Feasibility of long-term home noninvasive ventilation program in a general pediatric unit: 21 years' experience in Hong Kong.

Background: Long-term home noninvasive ventilation (NIV) is increasingly employed in children with sleep-disordered breathing and chronic respiratory failure. While studies suggest its successful implementation in tertiary care centers, little is known about the situation in a general care setting. Hence, we aim to evaluate the clinical profiles of these children in a general pediatric unit over the past two decades.

Use of heated humidified high flow nasal cannula for obstructive sleep apnea in infants.

Objective: Heated humidified high flow nasal cannula (HHHFNC) has gained popularity in the treatment of children with respiratory distress and bronchiolitis in the past decade. Its efficacy as a mode of non-invasive respiratory support has been demonstrated in both adults and children. However, reports on its use in the treatment of obstructive sleep apnea (OSA) in infants are limited.

Orthodontic plate for management of obstructive sleep apnoea in infants with Pierre Robin sequence: experience and protocol in Hong Kong.

Objective: To present the application of the pre-epiglottic baton plate (PEBP) in infants with Pierre Robin sequence (PRS) in the Southern Chinese population (Hong Kong) and to present the diagnosis and management protocol of these infants in our centre.

Design: Retrospective case series of three patients with PRS.

Setting: Neonatal Intensive Care Unit in Kwong Wah Hospital and Craniofacial Orthodontic Centre in United Christian Hospital, Hong Kong.

Synchronized abdominal compression as a novel treatment of life-threatening preschool asthma.

In severe asthma, management of life-threatening air trapping that persists despite initiation of standard asthma treatment is difficult in the absence of extracorporeal membranous oxygenation. Three children with life-threatening asthma could not be adequately ventilated despite maximum conventional treatment because of severe air trapping. A novel method of active expiration by abdominal compression with a standard ventilator was adopted with immediate effect with significant improvement in ventilation.

Determinants for asthma control, quality of life and use of complementary and alternative medicine in asthmatic pediatric patients in four cities.

Background: Asthma is a significant chronic health problem worldwide. Management aims at disease control by reducing functional impairment and exacerbations and improving quality of life (QoL). We report a multi-center study to survey asthma control and QoL in four cities in the Pearl River Delta.

Management of Recurrent Preschool, Doctor-Diagnosed Wheeze.

Preschool wheeze occurs in half of the children before they reach 6 y of age and recurrence is also common. Recurrent preschool wheeze is classified as either typical or atypical. For typical recurrent preschool wheeze, the diagnoses are either asthma or bronchiolitis/bronchitis.

A randomized placebo-controlled trial of traditional Chinese medicine as an add-on therapy to oral montelukast in the treatment of mild persistent asthma in children.

Objectives: Traditional Chinese medicine are commonly used for treatment of asthma. However, there are only very limited data about its efficacy in children. Therefore, we aimed to determine the efficacy of augmented Yu Ping Feng San (aYPFS) as an add-on to oral montelukast compared with montelukast alone for treatment of mild persistent asthma in children.

Prevalence of otitis media with effusion in children with allergic rhinitis, a cross sectional study.

Objectives: Otitis media with effusion (OME) may be caused by various factors including Eustachian tube dysfunction, inflammatory response as well as atopy. Allergic rhinitis (AR), a common chronic disorder in children, is associated with swelling of the mucosa and can therefore result in Eustachian tube dysfunction. This study aims to compare the prevalence of OME in subjects with and without AR.

A community-based cross-sectional immunisation survey in parents of primary school students.

Immunisation is a very important aspect of child health. Invasive pneumococcal and influenza diseases have been major vaccine-available communicable diseases. We surveyed demographics and attitudes of parents of primary school students who received pneumococcal conjugate vaccination (PCV) and compared them with those who did not receive pneumococcal vaccination.

Central Hypoventilation: A Case Study of Issues Associated with Travel Medicine and Respiratory Infection.

Aim. We presented the case of a child with central hypoventilation syndrome (CHS) to highlight issues that need to be considered in planning long-haul flight and problems that may arise during the flight. Case.

Complementary and alternative medicine for childhood asthma: an overview of evidence and patents.

Asthma is a prevalent childhood atopic disease associated with significant impairment of quality of life. Management relies on avoidance of triggers such as food and aeroallergens, the use of inhaled bronchodilators/corticosteroids and anti-allergic or immune-modulating therapies. Inhaled corticosteroids (ICSs) and bronchodilators have been the mainstay of treatment.

Natural history of snoring in Hong Kong adolescents.

Aim: To determine the natural history of snoring in children when they reached adolescence and the underlying risk factors for persistence of habitual snoring.

Methods: A follow-up telephone survey was conducted to determine the natural history of snoring in children who reached adolescence. The targeted interviewees of the follow-up survey were parents of 3047 children.

A review of normal values of infant sleep polysomnography.

Background: The objective of this study was to summarize current information about the normal values on infant sleep polysomnography for clinical use.

Methods: MEDLINE (Ovid), EMBASE (Ovid), and CINAHL (Ovid) from January 1976 to May 2007 were searched. Two reviewers independently reviewed all relevant articles, using preset inclusion criteria.

Validation of sleep-related breathing disorder scale in Hong Kong Chinese snoring children.

The purpose of this study is to validate the previously-validated Taiwan Chinese version of Sleep-Related Breathing Disorder scale (SRBD scale) in Hong Kong Chinese snoring children. SRBD scale is an instrument used for prediction of obstructive sleep apnea syndrome. (OSA) The Chinese version of SRBD scale were previously translated and validated in Taiwan.

Development of the Chinese version of the Paediatric Allergic Disease Quality of Life Questionnaire: reliability and validity.

Objective: Paediatric Allergic Disease Quality of Life Questionnaire is a health-related assessment tool designed for children with allergic diseases. This study aimed to translate the original English version of the Questionnaire to Chinese and to provide psychometric evidence on the validity and reliability of the translated version.

Design: Cross-sectional study.

Trends in childhood asthma hospitalisation in three Asia Pacific countries.

Aim: The study aims to examine recent childhood asthma hospitalisation rates in the Asia Pacific countries of Australia, Hong Kong and Singapore. On the background of reported decline in many countries with high asthma prevalence during late 1990s.

Methods: Annual asthma hospitalisation (ICD9-CM: 493 or ICD10-AM: J45-46)* and population data from 1994 to 2008, of children aged 0-14 years old, were obtained from the Australian National Hospital Morbidity Database, from the Hospital Authority in Hong Kong and from the Ministry of Health in Singapore.

Gender difference in snoring and how it changes with age: systematic review and meta-regression.

Purpose: The aim of this study was to study the interactions among age, gender, and snoring across all age groups

Methods: All cross-sectional study reporting gender-specific prevalence of snoring in general population published from 1966 through July 2008 were included and were meta-analyzed. The sources of heterogeneity among primary studies were studied by meta-regression.

Results: From a total of 1,593 citations reviewed, 63 were included in the analysis of snoring.

Risk factors for post-operative complications in Chinese children with tonsillectomy and adenoidectomy for obstructive sleep apnea syndrome.

Purpose: Tonsillectomy and adenoidectomy (T&A) is commonly performed in children with obstructive apnea syndrome (OSAS). It was our hospital practice to observe all patients post T&A in the pediatric intensive care unit. We aim to describe the post-operative complications after tonsillectomy and adenoidectomy in children with OSAS and to identify risk factors for these complications.

Validation of Pediatric Index of Mortality 2 in three pediatric intensive care units in Hong Kong.

Objective: To compare the probabilities of death predicted by Pediatric Index of Mortality 2 (PIM2) and Pediatric Index of Mortality 1 (PIM1) models against actual mortalities in 3 pediatric intensive care units in Hong Kong.

Methods: All consecutive patients admitted to pediatric intensive care units in 3 regional non-teaching hospitals between Jan 2006 and December 2006 were included. The data required for PIM1 and PIM2 were collected.

Heart rate variability in childhood obstructive sleep apnea.

The identification of patients with obstructive sleep apnea (OSA) is important because of morbidities associated with OSA. A previous adult study demonstrated the use of heart rate variability (HRV) as a tool to identify patients with moderate to severe OSA. Either a reduction in time parameters or an increase in LF/HF ratio was seen at overnight or 24-hr studies suggestive of increased sympathetic modulation.

Ambulatory blood pressure before and after adenotonsillectomy in children with obstructive sleep apnea.

Introduction: Hypertension is found to be associated with obstructive sleep apnea (OSA) in both children and adults. But data on the effect of blood pressure after adenotonsillectomy (AT) for children with OSA are limited and controversial.

Objective: To assess the impact of AT on different parameters of 24-h ambulatory blood pressure monitoring in children with OSA.

Improvement in quality of life after adenotonsillectomy in a child with Prader Willi syndrome.

We report a child with Prader Willi syndrome who developed obstructive sleep apnea (OSA). This patient underwent surgical treatment for OSA. There was improvement not only on her OSA but in her quality of life score as well.