Dr. Bryan Li, Dr. Gerry Kwok, Dr. Thomas Yau, 20190807035449
Case 1: A 59-year-old gentleman with advanced HCC was referred to our centre for management. He had a history of diabetes, hypertension and ischaemic heart disease. He was a nondrinker and not a carrier of hepatitis B or C.
Case 2: A 65-year-old man with a history of alcoholic cirrhosis and oesophageal varices was found to have rising AFP levels on routine follow-up. He also had a 3-year history of diabetes and was on diet control, with an HbA1cof 6.2 percent and fasting glucose of 6.8 mmol/L. He did not need any diabetic medications.
Case 1: A 73-year-old man with good past health presented to the emergency department with a few days’ history of involuntary low-amplitude unpredictable movements of his left arms and legs.
Case 2: An 84-year-old man with a few years’ history of type 2 diabetes mellitus was admitted with 2 days’ history of involuntary flinging movements of his right arm and leg.
Multidrug-resistant organisms (MDROs) are frequently defined as bacteria with resistance to three or more classes of antimicrobials. Common examples include methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum beta-lactamases (ESBL)–producing Enterobacteriaceae, carbapenem-resistant Enterobacteriaceae (CRE) and vancomycin-resistant Enterococci (VRE). The challenges of managing these infections are illustrated in the following two cases.
In this case report, we present the challenges encountered by physicians and cardiologists managing patients with advanced HF, and highlight the broadening spectrum of medical therapies and pathways that comprise contemporary practice.
A 38-year-old right-handed man had had epilepsy since 2 months of age. There was no relevant family history. Perinatal history was unremarkable. No other risk factors such as central nervous system infection or cerebral trauma were identified. Developmental history did not show major delay. His epilepsy was uncontrolled despite trying valproate, carbamazepine, clobazam, levetiracetam, oxcarbamazepine and perampanel.
Dr. Fanny Wai-San Ko, Dr. Wing-Ho Yip, 20180815064342
Although a majority of patients can achieve good asthma control with the use of inhaled corticosteroid (ICS) and bronchodilators, some patients’ asthma remain uncontrolled despite the use of these medications.
Dr. Kelvin Ki-Wan Chan, Dr. Chun-Ka Wong, 20180710000000
Case 1: Madam A became pregnant at 38 years of age. She carried a class IV risk under the modified WHO classification of maternal cardiovascular risk, for which pregnancy was contraindicated. Termination of pregnancy was repeatedly suggested, but the couple opted to continue with the pregnancy.
Case 2: Madam B had had hypertension since early adolescence. Apart from being obese with a Body Mass Index of 34 kg/m2and fatty liver disease, extensive investigations were unrevealing. Her family history was unremarkable. She was then lost to follow-up. At 24 years of age, madam B was referred back to our hospital for a high-risk pregnancy situation during her first trimester.
A 36-year-old banker with good past health presented to our rheumatology clinic with a 6-month history of bilateral wrist pain. He initially sought medical attention in the private sector for a 2-month history of bilateral symmetrical wrist pain and swelling.
Dr. Michael Sze, Dr. Tammy Ma, Dr. Yui-Ming Lam, 20180409000000
A 47-year-old gentleman with a known history of mitral valve prolapse (MVP) and mild-to-moderate mitral regurgitation since his 30s presented to Queen Mary Hospital with sudden onset of chest pain and palpitations for 1 day.
The syndrome of sensory neuronopathy and detection of anti-Hu antibody in 2010 were very strong indications of the presence of a malignant tumour. In a series of 200 patients positive for anti-Hu, 83.5 percent were found to have cancer, and 90 percent of the cancer cases were small-cell lung cancer.
The combination therapy comprising carfilzomib, cyclophosphamide and dexamethasone (KCd) is effective, with a tolerable safety profile, in an Asian cohort with high-risk multiple myeloma (MM) — thus providing a more economical alternative as a potential upfront regimen in resource-limited settings, according to leading experts during a myeloma education webinar.
Diabetes is a key risk factor for heart failure (HF), which is the leading cause of hospitalization in patients with or without diabetes. SGLT-2* inhibitors (SGLT-2is) have been shown to reduce the risk of hospitalization for HF (HHF) regardless of the presence or absence of diabetes.
Invasive fungal infections, particularly those caused by Candida species, are common in hospitalized, immunocompromised, or critically ill patients and are associated with considerable morbidity and mortality.