Triple-A syndrome--the first Chinese patient with novel mutations in the AAAS gene.

We report on the first Chinese patient with triple-A syndrome, who presented at 22 months with status epilepticus secondary to hyponatraemia and hypoglycaemia. Subsequent endocrine investigations confirmed primary adrenal insufficiency and aldosterone deficiency. In the presence of achalasia and alacrima, this patient satisfies the diagnostic criteria of triple-A syndrome. Further molecular testing detected compound heterozygous mutations in the AAAS gene: a c.580C --> T transition in exon 7 and a c.771delG single nucleotide deletion in exon 8. Testing of parents and brother confirmed their heterozygous carrier status.

Computerization of clinical practice in Hong Kong: a study of Chinese medicine practitioners.

PRIMARY OBJECTIVE: To explore the current level of computerization in clinical practice in the Hong Kong Special Administrative Region through a population-based, Chinese medicine practitioner (CMP). METHODS AND PROCEDURES: A self-completed, one-page two-sided, questionnaire were sent to the sample via mail, and a second mailing was sent to those who had not replied after 14 days. The sample consisted of 3335 listed CMPs registered with the Chinese Medicine Council of Hong Kong in 2002. MAIN OUTCOMES AND RESULTS: We received 1036 questionnaires from this mailed survey. After deducting those who had moved (n = 60), we calculated a response rate of 31.6%. Male respondents accounted for 81.8% (n = 847) of replies, and 279 respondents (26.9%) had used computer in their practices. The present analyses provide evidence that CMPs' current overall level of knowledge and use of computers in clinical practice is far from optimal. At best, only about 6.5% and 8.4% of CMPs in the study sample had computerized 4 - 8 clinical and 3 - 6 administrative functions, respectively. CONCLUSIONS: In Hong Kong primary health care systems place much emphasis on quality outcomes and cost reduction. In order to achieve these goals, apparatus that allows greater accountability represents a means by which healthcare providers and policy makers can exercise greater control over healthcare services. Thus, implementation of computer systems in clinical practice can be seen as a prominent part of this overall philosophy. The present study has systematically documented the extent of clinical computer use in HK, identified areas for improvement, as well as specific groups of CMPs who might benefit from targeted efforts to promote computerization in practice for CMPs.

Attitudes of Hong Kong Chinese to traditional Chinese medicine and Western medicine: survey and cluster analysis.

OBJECTIVES: To determine whether within a cohort of Hong Kong out-patients definable subtypes exist based on their attitudes to traditional Chinese medicine and Western medicine. DESIGN: Data were collected using a structured questionnaire. SETTING: The sample of 503 subjects was recruited at two local outpatient clinics in Hong Kong. MAIN OUTCOME MEASURES: The study employs demographic variables, illness status, the Chinese-Western Medical Belief Scale, trust of physicians and subjects' preferences on consultation fees, attitude of health care professional, efficacy of service and waiting time during consultation. RESULTS: A cluster analysis yielded three clusters based on their attitudes towards traditional Chinese and Western medicine. One cluster, 24% of the sample, is noted for being older, poorer, more likely to be female and to have chronic conditions; they are sceptical of western physicians. The second cluster (63% of the sample) is younger and have considerably more belief in Western than traditional Chinese medicine. The third group (14%) is intermediate in age and is noted for a marked faith in both forms of medicine. CONCLUSIONS: A clear profile of these attitudes of Hong Kong Chinese may benefit health care professionals in making appropriate patient-doctor relationships and planning patient care.