Cushing's syndrome due to atypical carcinoid of the mediastinum.

Ectopic Cushing's syndrome, caused by a neuroendocrine tumor (NET), is a rare finding. NETs of the mediastinum are extremely rare. NETs arising from the anterior mediastinum are generally aggressive. They are widely characterized at clinical presentations, and may be asymptomatic or present with atypical symptoms. Prognosis is often poor due to their local recurrence and distant metastasis despite a multimodal approach. A 33-year-old male patient was admitted to our department with a femoral soft tissue abscess, diabetes, and hypokalemia. He had no typical features of Cushing's syndrome. However, with a few simple tests, that is, a basal hormone profile, and low-dose and high-dose dexamethasone suppression tests, we diagnosed this complicated condition of ectopic adrenocorticotrophic hormone (ACTH) secretion. Thoracic computed tomography revealed an anterior mediastinal mass of 35 × 22 mm. A surgical excision of the tumor was proposed, and intra-operative pathology consultation returned positive for the suspected NET. Immunohistochemically, the tumor cells were positive for CK, CD56, Chromogranin, Synaptophysin, S100, and CD117. No thymic tissue was found. The Ki-67 was 4%. A diagnosis of primary NETs of the mediastinum, intermediate grade (G2), of atypical carcinoids according to WHO 2015 was established. This patient survived with no sequelae, no distant metastasis, no recurrence, and without adjuvant radiotherapy or chemotherapy 2 years after surgery thanks to earlier diagnosis and prompt surgical intervention. Mediastinum ectopic ACTH-secreting tumors are a rare type of cancer. According to recent research, these tumors frequently display more aggressive behavior and are linked to endocrinopathies. It is noted that patient might have a better outcome and a longer survival time due to earlier detection and complete resection of malignancies.

Undescribed chalcone and stilbene constituents from Lysimachia baviensis and their anti-inflammatory effect.

The chemical composition and anti-inflammatory activity of the endemic Lysimachia baviensis were investigated for the first time in this study. A phytochemical fractionation of the methanol extract of L. baviensis resulted in the isolation of a new stilbene (bavienside A, 1) and two new chalcone glycosides (baviensides B and C, 2 and 3). Their structures were elucidated via the interpretation of NMR and HRESIMS spectroscopic data. Compounds 1-3 strongly inhibited the production of nitric oxide in LPS-induced RAW264.7 cells with the IC50 values of 6.23, 2.86 and 3.51 µM, respectively. The C-acetylstilbene and carbomethyl chalcone structures in compound 1 and 3 were found for the first time from natural source and could be important markers for chemotaxonomy of Lysimachia baviensis.

Association of Smoking Media Literacy with Vietnamese and South Korean Adolescents' Susceptibility to Smoking.

Studies on how smoking media literacy (SML) is associated with susceptibility to smoking among adolescents in South Korea and Vietnam are scarce. Thus, we examined the association of SML with susceptibility to smoking among adolescents in these countries to initiate a collaborative global health program. In total, 460 adolescents (Vietnam: 277, South Korea: 183) aged 15-18 completed an online cross-sectional survey. SML was measured using the 15-item SML scale. Susceptibility to smoking was measured by three questions on future smoking and if offered a cigarette by a friend. A multiple logistic regression model explored the association of SML with susceptibility to smoking. The study revealed that higher SML was significantly associated with lower susceptibility to smoking among Vietnamese, but not South Korean adolescents. Further studies to identify pathways between other factors associated with SML and susceptibility to smoking are needed to develop culture-specific intervention strategies for smoking prevention.

Second-Hand Smoking Prevalence in Vietnamese Population Aged 15 and older: A Systematic Review and Meta-Analysis.

Background: Second-hand smoking (SHS) is associated with many health problems. However, its prevalence in the community population aged 15 years and older in Vietnam is unknown. Objectives: To quantify the prevalence of SHS in Vietnamese communities aged 15 and above. Methods: This is a meta-analysis that reviewed studies of the prevalence of SHS in Vietnam published in MEDLINE, Scopus, Pubmed and the WHO library database between 1 January 2010 and 31 December 2019. MedCalc was used to perform all the analyses, and publication bias was determined using funnel plots and Egger regression asymmetry tests. Q-test and I2 statistic were used to identify heterogeneity across studies. Results: There were 7 articles that met our inclusion criteria 2 surveys at the national level, 3 Cross-sectional studies and 2 Case-control studies) involving 184 921 participants. According to the meta-analysis, the overall random-effects pooled prevalence of SHS was 54.6% (95% CIs: 44.900-64.154) with a high level of heterogeneity (P = .0001, Q = 2245.60, I 2 = 99.73%). It is noteworthy that the pooled prevalence of SHS rose throughout the course of the survey years. Our research found no evidence of publication bias. Conclusions: Vietnam has ratified the implementation the WHO Framework Convention on Tobacco Control (FCTC) in 2004, there are still a large number of people who are adversely impacted by SHS. Given the tremendous cost that SHS imposes on health systems, our results underscore the critical need for the Vietnamese government to expedite an implementation of a set of stronger tobacco control practices, thus reducing the incidence of smoking-related illnesses and fatalities.

Knowledge, attitude and practice of parents on maternal care in a mountainous district of Vietnam: A qualitative study.

Barriers preventing parents from accessing healthcare services affect the effectiveness of maternal care in mountainous areas of Vietnam. AIM: This study aimed to examine the current knowledge, attitudes, and practice of parents about maternal care in a mountainous region of Cao Bang province. METHOD: With the participation of 18 individuals (mothers, fathers, and pregnant women), six semi-structured interviews and three group discussions were conducted at different commune health centers. RESULT: This study emerged three themes, including knowledge, attitude, and practice of parents. Overall, parental knowledge about maternal care was at a basic level. While they showed positive attitudes towards the importance of maternal healthcare, unexpected behaviors such as homebirth or poor attendance at maternal health visits were still evident. These behavior patterns reflect incorrect cultural beliefs about health along with geographical and economic barriers.

Prioritizing Training Needs of School Health Staff: The Example of Vietnam.

Competencies of school health staff (SHS) members, including school nurses, are crucial to improving child and adolescent health. In Vietnam, although SHS members are dispatched to schools, they have limited training opportunities. This study identified SHS members' training needs in a province of Vietnam. A cross-sectional, online survey was conducted with 204 SHS members. The performance and importance of SHS members' competencies were measured using 59-items and rated by a 5-point Likert scale. SHS members' training priorities were analyzed using the Borich Needs Assessment and the Locus for Focus model. Controlling infectious disease was the highest training priority while implementing health promotion programs was of relatively low priority. The high-priority training needs identified could be rendered mandatory in policy for continuing education of SHS members. Awareness of the importance of health promotion, which has been emphasized globally, should also be promoted via school health policy. These findings could guide development of future training programs for SHS members.

Heterostemma cucphuongense (Apocynaceae, Asclepiadoideae), a new species from Vietnam.

Heterostemma cucphuongense (Apocynaceae, Asclepiadoideae), a new species from Vietnam is described, illustrated and compared with the similar species Heterostemma succosum Kerr. Heterostemma cucphuongense differs from H. succosum by the morphology of the rachis of the inflorescence, the margins of the corolla lobes and the colour of the adaxial surface of the corolla.

Thickness effect on low-power driving of MoS2 transistors in balanced double-gate fields.

In field-effect transistors (FETs), when the thickness of the semiconducting transition metal dichalcogenides (TMDs) channel exceeds the maximum depletion depth, the entire region cannot be completely controlled by a single-gate electric field. The layer-to-layer carrier transitions between the van der Waals interacted TMD layers result in the extraordinary anisotropic carrier transport in the in-plane and out-of-plane directions. The performance of the TMD FETs can be largely enhanced by optimizing the thickness of the TMD channel as well as increasing the effective channel area through which the gate field is delivered. In this study, we investigated the carrier behavior and device performance in double-gate FETs fabricated using a 57 nm thick MoS2, which is thicker than the maximum depletion depth of about 50 nm, and a much thinner 4 nm thick MoS2. The results showed that in the thick MoS2, the gate voltages at both ends formed two independent channels which had no synergistic effect on the device performance owing to the inefficient delivery of the vertical electric field. On the other hand, in the thin MoS2 channel, the double-gate voltages effectively controlled one channel, resulting in twice the carrier mobility and operation in a low electric field region, i.e. below 0.2 MV cm-1.

Using the Stage-Based Approaches to Predict Breast Self-Examination Among Rural Vietnamese Women.

A stages-of-change approach would be helpful to understand cancer screening behaviors. This study aimed to identify the compliance and determinants of breast self-examination (BSE) based on transtheoretical model (TTM) and health belief model (HBM). A cross-sectional study was conducted with 296 rural Vietnamese women using a self-administered questionnaire consisting of Champion's HBM scales, breast cancer knowledge (BCK), integrated connection to neighborhood storytelling networks (ICSN), and TTM stages of BSE. A generalized ordered logistic regression was conducted to identify factors associated with TTM stages of BSE. About 61% of women did not currently perform BSE. Perceived benefit was significant in all stages changes. When changing to the action stage, perceived benefits, self-efficacy, and BCK were significant. When changing to the maintenance stage, perceived susceptibility, benefits, self-efficacy, and ICSN were significant. Determinants influencing BSE behavior were different in each TTM stage, indicating that educational programs should be introduced with stage-matched strategies to increase BSE.

Estimating the economic impact of canine rabies to Viet Nam 2005-2014.

The global economic impact of canine rabies has been estimated by several studies. Asia bears a disproportionate burden of this zoonosis due to high levels of human deaths and rates of post-exposure prophylaxis (PEP), but low investment in preventative dog vaccination. The same factors that cause rabies to burden much of Asia are also present in Viet Nam. This study estimated the economic burden of canine rabies in a societal perspective including direct and indirect cost of rabies in dogs, livestock, and humans. Using data collected from personal interviews, published literature, published and supplementary reports, and primary data collection, we estimated the economic impact of canine rabies in Viet Nam over a ten year period (2005-2014). We incorporated the direct and indirect costs for PEP, dog vaccination efforts, livestock losses, and disability adjusted life years (DALYs) into the analysis. General findings from this analysis indicated that over the 10 year study period, the total economic impact of canine rabies was over $719 million USD. The largest portion of impacts (92%) were made up of PEP-related costs. Canine rabies created between 36,560 and 45,700 DALYs, measured in years of life lost (YLL). A total of 914 human deaths were reported over the study period. Deaths/100,000 people were 0.11, which is lower than the reported level for Asian countries. The cost per dog vaccinated was $1.75 USD. Our results indicate that canine rabies impacts in Viet Nam are consistent with the burden elsewhere reported in Asia, with large expenditures on PEP and very small investments in dog vaccination.

No Clinical Benefit of Empirical Antimicrobial Therapy for Pediatric Diarrhea in a High-Usage, High-Resistance Setting.

Background: Pediatric diarrheal disease presents a major public health burden in low- to middle-income countries. The clinical benefits of empirical antimicrobial treatment for diarrhea are unclear in settings that lack reliable diagnostics and have high antimicrobial resistance (AMR). Methods: We conducted a prospective multicenter cross-sectional study of pediatric patients hospitalized with diarrhea containing blood and/or mucus in Ho Chi Minh City, Vietnam. Clinical parameters, including disease outcome and treatment, were measured. Shigella, nontyphoidal Salmonella (NTS), and Campylobacter were isolated from fecal samples, and their antimicrobial susceptibility profiles were determined. Statistical analyses, comprising log-rank tests and accelerated failure time models, were performed to assess the effect of antimicrobials on disease outcome. Results: Among 3166 recruited participants (median age 10 months; interquartile range, 6.5-16.7 months), one-third (1096 of 3166) had bloody diarrhea, and 25% (793 of 3166) were culture positive for Shigella, NTS, or Campylobacter. More than 85% of patients (2697 of 3166) were treated with antimicrobials; fluoroquinolones were the most commonly administered antimicrobials. AMR was highly prevalent among the isolated bacteria, including resistance against fluoroquinolones and third-generation cephalosporins. Antimicrobial treatment and multidrug resistance status of the infecting pathogens were found to have no significant effect on outcome. Antimicrobial treatment was significantly associated with an increase in the duration of hospitalization with particular groups of diarrheal diseases. Conclusions: In a setting with high antimicrobial usage and high AMR, our results imply a lack of clinical benefit for treating diarrhea with antimicrobials; adequately powered randomized controlled trials are required to assess the role of antimicrobials for diarrhea.

The evolving local social contract for managing climate and disaster risk in Vietnam.

How do disasters shape local government legitimacy in relation to managing climate- and disaster-related risks? This paper looks at how local authorities in Central Vietnam perceive their social contract for risk reduction, including the partial merging of responsibilities for disaster risk management with new plans for and investments in climate change adaptation and broader socioeconomic development. The findings indicate that extreme floods and storms constitute critical junctures that stimulate genuine institutional change. Local officials are proud of their strengthened role in disaster response and they are eager to boost investment in infrastructure. They have struggled to reinforce their legitimacy among their constituents, but given the shifting roles of the state, private sector, and civil society, and the undiminished emphasis on high-risk development models, their responsibilities for responding to emerging climate change scenarios are increasingly nebulous. The past basis for legitimacy is no longer valid, but tomorrow's social contract is not yet defined.

Callicarpa bachmaensis Soejima & Tagane (Lamiaceae), a new species from Bach Ma National Park in Thua Thien Hue Province, Central Vietnam.

A new species, Callicarpa bachmaensis Soejima & Tagane, sp. nov., is described and illustrated from Bach Ma National Park in Thua Thien Hue Province, Central Vietnam. This species has a characteristic liana habit, white corolla, and narrowly elliptic to narrowly lanceolate, entire, occasionally subequal leaves, by which it is clearly distinguished from the other previously known species of this genus.

Evaluation of Luminex xTAG Gastrointestinal Pathogen Panel Assay for Detection of Multiple Diarrheal Pathogens in Fecal Samples in Vietnam.

Diarrheal disease is a complex syndrome that remains a leading cause of global childhood morbidity and mortality. The diagnosis of enteric pathogens in a timely and precise manner is important for making treatment decisions and informing public health policy, but accurate diagnosis is a major challenge in industrializing countries. Multiplex molecular diagnostic techniques may represent a significant improvement over classical approaches. We evaluated the Luminex xTAG gastrointestinal pathogen panel (GPP) assay for the detection of common enteric bacterial and viral pathogens in Vietnam. Microbiological culture and real-time PCR were used as gold standards. The tests were performed on 479 stool samples collected from people admitted to the hospital for diarrheal disease throughout Vietnam. Sensitivity and specificity were calculated for the xTAG GPP for the seven principal diarrheal etiologies. The sensitivity and specificity for the xTAG GPP were >88% for Shigellaspp.,Campylobacterspp., rotavirus, norovirus genotype 1/2 (GI/GII), and adenovirus compared to those of microbiological culture and/or real-time PCR. However, the specificity was low (∼60%) for Salmonella species. Additionally, a number of important pathogens that are not identified in routine hospital procedures in this setting, such as Cryptosporidiumspp. and Clostridium difficile, were detected with the GPP. The use of the Luminex xTAG GPP for the detection of enteric pathogens in settings, like Vietnam, would dramatically improve the diagnostic accuracy and capacity of hospital laboratories, allowing for timely and appropriate therapy decisions and a wider understanding of the epidemiology of pathogens associated with severe diarrheal disease in low-resource settings.

Electrodeposition and Characterization of Hydroxyapatite on TiN/316LSS.

The deposition of TiN on stainless steel substrates may improve the stability and compatibility of this material with bone, which may be advantageously exploited for the elaboration of advanced pros- thetic devices. In this work, TiN-coated 316LSS (by way of DC magnetron sputtering) was used as a starting material for investigating the electrochemical post-deposition of hydroxyapatite (HAp) which has a composition close to that of bone. Electrodeposition was carried out starting from an aqueous medium containing solubilized Ca(NO3)2 and NH4H2PO4 in the presence of H2O2. We report the influence of experimental conditions on the morphology of the obtained HAp coating on TiN/316LSS. The effect of applied potential, temperature, H2O2 concentration, pH and duration of reaction were thoroughly discussed on the basis of X-ray diffraction (XRD), scanning electron microscopy (SEM), Fourier Transform Infrared (FTIR) spectroscopy and Energy Dispersive X-ray Spectroscopy (EDX) results. This method appears advantageous for producing HAp-coated implant materials.

Isolation, characterisation and biological evaluation of a phenoxazine, a natural dyestuff isolated from leaves of Peristrophe bivalvis.

Peristrophe bivalvis (L.) Merr. (Acanthaceae) is a wild growing and cultivated plant used for dyeing of foods by the ethnic minorities of Vietnam. The major component of the colour aqueous extract (CAE) of its leaves was identified as peristrophine by spectral analysis, especially the 2D NMR spectra (HSQC, HMBC and NOESY). Considering the widespread utilisation of the decoction of this plant for food dyeing, we evaluated the acute oral toxicity of the CAE. Based on the results in an acute toxicity study in mice, the LD50 value of the CAE was determined as 9100 ± 290 mg kg(-1) body weight. Additionally, in vitro cytotoxic assay showed an inhibition of peristrophine against Hepatocellular carcinoma (HepG2, IC503.90 µg mL(-1)). CAE and peristrophine (1) have also been tested for their ability to affect the cell number of the OCI acute myeloid leukaemia cell line. CAE and peristrophine significantly decreased the OCI cell number at different concentrations and times of treatment.

Development of a semi-quantitative food frequency questionnaire for dietary studies--focus on vitamin C intake.

The present work aimed to provide a basis for examination of intake of selected food items determined with a semi-quantitative food frequency questionnaire (SQFFQ) and planned-food selection (PFS). From February to July of 2003, ninety one cancer patients and 90 matched (same sex and age within 5 years) non-cancer patients were directly interviewed by trained interviewers using the designed questionnaire at the inpatient-department of Viet Duc hospital, Ha Noi City, Viet Nam. Study subjects consumed more SQFFQ-food items than PFS-food items, so that the latter method might not accurately reflect dietary habits regarding estimation of nutrient intake, especially vitamins. Because these are beneficial factors acting against cancer development at many sites, the absence of food items selected by SQFFQ may result in a poor database regarding possible confounding factors. For futher clarification we then focused on vitamin C contributions of Vietnamese food and analyzed data of the National Nutritional Household Survey in 2000: 7,686 households throughout the country (vitamin C intake status) and 158 households with 741 persons of the population of Hanoi city (individual food items contributing to vitamin C). Direct interview using a validated questionnaire with an album of current Vietnamese food items-recipes and weighing checks was conducted to obtain information regarding all types of food intake over the last 24-hours. Contribution analysis using the Nutritive Composition Table of Vietnamese Foods, revision 2000, and stepwise regression analysis was applied. Average intake adjusted by ages of vitamin C per person per day was estimated. In total, the study subjects were found to currently consume 184 food items. Average intake of vitamin C was 72.5 mg per person per day at the national level: 57.9% from leafy vegetables, 33.4% from fresh fruits, and 6.4% from non-leafy vegetables. For vitamin C contribution, the highest 25 food items contributed to a cumulative 95.3% of vitamin C intake with a cumulative R2=0.99.

Gastric and colo-rectal cancer mortality in Viet Nam in the years 2005-2006.

BACKGROUND: The International Collaborative Epidemiological Study of Host and Environmental Factors for Stomach and Colorectal Cancers in Southeast Asian Countries (SEACs) has been conducted in Viet Nam from 2003 to 2008 on a case-control basis. For further effective primary prevention, we examined gastric and colorectal cancer mortality nationwide in eight regions of Viet Nam in 2005-06. METHODS: Both demographic data and lists of all deaths in 2005-06 were obtained from all 10,769 commune health stations in Viet Nam. Five indicators included name, age, sex, date of death and cause of death was collected for each case. We selected only communes having the list of deaths with clear cause for each case and crude mortality rate for all causes from 300-600/100,000 as published by the Ministry of Health for a reasonable accuracy and completeness. Obtained data for all causes, all cancers, stomach and colorectal cancer deaths as well as demographic information were processed using Excel software and exported to STATA 8.0 for estimation of world age-standardized cancer mortality rates per 100,000. RESULTS: Data were available for 1,246 gastric cases, (819 male and 427 female) with age-standardized mortality rates from 12.7 to 31.3 per 100,000 in males and from 5.9 to 10.3 per 100,000 in females in the 8 regions of the country. For colorectal cancers, 542 cases (268 male and 274 female) gave mortality rates from 4.0 to 11.3 per 100,000 in males and from 3.0 to 7.8 per 100,000 in females. DISCUSSION: Stomach cancer mortality in males in the region of North East in the North Viet Nam (2005-06) was higher than that in Japan (2002) (31.3 versus 28.7 per 100,000) while colorectal cancer in Viet Nam was lower. While prevalence of Helicobacter pyloris infection in Viet Nam was from 70-75% in both males and females, the stomach cancer rate in males was significantly higher than in females, 31.3 versus 6.8 per 100,000, suggesting an influence of other environmental risk factors. Whether protective factors are operating against colorectal cancer in Viet Nam now needs to be explored.