Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine
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To assess the utilisation, effectiveness, and safety of arterial (angiographic) embolisation for management of severe primary postpartum haemorrhage in Hong Kong public hospitals. DESIGN. Retrospective study. ⋯ In Hong Kong, arterial embolisation for severe primary postpartum haemorrhage is a safe and effective treatment modality but is underutilised. If first-line medical treatment fails and patients are haemodynamically stable, the procedure should be considered an alternative management option. A prompt decision and early resort to arterial embolisation are advisable so as to reduce the morbidity and avoid resorting to open surgery.
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To determine the incidence of adverse events after ambulatory anaesthesia (postoperative nausea and vomiting, postoperative pain, difficulty in movement), and to evaluate the level of satisfaction of patients with our service. ⋯ Although ambulatory anaesthesia was associated with minor adverse events, patients could resume normal diet and daily activities quickly and were satisfied with the service.
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A carotid cavernous fistula is an abnormal communication between the internal carotid artery and the cavernous sinus. Rarely, this communication is associated with a persistent primitive trigeminal artery, with or without a trigeminal artery aneurysm. We report a case of spontaneous carotid-trigeminal cavernous fistula in which the persistent trigeminal artery was shown only on vertebral artery injection. The absence of an associated trigeminal artery aneurysm allowed a transvenous approach for endovascular treatment with coils and complete obliteration of the cavernous fistula.
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To study the effect of Nissen fundoplication and gastrostomy in severely neurologically impaired children. ⋯ Our results indicate that in severely neurologically impaired children with gastroesophageal reflux, vomiting, gastro-intestinal bleeding, and reflux indices based on 24-hour oesophageal pH monitoring were significantly reduced following fundoplication and gastrostomy. The incidence of pneumonia was unchanged. The recurrence rate of reflux was 30% and mortality rate was 20%.
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To ascertain the prevalence of subclinical severe acute respiratory syndrome-coronavirus (SARS-CoV) infection and study the transmission of SARS-CoV in a local outbreak at a residential care home for the elderly. ⋯ Subclinical SARS-CoV infection was rare in a residential care home for the elderly with an outbreak of SARS. Nonetheless the close working and living conditions for staff and residents in such a home may facilitate transmission of SARS despite vigilant precautionary measures.