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Article: World Hepatitis Day 2023: Are we close to the target?

Hui, Rex Wan-Hin / Fung, James

2023 Volume 158, Issue 1, Page(s) 1–4

MeSH term(s)	Humans ; Hepatitis ; Hepatitis A
Language	English
Publishing date	2023-08-17
Publishing country	India
Document type	Editorial ; Comment
ZDB-ID	390883-5
ISSN	0971-5916 ; 0019-5340
ISSN	0971-5916 ; 0019-5340
DOI	10.4103/ijmr.ijmr_1250_23
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Article ; Online: Comparing general anaesthesia versus sedation for endoscopic submucosal dissection: results from a systematic review and meta-analysis.

Leung, Choy-May / Hui, Rex Wan-Hin

Anaesthesiology intensive therapy

2023 Volume 55, Issue 1, Page(s) 9–17

Abstract: Endoscopic submucosal dissection (ESD) is an advanced endoscopic procedure for management of gastrointestinal tumours. ESD is usually performed under sedation. However, the use of general anaesthesia (GA) has been hypothesised to improve ESD outcomes. We ...

Abstract	Endoscopic submucosal dissection (ESD) is an advanced endoscopic procedure for management of gastrointestinal tumours. ESD is usually performed under sedation. However, the use of general anaesthesia (GA) has been hypothesised to improve ESD outcomes. We performed a systematic review and meta-analysis to compare GA against sedation in ESD. A systematic literature search was performed on Cochrane Library, EMBASE and MEDLINE using the terms "General Anaesthesia", "Sedation" and "Endoscopic submucosal dissection". Original articles comparing GA versus sedation in ESD were included. The risk of bias and level of evidence were assessed by validated methods. This review is registered in PROSPERO (CRD42021275813). 176 articles were found in the initial literature search, and 7 articles (comprising 518 patients receiving GA and 495 receiving sedation) were included. Compared with sedation, GA was associated with higher en-bloc resection rates in oesophageal ESD (RR 1.05; 95% CI: 1.00-1.10; I 2 = 65%; P = 0.05). GA patients also trended towards lower rates of gastrointestinal perforation in all ESD procedures (RR 0.62; 95% CI: 0.21-1.82; I 2 = 52%; P = 0.06). Rates of intra- procedural desaturation and post-procedural aspiration pneumonia were lower in GA patients than in patients under sedation. The included studies had a moderate to high risk of bias, and the overall level of evidence was low. GA appears safe and feasible for ESD, yet high-quality trials will be required before GA can be regularly implemented for ESD.
MeSH term(s)	Humans ; Anesthesia, General ; Pneumonia, Aspiration
Language	English
Publishing date	2023-06-12
Publishing country	Poland
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review
ISSN	1731-2531
ISSN (online)	1731-2531
DOI	10.5114/ait.2023.125416
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Article ; Online: Establishing a Junior Resident-Led Career Coaching Workshop for Medical Students.

Hui, Rex Wan-Hin / Leung, Choy-May

Academic medicine : journal of the Association of American Medical Colleges

2023 Volume 98, Issue 3, Page(s) 294–295

MeSH term(s)	Humans ; Mentoring ; Students, Medical ; Career Choice ; Surveys and Questionnaires
Language	English
Publishing date	2023-02-17
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	96192-9
ISSN	1938-808X ; 1040-2446
ISSN (online)	1938-808X
ISSN	1040-2446
DOI	10.1097/ACM.0000000000005113
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Zs.A 112: Show issues

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Article: Therapeutic advances in HBV cure.

Hui, Rex Wan-Hin / Mak, Lung-Yi / Seto, Wai-Kay / Yuen, Man-Fung

Clinical liver disease

2024 Volume 23, Issue 1, Page(s) e0161

Language	English
Publishing date	2024-04-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	2657644-2
ISSN	2046-2484
ISSN	2046-2484
DOI	10.1097/CLD.0000000000000161
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Article ; Online: Inhaled corticosteroid-phobia and childhood asthma: Current understanding and management implications.

Hui, Rex Wan Hin

Paediatric respiratory reviews

2019 Volume 33, Page(s) 62–66

Abstract: Asthma is the most prevalent chronic disease in children. Inhaled corticosteroids (ICS) is the first-line controller therapy for children with persistent asthma, however, suboptimal compliance to ICS therapy remains as a major obstacle in paediatric ... ...

Abstract	Asthma is the most prevalent chronic disease in children. Inhaled corticosteroids (ICS) is the first-line controller therapy for children with persistent asthma, however, suboptimal compliance to ICS therapy remains as a major obstacle in paediatric asthma management. Steroid-phobia, the fear of side-effects and subsequent aversion of ICS, has been widely reported in parents of asthmatic children. The reported prevalence of steroid-phobia varies widely from 19% to 67% in different populations. The concerns about ICS frequently raised by parents include growth suppression, weight gain, bone weakness, addiction and psychiatric disturbances. Outside of growth suppression, which is statistically significant yet mild in clinical studies, the other concerns are not evidence-based and are misconceptions. Conflicting results have been reported regarding the impact of steroid-phobia on ICS compliance. In contrast, steroid-phobia has consistent and negative effects on asthma control in children. While asthma educational programmes have demonstrable benefits in general paediatric populations, the generalisability of such programmes to steroid-phobic parents remains undetermined. There is a paucity of data on specific educational programmes to clear misconceptions and reduce steroid-phobia. Given the continually raising prevalence of paediatric asthma, high-quality studies are warranted to investigate the prevalence and impact of steroid-phobia, with an ultimate goal of developing effective strategies to tackle steroid-phobia and improve asthma care in children.
MeSH term(s)	Administration, Inhalation ; Adrenal Cortex Hormones/therapeutic use ; Asthma/drug therapy ; Attitude to Health ; Bone Density ; Depression ; Fear/psychology ; Fractures, Bone ; Growth Disorders ; Humans ; Intelligence ; Medication Adherence ; Mental Disorders ; Parents/psychology ; Patient Education as Topic ; Phobic Disorders/epidemiology ; Phobic Disorders/psychology ; Phobic Disorders/therapy ; Substance-Related Disorders ; Weight Gain
Chemical Substances	Adrenal Cortex Hormones
Language	English
Publishing date	2019-04-11
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2147664-0
ISSN	1526-0550 ; 1526-0542
ISSN (online)	1526-0550
ISSN	1526-0542
DOI	10.1016/j.prrv.2019.03.009
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Zs.A 5919: Show issues

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Article: Predicting and optimising risks for non-hepatic surgery in patients with cirrhosis: insights from the #FGDebate.

Hui, Rex Wan-Hin / Abbas, Nadir / Dunne, Philip / Tripathi, Dhiraj

Frontline gastroenterology

2023 Volume 15, Issue 1, Page(s) 86–87

Language	English
Publishing date	2023-09-21
Publishing country	England
Document type	News
ZDB-ID	2521857-8
ISSN	2041-4137
ISSN	2041-4137
DOI	10.1136/flgastro-2023-102510
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Zs.A 6880: Show issues

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Article ; Online: Thoracic Epidural Analgesia in Acute Pancreatitis: A Systematic Review.

Hui, Rex Wan-Hin / Leung, Choy-May

Pancreas

2022 Volume 51, Issue 7, Page(s) e95–e97

MeSH term(s)	Humans ; Analgesia, Epidural ; Pancreatitis ; Acute Disease ; Pain, Postoperative ; Pain Measurement
Language	English
Publishing date	2022-11-17
Publishing country	United States
Document type	Systematic Review ; Journal Article
ZDB-ID	632831-3
ISSN	1536-4828 ; 0885-3177
ISSN (online)	1536-4828
ISSN	0885-3177
DOI	10.1097/MPA.0000000000002111
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Zs.A 2160: Show issues

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Article ; Online: Incidence of Gastrointestinal Bleeding after Transesophageal Echocardiography in Patients with Gastroesophageal Varices: A Systematic Review and Meta-Analysis.

Hui, Rex Wan-Hin / Leung, Choy-May

Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography

2021 Volume 35, Issue 4, Page(s) 387–394

Abstract: Background: Transesophageal echocardiography (TEE) is useful for cardiac assessment and intraoperative monitoring. However, the safety of TEE in patients with cirrhosis and gastroesophageal varices has remained uncertain. The aim of this meta-analysis ... ...

Abstract	Background: Transesophageal echocardiography (TEE) is useful for cardiac assessment and intraoperative monitoring. However, the safety of TEE in patients with cirrhosis and gastroesophageal varices has remained uncertain. The aim of this meta-analysis was to determine the incidence of gastrointestinal bleeding after TEE in patients with varices. The secondary objectives were to compare bleeding risks between patients with and without varices and to determine the incidence of TEE-related esophageal perforation and mortality. Methods: A systematic literature search was conducted on MEDLINE, Embase, and the Cochrane Library using the terms "transesophageal echocardiography," "varices," "bleeding," and related terms. Articles describing the incidence of post-TEE bleeding in patients with varices were included. Non-English-language articles were excluded. Risk of bias and level of evidence were assessed using validated scales. The pooled weighted incidence of gastrointestinal bleeding and the risk difference in bleeding were calculated using a random-effects model. Results: Five hundred and sixty-nine articles were identified initially, and 10 articles (comprising of 908 patients) were included. The incidence of post-TEE bleeding in patients with varices was 0.84% (95% CI, 0.34% to 1.56%). When stratified by indication for TEE, the pooled incidence of bleeding was 0.68% (95% CI, 0.11% to 1.63%) for intraoperative TEE and 1.03% (95% CI, 0.23% to 2.29%) for diagnostic TEE. No cases of esophageal perforation or mortality were reported. Six studies included comparator groups of patients without varices, and the bleeding risk was comparable between patients with and those without varices (risk difference, 0.26%; 95% CI, -0.80% to 1.32%; I Conclusions: TEE appears to be associated with low gastrointestinal bleeding incidence in patients with gastroesophageal varices. Nonetheless, results should be treated with caution because of bias and low level of evidence. Large-scale high-quality studies will be required to confirm the safety of TEE in patients with gastroesophageal varices.
MeSH term(s)	Echocardiography, Transesophageal/adverse effects ; Esophageal and Gastric Varices/epidemiology ; Esophageal and Gastric Varices/etiology ; Gastrointestinal Hemorrhage/epidemiology ; Gastrointestinal Hemorrhage/etiology ; Humans ; Incidence ; Varicose Veins/complications
Language	English
Publishing date	2021-12-04
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	1035622-8
ISSN	1097-6795 ; 0894-7317
ISSN (online)	1097-6795
ISSN	0894-7317
DOI	10.1016/j.echo.2021.11.014
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Zs.A 2638: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MG 55: Show issues

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Article ; Online: The role of different viral biomarkers on the management of chronic hepatitis B.

Mak, Lung-Yi / Hui, Rex Wan-Hin / Fung, James / Seto, Wai Kay / Yuen, Man-Fung

Clinical and molecular hepatology

2023 Volume 29, Issue 2, Page(s) 263–276

Abstract: Chronic hepatitis B infection is a major public health challenge. With the advancement in technology, various components of the viral cycle can now be measured in the blood to assess viral activity. In this review article, we summarize the relevant data ... ...

Abstract	Chronic hepatitis B infection is a major public health challenge. With the advancement in technology, various components of the viral cycle can now be measured in the blood to assess viral activity. In this review article, we summarize the relevant data of how antiviral therapies impact viral biomarkers, and discuss their potential implications. Viral nucleic acids including hepatitis B virus (HBV) double-stranded deoxy-ribonucleic acid (DNA) and to a lesser extent, pre-genomic RNA, are readily suppressed by nucleos(t)ide analogues (NUCs). The primary role of these markers include risk prediction for hepatocellular carcinoma (HCC) and risk stratification for partial cure, defined as off-therapy virological control, or functional cure, defined as hepatitis B surface antigen (HBsAg) seroclearance plus undetectable serum HBV DNA for ≥6 months. Viral translational products including hepatitis e antigen, quantitative HBsAg and hepatitis B core-related antigen can be reduced by NUCs and pegylated interferon a. They are important in defining disease phase, delineating treatment endpoints, and predicting clinical outcomes including HCC risk and partial/ functional cure. As the primary outcome of phase III trials in chronic hepatitis B is set as HBsAg seroclearance, appropriate viral biomarkers can potentially inform the efficacy of novel compounds. Early viral biomarker response can help with prioritization of subjects into clinical trials. However, standardization and validation studies would be crucial before viral biomarkers can be broadly implemented in clinical use.
MeSH term(s)	Humans ; Hepatitis B, Chronic/diagnosis ; Hepatitis B, Chronic/drug therapy ; Hepatitis B Surface Antigens ; Carcinoma, Hepatocellular/diagnosis ; Carcinoma, Hepatocellular/drug therapy ; Antiviral Agents/therapeutic use ; Liver Neoplasms/diagnosis ; Liver Neoplasms/drug therapy ; DNA, Viral ; Hepatitis B virus/genetics ; Hepatitis B/drug therapy ; Biomarkers ; Hepatitis B Core Antigens
Chemical Substances	Hepatitis B Surface Antigens ; Antiviral Agents ; DNA, Viral ; Biomarkers ; Hepatitis B Core Antigens
Language	English
Publishing date	2023-01-19
Publishing country	Korea (South)
Document type	Journal Article ; Review
ZDB-ID	2672560-5
ISSN	2287-285X ; 2287-2728
ISSN (online)	2287-285X
ISSN	2287-2728
DOI	10.3350/cmh.2022.0448
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Article ; Online: Patient-Controlled Sedation Versus Clinician-Administered Sedation for Endoscopic Retrograde Cholangiopancreatography: A Systematic Review.

Hui, Rex Wan-Hin / Leung, Choy-May

Anesthesia and analgesia

2021 Volume 134, Issue 4, Page(s) 765–772

Abstract: Patient-controlled sedation (PCS) has been explored as a sedation method in endoscopic retrograde cholangiopancreatography (ERCP), yet a comprehensive review article on this topic is lacking. We performed a systematic review to compare PCS against ... ...

Abstract	Patient-controlled sedation (PCS) has been explored as a sedation method in endoscopic retrograde cholangiopancreatography (ERCP), yet a comprehensive review article on this topic is lacking. We performed a systematic review to compare PCS against clinician-administered sedation. The primary objectives are to compare the sedative dosage used and the sedation depth, while secondary objectives are to compare sedation failure rates, clinician intervention rates, and patient satisfaction. A systematic literature search was conducted on MEDLINE, EMBASE, and the Cochrane Library Database using the terms "ERCP," "Sedation," "Patient-controlled," and related terms. Randomized controlled trials comparing PCS against clinician-administered sedation in adults undergoing ERCP were included. Articles without English full texts were excluded. Studies were reviewed by 2 independent reviewers. The Cochrane Risk of Bias tool was used for quality assessment of individual included trials. This systematic review is registered in the International Prospective Register of Systematic Reviews (CRD42020198647). A total of 2619 articles were identified from the literature search. A total of 2615 articles were excluded based on the exclusion criteria. Four articles (comprised of 4 independent trials involving 425 patients) were included in analysis. When compared with clinician-administered sedation, PCS in ERCP may lead to lower propofol dosage used and lower sedation depth. The sedation failure rates appear to be higher in PCS, whereas lower rates of airway maneuvers are required. No significant difference was observable for patient satisfaction rates between PCS and clinician-administered sedation. The included studies demonstrated unclear to high risk of bias, particularly in randomization, incomplete outcome data, and outcome measurement. PCS appears to be a feasible option for sedation in ERCP. Nonetheless, large-scale, high-quality trials will be required before PCS can be regularly implemented in ERCP.
MeSH term(s)	Adult ; Cholangiopancreatography, Endoscopic Retrograde/adverse effects ; Cholangiopancreatography, Endoscopic Retrograde/methods ; Conscious Sedation/adverse effects ; Conscious Sedation/methods ; Humans ; Hypnotics and Sedatives/adverse effects ; Propofol
Chemical Substances	Hypnotics and Sedatives ; Propofol (YI7VU623SF)
Language	English
Publishing date	2021-08-23
Publishing country	United States
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	80032-6
ISSN	1526-7598 ; 0003-2999
ISSN (online)	1526-7598
ISSN	0003-2999
DOI	10.1213/ANE.0000000000005766
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