Publications by authors named "Ling Y Leung"
Article Synopsis
- With the rise of regional trauma networks, interhospital transfers for trauma patients often lead to unnecessary transfers, known as secondary overtriage, which pose risks and financial burdens.
- A 10-year study in Hong Kong assessed 3,852 trauma patients, revealing that 21% of transfers were unnecessary, with higher rates occurring in pediatric cases.
- Key factors associated with secondary overtriage included blunt trauma and lower injury severity scores, indicating a need for improved decision-making guidelines in trauma transfers.
Article Synopsis
- The study aimed to determine how the timing of initial antibiotic treatment affects mortality rates in hospital patients with sepsis.
- It analyzed data from 42 studies involving nearly 191,000 patients, focusing on the correlation between antibiotic administration timing and patient outcomes.
- Results indicated that administering antibiotics within 3-6 hours of sepsis recognition significantly reduced the risk of death compared to later administration, highlighting the urgency of early treatment.
Background: Low back pain (LBP) is a leading cause of disability worldwide and has posed numerous health and socioeconomic challenges. This study compared whether nonsteroidal anti-inflammatory drugs (NSAIDs) in combination with tramadol, tizanidine or placebo would be the best treatment regime to improve the Roland Morris Disability Questionnaire (RMDQ) scores at 1 week.
Methods: This was a multi-center, double-blind, randomized, and placebo-controlled trial including adult patients with acute LBP and sciatica in three emergency departments in Hong Kong.
Objective: Patients with dizziness commonly present to Emergency Departments (ED) and 6% of these patients will be diagnosed with acute stroke. The TriAGe+ score comprises of eight clinical parameters and stratifies patients into four risk groups. The Japanese authors reported that the tool performed well, so our aim was to validate this diagnostic tool in our ED in Hong Kong.
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- The study evaluates the impact of updated Abbreviated Injury Scale (AIS) versions (1998 vs. 2015) on injury severity scoring and survival prediction in trauma patients at a major hospital.
- There was a significant decrease in the number of patients classified as severely injured (ISS > 15) when using AIS 2015, particularly in the head and neck region.
- Despite these changes, the overall survival prediction (AUROC) using the Trauma and Injury Severity Score remained consistent across both AIS versions.
Article Synopsis
- The study aimed to assess the return to work (RTW) status of urban Asian injury patients in Hong Kong one year post-trauma.
- The research involved analyzing data from 1,115 trauma patients treated at four centers, identifying various factors influencing their ability to return to work, such as job nature and educational level.
- Results showed that six out of ten patients managed to return to work within the year, with significant correlations between factors like physical job demands and early recovery indicators and their successful RTW.
Article Synopsis
- The study aimed to assess the long-term health impacts of trauma on adults, focusing on functional outcomes and overall health status up to 7 years post-injury.
- Researchers followed trauma patients in Hong Kong, monitoring them at various intervals and comparing their mortality rates and health metrics (using tools like the GOSE and SF36) against expected rates in the general population.
- Findings indicated higher mortality rates and limited recovery in trauma patients over 7 years, with significant improvement in physical health only observed in younger patients and those with better initial recovery scores.
Background: Truly patient-centred care needs to be aligned with what patients consider important, and is highly desirable in the first 24 h of an acute admission, as many decisions are made during this period. However, there is limited knowledge on what matters most to patients in this phase of their hospital stay. The objective of this study was to identify what mattered most to patients in acute care and to assess the patient perspective as to whether their treating doctors were aware of this.
View Article and Find Full Text PDFPurpose: Hong Kong (HK) trauma registries have been using the Trauma and Injury Severity Score (TRISS) for audit and benchmarking since their introduction in 2000. We compare the mortality prediction model using TRISS and Revised Injury Severity Classification, version II (RISC II) for trauma centre patients in HK.
Methods: This was a retrospective cohort study with all five trauma centres in HK.
Background: We aim to compare the prognostic value of Quick Sepsis-Related Organ Failure Assessment (qSOFA) and the previous Systemic Inflammatory Response Syndrome (SIRS) criteria, the National Early Warning Score (NEWS) and along with their combinations in the emergency department (ED).
Methods: This single-centre prospective study recruited a convenience sample of unselected ED patients triaged as category 2 (Emergency) and 3 (Urgent). Receiver Operating Characteristic analyses were performed to determine the Area Under the Curve (AUC), along with sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios for the various scores.
Background: Glasgow Coma Scale (GCS) is one of the most commonly used patient assessment tools. This study aimed to determine whether an assessment aid can improve the GCS scoring accuracy by helicopter rescuers in Hong Kong.
Methods: In this randomised controlled trial, Air Crewman Officers (ACMOs) of Government Flying Service in Hong Kong were randomised into two groups, with and without assessment aid.
Article Synopsis
- Capillary blood lactate testing with handheld devices can expedite clinical decisions, particularly in prehospital settings.
- A study was conducted in a Hong Kong emergency department, involving 240 urgent care patients to assess the agreement between capillary lactate levels from handheld analysers and venous levels from a blood gas analyser.
- Results indicated poor agreement between the capillary measurements and the reference standard, suggesting limited clinical usefulness of the handheld lactate devices.
Background: To determine the validity of the Quick Sepsis-Related Organ Failure Assessment (qSOFA) in the prediction of outcome (in-hospital and 1-month mortality, intensive care unit (ICU) admission, and hospital and ICU length of stay) in adult patients with or without suspected infections where qSOFA was calculated and reported; Methods: Cochrane Central of Controlled trials, EMBASE, BIOSIS, OVID MEDLINE, OVID Nursing Database, and the Joanna Briggs Institute EBP Database were the main databases searched. All studies published until 12 April 2018 were considered. All studies except case series, case reports, and conference abstracts were considered.
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- The study investigates the effectiveness of paracetamol, ibuprofen, and their combination in treating pain from soft tissue injuries in the emergency department (ED).
- 782 adult patients were randomly assigned to receive either paracetamol, ibuprofen, or both, and their pain levels were measured over two hours and three days.
- The results showed no significant difference in pain relief or side effects among the three groups, suggesting that neither treatment is superior for mild to moderate soft tissue injury pain.
Introduction: To propose and evaluate a nomogram to assist paramedics to visually estimate the external blood loss on a non-absorbent surface and to identify whether the nomogram improves visual estimation.
Methods: The study was a prospective, paired-control design (pre-training control group & post-training group), utilizing Emergency Medical Assistant (EMA) I and II trainees from the Hong Kong Fire Services Ambulance Command Training School. A nomogram (blood loss volume to area on a non-absorbent surface) was prepared to aid blood loss estimation.
Objectives: This study aimed to investigate plasma concentrations of miR-124-3p and miR-16 as prognostic markers in emergency department patients with acute stroke.
Design And Methods: Plasma concentrations of miR-124-3p and miR-16 of 84 stroke patients (presenting to the emergency department within 24h from onset of symptoms) were determined by RT-qPCR. The primary outcome measure was 3-month mortality and the secondary outcome measure was post-stroke modified Rankin Score (mRS).
Background: Homologous recombination repair (HRR) pathway deficiencies have significant implications for cancer predisposition and treatment strategies. Improved quantitative methods for functionally characterizing these deficiencies are required to accurately identify patients at risk of developing cancer and to identify mechanisms of drug resistance or sensitivity.
Methods: Flow cytometry-based single cell network profiling (SCNP) was used to measure drug-induced activation of DNA damage response (DDR) proteins in cell lines with defined HRR pathway mutations (including ATM-/-, ATM+/-, BRCA1+/-, BRCA2-/-) and in primary acute myeloid leukemia (AML) samples.
Article Synopsis
- The study explored the use of miR-124-3p and miR-16 plasma levels as diagnostic tools for acute stroke.
- Results showed that miR-124-3p levels were higher in hemorrhagic stroke patients, while miR-16 levels were elevated in ischemic stroke patients.
- Both markers effectively distinguished between the two types of stroke, with miR-16 showing a stronger discriminatory odds ratio.
Gemtuzumab ozogamicin (GO), an immunoconjugate between an anti-CD33 antibody and a calicheamicin-γ(1) derivative, induces remissions and improves survival in a subset of patients with acute myeloid leukemia (AML). As the mechanisms underlying GO and calicheamicin-γ(1) resistance are incompletely understood, we herein used flow cytometry-based single cell network profiling (SCNP) assays to study cellular responses of primary human AML cells to GO. Our data indicate that the extent of DNA damage is quantitatively impacted by CD33 expression and drug efflux activity.
View Article and Find Full Text PDFAberrant activation of Hedgehog (Hh) signalling has been implicated in the pathogenesis of human cancers. However, the cognate molecular mechanisms contributing to this disregulated pathway are incompletely understood. In this study, we showed that Zic2 was frequently over-expressed and associated with high-grade cervical cancer (p = 0.
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