Objective
To give an overview and update on central nervous system inflammatory demyelinating diseases in Hong Kong.
Findings
Using retrospective analysis of records from the Multiple Sclerosis (MS) ...Specialist Panel, the prevalence of MS in Hong Kong was estimated to be 6.9 per 100,000, while the annual incidence were 0.86 (SD = 0.135, 95% CI = 0.76 to 0.96) and 0.16 (SD = 0.11, 95% CI = 0.08‐0.23) per 100,000 for adult and pediatric populations, respectively. Preliminary data from the Hong Kong MS Society's NMOSD (neuromyelitis optica spectrum disorders) Registry showed that the local prevalence of NMOSD was 3.3 per 100 000, with a seropositivity rate of 80%. MS and NMOSD both had a female preponderance, and MS had younger disease onset age. NMOSD patients had more long‐term disability in terms of EDSS (expanded disability status scale) but MS patients had more cognitive impairment. Radiological features that discriminated MS and NMOSD were similar to other populations, and brain atrophy was observed in both diseases. The number of available treatment options for MS in Hong Kong has greatly increased in the past decade, including injectables, oral disease‐modifying agents, and immune‐reconstitution therapies. For NMOSD, corticosteroids and oral immunosuppressants were the mainstay of treatment.
Summary
The updated prevalence of MS and NMOSD in Hong Kong was higher than previously reported, and comparable with other Asian countries. The clinical, laboratory and imaging features of MS and NMOSD in Hong Kong were similar to those in neighboring regions.
Aim
Understanding factors that contribute to treatment delay would inform early detection and intervention strategies in psychotic disorders. However, existing data were mixed and primarily conducted ...among early‐onset young patients. We examined duration of untreated psychosis (DUP) and its clinical and sociodemographic correlates in a large cohort of adult‐onset patients with psychosis.
Methods
A total of 360 patients with first‐onset psychosis aged 26–55 years were recruited consecutively as part of a controlled study of an early psychosis intervention service in Hong Kong Chinese. Demographic, sociodemographic and clinical characteristics relating to DUP were assessed within 4 months of onset.
Results
The population had a mean onset age of 36.6 years (SD = 8.7). The mean and median DUP were 515 days (SD = 1091) and 93 days (inter‐quartile range from 20 to 382.3), respectively. Multivariate regression analysis suggested that insidious mode of onset, hospitalization, a diagnosis of schizophrenia, poorer insight and younger age at onset significantly prolonged DUP. DUP was not related to premorbid functioning, family involvement during help seeking and living alone.
Conclusions
The initial period of untreated psychosis is determined by multiple factors. Whether family involvement is considered a kind of social support in shortening or prolonging DUP needs further examination. Local early intervention program for psychosis should take reference from these findings when formulating personalized plans to reduce delay.
Abstract Background Multiple sclerosis (MS) has a low prevalence in Hong Kong. Objective To reassess MS prevalence in Hong Kong and to examine associated risk factors for relapsing–remitting type MS ...patients to reach Kurtzke's Extended Disability Status Scale (EDSS) of 6.0, i.e. when walking aid was needed. Design Retrospective observational study on MS patients over 11 years. Setting Three tertiary hospitals in Hong Kong. Results A hundred and six patients were recruited. Female to male ratio was 3.2:1 and the prevalence was 4.8 per 100,000. 95 were relapsing–remitting (RR) type. The mean disease duration was 12.7 years (range: 1–45 years) and the duration of follow up was 11.0 +/− 0.8 (mean +/− SE) years. The initial mean EDSS was 1.59 and the latest mean EDSS was 4.26. 38 (40%) RR type MS patients progressed to EDSS 6.0 after a mean duration of 6.0 years. With Cox regression analysis, patients with older age (> 35y) of onset (HR 2.57; 95% CI:1.29–5.11), higher EDSS of 2.0 or more upon presentation (HR 2.19; 95%CI: 1.12–4.26) were associated with progression to EDSS of 6.0, while there was a tendency towards slower disease progression for patients initially presenting with optic symptoms (HR 0.52; 95%CI: 0.23–1.16). The number of relapses and use of interferon could not be shown to have significant effect on disease progression. Conclusions The local period prevalence ratio of MS was 4.8 per 100,000. Older age of onset and higher EDSS upon initial presentation were independent predictors for progression to EDSS of 6.0.
To determine the prevalence of mitochondrial diseases (MD) in Hong Kong (HK) and to evaluate the clinical characteristics and genetic landscape of MD patients in the region.
This study ...retrospectively reviewed the phenotypic and molecular characteristics of MD patients from participating public hospitals in HK between January 1985 to October 2020. Molecularly and/or enzymatically confirmed MD cases of any age were recruited via the Clinical Analysis and Reporting System (CDARS) using relevant keywords and/or International Classification of Disease (ICD) codes under the HK Hospital Authority or through the personal recollection of treating clinicians among the investigators.
A total of 119 MD patients were recruited and analyzed in the study. The point prevalence of MD in HK was 1.02 in 100,000 people (95% confidence interval 0.81-1.28 in 100,000). 110 patients had molecularly proven MD and the other nine were diagnosed by OXPHOS enzymology analysis or mitochondrial DNA depletion analysis with unknown molecular basis. Pathogenic variants in the mitochondrial genome (72 patients) were more prevalent than those in the nuclear genome (38 patients) in our cohort. The most commonly involved organ system at disease onset was the neurological system, in which developmental delay, seizures or epilepsy, and stroke-like episodes were the most frequently reported presentations. The mortality rate in our cohort was 37%.
This study is a territory-wide overview of the clinical and genetic characteristics of MD patients in a Chinese population, providing the first available prevalence rate of MD in Hong Kong. The findings of this study aim to facilitate future in-depth evaluation of MD and lay the foundation to establish a local MD registry.
Abstract
Aim
Understanding factors that contribute to treatment delay would inform early detection and intervention strategies in psychotic disorders. However, existing data were mixed and primarily ...conducted among early‐onset young patients. We examined duration of untreated psychosis (
DUP
) and its clinical and sociodemographic correlates in a large cohort of adult‐onset patients with psychosis.
Methods
A total of 360 patients with first‐onset psychosis aged 26–55 years were recruited consecutively as part of a controlled study of an early psychosis intervention service in
H
ong
K
ong
C
hinese. Demographic, sociodemographic and clinical characteristics relating to
DUP
were assessed within 4 months of onset.
Results
The population had a mean onset age of 36.6 years (
SD
= 8.7). The mean and median
DUP
were 515 days (
SD
= 1091) and 93 days (inter‐quartile range from 20 to 382.3), respectively. Multivariate regression analysis suggested that insidious mode of onset, hospitalization, a diagnosis of schizophrenia, poorer insight and younger age at onset significantly prolonged
DUP
.
DUP
was not related to premorbid functioning, family involvement during help seeking and living alone.
Conclusions
The initial period of untreated psychosis is determined by multiple factors. Whether family involvement is considered a kind of social support in shortening or prolonging
DUP
needs further examination. Local early intervention program for psychosis should take reference from these findings when formulating personalized plans to reduce delay.
A bubble of gas, trapped at the center of a spherical container of liquid will oscillate when spherical sound waves are generated at the surface of the container. For decades, theoreticians have been ...improving the dynamical theory governing the motion of the gas. However, a complete theory does not yet exist. The goal of this dissertation is to provide several new results on this subject which we hope will help in completing the entire theory. Several different aspects of the bubble dynamics are investigated. They include: (1) the effect of thermal diffusion on the temperature variation at the gas-liquid interface, (2) the way that temperature and pressure change on the gas-liquid interface affects the diffusion of gas into and out of the bubble, (3) the way that the amount of vapor from the liquid present in the bubble influences the bubble dynamics and bubble surface temperature and (4) the shape stability of the bubble surface. Among these, investigations of (1), (2) and (3) are original while (4) is an extension of recent work by C. C. Wu & P. H. Roberts.
