To download the Chinese version of the issue digest, please click here. You may find the link to download the full version of this article on HKMJ main page.

Hong Kong Med J 2009;15:85-9

A study into subarachnoid haemorrhages (SAH) and weather conditions has found there are more cases of this type of brain haemorrhage in winter and on days when the atmospheric pressure rises.

The study published in the April issue of the Hong Kong Medical Journal as Meteorological factors and aneurysmal subarachnoid haemorrhage in Hong Kong (Hong Kong Med J 2009;15:85-9) investigated 135 SAH cases over the years 2002-2006 and checked the prevailing atmospheric pressure, air temperature, and relative humidity to see if the weather had any bearing on the number of cases occurring each day.

The researchers, from the Division of Neurosurgery at the Prince of Wales Hospital found there was a relationship between the weather conditions and the number of SAH cases. In Hong Kong the atmospheric pressure is highest during the winter months (December to February) and lowest in the summer months (June to August). There were more cases of SAH from December to February, with the most occurring in January.

A change in daily atmospheric pressure also had an effect on the number of cases of SAH, suggesting a sudden rise in air pressure might trigger this type of brain haemorrhage. The authors say the reason for this is not yet understood and needs to be researched. “The mechanism linking atmospheric pressure change and aneurysmal rupture remains speculative and deserves exploration,” they conclude.

Hong Kong Med J 2009;15:100-9

A 5-year study of the use of laparoscopic surgery to manage severe obesity in Chinese patients has found that different procedures successfully achieved weight loss ranging from 34 to 61%.

The research, published as Laparoscopic bariatric surgery: a five-year review in the April issue of the Hong Kong Medical Journal (Hong Kong Med J 2009;15:100-9) reviewed the results of three types of procedures used to treat morbid obesity (laparoscopic adjustable gastric banding [LAGB], laparoscopic sleeve gastrectomy, and laparoscopic gastric bypass) in 94 patients.

The authors, from the Prince of Wales Hospital and the Chinese University of Hong Kong concluded that “sustainable weight loss and improvement of co-morbidities was achieved and our results were comparable to those from western countries.”

The three procedures used had different effects. The first to be used at Prince of Wales Hospital, from July 2002, was LAGB where a laparoscope is used to place an adjustable silicone band around the stomach. These bands are adjusted after surgery until the patient has reached a target weight loss. While a safe operation with fewer complications than other forms of obesity surgery, this method achieved the lowest percentage weight loss, though, at 34%, it was still considerable.

The other methods introduced after LAGB were laparoscopic sleeve gastrectomy (using a laparoscope to remove more than 75% of the stomach), and laparoscopic gastric bypass. The latter procedure is done for patients who tend to binge eat, and are likely to force the small stomach created by gastrectomy to swell.

These two procedures were also very effective in Chinese patients leading to 51% weight loss in those who had gastrectomy and 61% in those who had gastric bypass.