An infrequent case of retroperitoneal synovial sarcoma.

Synovial sarcoma (SS) is an uncommon malignant tumor, ranking third in prevalence within the soft tissue sarcomas group. The vast majority of synovial sarcomas are present in the extremities, with only 15% developing in the retroperitoneal space. Retroperitoneal synovial sarcoma (RSS) is an infrequent case of SS, with only about 20 cases reported in the literature. Diagnosing RSS before treatment remains challenging because of its nonspecific clinical symptoms. The disease is often detected at a later stage, leading to additional damage to other organs as well as complicated and ineffective treatment. Consequently, the 5-year survival rate is only 20%-29%. This report introduces a case of RSS in a 19-year-old male patient with imaging characteristics on computed tomography (CT) and magnetic resonance (MR).

HLA alleles associated with susceptibility and severity of the COVID-19 in Vietnamese.

The diversity of clinical manifestations in COVID-19 has been observed not only among individuals but also among various populations in globally. HLA molecules play a central role in physiology, protective immunity, and deleterious, disease-related autoimmune reactivity or overreaction. This study exploited the association between HLA frequencies and SARS-CoV-2 susceptibility and disease severity among the Vietnamese cohort (159 patients and 52 controls). A significant difference in frequency of both HLA class I and II in mild, moderate, and severe/fatal COVID-19 patients and negative exposure individuals - the controls were observed. Regarding SARS-CoV-2 sensitivity, HLA-A*03:01, 30:01, HLA-DQA1*01:02, DRB1*15:01, and DRB5*02:02 presented higher frequency in the control group compared with infected patients but DRB1 09:01 frequency was higher in infected patients. Regarding COVID-19 severity, HLA-F*01:01, 01:03 and DPA1*01:03 and 02:01, DPB1*04:01, DQA1*01:02, and DQB1*05:02 alleles were detected with higher frequency in severe patients but DOB*01:01, DRB1*05:01 and 09:01 had a significantly higher frequency in the mild group than remaining groups. Surprisingly, HLA-DQA1*01:02 and DRB1*09:01 alleles were identified with both inversely potential roles in protective function and severe risk. The obtained data herein will contribute to explore on the role of host genetic background in the pathology of COVID-19 disease.

Pulmonary artery penetration due to fish bone ingestion: A rare case report.

Accidental fish bone ingestion is a common manifestation at emergency departments. In most cases, ingested foreign bodies usually pass uneventfully through the gastrointestinal tract and complications only present in less than 5% of all patients. In this report, we present the first documented case of pulmonary artery injury due to a fish bone in a 63-year-old male patient hospitalized with hemoptysis after accidentally swallowing a fish bone 30 days ago. This patient subsequently had surgery and endoscopy to safely remove the foreign body and then recovered well on a follow-up examination. For cases of fish bone ingestion, contrast-enhanced chest computed tomography is one of the most essential tools to assess vascular problems and associated mediastinal infections-risk factors for life-threatening and long-term recurrent inflammation. Reconstructing planes along the foreign body axis and changing windows when analyzing CT scans is necessary to avoid missing lesions and dilemmas.

Diagnostic Performance of Magnetic Resonance Imaging in Discriminating Benign and Malignant Soft Tissue Tumors.

Objective: The study aimed to evaluate the role of magnetic resonance imaging (MRI) in differentiating between primary benign and malignant soft tissue tumors (STTs). Patients and Methods: The study was carried out on 110 patients with histopathological diagnoses of STTs. All patients underwent routine MRI before surgery/biopsy at Viet Duc University Hospital or Vietnam National Cancer Hospital, Hanoi, Vietnam, from January 2020 to October 2022. Data on preoperative MRI as well as the clinical features and pathological results of the patients were collected retrospectively. Univariate and multivariate linear regression were used to analyze the relationship between imaging, clinical parameters, and the ability to differentiate malignant from benign STTs. Results: Among 110 patients (59 men and 51 women), 66 had benign tumors and 44 had malignant tumors. The qualitative values that were significant in distinguishing between benign and malignant STTs were hypointensity on T1-weighted images (T1W; p<0.001), hypointensity on T2-weighted images (T2W; p=0.003), cysts (p=0.003)), necrosis (p<0.001), fibrosis (p=0.023), hemorrhage (p<0.001), lobulated margin (p<0.001), ill-defined border (p<0.001), peritumoral edema (p<0.001), vascular involvement (p<0.001), and heterogeneous enhancement (p<0.001). Regarding quantitative values, age (p=0.009), size (p<0.001), T1W signal quantification value (p=0.002), and T2W signal quantification value (p=0.007) showed statistically significant differences between benign and malignant tumors. Multivariate linear regression analysis showed that the combination of peritumoral edema and heterogeneous enhancement was the most valuable in the differential diagnosis of malignant tumors from benign tumors. Conclusion: MRI is valuable in discriminating between malignant and benign STTs. The presence of cysts, necrosis, hemorrhage, lobulated margin, ill-defined border, peritumoral edema, heterogeneous enhancement, vascular involvement, and T2W hypointensity is suggestive of malignant lesions, especially signs of peritumoral edema and heterogeneous enhancement. Advanced age and large tumor size are also suggestive of soft tissue sarcomas.

Spatiotemporal Evolution of SARS-CoV-2 Alpha and Delta Variants during Large Nationwide Outbreak of COVID-19, Vietnam, 2021.

We analyzed 1,303 SARS-CoV-2 whole-genome sequences from Vietnam, and found the Alpha and Delta variants were responsible for a large nationwide outbreak of COVID-19 in 2021. The Delta variant was confined to the AY.57 lineage and caused >1.7 million infections and >32,000 deaths. Viral transmission was strongly affected by nonpharmaceutical interventions.

Assessing the accuracy of the International Academy of Cytology Yokohama System for reporting breast fine needle aspiration biopsy cytology at a Vietnamese oncology centre.

BACKGROUND: Fine needle aspiration biopsy (FNAB), accompanied by classification systems for cytology, can offer a cheap and convenient option for the diagnosis of breast cancer in women with suspicious breast lumps. In this study, we aimed to assess the accuracy of the International Academy of Cytology (IAC) Yokohama system in a Vietnamese oncology centre. METHODS: A retrospective cross-sectional study was conducted from November 2021 to April 2022 at Vietnam National Cancer Hospital. We included patients with full hospital records regarding breast lesions for which FNAB was indicated. A total of 803 patients' FNAB specimens were assessed according to the IAC Yokohama system. The basic characteristics were summarised using the appropriate summary measurements. The risk of malignancy (ROM) was calculated for each classification category. RESULTS: The median age was 42.7 years (range: 14-85). The mean size of the lesions was 17.9 mm (range: 4-123 mm). We had 215 histopathological reports. The most common benign and malignant diagnoses were fibroadenoma and invasive carcinoma, respectively. The ROM for categories II, III, IV, and V was calculated as 3.4%, 37.5%, 95%, and 99.2% respectively. The sensitivity, specificity, positive predictive value, and negative predictive value were 96.4%, 97.2%, 98.5%, and 93.2%, respectively. CONCLUSION: The IAC Yokohama system offers a good option with which to predict underlying breast pathology using a simple and cheap procedure. However, pathologists require continuous training to ensure accurate interpretation of the slides.

Juvenile psammomatoid ossifying fibroma in paranasal sinuses: A case report and literature review.

Juvenile psammomatoid ossifying fibroma (JPOF) is a rare, benign type of ossifying fibroma. JPOFs predominantly present as rapidly growing masses with a high recurrence rate. We report a 40-year-old male patient who suffered from a large tumor with multiple invasions into the paranasal sinuses. Total excision was performed, and significant relief of clinical symptoms was recorded after 4 months of follow-up. Multi-departmental management involving radiologists, neurology surgeons, craniofacial surgeons, pathologists, and otolaryngologists is vital for JPOF treatment. First-line treatment options include total or partial resection, depending on the patient's condition.

HIV clinic-based buprenorphine plus naloxone versus referral for methadone maintenance therapy for treatment of opioid use disorder in HIV clinics in Vietnam (BRAVO): an open-label, randomised, non-inferiority trial.

BACKGROUND: UNAIDS recommends integrating methadone or buprenorphine treatment of opioid use disorder with HIV care to improve HIV outcomes, but buprenorphine adoption remains limited in many countries. We aimed to assess whether HIV clinic-based buprenorphine plus naloxone treatment for opioid use disorder was non-inferior to referral for methadone maintenance therapy in achieving HIV viral suppression in Vietnam. METHODS: In an open-label, non-inferiority trial (BRAVO), we randomly assigned people with HIV and opioid use disorder (1:1) by computer-generated random number sequence, in blocks of ten and stratified by site, to receive HIV clinic-based buprenorphine plus naloxone treatment or referral for methadone maintenance therapy in six HIV clinics in Vietnam. The primary outcome was HIV viral suppression at 12 months (HIV-1 RNA ≤200 copies per mL on PCR) by intention to treat (absolute risk difference [RD] margin ≤13%), compared by use of generalised estimating equations. Research staff actively queried treatment-emergent adverse events during quarterly study visits and passively collected adverse events reported during HIV clinic visits. This study is registered with ClinicalTrials.gov, NCT01936857, and is completed. FINDINGS: Between July 27, 2015, and Feb 12, 2018, we enrolled 281 patients. At baseline, 272 (97%) participants were male, mean age was 38·3 years (SD 6·1), and mean CD4 count was 405 cells per µL (SD 224). Viral suppression improved between baseline and 12 months for both HIV clinic-based buprenorphine plus naloxone (from 97 [69%] of 140 patients to 74 [81%] of 91 patients) and referral for methadone maintenance therapy (from 92 [66%] of 140 to 99 [93%] of 107). Buprenorphine plus naloxone did not demonstrate non-inferiority to methadone maintenance therapy in achieving viral suppression at 12 months (RD -0·11, 95% CI -0·20 to -0·02). Retention on medication at 12 months was lower for buprenorphine plus naloxone than for methadone maintenance therapy (40% vs 65%; RD -0·53, 95% CI -0·75 to -0·31). Participants assigned to buprenorphine plus naloxone more frequently experienced serious adverse events (ten [7%] of 141 vs four of 140 [3%] assigned to methadone maintenance therapy) and deaths (seven of 141 [5%] vs three of 141 [2%]). Serious adverse events and deaths typically occurred in people no longer taking ART or opioid use disorder medications. INTERPRETATION: Although integrated buprenorphine and HIV care may potentially increase access to treatment for opioid use disorder, scale-up in middle-income countries might require enhanced support for buprenorphine adherence to improve HIV viral suppression. The strength of our study as a multisite randomised trial was offset by low retention of patients on buprenorphine. FUNDING: National Institute on Drug Abuse (US National Institutes of Health).

Synthesis of Porous Biochar Containing Graphitic Carbon Derived From Lignin Content of Forestry Biomass and Its Application for the Removal of Diclofenac Sodium From Aqueous Solution.

Porous biochar containing graphitic carbon materials have received great attention from various disciplines, especially for environmental pollutant treatment, due to their cost-effective and specific textural properties. This study exhibited a two-step strategy to compose lignin-porous biochar containing graphitic carbon (LPGC) from pitch pine sawdust and investigated its adsorptive removal for diclofenac sodium (DCF) from an aqueous solution. Sulfuric acid (H2SO4) was utilized to obtain lignin content from biomass and potassium ferrate (K2FeO4) and was adopted to fulfill the synchronous carbonization and graphitization of LPGC. Through slow pyrolysis in atmospheric N2 (900°C - 2 h), the structure of the as-prepared sample was successfully modified. Using SEM images, a stripped layer structure was observed on the H2SO4-treated sample for both one-step and two-step activated samples, indicating the pronounced effect of H2SO4 in the layering of materials. K2FeO4 acted as an activator and catalyst to convert biomass into the porous graphitic structure. The BET surface area, XRD and Raman spectra analyses demonstrated that LPGC possessed a micro/mesoporous structure with a relatively large surface area (457.4 m2 g-1) as well as the presence of a graphitic structure. Further adsorption experiments revealed that LPGC exhibited a high DCF adsorption capacity (qmax = 159.7 mg g-1 at 298 K, pH = 6.5). The effects of ambient conditions such as contact time, solution pH, temperature, ionic strength, electrolyte background on the uptake of DCF were investigated by a batch adsorption experiment. Results indicated that the experimental data were best fitted with the pseudo second-order model and Langmuir isotherm model. Furthermore, the adsorption of DCF onto the LPGC process was spontaneous and endothermic. Electrostatic interaction, H-bonding interaction, and π-π interaction are the possible adsorption mechanisms. The porous biochar containing graphitic carbon obtained from the lignin content of pitch pine sawdust may be a potential material for eliminating organic pollutants from water bodies.

Should Scrotal Color Doppler Ultrasound Be Routinely Indicated in Fertility Evaluation of Non-Azoospermic Men?

OBJECTIVE: Scrotal ultrasound is not a routine investigation in the clinical approach to male infertility analysis. This study aims to identify the role of testicular Doppler ultrasound in male infertility assessment and its relation to semen parameters in non-azoospermic men. METHODS: Cross-sectional descriptive analysis of 558 men from infertile couples were examined at the Hue Center for Reproductive Endocrinology and Infertility, Hue University Hospital from June 2016 to May 2018. Some cohort characteristics, semen analysis and testicular Doppler ultrasound were analyzed. Men with acute systemic diseases, acute urinary tract infection, hepatic dysfunction, malignant diseases, retrograde ejaculation, cryptorchidism or azoospermia were excluded. RESULTS: The mean volumes of the right and left testicles were 8.87 and 8.77 ml, respectively. The total volume of the 2 sides was 17.63 ± 4.34 ml (95% confidence interval 17.27-18.00 ml). The mean right resistive index (RI) was 0.61 ± 0.23, and the mean left RI was 0.59 ± 0.01. The rate of normal semen quality was 23.2% in group with varicocele and 30.6% in group with non-varicocele. The ultrasound results from the normal semen group were much different from those of the abnormal semen group regarding testicular volume: mean right testis volume: 9.67 ± 1.88 vs. 8.75 ± 2.34 ml, p = 0.0096; mean left testis volume: 9.54 ± 1.78 vs. 8.51 ± 2.44 ml, p = 0.0047; mean total volume of 2 sides: 19.21 ± 3.60 vs. 17.26 ± 4.59 ml, p = 0.005 (varicocele group); mean right testis volume: 9.21 ± 2.21 vs. 8.63 ± 2.21 ml, p = 0.029 (non-varicocele group). The other indexes of color Doppler ultrasound (peak systolic velocity, end diastolic velocity, RI) were not found to correlate with semen quality. CONCLUSIONS: Testicular volume which has a close relation to the semen parameters could be used as a clinical prediction factor for the quality of semen.

Impact of a methadone maintenance therapy pilot in Vietnam and its role in a scaled-up response.

BACKGROUND: As a dual response to the HIV epidemic and the high level of injecting drug use in Vietnam, the Ministry of Health (MOH) initiated a pilot methadone maintenance therapy (MMT) program in Hai Phong and Ho Chi Minh City (HCMC) in early 2009. The objectives of the pilot were to provide evidence on whether MMT could be successfully implemented in Vietnam and scaled up to other localities. METHODS: A prospective study was conducted among 965 opiate drug users admitted to the pilot. Data on demographic characteristics, sexual behaviors, substance use behaviors (including heroin use), and blood-borne virus infection (HIV, hepatitis B, and hepatitis C) were collected at treatment initiation and then again at 3-, 6-, 9-, 12-, 18-, and 24-month intervals thereafter. RESULTS: Twenty-four months after treatment initiation, heroin use as measured by urine test or self-report had reduced from 100 % of participants at both sites to 14.6 % in Hai Phong and 22.9 % in HCMC. When adjusted for multiple factors in Generalized Estimating Equations (GEE) logistic regression modeling, independent predictors of continued heroin use after 24 months of MMT in HCMC were the following: poor methadone adherence (adjusted odds ratio (AOR) = 3.7, 95 % confidence interval (CI) 1.8-7.8); currently on antiretroviral treatment (ART) (AOR = 1.8, 95 % CI 1.4-2.4); currently on TB treatment (AOR = 2.2, 95 % CI 1.4-3.4); currently experiencing family conflict (AOR = 1.6, 95 % CI 1.1-2.4); and currently employed (AOR = 0.8, 95 % CI 0.6-1.0). For Hai Phong participants, predictors were the following: currently on ART (AOR = 2.0, 95 % CI = 1.4-3.0); currently experiencing family conflict (AOR = 2.0, 95 % CI = 1.0-3.9); and moderate adherence to methadone (AOR = 2.1, 95 % CI = 1.2-1.9). In Hai Phong, the percentage of participants who were employed had also increased by end of study from 35.0 to 52.8 %, while in HCMC the level remained relatively unchanged, between 52.2 and 55.1 %. DISCUSSION: Study findings were used in multiple fora to convince policymakers and the public on the significant and vital role MMT can play in reducing heroin use and improving quality of life for individuals and families. Four years after this study was completed, Vietnam had expanded MMT to 162 clinics in 44 provinces serving 32,000 patients.

Maternal body mass index and gestational weight gain and their association with perinatal outcomes in Viet Nam.

OBJECTIVE: To examine the association between gestational weight gain and maternal body mass index (BMI) among Vietnamese women and the risk of delivering an infant too small or too large for gestational age. METHODS: A prospective health-facility-based study of 2989 pregnant Vietnamese women was conducted in the city of Nha Trang in 2007-2008. Cubic logistic regression was used to investigate the association of interest. Infants were classified into weight-for-gestational-age categories according to weight centiles for the Asian population. Gestational age was based on the date of last menstrual period and adjusted by the results of first-trimester ultrasound. FINDINGS: BMI was low (< 18.5), normal (18.5-22.9) and high (≥ 23.0) in 26.1%, 65.4% and 8.5% of the women, respectively. In each of these BMI categories, the percentage of women who delivered infants too small for gestational age was 18.1, 10.0 and 9.4, respectively, and the mean gestational weight gain was 12.5 kg (standard deviation, SD: ± 3.6), 12.2 kg (SD: ± 3.8) and 11.5 kg (SD: ± 4.7), respectively. Among women with low BMI, the risk of delivering an infant too small for gestational age ranged from approximately 40% if the gestational weight gain was < 5 kg to 20% if it was 5-10 kg. CONCLUSION: Having a low BMI, commonly found in Viet Nam, puts women at risk of delivering an infant too small for gestational age, especially when total maternal gestational weight gain is < 10 kg.

Analogues of key precursors of aspartyl protease inhibitors: synthesis of trifluoromethyl amino epoxides.

The synthesis of the title compound is described through original and tailored synthetic protocols. The addition of vinylmagnesium bromide to CF(3)-N-aryl and N-alkyl aldimines was efficient and did not require an activating N-substituent. The resultant CF3-allylamines were converted in an efficient and completely stereoselective route to syn CF3-epoxides 3 via formation of bromhydrins 8. The same sequence performed from the aldimine substituted with the methyl ether of the (R)-phenylglycinol provided the homochiral (R,R)-amino epoxide (de >98%). This study has allowed access to the novel racemic and homochiral trifluoromethyl beta-amino epoxides, analogues of key precursors of various HIV protease inhibitors.