Risk Factors for Severe Seafood Allergy Among Adults in an Urban City in Vietnam.

Purpose: Increasing seafood consumption is associated with more frequent reports of food allergy. Little is known about seafood allergy (SFA) among adults in Vietnam. We investigated the characteristics of individuals with SFA and the risk factors for severe SFA. Patients and methods: A cross-sectional, web-based survey was conducted among individuals aged ≥ 18 years from universities in Ho Chi Minh City (Vietnam) between December 2021 and July 2022. The survey was based on a structured, validated questionnaire related to FA. Strict definitions of "convincing allergy" were used. Multivariate analysis was used to estimate the risk factors for severe SFA after adjusting for covariates. Data were analyzed using JASP (v.0.16.3) and SPSS (v.22.0). Results: Totally, 1038 out of 2137 (48.57%) individuals completed the questionnaire, of whom 285 (27.46%) had reported SFA. Convincing SFA accounted for 20.13% (209/1038) of the cases, with convincing shellfish allergy being more common than fish allergy. Participants with comorbid shellfish and fish allergy had higher prevalence of atopic dermatitis, peanut/nut allergy, other food allergy, and cutaneous and upper airway symptoms compared to participants with shellfish allergy (p < 0.05). The spectrum of reactive seafood was diverse and characterized by local species. The age of symptom onset was most commonly during late childhood and adolescence, with most reactions persisting into adulthood. A history of anaphylaxis, comorbid peanut, and tree nut allergy, and ≥3 allergens were associated with severe SFA. Conclusion: Features of causative, coexisting seafood allergy, and risk factors for severe SFA were demonstrated, which can provide a reference for future studies.

Environmental allergen reduction in asthma management: an overview.

Asthma is a prevalent non-communicable disease that affects both children and adults. Many patients with severe, uncontrolled asthma could not achieve total control despite using anti-asthmatic drugs. There is increasing evidence that allergy to environmental allergens, including both indoor and outdoor allergens, is associated with asthma symptoms and severe asthma. Frequently reported sensitized allergens were dust mites, cockroaches, grass pollens, molds, pets, and rodents in allergic asthma patients, although the patterns of widespread allergens differed from each country. Allergen avoidance is the cornerstone of asthma management, especially in sensitized subjects. This review summarizes environmental allergen avoidance and clarifies their effects on asthma control. Despite contrasting results about the impact of allergen exposure reduction on asthma control, several studies supported the beneficial effects of reducing asthma-related symptoms or risk of exacerbations as a nondrug therapy. Identifying environmental allergens is helpful for asthma patients, and further studies on clinically effective avoidance methods are required.

[Associations between multimorbidity patterns of 4 chronic diseases and physical activity with all-cause mortality].

Objective: To identify the prevalence of multimorbidity among a Chinese population, analyze the risk of all-cause mortality with different multimorbidity patterns, and the impact of exercise on the risk of multimorbidity-related mortality and life lost. Methods: The study was based on 437 408 MJ Health Management Center participants. The classification decision tree was used to explore multimorbidity patterns composed of hypertension, diabetes, chronic kidney disease (CKD), and chronic obstructive pulmonary disease (COPD). The Cox proportional hazards model was used to calculate the all-cause mortality hazard ratio (HR) for different multimorbidity patterns. Using Chiang's life table method, years of life lost were the difference in life expectancy for those with and without multimorbidity. Results: The prevalence rate of multimorbidity was 8.7%. Among multivariate patterns, the most common ones were "hypertension+CKD" (3.6%), "hypertension + diabetes + CKD" (1.1%) and "hypertension+diabetes+CKD+COPD" (0.1%). Compared with a healthy population, patterns with the highest mortality risk were "diabetes+CKD" (HR=3.80, 95%CI: 3.45-4.18), "diabetes+CKD+COPD" (HR=4.34, 95%CI: 3.43-5.49) and "hypertension+ diabetes+CKD+COPD" (HR=4.75,95%CI:4.15-5.43). Through low-intensity and moderate to high-intensity exercise, the increased HRs were attenuatedcompared with the inactive population. People with single disease and multimorbidity shortened life by 4.6 and 13.4 years, while exercise attenuated 2.3 and 4.6 years of life lost, of which low-intensity and moderate to high-intensity exercise saved 1.5 and 3.7 years of life lost due to chronic diseases. Conclusions: Multimorbidity patterns based on "diabetes + CKD" cause the highest mortality risk, and physical activity in reducing mortality was significant for either with or without multimorbidity. Higher exercise intensity leads to a greater relative reduction of mortality risk.

A Community-Based Model of Care During the Fourth Wave of the COVID-19 Outbreak in Ho Chi Minh City, Vietnam.

In response to a call for help during a surge in coronavirus disease-19 (COVID-19) cases in Ho Chi Minh City in July 2021, the University of Medicine and Pharmacy at Ho Chi Minh City developed and implemented a community care model for the management of patients with COVID-19. This was based on three main principles: home care; providing monitoring and care at a distance; and providing timely emergency care if needed. One team supported patients at home with frequent contacts and remote monitoring, while a second team transferred and cared for patients requiring treatment at field emergency care facilities. COVID-19-related mortality rates at the two districts where this approach was implemented (0.43% and 0.57%) were substantially lower than the overall rate in Ho Chi Minh City over the same period (4.95%). Thus, utilization of a community care model can increase the number of patients with COVID-19 who can be effectively managed from home, and use of field emergency care facilities limited the number of patients that had to be referred for tertiary care. Importantly, the community care model also markedly reduced the mortality rate compared with traditional methods of COVID-19 patient management.

Predictors of asthma control in elderly patients.

PURPOSE OF REVIEW: We are in the era of rapid aging of the global population. Elderly asthmatic patients have an increased frequency of hospitalization and a high mortality rate. In this review, we focus on comorbidities and treatment issues in terms of the predictors of asthma control in the elderly. RECENT FINDINGS: Some frequent comorbidities, such as chronic obstructive pulmonary disease, chronic sinusitis, obesity, and depression, are associated with uncontrolled asthma in elderly asthmatic patients. Smoking status in elderly asthmatic patients was associated with more frequent exacerbations. Management of comorbidities should be taken into account when we treat elderly asthmatic patients. Low treatment adherence, which is common in elderly asthmatic patients, predicts poor asthma control status. A poor knowledge about asthma, cognitive function impairment, and inappropriate inhaler technique result in low treatment adherence. Polypharmacy is associated with low treatment adherence, adverse drug reactions, and drug-drug interactions, and it is supposed to be a predictor of asthma control. SUMMARY: Multifactorial assessments, including comorbidities, treatment adherence, and polypharmacy, are important for better asthma control in elderly asthmatic patients. Further studies on the strategy for the management of elderly asthmatic patients in a real-world setting are warranted.

Left ventricular boundary detection from spatio-temporal volumetric computed tomography images.

This paper presents a new automatic technique for left ventricle boundary detection from a set of three-dimensional (3D) computed tomography (CT) volumetric cardiac images. The goals of this paper are to incorporate the temporal information into LV boundary detection, to link the shape modeling and LV boundary detection together, and to provide a compact representation of recovered LV boundaries to cardiac imaging. The proposed technique introduces spatio-temporal boundary detection and iterative model-based boundary refinement to left ventricular boundary extraction. The proposed technique has been applied to two sets of four-dimensional (4D) computed tomography images. Experimental results are compared with the manually edited images.

Erosive arthritis of the temporomandibular joint caused by Teflon-Proplast implants: plain film features.

Six patients had osseous destructive changes of the temporomandibular joint after placement of Teflon-Proplast implants for treatment of internal derangements. The implants were surgically removed from all six joints, and foreign-body reactions were found to account for the radiographic appearance. The plain film radiographic features included single or multiple osseous erosions of the mandibular condyle in all cases and the temporal bone of the glenoid fossa in two cases. Some erosions were poorly defined, whereas others were well defined, either with or without sclerotic margins. Radiologists must be aware of this possible complication of alloplastic temporomandibular joint implants in order to suggest the diagnosis in the appropriate clinical setting.

Radiography after orthognathic surgery. Part I. Normal appearance.

Osteotomies of the mandible and/or maxilla (orthognathic surgery) are common procedures for correcting facial defects. Radiographs of these patients are routinely obtained, and the radiologist must be aware of the normal postoperative appearance as well as surgical complications that may occur. This article presents the common surgical procedures done (sagittal split, vertical subcondylar, genioplasty mandibular osteotomies; and Le Fort I and mid-palatal split maxillary osteotomies) and the routine appearance of uncomplicated procedures on posteroanterior skull and panoramic radiographs. The metallic immobilization devices and orthodontic appliances are also described.

Radiography after orthognathic surgery. Part II. Surgical complications.

In a retrospective review of the radiographs from 100 patients who had undergone orthognathic surgery, the authors found that 10% of radiographs had evidence of surgical complications. These complications were fractures, temporomandibular joint dislocations, transected tooth roots, retained surgical devices, avascular necrosis, malunion or nonunion of osteotomy fragments, and osteomyelitis. Some of these complications are of little significance, while others require immediate intervention. Opacified maxillary sinuses and lucencies around tooth roots are frequent findings that may be confused with abnormalities; however, they represent postoperative blood in the sinuses and resorption of bone due to stress from orthodontic appliances, respectively.

Pseudoankylosis of the mandible after temporal bone attached craniotomy.

Mandibular hypomobility after intracranial surgical procedures is seldom encountered. A case of limited oral opening after temporal bone attached craniotomy is described. The condition is due to fibrosis of the temporalis muscle resulting in a pseudoankylosis of the temporomandibular joint. The appropriate operative intervention is transoral coronoidectomy, which restores normal joint function.

The normal temporomandibular joint: MR and arthrographic correlation.

Magnetic resonance (MR) images of 28 normal temporomandibular joints were obtained and correlated with respective arthrograms. There was a spectrum in the configuration and thickness of normal articular menisci. The anterior band varied from thin with a flat inferior margin to thick with a bulbous, convex inferior margin. The anatomic configuration of the meniscus as seen with MR correlated directly with normal variations of the anterior recess seen with arthrography. Concavity of the superior aspect of the anterior recess as seen on arthrography was caused by a thick, bulbous anterior band of the meniscus, whereas a flat anterior recess resulted from a thin anterior band without a convex inferior margin. This study emphasizes that the appearance of a concave anterior recess on static arthrograms is not necessarily due to a displaced meniscus.

Normal and abnormal temporomandibular joints: quantitative evaluation of inferior joint space arthrography.

Arthrography has been shown to provide important diagnostic information in patients with temporomandibular joint (TMJ) dysfunction. In this study, 60 arthrograms on totally asymptomatic patients and 64 arthrograms on symptomatic patients were evaluated. Quantitative evaluation of inferior joint space arthrography was performed with the help of a computer digitizing morphometry program. Results indicate a significant difference in the areas of the anterior and posterior recesses between normal and abnormal joints in the closed-mouth position. Differences between the 2 groups also exist in linear measurements of the anterior recess. This data further defines important diagnostic criteria in the arthrographic evaluation of both the normal and abnormal TMJ.

Temporomandibular joint arthrography following surgical treatment of internal derangements.

Arthrograms of the temporomandibular joint were obtained in 20 symptomatic joints that had previous reconstructive arthroplasty with disk repositioning because of internal derangements. Preoperative arthrograms were available for comparison in 18 joints. Symptoms resulting in a postoperative arthrogram included pain, limited ability to open the mouth, and clicking of the joints. Postoperative arthrographic findings included limited anterior translation of the condyle (90%), irregularity in outline of the intraarticular contrast agent (60%), a conical configuration of the posterior recess (25%), decreased size of the joint (28%), anterior displacement of the meniscus (25%), and perforated meniscus (15%). Many of these findings may have resulted from fibrosis and scarring, which may be a response to intraarticular bleeding. The mechanism by which the fibrosis causes the postsurgical arthrographic features is discussed.

Inferior joint space arthrography of normal temporomandibular joints: reassessment of diagnostic criteria.

Inferior joint space arthrograms of the temporomandibular joints of 31 healthy volunteers (62 joints) were obtained to determine normal arthrographic findings. The superior margin of the anterior recess was smooth and flat in 68% of the joints and concave in 32% with the subjects' mouths closed. The concavity was the result of the anterior ridge of the meniscus impinging on the contrast material. The concave impression could be distinguished easily from an anteriorly displaced meniscus on videotaped studies, which demonstrated a smooth transition of contrast material from the anterior to the posterior recess during opening of a subject's mouth. With the mouth open, the anterior recess decreased in size, appearing as a small, crescent-shaped collection of contrast material anterior to the head of the condyle in 52 joints (84%); it remained large in ten joints (16%) at maximal mouth opening. The configuration of the posterior recess was identical to that described previously; however, with the subjects' mouths closed, it was larger than the anterior recess, contrary to most previously reported results.

Compression osteosynthesis of mandibular fractures: a retrospective study.

A retrospective study was performed on 35 patients who had a total of 43 fractures of the mandible that had been treated using bone plates for internal fixation. The data suggest that the procedure has a high degree of success and low rate of morbidity.

Pneumomediastinum, pneumothorax, and cervical emphysema following mandibular fractures.

Subcutaneous emphysema of the neck and pneumomediastinum following facial trauma in the absence of neck, chest, or abdominal injuries is a rare entity. A case report of bilateral cervical subcutaneous emphysema, pneumothorax, and pneumomediastinum secondary to mandibular fractures is presented. The anatomic mechanism of injury, diagnosis, and treatment modalities are discussed.