Difference in quality of life and associated factors among the elderly in rural Vietnam.

BACKGROUND: In Vietnam today, many generations remain living together in a family. With escalating urbanization and population aging, mental health disorders and the quality of life (QoL) among the elderly are gradually presenting themselves as of great concern. The objective of this study was to examine gender differences in QoL and some associated factors among the elderly in rural Vietnam using the QoL scale of WHO (WHOQOL-BREF). METHODS: A cross-sectional study using quantitative methods. RESULTS AND CONCLUSIONS: The proportion of the elderly men having higher level of QoL in physical health, psychological health and environment was higher than that of their women counterparts. Reversely, of those having medium and lower QoL, females made up a larger proportion than males. The overall QoL score in elderly men (75.32) was higher than that of women (72.32) and the same pattern was witnessed in all four domains of QoL. While higher QoL in elderly men was significantly correlated with 5 factors, aged ≥ 80 years, following Buddhism and Christianity, having better connection and without illness in the past 6 months, these among female counterparts are aged ≥ 80 years, completing secondary level or above, having medium and high socioeconomic status and without illness in the last 6 months.

Ultraviolet radiation-induced cytokines promote mast cell accumulation and matrix metalloproteinase production: potential role in cutaneous lupus erythematosus.

OBJECTIVE: To examine the role of mast cells (MCs), cytokines, and matrix metalloproteinases (MMPs) following ultraviolet B (UVB) radiation in cutaneous lupus erythematosus (CLE). METHODS: Immunohistochemistry was used to determine the presence of MCs and the expression of MMP-1, MMP-9, interleukin (IL)-15, and CCL5/RANTES in skin from patients with CLE. Human keratinocytes were exposed to varying doses of UVB and supernatants were collected and assessed for IL-15, CCL5, MMP-1, and MMP-9 by protein assays. MC migration was determined against supernatants from UVB-treated keratinocytes. RESULTS: MCs in the skin of patients with CLE were significantly increased. MMP-1 and MMP-9 expression was abundant in these lesions. Intense reactivity for IL-15 and CCL5 was found in skin, particularly in epidermal keratinocytes, from patients with CLE. UVB irradiation induced IL-15, CCL5, MMP-1, and MMP-9 production from keratinocytes in a dose- and time-dependent manner. Supernatants obtained from UVB-treated keratinocytes induced MC migration, which was attenuated by anti-IL-15 and anti-CCL5 neutralizing antibodies. IL-15 induced MC-derived MMP production. CONCLUSIONS: Our results indicate that MCs and MMPs may play a role in the skin inflammation in CLE. MC recruitment as well as MMP production may be perpetuated by UV irradiation through locally released mediators.

Incidence and predictors of surgical-site infections in Vietnam.

OBJECTIVE: To determine the incidence of, and risk factors for, surgical-site infections (SSIs). DESIGN: Prospective observational study of all patients undergoing surgery during a 3-month period. SETTING: Two urban hospitals in Hanoi, Vietnam. PATIENTS: All 697 patients admitted for emergent and elective surgery. METHODS: Data were collected on all patients undergoing surgery during a 3-month period at each hospital. We stratified the data by type of surgery, wound class, and Study on the Efficacy of Nosocomial Infection Control (SENIC) risk index. The analysis was done with the data sets from each hospital separately and with the combined data. The risk factors for SSI were identified using a logistic-regression model. RESULTS: During the period of observation, 10.9% of 697 patients had SSI. The SSI rate was 8.3% for clean wounds, 8.6% for clean-contaminated, 12.2% for contaminated, and 43.9% for dirty wounds. The lowest rate of SSI (2.4%) was found in obstetric-gynecologic procedures and the highest rate (33.3%) in cardiothoracic operations. Using the SENIC risk index, the incidence of SSI in low-risk patients was 5.1%; for medium-risk patients, 13.5%, and high-risk patients, 24.2%. In a logistic-regression model, abdominal surgery (odds ratio [OR], 4.46; P<.01) and wound class IV (OR, 5.67; P<.01) were significant predictors of SSI. All patients were treated with prolonged courses of perioperative antibiotics. Overall infection control practices were poor as a result of deficient facilities, limited surgical instruments, and a lack of proper supplies for wound care and personal hygiene. CONCLUSIONS: There was a higher incidence of SSI in low-risk patients in Vietnam compared with developed countries. Excessive reliance on antimicrobial therapy as a means to limit SSI places patients at higher risk of adverse effects from treatment and also may contribute to worsening problems with antimicrobial resistance. Establishment of an infection control program with guidelines for antimicrobial use should improve the use of prophylactic antibiotics and attention to proper surgical and wound-care techniques. These interventions also should reduce the incidence of SSI and its associated morbidity and costs.

Urinary alpha-L-fucosidase in cystic fibrosis.

The binding of the urinary lysosomal enzyme alpha-L-fucosidase to free- and Sepharose 4B-bound concanavalin A has been compared in cystic fibrosis (CF) patients and normal controls. The concentration of methyl-alpha-D-mannoside necessary to prevent 50% of total alpha-L-fucosidase activity to bind to free and bound concanavalin A (Ki, 50%) was similar for CF (0.68 +/- 0.20 and 1.3 +/- 0.3 mmol/l, respectively) and normal controls (0.53 +/- 0.18 and 1.9 +/- 0.5 mmol/l, respectively). The CF and normal urinary alpha-L-fucosidase also showed similar pH optima (4.8), Km, app (0.071 and 0.074 mmol/l, respectively) and thermodenaturation curves at 44 degrees C (t1/2 = 108 min). We report that the kinetic and the concanavalin A-binding affinity of alpha-L-fucosidase are similar from urine of cystic fibrosis patients and controls.

Development of optimized transfectoma cell lines for production of chimeric antibodies in hollow fiber cell culture systems.

Methods for the selection of transfectoma cells that express large quantities of mouse-human chimeric antibodies have been develped. SP2/0 mouse myeloma cells were transfected with pSV2-gpt and pSV2-neo based immunoglobulin expression vectors. Double transfectants were selected using the xanthine-guanine phosphoribosyl transferase (gpt)and the neomycin (neo) selection marker genes. ELISA-based screening of transfectoma clones resulted in the isolation of IgG-producing transfectomas. Introduction of the kappa light-chain 3'-enhancer into the light-chain expression vector significantly increased immunoglobulin expression, but only when the enhancer was located at its physiological site, 9 kb downstream of the kappa constant region exon. With some of the transfectomas, final yields of up to 80 mg/L of chimeric IgG were obtained in conventional flask cultures using serum-free growth medium. A pilot-scale AcuSyst Maximizer hollow fiber cell culture system was used for the production of gram amounts of chimeric IgG. Results obtained with different transfectoma clones in conventional culture were not fully predictive for yields in the hollow fiber system. In contrast, differences in productivity between individual clones in the laboratory-scale Tecnomouse cell culture unit were comparable with those in the Maximizer system. Up to 200 mg of chimeric IgG were produced per day in one Maximizer bioreactor. (c) 1995 John Wiley & Sons, Inc.