Association of volunteer-administered home care with reduced emergency room visits and hospitalization among older adults with chronic conditions: A propensity-score-matched cohort study.

Objectives: The objective of this study was to examine the association of receiving care from a volunteer-administered outreach program with emergency room utilization and hospitalization among older people with chronic conditions in Hong Kong.

Methods: Volunteers consisting of retired healthcare professionals, university students, and openly recruited citizens received training to provide home care services to hospital-discharged older Chinese adults aged 65+ with chronic conditions who were identified as high-risk patients of hospital admission and referred by public healthcare providers. Several home visits were made to enhance the patients' self-care capacity.

Differential Impacts of Multimorbidity on COVID-19 Severity across the Socioeconomic Ladder in Hong Kong: A Syndemic Perspective.

The severity of COVID-19 infections could be exacerbated by the epidemic of chronic diseases and underlying inequalities in social determinants of health. Nonetheless, there is scanty evidence in regions with a relatively well-controlled outbreak. This study examined the socioeconomic patterning of COVID-19 severity and its effect modification with multimorbidity in Hong Kong.

Does Low Dose Angiotensin Converting Enzyme Inhibitor Prevent Pneumonia in Older People With Neurologic Dysphagia--A Randomized Placebo-Controlled Trial.

Objective: To examine if angiotensin converting enzyme inhibitor reduces the risk of pneumonia in older patients on tube-feeding because of dysphagia from cerebrovascular diseases.

Design: Randomized placebo-controlled trial.

Setting: Acute and subacute geriatrics units, speech therapists' clinic, and nursing home.

The synergistic effect of functional status and comorbidity burden on mortality: a 16-year survival analysis.

Objectives: The relationship between disability and comorbidity on mortality is widely perceived as additive in clinical models of frailty.

Design: National data were retrospectively extracted from medical records of community hospital.

Data Sources: There were of 12,804 acutely-disabled patients admitted for inpatient rehabilitation in Singapore rehabilitation community hospitals from 1996 through 2005 were followed up for death till 31 December 2011.

Development and validation of a clinical risk score for predicting drug-resistant bacterial pneumonia in older Chinese patients.

Background And Objective: Health care-associated pneumonia (HCAP) and drug-resistant bacterial pneumonia may not share identical risk factors. We have shown that bronchiectasis, recent hospitalization and severe pneumonia (confusion, blood urea level, respiratory rate, low blood pressure and 65 year old (CURB-65) score ≥ 3) were independent predictors of pneumonia caused by potentially drug-resistant (PDR) pathogens. This study aimed to develop and validate a clinical risk score for predicting drug-resistant bacterial pneumonia in older patients.

A new model for end-of-life care in nursing homes.

Objectives: This study aimed to promote quality end-of-life (EOL) care for nursing home residents, through the establishment of advance care plan (ACP) and introduction of a new care pathway. This pathway bypassed the emergency room (ER) and acute medical wards by facilitating direct clinical admission to an extended-care facility.

Design: An audit on a new clinical initiative that entailed the Community Geriatrics Outreach Service, ER, acute medical wards, and an extended-care facility during winter months in Hong Kong.

Predictors of viral pneumonia: the need for viral testing in all patients hospitalized for nursing home-acquired pneumonia.

Aim: Community-acquired pneumonia (CAP) is presumed to be bacterial in origin and empirical antibiotics are almost always given on admission. However, early detection of viral infection is also very important for hospital infection control and timely use of antiviral agents. The present study aimed to compare patients with viral and bacterial pneumonia, and identify independent predictors of viral pneumonia.

Role of atypical pathogens in nursing home-acquired pneumonia.

Objectives: No international consensus has been reached on the empirical use of antibiotics with atypical coverage in nursing home-acquired pneumonia (NHAP). Aspiration is an important cause of NHAP, but it may not require antimicrobial treatment. This study aimed to investigate the prevalence and clinical characteristics of AP infections and review the need for empirical antibiotics with atypical coverage in NHAP.

Should nursing home-acquired pneumonia be treated as nosocomial pneumonia?

Objectives: It is contentious whether nursing home-acquired pneumonia (NHAP) should be treated as community-acquired pneumonia (CAP) or health care-associated pneumonia. This study aimed to compare NHAP with CAP, and to examine whether multidrug-resistant (MDR) bacteria were significantly more common in NHAP than CAP.

Design: A prospective, observational cohort study

Setting: The medical unit of a tertiary teaching hospital

Participants: Patients 65 years and older, hospitalized for CAP and NHAP confirmed by radiographs from October 2009 to September 2010

Measurements: Demographic characteristics, Katz score, Charlson comorbidity index (CCI), pneumonia severity (CURB score), microbiology, and clinical outcomes were measured.

Predictors of in-hospital mortality of older patients admitted for community-acquired pneumonia.

Background: there were a few studies on the case mortality of pneumonia in older people, of which results were conflicting.

Objectives: this study aimed to identify risk factors associated with in-hospital mortality in older patients admitted for community-acquired pneumonia (CAP).

Design: a prospective cohort study.

Mobile-bearing knees reduce rotational asymmetric wear.

Polyethylene wear of bearing components is the most common long-term complication in total knee arthroplasty. One would anticipate differing kinematics would generate different wear patterns (including wear type, degree, and symmetry) on the articulating surface of mobile-bearing and fixed-bearing inserts. Because mobile-bearing designs facilitate movement of the insert relative to the tray when the knee rotates, we hypothesized mobile-bearing designs would reduce the incidence of rotational asymmetric wear.

Preparation of UHMWPE particles and establishment of inverted macrophage cell model to investigate wear particles induced bioactivites.

Total joint replacement surgery has been widely applied to patients with severe osteoarthritis. Aseptic loosening induced by wear particles generated during joint movement is the major reason causing the failure of joint implants. Interaction of ultra-high molecular weight polyethylene (UHMWPE) wear particles with macrophages stimulates the release of inflammatory cytokines and leads to bone resorption and osteolysis.

Long-term results of total condylar knee arthroplasty.

From 1979 to 1984, 126 consecutive Total Condylar (Howmedica, Rutherford, NJ) knee arthroplasties were performed at a hospital in Taiwan, of which 64 knees were available for evaluation. The patients' average weight was 58 kg. The average Hospital for Special Surgery knee score at the latest follow-up was 86 points.

A randomized, controlled trial of an intensive community nurse-supported discharge program in preventing hospital readmissions of older patients with chronic lung disease.

Objectives: To evaluate the effectiveness of an intensive community nurse (CN)-supported discharge program in preventing hospital readmissions of older patients with chronic lung disease (CLD).

Design: Randomized, controlled trial.

Setting: Two acute hospitals in the same health region in Hong Kong.

Long-term results of low contact stress mobile-bearing total knee replacements.

Five hundred ninety-eight consecutive primary low contact stress total knee replacements were done in 502 patients between 1985 and 1990. Clinical review was available for 495 knees (406 patients), 228 knees with meniscal-bearing prostheses and 267 knees with rotating-platform prostheses. The average followup was 12 years (range, 10-15 years).

Osteolysis in failed total knee arthroplasty: a comparison of mobile-bearing and fixed-bearing knees.

Background: Osteolysis is an important complication associated with total knee arthroplasty. The purpose of this study was to compare the prevalence of osteolysis after failed total knee arthroplasty with a mobile-bearing prosthesis and after failed arthroplasty with a fixed-bearing prosthesis.

Methods: Eighty revision total knee arthroplasties performed between 1995 and 1998 were included in this study.

Late dislocation of rotating platform in New Jersey Low-Contact Stress knee prosthesis.

Five patients with late rotational dislocation of the rotating platform bearing in the New Jersey Low-Contact Stress total knee arthroplasty are reported. The prostheses had functioned well for 8 to 12 years before failure. Preoperative radiographs showed asymmetric femorotibial joint spaces.