Docstoc

An Update on Empyema Thoracis

Document Sample
An Update on Empyema Thoracis Powered By Docstoc
					                                                                                                                                        April 2004 •



  THE HONG KONG
MEDICAL ASSOCIATION




   MONTHLY SELF-STUDY SERIES
   Please read the following article and complete the self-assessment
   questions. Participants in the HKMA CME Programme will be awarded
   1 credit point under the Programme for returning completed answer
   sheet on p.14 via fax (2865 0943) or by mail to the HKMA Secretariat
   on or before 15 May 2004. Answers to questions will be provided in
   the next issue of the HKMA CME Bulletin.




        An Update on Empyema Thoracis
        Dr. Chan Keung Kit                                                                      400IU/L, pH less than 7.2, and positive Gram stain or
        Medical Officer, Department of Paediatrics,                                             culture. Low pleural fluid pH is a good predictor of
        Kwong Wah Hospital                                                                      empyema; however, accurate dempyema thoracisermination
        Dr. Ng Kwok Keung, Daniel                                                               of pH requires cautious technique. Pleural fluid should be
        Consultant Paediatrician, Department of Paediatrics,                                    collected anaerobically in a heparinized tube and
        Kwong Wah Hospital                                                                      transported with ice for immediate analysis.
                                                                                                Empyema is thought to proceed through three well-
        Introduction                                                                            described stages during maturation: exudative,
        The incidence of empyema thoracis (ET) has increased                                    fibrinopurulent and organizing.(5) In the exudative stage,
        dramatically in children over the past decade. A sevenfold                              parapneumonic effusion develops and becomes secondarily
        increase in cases was first recorded in the UK in 1997,(1)                              infected. As infection progresses, the initially serous fluid
        and a similar increase has recently been reported in the                                becomes thick and purulent with organisms, fibrin, and
        USA. (2) The mode of therapy depends on the stage of                                    white blood cells. The ET is loculated in the fibrinopurulent
        disease, it ranges from antibiotics and simple drainage to                              stage. Additional time and inadequate treatment result in
        thoracotomy with decortication. The various aspects of                                  organization with fibroblasts and scar encasing the
        empyema thoracis will be discussed briefly.                                             empyema, lung, and pleural space. This becomes the
                                                                                                organizing stage. There is no defined duration for each
        Pathology                                                                               stage, but James(3) suggested that 2-4 weeks for progression
                                                                                                to the organizing stage.
        Empyema is the presence of grossly purulent fluid in the
        pleural space. The disease occurs most commonly as the
        result of antecedent bacterial pneumonia, but other                                     Microbiology
        etiologies include esophageal rupture, mediastinal or                                   Classically Staphylococcus aureus has accounted for the
        subdiaphragmatic disease, neoplasm, bacteremia,                                         greatest proportion of cases of paediatric empyema. (6)
        pancreatitis, chest trauma and thoracic surgery. (3) Host                               However, Streptococcus pneumoniae may now be the
        defenses are weakened in the nutrient-rich pleural space                                predominant pathogen both in the UK and the USA.(2,7,8)
        due to lack of a phagocytic surface for optimal white cell                              Other agents include Hameophilus influenzae,
        function; low levels of opsonins and complement; and                                    Streptococcus pyogenes, Enterobacteriaceae, anaerobes,
        conditions of acidosis, hypoglycemia, and hypoxia.                                      Leginoella, Histoplasma, Coccidioides, Aspergillus,
        Furthermore, many antibiotics do not work optimally in                                  Entamoeba, Nocardia, Mycobaterium tuberculosis and
        pleural empyema despite efficient penempyema                                            Paragonimus. The responsible bacterial pathogen often
        thoracisration into the pleural space.(4)                                               cannot be cultured from the pleural fluid.
        Empyema is suggested when pleural fluid exhibits a white
        cell count greater than 10,000/mm3 with a predominance
                                                                                                Clinical Features
        of segmented neutrophils, glucose under 40 mg/dL or less                                Most of the patients had symptoms attributable to their
        than half the serum level, protein level >3g/dL, LDH >                                  empyema, with fever being the most common symptom


     The Hong Kong Medical Association is dedicated to providing a coordinated CME programme for all members of the medical profession. Under the HKMA CME Programme, a
     CME register is installed to document the CME efforts of doctors and special CME avenues are provided. The Association strives to foster a vibrant environment of CME throughout
     the medical profession. Both members as well as non-members of the Association are welcome to join us. You may contact the HKMA Secretariat for details of the programme.




                                                                                                                                 HKMA CME BULLETIN               APRIL 2004
                                                                                   An Update on Empyema Thoracis



(65%), chest pain (37%), cough (21%), dyspnoea (19%),              Thomson performed a post hoc subgroup analysis
weight loss and lethargy (both are 5%). Seven percent of           suggesting that the use of small pigtail cathempyema
patients were asymptomatic.(9)                                     thoracisers was associated with shorter hospital stay than
                                                                   using conventional chest drains, this finding was later
Investigations                                                     supported by Pierrepoint.(15) He showed that compared to
                                                                   conventional chest drain, children who received pigtail
Pleural fluid analysis, pleural biopsy, chest radiographs,
                                                                   catheter had a significantly decreased period of drain in
ultrasonography and computerized tomography are the
                                                                   situ, were afebrile earlier, were clinically improved earlier
important investigations in the management of empyema.
                                                                   and were discharged earlier. A number of factors were
Pleural fluid analysis is important to confirm an empyema
                                                                   believed to contribute to this improved efficiency: the size
rather than simple pleural effusion by the glucose, LDH,
                                                                   of drainage fenestrations are considerably larger in the
protein level and pH. Pleural biopsy can determine the
                                                                   pigtail catheter compared to conventional drain; the
staging of disease accurately which will influence the
                                                                   pigtail catheter does not catheter occlude when kinked;
management plan significantly. Ultrasonography and
                                                                   the fixing system to the skin of the Pigtail catheter is much
computerized tomography are helpful for characterizing
                                                                   more secure than conventional drains. All these in
the fluid density, detecting the presence of septations and
                                                                   combination with the ease of insertion, results in much
loculations. They also facilitate optimal needle and catheter
                                                                   less pain and discomfort while in-situ. This results in better
placement and differentiate consolidated lung from pleural
                                                                   mobilization. This mobilization is important in dispersing
fluid.
                                                                   the fibrinolytics within the pleural space.
Therapeutic Options                                                Simpson(16) suggested the pus viscosity could be reduced
                                                                   by deoxyribonuclease (DNase) rather than by fibrinolytics.
Empyema is a serious condition with mortality of 10%.(10)
                                                                   He reported a case of empyema successfully treated with
The 3 immediate objectives of therapy are appropriate




                                                                                                                                        APRIL 2004
                                                                   use of DNase given intrapleurally which did not resolve
antibiotics, prompt drainage of the infected pleural space
                                                                   after standard treatment with fibrinolytics. (17) DNase
and lung re-expansion, the long-term objective is to
                                                                   depolymerizes deoxyribonuleoproteins and acts on DNA of
prevent chronic lung damage. There are several relative
                                                                   bacterial as well as mammalian origin, though the DNA in
new therapeutic options in the drainage and lung re-
                                                                   empyema is mainly derived from leucocytes.
expansion in the recent years.




                                                                                                                                        HKMA CME BULLETIN
                                                                   VATS is a relatively new technique without rendering the
The importance of drainage of the pleural space was
                                                                   patient to undergo thoracotomy with decortication.
dated back to the age of Hippocrates. (11) There are 2
                                                                   However, there are still controversies about its efficacy.
governing factors for successful drainage: loculation of
                                                                   Grewal(18) showed that length of stay was longer after this
fluid and increasing viscosity and adherence of pus to the
                                                                   procedure than with formal throacotomy. On the contrary,
pleural surfaces. Concerning the drainage, the instillation
                                                                   both Podbielski and Doski (19,20) suggested VATS was an
of fibrinolytics, usage of Pigtail cathempyema thoraciser
                                                                   attractive alternative to thoracotomy in terms of length of
and human recombinant deoxyribonuclease are the new
                                                                   hospital stay and drain in-situ. Decortication is a procedure
development. Video assisted thoracic surgery (VATS) is
                                                                   performing formal thoracotomy to remove the thickened
recently suggested to be an alternative to open thoracotomy
                                                                   inflammed pleural with fibrin deposits, the peel. The
with decortication.
                                                                   successful rate was claimed to be 95% without any
A major problem in the management of empyema thoracis              mortality.(9) However, it should be noted that it is a major
is the formation of fibrinous adhesions resulting in               operation, sometimes it is not permissible especially for
loculation of the pleural fluid and entrapment of the lung.        those children with other co-morbidities, such as
This leads to the rationale of using fibrinolytics. The use of     immunodeficiency.
intrapleural fibrinolytics for dissolution of empyema thoracis                                                                        p.3
                                                                   Carey(21) suggested the choices of therapeutic options for
was first described by Tillet et al(12) in 1949. Streptokinase
                                                                   each stage of illness. In exudative stage, antibitotics
and streptodornase were used. Thomson et al described
                                                                   treatment and therapeutic drainage is usually effective.
using purified urokinse to decrease the frequency of side
                                                                   Serial radiographs and ultrasound evaluation should be
effects(13). Urokinase 40,000 units was diluted in 40 ml
                                                                   used to monitor disease progress after commencement of
normal saline, and it was given through the chest drain 12
                                                                   antibiotic treatment. This stage is rarely seen in the clinical
hourly for 3 days. After instillation of the agent the chest
                                                                   practice as most patients have already entered the
drain was clamped and the patient was encouraged to
                                                                   fibrinopurulent stage when they present. In the
mobilize as much as possible over the next 4 hours.
                                                                   fibrinopurulent stage, in addition to antibiotics, fibrinolysis,
Suction pressure of negative 20 cm water was then
                                                                   VATS or open thoracotomy will be the treatment regime
applied to the drain until the next instillation was due. The
                                                                   depending on the patient’s clinical condition. In the
length of stay was demonstrated to be significantly
                                                                   organizing stage, antibiotics and open thoracotomy should
shorter than those receiving placebo. Allergic reactions
                                                                   be the gold standard of treatment.
were reported with the use of intrapleural streptokinase
with an incidence of 12.5%.(14) On the contrary, urokinase         In conclusion, treatment must be tailored according to the
is of human origin and allergic reactions have not been            stage of empyema. Precise radiological, histological staging
reported. The main effects of urokinase are on fibrinolysis        at presentation, usage of appropriate antibiotics,
of pleural loculations and re-establishing a pleural circulation   thoracentesis, vigilant monitoring of disease progress to
rather than on pus viscosity.
                    An Update on Empyema Thoracis



                    identify patients requiring thoracotomy should be the                       14. Bouros D, Schiza S, Patsourakis G, empyema thoracis al.
                    principle of management of empyema.                                             Intrapleural streptokinase versus urokinase in the treatment of
                                                                                                    complicated parapneumonic effusions: a prospective, double-
                    Key Lessons                                                                     blind study. Am J Respir Crit Care Med 1997;155:291-295
                    1. The incidence of empyema thoracis has increased                          15. Pierrepoint MJ, Evans A, Morris SJ, empyema thoracis al. Pigtail
                       dramatically in children over the past decade, both in                       cathempyema thoraciser drain in the treatment of empyema
                       the UK and the USA. The dominant culprit has                                 thoracis. Arch Dis Child 2002;87(4):331-332
                       changed to Streptococcus pneumoniae.                                     16. Simpson G, Roomes D, Herron M. The effects of streptokinase
                    2. In addition to antibiotics, additional therapeutic options                   and deoxyribonuclease on viscosity of human surgical and
                       are required.                                                                empyema pus. Chest 2000;117:1728-1733
                    3. Therapeutic aspiration with or without instillation of
                                                                                                17. Simpson G, Roomes D, Reeves B. Successful treatment of
                       fibrinolytics, thoractomy with decortication, and video
                                                                                                    empyema thoracis with human recombinant deoxyribonuclease.
                       assisted thoracic surgery (VATS) form an important part
                                                                                                    Thorax 2003;58(4):365-366
                       of management.
                                                                                                18. Grewal H, Jackson RJ, Wagner CW, empyema thoracis al. Early
                                                                                                    video-assiated thoracic surgery in the management of empyema.
                    References:
                                                                                                    Pediatrics 1999;103:e6
                    1. Rees JHM, Spencer DA, Parikh D, empyema thoracis al. Increase            19. Podbielski FJ, Maniar HS, Rodriguez HE, empyema thoracis al.
                        in incidence of childhood empyema in West Midlands, UK.                     Surgical strategy of complex empyema thoracis. J Sociempyema
                        Lancempyema thoracis 1997;349:402                                           thoracisy of Laparoendoscopic Surgeons 2000:4(4):287-290
                    2. Byington CL, Spencer LY, Johnson TA, empyema thoracis al. An             20. Doski JJ, Lou D, Hicks BA. Management of parapneumonic
                        epidermiological investigation of a sustained high rate of                  collections in infants and children. J Ped Surg 2000;35(2):265-
APRIL 2004




                        pediatric parapneumonic empyema: risk factors and                           268
                        microbiological associations. Clin Infect Dis 2002;34:434-440           21. Carey JA, Hamilton JRL, Spencer DA, empyema thoracis al.
                    3. Campbell JD, Nataro JP. Pleural empyema. Ped Infect Dis J                    Empyema thoracis: a role for open thoracotomy and
                        1999;18(8):725-726                                                          decortication. Arch Dis Child 1998;79(6):510-513.
                    4. Bryan RE, Salmon CJ. Pleural empyema. Clin Infect Dis
HKMA CME BULLETIN




                        1996;22:747-762
                    5. Temes RT, empyema thoracis al. Intrapleural fibrinolytics in
                        management of empyema thoracis. Chest 1996; 110(1):102-
                        106                                                                     Self-Assessment Questions
                    6. Freij BJ, Kusmiesz H, Nelson JD, empyema thoracis al.                    (Please indicate true of false to the following statements)
                        Parapneumonic effusions and empyema in hospitalized children:
                        a rempyema thoracisrospective review of 227 cases. Pediatr              1.   The incidence of empyema thoracis has increased
                        Infect Dis 1984;3:578-591                                                    dramatically in children over the past decade, both in
                    7. Eltringham G, Kearns A, Freeman R, empyema thoracis al.                       the UK and the USA.
                        Culture-negative childhood empyema is usually due to penicillin-
                                                                                                2.   Staphylococcus aureus accounts for the greatest
                        sensitive Streptococcus pneumoniae capsular serotype 1. J Clin
                                                                                                     proportion of cases of paediatric empyema.
                        Microbiol 2003;41:521-522
                    8. Hardie W, Bokulic R, Garcia VF, empyema thoracis al.                     3.   Fever is the most common symptom of empyema
                        Pneumococcal pleural empyemas in children. Clin Infect Dis                   thoracis.
   p.4                  1996;22:1057-1063                                                       4.   There are 3 stages of empyema thoracis: exudative,
                    9. Lemense GP, Strange C, Sahn SA. Empyema thoracis: therapeutic                 fibropurulent and organizing stages.
                        management and outcome. Chest 1995;107(6):1532-1537                     5.   Pleural biopsy is not required in the management of
                    10. Ferguson AD, Prescott RJ, Selkon JB, empyema thoracis al.                    empyema thoracis.
                        Empyema Subcommittee of the Research Committee of the
                                                                                                6.   Mortality of empyema thoracis is 10%.
                        British Thoracic Sociempyema thoracisy. Clinical course and
                        management of thoracic empyema. Q J Med 1998;89:285-9                   7.   Large bore chest drain is better for drainage in
                    11. Miller KS, Sahn SA. Chest tubes: indications, technique,                     empyema thoracis.
                        management and complications. Chest 1987;91:258-264                     8.   Antibiotics per se is effective for treatment of empyema
                    12. Tillet WS, Sherry S. Effect in patients of streptococcal fibrinolysin        thoracis.
                        (streptokinase) and streptococcal deoxyribonuclease on                  9.   Decortication is a formal thoractomy to remove the
                        fibrinous, purulent, and sanguinous exudations. J Clin Invest                thickened inflammed pleural with fibrin deposits, i.e.,
                        1949;28:173-186                                                              the peel.
                    13. Thomson AH, Hull J, Kumar MR, empyema thoracis al.
                                                                                                10. Empyema thoracis occurs most commonly as the
                        Randomized trial of intrapleural urokinase in the treatment of
                                                                                                    result of antecedent bacterial pneumonia.
                        childhood empyema. Thorax 2002;57:343-347
                                 Clinical                           Case Study

                     Please answer the questions for each quiz below by returning the completed answer sheet printed on page 14. This exercise will attract 0.5 CME point for participants
                     completing BOTH quizzes. Answers and explanations will be provided in the next issue.




                    Ms Chan was admitted because of congestive heart failure. Her blood pressure was around 80/40 mmHg. Her echocardiogram
                    showed a left ventricular ejection fraction of 20 % and dilated LV and RV chambers. Her ECG was shown below:

                    1. Would you comment on this ECG?

                                                                                                                                                     57 BPM
APRIL 2004
HKMA CME BULLETIN




                    2. What has been done to this patient that caused the ECG changes below?
                        a   coronary revascularization
                        b   biventricular pacemaker implantation
                        c   radiofrequency ablation
                        d   anti-arrhythmic drug therapy




   p.6




                    The content of the Office Cardiology Series is provided by:
                    Dr. So Yui Chi
                    M.B.,B.S.(H.K.), M.R.C.P.(U.K.)
                    Dr. Wong Shou Pang, Alexander
                    F.R.C.P., F.H.K.A.M.(Med.), F.H.K.C.P., Specialist in Cardiology
                    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.(Edin.), Specialist in Cardiology
                                                                                                  Clinical Case Study




A young patient with cryptogenic stroke - any role for the                         significant difference between aspirin and anticoagulant(7).
interventional cardiologist?                                                       With the availability of percutaneous PFO closure
                                                                                   technique, surgical PFO closure is not the procedure of
1. A 43 year old gentleman with good past health
   presents to you with a left sided weakness.                                     choice in most patients. Concerning the risk of recurrent
   Physical examination is unremarkable. A CAT                                     neurological events after percutaneous PFO closure,
   scan of brain confirms two small right parietal                                 Windecker S et al showed that the annual risk of recurrent
   infarcts. Routine blood tests are normal,                                       ischemic events was 3.4%(8). After all, the best therapeutic
   including a 75gm OGTT and a fasting lipid                                       modality remains unknown at this time because no head
   profile. The EKG is in sinus rhythm. The                                        to head comparison between these therapeutic options is
   autoimmune markers and clotting factors                                         available.
   screening are normal. What will be the next most
   appropriate investigation?                                                   4. This gentleman has recurrent transient ischemic
                                                                                   events seven months after the initial event despite
   (A) Holter study (B) Echocardiography
                                                                                   sequential treatment with aspirin and warfarin.
   (C)MRA (D) Transcranial Doppler
                                                                                   Once again, all the investigations are normal. What
   (B) This is a young patient with cryptogenic stroke. The                        is your management strategy?




                                                                                                                                                                                  APRIL 2004
   presence of two small right parietal infarcts points to
   an embolic phenomenon. An echocardiogram                                        PFO-occluder is indicated in this gentleman. In April 2002,
   (transthroacic and transesophageal) will help to rule                           U.S. Food and Drug Administration (FDA) approved the
   out any cardiac source of emboli.
                                                                                   Amplatzer-PFO-occluder for the non-surgical closure of a
2. Patent foramen ovale is associated with                                         patent foramen ovale (PFO) in patients with recurrent




                                                                                                                                                                                  HKMA CME BULLETIN
   cryptogenic stroke. True or false?                                              cryptogenic stroke due to presumed paradoxical embolism
                                                                                   through a PFO and who have failed conventional drug
   S e v e r a l c a s e c o n t ro l s t u d i e s u s i n g c o n t r a s t      therapy. It is also the authors’ practice to reserve
   echocardiography have established a strong association                          percutaneous PFO closure for those patients with failed
   between the diagnosis of cryptogenic stroke and the
   presence of patent foramen ovale (PFO) in young adults                          conventional drug treatment only.
   less than 55 years of age(1,2,3,4,5). Therefore, contrast
   echocardiography with agitated saline and Valsalva                              Refences:

   maneuver is required to rule out the presence of PFO.                           (1)   Webster MW, Chancellor AM, Smith HJ, Swift DL, Sharpe DN, Bass NM, Glasgow
   At the same time, one needs to look for any high risk                                 GL. Patent foramen ovale in young stroke patients Lancet. 1988 Jul 2;2(8601):11-
   characteristics of PFO which predispose patients for                                  2
   paradoxical embolism and stroke. Such features include                          (2)   Lechat P, Mas JL, Lascault G, Loron P, Theard M, Klimczac M, Drobinski G, Thomas
   a large PFO size, a greater degree of right to left shunt                             D, Grosgogeat Y. Prevalence of patent foramen ovale in patients with stroke. N
   as assessed by the amount of crossing microbubbles                                    Engl J Med. 1988 May 5;318(18):1148-52.
   and atrial septal aneurysm.
                                                                                   (3)   Hausmann D, Mugge A, Becht I, Daniel WG. Diagnosis of patent foramen ovale
                                                                                         by transesophageal echocardiography and association with cerebral and peripheral
3. What are the treatment options of cryptogenic                                         embolic events. Am J Cardiol. 1992 Sep 1;70(6):668-72.
   stroke and the recurrent risk of ischemic events?                               (4)   Cabanes L, Mas JL, Cohen A, Amarenco P, Cabanes PA, Oubary P, Chedru F,
                                                                                                                                                                                p.7
                                                                                         Guerin F, Bousser MG, de Recondo J. Atrial septal aneurysm and patent foramen
   In this case, contrast echocardiography confirms the                                  ovale as risk factors for cryptogenic stroke in patients less than 55 years of age.
                                                                                         A study using transesophageal echocardiography. Stroke. 1993 Dec;24(12):1865-
   presence of a PFO with instantaneous right to left shunt.                             73.
   There are no other high risk characteristics. One may
                                                                                   (5)   de Belder MA, Tourikis L, Leech G, Camm AJ. Risk of patent foramen ovale for
   conclude that this gentleman has cryptogenic stroke                                   thromboembolic events in all age groups. Am J Cardiol. 1992 May
   with presumed paradoxical embolism. Three treatment                                   15;69(16):1316-20.
   modalities are currently available: Antiplatelet (aspirin,                      (6)   Mas JL, Zuber M. Recurrent cerebrovascular events in patients with patent foramen
   clopidogrel), antithrombotic agent (warfarin) and PFO                                 ovale, atrial septal aneurysm, or both and cryptogenic stroke or transient ischemic
                                                                                         attack. French Study Group on Patent Foramen Ovale and Atrial Septal Aneurysm.
   closure (surgical or percutaneous). The risk of recurrent                             Am Heart J. 1995 Nov;130(5):1083-8.
   neurological events during medical treatment with
                                                                                   (7)   Bogousslavsky J, Garazi S, Jeanrenaud X, Aebischer N, Van Melle G. Stroke recurrence
   either aspirin or oral anticoagulant has been                                         in patients with patent foramen ovale: the Lausanne Study. Lausanne Stroke with
   retrospectively examined in patients with PFO and                                     Paradoxical Embolism Study Group. Neurology. 1996 May;46(5):1301-5.

   cryptogenic stroke less than 60 years of age. The                               (8)   Windecker S, Wahl A, Chatterjee T, Garachemani A, Eberli FR, Seiler C, Meier B.
   average annual rate of recurrence was 3.4% for the                                    Percutaneous closure of patent foramen ovale in patients with paradoxical
                                                                                         embolism: long-term risk of recurrent thromboembolic events. Circulation. 2000
   combined endpoint of TIA and CVA(6). In another study,                                Feb 29;101(8):893-8.
   the average annual recurrence rate was 3.8% with no
                               Clinical
                    Clinical Case Study
                                                                 Case Study




                     A 30 years old lady presented with multiple asymptomatic
                     skin nodules over her trunk and limbs for more than 20
                     years. The number of lesions increased progressively.
                     There were also pigmented patches over her body since
                     childhood. Her past health and family history was
                     unremarkable. Physical examination revealed multiple
                     soft, flesh-coloured nodules measuring 1 to 8 cm in size.
                     Pigmented patches were also noted on her abdomen
                     and limbs. Freckles were seen over her axilla. Slit lamp
                     examination of both eyes was unremarkable.

                     1.    What is the clinical diagnosis?                          and there was no history of recent travel. Physical examination
                     2.    What are the other clinical features of this             revealed superficial erosions and pustules over palms and
                           condition?                                               dorsum of both hands
                     3.    What are the investigations?
                                                                                    1. What is the clinical diagnosis?
                     4.    What are the possible complications?                        The diagnosis is impetigo contagiosa. This is the most
APRIL 2004




                     5.    What is the treatment?                                      common bacterial skin infection in children. Staphylococcus
                                                                                       aureus is the most common pathogen. Group A beta-
                                                                                       haemolytic streptococcus may also be isolated. In some
                                                                                       cases, both organisms can be cultured. The bacteria enter
                                                                                       through damaged skin. Impetigo is very contagious and
HKMA CME BULLETIN




                                                                                       can be spread by direct contact or scratching.

                                                                                    2. What are the clinical differential diagnoses?
                                                                                       The differential diagnoses include infected eczema, herpes
                                                                                       simplex, pustular drug eruption, erythema multiforme, and
                                                                                       subcorneal pustular dermatosis.

                                                                                    3. What are the investigations?
                                                                                       A Gram stain of the blister fluid will reveal gram-positive
                                                                                       cocci. A skin swab from pustules should be taken for culture
                                                                                       and sensitivity test. In patients with recurrent staphylococcal
                                                                                       impetigo, nasal swab should be taken as they may be nasal
                                                                                       carrier of Staphylococcus aureus.
                      The content of the Dermatology Series is provided by:
                      Dr. Tang Yuk Ming, William and Dr. Chan Loi Yuen              4. What are the possible complications?
   p.8                Specialists in Dermatology & Venereology                         Infection due to nephritogenic Group A beta-haemolytic
                                                                                       streptococci could be complicated by acute
                                                                                       glomerulonephritis occurring in 10-15%. Sepsis may also
                                                                                       develop in neonates.

                                                                                    5. What is the treatment?
                                                                                       The wound should be dressed with antiseptic followed by
                                                                                       application of topical antibiotics such as fucidin, mupirocin
                                                                                       or bacitracin. Systemic antibiotic is indicated except in
                                                                                       mildest cases and may include semisynthetic penicillin (e.g.,
                                                                                       cloxacillin or erythromycin), first-generation cephalosporins
                      An 8 years old boy presented with sudden onset of painful        (e.g., cephalexin) or fusidic acid. As the condition is
                      skin rash over both hands for few days. The lesions started      contagious, the patient should not return to school until
                      as small erythematous macules which enlarged and ruptured        all lesions clear. Topical mupirocin or systemic rifampicin
                      easily. There had been 2 similar attacks within recent 12        should be given to eradicate nasal carriage of
                      months. His past health and family history was unremarkable      Staphylococcus aureus if present.
                        CME                       for April & May 2004
                      Lecture
 CME Event                                                                                              Venue & Time

27 April 2004 (Tuesday)
                                                                                                   The Ballroom, Level 2
Current Management of Alzheimer’s Disease, from Mild Cognitive                                     Langham Hotel Hong Kong
Impairment to Severe Stages                                                                        (Former Great Eagle Hotel)
                                                                                                   8 Peking Road, TST
Prof. Serge Gauthier                                                                               Lunch: 1:00 - 2:00 p.m.
Senior Scientist of the CIHR-Rx&D Programme                                                        Lecture: 2:00 - 3:00 p.m.
Professor, Departments of Neurology and Neurosurgery, Psychiatry, and Medicine,
McGill University, Montreal, Canada.
This CME symposium is co-organized with Hong Kong Alzheimer’s Disease Association.
This symposium is free of charge. The luncheon and registration fee are sponsored by
Lundbeck Hong Kong.


6 May 2004 (Thursday)
                                                                                                   The Ballroom, Level 2
New Technology for the Diagnosis of Vaginal Candidiasis                                            Langham Hotel Hong Kong
                                                                                                   (Former Great Eagle Hotel)
Dr. Raymond Stanley Hyslop                                                                         8 Peking Road, TST
M.B.,B.S., F.R.C.O.G., F.R.A.N.Z.C.O.G.                                                            Lunch: 1:00 - 2:00 p.m.
Consultant Emeritus Obstetrician and Gynaecologist,                                                Lecture: 2:00 - 3:00 p.m.
The Liverpool Area Health Service, Sydney, Australia.




                                                                                                                                                       APRIL 2004
This symposium is free of charge. The luncheon and registration fee are
sponsored by Rockeby biomed Corporation Limited.



20 May 2004 (Thursday)                                                                             The HKMA Dr. Li Shu Pui Professional




                                                                                                                                                       HKMA CME BULLETIN
                                                                                                   Education Centre
HKMA Structured CME Programme with HKS&H – Acute Knee Injuries                                     2/F, Chinese Club Building
Dr. John Daniel Hooley                                                                             21-22 Connaught Road Central, HK
M.B.,B.S.(Syd.), F.R.C.S.(Edin.), F.H.K.C.O.S., F.H.K.A.M. (Orthopaedics)                          Lecture: 2:00 - 3:00 p.m.
Specialist in Orthopaedics                                                                         (Light lunch: 1:15 p.m.)


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

                                                                                                   [                            ]


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. Accreditation from other colleges is pending. (The Secretariat fax no.: 2865 0943)




                                                                                                                                                  p.9
                                                                                                                                                  Reply Slip
Please “” as appropriate.               
Free of charge lecture
   27 April 2004      : Current Management of Alzheimer’s Disease, from Mild Cognitive Impairment to Severe Stages
   6 May 2004         : New Technology for the Diagnosis of Vaginal Candidiasis
                                                                                                       HKMA Members         CME Participants
                                                                                                          HK$50                     HK$80
20 May 2004           : HKMA Structured CME Programme with HKS&H
                        HKMA                             CME Programme at Queen Elizabeth
                                                         Hospital
                    Structured



                                                                                                        S I N C E   1 8 7 0


                                    The Hong Kong Medical Association                                Kwong Wah Hospital




                                Lecture       Date                   Topic
                                I             25 April 2004          Anaesthesiology & Neurology
                                                                     1. Management of Chronic Pain
                                                                        Dr. Sun Kai On
                                                                         Consultant, Department of Anaesthesia, KWH
                                                                     2. Management of Parkinsonism — An Update
                                                                        Dr. Chung Tin Hei
                                                                         Fellow in Neurology, Department of M&G, KWH
APRIL 2004




                           II                 30 May 2004            Respiratory Medicine
                                                                     1. Update in Management of Pulmonary TB
                                                                        Dr. Chan Yuk Choi
                                                                         Consultant Chest Physician, TB & Chest Unit, WTSH
HKMA CME BULLETIN




                                                                     2. COPD: Pitfalls in Diagnosis and Management
                                                                        Dr. Yee Kwok Sang
                                                                         SMO, Dept of M&G, KWH

                           III                27 Jun 2004            Gastroenterology & Hepatology

                           IV                 25 Jul 2004            Cardiology

                           V                  22 Aug 2004            Rheumatology & Rehabilitation

                           VI                 26 Sept 2004           Endocrinology and DM

                           VII                24 Oct 2004            Renal Medicine



p.10
                    •   Venue : Lecture Theatre, 10/F, Yu Chun Keung
                                Memorial Medical Centre, KWH
                    •   Date  : April 2004 to March 2005
                    •   Time  : 2:00 - 5:00 pm
                    •   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.11 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 Programme at Queen Elizabeth
                                                       Hospital
          Structured


                     The Hong Kong Medical Association                                            Queen Elizabeth Hospital



            Lecture                Date                  Topic

            II                     9 May 2004            Paediatrics
                                                         1. Cervical Lymphadenopathy
                                                            Dr. Chan Lai Har, Grace
                                                            Consultant, Department of Paediatrics, QEH
                                                         2. Pitfalls in Diagnosis of Childhood Development
                                                            Dr. Yuen Hui Leung
                                                            Consultant, Department of Paediatrics, QEH
                                                         3. Warning Signs of Childhood Development
                                                            Dr. Wu Shun Ping
                                                            Associate Consultant, Department of Paediatrics, QEH
                                                         4. Bed Wetting in Children
                                                            Dr. Chan Kwai Yu, Winnie




                                                                                                                                            APRIL 2004
                                                            MO, Department of Paediatrics, QEH

            III                    13 June 2004          Surgery
                                                         1. The Spectrum of Minimal Access Surgery
                                                            Dr. Chick Wai Keung
                                                            Medical and Health Officer, Department of Surgery, QEH




                                                                                                                                            HKMA CME BULLETIN
                                                         2. Common Urological Problems
                                                            Dr. Chu Sau Kwan
                                                            SMO, Department of Surgery, QEH
                                                         3. Paed-Surgery Update
                                                            Dr. Leung Wai Yip, Michael
                                                            SMO, Department of Surgery, QEH



  Venue          :   Lecture Theatre, G/F, Block M, QEH
  Date           :   April 2004 to March 2005
  Time           :   2:00 – 5:00 pm
  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                                                      p.11
                                                                                                                                       Reply Slip
 I would like to register for the following lecture(s):

                                                                                        HKMA Member                 CME participants




Please“ ” as appropriate                     




Name        :                                                     Tel No.     :                       Fax No.   :
HKMA Membership No.
or HKMA CME No.                                                          Signature
                                  THE SOCIETY OF PHYSICIANS OF HONG KONG
                                                  SUNDAY SYMPOSIUM / CME LECTURE
                    Chairman                 :   Dr. Lam Tat Chung, Paul (                )
                                                 President, The Society of Physicians of Hong Kong
                                                 FRCP, FHKAM(Medicine), FHKAM(Psychiatry)

                    Date                     :   May 2, 2004 (Sunday)
                    Topics                   :   1. Management of Sports Injury – the Science Behind
                                                    Dr. Chien Ping, Eric (        )
                                                    Specialist in Orthopaedics and Traumatology
                                                    FRCS, FRACS(Ortho.), FHKAM(Orthopaedic Surgery)
                                                 2. Update on Management of Rheumatoid Arthritis
                                                    Dr. Chan Tak Hin (            )
                                                    Specialist in Rheumatology
                                                    FRCP, FHKCP, FHKAM(Med.)
APRIL 2004




                                                 3. Approach to Arthralgia and Arthritis
                                                    Dr. Ying King Yee, Shirley (          )
                                                    MRCP, FHKAM(Medicine)
                                                    Senior Medical Officer in Medicine/Rheumatology, PMH
HKMA CME BULLETIN




                    Time                     :   1:00 pm Lunch (Please be punctual) 2:00-4:00 pm Symposium

                    Date                     :   May 19, 2004 (Wednesday)
                    Topic                    :   Current Management of Back Pain
                                                 Dr. Fu Wai Kee (            )
                                                 Specialist in Orthopaedic Surgery
                                                 FRCS, FCSHK, FHKCOS, FHKAM(Ortho.)
                    Time                     :   1:30 pm Light Lunch        2:00 -3:00 pm Lecture

                    Place               : HKMA Dr. Li Shu Pui Professional Education Centre
p.12                Sponsor             : Merck Sharp & Dohme (Asia) Ltd.
                    CME                 : Under application         Enquiries : Ms. Becky Chiu (Tel: 2526 2626)
                    Open to doctors free of charge                  On first-come first-serve basis

                                      Registration Form (Reply by Fax: 2834 0756)
                    I       I wish to attend Sunday Symposium on May 2, 2004

                            Please reserve       I Full Lunch (Please be punctual)
                                                 I Lunch not required

                    I       I wish to attend CME Lecture on May 19, 2004 (Wednesday)

                    Name of doctor:_________________________________________                   Tel: ______________________
                THE SOCIETY OF PHYSICIANS OF HONG KONG
                             CME Lecture May 5, 2004 (Wednesday)
                         Diagnosing and Treating Irritable Bowel Syndrome,
                                   Practical Tools and Guidelines

Speaker     : Dr. Wayne J. Hu (         )
              MBBS(Lond.), MRCP(UK), FHKAM(Med.), FHKCP

Chairman : Dr. Lam Tat Chung, Paul (               )
           President, The Society of Physicians of Hong Kong
           FRCP, FHKAM(Medicine), FHKAM(Psychiatry)

Place      : HKMA Dr. Li Shu Pui Professional Education Centre
Time       : 1:30 pm        Light Lunch
             2:00-3:00 pm Lecture                                  Space for Name Card (in English)
Sponsor    : Novartis Pharmaceuticals (HK) Ltd.
CME Points : Under application




                                                                                                        APRIL 2004
Enquiry    : Ms. Becky Chiu
             Tel. 2526 2626

Open to doctors free of charge.
On first-come first-serve basis.




                                                                                                        HKMA CME BULLETIN
To register, please fax this advertisement
to 2577 0274 (Attn.: Mr. Paul Chong)



                THE SOCIETY OF PHYSICIANS OF HONG KONG
                              CME Lecture May 13, 2004 (Thursday)
                  Cardiovascular Safety of COX-2 Specific Inhibitors: An Update

Speaker     : Dr. Wong Bun Lap, Bernard (        )
              MBBS(HK), MRCP(UK), FHKCP(HK),FHKAM(Med.), DME(Irel.), DCH(Lond.)

Chairman : Dr. Lam Tat Chung, Paul (               )                                                  p.13
           President, The Society of Physicians of Hong Kong
           FRCP, FHKAM(Medicine), FHKAM(Psychiatry)

Place      : HKMA Dr. Li Shu Pui Professional Education Centre
Time       : 1:30 pm         Light Lunch
             2:00-3:00 pm Lecture
                                                                   Space for Name Card (in English)
Sponsor    : Pfizer Corporation Hong Kong Limited
CME Points : Under application
Enquiry    : Ms. Becky Chiu
             Tel. 2526 2626

Open to doctors free of charge.
On first-come first-serve basis.
To register, please fax this advertisement
to 2579 0599
                                              Answer                             for April 2004
                                               Sheet
                    Please return completed answer sheet to the HKMA Secretariat on or before 15 May 2004 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). (Fax: 2865 0943)




                    (I) An Update on Empyema Thoracis

                    (Please indicate “T” or “F” in each box.)


                           1                2                   3            4               5       6            7              8             9             10




                         ANSWERS TO MARCH 2004 ISSUE



                                A Gentleman with Post-operative
                                     Cough and Hiccough
                               1.                e                  7.            T
APRIL 2004




                               2.                c                  8.            T                                                                 X X ( X )
                               3.                T                  9.            F
                               4.                T                  10.           T
                               5.                T                  11.           T
HKMA CME BULLETIN




                               6.                T                  12.           T




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

                    (A) Clinical Cardiology Series

                    1.


                    2.

p.14



                    (B) Dermatology Series

                    1.


                    2.


                    3.


                    4.


                    5.
                                     CME                      Calendar

    Date/Time                                     Function                                                                                                                                                                               Remarks/




                                                                                                                                                                                  HKCPaed
                                                                                                                                                                                            HKCPath
                                                                                                          MCHK &




                                                                                                                                                                         HKCORL




                                                                                                                                                                                                             HKCPsy
                                                                                                                          HKCCM
                                                                                                                                  HKCEM


                                                                                                                                                  HKCOG
                                                                                                                                                                                                                                        Contact Info




                                                                                                                                                                 HKCOS
                                                                                                                                          HKCFP
                                                                                                          HKMA




                                                                                                                                                          COHK
                                                                                                                   HKCA




                                                                                                                                                                                                                       HKCR
                                                                                                                                                                                                                              CSHK
                                                                                                                                                                                                      HKCP
April 2004            HKMA CME Programme                                                                                                                                                                                             Fax answer sheet to
                      Monthly Self-Study Series - An Update on Empyema Thoracis                             1                                                                                                                        Fax: 2865 0943
                                                                                                                                                                                                                                     By 15 May 2004
17 Apr 2004           HKU – Dept of O&G                                                                                                                                                                                              Ms. Kathy Chang
(Sat)                 Maternal-Fetal Medicine Grand Round: Placenta praevia with accreta/                                                                                                                                            Tel: 2855 4648
1:00 – 2:30 pm        percreta: Is there anything new that we can offer?                                   1.5
                      Lecture Theatre, 6/F, Professorial Block, Queen Mary Hospital, HK
17 Apr 2004           Hong Kong Alzheimer’s Disease & Brain Failure Association                                                                                                                                                      Ms. Elsie Chung
(Sat)                 Certificate Course for Screening Diagnosing and Managing Alzheimer's                 1.5                                                                                                                       Tel: 2338 1120
1:00 - 3:00 pm        Disease in Primary Care (Session 1)
                      G/F, Wang Yip House, Wang Tau Hom Estate, Kln
17 Apr 2004           United Christian Hospital, Kwun Tong District Health Committee                                                                                                                                                 Ms. Marina Pun
(Sat)                 Refresher Course for Health Personnel 2004 (Session 2: New Era in COAD               1.5                                                                                                                       Tel: 2379 4888
1:30 – 3:45 pm        Treatment)
                      Lecture Theatre, G/F, Block P, United Christian Hospital, Kln
17 Apr 2004           Association of Medical Practitioners of Societies’ Clinics,
(Sat)                 Sun Yat-Sen University of Medical Sciences Hong Kong                                                                                                                                                           Tel: 2783 8988
1:30 – 4:00 pm        Alumni Association, Hong Kong China Association of
                      Medical Specialisum
                      Updated Management of Hyperlipidaemia                                                 2
                      HKMA Dr. Li Shu Pui Professional Education Centre, 2/F, Chinese Club Building,
                      21-22 Connaught Road Central, HK
17 Apr 2004           Hong Kong Association of Gerontology – Hong Kong Institute of                                                                                                                                                  Tel: 2558 1181
(Sat)                 Gerontology                                                                           2             10# 12# 12#                                                                  –      –               18#
2:00 – 4:00 pm        Certificate Course on Gerontology for Medical Practitioners (Session 1)
                      1/F, HKSR Lam Tin Complex, 7 Rehab Path, Lam Tin, Kln
17 Apr 2004           HKU Family Institute                                                                                                                                                                                           Tel: 2859 5300




                                                                                                                                                                                                                                                             APRIL 2004
(Sat)                 Intermediate Course in Family Therapy (X)                                             3                                                                                                                        Fax: 2964 9475
2:00 – 5:00 pm        Lecture Room, HKU Family Institute, 5/F., Tsan Yuk Hospital, 30 Hospital Road,
                      HK
17 Apr 2004           HKMA CME Programme, Our Lady of Maryknoll Hospital                                                                                                                                                             Ms. Clara Tsang
(Sat)                 Refresher Course for Health Care Providers 2003/2004 (VIII) –                         2       2      1       1      1       1       1       –      –         2 6# –                     –        –      2      Tel: 2354 2440
2:30 – 4:30 pm        Update on Sexually Transmitted Diseases                                                                                                                                                                        *
                      Training Room II, 1/F, OPD Block, Our Lady of Maryknoll Hospital, Kln
17-18 Apr 2004        HKU – Dept of Orthopaedic Surgery, College of Surgeons of Hong Kong                                                                                                                                            Dr. Wong Yat Wa




                                                                                                                                                                                                                                                             HKMA CME BULLETIN
(Sat – Sun)           A Spinal Cord Regeneration & Rehabilitation Conference                               10#                                                                                                                       Tel: 2974 0621
                      Faculty of Medicine Building, HKU, Sassoon Road, HK
17-18 Apr 2004        Hong Kong College of Family Physicians, Hong Kong College of                                                                                                                                                   Ms. Karen Yip
(Sat – Sun)           Community Medicine                                                                                                                                                                                             Tel: 2528 6618
                      Preparing for Public Health Crisis                                                   8#
                      Hong Kong Academy of Medicine Jockey Club Building, HK
18 Apr 2004           St. Teresa’s Hospital                                                                                                                                                                                          Dr. Lawrence Chan
(Sun)                 “Face OFF” – An Experience of Major head & Neck Surge in Public and                   2      1.5                                                                                                        1.5    Tel: 2780 2226
10:00 – 11:30 am      Private Hospital
                      9/F Conference Room, St. Teresa’s Hospital, Kln
18 Apr 2004           Hong Kong Doctors Union                                                                                                                                                                                        Tel: 2388 2728
(Sun)                 Symposium on “From ENT to Cervical Screening”Lecture Hall, 8/F, Block G,              3
1:00 - 5:30 pm        Princess Margaret Hospital, NT
18 Apr 2004           CUHK - Department of Medicine & Therapeutics                                                                                                                                                                   Ms Charmaine Lee
(Sun)                 Certificate Course in Diabetes Management and Education Year 2004                     3              3              2       2                                3         3 1.5                     3      3      Tel: 2632 5752
1:30 – 4:45 pm        (Module 1: Diabetes Management in special Situations)                                                                                                                                                          Fee: $400
                      4/F Sheraton Hong Kong Hotel & Towers, 20 Nathan Road, Kowloon
18 Apr 2004           CUHK - Dept of Medicine & Therapeutics                                                                                                                                                                         Ms Charmaine Lee
(Sun)                 Professional Diploma Programme in Diabetes Management and Education                                                                                                                                            Tel: 2632 5752
1:30 – 4:45 pm        Year 2004                                                                           122#            10# 6 8.5 5#                                            18# 20# 1.5                         122#18#        Reg. Fee: $400
                      (Module 1: Diabetes Management in special Situations)                                                      #
                      4/F., Sheraton Hong Kong Hotel & Towers, 20 Nathan Road, Kowloon
18 Apr 2004           HKMA CME Programme, Queen Elizabeth Hospital                                                                                                                                                                   Members: $50          p.15
(Sun)                 HKMA Structured CME Programme at QEH (I) – Medicine                                   3                                                                                                                        Non-M: $80
2:00 – 5:00 pm        HKMA Dr. Li Shu Pui Professional Education Centre, 2/F, Chinese Club Building,                                                                                                                                 Tel: 2861 1979
                      21-22 Connaught Road Central, HK                                                                                                                                                                               *
19 Apr 2004           Hong Kong Doctors Union, Tung Wah Eastern Hospital                                                                                                                                                             Tel: 2388 2728
(Mon)                 Certificate Course on Practical Diabetes Care for General Practitioners               2
1:00 – 3:30 pm        (Group A)
                      Tung Wah Eastern Hospital Diabetes Mellitus Centre, HK
19 Apr 2004           Princess Margaret Hospital - Dept of O&G, HKCOG                                                                                                                                                                Ms. Ginny Chan
(Tue)                 Topic Seminar                                                                         1                                                                                                                        Tel: 2990 3297
5:30 - 6:30 pm        Room 10, 2/F, Block G, Princess Margaret Hospital, NT
20 Apr 2004           HA – Queen Mary Hospital, Dept of Surgery                                                                                                                                                                      Ms. Rosanna Chung
(Tue)                 Research Meeting                                                                      1                                                                                                                        Tel: 2855 4238
8:00 – 8:30 am        5/F Lecture Theatre, Professorial Block, Queen Mar y Hospital, HK
20 Apr 2004           Hong Kong Doctors Union – Sham Shui Po Study Group                                                                                                                                                             Tel: 2388 2728
(Tue)                 Update of Weight Management in Private Sector                                         1
1:00 – 3:00 pm        Lily Room, 2/F Hotel Concourse, Mongkok, Kln
20 Apr 2004           Hong Kong Doctors Union, Tung Wah Eastern Hospital                                                                                                                                                             Tel: 2388 2728
(Tue)                 Certificate Course on Practical Diabetes Care for General Practitioners (Group B)     2
1:00 – 3:30 pm        Tung Wah Eastern Hospital Diabetes Mellitus Centre, HK
20 Apr 2004           HA - Tseung Kwan O Hospital, Dept of Surgery                                                                                                                                                                   Ms. Eunice Heath
(Tue)                 X-ray Meeting                                                                         1                                                                                                                        Tel: 2208 0751
4:00 – 5:00 pm        Conference Room, 2/F, Surgical Dept, Tseung Kwan O Hospital, NT
20 Apr 2004           HKU Family Institute                                                                                                                                                                                           Tel: 2859 5300
(Tue)                 Intermediate Course in Family Therapy (XI)                                            3                                                                                                                        Fax: 2964 9475
6:45 – 9:45 pm        Lecture Room, HKU Family Institute, 5/F., Tsan Yuk Hospital, 30 Hospital Road,
                      HK

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




                        Date/Time                                    Function                                                                                                                                                                         Remarks/




                                                                                                                                                                                                HKCPaed
                                                                                                                                                                                                          HKCPath
                                                                                                                        MCHK &




                                                                                                                                                                                       HKCORL




                                                                                                                                                                                                                           HKCPsy
                                                                                                                                        HKCCM
                                                                                                                                                HKCEM


                                                                                                                                                                HKCOG
                                                                                                                                                                                                                                                     Contact Info




                                                                                                                                                                               HKCOS
                                                                                                                                                        HKCFP
                                                                                                                        HKMA




                                                                                                                                                                        COHK
                                                                                                                                 HKCA




                                                                                                                                                                                                                                    HKCR
                                                                                                                                                                                                                                           CSHK
                                                                                                                                                                                                                    HKCP
                    21 Apr 2004           Pamela Youde Nethersole Eastern Hospital - Dept of O&G, HKCOG                                                                                                                                           Ms. Angel Hui
                    (Wed)                 Topic Seminar                                                                    1                                                                                                                      Tel: 2595 6408
                    8:30 - 9:30 am        Venue: to be advised
                    21 Apr 2004           HA – Princess Margaret Hospital, Dept of O&T                                                                                                                                                            Ms. Yiu
                    (Wed)                 Clinical Conference                                                              1                                                                                                                      Tel: 2990 3116
                    8:30 – 10:00 am       Room 9, 2/F, Block G, Princess Margaret Hospital, NT
                    21 Apr 2004           CUHK – Hong Kong Mood Disorder Centre                                                                                                                                                                   Ms. Lillian Lo
                    (Wed)                 A New Practical Course on Mood Disorders in Primary Care                                                                                                                                                Tel: 2144 6996
                    12:30 – 3:30 pm       (Session 9 – Review and synthesis: the evidence-based treatment of anxiety       2
                                          and depressive disorders in primary care)
                                          Ballroom A, 2/F, Langham Hotel, TST, Kln
                    21 Apr 2004           Hong Kong Doctors Union - Sheung Shui Study Group                                                                                                                                                       Tel: 2388 2728
                    (Wed)                 Practical Tips in the Treatment of Allergic Rhinitis Glory Super Seafood         1
                    1:00 – 3:00 pm        Restaurant, 1/F, Lung Fung Garden, 33 Lung Sum Avenue, Sheung Shui, NT
                    21 Apr 2004           Pamela Youde Nethersole Eastern Hospital                                                                                                                                                                Ms. Amy Ng
                    (Wed)                 Podiatrist Role in DM Management                                                 1                            1                                                                                         Tel: 2595 6887
                    1:15 – 2:45 pm        Lecture Hall (Room PB.01.014), 1/F, Pathology Block, Pamela Youde
                                          Nethersole Eastern Hospital, HK
                    21 Apr 2004           Merck Sharp & Dohme (Asia) Ltd                                                                                                                                                                          Mr. Marco Lok
                    (Wed)                 Management of Degenerative Joint Disease                                         1                                                                                                                      Tel: 7310 1002
                    1:15 - 3:30 pm        Capital Seafood Restaurant, Tai Po, NT
                    21 Apr 2004           Hong Kong Academy of Medicine                                                                                                                                                                           Tel: 2871 8787
                    (Wed)                 Case Studies In Psychiatry and Neurology                                         2
                    1:30 – 3:30 pm        HKMA Dr. Li Shu Pui Professional Education Centre, 2/F, Chinese Club Building,
                                          21-22 Connaught Road Central, HK
                    21 Apr 2004           United Christian Hospital - Dept of O&G, HKCOG                                                                                                                                                          Ms. Michelle Yeung
                    (Wed)                 The Unhappy Housewife in the Gynae Clinic                                        1                                                                                                                      Tel: 3513 4851
APRIL 2004




                    2:00 - 3:00 pm        Conference Room, Hospital Library, 1/F, Block H, United Christian Hospital, Kln
                    22 Apr 2004           Prince of Wales Hospital - Dept of O&G, HKCOG                                                                                                                                                           Ms. Alice Lai
                    (Thu)                 Clinical Pathological Conference                                                 1                                                                                                                      Tel: 2632 2810
                    12:30 - 1:30 pm       Seminar Room 1E, Prince of Wales Hospital, NT
                    22 Apr 2004           Hong Kong Doctors Union - Hong Kong West Study Group                                                                                                                                                    Tel: 2388 2728
                    (Thu)                 Diagnosis and Management of Erectile Dysfunction                                 1
                    1:00 - 3:00 pm        Novotel Century Harbourview, 508 Queen's Road West, HK
                    22 Apr 2004           Hong Kong College of Family Physicians                                                                                                                                                                  Ms. Kara Lo
HKMA CME BULLETIN




                    (Thu)                 Respiratory Tract Infections Management                                          1                                                                                                                      Tel: 2861 0230
                    2:00 - 3:00 pm        Crystal Ballroom, Holiday Inn Golden Mile Hotel, TST, Kln
                    22 Apr 2004           Hong Kong Sanatorium & Hospital - Dept of O&G, HKCOG                                                                                                                                                    Ms. Susan Cheng
                    (Thu)                 Role of Laparoscopic Pelvic Floor Reconstruction                                 1                                                                                                                      Tel: 2835 8800
                    7:30 - 8:30 pm        The Auditorium, 4/F Li Shu Pui Block, Hong Kong Sanatorium & Hospital, HK
                    23 Apr 2004           Tuen Mun Hospital - Dept of O&G, HKCOG                                                                                                                                                                  Ms. Angela Cheung
                    (Fri)                 Journal Club                                                                     1                                                                                                                      Tel: 2468 5404
                    12:30 - 1:30 pm       Room F2029, 2/F Special Block, Tuen Mun Hospital, NT
                    23 Apr 2004           The Hong Kong Society of Dermatology & Venereology                                                                                                                                                      Ms. Sandy Chung
                    (Fri)                 Advances Treatment in AK & BCC                                                   1                                                                                                                      Tel: 2116 4349
                    12:30 - 3:00 pm       Langham Hotel, TST, Kln
                    23 Apr 2004           Hong Kong Doctors Union - Shatin Study Group                                                                                                                                                            Tel: 2388 2728
                    (Fri)                 Current Treatment of Erectile Dysfunction                                        1
                    1:00 - 3:00 pm        Regal Riverside Hotel, Shatin, NT
                    23 Apr 2004           The Hong Kong Medical Association                                                                                                                                                                       Whole Course Fee:
                    (Fri)                 2nd Putonghua Certificate Course for Medical Practitioners (Session 11)         1.5                                                                                                                     $1,500 (15-session)
                    1:45 – 3:15 pm        HKMA Dr. Li Shu Pui Professional Education Centre, 2/F, Chinese Club Building,                                                                                                                          Ms. Dora Ho
                                          21-22 Connaught Road Central, HK                                                                                                                                                                        Tel: 2527 8285
                    23 Apr 2004           Hong Kong College of Family Physicians                                                                                                                                                                  Ms. Kara Lo
                    (Fri)                 Update on the Management of Wheezy Kids                                          1                                                                                                                      Tel: 2861 0230
                    2:00 - 3:00 pm        Derby Suites I-III, Level 3, Royal Park Hotel, NT
                    23 Apr 2004           HKU Family Institute                                                                                                                                                                                    Tel: 2859 5300
p.16                (Fri)                 Workshop on “Searching for Competence: Working with Mental Handicapped
                    2:00 – 5:00 pm        Familities”                                                                      3
                                          HKU Family Institute, 5/F Tsan Yuk Hospital, 30 Hospital Road, Sai Ying Pun,
                                          HK
                    24 Apr 2004           HKU - Faculty of Medicine                                                                                                                                                                               Ms. Cherry Lee
                    (Sat)                 Refresher Course in Forensic Medicine (Session I)                                3                                                                                                                      Tel: 2855 4875
                    9:00 – 12:30 pm       Cheung Kung Hai Conference Centre, G/F Academic and Administration
                                          Block, Faculty of Medicine Building, 21 Sassoon Road, HKU, HK
                    24 Apr 2004           HA – Pamela Youde Nethersole Eastern Hospital, Dept of Surgery                                                                                                                                          Ms. Miu Sze
                    (Sat)                 Journal Club / Evidence Based Medicine Course                                    1                                                                                                                      Tel: 2595 6419
                    10:00 – 11:00 am      Conference Room, Main Block, Pamela Youde Nethersole Eastern
                                          Hospital, HK
                    24 Apr 2004           Hong Kong Alzheimer's Disease & Brain Failure Association                                                                                                                                               Ms. Elsie Chung
                    (Sat)                 Certificate Course for Screening Diagnosing and Managing Alzheimer's                                                                                                                                    Tel: 2338 1120
                    1:00 - 3:00 pm        Disease in Primary Care (Session 2)                                             1.5
                                          G/F, Wang Yip House, Wang Tau Hom Estate, Kln
                    24 Apr 2004           HKU – Centre on Behavioral Health                                                                                                                                                                       Tel: 2589 0510
                    (Sat)                 Workshop on Psychotherapy and Counceling in Action: Live Demonstration           3
                    2:00 – 5:00 pm        for Professional Training (Session 2)
                                          G/F, Pauline Chan Building, 10 Sasson Road, HKU, HK
                    24 Apr 2004           Hong Kong College of Family Physicians                                                                                                                                                                  Ms. Kara Lo
                    (Sat)                 TCM Treatment in Diabetes                                                        3                                                                                                                      Tel: 2861 0230
                    2:00 – 5:00 pm        Lecture Hall, Hospital Authority Building, 147B Ar ygle Street, Kln
                    24-25 Apr 2004        HKU – Dept of Orthopaedic Surgery                                                                                                                                                                       Forum Secretariat
                    (Sat-Sun)             The First Hong Kong Orthopaedic Forum                                           8#                            6#                     6#                                   1.5#                          Tel: 2855 4654
                                          Academic and Admin Block, Faculty of Medicine Building, HKU,
                                          21 Sassoon Road, HK

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




    Date/Time                                         Function                                                                                                                                                                                   Remarks/




                                                                                                                                                                                           HKCPaed
                                                                                                                                                                                                     HKCPath
                                                                                                                   MCHK &




                                                                                                                                                                                  HKCORL




                                                                                                                                                                                                                      HKCPsy
                                                                                                                                   HKCCM
                                                                                                                                           HKCEM


                                                                                                                                                           HKCOG
                                                                                                                                                                                                                                                Contact Info




                                                                                                                                                                          HKCOS
                                                                                                                                                   HKCFP
                                                                                                                   HKMA




                                                                                                                                                                   COHK
                                                                                                                            HKCA




                                                                                                                                                                                                                               HKCR
                                                                                                                                                                                                                                      CSHK
                                                                                                                                                                                                               HKCP
25 Apr 2004           Sun Yat-Sen University of Medical Sciences Hong Kong
(Sun)                 Alumni Association, Association of Medical Practitioners of Societies‘                                                                                                                                                 Tel: 2783 8988
1:30 – 4:00 pm        Clinics, Hong Kong China Association of Medical Specialisum,                                   2
                      HKPHUDA
                      The Role of ARB in Hypertension Treatment
                      HKMA Dr. Li Shu Pui Professional Education Centre, 2/F, Chinese Club Building,
                      21-22 Connaught Road Central, HK
25 Apr 2004           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        Common arrhythmia
                      Plaza Conference Centre, 35/F Central Plaza, 18 Harbour Road, HK
25 Apr 2004           Hong Kong College of Family Physicians                                                                                                                                                                                 Ms. Kara Lo
(Sun)                 Palliative Care Update – Medical Doctor and Beyond                                             2                                                                                                                       Tel: 2861 0230
2:00 – 4:00 pm        Seminar Room 1, HA Building, 147B Argyle Street, Kln
25 Apr 2004           HKMA CME Programme, Kwong Wah Hospital                                                                                                                                                                                 Members: $50
(Sun)                 HKMA Structured CME Programme at KWH (I) - Anaesthesiology & Neurology                         3                                                                                                                       Non-M: $80
2:00 – 5:00 pm        Lecture Theatre, 10/F, Yu Chun Keung Memorial Medical Centre, KWH, Kln                                                                                                                                                 Tel: 2861 1979
                                                                                                                                                                                                                                             *
25 Apr 2004           CUHK – Dept of Medicine & Therapeutics                                                                                                                                                                                 Ms. Isabella Fu
(Sun)                 CUHK Diploma Programme in Advanced Internal Medicine 2004-05 – Stroke                          3      15# 10# 20#                    5# 1                   2# 18#                                              18#    Tel: 2632 3996
5:00 – 8:00 pm        Plaza Conference Centre, 35/F Central Plaza, 18 Harbour Road, HK
26 Apr 2004           Hong Kong Doctors Union, Tung Wah Eastern Hospital                                                                                                                                                                     Tel: 2388 2728
(Mon)                 Certificate Course on Practical Diabetes Care for General Practitioners (Group A)              2
1:00 – 3:30 pm        Tung Wah Eastern Hospital Diabetes Mellitus Centre, HK
27 Apr 2004           HA – Queen Mary Hospital, Dept of Surgery                                                                                                                                                                              Ms. Rosanna Chung
(Tue)                 Research Meeting                                                                               1                                                                                                                       Tel: 2855 4238
8:00 – 8:30 am        5/F Lecture Theatre, Professorial Block, Queen Mar y Hospital, HK




                                                                                                                                                                                                                                                                    APRIL 2004
27 Apr 2004           HKMA CME Programme                                                                                                                                                                                                     Free of charge
(Tue)                 Current Management of Alzheimer’s Disease, from Mild Cognitive Impairment to Severe Stages     1                                                                                                                       Tel: 2861 1979
1:00 – 3:00 pm        The Ballroom, Level 2, Langham Hotel Hong Kong (Former Great Eagle Hotel),                                                                                                                                             *
                      8 Peking Road, TST
27 Apr 2004           Hong Kong Doctors Union – Tuen Mun Study Group                                                                                                                                                                         Tel: 2388 2728
(Tue)                 Update of Weight Management in Private Sector                                                  1
1:00 – 3:00 pm        Gold Coast Yacht and Country Club, 1 Castle Peak Road, Castle Peak Bay, NT
27 Apr 2004           Hong Kong Doctors Union, Tung Wah Eastern Hospital                                                                                                                                                                     Tel: 2388 2728




                                                                                                                                                                                                                                                                    HKMA CME BULLETIN
(Tue)                 Certificate Course on Practical Diabetes Care for General Practitioners (Group B)              2
1:00 – 3:30 pm        Tung Wah Eastern Hospital Diabetes Mellitus Centre, HK
27 Apr 2004           Hong Kong College of Family Physicians                                                                                                                                                                                 Ms. Helen Lo
(Tue)                 Psoriasis: When should GP refer                                                                1                             1                                                                                         Tel: 3408 7921
1:30 – 2:45 pm        Staff Lounge, 1/F, Wai Oi Block, Caritas Medical Centre, Kln
27 Apr 2004           Hong Kong Society of Palliative Medicine                                                                                                                                                                               Ms. Creamy Cheung
(Tue)                 Palliative Medicine Doctors’ Meeting                                                           2                                                                                                                       Tel: 2958 6261
6:00 – 7:30 pm        Lecture Theatre, Block M, Queen Elizabeth Hospital, Kln
27 Apr 2004           HKU Family Institute                                                                                                                                                                                                   Tel: 2859 5300
(Tue)                 Intermediate Course in Family Therapy (XII)                                                    3                                                                                                                       Fax: 2964 9475
6:45 – 9:45 pm        Lecture Room, HKU Family Institute, 5/F., Tsan Yuk Hospital, 30 Hospital Road,
                      HK
27-29 Apr 2004        HKU – Dept of Surgery, Skills Development Centre                                                                                                                                                                       Program Manager
(Tue-Thu)             Advanced Trauma Life Support (ATLS) Programme                                                 8#                                                                                                                       Tel: 2855 4885
                      Skills Development Centre, Dept of Surger y, HKU Medical Centre,
                      3/F C Wing, Main Block, Queen Mary Hospital, HK
28 Apr 2004           Pamela Youde Nethersole Eastern Hospital – Dept of O&G, HKCOG                                                                                                                                                          Ms. Angel Hui
(Wed)                 Topic Seminar                                                                                  1                                                                                                                       Tel: 2595 6408
8:30 – 9:30 am        Venue: to be advised
28 Apr 2004           HA – Princess Margaret Hospital, Dept of O&T                                                                                                                                                                           Ms. Yiu
(Wed)                 Clinical Conference                                                                            1                                                                                                                       Tel: 2990 3116
8:30 – 10:00 am       Room 9, 2/F, Block G, Princess Margaret Hospital, NT
28 Apr 2004           Queen Elizabeth Hospital – Dept of O&G, HKCOG                                                                                                                                                                          Ms. Betty Cheng      p.17
(Wed)                 Topic Seminar                                                                                  1                                                                                                                       Tel: 2958 6049
1:00 – 2:00 pm        B3, Seminar Room, Queen Elizabeth Hospital, Kln
28 Apr 2004           Canossa Hospital (Caritas)                                                                                                                                                                                             Ms. Wendy Lee
(Wed)                 Practical Management of Vesicoureteral Reflux                                                  1                             1                                         1                                         1     Tel: 2522 2181
1:30 – 2:30 pm        2/F Conference Room, Canossa Hospital, HK
28 Apr 2004           Hong Kong Academy of Medicine                                                                                                                                                                                          Tel: 2871 8787
(Wed)                 Hip Arthritis in the Young Adult; Back Pain                                                    2
1:30 – 3:15 pm        Lecture Theatre, 1/F, Pathology Building, Pamela Youde Nethersole Eastern
                      Hospital, HK
28 Apr 2004           HKU Family Institute                                                                                                                                                                                                   Tel: 2859 5300
(Wed)                 Certificate Course in Family Therapy for Health Care Professionals (Session 6)                 3                              2
1:30 – 4:30 pm        Lecture Hall, HKU Family Institute, 5/F Tsan Yuk Hospital, 30 Hospital Road,
                      Sai Ying Pun, HK
28 Apr 2004           United Christian Hospital – Dept of O&G, HKCOG                                                                                                                                                                         Ms. Michelle Yeung
(Wed)                 Perinatal Risks of IVF Pregnancies                                                             1                                                                                                                       Tel: 3513 4851
2:00 – 3:00 pm        Conference Room, Hospital Library, 1/F, Block H, United Christian Hospital, Kln
29 Apr 2004           Prince of Wales Hospital – Dept of O&G, HKCOG                                                                                                                                                                          Ms. Alice Lai
(Thu)                 The use of Misoprostol in Gynaecology: a Review                                                1                                                                                                                       Tel: 2632 2810
12:30 – 1:30 pm       Seminar Room 1E, Prince of Wales Hospital, NT
29 Apr 2004           HA – Yan Chai Hospital, Dept of Paediatrics                                                                                                                                                                            Ms. Rachel Yeung
(Thu)                 Update / Case Presentation                                                                     1                                                                                                                       Tel: 2417 8358
12:45 – 1:45 pm       Conference Room 2, 3/F, Block B, Yan Chai Hospital, NT
29 Apr 2004           Hong Kong Doctors Union – Tseung Kwan O Study Group                                                                                                                                                                    Tel: 2388 2728
(Thu)                 Allergic Rhinitis and Its Impacts on Asthma                                                    1
1:00 – 3:00 pm        Maxim’s Chinese Restaurant, Shop No. 2008, Level 2, Metro City Plaza II,
                      Tseung Kwan O, NT

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




                        Date/Time                                      Function                                                                                                                                                                            Remarks/




                                                                                                                                                                                                     HKCPaed
                                                                                                                                                                                                               HKCPath
                                                                                                                             MCHK &




                                                                                                                                                                                            HKCORL




                                                                                                                                                                                                                                HKCPsy
                                                                                                                                             HKCCM
                                                                                                                                                     HKCEM


                                                                                                                                                                     HKCOG
                                                                                                                                                                                                                                                          Contact Info




                                                                                                                                                                                    HKCOS
                                                                                                                                                             HKCFP
                                                                                                                             HKMA




                                                                                                                                                                             COHK
                                                                                                                                      HKCA




                                                                                                                                                                                                                                         HKCR
                                                                                                                                                                                                                                                CSHK
                                                                                                                                                                                                                         HKCP
                    29 Apr 2004           The Society of Physicians of Hong Kong                                                                                                                                                                       Dr. T.H. Chan
                    (Thu)                 Clinical and Laboratory Diagnosis of SARS                                            1                                                                                                                       Tel: 2882 3108
                    2:00 – 3:00 pm        HKMA Dr. Li Shu Pui Professional Education Centre, 2/F, Chinese Club Building,
                                          21-22 Connaught Road Central, HK
                    29 Apr 2004           Hong Kong College of Family Physicians                                                                                                                                                                       Ms. Kara Lo
                    (Thu)                 How to start research in a family practice clinic or in private general practice     2                                                                                                                       Tel: 2861 0230
                    2:00 – 3:30 pm        Auditorium 305, Duke of Windsor Social Service Building, 15 Hennessy Road,
                                          Wanchai, HK
                    29 Apr 2004           Hong Kong Baptist Hospital – Dept of O&G, HKCOG                                                                                                                                                              Ms. Polly Tam
                    (Thu)                 Continuing Professional Development (CPD); Modern Concepts of Meconium               1                                                                                                                       Tel: 2339 8873
                    7:30 – 8:30 pm        Stained Liquor
                                          Nursing School Lecture Room, 2/F Au Shue Hung Health Centre,
                                          Hong Kong Baptist Hospital, Kln
                    30 Apr 2004           Hong Kong Sanatorium & Hospital                                                                                                                                                                              Ms. Susan Cheng
                    (Fri)                 Teleconference / Live Lectures                                                      2.5                                                                                                                      Tel: 2835 8800
                    8:00 – 11:00 am       4/F, The Auditorium, Li Shu Pui Block, Hong Kong Sanatorium & Hospital, HK                                                                                                                                   *
                    30 Apr 2004           Tsuen Wan Adventist Hospital                                                                                                                                                                                 Tel: 2276 7180
                    (Fri)                 Outpatient Treatment of Burns                                                        1
                    1:15 – 3:00 pm        Longwall Hall / Auditorium, Tsuen Wan Adventist Hospital, 199 Tsuen King
                                          Circuit, Tsuen Wan, NT
                    30 Apr 2004           The Hong Kong Medical Association                                                                                                                                                                            Whole Course Fee:
                    (Fri)                 2nd Putonghua Certificate Course for Medical Practitioners (Session 12)             1.5                                                                                                                      $1,500 (15-session)
                    1:45 – 3:15 pm        HKMA Dr. Li Shu Pui Professional Education Centre, 2/F, Chinese Club Building,                                                                                                                               Ms. Dora Ho
                                          21-22 Connaught Road Central, HK                                                                                                                                                                             Tel: 2527 8285
                    2 May 2004            CUHK – Department of Medicine & Therapeutics                                                                                                                                                                 Ms Charmaine Lee
                    (Sun)                 Certificate Course in Diabetes Management and Education Year 2004                    3              3               2      3                                 3        3 1.5                     3     3      Tel: 2632 5752
                    1:30 – 4:45 pm         (Module 1: Diabetes and Cardiovascular Diseases)                                                                                                                                                            Fee: $400
APRIL 2004




                                          4/F Sheraton Hong Kong Hotel & Towers, 20 Nathan Road, Kowloon
                    2 May 2004            CUHK – Dept of Medicine & Therapeutics                                                                                                                                                                       Ms Charmaine Lee
                    (Sun)                 Professional Diploma Programme in Diabetes Management and                          122#            10# 6 8.5 5#                                            18# 20# 1.5                         122# 18#      Tel: 2632 5752
                    1:30 – 4:45 pm        Education Year 2004 (Module 1: Diabetes and Cardiovascular Diseases)                                      #                                                                                                  Reg. Fee: $400
                                          4/F., Sheraton Hong Kong Hotel & Towers, 20 Nathan Road, Kowloon
                    2 May 2004            HKMA CME Programme                                                                                                                                                                                           Free of Charge
                    (Sun)                 Office Dermatology cum Consultation Forum on CME Compliance                          2                                                                                                                       Tel: 2861 1979
                    2:00 – 4:00 pm        Auditorium, 6/F, Chinese YMCA of Hong Kong                                                                                                                                                                   *
HKMA CME BULLETIN




                    2 May 2004            Hong Kong Public Hospitals, Department of Health and University                                                                                                                                              Tel: 2770 3676
                    (Sun)                 Doctors Association                                                                  2
                    2:00 – 5:00 pm        Workshop on Training Primary Care Physicians to Implement Practical Skills in
                                          Treatment of Depressive Patients (Day 1)
                                          2/F Jordan Room, Eaton Hotel, 380 Nathan Road, Kln
                    3 May 2004            Hong Kong Doctors Union, Tung Wah Eastern Hospital                                                                                                                                                           Tel: 2388 2728
                    (Mon)                 Certificate Course on Practical Diabetes Care for General Practitioners              2
                    1:00 – 3:30 pm        (Group A)
                                          Tung Wah Eastern Hospital Diabetes Mellitus Centre, HK
                    3 May 2004            HA – Our Lady of Maryknoll Hospital, Dept of Surgery                                                                                                                                                         Ms. Clara Tsang
                    (Mon)                 Topical Workshop – Recent Advances in Mx of Colo-rectal Carcinoma                    1                                                                                                                       Tel: 2354 2440
                    3:00 – 4:00 pm        Conference Room D, 1/F OPD Block, Our Lady of Mar yknoll Hospital, Kln
                    4 May 2004            Hong Kong Doctors Union, Tung Wah Eastern Hospital                                                                                                                                                           Tel: 2388 2728
                    (Tue)                 Certificate Course on Practical Diabetes Care for General Practitioners              2
                    1:00 – 3:30 pm        (Group B)
                                          Tung Wah Eastern Hospital Diabetes Mellitus Centre, HK
                    4 May 2004            Hong Kong Dietetic Association, Hong Kong Society of Clinical                                                                                                                                                Ms. Connie Ng
                    (Tue)                 Oncology                                                                             1                                                                                                          1            Tel: 2566 8711
                    7:00 – 10:00 pm       New Approaches to Managing Malignacy Induced Weight Loss
                                          The Ballroom, Sheraton Hotel, 20 Nathan Road, TST, Kln
                    4 May 2004            Sportsmed HK                                                                                                                                                                                                 Tel: 2715 4577
                    (Tue)                 Running Assessment                                                                   1
p.18                7:30 – 8:30 pm        715 Jardine House, Central, HK
                    5 May 2004            HA – Castle Peak Hospital                                                                                                                                                                                    Ms. Fion Ling
                    (Wed)                 Seminar – Ethical Issues in the Practice of Psychiatry                               2                                                                                                                       Tel: 2456 7843
                    11:30 – 1:00 pm       Lecture Theatre, Block D, Castle Peak Hospital, NT
                    6 May 2004            Hong Kong Baptist Hospital                                                                                                                                                                                   Dr. L.T. Yung
                    (Thu)                 A Review of Acute Post-Operative Pain Management                                    1.5                                                                                                                      Tel: 2339 8888
                    8:00 – 9:30 am        Nursing School Lecture Room, 2/F, ASHHC, Hong Kong Baptist Hospital, Kln

                    6 May 2004            HKMA CME Programme                                                                                                                                                                                           Free of charge
                    (Thu)                 New Technology for the Diagnosis of Vaginal Candidiasis                              1                                                                                                                       Tel: 2861 1979
                    1:00 – 3:00 pm        The Ballroom, Level 2, Langham Hotel Hong Kong (Former Great Eagle Hotel),                                                                                                                                   *
                                          8 Peking Road, TST
                    6 May 2004            HA – Kwong Wah Hospital, Dept of Paed                                                                                                                                                                        Ms. Annie Young
                    (Thu)                 Lecture – Update on Paed Epilepsy                                                    1                                                                                                                       Tel: 2781 5055
                    2:00 – 3:00 pm        Lecture Room, 1/F Nurses Quarter, Kwong Wah Hospital, Kln
                    6 May 2004            Hong Kong Doctors Union                                                                                                                                                                                      Tel: 2388 2728
                    (Thu)                 Video Cassette Session – Domestic Violence: Recognizing and Treating Abused          1                             1
                    2:15 – 3:15 pm        Patients
                                          Room 901, Hang Shing Building, 363-373 Nathan Road, Kln
                    6 May 2004            HA – Tuen Mun Hospital, Dept of Family Medicine                                                                                                                                                              Ms. Cowin Tang
                    (Thu)                 Infection Control                                                                    1                                                                                                                       Tel: 2468 6601
                    5:30 – 6:45 pm        Room 614, Ambulatory Care Centre, Tuen Mun Hospital, NT
                    7 May 2004            Hong Kong Doctors Union – Sham Shui Po Study Group                                                                                                                                                           Tel: 2388 2728
                    (Fri)                 Management of Depression in General Practice                                         1
                    1:00 – 3:00 pm        Dragon Dynasty, G/F, 226-242 Cheung Sha Wan Road, Kln


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




    Date/Time                                    Function                                                                                                                                                                        Remarks/




                                                                                                                                                                           HKCPaed
                                                                                                                                                                                     HKCPath
                                                                                                   MCHK &




                                                                                                                                                                  HKCORL




                                                                                                                                                                                                      HKCPsy
                                                                                                                   HKCCM
                                                                                                                           HKCEM


                                                                                                                                           HKCOG
                                                                                                                                                                                                                                Contact Info




                                                                                                                                                          HKCOS
                                                                                                                                   HKCFP
                                                                                                   HKMA




                                                                                                                                                   COHK
                                                                                                            HKCA




                                                                                                                                                                                                               HKCR
                                                                                                                                                                                                                      CSHK
                                                                                                                                                                                               HKCP
7 May 2004            The Hong Kong Medical Association                                                                                                                                                                      Whole Course Fee:
(Fri)                 2nd Putonghua Certificate Course for Medical Practitioners (Session 13)        1.5                                                                                                                     $1,500 (15-session)
1:45 – 3:15 pm        HKMA Dr. Li Shu Pui Professional Education Centre, 2/F, Chinese Club Building,                                                                                                                         Ms. Dora Ho
                      21-22 Connaught Road Central, HK                                                                                                                                                                       Tel: 2527 8285
7 May 2004            HKU Family Institute                                                                                                                                                                                   Tel: 2859 5300
(Fri)                 Certificate Course in Family Therapy for Health Care Professionals (Session 7)  3               2
7:00 – 10:00 pm       Lecture Hall, HKU Family Institute, 5/F Tsan Yuk Hospital, 30 Hospital Road,
                      Sai Ying Pun, HK
8 May 2004            HKU – Faculty of Medicine                                                                                                                                                                              Ms. Cherry Lee
(Sat)                 Refresher Course in Forensic Medicine (Session II)                              3                                                                                                                      Tel: 2855 4875
9:00 – 12:30 pm       Cheung Kung Hai Conference Centre, G/F Academic and Administration Block,
                      Faculty of Medicine Building, 21 Sassoon Road, HKU, HK
8 May 2004            Hong Kong Association of Gerontology – Hong Kong Institute of                                                                                                                                          Tel: 2558 1181
(Sat)                 Gerontology                                                                     2      10# 12# 12#                       – –       18#
2:00 – 4:00 pm        Certificate Course on Gerontology for Medical Practitioners (Session 2)
                      1/F, HKSR Lam Tin Complex, 7 Rehab Path, Lam Tin, Kln
8 May 2004            HKMA CME Programme, Our Lady of Maryknoll Hospital                                                                                                                                                     Ms. Clara Tsang
(Sat)                 Refresher Course for Health Care Providers 2003/2004 (IX) –                     2   2 1 1 1 1 1 – – 2 6# – – – 2                                                                                       Tel: 2354 2440
2:30 – 4:30 pm        Office Management of Muskelo-skeletal problems in General Practice
                      Training Room II, 1/F, OPD Block, Our Lady of Maryknoll Hospital, Kln
8 – 11 May 2004       Hospital Authority                                                                                                                                                                                     Tel: 2300 6808
(Sat – Tue)           Hong Kong SARS Forum and Hospital Authority Convention 2004                    20# 15# 10# 12# 10# 5# 12# 5# 2# 18# 24# 8# 18# 25# 18#
                      Hong Kong Convention & Exhibition Centre, HK
9 May 2004            St. Teresa’s Hospital                                                                                                                                                                                  Dr. Lawrence Chan
(Sun)                 Laparoscopic Ureterolithotomy and Nephrectomy                                   2                                                                                                                      Tel: 2771 2312
10:00 – 11:30 am      9/F Conference Room, Hospital Building, St. Teresa’s Hospital, Kln
9 May 2004            CUHK – Dept of Medicine & Therapeutics                                                                                                                                                                 Ms. Suzanne Shek




                                                                                                                                                                                                                                                     APRIL 2004
(Sun)                 CUHK Diploma Programme in Advanced Internal Medicine 2003-04 –                                                                                                                                         Tel: 2632 3127
1:00 – 4:00 pm        Infection of the Urinary Tract                                                  3      10#         5# 0.5       18# 10#            18#
                      Kai Cheong Tong, G/F, Postgraduate Education Centre, PWH, Shatin, NT
9 May 2004            HKMA CME Programme, Queen Elizabeth Hospital                                                                                                                                                           Members: $50
(Sun)                 HKMA Structured CME Programme at QEH (II) – Paediatrics                         3                                                                                                                      Non-M: $80
2:00 – 5:00 pm        Lecture Theatre, G/F, Block M, Queen Elizabeth Hospital, Kln                                                                                                                                           Tel: 2861 1979
                                                                                                                                                                                                                             *
9 May 2004            Hong Kong Public Hospitals, Department of Health and University                                                                                                                                        Tel: 2770 3676




                                                                                                                                                                                                                                                     HKMA CME BULLETIN
(Sun)                 Doctors Association                                                             3
2:00 – 6:15 pm        Workshop on Training Primary Care Physicians to Implement Practical Skills in
                      Treatment of Depressive Patients (Day 2)
                      1/F Nathan Room, Eaton Hotel, 380 Nathan Road, Kln
9 May 2004            CUHK – Dept of Medicine & Therapeutics                                                                                                                                                                 Ms. Suzanne Shek
(Sun)                 CUHK Diploma Programme in Advanced Internal Medicine 2003-04 –                                                                                                                                         Tel: 2632 3127
4:30 -7:30 pm         Proteinuria and Haematuria                                                      3            10#                     5# 0.5                          18# 10#                                    18#
                      Kai Cheong Tong, G/F, Postgraduate Education Centre, Prince of Wales
                      Hospital, Shatin, NT
10 May 2004           Hong Kong Doctors Union, Tung Wah Eastern Hospital                                                                                                                                                     Tel: 2388 2728
(Mon)                 Certificate Course on Practical Diabetes Care for General Practitioners         2
1:00 – 3:30 pm        (Group A)
                      Tung Wah Eastern Hospital Diabetes Mellitus Centre, HK
11 May 2004           HKU – Centre on Behavioral Health                                                                                                                                                                      Tel: 2589 0510
(Tue)                 Workshop on Psychotherapy and Counceling in Action: Live Demonstration          3
4:00 – 7:00 pm        for Professional Training (Session 3)
                      G/F, Pauline Chan Building, 10 Sasson Road, HKU, HK
12 May 2004           Hong Kong Academy of Medicine                                                                                                                                                                          Tel: 2871 8787
(Wed)                 Management of Cancer Pain; Sleep Disorders                                      2
1:30 – 3:30 pm        Lecture Theatre, M Block, Queen Elizabeth Hospital, Kln
14 May 2004           The Hong Kong Medical Association                                                                                                                                                                      Whole Course Fee:
(Fri)                 2nd Putonghua Certificate Course for Medical Practitioners (Session 14)        1.5                                                                                                                     $1,500 (15-session)
1:45 – 3:15 pm        HKMA Dr. Li Shu Pui Professional Education Centre, 2/F, Chinese Club Building,                                                                                                                         Ms. Dora Ho           p.19
                      21-22 Connaught Road Central, HK                                                                                                                                                                       Tel: 2527 8285
14 May 2004           Union Hospital                                                                                                                                                                                         Tel: 2608 3388
(Fri)                 CPD – Continuous Professional Development & Clinical and Pathological
2:00 – 3:00 pm        Implications of Chorioamnionitis                                                1                            1
                      Seminar Room, 2/F, Medical Centre Union Hospital,
                      18 Fu Kin Street, Tai Wai, Shatin, NT
15 May 2004           United Christian Hospital, Kwun Tong District Health Committee                                                                                                                                         Ms. Marina Pun
(Sat)                 Refresher Course for Health Personnel 2004 (Session 3: Update on               1.5
1:30 – 3:45 pm        Mangement of epilepsy; Paediatric Dentistry – current trends)
                      Lecture Theatre, G/F, Block P, United Christian Hospital, Kln
15 May 2004           Hong Kong Association of Gerontology – Hong Kong Institute of                                                                                                                                          Tel: 2558 1181
(Sat)                 Gerontology                                                                     2            10# 12# 12#                                                                  –      –              18#
2:00 – 4:00 pm        Certificate Course on Gerontology for Medical Practitioners (Session 3)
                      1/F, HKSR Lam Tin Complex, 7 Rehab Path, Lam Tin, Kln


*   Colleges accreditation pending
#   Total CME points for entire course
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. Cynthia Chan, Executive Officer at Tel: 2527
8452, Fax: 2865 0943 or email: cynthia@hkma.org
Your comments to the HKMA CME Bulletin are mostly welcome. Please send your opinion to Dr. Choi Kin, CME Bulletin Co-ordinator, at cme@hkma.org.