The aim of this study is to determine the association between waist circumference (WC) and childh... more The aim of this study is to determine the association between waist circumference (WC) and childhood-masked hypertension. A territory-wide, school-based cohort of 1385 Hong Kong students (672 boys and 713 girls) aged 8-17 years was analysed. The ambulatory blood pressure-monitoring assessment was performed using validated oscillometric recorders (A&D TM-2430 (A&D Inc., Tokyo, Japan)) following American Heart Association's recommendations. Subjects were considered normotensive if their casual blood pressure, 24-h daytime and night-time average systolic blood pressure and diastolic blood pressure (DBP) were <95th percentile. If one or more of the ambulatory blood pressure parameters was ≥95th percentile, subjects would be considered suffering from masked hypertension (MH). Subjects who had three successive casual blood pressure measurements above the 95th percentile were excluded. By body mass index, 148 (10.7%) subjects were obese, 182 (13.1%) overweight and 359 (25.9%) having...
The Journal of Sports Medicine and Physical Fitness, Mar 1, 2008
The aim of this study was to examine the effects of a 6-week diet and exercise program, with emph... more The aim of this study was to examine the effects of a 6-week diet and exercise program, with emphasis on strength training, on the physical self-concept, body composition, and physical fitness of young overweight and obese children. Eighty-two overweight and obese children aged 8-11 years were randomized into a diet-only or a diet-and-strength training group. Self-concept, body composition and physical fitness were measured before and after the 6-week study period using the Physical Self Description Questionnaires (PSDQ), dual-energy X-ray absorptiometry (DXA), and standard fitness tests. Dietary intake was assessed with a food frequency questionnaire. Total daily energy intake was significantly reduced in both groups with a trend of more reduction in the diet-only group. Both groups developed greater confidence in strength. Those in the diet-and-strength training group also improved their endurance self-concept. Body Mass Index (BMI) decreased significantly in both groups. Lean mass increased significantly in both groups but significantly more in the diet-and-strength training group (+0.8 kg vs +0.3 kg, P&amp;amp;amp;amp;amp;amp;lt;0.05). Handgrip, shuttle run, sit-up, and push-up were significantly improved in both groups, to a significantly greater extent in the diet-and-strength training group. These findings confirm the 6-week program of either diet-only or diet-and-strength training improved overweight/obese children&amp;amp;amp;amp;amp;amp;#39;s self-perception of muscular strength and body composition. With the diet-and-strength training program, self-concept in endurance also improved and the gain in lean body mass was more than double that of the diet only group.
Education is so strongly emphasized in the Chinese culture that academic success is widely regard... more Education is so strongly emphasized in the Chinese culture that academic success is widely regarded as the only indicator of success, while too much physical activity is often discouraged because it drains energy and affects academic concentration. This study investigated the relations among academic achievement, self‐esteem, school conduct and physical activity level. The participants were 333 Chinese pre‐adolescents (aged 8–12)
Journal of Paediatrics and Child Health, Jun 1, 2008
To validate a Tanner stages self-assessment questionnaire using gender-specific line drawings and... more To validate a Tanner stages self-assessment questionnaire using gender-specific line drawings and brief explanatory text in Chinese. A cross sectional study design. One primary and two secondary schools. 172 boys and 182 girls aged between 8 and 18 years. Students&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; self-assessments of pubertal maturation were compared with assessments made by a same gender rater using visual depiction physical examination. Raters&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; physical examinations were performed after the children had answered the self-assessment questionnaire individually and in private. Raters were blinded to the self-assessment results. Accuracy rates and weighted kappa statistic were used to evaluate the degree of agreement between children and raters. Substantial to almost perfect agreement was found between self- and rater&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s assessments of breast development and pubic hair growth in girls [weighted kappa 0.72 (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001, 95% CI 0.66, 0.79) and 0.83 (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001, 95% CI 0.78, 0.87) respectively]. Moderate to substantial agreement was found between self- and rater&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s assessments of male genital development and pubic hair growth [weighted kappa 0.58 (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001, 95% CI 0.48, 0.68) and 0.80 (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001, 95% CI 0.74, 0.86) respectively]. Most agreements between self- and rater&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s assessments differed by only one Tanner stage. Agreement was higher for girls than boys. Girls tended to overestimate their breast stages and boys tended to underestimate their genitalia development. This study confirms that a Tanner pubertal self-assessment questionnaire with line drawings and explanatory Chinese text can reliably estimate sexual maturation status in Hong Kong Chinese children.
Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine
To investigate the total daily energy expenditure and physical activity pattern of a group of obe... more To investigate the total daily energy expenditure and physical activity pattern of a group of obese and non-obese Hong Kong children. Cross-sectional study. University teaching hospital, Hong Kong. Eighteen obese children aged 6 to 17 years and 18 age- and sex-matched non-obese children in the local Hong Kong community. Total daily energy expenditure and physical activity pattern were estimated for 3 days using heart rate monitoring. Body composition was measured by dual-energy X-ray absorptiometry. In obese children, both total fat mass and fat-free mass were greater than in non-obese children. Total daily energy expenditure and its sleep and sedentary components were higher in absolute terms (by 42%, 43%, and 126%, respectively) for obese children. When normalised for body weight, the basal metabolic rate was no different between obese and non-obese children, while the total daily energy expenditure of the obese children was significantly lower (by 22%) than that of non-obese children. When normalised for fat-free mass, the basal metabolic rate and the sedentary component of total daily energy expenditure were significantly higher for obese children. Obese children spent 12% less time asleep, but 51% more time in sedentary activity and 30% less time physically active: a ratio of active-to-sedentary waking time of 0.6 for obese children and 1.9 for non-obese children. Although the basal metabolic rate may be influenced by body composition, the finding of a normal basal metabolic rate when normalised for body weight suggests that an intrinsic difference of metabolic rate is not a major contributory cause of obesity. The study pointed particularly to the potential benefit of increasing physical exercise time relative to sedentary activities to reduce the prevalence of childhood obesity. Obese and non-obese children had similar basal metabolic rates when adjusted by fat-free mass and fat mass. Obese children spent more time in sedentary activities.
Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi
To explore the optimal threshold values of waist circumference (WC) for detecting cardiovascular ... more To explore the optimal threshold values of waist circumference (WC) for detecting cardiovascular (CV) risk factors among Chinese children and adolescents. Association of WC with CV risk factors was studied among 65,898 children aged 7-18 years whose data were pooled from nine previous studies in China. CV risk factors in this study included hypertension (blood pressure above 95 percentile levels), dyslipidemia (with one or more of the following three indexes: TG &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or = 1.7 mmol/L, TC &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or = 5.18 mmol/L, and HDL-C &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; or = 1.04 mmol/L) and elevated glucose level (fasting plasma glucose &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or = 5.6 mmol/L). Receive-operating characteristic analysis (ROC) and logistic regression were employed to derive optimal age- and sex-specific waist circumference references for predicting CV risk factors. A slight increasing trend of CV risk factors was observed starting from the 75th percentile of waist circumference in the study population, while a remarkable increasing trend occurred from the 90th percentile. The optimal waist circumference thresholds for predicting high blood pressures were at the 75th percentile for both boys and girls, which was at the 90th percentiles for detecting at least two of the above three CV risk factors. In comparison with children with waist circumference below the 75th percentile, the odds ratio of two CV risk factors doubled among children with waist circumference between the 75th and the 90th percentile, and increased by 6 times among children with waist circumference above the 90th percentile. The trend of high blood pressure increasing with waist circumference remained significant after having been stratified by BMI category. The 75th and the 90th percentiles of WC are the optimal cut-off points for predicting an increased and a substantially increased risk of CV factors in Chinese children and adolescents, respectively.
Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine
We report a case of severe poisoning in a 57-day-old infant who presented with vomiting, convulsi... more We report a case of severe poisoning in a 57-day-old infant who presented with vomiting, convulsions, and shock after ingesting a bottle of milk containing a decoction of Rhododendron simsii. The grandmother collected this toxic plant from a cultivated area, believing it was good for the airways. Grayanotoxin was detected in both the urine and plant specimens. The infant made a good recovery after requiring ventilatory support for 2 days. Rhododendron is a common gardening shrub in Hong Kong. Some Rhododendron species are poisonous and contain grayanotoxin. Intentional or accidental ingestion of toxic plants can be severe or even life-threatening. It is therefore essential that clinicians be familiar with local toxic plant species.
Body mass index (BMI) and waist circumference (WC) correlate with cardiovascular (CV) risk factor... more Body mass index (BMI) and waist circumference (WC) correlate with cardiovascular (CV) risk factors in childhood which track into adulthood. WC provides a measure of central obesity, which has been specifically associated with CV risk factors. Reference standards for WC, and for WC and BMI risk threshold values are not established in Chinese children. To construct reference percentile charts of WC, establish relationships between WC, BMI and other risk factors, and propose WC and BMI threshold values predictive of CV risk factors in Hong Kong ethnic Chinese children. Weight, height, waist and hip circumference were measured in 2593 (52% boys, 47% girls) randomly sampled Hong Kong school children aged 6-12 years. In 958 of these and 97 additional overweight children (n=1055), the relationships between WC, BMI, waist/hip and waist/height ratio and six age-adjusted CV risk factors (>85% percentile levels of blood pressure (BP), fasting triglycerides, low-density lipoprotein (LDL) cho...
Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine, 2005
To describe the epidemiology, clinical characteristics, and management of Kawasaki disease in chi... more To describe the epidemiology, clinical characteristics, and management of Kawasaki disease in children in Hong Kong. Retrospective survey of medical records from July 1994 to June 1997, and prospective data collection from July 1997 to June 2000. Hospitals with a paediatric unit in Hong Kong. Patients diagnosed with Kawasaki disease between July 1994 and June 2000 in public hospitals in Hong Kong. Incidence of Kawasaki disease and coronary artery aneurysm rates. A total of 696 cases of Kawasaki disease were reported. There were 435 (62.5%) boys and 261 (37.5%) girls giving a male to female ratio of 1.7:1. The age ranged from 1 month to 15 years 5 months with a median of 1.7 years. Infants (<1 year) constituted the largest group of patients (223, 32.0%) and overall, 638 (91.7%) were younger than 5 years. Skin rash, conjunctivitis, and oral signs were among the principal clinical features present in over 80% of cases. Prominent cervical lymph nodes larger than 1.5 cm were less comm...
Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine, 2005
Asthma is characterised by variable degrees of airway obstruction, airway hyper-responsiveness, a... more Asthma is characterised by variable degrees of airway obstruction, airway hyper-responsiveness, and chronic airway inflammation. Current guidelines emphasise that inhaled corticosteroid treatment is the mainstay of asthma therapy because it targets the underlying airway inflammation. It is prudent to use the lowest possible dose of inhaled corticosteroid compatible with good asthma control. In clinical practice, the use of or the reduction of inhaled corticosteroid dosage is based on symptoms and lung function, both of which have been shown to have a poor correlation with airway inflammation. The use of induced sputum as a marker of airway inflammation improves asthma monitoring and optimises treatment in adults. This review discusses the technique of sputum induction, its clinical application, and our experience of its use in asthmatic children.
International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity, 2004
To investigate whether the discrepancy between actual and ideal body size rating is related to Ch... more To investigate whether the discrepancy between actual and ideal body size rating is related to Chinese children's global self-esteem and global physical self-concept. A cross-sectional study of school children who completed questionnaires related to global self-esteem, global physical self-concept, and actual vs ideal body size. A total of 386 Chinese children (44% girls and 56% boys) aged 7-13 y from a primary school in Hong Kong, China. Global self-esteem and physical self-concept were measured using the physical self-descriptive questionnaire. Actual vs ideal body size discrepancy was established using the silhouette matching task. No significant relationship was found between global self-esteem and actual-ideal body size discrepancy of children. Global physical self-concept had a moderate negative correlation (r=-0.12) with the body size discrepancy score and the discrepancy score explained very limited variance (R(2)=0.015; F(1, 296)=4.51; P<0.05) in global physical self...
The aim of this study is to determine the association between waist circumference (WC) and childh... more The aim of this study is to determine the association between waist circumference (WC) and childhood-masked hypertension. A territory-wide, school-based cohort of 1385 Hong Kong students (672 boys and 713 girls) aged 8-17 years was analysed. The ambulatory blood pressure-monitoring assessment was performed using validated oscillometric recorders (A&D TM-2430 (A&D Inc., Tokyo, Japan)) following American Heart Association's recommendations. Subjects were considered normotensive if their casual blood pressure, 24-h daytime and night-time average systolic blood pressure and diastolic blood pressure (DBP) were <95th percentile. If one or more of the ambulatory blood pressure parameters was ≥95th percentile, subjects would be considered suffering from masked hypertension (MH). Subjects who had three successive casual blood pressure measurements above the 95th percentile were excluded. By body mass index, 148 (10.7%) subjects were obese, 182 (13.1%) overweight and 359 (25.9%) having...
The Journal of Sports Medicine and Physical Fitness, Mar 1, 2008
The aim of this study was to examine the effects of a 6-week diet and exercise program, with emph... more The aim of this study was to examine the effects of a 6-week diet and exercise program, with emphasis on strength training, on the physical self-concept, body composition, and physical fitness of young overweight and obese children. Eighty-two overweight and obese children aged 8-11 years were randomized into a diet-only or a diet-and-strength training group. Self-concept, body composition and physical fitness were measured before and after the 6-week study period using the Physical Self Description Questionnaires (PSDQ), dual-energy X-ray absorptiometry (DXA), and standard fitness tests. Dietary intake was assessed with a food frequency questionnaire. Total daily energy intake was significantly reduced in both groups with a trend of more reduction in the diet-only group. Both groups developed greater confidence in strength. Those in the diet-and-strength training group also improved their endurance self-concept. Body Mass Index (BMI) decreased significantly in both groups. Lean mass increased significantly in both groups but significantly more in the diet-and-strength training group (+0.8 kg vs +0.3 kg, P&amp;amp;amp;amp;amp;amp;lt;0.05). Handgrip, shuttle run, sit-up, and push-up were significantly improved in both groups, to a significantly greater extent in the diet-and-strength training group. These findings confirm the 6-week program of either diet-only or diet-and-strength training improved overweight/obese children&amp;amp;amp;amp;amp;amp;#39;s self-perception of muscular strength and body composition. With the diet-and-strength training program, self-concept in endurance also improved and the gain in lean body mass was more than double that of the diet only group.
Education is so strongly emphasized in the Chinese culture that academic success is widely regard... more Education is so strongly emphasized in the Chinese culture that academic success is widely regarded as the only indicator of success, while too much physical activity is often discouraged because it drains energy and affects academic concentration. This study investigated the relations among academic achievement, self‐esteem, school conduct and physical activity level. The participants were 333 Chinese pre‐adolescents (aged 8–12)
Journal of Paediatrics and Child Health, Jun 1, 2008
To validate a Tanner stages self-assessment questionnaire using gender-specific line drawings and... more To validate a Tanner stages self-assessment questionnaire using gender-specific line drawings and brief explanatory text in Chinese. A cross sectional study design. One primary and two secondary schools. 172 boys and 182 girls aged between 8 and 18 years. Students&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; self-assessments of pubertal maturation were compared with assessments made by a same gender rater using visual depiction physical examination. Raters&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; physical examinations were performed after the children had answered the self-assessment questionnaire individually and in private. Raters were blinded to the self-assessment results. Accuracy rates and weighted kappa statistic were used to evaluate the degree of agreement between children and raters. Substantial to almost perfect agreement was found between self- and rater&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s assessments of breast development and pubic hair growth in girls [weighted kappa 0.72 (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001, 95% CI 0.66, 0.79) and 0.83 (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001, 95% CI 0.78, 0.87) respectively]. Moderate to substantial agreement was found between self- and rater&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s assessments of male genital development and pubic hair growth [weighted kappa 0.58 (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001, 95% CI 0.48, 0.68) and 0.80 (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001, 95% CI 0.74, 0.86) respectively]. Most agreements between self- and rater&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s assessments differed by only one Tanner stage. Agreement was higher for girls than boys. Girls tended to overestimate their breast stages and boys tended to underestimate their genitalia development. This study confirms that a Tanner pubertal self-assessment questionnaire with line drawings and explanatory Chinese text can reliably estimate sexual maturation status in Hong Kong Chinese children.
Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine
To investigate the total daily energy expenditure and physical activity pattern of a group of obe... more To investigate the total daily energy expenditure and physical activity pattern of a group of obese and non-obese Hong Kong children. Cross-sectional study. University teaching hospital, Hong Kong. Eighteen obese children aged 6 to 17 years and 18 age- and sex-matched non-obese children in the local Hong Kong community. Total daily energy expenditure and physical activity pattern were estimated for 3 days using heart rate monitoring. Body composition was measured by dual-energy X-ray absorptiometry. In obese children, both total fat mass and fat-free mass were greater than in non-obese children. Total daily energy expenditure and its sleep and sedentary components were higher in absolute terms (by 42%, 43%, and 126%, respectively) for obese children. When normalised for body weight, the basal metabolic rate was no different between obese and non-obese children, while the total daily energy expenditure of the obese children was significantly lower (by 22%) than that of non-obese children. When normalised for fat-free mass, the basal metabolic rate and the sedentary component of total daily energy expenditure were significantly higher for obese children. Obese children spent 12% less time asleep, but 51% more time in sedentary activity and 30% less time physically active: a ratio of active-to-sedentary waking time of 0.6 for obese children and 1.9 for non-obese children. Although the basal metabolic rate may be influenced by body composition, the finding of a normal basal metabolic rate when normalised for body weight suggests that an intrinsic difference of metabolic rate is not a major contributory cause of obesity. The study pointed particularly to the potential benefit of increasing physical exercise time relative to sedentary activities to reduce the prevalence of childhood obesity. Obese and non-obese children had similar basal metabolic rates when adjusted by fat-free mass and fat mass. Obese children spent more time in sedentary activities.
Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi
To explore the optimal threshold values of waist circumference (WC) for detecting cardiovascular ... more To explore the optimal threshold values of waist circumference (WC) for detecting cardiovascular (CV) risk factors among Chinese children and adolescents. Association of WC with CV risk factors was studied among 65,898 children aged 7-18 years whose data were pooled from nine previous studies in China. CV risk factors in this study included hypertension (blood pressure above 95 percentile levels), dyslipidemia (with one or more of the following three indexes: TG &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or = 1.7 mmol/L, TC &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or = 5.18 mmol/L, and HDL-C &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; or = 1.04 mmol/L) and elevated glucose level (fasting plasma glucose &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or = 5.6 mmol/L). Receive-operating characteristic analysis (ROC) and logistic regression were employed to derive optimal age- and sex-specific waist circumference references for predicting CV risk factors. A slight increasing trend of CV risk factors was observed starting from the 75th percentile of waist circumference in the study population, while a remarkable increasing trend occurred from the 90th percentile. The optimal waist circumference thresholds for predicting high blood pressures were at the 75th percentile for both boys and girls, which was at the 90th percentiles for detecting at least two of the above three CV risk factors. In comparison with children with waist circumference below the 75th percentile, the odds ratio of two CV risk factors doubled among children with waist circumference between the 75th and the 90th percentile, and increased by 6 times among children with waist circumference above the 90th percentile. The trend of high blood pressure increasing with waist circumference remained significant after having been stratified by BMI category. The 75th and the 90th percentiles of WC are the optimal cut-off points for predicting an increased and a substantially increased risk of CV factors in Chinese children and adolescents, respectively.
Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine
We report a case of severe poisoning in a 57-day-old infant who presented with vomiting, convulsi... more We report a case of severe poisoning in a 57-day-old infant who presented with vomiting, convulsions, and shock after ingesting a bottle of milk containing a decoction of Rhododendron simsii. The grandmother collected this toxic plant from a cultivated area, believing it was good for the airways. Grayanotoxin was detected in both the urine and plant specimens. The infant made a good recovery after requiring ventilatory support for 2 days. Rhododendron is a common gardening shrub in Hong Kong. Some Rhododendron species are poisonous and contain grayanotoxin. Intentional or accidental ingestion of toxic plants can be severe or even life-threatening. It is therefore essential that clinicians be familiar with local toxic plant species.
Body mass index (BMI) and waist circumference (WC) correlate with cardiovascular (CV) risk factor... more Body mass index (BMI) and waist circumference (WC) correlate with cardiovascular (CV) risk factors in childhood which track into adulthood. WC provides a measure of central obesity, which has been specifically associated with CV risk factors. Reference standards for WC, and for WC and BMI risk threshold values are not established in Chinese children. To construct reference percentile charts of WC, establish relationships between WC, BMI and other risk factors, and propose WC and BMI threshold values predictive of CV risk factors in Hong Kong ethnic Chinese children. Weight, height, waist and hip circumference were measured in 2593 (52% boys, 47% girls) randomly sampled Hong Kong school children aged 6-12 years. In 958 of these and 97 additional overweight children (n=1055), the relationships between WC, BMI, waist/hip and waist/height ratio and six age-adjusted CV risk factors (>85% percentile levels of blood pressure (BP), fasting triglycerides, low-density lipoprotein (LDL) cho...
Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine, 2005
To describe the epidemiology, clinical characteristics, and management of Kawasaki disease in chi... more To describe the epidemiology, clinical characteristics, and management of Kawasaki disease in children in Hong Kong. Retrospective survey of medical records from July 1994 to June 1997, and prospective data collection from July 1997 to June 2000. Hospitals with a paediatric unit in Hong Kong. Patients diagnosed with Kawasaki disease between July 1994 and June 2000 in public hospitals in Hong Kong. Incidence of Kawasaki disease and coronary artery aneurysm rates. A total of 696 cases of Kawasaki disease were reported. There were 435 (62.5%) boys and 261 (37.5%) girls giving a male to female ratio of 1.7:1. The age ranged from 1 month to 15 years 5 months with a median of 1.7 years. Infants (<1 year) constituted the largest group of patients (223, 32.0%) and overall, 638 (91.7%) were younger than 5 years. Skin rash, conjunctivitis, and oral signs were among the principal clinical features present in over 80% of cases. Prominent cervical lymph nodes larger than 1.5 cm were less comm...
Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine, 2005
Asthma is characterised by variable degrees of airway obstruction, airway hyper-responsiveness, a... more Asthma is characterised by variable degrees of airway obstruction, airway hyper-responsiveness, and chronic airway inflammation. Current guidelines emphasise that inhaled corticosteroid treatment is the mainstay of asthma therapy because it targets the underlying airway inflammation. It is prudent to use the lowest possible dose of inhaled corticosteroid compatible with good asthma control. In clinical practice, the use of or the reduction of inhaled corticosteroid dosage is based on symptoms and lung function, both of which have been shown to have a poor correlation with airway inflammation. The use of induced sputum as a marker of airway inflammation improves asthma monitoring and optimises treatment in adults. This review discusses the technique of sputum induction, its clinical application, and our experience of its use in asthmatic children.
International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity, 2004
To investigate whether the discrepancy between actual and ideal body size rating is related to Ch... more To investigate whether the discrepancy between actual and ideal body size rating is related to Chinese children's global self-esteem and global physical self-concept. A cross-sectional study of school children who completed questionnaires related to global self-esteem, global physical self-concept, and actual vs ideal body size. A total of 386 Chinese children (44% girls and 56% boys) aged 7-13 y from a primary school in Hong Kong, China. Global self-esteem and physical self-concept were measured using the physical self-descriptive questionnaire. Actual vs ideal body size discrepancy was established using the silhouette matching task. No significant relationship was found between global self-esteem and actual-ideal body size discrepancy of children. Global physical self-concept had a moderate negative correlation (r=-0.12) with the body size discrepancy score and the discrepancy score explained very limited variance (R(2)=0.015; F(1, 296)=4.51; P<0.05) in global physical self...
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