SummaryObjective To examine the association of air pollutants with hospital admission for childhood asthma in Hong Kong. Methods Data on hospital admissions for asthma, influenza and total hospital admissions in children aged 418 years at all Hospital Authority hospitals during 1997-2002 were obtained. Data on daily mean concentrations of particles with aerodynamic diameter o 10 mm (i. e. PM 10 ) and o 2.5 mm (i. e. PM 2.5 ), nitrogen dioxide (NO 2 ), sulphur dioxide (SO 2 ), and ozone (O 3 ) and data on meteorological variables were associated with asthma hospital admissions using Poisson's regression with generalized additive models for correction of yearly trend, temperature, humidity, day-of-week effect, holiday, influenza admissions and total hospital admission. The possibility of a lag effect of each pollutant and the interaction of different pollutants were also examined. Results The association between asthma admission with change of NO 2 , PM 10 , PM 2.5 and O 3 levels remained significant after adjustment for multi-pollutants effect and confounding variables, with increase in asthma admission rate of 5.64% (3.21-8.14) at lag 3 for NO 2 , 3.67% (1.52-5.86) at lag 4 for PM 10 , 3.24% (0.93-5.60) at lag 4 for PM 2.5 and 2.63% (0.64-4.67) at lag 2 for O 3 . Effect of SO 2 was lost after adjustment. Conclusion Ambient levels of PM 10 , PM 2.5 , NO 2 and O 3 are associated with childhood asthma hospital admission in Hong Kong.

and H2) were recognized from MV cases during 1992-2007. Viruses of genotype H1 and D3 are implicated as indigenous strains in Taiwan. In Taiwan, one-dose measles immunization program began in 1978, and two-dose policy started in 1984. Two catch-up campaigns were implemented in 1992-1994 and 2002-2004 separately. The vaccine coverage rate with 1st dose MV (for 12-15 months) and 2nd dose MMR (for 6 years old) was over 90% and 95% since 1996. The multiple genotypes and sporadic cases discovered after 2003 (except 2 cases in 2005) were all imported. The measles mass vaccination program has successfully interrupted the transmission of indigenous MV in Taiwan.

We report a case of Penicillium marneffei infection in a previously healthy 3.5 years-old Chinese boy and review the literature. The details of the case are described with emphasis on his immune function and treatment outcome. This boy had transient immunodeficiency involving phagocytic and NK cells due to P. marneffei infection which resolved after treatment with gamma interferon and amphotericin B. A prolonged course of fluconazole of 1 year was successful in preventing relapse. Gamma interferon, amphotericin B and a prolonged course of fluconazole may be useful in the treatment of life-threatening infection by P. marneffei.

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Funding Acknowledgements Type of funding sources: None. Background Cardiac implantable electronic devices (CIEDs) are the mainstream therapy for advanced atrioventricular block or sustained ventricular arrhythmia. EHRA survey (1) showed that cephalic vein dissection and blind subclavian vein puncture are the preferred techniques for the implantation of CIED leads in European centres. Ultrasound (US) guided axillary puncture has emerged as feasible alternative for safe and rapid venous access for lead implantation. However, insufficient evidence to support its widespread adoption. Aim To compare the complication rates and clinical outcomes of CIED implantations utilising self-taught US guided axillary puncture versus non-US guided venous access (Subclavian puncture and fluroscopy guided axillary puncture). Assess the mean time to gain venous access and overall success rate in US guided technique. Methods Retrospective , observational study across two sites involving all CIED implantations of four experienced implanters over the year from January 2021 - June 2022. Patient's demographics, venous access time, complications and clinical outcomes were extracted from electronic database. US axillary access technique was self-taught. Results and Outcomes Venous access was obtained by US Guided axillary puncture in 146 patients, non-US guided in 208 patients. Successful axillary venous access by ultrasound guidance is 97%(146/151) with mean time to venous access of 2.1 minutes. Baseline demographics (age, gender) and comorbidities (hypertension, diabetes, cardiomyopathy, coronary artery disease, dyslipidemia, renal failure, oral steroid use, nicotine use) were similar between both US-guide and non-US guided groups, usage of oral anticoagulations (32.9% vs 39.4%,p=0.208) and antiplatelet agents(28.1% vs 35.1%,p=0.164) were not statistically different. Greater proportion of dual chamber pacemakers were implanted in US guided access group versus non-US guided (39.7% vs 27.9%,p=0.015). US Guided axillary access resulted in lower overall complication rate (2.1% vs 8.9%, p=0.0196): lower risk of pneumothorax (0% vs 3.8%,p=0.0236), lower risk of haemathoma (0% vs 3.4%,p=0.0448). No difference in short term pocket/lead infection or lead displacement. Severe vascular complications remains low in both groups. Stepwise binary regression analysis demonstrated US guidance as independent predictor of lower overall complication rate, odd-ratio 0.195 (95% CI 0.054 - 0.706). Summary: This multi-centered, retospective observational study demonstrated that US guided axillary access has high overall success rate, not time consuming and resulted in lower complication rates (especially pneumothorax and pocket haemathoma), despite the US access technique being self-taught and have greater proportion of dual chamber device implantations. US guided axillary access is demonstrated to be independently associated with 5-fold lower risk of complications.

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