The aim of this study is to determine whether pet dogs owned by patients with systemic lupus erythematosus (SLE) are at a higher risk of developing SLE. Diagnosis of canine SLE was mainly based on the 11 diagnostic criteria for human SLE and two marked immunological features of canine SLE. Among 59 pet dogs owned by 37 SLE patients, 11 (18.64%) were ANA positive, and three (5.08%) had SLE. In contrast, of 187 pet dogs owned by non-SLE households, nine (4.81%) were ANA positive, and none (0%) had SLE. Among 650 outpatient dogs registered in the veterinary hospital, 34 (5.23%) were ANA positive, and six (0.92%) had SLE. Frequency of ANA and SLE among pet dogs owned by SLE patients was significantly higher than in pet dogs owned by non-SLE households (P = 0.001 for ANA; P = 0.013 for SLE) and in outpatient dogs (P < 0.001 for ANA; P = 0.032 for SLE). With respect to canine SLE development, the relative risk or risk ratio (R) of human SLE contact varied from 5.5 (compared with outpatient dogs) to near the infinite (compared with dogs owned by non-SLE households). The prevalence of canine SLE among pet dogs of SLE patients was therefore estimated to be 508 per 10 000 [95% confidence interval (95% CI), 0-1068]. In conclusion, pet dogs with human SLE contact were at a higher risk of developing SLE. Our results indicate that a common environmental factor or zoonotic agent may be involved in the development of human and canine SLE.

Objective: To investigate the prevalence of lower urinary tract symptoms in adolescents and the effects of psychotropic substance use. Methods:This was a population-based crosssectional survey using a validated questionnaire in students from 45 secondary schools in Hong Kong randomly selected over the period of January 2012 to January 2014. A total of 11 938 secondary school students (response rate, 74.6%) completed and returned a questionnaire that was eligible for analysis. Individual lower urinary tract symptoms and history of psychotropic substance abuse were documented.Results: In this study, 11 617 non-substance abusers were regarded as control subjects and 321 (2.7%) were psychotropic substance users. Among the control subjects, 2106 (18.5%) had experienced at least one lower urinary tract symptom with urinary frequency being the most prevalent symptom (10.2%). Females had more daytime urinary incontinence (P<0.001) and males had more voiding symptoms (P=0.01). Prevalence of lower urinary tract symptoms increased with age from 13.9% to 25.8% towards young adulthood and age of ≥18 years (P<0.001). Among the substance users, ketamine was most commonly abused. Substance users had significantly more lower urinary tract symptoms than control subjects (P<0.001). In multivariate analysis, increasing age and psychotropic substance population have incurred significant costs to the health care system. In children, the association of LUTS with urinary tract infection, persistent vesicoureteric reflux, renal scarring, and constipation have drawn substantial attention over the years. 3,4 Among various LUTSs, urinary incontinence (UI) has been most extensively investigated in children with the reported prevalence varying from 1.8% to ORIGINAL ARTICLE abuse increased the odds for lower urinary tract symptoms. Non-ketamine substance users and ketamine users were respectively 2.8-fold (95% confidence interval, 2.0-3.9) and 6.2-fold (4.1-9.1) more likely than control subjects to develop lower urinary tract symptoms. Females (odds ratio=9.9; 95% confidence interval, 5.4-18.2) were more likely to develop lower urinary tract symptoms than males (4.2; 2.5-7.1) when ketamine was abused. Conclusions:Lower urinary tract symptoms are prevalent in the general adolescent population. It is important to obtain an accurate history regarding psychotropic substance use when treating teenagers with lower urinary tract symptoms.

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Background: There is little consensus for the choice of adjuvant therapy for gastric cancer. This study aimed to compare treatment outcomes and toxicities of adjuvant capecitabine-oxaliplatin (XELOX) with adjuvant chemoradiation (CRT). Methods: Patients with resected gastric cancer stage IIA to IIIC disease treated between January 2004 and July 2018 were analysed retrospectively. Patients were treated with XELOX for eight cycles or CRT. For CRT, 5 cycles of 5-fluorouracil (5FU)/leucovorin with 45 Gy in 25 fractions radiotherapy (RT) concurrent with cycles 2 and 3 were given. Relapse-free survival (RFS) and overall survival (OS) were used to compare the effect of adjuvant chemotherapy and CRT. Acute toxicities and the pattern of relapse were also analysed. Results: 120 patients were included. 52 patients were treated with XELOX, and 68 patients were treated with CRT. Univariate analysis resulted in a five-year OS of 66% for XELOX, as compared with 48% for CRT (HR 0.706, 95% CI 0.413-1.208, p=0.202). The five-year RFS was 58% for XELOX, and 43% for CRT (HR 0.708, 95% CI 0.424-1.183, p= 0.185). On multivariate analysis, both RFS and OS favored XELOX: RFS HR 0.51 (95% CI 0.29-0.87), p=0.014; OS HR 0.45 (95% CI 0.25-0.81), p=0.007 when XELOX was compared with CRT. Patterns of failure were similar in the two groups, with distant metastases being most common. Acute toxicity grade 3/4 was seen in 42% of patients for XELOX, as compared to 65% of patients for CRT (p=0.015). Neutropenia ≥ grade 3 was more frequent in the CRT group (60% vs 21%; p <0.001).