1.Vagus nerve stimulation for refractory epilepsy: long term efficacy and side-effects.
Andrew Che Fai HUI ; Joseph Man Kuen LAM ; Ka Shing WONG ; Richard KAY ; Wai Sing POON
Chinese Medical Journal 2004;117(1):58-61
BACKGROUNDIn general vagus nerve stimulation (VNS) can serve as an adjunctive treatment for patients with refractory partial-onset seizures. And we evaluated the long-term efficacy and safety of VNS in a group of Chinese patients with refractory epilepsy.
METHODSOf 127 patients with refractory epilepsy, 13 patients who were not eligible for surgical intervention were implanted with the Cyberonics VNS system. Seizure frequency, physical examination and side effects profile were recorded at follow-up visits for a minimum of 18 months.
RESULTSMean duration of treatment was 47.4 months, and the longest follow-up period was 71 months. Mean baseline seizure frequency was 26.6 seizures per month. The mean percentage reductions in convulsions were 33.2%, 47.1% and 40.0% at 6, 12 and 18 months, respectively. One patient became seizure free, and six (46%) had 50% or more reduction in seizure frequency. Response was poor (< 20% reduction) in five patients (39%). Side effects were uncommon.
CONCLUSIONSThe effectiveness of VNS was sustained and was well tolerated but benefited only a sub-group of patients with intractable convulsions.
Adolescent ; Adult ; Electric Stimulation Therapy ; methods ; Epilepsy ; therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Prospective Studies ; Prostheses and Implants ; Treatment Outcome ; Vagus Nerve ; physiology
2.Factors associated with falls among community-dwelling older people in Taiwan.
Tai Yin WU ; Wei Chu CHIE ; Rong Sen YANG ; Jen Pei LIU ; Kuan Liang KUO ; Wai Kuen WONG ; Chen Kun LIAW
Annals of the Academy of Medicine, Singapore 2013;42(7):320-327
INTRODUCTIONFalls are common among older people. Previous studies have shown that falls were multifactorial. However, data regarding community-dwelling Chinese population are minimal. We aimed to study factors associated with falls among community-dwelling older Chinese people.
MATERIALS AND METHODSWe conducted a cross-sectional study in a community hospital in Taiwan in 2010. Our sample included 671 elders from the 3680 examinees of the free annual Senior Citizens Health Examination. Participants were interviewed with a detailed questionnaire, and 317 elders were further invited for serum vitamin D tests. The main outcome was falls in the previous 12 months. Predictor variables included sociodemographic characteristics, lifestyle risk factors, body stature, frailty, serum 25 (OH) D levels, and medications.
RESULTSThe mean age of the 671 participants was 75.7 ± 6.4 years old, and 48.7% of which were female. Fallers comprised 21.0% of the study population. In multivariate models, female gender (adjusted odds ratio (aOR): 2.32), loss of height in adulthood (aOR: 1.52), low body weight (aOR: 2.69), central obesity (aOR: 1.67), frailty (aOR: 1.56), polypharmacy (aOR: 2.18) and hyperglycaemia (aOR: 1.56) were factors associated with falls. Vitamin D insufficiency (serum 25 (OH) D levels <30 ng/mL) was not associated with falls (OR: 0.78; 95% CI, 0.38 to 1.60) (n = 317) in this study.
CONCLUSIONAmong community-dwelling older people in Taiwan, falls were mainly associated with female gender, polypharmacy, frailty, reduced body height, low body weight or central obesity, and hyperglycaemia. In addition to other risk factors, body stature should be considered as a novel risk factor when screening elders at risk for falls.
Accidental Falls ; prevention & control ; statistics & numerical data ; Aged ; Aged, 80 and over ; Body Constitution ; Cross-Sectional Studies ; Demography ; Female ; Geriatric Assessment ; methods ; Humans ; Hyperglycemia ; epidemiology ; Independent Living ; statistics & numerical data ; Male ; Middle Aged ; Odds Ratio ; Polypharmacy ; Risk Assessment ; methods ; statistics & numerical data ; Risk Factors ; Sex Factors ; Socioeconomic Factors ; Taiwan ; epidemiology
3.A superspreading event involving a cluster of 14 coronavirus disease 2019 (COVID-19) infections from a family gathering in Hong Kong SAR (China)
Ho Leung Lam ; Tsz Sum Lam ; Chi Hong Wong ; Wing Hang Lam ; Chi Mei Emily Leung ; Chau Kuen Yonnie Lam ; Tin Wai Winnie Lau ; Chi Hin Billy Ho ; Ka Hing Wong ; Shuk Kwan Chuang
Western Pacific Surveillance and Response 2020;11(4):36-40
Objective: An outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in Wuhan, China, in December 2019, with subsequent spread around the world. Hong Kong Special Administrative Region SAR (China) recorded its first confirmed cases on 23 January 2020. In this report, we describe a family cluster of 12 confirmed cases, with two additional confirmed cases from secondary transmission.
Methods: We reported the epidemiological, clinical and laboratory findings of the family cluster, as well as the public health measures instituted.
Results: All 12 confirmed COVID-19 cases were among the 19 attendees of a three-hour Chinese New Year family dinner consisting of hotpot and barbecue dishes. Environmental sampling of the gathering venue was negative. Two additional confirmed cases, who were co-workers of two confirmed cases, were later identified, indicating secondary transmission. Contact tracing, quarantine and environmental disinfection were instituted to contain further spread.
Discussion: Our findings were highly suggestive of a superspreading event during the family gathering. The source was likely one of the cases during the pre-symptomatic phase. The event attested to the high infectivity of SARS-CoV-2 through human-to-human transmission from social activities and argued for the necessity of social distancing in curtailing the disease spread.