Tactics to Improve the Judicious Use of Antibiotics For by qxc16070

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									                                                                                                                                                       THE HONG KONG
                                                                                                                                                    MEDICAL ASSOCIATION




                                                                                                                 August 2005 •
                                                                                                                September 2005 •




                                                                                            prescribing for URTI is rising and newer, more expensive
      Tactics to Improve the                                                                and broader spectrum antibiotics are being prescribed
                                                                                            more than previously.14

      Judicious Use of                                                                      Why do we concern with more judicious use of
                                                                                            antibiotics in the Primary Care Sector?
                                                                                            Apart from the above-mentioned marginal benefits to
      Antibiotics For Patients                                                              patients, antibiotics prescriptions for URTI have been
                                                                                            shown to lead to multiple potential serious consequences.
                                                                                            Little P. et al15 has demonstrated the medicalising effect of
      with Upper Respiratory                                                                prescribing antibiotics causing higher reattendance in a
                                                                                            randomised trial of prescribing strategies for sore throat.
      Tract Infection (hereafter                                                            Receiving antibiotics reinforces patients’ perceptions that
                                                                                            they should consult for similar problems in the future, and
                                                                                            their expectations of receiving a similar antibiotic
      refer to as ‘URTI’)                                                                   prescription. A previous antibiotic usage has a strong
                                                                                            relationship with the belief in the effectiveness of antibiotics
                                                                                            for URTI.16 This leads to higher but unnecessary consultation
      Dr. Kan Chi Leung, David                                                              requests from patients 17 , which have the financial
      Physician in Private Practice                                                         implications for the Health Services.
      MB.,B.S.(H.K.), M.R.C.P. (Ire), M.R.C.G.P.(UK),
                                                                                            Perhaps the most serious consequence of inappropriate
      F.H.K.C.F.P., F.R.A.C.G.P., D.C.H. (RCSI), D.C.H. (NUI),
                                                                                            prescription of antibiotics is the development of bacterial
      D.C.H. (Glasg.), Dip. Derm. (Glasg.).
                                                                                            resistance. 18 For patients themselves, recent use of
      I.     Introduction                                                                   antibiotics increases the likelihood of carriage of resistant
                                                                                            pneumococci between two to seven fold.19 Patients with
      Upper Respiratory Tract Infection (‘URTI’) are by far the                             invasive diseases caused by resistant pneumococci are
      commonest diagnosis made by family physicians in Hong                                 more likely to report the use of antibiotics within weeks
      Kong, accounting for 34.6% of all diagnoses made in the                               before infection as compared with patients suffering from
      1994 morbidity survey conducted by the Hong Kong                                      non-invasive disease caused by susceptible pneumococci.
      College of Family Physicians. 1 It is well recognised that
      antibiotics could only modify slightly the course of throat                           The use of antibiotics by one person also affects those in
      infections.2, 3, 4 Research reports have similarly demonstrated                       their immediate environment. There are reports of invasive,
      that the same is true for acute otitis media5, sinusitis6, 7                          resistant pneumococci being transferred between children
      and acute bronchitis. 8, 9 Despite these recognitions,                                in day-care centres.20 The use of antibiotics in an individual
      unnecessary antibiotic prescriptions remain a common                                  has implications for society, since resistance increases in
      practice. European and American studies have shown that                               proportion to the amount of antibiotics consumed in the
      more than 50% of children and adults consulting for colds                             community. 21 In Finland, a study demonstrated that
      and URTI receive antibiotic prescriptions.10, 11, 12, 13 Antibiotic                   erythromycin resistance amongst group A streptococci




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           p.2                       Tactics to Improve the Judicious Use of Antibiotics For Patients with Upper Respiratory Tract Infection (hereafter refer to as ‘URTI’)



                                        decreased from 16.5 to 8.6 percent over a four-year                   A. Guidelines
                                        period during a nationwide programme to limit the use of
                                        erythromycin.22 Streptococcus pneumoniae, the leading                 The commonest response has been to promote guidelines
                                        cause of community acquired disease, were universally                 and other educational strategies. The passive dissemination
                                        sensitive to penicillin until 1967.23 But increasing resistance       of information was generally ineffective in altering practice
                                        and multi-drug resistance is now common. In Hong Kong,                no matter how important the issues are.34, 35, 36, 37 There
                                        the prevalence of penicillin resistant streptococcus                  were, however, some positive results when clinicians were
                                        pneumoniae has surged from 0% in 1953 to 10% in                       involved in the construction of local guidelines.38 However,
                                        1993, and further to 49% in 2000.24 Similarly, macrolide              use of guidelines can never regulate all the complexities of
                                        resistance rose from 10% in 1993 to 79% in 1998.25 In                 the clinical practice.
                                        Spain, where antibiotics has been more freely available,              B. Patient Education
                                        the incidence of resistant pneumococci rose from 6% in
                                        1979 to 44% in 1989.26                                                If patients are empowered in appropriate self care for
                                                                                                              URTI, their chances of asking for unnecessary antibiotics
                                        What keeps the problem going on?                                      will be reduced. Previous works showed that patients
                                        Authoritative guidelines are abundant. 27, 28, 29, 30 Doctors         generally have little insights into the indications for
                                        continue prescribing despite acknowledging that antibiotics           antibiotics and the relationship between use of antibiotics
                                        may not be indicated, and they recognise this dilemma in              and the development of resistant organisms.39 Our literature
                                        their practice.31 Our prescribing behaviour is affected by            search showed mixed results on appropriate use of
                                        many other non-clinical factors. In a busy clinic, we have            antibiotics by providing education to patients. While one
                                        insufficient time to educate patients about the judicious             study showed enhanced self care for URTI40, the other
                                        use of antibiotics. Consultation is frequently concluded              showed either no effect 41 or even increased physician
                                        with prescription of antibiotic(s) when under patients’               visits. 42 The recent clinical trial by MacFarlene JT et al
                                        request. 32 Diagnostic uncertainty also contributes to                showed that the reconsultations rate and antibiotic
                                        unnecessary antibiotic use. A survey of primary care                  prescriptions were reduced by providing patient with a
                                        doctors shows that many have inaccurate knowledge                     simple leaflet about the natural history of upper respiratory
                                        regarding to the need for antibiotics in patients with                tract infections.43
                                        purulent rhinits. 33 Whether real or perceived, patients’
                                        expectations for antibiotics affect our prescribing decisions.        C. Use of Information Technology
                                        Years of taking antibiotics for viral respiratory infections          The effect of antibiotic guidelines is more substantial
                                        have created a reinforcing behaviour that leads to increasing         when they are made interactive through computer
                                        use of antibiotics.                                                   technology. 44, 45, 46, 47, 48 Evans et al 44 developed a
                                        Focus on the judicious use of antibiotics should shift from           computerised ‘antibiotic consultant’ which would predict
                                        why antibiotics should be used more selectively to                    the most likely pathogens and display the likely effective
                                        effective strategies for changing the behaviours of                   regimen based on the clinical information supplied. His
                                        physicians and patients. In this paper, strategies for the            ‘antibiotic consultant’ suggested an antibiotic regimen to
                                        different possible useful intervention will be reviewed.              which all isolated pathogens were shown to be susceptible
                                                                                                              for 453 (94%) of 482 culture results, while physicians
                                        II. Literature Search                                                 ordered an antibiotic regimen to which all isolated
                                        We searched for randomised controlled trials, reviews and             pathogen were only susceptible for 369 culture results
                                        meta-analyses on “Medline” with strings of ‘judicial’,                (77%). Another computer based programme implemented
                                        ‘antibiotics’, ‘prescriptions’, ‘strategies’ and ‘resistance’.        antibiotic practice guideline in a decision-support system.45
                                        We included papers in English published since 1966 and                Analysis using a standardised method (defined daily doses)
                                        included all age groups. Papers related to the topic were             showed that antibiotic use decreased by 22.8% with
                                        retrieved in full and read in details. The references lists of        improved clinical outcomes with this programme. Another
                                        the retrieved research results were read and secondary                computer-based system generated an “alert” when the
                                        literatures were looked for. Emphasis was given at                    prescribed antibiotic therapy were potentially inappropriate
                                        searching papers with reported explicit selection criteria            on the basis of microbiology sensitivity data.46 60% of the
                                        and the main outcomes considered were changes in the                  “alerts” proved to be clinically appropriate and 20%
                                        performances and clinical outcomes. We also searched the              prompted a therapeutic change. Avorn et al developed a
                                                                                                              similar but paper-based education order form of antibiotics
HKMA CME BULLETIN • SEPTEMBER 2005




                                        latest issue of Clinical Evidence, the Cochrane Database of
                                        Systemic Reviews and Database of Abstracts of Reviews                 that addressed appropriate dosing of antibiotics.48 Orders
                                        and Effectiveness (www.york.ac.uk). Finally, more articles            with incorrect dosage were significant decreased after the
                                        were found through the Best Evidence published by the                 intervention.
                                        American College of Physicians (www.acponline.org).
                                                                                                              D. Prescription Feedback
                                        References were also taken from the Standing Medical
                                        A d v i s o r y C o m m i t t e e ( S M A C ) re p o r t f ro m U K   Only providing feedback to doctors regarding their own
                                        (www.doh.gov.uk/smac1.htm).                                           antibiotic prescribing practice has no major impact on
                                                                                                              changing the prescribing habits of family physicians. 49
                                        III. Summary of the Literature Findings                               Prescriber feedback, together with an education outreach
                                                                                                              visit achieved a good influence on antibiotic prescribing
                                        A range of strategies was available and their effectiveness           and provided a model for targeting educational input.50
                                        was also assessed.                                                    This improved prescribing behaviour was maintained
       Tactics to Improve the Judicious Use of Antibiotics For Patients with Upper Respiratory Tract Infection (hereafter refer to as ‘URTI’)        p.3



during a 5-year follow-up.51 Academic detailing is a more                            Computer decision support system can enhance more
intensive education outreach program of face-to-face                                 appropriate prescriptions and provide prescribing feedback
education provided by a pharmacist or physicians who are                             to doctors. Unfortunately computer is still not widely used
trained to provide evidence-based prescribing information                            in primary care settings. A busy practitioner may be
to doctors in an interactive encounter. Studies on academic                          unwilling to use computer support during consultations.
detailing showed a significant and sustained reduction in                            Some may also face obstacles in using computers. Even
the inappropriate use of antibiotics.52, 53, 54, 55 Unnecessary                      though computer system can lead to better performance
prescriptions were reduced and much cost was saved.                                  of doctors on correct prescriptions, it is not helpful in
                                                                                     clinching diagnoses.60
As a summary of the above literature findings, passive
dissemination of guidelines is not likely to improve                                 Providing prescribing feedback to doctors has been a
performance outcomes. There are wide variation in the                                successful strategy. The feedback can entail comparison
size of improvements in performances achieved by clinical                            with peers or with a standard. However, the lack of
guidelines. Whether guidelines can be effective depend on                            prescribing data and surveillance in our community setting
other factors, as illustrated in the following table.                                is a major limiting factor.
(Table 1)56 – Classification of Clinical Guidelines in                               Academic detailing or peer education is effective. But it is
              Terms of Probability of being Effective                                difficult to implement and may be expensive as it needs to
              (After Grimshaw and Pussell)                                           identify each doctor’s need and to train sufficient doctors.
 Probability of    Development        Dissemination            Implementation        Finally surveillance is most important to measure the
 Being effective   Strategy           Strategy                 Strategy              results of the different strategies. Surveillance consists of
                                                                                     compilation of routine data, sentinel laboratory and
 High              Internal           Specific educational    Patient Specific
                                                                                     special surveys, and with these activities cross validate
                                      intervention (for       reminder at
                                                                                     each other. It is unfortunate that surveillance and self-
                                      example, problem        time of consultation
                                                                                     audit are not routinely performed by most of family
                                      based learning packing)
                                                                                     physician colleagues.
 Above average     Intermediate       Continuing education     Patient specific
                                                                                     Meanwhile, we can improve the antibiotic use through
                                      (for e.g. lecture)       feedback
                                                                                     swifter diagnoses. Simple diagnostic kits can be introduced
 Below average     External, local    Mailing target groups    General feedback      into our practice and are valuable if they give an instant
                                                                                     result which is sensitive and specific enough. Meier et al
 Low               External, national Publication in journal   General reminder      found that an antigen detection test for streptococcus
                                                                                     pyogenes, which gave immediate results with throat
In the table, the development strategy is where and how                              swabs, led to a reduction in proportions of culture
the guidelines are produced. The dissemination strategy is                           negative patients who were given antibiotics from 53% to
how the guidelines are brought to the attention of                                   32%.61 The savings on withholding unnecessary antibiotic
physicians and finally the implementation strategy is how                            use offset the costs of the tests, not to mention other
the physicians are prompted to follow them. The most                                 benefits achieved by reducing antibiotic usage. Similarly,
effective guidelines are those developed locally and                                 office laboratory tests are now available for the rapid
internally by the doctors who are going to use them,                                 diagnosis of Influenza.62
introduced as part of a specific education intervention,
and implemented via a specific prompt action that appears                            Implementation of Strategies
at the time of the consultation e.g. the computer decision
                                                                                     Different doctors will encounter different obstacles when
support.
                                                                                     implementing the different strategies. Implementing
Finally, multifaceted interventions, that is a combination of                        changes is not a single action but involves a combination
two or more interventions, are more effective than single                            of interventions linked to specific obstacles to change.
interventions.57, 58, 59 In the Systematic review of guideline                       Different approaches for changing clinic practice is valid
implementation by Gross PA et al, evidences showed that                              and effective, provided they are adapted to the specific
multifaceted implementation methods were most successful                             features at the target group and the clinical settings.
in encouraging appropriate antimicrobial use.59                                      Implementation of strategies in clinical practice is a
                                                                                     stepwise and cyclical process, which is summarized with
                                                                                                                                                       HKMA CME BULLETIN • SEPTEMBER 2005




IV. Discussion                                                                       the following flow chart.63
Although quite a lot is known about prescribing and
antibiotic consumption patterns in the hospitals in Hong
Kong, knowledge of such patterns in the community,
where most of the URTIs are being treated, is limited. In
the community setting, we still remain mainly on the stage
of passive dissemination of guidelines and lectures which
have been shown to be relatively ineffective in changing
prescribing behaviour – effective strategies, like those
found from the literature review, are still not in practice.
Further research is necessary to find out the obstacles to
implement these changes.
   Tactics to Improve the Judicious Use of Antibiotics For Patients with Upper Respiratory Tract Infection (hereafter refer to as ‘URTI’)     p.5



Develop a change proposal                                            Appendix
• Crucial elements well defined                   Adapt
• Based on evidence and consensus                                    The Physician and Patient Resources Promoting Rational
                                                  change             Antibiotic Prescribing.
• Tested in practice, adapted to local            proposal
   needs                                                             Focus        Organizations (Web Site)          Content
• Low complexity, compatible to routines
• Attractive, accessible format                                      Physician/   Center for Disease Control and    “Judicious Use of
• Credible source                                                    patient      Prevention, Atlaots,              Antibiotic” program
                                                                                  GA (www.cdc.org)                  contains information
                                                                                                                    on appropriate
Identify obstacles to change                                                                                        antibiotic use.
• Obstacles related to clinician,
   social context of care provision,                                 Physician/   National Institute of Allegry and Antimicrobial
   or organisational context                      Identify           Patient      Infectious Diseases, Bethesda, MD Resistance
• Obstacles related to stages in change           new                             (www.niaid.nih.gov/factsheets/    Fact Sheet.
   process (dissemination, adoption,                                              antimicro.htm)
                                                  obstacles
   implementation, continuation)                                     Physician/   Alliance for Prudent Use of       Educational materials
• Segmentation of target ground                                      Patient      Antibiotics, Boston, MA           with links to a
                                                                                  (www.healthsci.tufts.edu/apua)    network of antibiotic
                                                                                                                    resistance
Link Interventions to obstacles
                                                                                                                    researchers.
• Dissemination: improve interest
   understanding                                                     Physician    Infectious Diseases Society of    Reference to the
• Adoption: Improve attitude and intention        Select                          America, Alexandra, VA            Society’s guidelines
   to change                                                                      (www.journals.uchicago.edu/       on prevention of
                                                  new
• Implementation: Improve actual use                                              IDSA/guide/SE38584.pdf)           antimicrobial
• Continuation: fixed habit                    interventicion                                                       resistance in hospital.
                                                                     Patient      American Medical Association,     Practical information
Develop a plan                                                                    Chicago, IL                       on antibiotics and
• Combination of strategies                                                       (www.ama-assn.org/insight/        infectious diseases.
• Define intermediate and long-term                                               gen_hlth/Antibiot/antio01.htm)
   targets                                        Adapt
                                                  the                Self-Assessment Questions
• Arrange procedures and tasks
• Set a time schedule                             plan               (Please indicate true or false to the following questions.)
                                                                     1. Upper respiratory tract infections accounted for 44.6%
Carry but the plan and evaluate progress                                 of all diagnoses made in 1994 morbidity survey
• Carry out different steps and                   Targets                conducted by the Hong Kong College of Family
   continuously evaluate progress                 not                    Physicians in 1994.
                                                  achieved           2. Perhaps the most serious consequence of inappropriate
                                                                         prescription of antibiotics is the development of
   Intermediated targets achieved                                        bacterial resistance.
                                                                     3. The use of antibiotics by one person also affects those
                                                                         in their immediate environment.
V. Conclusion                                                        4. Focus in the judicious use of antibiotics should shift
As family physicians, we should adopt the evidence-based                 from why antibiotics should be used more selectively
medicine, provide education and share treatment rules                    to effective strategies for changing behaviour of
with our patients. We can be reassured from the                          physicians and patients.
encouraging evidence that patient satisfaction does not              5. The use of guidelines can regulate all the complexities
fall amongst those who are not prescribed with an                        of the clinical practice.
antibiotics.4 Patient satisfaction comes with the time we            6. The recent trial by MacFarlene J.T. et al. showed that
                                                                                                                                                HKMA CME BULLETIN • SEPTEMBER 2005




spend in explaining the illness and their understanding in               the reconsultations rate and antibiotic prescriptions
the choice of treatment we provided.                                     were reduced by providing patient with a simple leaflet
                                                                         about the natural history of Upper Respiratory Tract
                                                                         Infections.
                                                                     7. The effect of antibiotic guidelines is more substantial
                                                                         when they were made interactive through computer
                                                                         technology.
                                                                     8. Only providing feedback to doctors regarding their
                                                                         own prescribing practice has major impact on changing
                                                                         the prescribing levels of family physicians.
                                                                     9. Surveillance is the most important factor to measure
                                                                         the results of the different strategies.
                                                                     10. We cannot improve the judicious antibiotic use through
                                                                         swifter diagnoses.
      Tactics to Improve the Judicious Use of Antibiotics For Patients with Upper Respiratory Tract Infection (hereafter refer to as ‘URTI’)                            p.7



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27.   Genevieve Ressel Practice guidelines. Principles of Appropriate antibiotic      59. Gross PA, Pugat D. Implementing practice guidelines of appropriate
      use. Am Fam Physicians August 1, 2002.                                              antimicrobial usage: a systematic review. Med Care 2001 Aug 39 (8
28.   Leonard Leinovice, IL Hana Shraga. How do you choose antibiotic                     Supp 2) II: 55-69.
      treatment? BMJ 1999; 318: 1614-1618.                                            60. Johnson ME, Langton KB, Haynes RB, Mrtieu A. Effects of computer
29.   S W Wong, D KK Ng, S Wu. Management of upper respiratory tract                      based clinic decision support systems on clinical performance and patient
      infection in children: a review. HK Pract. 2000; 22: 242-251.                       outcome: a critical appraisal of research. Ann Int Med 1994; 120: 135-
30.   R Gonzales, John G Bartlett, Richard E Besser. Principles of appropriate            142.
      antibiotic use for treatment of non-specific upper respiratory tract            61. Mier Fa, Jonathan Howland, Julie Johnson. Effects of Rapid Antigen
      infections in adults. Ann Med 2001; 134: 476-502.                                   Test for Group A streptococcal Pharyngitis on Physician Prescribing and
31.   Bradley C. Uncomfortable prescribing decisions: a critical incident study.          Antibiotic Costs. Arch Intern Med. 1990; 150: 1696-1700.
      BMJ 1992; 304: 294-296.                                                         62. Rapid diagnostic test for influenza. Med Lett Drugs Ther 1999; 41(1068):
32.   Avorn J, Solomon DH. Cultural and economic factors that misshape                    121-122.
      antibiotic use: the nonpharmacologic basis of therapeutics. Ann Intern          63. Richard Grol. Education and Debate. Beliefs and evidence in changing
      Med 200; 133: 128-135.                                                              clinical practice. BMJ 1997; 315: 418-421.
           p.8

                                     Clinical Case Study
                                     Please answer the questions for each quiz below by returning the completed answer sheet printed on page 19. This exercise will attract 0.5 CME point for participants completing
                                     BOTH quizzes. Answers and explanations will be provided in the next issue.




                                                                                                                                 Answers to August 2005
                                            Clinical Cardiology Series                                                           Clinical Cardiology Series


                                           A 65 year old man with good past health presents to
                                           your office with recent palpitation attacks. He experiences                           For each of the following clinical presentation with
                                           a mild decrease in exercise tolerance, although there is                              neoplastic tumor, choose and match the correct
                                           no symptom of congestive heart failure. Physical                                      transthoracic or transesophageal two-dimensional image
                                           examination reveals no cardiac murmur and his blood                                   that most likely fit the listed presentation:
                                           pressure is normal. ECG shows atrial fibrillation.
                                                                                                                                 1. Carcinoma of esophagus confirmed by upper
                                           1. Is cardioversion indicated for him?                                                   endoscopy who presented with difficulty in swallowing
                                                                                                                                    and progressive weight loss

                                           2. How should you prepare the patient for
                                                                                                                                 2. Left atrial myxoma who presented with systemic
                                              cardioversion?                                                                        embolization and left sided stroke

                                           3. What should be the technique of cardioversion?                                     3. Bronchogenic carcinoma with a large soft tissue
                                                                                                                                    shadow over the left upper lobe on CXR who presented
                                           4. What are the risks of cardioversion?                                                  with hoarseness of voice. The cardiac ultrasound
                                                                                                                                    examination confirmed intracardiac extension of
                                           The content of the Office Cardiology Series is provided by:
                                                                                                                                    tumor
                                           Dr. LI Siu Lung, Steven
                                           M.B.,B.S.(H.K.), M.R.C.P.(U.K.), F.H.K.A.M., F.H.K.C.P., F.R.C.P.(Glasg.), F.R.C.P.   4. Primary malignant angiosarcoma of the heart with
                                           (Edin.), Specialist in Cardiology
                                           Dr. WONG Shou Pang, Alexander                                                            the histology confirmed by open heart surgical
                                           F.R.C.P., F.H.K.A.M.(Med.), F.H.K.C.P., Specialist in Cardiology                         debulking procedure

                                                                                                                                 Answers:

                                                                                                                                 Presentation 2 (Fig. 1)
                                                                                                                                 This image shows the classical ultrasound appearance of
                                                                                                                                 myxoma with it gelatinous appearance and cystic echolucencies.
                                                                                                                                 Myxoma is the commonest primary benign intracardiac tumor
                                                                                                                                 encountered. 87% of myxoma is located in the left atrium.
                                                                                                                                 Diagnosis almost assures if attachment site to the interatrial
HKMA CME BULLETIN • SEPTEMBER 2005




                                                                                                                                 septum can be established. Myxoma is not a “benign” tumor
                                                                                                                                 in the sense that tumor fragmentation and thromboembolism
                                                                                                                                 from the tumor surface may occur. Damage to the mitral valve
                                                                                                                                 can occur when the tumor adheres to it. Systemic symptoms
                                                                                                                                 (fever and weight loss) result from secretion of interleukin-6.
                                                                                                                                 Once diagnosed, it should be removed surgically as soon as
                                                                                                                                 possible due to risk of systemic embolization. Post operatively,
                                                                                                                                 patients should be followed up by serial echo screening for
                                                                                                                                 possible tumor recurrence. A familial pattern with autosomal
                                                                                                                                 dominance inheritance is well described. Family screening should
                                                                                                                                 be offered with the following atypical presentations 1) multiple
                                                                                                                                 myxomas 2) atypical location 3) young age (< 30 year old).
                                                                             Clinical CaseCase Study
                                                                                 Clinical Study        p.9



Presentation 3 (Fig. 2)                                             Fig. 1
This image shows the intracardiac extension of soft tissue tumor
through the left upper pulmonary vein into the left atrium.
Thrombus is not a differential diagnosis since it will not occur
inside the pulmonary vein. Once an intracardiac tumor is
identified, the following information should be obtained: 1)
anatomical location & attachment site of the tumor 2)
surrounding venous inflow tracts extension – superior & inferior
vena cava, coronary sinus for right sided tumors; all pulmonary
veins for left sided tumors 3) pericardial effusion which is a
common occurrence in primary or metastatic malignant cardiac
tumors 4) any involvement of adjacent cardiac structures e.g.
cardiac valves, coronary artery ostium, encasement of great
vessels which may affect surgical planning. For this patient,
histological confirmation of pleomorphic large cell carcinoma       Fig. 2
was obtained by bronchoscopy and the intracardiac extension
of tumor precluded him from curative surgery.

Presentation 1 (Fig. 3)
This image is the classical appearance of a posterior mediastinal
tumor when seen from transthoracic echo examination. The
posterior left atrial border was being compressed externally
by the large soft tissue tumor. Carcinoma of the esophagus is
the commonest cause of posterior mediastinal tumor in our
locality. Transesophageal examination before an upper
endoscopy is a definite contraindication in patients with
posterior mediastinal tumor. Esophageal rupture or perforation
will be a serious and fatal complication in “blind”
                                                                    Fig. 3
transesophageal procedures.

Presentation 4 (Fig. 4)
Though extremely rare, angiosarcoma is still the commonest
primary malignant cardiac tumor encountered. The malignant
nature of this primary intracardiac tumor can be seen from
the image – infiltration of the whole coronary sinus, the
transverse sinus between the left pulmonary artery and left
atrium by soft tissue tumor. All primary malignant cardiac
tumors have very grim prognosis. This patient died 8 months
after the diagnosis despite multiple courses of aggressive
chemotherapy.

The malignant nature of cardiac tumor can usually be                Fig. 4
established by echo, but the histology cannot be ascertained
by whatever imaging modality. Therefore a management
                                                                                                            HKMA CME BULLETIN FEBRUARY 2005
                                                                                                         HKMA CME BULLETIN •• SEPTEMBER2005




approach to obtain histological proof is always warranted. We
                                                                                                                               • JUNE 2005




have seen patients with intracardiac malignant lymphoma who
presented in a similar manner, histological proof can only be
obtained during surgery and the disease is cured by subsequent
chemotherapy.
                                                                                                          HKMA CME BULLETIN
p.10                                 Clinical Case Study



                                                                                                   Answers to August 2005
                                        Dermatology Series
                                                                                                   Dermatology Series



                                                                                                   A 16 year old male complained
                                                                                                   of increased pigmentation on
                                                                                                   the right side of his back for
                                                                                                   two years. He denied any
                                                                                                   preceding skin disease. The
                                                                                                   lesion gradually increased in
                                                                                                   size but there was no symptom.
                                                                                                   Significant pigmentary or melanocytic lesion was not reported
                                                                                                   in the family. Physical examination revealed a large
                                                                                                   hyperpigmented patch on his right upper back extending
                                                                                                   medially to the midline and laterally involving right shoulder
                                                                                                   and arm. There were no papules or plaques. The lesion has
                                                                                                   i r re g u l a r m a r g i n b u t t h e h y p e r p i g m e n t a t i o n w a s
                                                                                                   homogeneous. Close examination of the lesion showed
                                                                                                   hypertrichosis.
                                       An 8 year old otherwise healthy boy presented with
                                       multiple skin papules over his upper limb for three         1. What are the clinical differential diagnoses?
                                       months. The skin lesions were asymptomatic, except              The clinical differential diagnoses include Becker’s naevus,
                                       for occasional itch and mild pain. His elder brother            congenital melanocytic naevus, epidermal naevus, post-
                                       also got similar skin lesions. Physical examination             inflammatory hyperpigmentation and large lentigos.
                                       revealed multiple 2-4 mm size papules over his
                                       forearm, some appeared as pearly. Central depression        2. What is the most likely clinical diagnosis in this patient?
                                       was seen in some lesion. Some lesions appeared to               Becker’s naevus. It is characterized by unilateral irregularly
                                                                                                       pigmented macular lesion and often associated with
                                       be arranged in a line.
                                                                                                       hypertrichosis. The lesion usually develops and first noted
                                                                                                       in puberty.
                                       1. What is the clinical diagnosis?
                                                                                                   3. What is the investigation that confirms the clinical
                                                                                                      diagnosis?
                                       2. What is the natural course of the disease?
                                                                                                       A skin biopsy for histopathology and/or electron
                                                                                                       microscopic study can confirm the clinical diagnosis. The
                                       3      What is Koebner phenomenon?                              lesion is characterised by increased basal pigmentation
                                                                                                       without significant increase of melanocytes. Hair follicles
                                                                                                       are usually normal but can be increased and enlarged.
                                       4. How would you confirm the diagnosis?                         Increased smooth muscle is almost always found in deep
                                                                                                       dermis.
                                       5. What are the treatments?
                                                                                                   4. What are the other clinical associations with this
HKMA CME BULLETIN • SEPTEMBER 2005




                                                                                                      condition?
                                                                                                       Associated features include unilateral hypoplasia of breast,
                                                                                                       shoulder girdle, pectoralis major muscle, or upper limb.
                                           The content of the Dermatology Series is provided by:
                                                                                                       There may also be vertebral defects, multiple leiomymas,
                                           Dr. CHAN Loi-yuen & Dr. TANG Yuk-ming, William
                                                                                                       and localised lipoatrophy.
                                           Specialists in Dermatology & Venereology

                                                                                                   5. What is the treatment for the lesion?
                                                                                                       Treatment aims at reduction of hyperpigmentation and
                                                                                                       excessive hair. Laser therapy, such as Q-switched ruby has
                                                                                                       been reported to be successful in treating the
                                                                                                       hyperpigmentation and hypertrichosis.
                                                                                                                                                                                                                                                                                    p.13
                                                                                                                                                                                                                                                                                   p.13
                        CME Lecture for October 2005



                        13 October 2005 (Thursday)                                                                                                                                        The HKMA Dr. Li Shu Pui
                                                                                                                                                                                          Professional Education Centre
                        HKMA Structured CME Programme with HKS&H –                                                                                                                        2/F, Chinese Club Building
                        Nuclear Medicine Imaging & Treatment                                                                                                                              21-22 Connaught Road Central, HK
                        Dr. Ho Chi Lai, Garrett                                                                                                                                           Lecture: 2:00 – 3:00 p.m.
                                                                                                                                                                                          [Light lunch will be started at 1:15 p.m.]
                        Director, Department of Nuclear Medicine & Positron Emission Tomography
                        M.B.,B.S.(HK), M.Sc.(Stanford), Diplomate, American Board of Nuclear Medicine

                        This symposium is co-organized with Hong Kong Sanatorium & Hospital.



                        20 October 2005 (Thursday)                                                                                                                                        The Ballroom, Level 2
                        Office Dermatology                                                                                                                                                Langham Hotel Hong Kong
                                                                                                                                                                                          (Former Great Eagle Hotel)
                        Dr. Wong Kwok On
                                                                                                                                                                                          8 Peking Road, TST
                        Specialist in Dermatology
                                                                                                                                                                                          Lunch: 1:00 – 2:00 p.m.
                                                                                                                                                                                          Lecture: 2:00 – 3:00 p.m.
                        This symposium is sponsored by Roche Hong Kong Limited.




                        Registration:                   Please fill in and return the Registration Form together with a cheque of adequate amount made payable to “The Hong
                                                        Kong Medical Association” to 5/F Duke of Windsor Social Service Building, 15 Hennessy Road, Hong Kong. Each lecture
                                                        will carry 1 CME point under the MCHK/HKMA CME Programme (unless otherwise stated). Accreditation from other
                                                        colleges is pending. (The Secretariat fax no.: 2865 0943)
                                                        Please be informed that Confirmation Letter of Registration is required. If you have not received any replies, please do
                                                        not hesitate to contact us at 2527 8452.




                                                                         Please register for participation. First come, first served.
○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○    ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○    ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○    ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○    ○   ○


                    I would like to register for the following CME lecture(s):


                    Please “” as appropriate.                                                   

                                                                                                                                                                                          HKMA Members                             CME Participants
                                                                                                                                                                                                                                                                                   Reply Slip
                                                                                                                                                                                             HK$50                                     HK$80
                    HKMA Structured CME Programme with HKS&H
                    13 October 2005                         : Nuclear Medicine Imaging & Treatment

                    HKMA CME Lecture
                    20 October 2005                         : Office Dermatology


                    I enclose herewith a cheque of
                                                                                                                          HK$


                    Name                                                                                         Tel No.                                                                   Fax No.

                    HKMA Membership No.
                    or HKMA CME No.                                                                                                                           Signature

                    Data collected will be used and processed for the purposes related to the MCHK/HKMA CME Programme only. All registration fees are not refundable or transferable.
p.14

                                     HKMA Structured CME Programme at Kwong Wah Hospital



                                                                                                                                S I N C E   1 8 7 0

                                                  The Hong Kong Medical Association                                          Kwong Wah Hospital

                                            Lecture          Date                      Topic
                                           VI                25 September 2005         Otorhinolaryngology
                                                                                         Middle Ear Disease
                                                                                         Dr. Chiu Kit Yee, Sherlianne
                                                                                         Specialist in Otorhinolaryngology

                                                                                       Hepatology
                                                                                         Update on Management of Viral Hepatitis
                                                                                         Dr. Tung Yau Man, Steven
                                                                                        Medical Officer, Dept of M&G, KWH

                                           VII               30 October 2005           Paediatrics
                                                                                       1. Sleep Disorders in Paediatric Patients
                                                                                          Dr. Ng Kwok Keung
                                                                                          Consultant, Dept of Paediatrics, KWH

                                                                                       2. Management of Wheezy Child
                                                                                          Dr. Chow Pok Yu
                                                                                          Senior Medical Officer, Dept of Paediatrics, KWH




                                     •   Venue : Lecture Theatre, 10/F, Yu Chun Keung Memorial
                                                 Medical Centre, KWH
                                     •   Time  : 2:00 – 5:00 p.m.
                                     •   Fee   : HK$50 per lecture for HKMA Members
                                                 HK$80 per lecture for CME Participants


                                                                  Light snacks and lecture notes will be provided.


                                     Registration: Please fill in and return the Registration Form on p.15 together with a cheque of adequate amount made payable to
                                                   “The Hong Kong Medical Association” to 5/F Duke of Windsor Social Service Building, 15 Hennessy Road, Hong Kong.
                                                   Each lecture will carry 3 CME points under the MCHK/HKMA CME Programme.
HKMA CME BULLETIN • SEPTEMBER 2005
                                                                                                                                                                                                                                                                                      p.15

                    HKMA Structured CME Programme at Queen Elizabeth Hospital




                                              The Hong Kong Medical Association                                                                                                              Queen Elizabeth Hospital

                                        Lecture                           Date                              Topic

                                    VII                           16 October 2005                           Orthopaedics & Traumatology
                                                                  2:00 – 4:00 p.m.                             Sports Injuries
                                                                  2 CME pts only                               Dr. Ho Ching Lun
                                                                  for this lecture                             Specialist in Orthopaedics & Traumatology
                                                                                                            Neurosurgery
                                                                                                               Radiosurgery: An Introduction for General Practitioners
                                                                                                               Dr. Tan Tze Ching
                                                                                                               Senior Medical Officer, Dept of Neurosurgery, QEH

                                    VIII                          6 November 2005                           Psychiatry
                                                                                                            1. Practical Issues of Psychiatric Drug Use
                                                                                                               Dr. Nguyen Gia Hung, Desmond
                                                                                                               Senior Medical Officer, Dept of Psychiatry, KH
                                                                                                            2. Psychological Treatment of Depression
                                                                                                               Dr. Lin Wei
                                                                                                               Medical Officer, Dept of Psychiatry, KH
                                                                                                            3. Alcohol and Minor Tranquillisers
                                                                                                               Dr. Ng Kong Man
                                                                                                               Medical Officer, Dept of Psychiatry, KH



                         Venue : Lecture Theatre, G/F, Block M, QEH
                         Time : 2:00 – 5:00 p.m.
                                              Please note the 16 October lecture will be from 2:00 –
                                              4:00 p.m.
                         Fee                : HK$50 per lecture for HKMA Members
                                              HK$80 per lecture for CME Participants

                                                                                   Light snacks and lecture notes will be provided.
                                                                                                First come, first served.
○   ○   ○   ○   ○   ○   ○   ○   ○   ○     ○   ○   ○   ○   ○   ○   ○   ○    ○   ○   ○   ○    ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○    ○   ○   ○   ○   ○   ○    ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○    ○   ○                                 ○      ○   ○



                                              HKMA Structured CME Programme at QEH/KWH – Registration Form

                        I would like to register for the following lecture(s):                                                                                              HKMA Members                                     CME Participants
                                                                                                                                                                                                                          (Non-HKMA members):
                                                                                                                                                                                                                                                                                      Reply Slip
                                                                                                                                                                        HK$50                                                 HK$80
                                                                                                                                                                                                                                                                                               HKMA CME BULLETIN • SEPTEMBER 2005




                                                      25 September 2005: Otorhinolaryngology & Hepatology
                                KWH
                                                      30 October 2005:   Paediatrics

                                                      16 October 2005:                     Orthopaedics & Traumatology and Neurosurgery
                                QEH
                                                                                           (2 CME points only)
                                                      6 November 2005:                     Psychiatry

                    Please “ ” as appropriate.                                                 
                    I enclose herewith a cheque of
                                                                                                        HK$
                    Name                :                                                                                   Tel No.             :                                                    Fax No.              :
                    HKMA Membership No.
                    or HKMA CME No.                                                                                                     Signature
p.16

                                                                                 HKMA CME Online
                                     We are pleased to announce the inauguration of our long-awaited CME Online web site funded by the Commerce and
                                     Industry Branch of the Commerce, Industry and Technology Bureau under the Professional Services Development Assistance
                                     Scheme.




                                     The above web site at http://www.hkmacme.org or http://www.cmehkma.org has the following features:

                                     •     Allows members to view their accumulated CME points online through the CME Points Tracker.
                                     •     Allows members to take accredited CME modules online at your own time and convenience.
                                     •     Allows members to obtain instant feedback in the form of correct answers in the case of multiple-choice questions.
                                     •     CME points are awarded instantaneously for multiple-choice and true/false questions.
                                     •     Allows members to earn extra CME points through extra online CME articles.
                                     •     Allows members to locate information using the keyword searching engine.
                                     •     Allows members to check anytime available CME programmes, meetings and functions.

                                     Getting Started:
HKMA CME BULLETIN • SEPTEMBER 2005




                                     1.    Type in your Medical Council registration number for “Username”.
                                     2.    Type in your HKMA membership number or HKMA CME participant number for “Password”.
                                     3.    Click “LOGIN”.
                                     4.    Fill in the registration form displayed in front of you. (Parts indicated with red asterisks are compulsory.)
                                     5.    Click “Submit” button ➔ There you are! Enjoy!

                                     * If you choose to do the self-study online, there is no need for you to fax the answer sheet to the Secretariat.

                                     We welcome enquiries and feedback which can be faxed to the Secretariat on 2865 0943 or emailed to us at cme@hkma.org.




                                     The HKMA CME Online Website is developed and maintained by Elsevier        for the Hong Kong Medical Association.
                                                                                                                           p.17

        Refresher Course for Health Care Providers 2005/2006
                         Jointly organized by
    The Hong Kong Medical Association and Our Lady of Maryknoll Hospital



              The Hong Kong Medical Association                                 Our Lady of Maryknoll Hospital

Venue:         Training Room II, 1/F, OPD Block, Our Lady of Maryknoll Hospital
               (118 Shatin Pass Road, Wong Tai Sin, Kowloon)

Time:          2:30 – 4:30 p.m.
 Date                 Topic                                        Speaker
 10 Sept 2005         Drug Addictions in Our                       Dr. Ben CHEUNG
                      Community – What Can We Do?                  Senior Medical Officer, KCH
 8 Oct 2005           Cognitive Behavioural Therapy for            Dr. Andy Kit Ying CHEUNG
                      Beginners (Psychological Treatment           Specialist in Family Medicine
                      for Depression)
 12 Nov 2005          Common Gynaecological                        Dr. Siu Keung LAM
                      Problems in the Community                    Consultant, Department of O&G, KWH
 10 Dec 2005          Diabetes Mellitus – From Primary             Dr. Vincent YEUNG
                      to Secondary Care                            Chief of Services, Department of Medicine &
                                                                   Geriatrics, OLMH
 14 Jan 2006          Update on Travel Medicine                    Dr. Joyce TANG
                                                                   Medical Director, United Christian Nethersole
                                                                   Community Health Service
 11 Feb 2006          Office Procedures – Worth Attempting         Dr. AU Yiu Kai
                                                                   Consultant, In-charge, Department of Surgery, OLMH
 11 Mar 2006          How to Provide Family Oriented               Dr. Cynthia CHAN
                      Care in General Practice                     Consultant, Department of Family Medicine, NTWC
 8 Apr 2006           Common Geriatric Problems in the             Dr. Samuel Sze Lok SZETO
                      Community – How to Handle                    Senior Medical Officer, Department of Geriatrics, KWH
 13 May 2006          Contraception and Family                     Dr. Grace WONG
                      Planning in Primary Care                     Senior Doctor, FPA
 10 Jun 2006          Rheumatoid Problems – The Often              Dr. Mo Yin MOK
                      Encountered in Family Practice               Specialist in Rheumatology, QMH
 8 Jul 2006           Gastro-oesophageal Reflux                    Dr. Raymond Wai Man WONG
                      (GERD) – An Update                           Specialist in Gastroenterology & Hepatology,
                                                                                                                             HKMA CME BULLETIN • SEPTEMBER 2005




                                                                   St. Paul’s Hospital
 12 Aug 2006          Plastic Surgery Procedures                   Dr. Anna Wai Man WONG
                                                                   Specialist in Plastic Surgery
A Certificate of Attendance will be presented at the end of the course for those achieving > 80% of attendance.

CME Accreditions
HK College of Family Physicians 2 credit points & MCHK/HKMA CME Programme 2 credit points

Light refreshment or lunch provided
(Sponsored by: BMS, Boehringer-Ingelheim, Eisai, GSK, AstraZeneca, Neo Derm, Pfizer, Schering AG, Wyeth)

Limited car parking can be reserved, on first-come-first-served basis.
RSVP: Tel:     2354 2440 (Ms Clara Tsang, OLMH)
       Fax: 2327 6852
                                                                                                                                                               p.19

Answer Sheet for September 2005
Please return completed answer sheet to the HKMA Secretariat (Fax: 2865 0943) on or before 15 October 2005 for documentation. 1 CME point will be
awarded for answering the Monthly Self-Study Series (I) and an extra 0.5 CME point for completing the Clinical Case Study (II). However, if you choose to do
the exercises online, you do not need to return this answer sheet by fax.




(I) Tactics to Improve the Judicious Use of Antibiotics For Patients with Upper Respiratory Tract Infection
    (hereafter refer to as ‘URTI’)
(Please indicate “T” or “F” in each box.)

        1                 2                 3             4                5         6              7               8              9              10




         ANSWERS TO AUGUST 2005 ISSUE



             Management of Community Acquired
             Pneumonia (CAP) in General Practice

              1.               T                 6.           T                                                                        X X ( X )
              2.               T                 7.           F
              3.               F                 8.           F
              4.               T                 9.           F
              5.               F                10.           F




(II) Clinical Case Study
(Please answer both quizzes and write down the answers in the space provided.)

(A) Clinical Cardiology Series

1.


2.


3.


4.



(B) Dermatology Series
                                                                                                                                                                 HKMA CME BULLETIN • SEPTEMBER 2005




1.


2.


3.


4.


5.
                                                                                                                                                                                                                                                                                                                                       p.21
                                                                                           Chronic Kidney Disease (CKD) Workshop 2005
                    Chronic Kidney Disease (CKD) is a new term to denote any kidney disease of greater than three months duration irrespective of the
                    cause of the renal impairment. CKD is divided into five stages and this helps greatly in the communication between doctors and
                    patients. The American National Kidney Foundation proposed a scheme of treatment according to the different stages of disease and
                    this is of immense use to the renal physicians and the family doctors.

                    This workshop consists of 6 Tuesday meetings. There will also be guided visits to renal centres and hands-on sessions on computer-
                    assisted clinical decision support. Software will be provided for desktop computers or Palm PDA. At the end of the course, the
                    participants will have good knowledge of early detection of renal diseases, the management according to different stages of disease
                    and the renal replacement therapy in advanced cases.

                                         Date                                                              :        18, 25 October; 1, 8, 15 & 22 November 2005 (Tuesdays)
                                         Time                                                              :        1:45 – 3:15 p.m. (Lunch will be served at 1:00 p.m.)
                                         Venue                                                             :        Lecture I, III to VI: Lecture Theatre, M Block, G/F., Queen Elizabeth Hospital
                                                                                                                    Lecture II: Multifunction Room, D Block, Queen Elizabeth Hospital
                                         Organizers                                                        :        The Hong Kong Medical Association YauTsimMong Community Network, Queen Elizabeth Hospital,
                                                                                                                    The Hong Kong Baptist Hospital & Integrated Dialysis Facilities (HK) Ltd.
                                         Languages                                                         :        Cantonese and English (course materials in English)
                                         Registration Fee                                                  :        For whole course HK$250 (HK$50 per lecture)
                                                                                                                                                                           Programme
                                         Lecture Date                                                                       Topics                                                                                                                                Speakers

                                         I                                     18 Oct 2005                                  ~ Introduction to Chronic Kidney Disease (CKD)                                                                                        Dr. Choi Kin
                                                                               (Tue)                                        ~ Management of CKD and the Sun Tse         =Military Protocol                                                                        Dr. Ho Chung Ping
                                                                                                                            This symposium is sponsored by Abbott Laboratories Ltd.
                             ○       ○        ○       ○       ○        ○       ○       ○       ○   ○   ○    ○   ○   ○   ○    ○   ○   ○   ○   ○   ○    ○   ○   ○   ○        ○   ○   ○        ○   ○   ○   ○   ○   ○    ○   ○   ○   ○   ○   ○   ○    ○   ○   ○   ○   ○   ○    ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○

                                         II                                    25 Oct 2005                                  ~ Running a Pre-dialysis Clinic                                                                                                       Dr. Ho Chung Ping
                                                                               (Tue)                                        ~ Management of Glomerulonephritis                                                                                                    Dr. Li Fu Keung
                                                                                                                            This symposium is sponsored by Kirin Pharmaceutical (Asia) Co. Ltd.
                             ○       ○        ○       ○       ○        ○       ○       ○       ○   ○   ○    ○   ○   ○   ○    ○   ○   ○   ○   ○   ○    ○   ○   ○   ○        ○   ○   ○        ○   ○   ○   ○   ○   ○    ○   ○   ○   ○   ○   ○   ○    ○   ○   ○   ○   ○   ○    ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○

                                         III                                   1 Nov 2005                                   ~ Management of Diabetic Nephropathy                                                                                                  Dr. Ho Chung Ping
                                                                               (Tue)                                        ~ Practical Diabetic Management                                                                                                       Dr. Choi Kin Lam
                                                                                                                            This symposium is sponsored by Janssen Pharmaceutical Ltd.
                             ○       ○        ○       ○       ○        ○       ○       ○       ○   ○   ○    ○   ○   ○   ○    ○   ○   ○   ○   ○   ○    ○   ○   ○   ○        ○   ○   ○        ○   ○   ○   ○   ○   ○    ○   ○   ○   ○   ○   ○   ○    ○   ○   ○   ○   ○   ○    ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○

                                         IV                                    8 Nov 2005                                   ~ The Principles and Practice of Haemodialysis                                                                                        Dr. Tsang Wai Kay
                                                                               (Tue)                                        ~ Haemodialysis in Hong Kong – An Overview                                                                                            Dr. Ho Chung Ping
                                                                                                                            This symposium is sponsored by Janssen Pharmaceutical Ltd.
                             ○       ○        ○       ○       ○        ○       ○       ○       ○   ○   ○    ○   ○   ○   ○    ○   ○   ○   ○   ○   ○    ○   ○   ○   ○        ○   ○   ○        ○   ○   ○   ○   ○   ○    ○   ○   ○   ○   ○   ○   ○    ○   ○   ○   ○   ○   ○    ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○

                                         V                                     15 Nov 2005                                  ~ The Evolution of Peritoneal Dialysis Treatment                                                                                      Dr. Ho Chung Ping
                                                                               (Tue)                                        ~ Management of CAPD Patient                                                                                                          Dr. Wong Kim Ming, Francis
                                                                                                                            This symposium is sponsored by Kirin Pharmaceutical (Asia) Co. Ltd.
                             ○       ○        ○       ○       ○        ○       ○       ○       ○   ○   ○    ○   ○   ○   ○    ○   ○   ○   ○   ○   ○    ○   ○   ○   ○        ○   ○   ○        ○   ○   ○   ○   ○   ○    ○   ○   ○   ○   ○   ○   ○    ○   ○   ○   ○   ○   ○    ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○

                                         VI                                    22 Nov 2005                                  ~ Medical Aspects of Renal Transplantation                                                                                            Dr. Tsang Wai Kay
                                                                               (Tue)                                        ~ Surgical Aspects of Renal Transplantation                                                                                           Dr. Chan Yau Tung
                                                                                                                            This symposium is sponsored by Takeda Pharmaceutical Co. Ltd.


                    Registration: Please send the completed registration form to RM 811A, Champion Building, 301 Nathan Road, Kowloon, Hong Kong. Please
                    make cheque payable to “Integrated Dialysis Facilities, (HK) Ltd”. For enquiries, please contact Dr. Ho Chung Ping at 2771 1366 or cpho@hkma.org.
                    Each lecture will carry 1.5 CME points under the MCHK/HKMA CME programme. Accreditation from other colleges is pending.
                                         A Certificate of Attendance will be issued to the participants who obtain over 80% attendance rate.
                                                                                                           Please register for participation. First come, first served. (Max. capacity 120)
○   ○   ○   ○   ○   ○    ○       ○       ○        ○       ○        ○       ○       ○       ○       ○   ○   ○    ○   ○   ○   ○    ○   ○   ○   ○   ○   ○    ○   ○   ○        ○   ○   ○        ○   ○   ○   ○   ○   ○    ○   ○   ○   ○   ○   ○   ○    ○   ○   ○   ○   ○   ○    ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○    ○   ○
                                                                                                                                                                                                                                                                                                                                       Reply Slip                             ○      ○   ○


                                                                                                                                                          REGISTRATION FORM
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                                 Lecture I                                                 18 Oct 2005                                                    Lecture III                           1 Nov 2005                                                Lecture V                    15 Nov 2005
                                 Lecture II                                                25 Oct 2005                                                    Lecture IV                            8 Nov 2005                                                Lecture VI                   22 Nov 2005

                        Whole Course HK$250.00 or HK$50.00 per Lecture x                                                                                                                        .
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p.22

                                     CME Calendar
                                         Date/Time                                   Function                                                                                                                                                                           Remarks/




                                                                                                                                                                                                                  HKCPaed
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                                                                                                                                                                                                                                                                       Contact Info




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                                                                                                                                                                          HKCFP
                                                                                                                                          HKMA




                                                                                                                                                                                          COHK
                                                                                                                                                   HKCA




                                                                                                                                                                                                                                                      HKCR
                                                                                                                                                                                                                                                             CSHK
                                                                                                                                                                                                                                      HKCP
                                     Sep 2005             HKMA CME Programme                                                                                                                                                                                        Fax answer sheet to
                                                          Monthly Self-Study Series – Tactics to Improve the Judicious Use                  1                                                                                                                       Fax: 2865 0943
                                                          of Antibiotics FOR Patients with Upper Respiratory Tract Infection                                                                                                                                        By 15 October 2005
                                                          (hereafter refer to as ‘URTI’)
                                     Sep 2005             The Federation of Medical Societies of Hong Kong
                                                          The Hong Kong Medical Diary Monthly Self-Study Series –                           1
                                                          “Positive Ageing”
                                     16 Sep 2005          Tuen Mun Hospital/ HKCOG                                                                                                                                                                                  Ms. Angela Cheung
                                     (Fri)                Clinical Pathological Conference                                                  2                                                                                                                       Tel: 2468 5404
                                     12:30 – 2:00 pm      G/F, Seminar Room, Pathology Block, Tuen Mun Hospital
                                     16 Sep 2005          The Society of Physicians of Hong Kong                                                                                                                                                                    Ms. Becky Chiu
                                     (Fri)                (1) Progress in Obsessive-Compulsive Disorder                                     1                                                                                                                       Tel: 2526 2626
                                     1:30 – 3:15 pm       (2) Psychological Management of Obsessive-Compulsive Disorder
                                                          HKMA Dr. Li Shu Pui Professional Education Centre
                                     16 Sep 2005          HKU – Centre on Behavioral Health                                                                                                                                                                         Miss Loretta Fung
                                     (Fri)                Therapy in the Satir Model – Advanced Professional Course for Practitioners       3                                                                                                                       Tel: 2589 0510
                                     6:30 – 9:30 pm       Centre on Behavioral Health, The University of Hong Kong,
                                                          G/F Pauline Chan Building, 10 Sassoon Road, Pokfulam
                                     16 Sep 2005          Hong Kong Paediatric Society                                                                                                                                                                              Dr. KC Ma
                                     (Fri)                (1) Epidemiology of Pneumococcal Diseases and New Era in Vaccination              1                                                                                                                       b300597@
                                     7:00 – 8:45 pm       (2) Should We Give Pneumococcal Conjugate Vaccine for                                                                                                                                                     mailserv.cuhk.edu.hk
                                                              All Infants in Hong Kong?
                                                          Grand Ballroom, Conrad Hong Kong Hotel, Pacific Place, 88 Queensway,
                                                          Hong Kong
                                     17 Sep 2005          Hospital Authority/Hong Kong Midwives Association/HKCOG                                                                                                                                                   Winnie
                                     (Sat)                Caesarean Section on Request Seminar                                              3                                                                                                                       Tel: 2871 8700
                                     9:00 am – 12:00 noon Function Room, 2/F., Hospital Authority Building, 147B Argyle Street, Kowloon
                                     17 Sep 2005          HKU – Centre on Behavioral Health                                                                                                                                                                         Miss Loretta Fung
                                     (Sat)                Psychotherapy and Counselling in Action 2005                                      3                                                                                                                       Tel: 2589 0510
                                     2:00 – 5:00 pm       Centre on Behaviioral Health, The University of Hong Kong, G/F Pauline Chan
                                                          Building, 10 Sassoon Road, Pokfulam
                                     17 Sep 2005          Diabetes Hong Kong                                                                                                                                                                                        Ms. Choi Mei Ling
                                     (Sat)                Certificate Course on Practical Management of People with Diabetes Mellitus      1.5                                                                                                                      Tel: 2723 2087
                                     2:15 – 4:00 pm       – Session 5
                                                          (1) DM Macrovascular Complication and hypertension
                                                          (2) Practical learning – exercise
                                                          Conference room II, 1st floor, Shatin Hospital
                                     17 Sep 2005          HKU – Faculty of Medicine                                                                                                                                                                                 Ms. Anna Choy
                                     (Sat)                Certificate Course in Paediatric Cardiology 2005 (Module 2)                       4                                                                                                                       Tel: 2518 2629
                                     2:30 – 6:30 pm       Pao Yue Kong Auditorium, G/F, Hong Kong Academy of Medicine
                                     18 Sep 2005          Hong Kong Public Hospitals, Department of Health & University                                                                                                                                             Ms. Jody Cheng
                                     (Sun)                Doctors Association (PHUDA) and Hong Kong Primary Care                            2                                                                                                                       Tel: 2599 8805
                                     2:00 – 5:00 pm       Foundation (PCF)
                                                          Advanced Practical Certificate Course for Primary Care Physicians:
                                                          Practical Skills for Depression and Anxiety Disorders, Menopause and
                                                          associated mood problems – (Session 3)
                                                          Crystal Room 1, Holiday Inn Hong Kong Golden Mile, 50 Nathan Road,
                                                          Tsimshatsui, Kln
                                     20 Sep 2005          Dept of Clinical Oncology, PWH/ HKCR                                                                                                                                                                      Ms. Diane Lee
                                     (Tue)                Combined Head and Neck Meeting                                                    1                                                                                                                       Tel: 2871 8830
                                     10:00 – 11:00 am     A.K.C. Surgical Library, 4/F, Clinical Sciences Building, PWH
                                     20 Sep 2005          HKMA – Tai Po Community Network                                                                                                                                                                           Mr. Kelvin Chan
                                     (Tue)                2005                                                                              1       1      1       1       1      —              — 0.5             1         1        1      —        1      1      Tel: 2387 8555
                                     2:00 – 3:00 pm
                                     21 Sep 2005          Hong Kong College of Emergency Medicine                                                                                                                                                                   Ms. Juana Ng
                                     (Wed)                Basic Life Support Provider Course (BLS)                                          5                             4                               2                 —                 2                     Tel: 2871 8877
                                     8:30 am – 4:30 pm    A&E Training Centre, Tang Shiu Kin Hospital, 282 Queen’s Road East,
                                                          Wan Chai
                                     21 Sep 2005          Our Lady of Maryknoll Hospital                                                                                                                                                                            Tel: 2320 2121
                                     (Wed)                Grand Round: Case Presentation                                                    1
                                     12:30 – 1:45 pm      Training Room D, 1/F, OPD Block
                                     21 Sep 2005          Human Health Medical Centre                                                                                                                                                                               Dr. Jennifer Chu
                                     (Wed)                Management of Chronic Hepatitis B                                                1.5                                                                                                                      Tel: 2623 6383
                                     1:30 - 3:00 pm       House of Canton, Festival Walk, Kowloon Tong, Kowloon
HKMA CME BULLETIN • SEPTEMBER 2005




                                     21 Sep 2005          HA – Princess Margaret Hospital, Internal Medicine                                                                                                                                                        Ms. Esvin Chan
                                     (Wed)                TB as example of air borne infection                                              1                                                                                                                       Tel: 2990 3772
                                     2:00 – 3:00 pm       Hospital Hall, G8, Princess Margaret Hospital
                                     21 Sep 2005          Dept of Clinical Oncology, PWH/HKCR                                                                                                                                                                       Ms. Diane Lee
                                     (Wed)                Topic Review                                                                      1                                                                                                                       Tel: 2871 8830
                                     2:30 – 3:30 pm       Lecture Room, Dept of Clinical Oncology, PWH
                                     22 Sep 2005          Prince of Wales Hospital/ HKCOG                                                                                                                                                                           Ms. Alice Lai
                                     (Thur)               Infertility and Lifestyle                                                         1                                                                                                                       Tel: 2632 2810
                                     12:30 – 1:30 pm      Allan Chang Seminar Room, 1E, O&G Dept, PWH
                                     22 Sep 2005          HKDU – Sham Shui Po Study Group                                                                                                                                                                           Tel: 2388 2728
                                     (Thur)               Dual Inhibition: Shaping the Future of Lipid Management                           1
                                     12:30 – 3:00 pm      Garden Restaurant, Garden Bakery Centre, 58 Castle Peak Road, Kowloon
                                     22 Sep 2005          HKMA CME Programme                                                                                                                                                                                        Ms. Charlene Cheung
                                     (Thur)               CME Certificate Course on Advances in Chronic Diseases Management –               1       1      1       1       1      1 0.5 — 0.5                                1 0.5# 1                 1      1      Tel: 2105 4873
                                     1:00 – 3:00 pm       Diabetes Management from Therapy to Practice
                                                          HKMA Dr. Li Shu Pui Professional Education Centre, 2/F,
                                                          Chinese Club Building, 21-22 Connaught Road, Central, HK



                                     *   Colleges accreditation pending
                                     #   Total CME points for entire course
                                                                                                                                                CME Calendar                                                                                           p.23




    Date/Time                                    Function                                                                                                                                                                           Remarks/




                                                                                                                                                                              HKCPaed
                                                                                                                                                                                        HKCPath
                                                                                                      MCHK &




                                                                                                                                                                     HKCORL




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                                                                                                                                                                                                                                   Contact Info




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                                                                                                                                      HKCFP
                                                                                                      HKMA




                                                                                                                                                      COHK
                                                                                                               HKCA




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                                                                                                                                                                                                                         CSHK
                                                                                                                                                                                                  HKCP
22 Sep 2005          The Federation of Medical Societies of Hong Kong & Hong Kong                                                                                                                                               Tel: 2527 8898
(Thur)               Ophthalmological Society                                                          1.5
7:00 – 8:30 pm       Certificate Course on General Ophtalmology
                     (1) Paediatric Ophthalmology
                     (2) Squint
                     Room 103, 1/F, Duke of Windsor Social Service Building, 15 Hennessy Road,
                     Wanchai, HK
22 – 24 Sep 2005     HKU – Faculty of Medicine, Hong Kong Chapter, American                                                                                                                                                     Mr. Lobo Yau
(Thu – Sat)          College of Surgeons                                                               13#                                                                                                                      Tel: 2855 4885
                     Advanced Trauma Life Support (ATLS) Student Course
                     Skills Development Centre, Department of Surger y, University of Hong Kong
                     Medical Centre, Queen Mary Hospital
23 Sep 2005          Tuen Mun Hospital/ HKCOG                                                                                                                                                                                   Ms. Angela Cheung
(Fri)                Prenatal Diagnosis – Update                                                        1                                                                                                                       Tel: 2468 5404
12:30 – 1:30 pm      Room F2029, 2/F, Special Block, Tuen Mun Hospital
23 Sep 2005          Sun Yat-sen University of Medical Science Hong Kong Alumni                                                                                                                                                 Ms. Alice Ma
(Fri)                Association, Association of Medical Practitioners of Societies’ Clinics,           1                                                                                                                       Tel: 2384 8490
1:00 – 3:15 pm       The Hong Kong China Association of Medical Specialism
                     New Advance in Cancer Treatments
                     HKMA Dr. Li Shu Pui Professional Education Center, 2/F Chinese Club Building,
                     21-22 Connaught Road, Central, Hong Kong
23 Sep 2005          City Medical Center, Hong Kong                                                                                                                                                                             Ms. Candy Choi
(Fri)                (1) Recent Advances in the Management of HCC                                      1.5                                                                                                                      candy.k.choi@gsk.com
1:45 – 3:15 pm       (2) Hepatitis B Therapy: What can we achieve?                                                                                                                                                              Fax: 2506 1378
                     Langham Place Hotel, 555 Shanghai Street, Mongkok, Kowloon, Hong Kong
23 Sep 2005          Union Hospital                                                                                                                                                                                             Ms. Fion Chow
(Fri)                Paediatric minimally invasive surgery – new frontiers                              1                             1                                        1                                         1      Tel: 2608 3184
2:00 – 3:00 pm       Seminar Room, 2/F, Medical Centre, Union Hospital
24 Sep 2005          HKU – Centre on Behavioral Health                                                                                                                                                                          Miss Loretta Fung
(Sat)                Therapy in the Satir Model – Advanced Professional Course for Practitioners        4                                                                                                                       Tel: 2589 0510
9:00 am – 1:00 pm    Centre on Behavioral Health, The University of Hong Kong, G/F Pauline Chan
                     Building, 10 Sassoon Road, Pokfulam
24 Sep 2005          HA/HKCCM                                                                                                                                                                                                   Ms. Isabella Wong
(Sat)                Case presentations and journal presentations in areas related to                   3                                                                                                                       Tel: 2871 8844
9:30 am – 12:00 noon Administrative Medicine
                     Seminar Room 1, M/F, Hospital Authority Building
24 Sep 2005          HKU – Faculty of Medicine                                                                                                                                                                                  Ms. Leung
(Sat)                Maternal-Fetal Medicine Grand Round Pregnancy outcomes of                         1.5                                                                                                                      Tel: 2855 4517
1:00 – 2:30pm        333 chromosomal abnormalities from 19,517 amniocenteses performed
                     for advanced maternal age
                     Lecture Theatre, 6/F Professorial Block, Queen Mar y Hospital, Pokfulam,
                     Hong Kong
24 Sep 2005          The Hong Kong Society for Colposcopy and Cervical Pathology;                                                                                                                                               Dr. Vivian Yu
(Sat)                the Department of Obs & Gyn, Princess Margaret Hospital/ HKCOG                     3                             3       3                                          3                                      Tel: 2990 3159
1:45 – 5:15 pm       Colposcopy Workshop 2005
                     Hall, 8/F, Block G, Princess Margaret Hospital
24 Sep 2005          Hong Kong Stroke Society                                                                                                                                                                                   Dr. Ng Ping Wing
(Sat)                Hong Kong Stroke Society Annual Meeting                                            3                             3                                                 2.5 2                     2 2.5         Tel: 3513 4829
2:00 – 5:00 pm       Ching Room, 4/F, Sheraton Hotel, Kowloon
24 Sep 2005          HKU – Centre on Behavioral Health                                                                                                                                                                          Miss Loretta Fung
(Sat)                Therapy in the Satir Model – Advanced Professional Course for Practitioners        3                                                                                                                       Tel: 2589 0510
2:00 – 5:00 pm       Centre on Behavioral Health, The University of Hong Kong,
                     G/F Pauline Chan Building, 10 Sassoon Road, Pokfulam
25 Sep 2005          HKU – Centre on Behavioral Health                                                                                                                                                                          Miss Loretta Fung
(Sun)                Therapy in the Satir Model – Advanced Professional Course for Practitioners        4                                                                                                                       Tel: 2589 0510
9:00 am – 1:00 pm    Centre on Behavioral Health, The University of Hong Kong, G/F Pauline Chan
                     Building, 10 Sassoon Road, Pokfulam
25 Sep 2005          Hong Kong Doctors Union                                                                                                                                                                                    Tel: 2388 2728
(Sun)                The 82nd HKDU Sunday Afternoon Symposium                                          1.5
1:00 - 4:00 pm       Lecture Hall, 8th Floor, Block G, Princess Margaret Hospital, Kwai Chung, N.T.
25 Sep 2005          The Society of Physicians of Hong Kong                                                                                                                                                                     Ms. Becky Chiu
(Sun)                Sunday Symposium                                                                  2.5                                                                                                                      Tel: 2526 2626
1:00 - 4:30 pm       (1) Update of Benign Prostate Hypertrophy Treatment 2005
                     (2) The Approach of Osteoporosis Management
                                                                                                                                                                                                                                                         HKMA CME BULLETIN • SEPTEMBER 2005




                     (3) Current Opinion on Pain Management
                     HKMA Dr.Li Shu Pui Professional Education Centre
25 Sep 2005          CUHK – Dept of Medicine & Therapeutics                                                                                                                                                                     Ms. Isabella Fu
(Sun)                CUHK Diploma Programme in Advanced Internal Medicine 2004-05                       3      15# 10# 20#                    5# 1                   2# 18#                                              18#    Tel: 2632 3996
1:30 – 4:30 pm       – Osteoporosis
                     Plaza Conference Centre, 35/F Central Plaza, 18 Harbour Road, HK
25 Sep 2005          HKMA CME Programme, Kwong Wah Hospital                                                                                                                                                                     Members: $50
(Sun)                HKMA Structured CME Programme at KWH (6) – Update on Management                    3       3     —        3 2.5 3                1      — 1.5 2 1.5 2                                3       3      3      Non-M: $80
2:00 – 5:00 pm       of Viral Hepatitis and Approach to Chronic Diarrhea Syndrome                                                                                                                                               Tel: 2861 1979
                     Lecture Theatre, 10/F, Yu Chun Keung Memorial Medical Centre,
                     Kwong Wah Hospital, Kln
25 Sep 2005          HKU – Centre on Behavioral Health                                                                                                                                                                          Miss Loretta Fung
(Sun)                Therapy in the Satir Model – Advanced Professional Course for Practitioners        3                                                                                                                       Tel: 2589 0510
2:00 – 5:00 pm       Centre on Behavioral Health, The University of Hong Kong,
                     G/F Pauline Chan Building, 10 Sassoon Road, Pokfulam
25 Sep 2005          Hong Kong Doctors Union                                                                                                                                                                                    Tel: 2388 2728
(Sun)                The 83rd HKDU Sunday Afternoon Symposium                                           2
3:30 – 6:00 pm       Lecture Hall, 8th Floor, Block G, Princess Margaret Hospital, Kwai Chung, N.T.

*   Colleges accreditation pending
#   Total CME points for entire course
p.24                                         CME Calendar




                                         Date/Time                                   Function                                                                                                                                                                           Remarks/




                                                                                                                                                                                                                  HKCPaed
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                                                                                                                                                                                                         HKCORL




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                                                                                                                                                                                                                                                                       Contact Info




                                                                                                                                                                                                 HKCOS
                                                                                                                                                                          HKCFP
                                                                                                                                          HKMA




                                                                                                                                                                                          COHK
                                                                                                                                                   HKCA




                                                                                                                                                                                                                                                      HKCR
                                                                                                                                                                                                                                                             CSHK
                                                                                                                                                                                                                                      HKCP
                                     25 Sep 2005           CUHK – Dept of Medicine & Therapeutics                                                                                                                                                                   Ms. Isabella Fu
                                     (Sun)                 CUHK Diploma Programme in Advanced Internal Medicine 2004-05                     3      15# 10# 20#                    5# 1                   2# 18#                                              18#    Tel: 2632 3996
                                     5:00 – 8:00 pm        – Dementia and nutrition in elderly
                                                           Plaza Conference Centre, 35/F Central Plaza, 18 Harbour Road, HK
                                     26 Sep 2005           The College of Surgeons of Hong Kong                                                                                                                                                                     Ms. Cindy Leung
                                     (Mon)                 Luncheon Symposium: A Multi-displinary Approach in the Management of Scar        2                                                                                                                       Tel: 2871 8799
                                     1:00 – 3:00 pm        Function Room 205, 2nd Floor, Hospital Authority Building,
                                                           147B Argyle Street, Kowloon
                                     26 Sep 2005           HKU – HKU Family Institute                                                                                                                                                                               Miss Wong Oi Ling
                                     (Mon)                 Certificate Course in Family Therapy – Level 1 (Session 1)                       3                                                                                                                       Tel: 2859 5300
                                     6:40 – 9:40 pm        Lecture Hall, HKU Family Institute, 5/F Tsan Yuk Hospital, 30 Hospital Road,
                                                           Sai Ying Pun, HK
                                     26 Sep 2005           The Federation of Medical Societies of Hong Kong & Hong Kong                                                                                                                                             Tel: 2527 8898
                                     (Mon)                 Neurosurgical Society – Nurse Chapter                                           1.5
                                     7:00 – 8:30 pm        Certificate Course on Elementary Neurosurgical Nursing –
                                                           Session 1: Neurological Assessment
                                                           Room 204, 2/F, Duke of Windsor Social Service Building, 15 Hennessy Road,
                                                           Wanchai, HK
                                     27 Sep 2005           Pamela Youde Neteresole Eastern Hospital/HKCOG                                                                                                                                                           Ms. Angel Hui
                                     (Tue)                 Topic Seminar                                                                    1                                                                                                                       Tel: 2595 6408
                                     8:30 – 9:30 am        To be advised
                                     27 Sep 2005           Dept of Clinical Oncology, PWH/ HKCR                                                                                                                                                                     Ms. Diane Lee
                                     (Tue)                 Combined Head and Neck Meeting                                                   1                                                                                                                       Tel: 2871 8830
                                     10:00 – 11:00 am      A.K.C. Surgical Library, 4/F, Clinical Sciences Building, PWH
                                     27 Sep 2005           HKDU Shatin Study Group                                                                                                                                                                                  Tel: 2388 2728
                                     (Tue)                 Arthritis and NSAIDs: Any Reliable Choice                                        1
                                     1:00 – 3:00 pm        Regal Riverside Hotel, Shatin, N.T.
                                     27 Sep 2005           HA – Tseung Kwan O Hospital, Orthopaedics & Traumatology                                                                                                                                                 Ms. Peggy Lee
                                     (Tue)                 Acadmic Activity for General Private Practitioners – Current concepts on         2                                                                                                                       Tel: 2208 0752
                                     1:30 – 3:00 pm        Sports Knee Injuries
                                                           Auditorium, G/F Tseung Kwan O Hospital
                                     27 Sep 2005           HKU – Centre on Behavioral Health                                                                                                                                                                        Miss Loretta Fung
                                     (Tue)                 Psychotherapy and Counselling in Action 2005                                     3                                                                                                                       Tel: 2589 0510
                                     4:00 – 7:00 pm        Centre on Behaviioral Health, The University of Hong Kong,
                                                           G/F Pauline Chan Building, 10 Sassoon Road, Pokfulam
                                     27 Sep 2005           HKU – HKU Family Institute                                                                                                                                                                               Miss Wong Oi Ling
                                     (Tue)                 Certificate Course in Family Therapy – Level II (Session 1)                      3                                                                                                                       Tel: 2859 5300
                                     6:40 – 9:40 pm        Lecture Room, HKU Family Institute, 5/F Tsan Yuk Hospital, 30 Hospital Road,
                                                           Sai Ying Pun, HK
                                     28 Sep 2005           Our Lady of Maryknoll Hospital                                                                                                                                                                           Tel: 2320 2121
                                     (Wed)                 Grand Round: Update in Management of Parkinsonism (part 2)                       1
                                     12:30 – 1:45 pm       Training Room D, 1/F, OPD Block
                                     28 Sep 2005           Queen Elizabeth Hospital/HKCOG                                                                                                                                                                           Ms. Betty Cheng
                                     (Wed)                 Topic Seminar                                                                    1                                                                                                                       Tel: 2958 6049
                                     1:00 – 2:00 pm        B3, Seminar Room, Queen Elizabeth Hospital
                                     28 Sep 2005           United Christian Hospital/HKCOG                                                                                                                                                                          Ms. Michelle Yeung
                                     (Wed)                 NND and IUD Audit 6-8/05; Journal Club                                           1                                                                                                                       Tel: 3513 4851
                                     2:00 – 3:30 pm        Conference Room, Hospital Library, 1/F, Block H, UCH
                                     28 Sep 2005           Hong Kong Academy of Medicine                                                                                                                                                                            Tel: 2871 8888
                                     (Wed)                 (1) Cerebral Pals                                                                2
                                     2:00 – 4:00 pm        (2) Basics of Paediatric Orthopaedic
                                                           Lecture Theatre, M Block, Queen Elizabeth Hospital, Kowloon
                                     28 Sep 2005           Dept of Clinical Oncology, PWH/ HKCR                                                                                                                                                                     Ms. Diane Lee
                                     (Wed)                 Topic Review                                                                     1                                                                                                                       Tel: 2871 8830
                                     2:30 – 3:30 pm        Lecture Room, Dept of Clinical Oncology, PWH
                                     28 Sep 2005           Hong Kong College of Emergency Medicine                                                                                                                                                                  Ms. Juana Ng
                                     (Wed)                 Conjoint Toxicology Round (every other months)                                   2                                                                                                                       Tel: 2871 8877
                                     5:00 – 7:30 pm        Lecture Theatre, G/F, Block F, Ng Wing Tong Block, UCH
                                     28 Sep 2005           Hong Kong Society of Paediatric Respirology                                                                                                                                                              Dr. T. Y Miu
                                     (Wed)                 Chronic Cough in Children                                                        2                                                                                                                       Tel: 2958 6656
                                     6:30 – 8:00 pm        Seminar Room, 1/F, Nursing Quarters, Kwong Wah Hospital
                                     28 Sep 2005           The Federation of Medical Societies of Hong Kong & The Hong Kong                                                                                                                                         Tel: 2527 8898
                                     (Wed)                 Thoracic Society Ltd & American College of Chest Physicians                     1.5
                                     7:00 – 8:30 pm        (HK and Macau Chapter)
HKMA CME BULLETIN • SEPTEMBER 2005




                                                           Certificate Course in Respiratory Medicine – Session 1
                                                           – Lung Cancer: New challenges in the Diagnosis and Treatment
                                                           Room 204, Duke of Windsor Social Service Building, 15 Hennessy Road,
                                                           Wanchai, HK
                                     29 Sep 2005           Prince of Wales Hospital/HKCOG                                                                                                                                                                           Ms. Alice Lai
                                     (Thur)                Perinatal Meeting                                                                1                                                                                                                       Tel: 2632 2810
                                     12:30 – 1:30 pm       Allan Chang Seminar Room, 1E, O&G Dept, PWH
                                     29 Sep 2005           HKMA CME Programme                                                                                                                                                                                       Ms. Charlene Cheung
                                     (Thur)                CME Certificate Course on Advances in Chronic Diseases Management –              1                                                                                                                       Tel: 2105 4873
                                     1:00 – 3:00 pm        Role of Antiplatelet Therapy in Ischaemic Events
                                                           HKMA Dr. Li Shu Pui Professional Education Centre, 2/F,
                                                           Chinese Club Building, 21-22 Connaught Road, Central, HK
                                     29 Sep 2005           The Federation of Medical Societies of Hong Kong & Hong Kong                                                                                                                                             Tel: 2527 8898
                                     (Thur)                Ophthalmological Society                                                        1.5
                                     7:00 – 8:30 pm        Certificate Course on General Ophtalmology
                                                           (1) Glaucoma
                                                           (2) Retinal Detachment
                                                           Room 103, 1/F, Duke of Windsor Social Service Building, 15 Hennessy Road,
                                                           Wanchai, HK
                                     *   Colleges accreditation pending
                                     #   Total CME points for entire course
                                                                                                                                               CME Calendar                                                                                        p.25




    Date/Time                                   Function                                                                                                                                                                           Remarks/




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                                                                                                                                                                                                                 HKCR
                                                                                                                                                                                                                        CSHK
                                                                                                                                                                                                 HKCP
29 – 30 Sep 2005      Hong Kong College of Emergency Medicine                                                                                                                                                                  Ms. Juana Ng
(Thur – Fri)          Advanced Cardiovascular Life Support Provider Course (ACLS)                     10#                            8#                             4#                 —                4#                     Tel: 2871 8877
                      A&E Training Center, Tang Shiu Kin Hospital, 282 Queen’s Road East,
                      Wan Chai, HK
30 Sep 2005           The Society of Physicians of Hong Kong                                                                                                                                                                   Ms. Becky Chiu
(Fri)                 Update on Treatment of Breast and Colorectal Cancer                              1                                                                                                                       Tel: 2526 2626
1:30 – 3:00 pm        HKMA Dr. Li Shu Pui Professional Education Centre
30 Sep 2005           Union Hospital                                                                                                                                                                                           Ms. Fion Chow
(Fri)                 Recent advances in cardiac imaging and their clinical applications               1                             1                                                           1               1             Tel: 2608 3184
2:00 – 3:00 pm        Seminar Room, 2/F, Medical Centre, Union Hospital
30 Sep 2005           OM-Review Meeting                                                                                                                                                                                        Ms. Isabella Wong
(Fri)                 111 Health retirement – Inconsistencies in decisions between doctors             2                                                                                                                       Tel: 2871 8844
2:30 – 4:30 pm        25/F, Harbour Building, Central, HK
Oct 2005              The Federation of Medical Societies of Hong Kong
                      The Hong Kong Medical Diary Monthly Self-Study Series –                          1
                      “Recent Advances in Hand and Microsurgery”
2 Oct 2005            St. Teresa’s Hospital                                                                                                                                                                                    Dr. Lawrence
(Sun)                 Incorporating Targeted Therapy in your practice for patients                     2             —        1 1.5                                                              1.5             1.5 1.5       Siu Hung Chan
10:00 – 11:30 am      with colorectal cancer                                                                                                                                                                                   Tel: 2771 2312
                      9/F, Conference Room, St. Teresa’s Hospital
2 Oct 2005            CUHK – Department of Medicine and Therapeutics                                                                                                                                                           Ms. Noel Tam
(Sun)                 CUHK Diploma Programme in Advances in Medicine 2005 – 2006                       3                                                                                                                       Tel: 2632 3173
1:30 – 4:30 pm        – a) Pituitary Disorders
                      Kai Cheong Tong, G/F Postgraduate Education Center,
                      Prince of Wales Hospital, Shatin, HK
2 Oct 2005            CUHK – Department of Medicine and Therapeutics                                                                                                                                                           Ms. Noel Tam
(Sun)                 CUHK Diploma Programme in Advances in Medicine 2005 – 2006                       3                                                                                                                       Tel: 2632 3173
5:00 – 8:00 pm        – b) Introduction to dermatology and topical therapy
                      Kai Cheong Tong, G/F Postgraduate Education Center,
                      Prince of Wales Hospital, Shatin, HK
3 Oct 2005            HKU – HKU Family Institute                                                                                                                                                                               Miss Wong Oi Ling
(Mon)                 Certificate Course in Family Therapy – Level 1 (Session 2)                       3                                                                                                                       Tel: 2859 5300
6:40 – 9:40 pm        Lecture Hall, HKU Family Institute, 5/F Tsan Yuk Hospital, 30 Hospital Road,
                      Sai Ying Pun, HK
3 Oct 2005            The Federation of Medical Societies of Hong Kong & Hong Kong                                                                                                                                             Tel: 2527 8898
(Mon)                 Neurosurgical Society – Nurse Chapter                                           1.5
7:00 – 8:30 pm        Certificate Course on Elementary Neurosurgical Nursing
                      – Session 2: Neurological Investigations
                      Room 204, 2/F, Duke of Windsor Social Service Building, 15 Hennessy Road,
                      Wanchai, HK
3 Oct 2005            Hong Kong Baptist Hospital                                                                                                                                                                               Ms. Cheng
(Mon)                 Session A: Role of Aldosterone Receptor Blockade in the Management of           1.5                                                                                                                      Tel: 2963 5524
7:30 – 9:00 pm        Heart Failure
                      Session B: Latest Clinical Evidence in Hypertension Management –
                      the ASCOT Study
                      The Ballroom, 3/F, Sheraton Hong Kong Hotel & Towers
4 Oct 2005            HA – Pok Oi Hospital, Internal Medicine Dept                                                                                                                                                             Dr. Eddie Chow/
(Tue)                 Hyperlipideamia                                                                  1                                                                                                                       Ms. Carmen Cheung
8:45 – 10:45 am       Conference Room 1AB, 1/F Admin Building, Pok Oi Hospital                                                                                                                                                 Tel: 2486 8420
4 Oct 2005            HA – Caritas Medical Centre, Family Medicine Dept co-joint with                                                                                                                                          Ms. Helen Lo
(Tue)                 HKCFP, HKDU, HKAM, HKMA                                                          1                                                                                                                       Tel: 3408 7921
1:30 – 2:45 pm        Retinal detachment – Diagnosis and Management
                      Staff Lounge, 1/F Wai Oi Building, CMC
4 Oct 2005            HKU – HKU Family Institute                                                                                                                                                                               Miss Wong Oi Ling
(Tue)                 Certificate Course in Family Therapy – Level II (Session 2)                      3                                                                                                                       Tel: 2859 5300
6:40 – 9:40 pm        Lecture Room, HKU Family Institute, 5/F Tsan Yuk Hospital, 30 Hospital Road,
                      Sai Ying Pun, HK
5 Oct 2005            Hong Kong College of Emergency Medicine                                                                                                                                                                  Ms. Juana Ng
(Wed)                 Basic Life Support Provider Course (BLS)                                         5                             4                               2                 —                 2                     Tel: 2871 8877
8:30am – 4:30 pm      A&E Training Centre, Tang Shiu Kin Hospital, 282 Queen’s Road East, Wan Chai
5 Oct 2005            HKDU Tsuen Wan Study Group                                                                                                                                                                               Tel: 2388 2728
(Wed)                 Electrolyte Disorder                                                             1
1:00 – 3:00 pm        Lecture Theatre, 3/F, Block A, Yan Chai Hospital Nursing School,
                      Tsuen Wan, N.T.
                                                                                                                                                                                                                                                     HKMA CME BULLETIN • SEPTEMBER 2005




5 Oct 2005            HA – Princess Margaret Hospital, Internal Medicine Dept                                                                                                                                                  Ms. Esvin Chan
(Wed)                 A patient with hyponatremia, hypokalemia, hypomagnesemia and                     1                                                                                                                       Tel: 2990 3772
2:00 – 3:00 pm        metabolic alkalosis
                      Hospital hall, G8, Princess Margaret Hospital
5 Oct 2005            HA – Infectious Disease Control Centre & Infection control Branch                                                                                                                                        Mr. Ivan Wong
(Wed)                 14th Clinical Infection and Public Health Forum                                  1                                                                                                                       Tel: 3523 0183
6:00 – 7:00 pm        Lecture Theatre, G/F, CHP Building
5 Oct 2005            The Federation of Medical Societies of Hong Kong & The Hong Kong                                                                                                                                         Tel: 2527 8898
(Wed)                 Thoracic Society Ltd & American College of Chest Physicians                     1.5
7:00 – 8:30 pm        (HK and Macau Chapter)
                      Certificate Course in Respiratory Medicine – Session 2
                      – SARS and H5N1: What Have We Learnt?
                      Room 204, Duke of Windsor Social Service Building, 15 Hennessy Road,
                      Wanchai, HK
6 Oct 2005            HA – Kwong Wah Hospital, Obstetrics & Gynaecology Dept                                                                                                                                                   Ms. Vivian Chan
(Thur)                Cardiotocography Workshop                                                        1                                                                                                                       Tel: 3517 5056
1:00 – 2:00 pm        Seminar Room, 10/F, North Wing, Kwong Wah Hospital



*   Colleges accreditation pending
#   Total CME points for entire course
p.26                                         CME Calendar




                                         Date/Time                                    Function                                                                                                                                                                            Remarks/




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                                                                                                                                                                                                                                                        HKCR
                                                                                                                                                                                                                                                               CSHK
                                                                                                                                                                                                                                        HKCP
                                     6 Oct 2005            HKMA CME Programme                                                                                                                                                                                         Ms. Charlene Cheung
                                     (Thur)                CME Certificate Course on Advances in Chronic Diseases Management                  1                                                                                                                       Tel: 2105 4873
                                     1:00– 3:00 pm         – Beyond Bone Density Bone Strength & Osteoporosis
                                                           HKMA Dr. Li Shu Pui Professional Education Centre, 2/F,
                                                           Chinese Club Building, 21-22 Connaught Road, Central, HK
                                     6 Oct 2005            HA – Caritas Medical Centre, Ophthalmology Dept co-joint with                                                                                                                                              Ms Greta Cheung
                                     (Thur)                private specialists from HKS/KWC Ophthalmologists                                  3                                                                                                                       Tel: 3408 7421
                                     2:00 – 6:00 pm        Seminar and live surgery on refractive surgery
                                                           Hong Kong Sanatorium
                                     6 Oct 2005            Hong Kong Doctors Union                                                                                                                                                                                    Tel: 2388 2728
                                     (Thur)                Early Differential Diagnosis and Treatment of Lung Disease                         1
                                     2:15 – 3:15 pm        (Video Cassette Session)
                                                           Room 901, Hang Shing Bldg, 363-373, Nathan Road, Kln
                                     6 Oct 2005            The Federation of Medical Societies of Hong Kong & Hong Kong                                                                                                                                               Tel: 2527 8898
                                     (Thur)                Ophthalmological Society                                                          1.5
                                     7:00 – 8:30 pm        Certificate Course on General Ophtalmology
                                                           (1) Common Macular Diseases
                                                           (2) Diabetic Retinopathy
                                                           Room 103, 1/F, Duke of Windsor Social Service Building, 15 Hennessy Road,
                                                           Wanchai, HK
                                     6 – 7 Oct 2005        HA – Pamela Youde Nethersole Eastern Hospital, General Surgery Dept                                                                                                                                        Ms. Olivia Ho
                                     (Thur – Fri)          9th Digestive Endoscopy Course                                                    10#                                                                                                                      Tel: 2595 6362
                                                           Lecture Theatre, Multi-centre Block B, G/F,
                                                           Pamela Youde Nethersole Eastern Hosptial
                                     7 Oct 2005            Hong Kong Baptist Hospital                                                                                                                                                                                 Tel: 2339 8888
                                     (Fri)                 Survival of minimal invasive surgery in private sector                            1.5
                                     8:00 – 9:30 am        The Chapel, 9/F, Hong Kong Baptist Hospital
                                     7 Oct 2005            HKU – Centre on Behavioral Health                                                                                                                                                                          Miss Loretta Fung
                                     (Fri)                 Therapy in the Satir Model – Advanced Professional Course for Practitioners        3                                                                                                                       Tel: 2589 0510
                                     6:30 – 9:30 pm        Centre on Behavioral Health, The University of Hong Kong,
                                                           G/F Pauline Chan Building, 10 Sassoon Road, Pokfulam
                                     8 Oct 2005            CUHK – Department of Social Work, Kwai Chung Hospital –                                                                                                                                                    Miss Vienna King
                                     (Sat)                 Yaumatei Child & Adolescent Psychiatric Centre                                    10#                            10#                                     18#                        —                      Tel: 2609 8783
                                     9:30am – 5:30 pm      Integrated Training Course on Childhood and Adolescent Disorders
                                                           (Session 1)
                                                           SWC LT1, Lecture Theatre, Shaw College, CUHK
                                     8 Oct 2005            Social Hygiene Service, PHSB, CHP, DH                                                                                                                                                                      Miss Landy Lee
                                     (Sat)                 Interactive STI (Sexually Transmitted Infections) Workshop for clinicians 2005     2                                                                                                                       Tel: 2540 9804
                                     2:15 – 4:30 pm        Cheung Sha Wan Dermatological Clinic, 3/F West Kowloon Health Centre,
                                                           303 Cheung Sha Wan Road, Shamshuipo, Kowloon
                                     8 Oct 2005            HKMA CME Programme ,Our Lady of Maryknoll Hospital                                                                                                                                                         Ms. Clara Tsang
                                     (Sat)                 Refresher Course for Health Care Providers 2005/2006 – Cognitive                   2      15# 10#                10# — 3# — 2#                                     24# 1            —        2      2      Tel: 2320 2121
                                     2:30 – 4:30 pm        behavioural therapy for beginners (Psychological treatment for depression)
                                                           Training Room II, 1/F, OPD Block, Our Lady of Maryknoll Hospital,
                                                           118 Shatin Pass Road, Wong Tai Sin, Kln
                                     8 Oct 2005            Hong Kong Paediatric Society & Hong Kong College of Paediatricians                                                                                                                                         Ms. Vivienne Fung
                                     (Sat)                 Update Series on Child Health 2005 (Session 4) –                                   3                                                                                                                       Tel: 2859 6421
                                     2:30 – 5:00 pm        (1) Therapeutic Cardiac Catheterization in Children
                                                           (2) New Trends in Infection Control
                                                           Ballroom, 3/F, Sheraton Hong Kong Hotel, Tsim Sha Tsui, Kowloon
                                     8 Oct 2005            HKU – Faculty of Medicine                                                                                                                                                                                  Ms. Anna Choy
                                     (Sat)                 Certificate Course in Paediatric Cardiology 2005 (Module 3)                        4                                                                                                                       Tel: 2518 2629
                                     2:30 – 6:30 pm        Pao Yue Kong Auditorium, G/F, Hong Kong Academy of Medicine
                                     8 – 9 Oct 2005        HKU – Faculty of Medicine                                                                                                                                                                                  Mr. Lobo Yau
                                     (Sat – Sun)           Advances in Deafness Management                                                   10#                                                                                                                      Tel: 2855 4885
                                                           Lecture: Cheung Kung Hai Lecture Theatre 2 & 3, G/F W illiam
                                                           M. W. Mong Block, Faculty of Medicine Building, 21 Sassoon Road, HK
                                                           Workshop: Room LG-S2, G/F Laboratory Block, Faculty of Medicine Building,
                                                           21 Sassoon Road, HK
                                     9 Oct 2005            Hong Kong Society of Paediatric Respiratory                                                                                                                                                                Ms. Sandy Chung
                                     (Sun)                 Annual Scientific Meeting                                                          5                                                                                                                       Tel: 2116 4349
                                     8:30 am – 5:00 pm     Sheraton Hong Kong Hotel & Towers
                                     10 Oct 2005           The Federation of Medical Societies of Hong Kong & Hong Kong                                                                                                                                               Tel: 2527 8898
                                     (Mon)                 Neurosurgical Society – Nurse Chapter                                             1.5
HKMA CME BULLETIN • SEPTEMBER 2005




                                     7:00 – 8:30 pm        Certificate Course on Elementary Neurosurgical Nursing –
                                                           Session 3: Concept of Raised ICP Nursing Management of
                                                           Patient with Increased ICP & ICP Monitoring
                                                           Room 204, 2/F, Duke of Windsor Social Service Building, 15 Hennessy Road,
                                                           Wanchai, HK
                                     10 Oct 2005           Hong Kong Surgical Specialists                                                                                                                                                                             Brenda Cresswell
                                     (Mon)                 Hong Kong Surgical Specialists Lecture 2005 –                                      2      1.5                    2       1 0.5 —                                             0.5                    1.5    Tel: 2715 4577
                                     7:30 – 9:00 pm        (1) Uterine fibroid – Management
                                                           (2) Update on management of cataract & ARMD
                                                           Hong Kong Surgical Specialist, 715 Jardine House, Central, HK
                                     10 Oct 2005           HKU – HKU Family Institute                                                                                                                                                                                 Miss Wong Oi Ling
                                     (Mon)                 Certificate Course in Family Therapy – Level 1 (Session 3)                         3                                                                                                                       Tel: 2859 5300
                                     6:40 – 9:40 pm        Lecture Hall, HKU Family Institute, 5/F Tsan Yuk Hospital, 30 Hospital Road,
                                                           Sai Ying Pun, HK
                                     12 Oct 2005           Hong Kong College of Emergency Medicine                                                                                                                                                                    Ms. Juana Ng
                                     (Wed)                 Basic Life Support Provider Course (BLS)                                           5                             4                              2                  —                 2                     Tel: 2871 8877
                                     8:30 am – 4:30 pm     A&E Training Centre, Tang Shiu Kin Hospital, 282 Queen’s Road East,
                                                           Wan Chai

                                     *   Colleges accreditation pending
                                     #   Total CME points for entire course
                                                                                                                                                 CME Calendar                                                                                        p.27




    Date/Time                                   Function                                                                                                                                                                             Remarks/




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                                                                                                                                                                                                                          CSHK
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12 Oct 2005           Human Health Medical Centre                                                                                                                                                                                Dr. Jennifer Chu
(Wed)                 Childhood Asthma                                                                  1.5                                                                                                                      Tel: 2623 6383
1:30 – 3:00 pm        Festive China, Festival Walk, Kowloon
12 Oct 2005           Department of Obstetrics & Gynaecology, HKU/ HKCOG                                                                                                                                                         Ms. Ophelia Fung
(Wed)                 MFM/ OBS Journal Club                                                              1                                                                                                                       Tel: 2855 3400
4:00 – 5:00 pm        K509, 5/F, Block K, Queen Mary Hospital
12 Oct 2005           The Federation of Medical Societies of Hong Kong & The Hong Kong                                                                                                                                           Tel: 2527 8898
(Wed)                 Thoracic Society Ltd & American College of Chest Physicians                       1.5
7:00 – 8:30 pm        (HK and Macau Chapter)
                      Certificate Course in Respiratory Medicine – Session 3
                      – Community Acquired Pneumonia and Tuberculosis
                      Room 204, Duke of Windsor Social Service Building, 15 Hennessy Road,
                      Wanchai, HK
13 Oct 2005           Hong Kong Sanatorium & Hospital, Orthopaedic and Sports Medicine                                                                                                                                           Dr. W. C. Wu
(Thur)                Orthopaedic Clinical Meeting                                                       1             —        1 10#                          2                         12# —                     1             Tel: 2835 7890
8:30 – 9:30 am        Room 1103, 11/F, Li Shu Pui Block, Hong Kong Sanatorium & Hospital
13 Oct 2005           HKMA, HK Sanatorium & Hospital                                                                                                                                                                             Tel: 2861 1979
(Thur)                HKMA Structured CME Programme with HKS&H 2005 (Jul – Dec)                          1       1      1 0.5 1                1 0.5 — 0.5 1                              1 0.5 1                  1      1
1:30 – 3:00 pm        – Nuclear Medicine Imaging & Treatment
                      HKMA Dr. Li Shu Pui Professional Education Centre, 2/F,
                      Chinese Club Building, 21-22 Connaught Road Central, HK
13 Oct 2005           The Federation of Medical Societies of Hong Kong & Hong Kong                                                                                                                                               Tel: 2527 8898
(Thur)                Ophthalmological Society                                                          1.5
7:30 – 8:30 pm        Certificate Course on General Ophtalmology
                      (1) Oculoplastic Surgeries
                      (2) Laser Treatment of Eye Diseases
                      Room 103, 1/F, Duke of Windsor Social Service Building, 15 Hennessy Road,
                      Wanchai, HK
14 Oct 2005           HKU – Centre on Behavioral Health                                                                                                                                                                          Miss Loretta Fung
(Fri)                 Therapy in the Satir Model – Advanced Professional Course for Practitioners        3                                                                                                                       Tel: 2589 0510
6:30 – 9:30 pm        Centre on Behavioral Health, The University of Hong Kong,
                      G/F Pauline Chan Building, 10 Sassoon Road, Pokfulam
14 – 16 Oct 2005      Fetal Medicine Foundation & O&G Department, CUHK/HKCOG                                                                                                                                                     Ms. Resanta Lee/
(Fri – Sun)           The First Asian Pacific Congress in Maternal Fetal Medicine                       10#                                                                                                                      Ms. Eva Hwa
                      Postgraduate Education Centre, Prince of Wales Hospital, Shatin,                                                                                                                                           Tel: 2632 2807/
                      New Territorries                                                                                                                                                                                           2632 2806
15 Oct 2005           HKU – Faculty of Medicine                                                                                                                                                                                  Ms. Janet Kwok
(Sat)                 Train the Trainer Workshop on Osteoporosis                                        4.5                                                                                                                      Tel: 2855 3937
9:00 am – 4:00 pm     Lecture Theatre I, G/F Cheung Kung Hai Conference Centre,
                      William M. W. Mong Block, Faculty of Medicine Building
15 Oct 2005           The Hong Kong Anti-Cancer Society, Hospital Authority Health InfoWorld                                                                                                                                     Mrs. Tammy Lee
(Sat)                 Symposium for Medical & Health Professionals                                      2.5                                                                                                                      Tel: 2814 1232
10:05 am – 1:00 pm    Breast Cancer: Prevention & Cure in 21st Century
                      Lecture Theatre, Hospital Authority Building
15 Oct 2005           The Society of Physicians of Hong Kong                                                                                                                                                                     Ms. Becky Chiu
(Sat)                 Scientific Meeting                                                                 1                                                                                                                       Tel: 2526 2626
1:00 – 3:15 pm        (1) Management of Degenerative Joint Diseases
                      (2) The New Frontier Pain Management: Evolving Role of COX-2 Inhibitor
                      HKMA Dr. Li Shu Pui Professional Education Centre
15 Oct 2005           HKU – HKU Family Institute                                                                                                                                                                                 Miss Wong Oi Ling
(Sat)                 Certificate Course in Family Therapy – Level II (Session 3)                        3                                                                                                                       Tel: 2859 5300
2:00 – 5:00 pm        Lecture Room, HKU Family Institute, 5/F Tsan Yuk Hospital, 30 Hospital Road,
                      Sai Ying Pun, HK
15 Oct 2005           The Hong Kong Society of Rheumatology                                                                                                                                                                      Tel: 2882 3108
(Sat)                 MRCP Teaching Course in Rheumatology                                               2
2:00 – 5:00 pm        (1) Clinical Photos & data interpretation
                      (2) Short cases examination (I)
                      (3) Short cases examination (II)
                      (4) Medical ethics & Communication
                      Sheraton Hotel, Tsimshatsui, Kowloon
15 Oct 2005           HKU – Centre on Behavioral Health                                                                                                                                                                          Miss Loretta Fung
(Sat)                 Psychotherapy and Counselling in Action 2005                                       3                                                                                                                       Tel: 2589 0510
2:00 – 5:00 pm        Centre on Behaviioral Health, The University of Hong Kong,
                      G/F Pauline Chan Building, 10 Sassoon Road, Pokfulam
                                                                                                                                                                                                                                                       HKMA CME BULLETIN • SEPTEMBER 2005




15 Oct 2005           Social Hygiene Service, PHSB, CHP, DH                                                                                                                                                                      Miss Landy Lee
(Sat)                 Interactive STI (Sexually Transmitted Infections) Workshop for clinicians 2005     2                                                                                                                       Tel: 2540 9804
2:15 – 4:30 pm        Cheung Sha Wan Dermatological Clinic, 3/F West Kowloon Health Centre,
                      303 Cheung Sha Wan Road, Shamshuipo, Kowloon
15 Oct 2005           HKU – Faculty of Medicine                                                                                                                                                                                  Ms. Anna Choy
(Sat)                 Certificate Course in Paediatric Cardiology 2005 (Module 4)                        4                                                                                                                       Tel: 2518 2629
2:30 – 6:30 pm        Pao Yue Kong Auditorium, G/F, Hong Kong Academy of Medicine
16 Oct 2005           Hong Kong Surgical Laser Association                                                                                                                                                                       Ms. Sue Cheng
(Sun)                 Hong Kong Laser Forum 2005                                                        4.5                                                                                                                      Tel: 2301 4111
9:00 am – 5:00 pm     Lecture Theatre, Hospital Authority Building, 147B Argyle Street,
                      Kowloon, HK
16 Oct 2005           Hong Kong Surgical Laser Association                                                                                                                                                                       Ms. Sue Cheng
(Sun)                 Hong Kong Laser Forum 2005 – Intense Pulsed Light Certificate Course               4                                                                                                                       Tel: 2301 4111
9:15 am – 4:00 pm     Lecture Theatre, Hospital Authority Building, 147B Argyle Street,
                      Kowloon, Hong Kong




*   Colleges accreditation pending
#   Total CME points for entire course
p.28                                         CME Calendar




                                         Date/Time                                      Function                                                                                                                                                                      Remarks/




                                                                                                                                                                                                                HKCPaed
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                                     16 Oct 2005            The Hong Kong Society of Rheumatology                                                                                                                                                                 Tel: 2882 3108
                                     (Sun)                  11th Annual Scientific Meeting                                                2
                                     10:00am – 5:00 pm      (i) Free Paper Presentation Session
                                                            (ii) Thromboembolic complications of systemic lupus erythmatosus
                                                            (iii) Infections in patients with systemic lupus erythematosus
                                                            (iv) Avascular necrosis of femoral head: Etology, Dlagnosis and treatment
                                                            (v) Rheumatic diseases and osteoporosis
                                                            Sheraton Hotel
                                     16 Oct 2005            The Society of Physicians of Hong Kong                                                                                                                                                                Ms. Becky Chiu
                                     (Sun)                  Sunday Symposium:                                                            2.5                                                                                                                      Tel: 2526 2626
                                     2:00 – 4:30 pm         (1) New Approaches to the management of Type II Diabetes
                                                            (2) Latest Advances in Asthma Management
                                                            (3) Case Presentation - A Patient with Abnormal Movement Disorder
                                                            HKMA Dr. Li Shu Pui Professional Education Centre
                                     16 Oct 2005            HKMA CME Programme, Queen Elizabeth Hospital                                                                                                                                                          Members: $50
                                     (Sun)                  HKMA Structured CME Programme at QEH (7) – Neurosurgery                       3       3      –       3 2.5 3                1       – 1.5                     1.5 –             3       3      3      Non-M: $80
                                     2:00 – 5:00 pm         and Orthopaedics & Traumatology                                                                                                                                                                       Tel: 2861 1979
                                                            Lecture Theatre, G/F, Block M, Queen Elizabeth Hospital, Kln
                                     17 Oct 2005            HKU - HKU Family Institute                                                                                                                                                                            Miss Wong Oi Ling
                                     (Mon)                  Certificate Course in Family Therapy - Level 1 (Session 4)                    3                                                                                                                       Tel: 2859 5300
                                     6:40 – 9:40 pm         Lecture Hall, HKU Family Institute, 5/F Tsan Yuk Hospital,
                                                            30 Hospital Road, Sai Ying Pun, HK
                                     18 Oct 2005            HA - Our Lady of Maryknoll Hospital                                                                                                                                                                   Ms. Law Wing Yi
                                     (Tue)                  Basic Life Support for Health Care Provider                                   5                                                                                                                       Tel: 2354 2248
                                     8:30am – 4:30 pm       Resuscitation Training Site, American Heart Association,
                                                            1st Floor, OPD Block, Our Lady of Maryknoll Hosptial
                                     18 Oct 2005            HKMA - Yau Tsim Mong Community Network,                                                                                                                                                               Dr. Ho Chung Ping
                                     (Tue)                  Queen Elizabeth Hospital, The Hong Kong Baptist Hospital,                    1.5                                                                                                                      Tel: 2771 1366
                                     1:00 – 3:15 pm         Integrated Dialysis Facilities
                                                            Chronic Kidney Disease (CKD) Workshop 2005 (Lecture 1)
                                                            –     Introduction to Chronic Kidney Disease (CKD)
                                                            –     CKD management and the Sun Tze             military protocol
                                                            Lecture Theatre, M Block, Queen Elizabeth Hospital
                                     18 Oct 2005            HKU - HKU Family Institute                                                                                                                                                                            Miss Wong Oi Ling
                                     (Tue)                  Certificate Course in Family Therapy - Level II (Session 4)                   3                                                                                                                       Tel: 2859 5300
                                     6:40 – 9:40 pm         Lecture Room, HKU Family Institute, 5/F Tsan Yuk Hospital,
                                                            30 Hospital Road, Sai Ying Pun, HK


                                     *    Colleges accreditation pending
                                     #    Total CME points for entire course

                                                                                                            HKMA CME Bulletin
                                                                                                          Monthly Self-Study Series
                                                                                                                    Call for Articles
                                            Since its publication, the HKMA CME Bulletin has become one of the most popular CME readings for doctors. This monthly
                                            publication has been serving more than 6,300 readers each month through practical case studies and picture quizzes. To
                                            enrich its content, we are inviting articles from experts of different specialties. Interested contributors may refer to the General
                                            Guidance below. Other formats are also welcome. For further information, please contact Miss Sophia Lau at 2527 8452 or by
                                            email at cme@hkma.org.

                                              General Guidance for Authors
                                              (1)     Intended readers              :    General practitioners
                                              (2)     Length of article             :    Approximately 8-10 A-4 pages in 12-pt fonts in single line spacing
                                              (3)     Review questions              :    Recommended to include 10 self-assessment questions in true-or-false format. (It is
HKMA CME BULLETIN • SEPTEMBER 2005




                                                                                         recommended that analysis and answers to most questions be covered in the article.)
                                              (4)     Language                      :    English (preferably with an optional Chinese introduction of 200-300 words)
                                              (5)     Key Lessons                   :    Recommended to include, if possible, a key message in point-form at the end of the article
                                              (6)     Highlights                    :    It is preferable that key messages in each paragraph/section be highlighted in bold types
                                              (7)     Others                        :    List of full name(s) of author(s), with qualifications and current appointment quoted
                                              (8)     Deadline                      :    All manuscripts for publication of the month should reach the Editor before the 15th of the
                                                                                         previous month

                                            All articles submitted for publication are subject to review and editing by the Editorial Board.

                                     Note: For each issue of the CME Bulletin, we shall try our best to include all the CME activities for the month, which are made known to the Association Secretariat. The
                                     credit points awarded by each college are herein indicated for members' reference only. While we try our best to ensure the information to be most accurate and
                                     up-to-date, members interested in any of these functions are advised to check with the respective organizers for confirmation of the details.
                                     Pharmaceutical advertisements are welcome. For advertising rates and placement details, please contact Ms. Sophia Lau, Executive Officer at
                                     Tel: 2527 8452, Fax: 2865 0943 or email: sophia@hkma.org
                                     Your comments to the HKMA CME Bulletin are most welcome. Please send your opinion to Dr. Wong Bun Lap, Bernard, Editor of HKMA CME Bulletin, by fax at
                                     2865 0943 or via e-mail at cme@hkma.org.

								
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