Severe acute respiratory syndrome (SARS) has recently recognized as a new human infectious disease. A novel coronavirus was identified as the causative agent of SARS. This report summarizes the hematological findings in SARS patients and proposes a hypothesis for the pathophysiology of SARS coronavirus related abnormal hematopoiesis. Hematological changes in patients with SARS were common and included lymphopenia (68% - 90% of adults; 100% of children, n = 10), thrombocytopenia (20% - 45% of adults, 50% of children), and leukopenia (20% - 34% of adults, 70% of children). The possible mechanisms of this coronavirus on blood system may include (1) directly infect blood cells and bone marrow stromal cells via CD13 or CD66a; and/or (2) induce auto-antibodies and immune complexes to damage these cells. In addition, lung damage in SARS patients may also play a role on inducing thrombocytopenia by (1) increasing the consumption of platelets/megakaryocytes; and/or (2) reducing the production of platelets in the lungs. Since the most common hematological changes in SARS patients were lymphopenia and immunodeficiency. We postulate that hematopoietic growth factors such as G-CSF, by mobilizing endogenous blood stem cells and endogenous cytokines, could become a hematological treatment for SARS patients, which may enhance the immune system against these virus.
Adult ; Antigens, CD ; immunology ; Antigens, Differentiation ; immunology ; CD13 Antigens ; immunology ; Cell Adhesion Molecules ; Child ; Hematologic Diseases ; immunology ; physiopathology ; Hematopoiesis ; physiology ; Humans ; SARS Virus ; Severe Acute Respiratory Syndrome ; immunology ; physiopathology ; virology

INTRODUCTIONTo determine the magnitude of gender difference in paediatric hospital admissions.

MATERIALS AND METHODSWe reviewed discharge data of general medical paediatric admissions to a university teaching hospital in Hong Kong from 1984 to 2000. Based on ICD-9 codes, 9 broad categories of disease with related sub-categories were used, namely respiratory, gastrointestinal, neurological, renal, cardiac, haematological/oncological, neonatal, miscellaneous and social. Data on patients admitted to the haematological, oncological and neonatal wards were excluded from this analysis.

RESULTSThere were 92,332 patients admitted to the general paediatric wards. The 7 leading causes for admission accounted for 62% of all admissions: gastroenteritis (14%), upper respiratory tract infections (12%), asthma/wheezy bronchitis (10%), pneumonia (10%), bronchiolitis (6%), febrile convulsions (7%) and other convulsions (4%). Across almost all categories, there was a consistent excess of males (59.1% of all admissions). The male excess was even more pronounced for urinary tract infections (72%) and nephrotic syndrome (80%). The main sub-categories without this male predominance were accidents, accidental ingestion and social admissions (50% males), failure to thrive (49% males), acyanotic congenital heart disease (48%), endocrine (42%), auto-immune conditions (30%) and attempted suicide (19%).

CONCLUSIONSAlthough male vulnerability to illness has long been recognised, the consistency and magnitude of these gender differentials in admissions was impressive. More vigorous exploration of the underlying mechanisms responsible for this phenomenon is warranted.

Adolescent ; Child ; Child, Preschool ; Female ; Gastrointestinal Diseases ; epidemiology ; Heart Diseases ; epidemiology ; Hematologic Diseases ; epidemiology ; Hong Kong ; epidemiology ; Hospitals, University ; utilization ; Humans ; Infant ; Kidney Diseases ; epidemiology ; Male ; Patient Admission ; statistics & numerical data ; Respiratory Tract Diseases ; epidemiology ; Retrospective Studies ; Sex Factors

INTRODUCTION: Frontline healthcare workers (HCWs) exposed to coronavirus disease 2019 (COVID-19) are at risk of psychological distress. This study evaluates the psychological impact of COVID-19 pandemic on HCWs in a national paediatric referral centre. METHODS: This was a survey-based study that collected demographic, work environment and mental health data from paediatric HCWs in the emergency, intensive care and infectious disease units. Psychological impact was measured using the Depression, Anxiety, Stress Scale-21. Multivariate regression analysis was performed to identify risk factors associated with psychological distress. RESULTS: The survey achieved a response rate of 93.9% (430 of 458). Of the 430 respondents, symptoms of depression, anxiety and stress were reported in 168 (39.1%), 205 (47.7%) and 106 (24.7%), respectively. Depression was reported in the mild (47, 10.9%), moderate (76, 17.7%), severe (23, 5.3%) and extremely severe (22, 5.1%) categories. Anxiety (205, 47.7%) and stress (106, 24.7%) were reported in the mild category only. Collectively, regression analysis identified female sex, a perceived lack of choice in work scope/environment, lack of protection from COVID-19, lack of access to physical activities and rest, the need to perform additional tasks, and the experience of stigma from the community as risk factors for poor psychological outcome. CONCLUSION A high prevalence of depression, anxiety and stress was reported among frontline paediatric HCWs during the COVID-19 pandemic. Personal psychoneuroimmunity and organisational prevention measures can be implemented to lessen psychiatric symptoms. At the national level, involving mental health professionals to plan and coordinate psychological intervention for the country should be considered.
Adult ; Anxiety/etiology* ; COVID-19/psychology* ; Depression/etiology* ; Female ; Health Surveys ; Hospitals, Pediatric ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Occupational Diseases/etiology* ; Pandemics ; Personnel, Hospital/psychology* ; Prevalence ; Risk Factors ; Self Report ; Severity of Illness Index ; Singapore/epidemiology* ; Stress, Psychological/etiology*

BACKGROUND: Eczema is the most common skin problem among children in Hong Kong. Previous studies have highlighted that the quality of life of the families of children with eczema influences the effects of eczema interventions. However, the Chinese version of the Family Dermatology Life Quality Index (C-FDLQI), a tool for measuring the quality of life of the families of children with eczema, has not yet been validated. OBJECTIVE: This study examined the psychometric properties of the C-FDLQI among parents and caregivers of children with eczema in Hong Kong. METHODS: This study evaluated the internal consistency, test-retest reliability and structural validity of the C-FDLQI and its convergent validity by examining its correlations with the SCORing Atopic Dermatitis (SCORAD) and the Cantonese version of the Children’s Dermatology Life Quality Index (C-CDLQI) among 147 Chinese parents/caregivers of children with varying degrees of eczema.
Asian Continental Ancestry Group ; Caregivers ; Child ; Dermatitis, Atopic ; Dermatology ; Eczema ; Hong Kong ; Humans ; Parents ; Psychometrics ; Quality of Life ; Reproducibility of Results ; Semantics ; Skin

INTRODUCTIONTraditional Chinese medicine (TCM) has been used as an alternative in treating children with atopic dermatitis (AD) but its efficacy and potential side effects are debatable. We recently used a TCM capsule (PentaHerbs) on 9 children and observed significant reductions in clinical scores of disease severity. However, there have been concerns that the therapeutic effects of many forms of TCM are due to the presence of corticosteroids. The purpose of this study was to evaluate if common corticosteroids are present in PentaHerbs capsules.

MATERIALS AND METHODSPentaHerbs powder was analysed with thin-layer chromatography, infra-red spectrophotometry and liquid chromatography mass spectrometry.

RESULTSHydrocortisone, prednisolone, fludrocortisone and dexamethasone were not detected in the PentaHerbs capsules.

CONCLUSIONCorticosteroids are not present in the 5 familiar herbs that were earlier shown to have efficacy on AD.

Child ; Chromatography, Thin Layer ; Dermatitis, Atopic ; drug therapy ; Drug Combinations ; Drugs, Chinese Herbal ; chemistry ; therapeutic use ; Glucocorticoids ; analysis ; therapeutic use ; Humans ; Mass Spectrometry ; Pilot Projects ; Spectrophotometry, Infrared