Publications (132) View all
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Article: Reference standards for forced expiratory indices in Chinese preschool children.
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ABSTRACT: Spirometric testing is traditionally achievable in children of school-age and beyond. Incorporation of interactive incentives motivates preschool children to facilitate measurement of forced expiratory indices. Validated spirometric reference standards are available for Caucasian preschoolers but lacking in Asians. We established spirometric references in Chinese children aged 2-7 years, who were recruited from 19 randomly selected nurseries and kindergartens in Hong Kong. Parents completed International Study of Asthma and Allergies in Childhood questionnaire, and children concurrently performed incentive spirometry on-site according to international guideline. Prediction equations for spirometric indices were formulated by linear regression. One thousand four hundred two (72.9%) of 1,922 consented children, with mean (SD) age 4.4 (1.0) years, successfully performed spirometry. Following exclusions due to medical and technical reasons, 895 (63.8%) children contributed spirometric data to our references. Girls had lower FEV(0.5) , FEV(0.75) , FEV(1) , FVC, and PEF but similar FEF(25-75) than boys, adjusted for age, weight, and standing height as covariates. Standing height was the most important predictor for FEV(0.5) , FEV(0.75) , FEV(1) , FVC, and PEF in both boys (adjusted R(2) 0.525-0.734) and girls (adjusted R(2) 0.583-0.721), whereas the best prediction model for both gender is formed by standing height, weight, and age. At various standing heights, our preschoolers had FEV(1) Z-scores 0.13-1.00 higher than those of collaborative Caucasian reference. This study justifies the need for ethnic-specific reference equations and presents spirometry references in young Chinese children. Their forced expiratory indices are determined by gender, age, weight and standing height, and standing height is the best anthropometric index to predict all spirometric indices. Pediatr Pulmonol. © 2013 Wiley Periodicals, Inc.Pediatric Pulmonology 02/2013; · 2.53 Impact Factor -
Article: Determinants and reference equation of exhaled nitric oxide in the Chinese population.
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ABSTRACT: Measurement of fractional exhaled nitric oxide concentration (FeNO) has been proposed as a useful biomarker for monitoring and management of airway diseases. Limited information is available regarding the reference levels of FeNO levels in the Chinese adults. This study aimed to investigate the reference equation and determinants of FeNO in the Chinese adults.1093(577males) healthy non-smoking subjects aged 18-90yrs were recruited. FeNO was measured online using a chemiluminescence analyser. Other assessments included spirometry, skin prick tests, total serum immunoglobulin E(IgE) levels and eosinophil count in peripheral blood.The geometric mean FeNO was 32.6(95% reference interval[RI] 31.4-33.7)ppb for all subjects. FeNO value was higher in males than females (geometric mean[95%RI]: 38.3[36.5-40.2] vs 27.1[25.8-28.5]ppb, p<0.0001); and in atopic than non-atopic subjects (34.6[33.0-36.3] vs 29.8[28.3-31.4]ppb, p<0.0001). FeNO correlated with age (r(2)=0.23), height (r(2)=0.20), IgE level (r(2)=0.18), and % eosinophil count (r(2)=0.18), all with p<0.0001, but not with spirometric parameters. Based on multiple regression modeling, the reference equation of FeNO value was:log(FeNO)=0.781+0.104(sex[1=male,0=female])+0.004(age in years) +0.084(atopy[1=atopic,0=non-atopic])+0.003(height in cm).FeNO of Chinese adults is higher than the Caucasian population, and is affected by age, gender, height and atopic status. This study provides useful references for the interpretation of FeNO.European Respiratory Journal 11/2012; · 5.89 Impact Factor -
Article: Cadmium and lead in Hong Kong school children.
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ABSTRACT: AIM:: Cadmium (Cd) and lead (Pb) are toxic elements in our environment. This study is to determine the reference intervals of Cd and Pb in blood and urine from Hong Kong school children and to identify their determinants. METHODS:: A total of 2209 secondary school children and 893 preschool children were recruited. Cd and Pb in blood and urine were measured by inductively-coupled plasma mass spectrometry. RESULTS:: Blood Cd was affected by age, smoking and residential district, while urine Cd was influenced by age and blood Cd. Blood Cd was positively correlated with smoking as confirmed by urinary cotinine (rho = 0.183, p < 0.001, n = 2074). Blood Pb was dependent on gender and residential district, while urinary Pb was dependent on gender and blood Pb. Students from schools of lower academic grading had higher blood Cd and Pb than those from higher academic grading schools (p < 0.001, respectively). Urinary albumin was positively associated with urinary Cd and Pb. CONCLUSIONS:: Using a non-occupationally exposed population, the reference ranges are: blood Cd <21.9 nmol/L for smokers and <8.8 nmol/L for non-smokers, and blood Pb <203.8 nmol/L. Reference intervals for urinary Cd and Pb are also reported.Pathology 10/2012; · 2.38 Impact Factor -
Article: The ideal moisturizer: a survey of parental expectations and practice in childhood-onset eczema.
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ABSTRACT: Abstract Aim: We evaluated the moisturizing and bathing practices and preferences of patients with childhood-onset eczema. Methods: The attitudes and practice of patients with eczema managed at a pediatric dermatology clinic were evaluated, using children with non-eczematous skin diseases as controls. Disease severity of eczema in the preceding 12 months was evaluated by the Nottingham Eczema Severity Score (NESS). Skin hydration (SH) and transepidermal water loss (TEWL) were assessed. Results: Majority of patients took shower instead of bath and spent 12-13 min in shower. Most eczema patients applied emollients after shower/bath. Air-conditioning use was frequent, and patients with eczema maintained a lower ambient temperature than non-eczema patients (p = 0.001). Most eczema patients reported regular emollient usage (1.8 times/day for mild vs 2.8 times/day for moderate-to-severe eczema, p = 0.001), and acceptability of the current product was good to fair. Parents reported that the current emollients were most often recommended by doctors. Majority of parents/patients with mild eczema thought an ideal emollient needs only to be used twice a day whereas moderate-to-severe patients preferred more frequent usage (p = 0.001), and most of them preferred a non-fragrant, non-herbal white cream. Agreements concerning ideal emollient usage were only "moderate-to-fair" (kappa values <0.61), implying what parents/patients practiced was not the same as what they preferred. Conclusion: This study helps better understand the emolliation practices and preferences of eczema patients. Doctors remain the most important source of recommendation. Majority think an ideal moisturizer is a non-fragrant, non-herbal, white or transparent cream which needs only to be used two to three times per day. Compliance may be enhanced if the recommended moisturizer conforms to the parents/patients preference.Journal of Dermatological Treatment 03/2012; · 1.23 Impact Factor -
Article: Domestic exposure to aeroallergens in Hong Kong families with asthmatic children.
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ABSTRACT: Indoor aeroallergen exposures increased asthma symptoms in Caucasians, but their determinants and relationship to asthma and allergy in Asians are unclear. This study investigated exposures to cat, cockroach, and Blomia tropicalis allergens in 115 Hong Kong families with asthmatic children. Patients underwent exhaled nitric oxide and spirometric measurements. Home visits were made within 2 weeks during which parents completed a standardized questionnaire. Fel d 1, Bla g 2, and Blo t 5 in dust samples collected from patients' mattresses, bedroom floors, and living room floors were measured by immunoassays. These aeroallergens were only detectable in some homes (38-55% for Fel d 1; 9-21% for Bla g 2, and 7-14% for Blo t 5). The presence of cat and/or dog was a strong determinant for Fel d 1 in all indoor sites. The timing and frequency of bedding change was associated with Bla g 2 levels, whereas the timing of bedroom floor cleaning was a consistent factor for Blo t 5 levels. Asthmatic children in families with high allergen exposure were more likely to have ≥4 wheezing attacks in preceding 12 months and exercise-induced wheezing than those with normal allergen exposure (P = 0.051 and 0.030, respectively). Mattress levels of all three allergens were also associated with severity of several allergy symptoms (P = 0.025-0.005). None of these aeroallergens correlated with exhaled nitric oxide and spirometric parameters. This study identifies determinants for cat, cockroach, and B. tropicalis levels in Hong Kong families with asthmatic children. These exposures are associated with severity of allergy symptoms.Pediatric Pulmonology 07/2011; 46(7):632-9. · 2.53 Impact Factor
