respectively. Fifty-four boys and 12 girls were found to have OSAS. Three questions were found to be highly significant in predicting for the presence of OSAS-snoring, nocturnal mouth breathing, and sweating. A composite score of 7 from the three questions (range 0-12) was found to discriminate the OSAS cases best [ROC curve, AUC = 0.8 (95% CI = 0.8-0.9)]. The sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs) were 75.4, 80.5, 61.3, and 88.9%, respectively. Test-retest reliability was undertaken in 51 subjects and the measurement of agreement (Kappa value) was 0.6. This HK-CSQ is a useful, valid, and reliable screening instrument for the presence of OSAS in children.

Adolescent↗
PubMed2005

Comparing MSLT and ESS in the measurement of excessive daytime sleepiness in obstructive sleep apnoea syndrome.

OBJECTIVE: The objective of this study is to compare the use of Multiple Sleep Latency Test (MSLT) and Epworth Sleepiness Scale (ESS) in measuring excessive daytime sleepiness (EDS) in patients with different severity of obstructive sleep apnoea syndrome (OSAS). METHOD: Two hundred ninety-six consecutive OSAS patients, with their EDS measured by a Chinese version of ESS and a five-nap MSLT, and their severity of OSAS (determined by respiratory disturbance index) by a nocturnal polysomnogram, were classified into mild (RDI 5-15/h, n=59), moderate (RDI 15-30/h, n=71) and severe (RDI >30/h, n=166) groups, respectively. Their ESS, MSLT and other sleep parameters were compared. RESULTS: The severe group had significantly shorter mean sleep latency (MSL=6.26+/-4.90 min) than the moderate (8.26+/-4.57 min) and mild groups had (8.07+/-4.37 min). There was no significant difference in their ESS scores. CONCLUSION: MSLT is better than ESS in the measurement of EDS in relation to the severity of OSAS in clinical patients.

Adult↗
PubMed2004

Factors associated with psychosis among patients with severe acute respiratory syndrome: a case-control study.

We observed that a number of patients with severe acute respiratory syndrome (SARS) developed affective psychosis during the acute phase of their illness. We reviewed all SARS-related psychiatric consultations in Hong Kong and investigated the risk factors for psychosis among patients with SARS in a matched case-control study. Patients with SARS-related psychosis received higher total doses of steroids and had higher rates of family history of psychiatric illness. The findings of the present study suggest that steroid toxicity, personal vulnerability, and, probably, psychosocial stressors jointly contributed to the development of psychosis in patients with SARS.

Adolescent↗
PubMed2004

Childhood obstructive sleep apnoea: an update.

OBJECTIVE: To review literature on epidemiology, complications, diagnosis, and treatment of childhood obstructive sleep apnoea. DATA SOURCE: Literature search of MEDLINE up to July 2004 using the following key words: 'obstructive sleep apnoea syndrome', 'children', 'epidemiology', 'complications', 'treatment', and 'polysomnography'. STUDY SELECTION: Literature and data related to the aspects of childhood obstructive sleep apnoea. DATA EXTRACTION: Relevant information and data were reviewed by the authors. DATA SYNTHESIS: There is a paucity of normal data on childhood obstructive sleep apnoea. Varying definitions and diagnostic criteria have been used in different studies, making direct comparison difficult. However, a small-scale local study found that the prevalence and clinical features of this condition were similar to data published overseas. Increasing evidence suggests that childhood obstructive sleep apnoea is associated with cardiovascular morbidity and neurocognitive dysfunction. Overnight polysomnography has remained the gold standard for diagnosing obstructive sleep apnoea but the diagnostic criteria has not been standardised nor correlated with the long-term outcome. Surgical intervention has remained the treatment of choice, although alternative therapies are being evaluated. CONCLUSION: Consensus on the various important aspects of childhood obstructive sleep apnoea is still limited, especially the definition, diagnosis, and long-term sequelae of this condition. Further advances can only be made with international collaborative research, using evidence-based definitions, standardised techniques, and polysomnographic criteria.

Adrenal Cortex Hormones↗
PubMed2004

Delayed neuropsychiatric impairment after carbon monoxide poisoning from burning charcoal.

Poisoning by carbon monoxide from burning charcoal has become one of the popular and lethal ways of attempting suicide in Hong Kong. Survivors of the carbon monoxide poisoning often face acute and delayed adverse problems in both their physical and mental health. We report two cases of delayed onset neuropsychiatric complications caused by carbon monoxide poisoning from burning charcoal. These symptoms were characterised by a latent period, followed by an abrupt and profound deterioration in the neurocognitive function with a seemingly reversible course. The literature is reviewed regarding the aetiology, pathophysiology, and management of this condition. Regular monitoring of their neurocognitive function and forewarning of this potential complication to the survivors of carbon monoxide poisoning and their families should be essential.

Adult↗
PubMed2003

Video sleep nasendoscopy: the Hong Kong experience.

Video sleep nasendoscopy is a valuable technique for the study of upper airway dynamics in obstructive sleep apnea syndrome. The authors' 10-year experience with its use in Hong Kong has allowed technique refinement for safety and optimal evaluation. Its use in the evaluation of patients who snore, patients with obstructive sleep apnea syndrome, and continuous positive airway pressure titration is presented.

Adult↗
PubMed2003

A controlled study of sleep related disordered breathing in obese children.

BACKGROUND: Unlike the adult sleep related disordered breathing (SDB) patients who are typically obese, the relation between obesity and childhood SDB is not clear. AIMS: To investigate whether obese children are more at risk of obstructive SDB when compared to normal population, and whether this risk is potentiated by the presence of pharyngeal lymphoid tissue. METHODS: Forty six obese children (age 10.8 (SD 2.3) years; BMI 27.4 (SD 5.1)), and 44 sex and age matched normal weight children (age 11.7 (SD 2.1) years; BMI 18 (SD 1.8)) were studied. All children underwent a set of physical examinations (including the upper airways) and sleep studies. RESULTS: The obese children were different from the normal weight children in terms of type (predominantly obstructive), frequency, and severity of respiratory disturbances. Depending on the criteria used, 26% or 32.6% of obese children had SDB; 2.3% of normal controls had OAI > or =1 and 4.5% had RDI > or =5. Presence of SDB was related to presence of tonsils (size >2; range 0-4) (OR 12.67, 95% CI 2.14 to 75.17) and BMI (OR 1.20, 95% CI 1.08 to 1.33). CONCLUSIONS: Results suggest that obese children are at increased risk of obstructive SDB; the presence of any pharyngeal lymphoid tissue enlargement in obese children should therefore be aggressively managed.

Adolescent↗
PubMed2002

Gender differences in insomnia--a study in the Hong Kong Chinese population.

OBJECTIVE: To study the epidemiology of insomnia in the adult Chinese population in Hong Kong and to examine the potential gender-related demographic and lifestyle factors in insomnia. METHODS: A population study via random telephone survey with a structured questionnaire was carried out for noninstitutionalized Chinese adults aged 18-65 by trained lay interviewers. The questionnaire included demographic data, sleep habits and problems, insomnia symptoms and lifestyle questions. RESULTS: A total of 9851 subjects (46.4% male; 53.6% female) were included in the final analysis. The overall prevalence of Hong Kong Chinese as suffering from insomnia during the preceding month (with a frequency of sleep disturbance of at least three times per week) was 11.9% (95% CI 11.2-12.6), including difficulty in initiating sleep (DIS) (4.5%; 95% CI 4.1-5.0), difficulty in maintaining sleep (DMS) (6.9%; 95% CI 6.4-7.5) and early morning awakening (EMA) (4.0%; 95% CI 3.6-4.4). Females were about 1.6 times at higher risk for insomnia than males. The prevalence of insomnia was also shown to increase with age. Multivariate analysis showed that unemployment, lower economic status, alcohol consumption, regular medication and psychiatric disturbance were all associated with higher risks of insomnia in both sexes. Furthermore, lower education level and being retired was associated with a higher risk of insomnia in males, but being a housewife, divorced/widowed, and complaining of a nocturnal noisy environment were associated with a higher risk of insomnia in females. Among all these factors, psychiatric disturbance was the most influential risk factor for insomnia in both sexes. The reasons for gender differences of insomnia may include their differences in the prevalence of psychiatric morbidities, symptom endorsement, gonadal steroids, sociocultural factors and coping strategies. CONCLUSIONS: Overall, 11.9% of the Hong Kong Chinese adult population complained of frequent insomnia in the preceding month. There was a higher prevalence of insomnia in females. Although there were common risk factors for insomnia in both sexes, there existed gender-specific risk factors.

Adolescent↗
PubMed2001

Rationales for Food Refusal in Chinese Patients with Anorexia Nervosa.

OBJECTIVE: To study the rationales for food refusal among Chinese patients with typical and atypical anorexia nervosa. METHOD: Forty-eight consecutive patients with broadly defined anorexia nervosa underwent evaluation with a self-report rationale for food refusal questionnaire, the 12-item General Health Questionnaire (GHQ-12), the 21-item Beck Depression Inventory (BDI-21), the Hamilton Depression Rating Scale (HDRS), and other clinical assessments. RESULTS: Fat-phobic patients (N = 32) had a significantly higher premorbid body mass index than non-fat-phobic patients (N = 16), but they did not differ on other clinical parameters, GHQ-12, BDI-21, and HDRS scores. At clinical presentation, 3 months, and 1 year prior to presentation, fat phobia and stomach bloating were the most common rationales for food refusal among fat-phobic and non-fat-phobic patients, respectively. A total of 31% of fat-phobic patients endorsed non-fat-phobic rationales at the time of clinical presentation, whereas non-fat-phobic patients adhered to non-fat-phobic attributions more consistently. DISCUSSION: The rationales used by anorexic patients to explain noneating are more varied than implied in the 4th ed. of the Diagnostic and Statistical Manual of Mental Disorders and the ICD-10 Classification of Mental and Behavior Disorders: Clinical Descriptions and Diagnostic Guidelines. A broadened conceptualization of anorexia nervosa may enhance an understanding of patients' illness experiences and enliven research on eating disorders.

Adult↗
PubMed2001

Herbal treatment of insomnia.

Insomnia is a common problem requiring appropriate recognition and management. Despite recent advances in the development of newer hypnotics in western medicine, a significant proportion of patients with insomnia, both locally and internationally, consume herbal hypnotics regularly. The safety and efficacy of these herbal remedies remains uncertain. In this paper, details of different herbs used in western and traditional Chinese medicine for the treatment of insomnia are reviewed. Although current data suggests the use of some herbal treatments in insomnia may be efficacious, further laboratory and clinical studies are required.

Complementary Therapies↗
PubMed2000

Sleep-related injury in the elderly--an epidemiological study in Hong Kong.

OBJECTIVES: Sleep-related injury is a serious but under-recognized condition. We examined the occurrence of sleep-related injuries and REM sleep behavior disorder (RSBD) in a community sample of elderly in Hong Kong. DESIGN: A representative sample of elderly aged 70 years or above were interviewed with a screening question on the presence of sleep-related injuries. Those who answered affirmatively as well as a subsample of negative responders were interviewed by clinicians. Patients with suspected sleep disorders underwent physical and psychiatric assessment as well as sleep studies. SETTING: NA. PATIENTS OR PARTICIPANTS: NA. INTERVENTIONS: NA. RESULTS: In total, 1034 elderly were surveyed and 0.8% reported history of sleep-related injury. Four subjects were confirmed to have RSBD, giving an estimated prevalence of RSBD of 0.38% (95% CI=0.01 to 0.76%). One subject had suspected RSBD but refused investigations while 1 had history suggestive of transient RSBD but could not be confirmed by the sleep studies. The course of RSBD in these subjects was that of a waxing and waning course instead of a progressive deterioration as described in previous literature. Two patients had been hospitalized for sleep-related injury before but their sleep disorder was not recognized. CONCLUSIONS: We found that sleep-related injury and RSBD were not rare in the elderly but were frequently under-recognized. Our study calls for greater attention to elderly who had sustained injury during sleep.

Aged↗
PubMed2000

A validity study of Ullanlinna Narcolepsy Scale in Hong Kong Chinese.

OBJECTIVE: To validate the Chinese version of Ullanlinna Narcolepsy Scale (CUNS). METHODS: A total of 234 subjects [163 male (69.7%) and 71 female (30.3%)] including 17 patients with narcolepsy, 21 normal controls and 196 patients with various sleep and psychiatric disorders were studied. The diagnoses of these patients were independently ascertained with sleep laboratory confirmation whenever indicated. All the subjects were interviewed through the telephone by a trained lay interviewer who was blind to the diagnosis. The questionnaire included demographic information, sleep habits and CUNS. RESULTS: Narcoleptic patients had a significantly higher CUNS score (18.6+/-4.7; 95% confidence interval (CI) 16.2-21.0) and differentiated well from all the other groups (F(6,227)=28.4, P<0.001). The CUNS has a satisfactory internal consistency with Cronbach's alpha of 0.75. The principal component analysis with varimax rotation revealed two factors, namely sleepiness and cataplexy factors, which accounted for 45.5% of the total variance. The best cut-off point for the CUNS scale was found to be at 13/14 with high specificity (93.5%), sensitivity (94.1%), negative predictive value (NPV, 99.5%) and modest positive predictive value (PPV, 53.3%). The AUC of receiver operating characteristic (ROC) analysis was 0.97 (95% CI 0.95-0.99). CONCLUSIONS: The CUNS was validated with satisfactory psychometric properties. The cross-cultural validation of UNS scale suggested that it could be used across the ethnic groups.

Adolescent↗
PubMed2000

Thyroid function and psychiatric morbidity in patients with manic disorder receiving lithium therapy.

Euthyroid hyperthyroxinemia as a result of a transient increase in thyroid-stimulating hormone (TSH) levels may contribute to the development of manic disorder. Lithium has a potent short-term antithyroidal effect that may account for its antimanic action. The thyroid function and psychiatric morbidity of 46 adult patients with manic disorder were assessed prospectively before and 1 and 6 months after lithium treatment. At baseline, the free thyroxine level (FT4, 16.23 +/- 3.11 pmol/L) was at the high end of the normal range, whereas the free triiodothyronine (FT3, 4.24 +/- 0.65 pmol/L) and TSH (1.47 +/- 0.73 mIU/L) levels were within the normal range. All patients were clinically euthyroid, but five of them (11%) had elevated FT4 levels. Baseline FT3 and FT4 levels were positively correlated with past psychiatric morbidity. The FT4 level at baseline and after 1 month of treatment was positively correlated with scores on the Brief Psychiatric Rating Scale (p < 0.02) and negatively correlated with scores on the Global Assessment Scale (p < 0.005). During the first month of treatment, the reduction of FT3 and FT4 levels was significantly correlated with a decrease in psychiatric symptoms. By 6 months, the FT3 level was no longer significantly different from that at the baseline, but FT4 levels remained significantly lower. The TSH level increased progressively from baseline to 6 months. Multilevel models showed that FT4 and serum lithium levels were positively and negatively associated with psychiatric symptoms, respectively. The findings of the study lend support to the notion that euthyroid hyperthyroxinemia contributes to acute mania and suggest that lithium's short-term antimanic action may be mediated by its antithyroid effect.

Adult↗
PubMed2000

Alveolar hypoventilation syndrome in brainstem glioma with improvement after surgical resection.

A 3-year-old boy presented with brainstem astrocytoma and central alveolar hypoventilation syndrome. Contrast MRI of the brain showed that the tumor involved the cerebellum, with compression of brainstem, and resolved after surgical resection. Polysomnography performed before and after total tumor resection showed significant improvement in nocturnal respiratory rate, respiratory disturbance index, and oxygen desaturation. It is apparent that central alveolar hypoventilation syndrome secondary to brainstem tumor may improve after surgical resection for those with favorable anatomic location and histology. Serial polysomnography and MRI scans are useful for diagnosis and in the management plan, and to monitor progress.

Astrocytoma↗
PubMed2000

Genetic analysis of the CYP2D6 locus in a Hong Kong Chinese population.

BACKGROUND: The cytochrome P450 CYP2D6 enzyme debrisoquine 4-hydroxylase metabolizes many different classes of commonly used drugs, such as tricyclic antidepressants and neuroleptics. Genetic polymorphism of the CYP2D6 gene is responsible for pronounced interindividual and interracial differences in the metabolism of these drugs. The CYP2D6*10 allele and its variants are the most frequent alleles found in Orientals, and they are responsible for diminished debrisoquine 4-hydroxylase activity because of the presence of a C(188)-->T mutation in exon 1. METHODS: One hundred nineteen Hong Kong Chinese subjects were genotyped by means of allele-specific PCR, PCR, and restriction enzyme analysis for 10 CYP2D6 alleles (CYP2D6*1, *2, *4D, *5, *8/*14, *10A, *10B, *15, *16, and J9). RESULTS: CYP2D6*10B was the most prevalent allele, and CYP2D6*10/CYP2D6*10 was the most frequent genotype, representing 41.17% [corrected] of the population. CONCLUSIONS: There was no significant difference in the prevalence of the alleles analyzed between our study and the Chinese populations genotyped previously. This is the largest study in terms of the number of CYP2D6 alleles analyzed in an Oriental population and the first one conducted in a Hong Kong Chinese population.

Alleles↗
PubMed2000

Recent advances in the management of depression and psychopharmacology.

OBJECTIVE: To review the recent advances in the management of depression and psychopharmacology. DATA SOURCES: Medline and non-Medline literature search. STUDY SELECTION: The following key words were used: depression/therapy, depressive disorders, antidepressant, psychopharmacology, and mental health services. Years of study: 1988 to 1998. DATA EXTRACTION: Original articles, review papers, meta-analyses, and relevant book chapters were reviewed. DATA SYNTHESIS: Recent advances in research on depression have confirmed that it is a common, recurrent, and disabling medical disorder. The latest epidemiological studies from the United States suggest that its lifetime prevalence is more than 17%, while a lower, but still substantial, proportion of Chinese people have the same disorder. The highly recurrent nature and conspicuous morbidity of depression call for the continuation of antidepressant treatment beyond the initial resolution of symptoms. For the first episode of depression, 6 to 9 months of adequate antidepressant treatment is indicated. For patients with recurrent depression, maintenance therapy for several years is needed. The increasingly widespread use of selective serotonin re-uptake inhibitors and other newer antidepressants has increased the direct drug cost, but the total health care expenditure may not be raised and may even be reduced. CONCLUSION: Proper recognition and management of depression at both the clinical and health care policy levels are urgently needed.

Antidepressive Agents↗