Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine
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To review data on children who have both obesity and obstructive sleep apnoea syndrome. ⋯ Children with obesity and obstructive sleep apnoea syndrome face a double challenge. A holistic approach to management requires a clear understanding of how both problems interact.
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The survival rate for non-traumatic out-of-hospital cardiac arrest in Hong Kong is low (1.25%-1.6%). Despite the reduced time interval between call receipt and first defibrillatory shock to 11.12 minutes during the past decade, the time interval between collapse/recognition and first defibrillatory shock, at 14.25 minutes, is too long. Studies of out-of-hospital cardiac arrest performed in Hong Kong were reviewed to ascertain whether a public access defibrillation programme can improve survival in Hong Kong. ⋯ A public access defibrillation programme employing responders at scenes of cardiac arrests can eliminate the collapse/recognise-to-call receipt and call receipt-to-vehicle stops time intervals before defibrillation. Possible sites of public access defibrillation could include the airport and other immigration points, which have a high volume of people passing through, with projected figures for out-of-hospital cardiac arrest at these sites supporting this consideration. For successful implementation of public access defibrillation, a comprehensive educational programme and coordination with the emergency medical service are required.
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The risk of mass exposure to toxic substances has increased steadily during the twentieth century due to the expansion of industry and the deliberate development and use of agents of chemical warfare. Although Hong Kong is considered a relatively safe place, hoax anthrax attacks have occurred since 17 October 2001. ⋯ Recognition and identification of hazardous materials, assessment of the conditions, decontamination, and protection of staff and facilities are important elements in the formulation of a contingency plan. The objective of this article is to outline the efforts of the Hong Kong Hospital Authority in formulating a hospital response to incidents involving hazardous materials.
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Sudden unexpected death in epilepsy is the most common category of seizure-related death for patients who develop chronic epilepsy, accounting for up to 17% of epilepsy deaths. Sudden unexpected death in epilepsy is defined as a sudden, unexpected, non-accidental death in an individual with epilepsy with or without evidence of a seizure having occurred (excluding documented status epilepticus) and where autopsy does not reveal an anatomical or toxicological cause of death. Incidence rates range between 0.35 and 2.70 per 1000 person-years in the population-based studies and between 1.50 and 9.30 per 1000 person-years in selected cohorts. Seizure frequency appears to be an important factor in sudden unexpected death in epilepsy, although the exact pathogenetic mechanisms involved are unclear.
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Sedation during diagnostic or therapeutic procedures must be safe and comfortable for patients. To achieve this, additional suitably qualified staff must be available throughout the procedure to administer sedation and monitor the patient. ⋯ The presence of an anaesthesiologist is desirable when dealing with patients at high-risk of complications. Good sedation practice involves presedation assessment and optimal selection of patients, careful monitoring and support from dedicated staff, and adherence to recovery and discharge criteria.