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Search Results: 1 - 10 of 31976 matches for " Martin CS Wong "
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Antihypertensive drug class and impaired fasting glucose: a risk association study among Chinese patients with uncomplicated hypertension
Martin CS Wong, Johnny Y Jiang, H Fung, Sian Griffiths, Stewart Mercer
BMC Pharmacology and Toxicology , 2008, DOI: 10.1186/1472-6904-8-6
Abstract: The odds ratios of having above borderline (≥ 6.1 mmol/l) and adverse (≥ 7.0 mmol/l) glucose levels, respectively, were studied according to patient age, gender, socioeconomic status, clinic types and antihypertensive drug classes by multivariable regression analyses.The fasting glucose levels were statistically similar (p = 0.786) among patients prescribed thiazide diuretics (5.48 mmol/l, 95%, 5.38, 5.59), calcium channel blockers (5.46 mmol/l, 95% C.I. 5.37, 5.54), β-blockers (5.42 mmol/l, 95% C.I. 5.34, 5.51) and drugs acting on the renin angiotensin system (RAS) [5.41 mmol/l, 95% C.I. 5.20, 5.61]. Multivariate analyses reported no significant associations between antihypertensive drug class and impaired fasting glucose. Elderly patients and male gender were significantly more likely to present with above borderline and adverse readings respectively.Clinicians should be aware of the increased risk of impaired fasting glucose in these groups, and use of thiazides should not in itself deter its use as a first-line antihypertensive agent among ethnic Chinese patients.Hypertension was estimated to be present in at least 73% of citizens in the United States who have diabetes [1]. Many people were diagnosed with hypertension prior to diabetes [2], and a significant number of hypertensive patients have diabetes gone unrecognized [3]. Diabetes was reported to impose a two-fold or greater risk for cardiovascular morbidity and mortality [4] and together with hypertension this risk increased dramatically [5]. The co-existence of diabetes and hypertension are associated with greater degrees of arterial stiffness [6] which leads to earlier rises in systolic and pulse pressures [7].The importance of early detection of diabetes among hypertensive patients has been highlighted in the guidelines of the American Diabetes Association [8] and the seventh report of the Joint National Committee [9], which called for screening for diabetes at the time of diagnosing hypertension and rep
Can the concept of Health Promoting Schools help to improve students' health knowledge and practices to combat the challenge of communicable diseases: Case study in Hong Kong?
Albert Lee, Martin CS Wong, Vera MW Keung, Hilda SK Yuen, Frances Cheng, Jennifer SY Mok
BMC Public Health , 2008, DOI: 10.1186/1471-2458-8-42
Abstract: A cross-sectional study using multi-stage random sampling was conducted among schools with awards (HSA) and those schools not involved in the award scheme nor adopting the concept of HPS (non-HPS). For HSA group, 5 primary schools and 7 secondary schools entered the study with 510 students and 789 students sampled respectively. For the 'Non-HPS' group, 8 primary schools and 7 secondary schools entered the study with 676 students and 725 students sampled respectively. A self-administered questionnaire was used as the measuring instrument.Students in the HSA category were found to be better with statistical significance in personal hygiene practice, knowledge on health and hygiene, as well as access to health information. HSA schools were reported to have better school health policy, higher degrees of community participation, and better hygienic environment.Students in schools that had adopted the HPS framework had a more positive health behaviour profile than those in non-HPS schools. Although a causal relationship is yet to be established, the HPS appears to be a viable approach for addressing communicable diseases.Health behaviours are strongly determined by the different social, economic and environmental circumstances of individuals and populations. Improvement of health literacy can help individuals to tackle the determinants of health better as it builds up the personal, cognitive and social skills which determine the ability of individuals to gain access to, understand and use of information to promote and maintain good health [1]. Schools are essential in helping students to achieve health literacy [2]. The concept of the health promoting school (HPS) has been advocated as an effective approach to promote health in schools [3,4]. It embodies a holistic, whole school approach in which a broad health education curriculum is supported by the environment and ethos of the school and shifts health into a more dynamic and political domain to address the determinants
Predictors of switching from beta-blockers to other anti-hypertensive drugs: a review of records of 19,177 Chinese patients seen in public primary care clinics in the New Territory East, Hong Kong
Martin CS Wong, Harry HX Wang, Johnny Y Jiang, Stephen Leeder, Sian M Griffiths
Asia Pacific Family Medicine , 2011, DOI: 10.1186/1447-056x-10-10
Abstract: We used a validated database which consisted of the demographic and clinical information of all Chinese patients prescribed a beta-blocker from any public, family practice clinics between 01 Jan 2004 to 30 June 2007 in one large Territory of Hong Kong. The proportion of patients switched from beta-blockers to another antihypertensive agent 180 days within their first prescription was studied, and the factors associated with medication switching were evaluated by using multivariate regression analyses.From 19,177 eligible subjects with a mean age of 59.1 years, 763 (4.0%) were switched from their beta-blockers within 180 days of commencing therapy. A binary logistic regression model used medication switching as the outcome variable and controlled for age, gender, socioeconomic status, clinic setting (general out-patient clinics, family medicine specialist clinic or staff clinics), district of residence, visit type (new vs. follow-up attendance), the number of concomitant co-morbidities, and the calendar year of prescription. It was found that older patients (age 50-59 years: adjusted odds ratio [AOR] 1.38, 95% C.I. 1.12-1.70; p = 0.002; age 60-69 years: AOR 1.63 95% C.I. 1.30-2.04, p < 0.001; age ≥ 70 years: AOR 1.82, 95% C.I. 1.46-2.26, p < 0.001; referent age < 50 years) and new visitors (AOR 0.57, 95% C.I. 0.48-0.68, p < 0.001) were more likely to have their medication switched.Closer monitoring of the medication taking behavior among the older patients and the new clinic visitors prescribed a beta-blocker is warranted. Future studies should evaluate the reasons of drug switching.Hypertension is a global health problem and represents one of the most important, modifiable risk factors for renal and cardiovascular diseases [1] It affects more than 30% of the general US population [2], and estimates of the cost of the disorder are around $66.4 billion worldwide in 2007 [3]. Its prevalence is high over the globe, including Asia Pacific countries [4]. Despite the effec
Health services research in the public healthcare system in Hong Kong: An analysis of over 1 million antihypertensive prescriptions between 2004–2007 as an example of the potential and pitfalls of using routinely collected electronic patient data
Martin CS Wong, Johnny Y Jiang, Jin-ling Tang, Augustine Lam, Hong Fung, Stewart W Mercer
BMC Health Services Research , 2008, DOI: 10.1186/1472-6963-8-138
Abstract: Data on antihypertensive drug prescriptions were retrieved from the electronic Clinical Management System (e-CMS) of all primary care clinics run by the Health Authority (HA) in the New Territory East (NTE) cluster of Hong Kong between January 2004 and June 2007. Information was also retrieved on patients' demographic and socioeconomic characteristics, visit type (new or follow-up), and relevant diseases (International Classification of Primary Care, ICPC codes).1,096,282 visit episodes were accessed, representing 93,450 patients. Patients' demographic and socio-economic details were recorded in all cases. Prescription details for anti-hypertensive drugs were missing in only 18 patients (0.02%). However, ICPC-code was missing for 36,409 patients (39%). Significant independent predictors of whether disease codes were applied included patient age ≥ 70 years (OR 2.18), female gender (OR 1.20), district of residence (range of ORs in more rural districts; 0.32–0.41), type of clinic (OR in Family Medicine Specialist Clinics; 1.45) and type of visit (OR follow-up visit; 2.39).In the 57,041 patients with an ICPC-code, uncomplicated hypertension (ICPC K86) was recorded in 45,859 patients (82.1%). The characteristics of these patients were very similar to those of the non-coded group, suggesting that most non-coded patients on antihypertensive drugs are likely to have uncomplicated hypertension.The e-CMS database of the HA in Hong Kong varies in quality in terms of recorded information. Potential future health services research using demographic and prescription information is highly feasible but for disease-specific research dependant on ICPC codes some caution is warranted. In the case of uncomplicated hypertension, future research on pharmaco-epidemiology (such as prescription patterns) and clinical issues (such as side-effects of medications on metabolic parameters) seems feasible given the large size of the data set and the comparability of coded and non-coded patients.T
Comparison of primary care experiences among adults in general outpatient clinics and private general practice clinics in Hong Kong
Samuel YS Wong, Kenny Kung, Sian M Griffiths, Tanya Carthy, Martin CS Wong, Su V Lo, Vincent CH Chung, William B Goggins, Barbara Starfield
BMC Public Health , 2010, DOI: 10.1186/1471-2458-10-397
Abstract: One thousand adults in Hong Kong aged 18 and above were interviewed by a telephone survey. The modified Chinese translated Primary Care Assessment Tool was used to collect data on respondents' primary care experience.Our results indicated that services provided by GOPC were more often used by female, older, poorer, chronically-ill and less educated population. GOPC participants were also more likely to have visited a specialist or used specialist services (69.7% vs. 52.0%; p < 0.001), although this difference in utilization of specialist services disappeared after adjusting for age (55.7% vs. 52.0%, p = 0.198). Analyses were also performed to asses the relationship between healthcare settings (GOPCs versus private GPs) and primary care quality. Private GP patients achieved higher overall PCAT scores largely due to better accessibility (Mean: 6.88 vs. 8.41, p < 0.001) and person-focused care (Mean: 8.37 vs. 11.69, p < 0.001).Our results showed that patients primarily receiving care from private GPs in Hong Kong reported better primary care experiences than those primarily receiving care from GOPCs. This was largely due to the greater accessibility and better interpersonal relationships offered by the private GPs. As most patients use both GOPCs and private GPs, their overall primary care experiences may not be as different as the findings of this study imply.Considerable evidence supports the important role of primary care in the prevention of illness and death, regardless of whether the care is characterized by the supply of primary care physicians, a relationship with a source of primary care, or the receipt of important features of primary care [1]. Good primary care, in contrast to specialist services, is also associated with a more equitable distribution of health within and across populations [2,3]. Overall, both individual and ecological studies have demonstrated that high quality primary care is associated with better health outcomes [4-6].Early reports of th
Antagonist-mediated down-regulation of toll-like receptors increases the prevalence of human papillomavirus infection in systemic lupus erythematosus
Shui-Lian Yu, Paul KS Chan, Chun-Kwok Wong, Cheuk-Chun Szeto, Suzanne C Ho, Karine So, May MY Yu, So-Fan Yim, Tak-Hong Cheung, Martin CS Wong, Jo LK Cheung, Apple CM Yeung, Edmund K Li, Lai-Shan Tam
Arthritis Research & Therapy , 2012, DOI: 10.1186/ar3803
Abstract: Protein levels of TLRs 3, 7, 8 and 9 in cervical epithelial cells of lupus patients and controls with or without HPV infection were assessed using flow cytometry. Characteristics associated with the differential expression of TLRs in systemic lupus erythematosus (SLE) were elucidated. The effect and interferon-stimulated genes (ISGs) (ISG15 and Mx-1) gene expressions were then measured in oncogenic HeLa (HPV18), CaSki (HPV) and C33A (HPV negative) cell lines using flow cytometry and quantitative real-time PCR. Ex vivo productions of cytokines and interferon-gamma (IFN-γ) upon TLR ligands stimulations were subsequently measured using cytometric bead array and ELISA.For subjects with HPV infection, levels of TLR3 and TLR7 were significantly lower in lupus patients compared with controls. Significantly decreased TLRs 7, 8 and 9 levels were observed in HPV-negative SLE compared to healthy controls. For SLE with and without HPV infection, TLR7 and 9 levels were significantly lower in infected SLE than those in HPV-negative patients. Independent explanatory variables associated with down-regulation of TLR7 level included HPV infection and a higher cumulative dose of prednisolone; while a higher cumulative dose of hydroxychloroquine and HPV infection were associated with down-regulation of TLR9 level. In cervical cell lines, TLRs 3, 7, 8, 9 protein levels and antiviral ISG15 and Mx-1 gene expressions were inhibited in two oncogenic HPV types. Functional data showed that the induction of pro-inflammatory cytokines by TLR ligands (R837, ssRNA and ODN2395) was greatly impaired in CaSki and HeLa than C33A cells.In conclusion, prednisolone and TLR antagonist (hydroxychloroquine) may down-regulate protein levels of TLR7 and TLR9 in lupus patients, thereby decreasing the innate immune response against HPV infection. Upon infection, HPV further down-regulate TLR7 and 9 levels for viral persistence. Furthermore, reduction of nucleic acid-sensing TLRs 7, 8 and 9 in carcinogenic HPVs
Carcinoma of stomach detected by routine transabdominal ultrasound
MFE Wong,SFJ Shum,WK Chau,CS Cheng
Biomedical Imaging and Intervention Journal , 2010, DOI: 10.2349/biij.6.4.e39
Abstract:
Targeted therapy for esophagogastric cancers: a review
Khattak MA, Martin HL, Karapetis CS
OncoTargets and Therapy , 2012, DOI: http://dx.doi.org/10.2147/OTT.S25117
Abstract: rgeted therapy for esophagogastric cancers: a review Review (2462) Total Article Views Authors: Khattak MA, Martin HL, Karapetis CS Published Date May 2012 Volume 2012:5 Pages 91 - 102 DOI: http://dx.doi.org/10.2147/OTT.S25117 Received: 24 February 2012 Accepted: 27 March 2012 Published: 21 May 2012 Muhammad A Khattak,1 Hilary L Martin,2 Christos S Karapetis1,3 1Flinders Medical Centre, Adelaide, South Australia; 2Calvary Hospital, Adelaide, SA, Australia; 3Flinders University, Adelaide, SA, Australia Abstract: The incidence of esophagogastric cancers is increasing rapidly in the Western population. Despite better understanding of the biology and intense research in the treatment of these cancers, the long-term survival remains poor both in the locally advanced and metastatic settings. The addition of combined modality strategies has resulted in modest improvement in 5-year survival rates. A number of biologic agents targeting epidermal-derived growth factor receptor, vascular endothelial derived growth factor and its receptor, and mammalian target of rapamycin (mTOR) are being currently evaluated in Phase II and III clinical trials. Some of these, like trastuzumab, cetuximab, and bevacizumab, have shown promising results. This review provides a brief overview of the recent developments in biologic agents for the treatment of esophagogastric cancers.
Targeted therapy for esophagogastric cancers: a review
Khattak MA,Martin HL,Karapetis CS
OncoTargets and Therapy , 2012,
Abstract: Muhammad A Khattak,1 Hilary L Martin,2 Christos S Karapetis1,31Flinders Medical Centre, Adelaide, South Australia; 2Calvary Hospital, Adelaide, SA, Australia; 3Flinders University, Adelaide, SA, AustraliaAbstract: The incidence of esophagogastric cancers is increasing rapidly in the Western population. Despite better understanding of the biology and intense research in the treatment of these cancers, the long-term survival remains poor both in the locally advanced and metastatic settings. The addition of combined modality strategies has resulted in modest improvement in 5-year survival rates. A number of biologic agents targeting epidermal-derived growth factor receptor, vascular endothelial derived growth factor and its receptor, and mammalian target of rapamycin (mTOR) are being currently evaluated in Phase II and III clinical trials. Some of these, like trastuzumab, cetuximab, and bevacizumab, have shown promising results. This review provides a brief overview of the recent developments in biologic agents for the treatment of esophagogastric cancers.Keywords: adenocarcinoma, squamous cell carcinoma, VEGF, trastuzumab, Her2- positive EGC
Almost all integer matrices have no integer eigenvalues
Greg Martin,Erick B. Wong
Mathematics , 2007,
Abstract: For a fixed $n\ge2$, consider an $n\times n$ matrix $M$ whose entries are random integers bounded by $k$ in absolute value. In this paper, we examine the probability that $M$ is singular (hence has eigenvalue 0), and the probability that $M$ has at least one rational eigenvalue. We show that both of these probabilities tend to 0 as $k$ increases. More precisely, we establish an upper bound of size $k^{-2+\epsilon}$ for the probability that $M$ is singular, and size $k^{-1+\epsilon}$ for the probability that $M$ has a rational eigenvalue. These results generalize earlier work by Kowalsky for the case $n=2$ and answer a question posed by Hetzel, Liew, and Morrison.
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