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Biomedical subjects

Albert Lee

Publications and source records attributed to Albert Lee.

34 records · Page 2Linked to original sources
PubMed2003

Determination of two intact glucosinolates in vegetables and Chinese herbs.

A reversed-phase HPLC method was developed for analyzing sinigrin and gluconasturtiin in six vegetable and two Chinese herb samples. A gradient program and mobile phases using methanol and 0.05% trifluoroacetic acid containing 20 mM ammonium acetate allowed sufficient retention and separation of the glucosinolates in the sample extracts. Quadrupole time-of-flight tandem mass spectrometry in negative ion electrospray ionization was used to analyze the fractions collected from the HPLC elution to confirm the identification of the glucosinolates. The levels of sinigrin and gluconasturtiin in the vegetables and Chinese herbs were determined by using an external calibration method. Concentrations of gluconasturtiin in the Chinese herbs were more than 15 times higher than those of sinigrin. Detection limits were 18 nmol g(-1) for sinigrin and 4 nmol g(-1) for gluconasturtiin when 50 g of fresh vegetable was analyzed.

Chromatography, High Pressure Liquid↗
PubMed2003

Case clustering in pityriasis rosea: a multicenter epidemiologic study in primary care settings in Hong Kong.

OBJECTIVES: To investigate the epidemiology of pityriasis rosea in primary care settings in Hong Kong and to analyze for temporal clustering. DESIGN: Retrospective epidemiologic study. SETTING: Six primary care teaching practices affiliated with a university. Patients Forty-one patients with pityriasis rosea, 564 patients with atopic dermatitis (negative control condition), and 35 patients with scabies (positive control condition). METHODS: We retrieved all records of patients with pityriasis rosea, atopic dermatitis, or scabies diagnosed in 3 years. We analyzed temporal clustering by a method based on a regression model. RESULTS: The monthly incidence of pityriasis rosea is negatively but insignificantly correlated with mean air temperature (gamma s = -0.41, P =.19) and mean total rainfall (gamma s = -0.34, P =.27). Three statistically significant clusters with 7, 6, and 7 cases were identified (P =.03), occurring in the second coldest month in the year (February), the second hottest month (July), and a temperate month (April), respectively. For atopic dermatitis (negative control condition), the nonclustering regression model was selected by Akaike information criteria. For scabies (positive control condition), 1 cluster of 20 cases was detected (P =.03). CONCLUSIONS: Significant temporal clustering independent of seasonal variation occurred in our series of patients with pityriasis rosea. This may be indicative of an infectious cause.

Adolescent↗
PubMed2003

How to minimize inappropriate utilization of Accident and Emergency Departments: improve the validity of classifying the general practice cases amongst the A&E attendees.

Studies have found that one-third to two-thirds of all patients attending Accident and Emergency (A and E) Departments could be managed appropriately by general practitioners (GPs). There is also evidence that referral to GPs can be acceptable to patients. The question of primary concern is screening non-urgent cases with high degrees of sensitivity (S), specificity (SP), and positive predictive value (PPV). This paper reports the findings of the validity (S, SP and PPV) of nurses and patients in triaging A and E visitors. A cross sectional study was conducted over a 1 year period and subjects were randomly selected from four A and E Departments located across the four principle geographic regions of Hong Kong by stratified, two-stage sampling. S, SP and PPVs were computed for both non-weighted and weighted conditions. The gold standard for defining the true urgency status of each selected patient was based on a review of the patient's record 3-21 days (or longer if necessary) following the A and E visit. The record review in each A and E was blinded and done independently by a panel of two (and if disagreement existed, three) senior emergency physicians who did not practice in the same hospital. The greatest weights would be for incorrect decisions with greatest impact on patients' well being. The most accurate unweighted nurses' triage classification had an average sensitivity of 87.8%, specificity of 83.9%, and a PPV of 70.1%. When weighted, the average sensitivity reduced to 75%, specificity to 65.7%, and PPV to 54%. The most accurate unweighted patients' self-triage classification yielded a sensitivity of 62.5%, specificity of 69.2%, and a PPV of 58.1%, and correspondingly reduced to 43.3, 49.2 and 38.6% if weights were applied. Validity of the derived patients' self-classifications was too inaccurate for practical use. Hong Kong's current use of a five-point urgency scale by nurses would be further refined for identifying non-urgent visitors. If a mechanism was put in place for additional screening on visitors with a borderline semi-urgent or non-urgent status, the nurses could safely reassign non-urgent patients to GP care. If implemented, a significant impact on hospital costs could be realized.

Concurrent Review↗
PubMed2003

The need for integrated primary health care to enhance the effectiveness of health services.

With the increasing prevalence of chronic illnesses and health compromising behaviours, health care expenditure is escalating with the expansion of hospital services. Integrated primary health care would enhance the cost effectiveness of health care delivery. Recent studies on primary care health services research in Hong Kong indicated that there is a high level of inappropriate utilisation of hospital emergency services, a high prevalence of youth health risk behaviours particularly mental health which would lead to a heavy burden on health services in the future. The community based rehabilitation provided a better quality of life for chronic illness patients, better drug compliance for chronic illness patients in family practice, and a disproportionate amount of budget is spent on law reinforcement and treatment for drug abuse rather than on prevention and education. The findings strongly indicate the need to have a strong primary health care team with well trained family physicians and trained health professionals as primary care practitioners to provide services on health promotion; curative; rehabilitation and supporting services; supporting self help activities of individuals, families and groups. This would minimize compartmentalisation in health care delivery, and is also a cost effective way of providing high quality holistic and comprehensive care that meets the needs of the majority of the population.

Adolescent↗
PubMed2003

The roles of endonucleolytic cleavage and exonucleolytic digestion in the 5'-end processing of S. cerevisiae box C/D snoRNAs.

Small nucleolar RNAs (snoRNAs) play important roles in ribosomal RNA metabolism. In Saccharomyces cerevisiae, box C/D snoRNAs are synthesized from excised introns, polycistronic precursors, or independent transcription units. Previous studies have shown that only a few independently transcribed box C/D snoRNAs are processed at their 5' end. Here we describe 12 additional independently transcribed box C/D snoRNAs that undergo 5'-end processing. 5' Extensions found in the precursors of these snoRNAs contain cleavage sites for Rnt1p, the S. cerevisiae homolog of RNase III, and unprocessed precursors accumulate in vivo in the absence of Rnt1p. Rnt1p cleavage products were identified in vivo when the 5' --> 3' exonucleases Xrn1p and Rat1p are inactivated (xrn1delta rat1-1) and in vitro using model RNA substrates and recombinant Rnt1p. Some of these snoRNAs show increased levels of unprocessed precursors when the rnt1Delta deletion is combined to the xrn1delta rat1-1 mutation, suggesting that these exonucleases participate in the 5' processing or the degradation of the snoRNA precursors. Unprocessed precursors are not significantly destabilized in the absence of the trimethylguanosine capping enzyme Tgs1p, suggesting that a 5' monomethyl cap is sufficient to ensure stabilization of these precursors. These results demonstrate that the majority of independently transcribed box C/D snoRNAs from the yeast genome undergo 5'-end processing and that the Rnt1p endonuclease and the Xrn1p and Rat1p 5' --> 3'exonucleases have partially redundant functions in the 5'-end processing of these snoRNAs.

Base Sequence↗
PubMed2003

A randomised controlled trial of educational counselling on the management of women who have suffered suboptimal outcomes in pregnancy.

OBJECTIVES: To study whether proactive educational counselling, in addition to routine clinical care, reduces psychological morbidity and improves quality of life and client satisfaction among women who suffer suboptimal outcomes during childbirth. DESIGN: A randomised controlled trial. SETTING: Obstetric unit of a tertiary teaching hospital. POPULATION: Women who had unexpected antenatal, intrapartum or postpartum events leading to suboptimal outcomes during pregnancy and childbirth. INTERVENTION: Educational counselling provided by a trained research nurse in the postnatal ward after delivery. Women in the control group received routine clinical care. MAIN OUTCOME MEASURES: The Hospital Anxiety and Depression Scale, the General Health Questionnaire and the Clinical Global Impression (before and after counselling, at six weeks and six months post-delivery) and the World Health Organisation Quality of Life scale (WHO-QOL) (at six weeks and six months post-delivery). RESULTS: There was no significant difference in psychological morbidity, quality of life or client satisfaction between the counselling group and the control group. Participants who underwent elective caesarean section and who had the educational counselling had significantly lower depression scores [mean 2.6 (SD 2.6)] compared with those receiving routine care [mean 3.9 (SD 3.2)]. On the other hand, educational counselling may have deleterious effect to women's quality of life in those who had instrumental delivery. Participants allocated to the counselling group had a lower mean score 68 (SD 13) in the physical domain of WHO-QOL than those in the intervention group 74 (SD 13). CONCLUSION: Educational counselling, given on top of routine clinical care, does not give additional beneficial effects on the psychological wellbeing and quality of life of women who encountered suboptimal outcomes during pregnancy.

Adult↗
PubMed2002

Who would become a successful Dean of Faculty of Medicine: academic or clinician or administrator?

It has been a long tradition that the medical school dean is an expert in a specialist field with a well-established reputation in research and clinical services. Medical education is no longer simply disease orientated; it is required to put an emphasis on prevention, the need for better management of the health care system, and the need for a better understanding of the sociopolitical aspects of medical care. The deans of medical schools must appreciate the social role of medical education, and the social contract with the community. Although doctors might have difficulties with leadership because they are trained to work as individuals and to value highly their independence and autonomy, good communication skills are an asset for clinicians in management roles. It does not matter whether the background of the dean is academic, clinical or administrative; the most important thing is to possess the managerial skills to tackle the three-way tension between management, academic leadership and professional leadership. The job should be open to people with a good knowledge of and background in health and fiscal expertise, and also a high degree of management, diplomatic and interpersonal skills. Those skills should also be emphasized in the medical curriculum.

Administrative Personnel↗
PubMedDate not supplied

The diagnostic criteria of Gianotti-Crosti syndrome: are they applicable to children in India?

In order to evaluate the applicability of the diagnostic criteria to children with Gianotti-Crosti syndrome (GCS) in India we retrieved all clinical records of children with a definite diagnosis of this syndrome seen over 30 months in a private dermatology practice. The controls were children for whom Gianotti-Crosti had been suspected but the final diagnosis was not this syndrome, and children in whom it was not suspected but who were diagnosed with any of the differential diagnoses of the syndrome. We documented the presence or absence of the positive and negative clinical features for all patients and controls. The clinical records of 23 children with GCS and 74 controls were retrieved. The three positive clinical features--1) papules or papulovesicles 1-10 mm in diameter on at least three of the following four sites: cheeks, buttocks, extensor surfaces of the forearms, extensor surfaces of legs; 2) being symmetrical; 3) lasting for at least 10 days--were sensitive and positively correlated with GCS. Both negative clinical features--extensive truncal lesions and scaly lesions--are negatively correlated with this syndrome. All 23 children with GCS and none of the controls fulfilled the set of diagnostic criteria. We concluded that the Gianotti-Crosti diagnostic criteria are applicable to affected children in India.

Acrodermatitis↗
PubMedDate not supplied

Pityriasis rosea--an update.

Recent controversies on the etiology, diagnosis and treatment have led to increased interest in pityriasis rosea (PR). We review these aspects of the disease. PR is universal. The incidence is around 0.68 per 100 dermatological patients, or 172.2 per 100,000 person-years. The prevalence in people aged between 10 and 29 years is 0.6%. The male to female ratio is around 1:1.43. Evidence on seasonal variation is conflicting, but there is no evidence that the incidence is dependent on mean air temperature, mean total rainfall, or mean relative humidity. Spatial-temporal and temporal clustering of cases of PR has been reported. The association of PR with human herpesvirus-7 infection is still controversial. Owing to the extreme high sensitivities of sequence-based detection methods such as polymerase chain reaction, novel criteria should be applied to evaluate the evidence. There is no evidence that PR is associated with other viral or bacterial infections. The role of autoimmunity in PR warrants further investigations. Many patients with PR have one or more atypical features. Application of validated diagnostic criteria may be helpful for atypical cases. The efficacy of macrolides, including erythromycin, in PR is still under evaluation. There is no evidence that antiviral agents are effective. The efficacies of ultraviolet radiotherapy and systemic corticosteroids are not well established. In managing a patient with PR, we should concentrate more on how the eruption is affecting the quality of life, i.e. the illness, rather than the extent and severity of the eruption, i.e. the disease.

Anti-Bacterial Agents↗