Correlation of whole blood hydroxychloroquine concentration with cutaneous lupus erythematosus and factors associated with it: First multicenter, cross-sectional analysis in Malaysia.

Hydroxychloroquine (HCQ) is the first-line systemic treatment for cutaneous lupus erythematosus (CLE). Whole blood HCQ concentration (WBHCQ) was found to correlate with CLE severity among Caucasians. However, studies on Asians are scarce. We aim to explore the relationship of WBHCQ with CLE disease activity among multi-racial Malaysians and the factors associated with WBHCQ. A cross-sectional study targeting patients with CLE was conducted from 1 June till 30 November 2019. Disease activity was assessed using Cutaneous Lupus Erythematosus Disease Area and Severity Index - Activity Score (CLASI-AS). Blood was analyzed for WBHCQ concentration using a high-performance liquid chromatography technique. Statistical analysis was done using R studio version 1.2.1335. A total of 88 subjects (male : female, 4.5:1) with a median age of 41 years old were recruited. The median duration CLE was 5 years. The majority had acute cutaneous lupus (n = 45, 51.1%). The median WBHCQ was 946.8 ng/mL. Indians were found to have the highest WBHCQ (median ± interquartile range [IQR], 1515.4 ± 1494.8 ng/mL). Males had a lower WBHCQ (median ± IQR, 733.5 ± 573.8 ng/mL) than females (995.5 ± 925.1 ng/mL). However, no statistically significant association between race and sex with WBHCQ was demonstrable (p = 0.247, p = 0.066). No correlation was demonstrated between WBHCQ and CLASI-AS (r = -0.02, p = 0.851). A positive correlation was found between HCQ dosage (ideal bodyweight) and WBHCQ (r = 0.24, p = 0.027). No other factors were found associated with WBHCQ. Indians and females were observed to have higher WBCHQ; however, no significant correlation was identified. Further study is required to confirm the finding.

Attitudes towards suicide following an undergraduate suicide prevention module: experience of medical students in Hong Kong.

OBJECTIVES: To explore qualitative and quantitative changes in attitudes and experiences of medical students following a special study suicide prevention module. DESIGN: Pilot study. SETTING: The University of Hong Kong, Hong Kong. PARTICIPANTS: A 2-week intensive special studies module was delivered to third- and fourth-year medical students in June 2011. The module was elective and involved several modes of teaching. All students filled the Chinese Attitude toward Suicide Questionnaire before and after the course. They also provided written feedback about the module experience. Three students participated in in-depth interviews. RESULTS: In all, 22 students aged 20 to 23 years enrolled in the special studies module; 15 (68%) of whom were male and only one was married. Positive trends were noted in attitudes towards suicide following the participation in the special studies module, namely, reduced negative appraisal of suicide, reduced stigmatisation of the phenomena, and increased sensitivity to suicide-related facts. Feedback of the students suggested inclusion of this module into the main medical curriculum, increased confidence in dealing with issues related to suicide, and appreciation of skills focusing on interviewing in patients. Overall the module was well received by medical students. CONCLUSIONS: A suicide prevention training module seems to have been valued by students and lead to positive attitudes towards understanding suicide. Adopting this initiative as a suicide prevention strategy warrants further exploration.

The significance of LMO2 expression in the progression of prostate cancer.

LIM domain only 2 (LMO2) proteins are important regulators in determining cell fate and controlling cell growth and differentiation. This study has investigated LMO2 expression in human prostatic tissue specimens, prostate cancer cell lines, and xenografts; and has assessed the possible role and mechanism of LMO2 in prostate carcinogenesis. Immunohistochemical analysis on a tissue microarray consisting of 91 human prostate specimens, including normal, prostatic hyperplasia, high-grade prostatic intraepithelial neoplasia, and invasive carcinoma, revealed that overexpression of LMO2 was significantly associated with advanced tumour stage, as measured by Gleason score (p = 0.012), as well as with the development of distant metastasis (p = 0.018). These data were supported by quantitative real-time PCR experiments, where LMO2 mRNA levels were found to be significantly higher in prostate tumour specimen than in normal epithelium (p = 0.037). The expression of LMO2 in cell lines and xenografts representing androgen-dependent (AD) and androgen-independent (AI) prostate cancer stages was further studied. Consistent with the in vivo data, LMO2 mRNA and protein were found to be overexpressed in the more aggressive AI cells (PC3, DU145, and AI CWR22 xenografts) compared with less aggressive AD cells (LNCaP and AD CWR22 xenografts). Furthermore, stable introduction of LMO2 into LNCaP cells conferred enhanced cell motility and invasiveness in vitro, accompanied by down-regulation of E-cadherin expression. Taken together, these findings provide the first evidence to support the hypothesis that LMO2 may play an important role in prostate cancer progression, possibly via repression of E-cadherin expression.

A survey on the involvement of accident and emergency doctors in medicolegal work in Hong Kong.

This study reports the results from a questionnaire survey on the pattern of medico-legal work undertaken by doctors working in Accident & Emergency Departments (ED) and their self-evaluation of competency in forensic medicine. A total of 155 questionnaires were returned with a response rate of 46%. Only 30% (46) respondents were fellows of the Hong Kong College of Emergency Medicine but 46% (71) had more than 6 years of experience working in the ED. Most of the requests for medical report came from police and insurance companies. Fellows had more experience writing reports on homicide, sexual assault and child abuse than non-fellows did. Nearly all fellows and three quarters (74%) of non-fellows had given evidence in courts of law. Physical assault was the commonest and sexual assault the least common experience. Most respondents had experience of attending district court (83%), followed by coroner inquest (67%), magistracy (66%) and high court (45%). Respondents were asked to rate themselves on their competence in various subject areas. It can be seen that respondents were less comfortable in areas like homicide, child abuse and sexual assault. On the job coaching by a senior seems to be the major mode of training. Both fellows (61%) and non-fellows (36%) favored some form of courses with a hands-on workshop element in future.

Fatal gastrointestinal haemorrhage due to coexisting primary aorto-enteric and aorto-colic fistulae. Complicating untreated atheromatous abdominal aortic aneurysm.

We report a case of aorto-enteric and aorto-colonic fistulae in a 73 year old man with no previous abdominal surgery which resulted in massive gastrointestinal haemorrhage and death and was undiagnosed despite several hospital admissions and endoscopic examinations. This case serves to highlight an extremely rare but fatal condition, which is potentially treatable, if an early diagnosis is made.

Rape in Hong Kong: an overview of current knowledge.

This paper summarises all published and unpublished material available on the topic of rape in Hong Kong. Data including epidemiology, victim profile, assault characteristics, are presented. Most of the data shown are from the 15-year period between 1981 and 1995. Gaps in knowledge are highlighted so as to direct the attention of local researchers and overseas research collaborators.