Biomedical subjects

T N Chau

Publications and source records attributed to T N Chau.

22 records · Page 2Linked to original sources

PubMed1998

Thrombelastographic changes and early rebleeding in cirrhotic patients with variceal bleeding.

BACKGROUND: Routine coagulation tests do not necessarily reflect haemostasis in vivo in cirrhotic patients, particularly those who have bleeding varices. Thrombelastography (TEG) can provide a global assessment of haemostatic function from initial clot formation to clot dissolution. AIM: To evaluate TEG changes in cirrhotic patients with variceal bleeding and their association with early rebleeding. PATIENTS/METHODS: Twenty cirrhotic patients with active variceal bleeding had serial TEG and routine coagulation tests daily for seven days. The TEG variables before the day of rebleeding (n = 6) were compared with those of patients without rebleeding (n = 14). RESULTS: Baseline characteristics of the rebleeding and non-rebleeding groups were comparable apart from a higher incidence of uncontrolled infection on the day of rebleeding in the rebleeding group (p = 0.007). The patients in the rebleeding group were more hypocoagulable before the day of rebleeding as shown by longer r (42 v 24 mm, p < 0.001) and k (48 v 13 mm, p < 0.001) and smaller a (12 v 38 degrees, p < 0.001) compared with the mean of daily results of the non-rebleeding group. Routine coagulation tests, however, showed no significant differences between the two groups. CONCLUSION: The results of serial TEG measurements suggest that hypocoagulability may be associated with early rebleeding in cirrhotic patients.

Adult↗

PubMed1997

Haemolysis complicating acute viral hepatitis in patients with normal or deficient glucose-6-phosphate dehydrogenase activity.

Haemolytic anaemia as a complication of acute hepatitis has been reported in up to 23% of patients. However, the incidence may rise up to 70-87% in patients who have glucose-6-phosphate dehydrogenase (G6PD) deficiency. Massive intravascular haemolysis with renal failure, hepatic encephalopathy and even death have been reported. In our retrospective study of patients with acute viral hepatitis, the overall incidence of acute haemolysis was 4% (17/434). Only 53% (9/17) of them had G6PD deficiency. Patients with acute haemolysis had a significantly higher peak bilirubin level and required more prolonged hospitalization. Since hepatitis A virus vaccination, unlike hepatitis B virus vaccination, is not yet recommended for routine immunization, we suggest subjects who are G6PD-deficient should be vaccinated against hepatitis A. In endemic areas of hepatitis A virus infection, universal immunization remains the definitive answer.

Adolescent↗

PubMed1997

Acute viral hepatitis in Hong Kong: a study of recent incidences.

Acute hepatitis patients admitted to a referral centre from January 1995 through December 1995 were studied to determine the seroprevalence of the hepatitis viruses and related risk factors. Of the 434 patients with acute viral hepatitis, the episodes due to hepatitis A, B, C, D, and non-A, non-B, non-C, (non-ABC) were 214 (49.3%), 163 (37.6%), 7 (1.6%), 0 (0%), and 50 (11.5%), respectively. Acute hepatitis A and non-ABC hepatitis commonly occur in late spring and early summer and are probably related to the intake of shellfish and travel to endemic areas. Approximately 60% of cases of symptomatic hepatitis B infection were acute exacerbations of chronic infection. Sexual exposure was the single most important risk factor for acute hepatitis B infection. The rarity of acute hepatitis C and D might be related to the low rate of intravenous drug use in our locality. Hepatitis E virus probably contributed significantly to the cases of non-ABC hepatitis. Further studies are needed to establish the importance of various causative agents of acute hepatitis in Hong Kong.

Journal Article↗

PubMed1996

Association of self-limited cytomegalovirus colitis and shigellosis in an immunocompetent patient.

Cytomegalovirus (CMV) infection of the colon has been rarely reported in immunocompetent patients. Patients with severe acute illness or disseminated CMV infection have high mortality. In contrast, the patients with local injury of the colon due either to other gastrointestinal infections or to anal intercourse, who are otherwise healthy, usually have self-limited disease. The CMV infection is believed to be the bystander and may be treated conservatively. Concomitant CMV colitis and other gastrointestinal infections occur exclusively in immunosuppressed patients. We report, to our knowledge, the first case of co-infection of the colon with CMV and Shigella in an immunocompetent patient. The hypothesis is that the mucosal damage caused by Shigella infection may predispose the colon to secondary CMV invasion.

Colitis↗