We describe a case of severe pulmonary hypertension and transient right-sided hypertrophic cardiomyopathy in a neonate, caused by premature closure of ductus arteriosus after short-term maternal use of diclofenac sodium (Voltaren). In view of this associated complication, diclofenac sodium should be avoided during pregnancy. In addition, maternal diclofenac sodium ingestion should be suspected if a newborn develops severe pulmonary hypertension and/or right-sided hypertrophic cardiomyoptathy with closed ductus arteriosus.

A total of 173 boys aged 10 to 179 months with previous unilateral inguinal herniotomy were called back for follow-up. Clinical and ultrasound examinations of the scrotum were performed. The interval between operation and follow-up was 6 to 123 months (mean 31.68 months). One boy (0.58%) had a more than 50% and 10 (5.8%) had a more than 25% decrease in testicular volume on the operated side when compared with the non-operated side.

No abstract

Objective: To compare the incidence of catheter-related infection in the bloodstream and non-infectious complication rate of Hickman catheter and peripherally inserted central venous catheter (PICC) in oncology patients. Methods: A retrospective study was performed of oncology patients who underwent Hickman catheter or PICC placement at the radiology department of a regional hospital in Hong Kong from January 2008 to December 2013. The catheter-related bloodstream infection rate, time to infection onset, and non-infectious complication rate of the Hickman group and PICC group were evaluated and compared. Results: During the study period, 161 Hickman catheters and 29 PICCs were inserted in oncology patients (n = 190). There were 38 cases of catheter-related bloodstream infection in the Hickman group and four cases in the PICC group. The catheter-related bloodstream infection rate for all catheters, Hickman group, and PICC group was 1.364, 1.340 and 1.654 per 1000-catheter-days, respectively. For non-infectious complications, 15 of 161 Hickman cases had complications (6 catheter blockage, 5 leakage, 4 migration and dislodgement). In the PICC group, 6 of 29 had complications (3 blockage, and 3 migration and dislodgement). There was, however, no statistically significant difference between the Hickman and PICC groups in terms of number of infections (p = 0.241), time to infection onset (p = 0.187), non-infectious complication rate (p = 0.101), and overall complication rate (p = 0.766). Conclusion: With the less invasive nature of PICC insertion, it provides a viable means of vascular access for oncology patients.

Objectives: To determine the effect of transarterial chemoembolisation (TACE) on liver function and procedurerelated mortality in patients with unresectable hepatocellular carcinoma (HCC) and portal vein tumour thrombosis (PVTT). Methods: This was a retrospective study of patients with HCC and PVTT who underwent TACE from January 2012 to December 2013 at a single tertiary medical centre in Hong Kong. Patient demographics, aetiology of cirrhosis, alpha fetoprotein (AFP) level, tumour size, number of tumours, liver function (total bilirubin, albumin, international normalised ratio [INR]), and Child-Pugh score were evaluated before and 4 weeks after TACE. The 30-day mortality was also recorded. Results: TACE was performed in 26 patients with unresectable HCC and PVTT (mean age, 61 years). The mean total bilirubin level before and after TACE was 18.2 μmol/l and 26.8 μmol/l (p = 0.140), respectively, and mean albumin level fell from 36.8 g/l to 33.9 g/l (p = 0.009). The respective mean INR before and after TACE was 1.1 and 1.2 (p = 0.120), the AFP level was 35,364.0 ng/ml and 37,424.5 ng/ml (p = 0.563), and the mean Child-Pugh score was 6.0 and 6.6. The mean and median survival of patients was 5.1 months (range, 1.5-8.8 months) and there was no 30-day mortality. Conclusion: TACE has a deteriorating effect on liver function in patients with unresectable HCC and PVTT. Nonetheless since there were no procedure-related deaths and TACE has potential survival benefits, it should be a treatment option along with superselective catheterisation of tumour feeding vessels for patients with HCC and PVTT.