TLC-NOSF dressings as a first-line local treatment of chronic wounds: a systematic review of clinical evidence.

OBJECTIVE: Several national and international guidelines recommend lipidocolloid technology with a nano-oligosaccharide factor (TLC-NOSF) dressings (UrgoStart dressing range, Laboratoires Urgo, France) for treating patients with chronic wounds. However, these dressings are still often reported as second-line options, potentially leading to loss of opportunity for patients and additional costs for payers. This review aimed to explore the reported wound healing and patient outcomes as well as the related costs when the dressings were used as first-line treatment in patients with different types of chronic wounds. METHOD: A systematic review of the literature was conducted. Databases (MEDLINE, Embase, Emcare, and Google Scholar) were searched up to 1 February 2024, without any language or time period limitations. Studies were eligible if the evaluated dressings had been used as a first-line treatment for chronic wounds, that is, as an integral part of the standard of care (SoC) at the patient's first presentation and/or in recent wounds. The main evaluation criteria included: wound healing rate; time to reach wound closure; change in patients' quality of life (QoL); and associated costs. The quality of evidence of the included studies was appraised using well-recognised risk-of-bias tools suitable for different study designs. A narrative synthesis describes the findings in three sections depending on the type of comparison. This report followed the principles of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: A total of 17 studies published between 2017 and 2024 met the eligibility criteria. A comparative analysis between TLC-NOSF dressings and standard dressings, both of which were used as first-line treatment, was reported in nine studies. A comparative analysis between the use of TLC-NOSF dressings as first-line and second-line treatments was reported in eight studies, and five studies reported a systematic use of the TLC-NOSF dressing as first-line treatment without a control group. Overall, the included studies had a relatively low risk of bias for the respective types of evidence. Data of 10,191 patients of both sexes and different age groups with a total of 10,203 wounds (diabetic foot ulcers, leg ulcers, pressure injuries, and other types of chronic wounds) were included in the analysis: 7775 treated with the evaluated dressing and 2428 treated with a comparator dressing. The data suggested that using TLC-NOSF as a first-line treatment for chronic wounds consistently resulted in significantly higher healing rates, shorter healing times, and cost savings compared with standard dressings used under similar conditions. Real-life evidence confirmed the results obtained in clinical trials and economic models, within similar ranges, regardless of the settings involved or of the characteristics of the patients and wounds treated. The wound healing rates ranged around 70-80% by week 20/24 and time-to-heal was reported on average around seven weeks, with slightly longer times reported in wounds with a more severe prognosis. Furthermore, the dressings were shown to improve patient QoL, and were well tolerated and accepted, supporting a wider adoption approach. CONCLUSION: The results of this review are aligned with the current guidelines recommending the use of TLC-NOSF dressings in the treatment of patients with chronic wounds. They support its wider implementation as a first-line treatment and as an integral part of SoC for these wounds in the daily practice of all centres involved in their management.

Evaluation of Left Diastolic Function in Dilated Cardiomyopathy According to the 2016 ASE/EACVI Recommendations.

Objectives: To assess left ventricular diastolic function by using echocardiography in patients with dilated cardiomyopathy, and the relationship between left ventricular diastolic function and left ventricular dilatation, New York Heart Association (NYHA) heart failure index, left ventricular ejection fraction, and left ventricular fractional shortening. Methods: A descriptive cross-sectional study was conducted on patients with primary dilated cardiomyopathy hospitalized in Hue Central Hospital from April 2018 to August 2020. Results: The mean end-diastolic left ventricular volume was 133.57±31.58 mL and the mean end-systolic left ventricular volume was 99.9±26.03 mL. The mean left atrial volume was 61.63±27.13 mL. The mean end-diastolic and end-systolic left ventricular diameters were 66.11±7.3 mm and 57.7±8.02 mm, respectively. The mean left ventricular ejection fraction was 24.68±5.97%. The mean left ventricular fractional shortening was 12.91±4.55%. The highest rate was grade II diastolic dysfunction (44.6%), followed by grade III diastolic dysfunction (35.8%) and grade I diastolic dysfunction at 19.6%. There was a moderate positive correlation between the left ventricular diastolic dysfunction and the NYHA class of heart failure with r=0.445, p<0.001. All dilated cardiomyopathy patients in the study group had mainly grade II-III severe diastolic dysfunction. Conclusions: Routine evaluation of diastolic function in patients with heart failure can help in elucidation of pathogenesis and management of patients. This dysfunction was clearly demonstrated by the change in the parameters of the evaluation of left ventricular diastolic function on echocardiography according to the 2016 ASE/EACVI recommendations, a new recommendation introduced to approach the assessment of diastolic function in a more convenient and easier way.

A Cross-Sectional Study of Serum Ferritin Levels in Vietnamese Adults with Metabolic Syndrome.

Background: Metabolic syndrome is one of the most common public health concerns in the 21st century. Several previous studies have shown an association between increased serum ferritin levels and other components of metabolic syndrome and the risk of metabolic syndrome. They conclude that ferritin can be viewed as a predictor of metabolic syndrome risk. This study investigates some main features of metabolic syndrome and the serum ferritin levels in a Vietnamese adult cohort with metabolic syndrome. Methods: A descriptive cross-sectional study was conducted on 207 patients who were treated at the General Internal Medicine-Geriatric Department, Hue Central Hospital, from May 2018 to August 2020. Patients were divided into two groups: the study group (104 patients with metabolic syndrome) and the control group (103 patients without metabolic syndrome and no serum ferritin-mediated disease). The metabolic syndrome was diagnosed by a joint interim statement of the International Diabetes Federation/American Heart Association/National Heart, Lung, and Blood Institute/World Heart Federation/International Atherosclerosis Society/International Association for the Study of Obesity in 2009. Results: Hypertriglyceridemia-hypertension-hyperglycemia (50.9%) is the most common combination of metabolic syndrome components. The mean serum ferritin concentration was 391.62±181.97ng/mL and 124.55±63.95ng/mL in the metabolic syndrome and control groups, respectively. In the metabolic syndrome group, increased ferritin concentration accounted for 86.54% for men, the mean serum ferritin concentration was 453.064 ± 161.75ng/mL (increased ferritin concentration accounted for 96.15%) for women; the mean serum ferritin concentration was 330.17 ± 181.71 ng/mL (increased ferritin concentration accounted for 86.54%). Conclusion: The serum ferritin level is significantly increased in Vietnamese patients with metabolic syndrome.

Aetiology and Potential Animal Exposure in Central Nervous System Infections in Vietnam.

An estimated 73% of emerging infections are zoonotic in origin, with animal contact and encroachment on their habitats increasing the risk of spill-over events. In Vietnam, close exposure to a wide range of animals and animal products can lead to acquisition of zoonotic pathogens, a number of which cause central nervous system (CNS) infections. However, studies show the aetiology of CNS infections remains unknown in around half of cases. We used samples and data from hospitalised patients with CNS infections, enrolled into the Vietnam Initiative on Zoonotic Infections multicentre study, to determine the association between aetiology and animal contact including those in whom the cause was unknown. Among 933 patients, a pathogen or an antibody response to it was identified in 291 (31.2%, 95% CI 28.3-34.3%). The most common pathogens were Streptococcus suis (n = 91 (9.8%, 8.0-11.9%)) and Japanese encephalitis virus (JEV) (n = 72 (7.7%, 6.1-9.7%)). Commonly reported animal contact included keeping, raising or handling (n = 364 (39.0%, 35.9-42.2%)) and handling, cooking or consuming raw meat, blood or viscera in the 2 weeks prior to symptom onset (n = 371 (39.8%, 36.6-43.0%)), with the latter most commonly from pigs (n = 343 (36.9%, 33.8-40.1%). There was no association between an unknown aetiology and exposure to animals in a multivariate logistic regression. Further testing for unknown or undetected pathogens may increase diagnostic yield, however, given the high proportion of zoonotic pathogens and the presence of risk factors, increasing public awareness about zoonoses and preventive measures can be considered.

Relationship Between Vitamin D Status and the Relevant Parameters of Glucose in Patients with Type 2 Diabetes.

INTRODUCTION: Clarifying the prevalence of vitamin D deficiency in diabetic patients, and the relationship between vitamin D concentration and insulin resistance, fasting plasma glucose, and HbA1C in patients in Hue City, Vietnam. METHODS: A cross-sectional study on 110 diabetic patients examined at Hue Central Hospital and Hue University of Medicine and Pharmacy Hospital. These patients were collected venous blood sampling, and the 25(OH)D test, fasting plasma glucose test, fasting insulin test, HOMA-IR and QUICKI calculation. RESULTS: Vitamin D deficiency and insufficiency prevalence were 51.8%. The average concentration of 25(OH)D (ng/mL) was 30.67 ± 8.55; this concentration in fasting glucose level ≤8 mmol/l group and >8 mmol/l group was 32.08 ± 9.26 and 28.55±6.91 (p = 0.033); it was 32.95 ± 8.58 and 28.97 ± 8.17 in HOMA-IR ≤3.5 and HOMA-IR >3.5 group, (p = 0.015); in QUICKI ≤0.32 group, it was 29.16 ± 8.12; in QUICKI >0.32 group, it was 32.85 ± 8.76 (p = 0.025). Patients with an ideal exercise level have higher average levels of 25(OH)D (32.11±8.62 vs 26.83±7.16, p=0.003). The average levels of 25(OH)D in male patients are higher than in female patients (33.47±0.08 vs 29.01±8.43, p=0.008). Vitamin D deficiency and insufficiency prevalence in patients with HOMA-IR ≤3.5 and QUICKI >0.32 were 36.2% and 37.8%, whereas in those with HOMA-IR >3.5 and QUICKI ≤0.32 they were 63.5% and 61.5% (p = 0.007 and 0.02, respectively). 25(OH)D is negative correlation with fasting glucose level and HOMA-IR, with r = -0.229 and -0.192, respectively (p = 0.016 and 0.045); 25(OH)D was positively correlated with QUICKI, with r = 0.235, p = 0.008. CONCLUSION: Patients who have better glucose-related parameters, such as fasting blood sugar, HOMA-IR and QUICKI, have a better vitamin D status. Some blood sugar-related factors, such as exercise level and sex, are related to vitamin D status.

Novel DNA materials and their applications.

The last two decades have witnessed the exponential development of DNA as a generic material instead of just a genetic material. The biological function, nanoscale geometry, biocompatibility, biodegradability, and molecular recognition capacity of DNA make it a promising candidate for the construction of novel functional nanomaterials. As a result, DNA has been recognized as one of the most appealing and versatile nanomaterial building blocks. Scientists have used DNA in this way to construct various amazing nanostructures, such as ordered lattices, origami, supramolecular assemblies, and even three-dimensional objects. In addition, DNA has been utilized as a guide and template to direct the assembly of other nanomaterials including nanowires, free-standing membranes, and crystals. Furthermore, DNA can also be used as structural components to construct bulk materials such as DNA hydrogels, demonstrating its ability to behave as a unique polymer. Overall, these novel DNA materials have found applications in various areas in the biomedical field in general, and nanomedicine in particular. In this review, we summarize the development of DNA assemblies, describe the innovative progress of multifunctional and bulk DNA materials, and highlight some real-world nanomedical applications of these DNA materials. We also show our insights throughout this article for the future direction of DNA materials.