Publications by authors named "Raymond Tsang"

Background: Inspiratory muscle training (IMT) is often employed to enhance improvement in inspiratory muscle strength. However, the relationship between inspiratory muscle recruitment patterns and increasing inspiratory load remains unclear. Furthermore, the effect of breathing instructions on diaphragm activity at various inspiratory loads is unknown.

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Purpose: To examine the effects of inspiratory muscle training (IMT) on pulmonary and diaphragmatic function, exercise capacity, balance and quality of life (QOL), in post-stroke individuals.

Methods: A literature search was conducted using MEDLINE, CINAHL, EMBASE, PubMed, PEDro, Web of Science and China Biological Medicine databases. Randomized controlled trials (RCTs) with a PEDro score ≥6 focusing on the effects of IMT were included.

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Background: Patients with poststroke pusher syndrome (PS) require longer duration of rehabilitation and more supplemental care after discharge. Effective treatment of PS remains a challenge. The role of repetitive transcranial magnetic stimulation (rTMS) for PS has not been examined.

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Article Synopsis
  • Locally recurrent nasopharyngeal carcinoma (NPC) poses significant treatment challenges due to the absence of standardized guidelines for postoperative re-irradiation (re-RT).
  • This article reviews international recommendations for managing resectable cases of locally recurrent NPC, focusing on re-RT strategies and addressing controversial issues like surgical margins and resectability criteria.
  • The consensus suggests a clearer definition of resectability, optimal re-RT doses around 60 Gy, and emphasizes the potential benefits of hyperfractionation to minimize treatment toxicity, aiming to improve patient outcomes.
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  • Serotype a (Hia) is becoming a significant cause of serious infections in young Indigenous children in the North American Arctic and Sub-Arctic areas.
  • A study compared the presence of Hia in children with respiratory infections from high-incidence regions like Nunavut to low-incidence areas like Southern Ontario.
  • The study found Hia was present in 3.0% of children in Nunavut versus 0.6% in Southern Ontario, indicating ongoing circulation of the bacteria in Northern communities which could potentially lead to more severe outbreaks.
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Syphilis, caused by subsp. (TPA), is becoming a significant public health concern, with rising incidence in Manitoba exceeding the national average. The province has also seen a demographic shift leading to women representing 51.

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Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory condition of the nasal and paranasal tissues, characterized by the presence of bilateral nasal polyps. An expert panel of specialists from the Asian-Pacific region and Russia was convened to develop regional guidance on the management of CRSwNP through a consensus approach. The present article presents the chief observations and recommendations from this panel to provide guidance for clinicians in these areas.

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Objective: To identify recent trends in invasive meningococcal diseases (IMD) in Quebec, Canada, with a focus on MenY cases and MenY strains.

Methods: IMD cases and MenY strains from January 1, 2015 to August 11, 2023 were analyzed for clonal analysis and prediction of susceptibility to MenB vaccines. MenY strains of ST-23 CC from Quebec were analyzed with global MenY strains by core-genomic multi-locus sequence typing (cg-MLST).

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Background: serotype a (Hia) has recently emerged as an important cause of invasive disease, mainly affecting young Indigenous children. Carriage of is a pre-requisite for invasive disease and reservoir for transmission. To better understand the epidemiology of invasive Hia disease, we initiated a multicentre study of nasopharyngeal carriage among Canadian children.

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This study aimed to compare the efficacy of online exercise therapy with conventional exercise therapy for young adults with chronic neck pain. A randomized clinical trial recruiting 35 university students with self-reported chronic neck pain was conducted. The experimental group receiving 6-week online exercise therapy and active control group receiving the same face-to-face conventional exercise therapy.

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Knee and hip osteoarthritis are common disabling conditions globally. Although numerous international clinical practice guidelines exist to guide physiotherapy management, not all recommendations issued from these guidelines can be translated to other contexts without considering the cultural acceptability and clinical implementability of targeted countries. Because the ADAPTE framework provides a robust methodology to adapt guidelines to the local context, this study used its methodology to adapt high-quality guideline recommendations to promote optimal physiotherapy care for knee and hip osteoarthritis in Hong Kong.

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Article Synopsis
  • Sinonasal neoplasms (both benign and malignant) are complex issues for clinicians, highlighting the need for collaboration to improve patient care, as presented in the International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors (ICSNT).
  • The ICSNT document organizes findings into four main sections: general principles, benign neoplasms, malignant neoplasms, and quality of life, covering 48 specific topics and providing evidence-based recommendations and summaries based on their rigor.
  • This comprehensive document reflects a collective effort from an international team to advance understanding and intervention methods for sinonasal neoplasms, while also identifying future research opportunities.
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Background: There is limited evidence to support the use of vestibular rehabilitation therapy (VRT) on improving balance and gait in patients after stroke. This systematic review aimed to evaluate the effects of VRT in addition to usual rehabilitation compared with usual rehabilitation on improving balance and gait for patients after stroke.

Methods: This review followed the Preferred Reporting Items for Systematic reviews and Meta-Analysis statement guidelines.

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Objective: To evaluate the sensitivities and specificities of Epstein-Barr virus (EBV) DNA in the detection of locally recurrent or persistent nasopharyngeal carcinoma (NPC) through nasopharyngeal (NP) brush biopsy and plasma, respectively, and whether a combination of both would be superior to the individual tests.

Study Design: A case-control study was conducted from September 2016 to June 2022.

Setting: A multicentre study at 3 tertiary referral centers in Hong Kong was conducted by the Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong.

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Inadequate resection margins in head and neck squamous cell carcinoma surgery necessitate adjuvant therapies such as re-resection and radiotherapy with or without chemotherapy and imply increasing morbidity and worse prognosis. On the other hand, taking larger margins by extending the resection also leads to avoidable increased morbidity. Oropharyngeal squamous cell carcinomas (OPSCCs) are often difficult to access; resections are limited by anatomy and functionality and thus carry an increased risk for close or positive margins.

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Article Synopsis
  • - The study analyzed the molecular epidemiology of invasive meningococcal disease (IMD) in Atlantic Canada from 2014 to 2020, specifically looking at serotype and potential vaccine coverage for serogroup B (MenB).
  • - Results revealed a variety of strains, with MenB being the most common (42 out of 56 isolates), and distinct geographical distributions of certain clones in Newfoundland and Labrador versus New Brunswick and Nova Scotia.
  • - Vaccine predictions indicated that 54.8% of MenB strains were likely covered by the MenB vaccine Bexsero, while a high percentage (95.3%) could be covered by Trumenba, highlighting the importance of ongoing surveillance in IMD. *
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A meeting of experts was held in November 2021 to review and discuss available data on performance of Epstein-Barr virus (EBV)-based approaches to screen for early stage nasopharyngeal carcinoma (NPC) and methods for the investigation and management of screen-positive individuals. Serum EBV antibody and plasma EBV DNA testing methods were considered. Both approaches were found to have favorable performance characteristics and to be cost-effective in high-risk populations.

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Invasive type a (iHia) disease was detected in Alaska and Northern Canada in 2002 and 2000, respectively. From 2006 to 2017, 164 iHia cases (Alaska=53, Northern Canada=111) were reported. Rates of iHia disease per 100,000 persons were higher in Northern Canada compared to Alaska and were significantly higher in Indigenous (Alaska 2.

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The effects of the COVID-19 pandemic continue to constrain health-care staff and resources worldwide, despite the availability of effective vaccines. Aerosol-generating procedures such as endoscopy, a common investigation tool for nasopharyngeal carcinoma, are recognised as a likely cause of SARS-CoV-2 spread in hospitals. Plasma Epstein-Barr virus (EBV) DNA is considered the most accurate biomarker for the routine management of nasopharyngeal carcinoma.

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Background: A resurgence of syphilis infections has been described in a number of countries including Canada in the last decade.

Methods: This study identified polymerase chain reaction (PCR) positive syphilis cases based on detection of genes (, , and ) in 3,350 clinical specimens obtained from patients in the province of Manitoba, Canada between 2017 and 2020. Patient demographics were obtained from specimen requisition forms.

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Over the past few years, the increase in infectious syphilis outbreaks in major urban centres and remote or rural locations in Canada, often affecting hard-to-reach patient populations, has renewed an interest and urgency in studying the use of point-of-care tests (POCTs) that can provide test results at the time and place of primary health care delivery, obviating the repeat visit necessary with traditional syphilis serology or molecular diagnostic tests. In 2015, the Canadian Public Health Laboratory Network released its first laboratory guideline for the use of POCTs in the diagnosis of syphilis in Canada. Although Canada has no licensed POCT, two POCTs (Syphilis Health Check and the DPP® HIV Syphilis System) have received US Food and Drug Administration (FDA) approval under premarket approval applications.

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This review summarizes the recent Global Meningococcal Initiative (GMI) regional meeting, which explored meningococcal disease in North America. Invasive meningococcal disease (IMD) cases are documented through both passive and active surveillance networks. IMD appears to be decreasing in many areas, such as the Dominican Republic (2016: 18 cases; 2021: 2 cases) and Panama (2008: 1 case/100,000; 2021: <0.

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Objectives: The primary objective is to evaluate the incidence of occult nodal metastasis in patients undergoing total laryngectomy with cN0 disease. Other objectives are to compare the survival between different treatments of the neck, identify possible associated risk factors, and evaluate the effectiveness of elective neck dissection in this population with regards to oncological outcomes.

Study Design: Retrospective review.

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