Acute Kidney Injury After Percutaneous Coronary Intervention Guided by Intravascular Ultrasound.

Purpose We investigated the impact of intravascular ultrasound guidance on reducing the incidence of contrast-induced acute kidney injury (CI-AKI) in patients undergoing percutaneous coronary intervention (PCI). Methods Ninety-nine patients were enrolled in this prospective cohort who were not randomly assigned to angiography-guided percutaneous coronary intervention or intravascular ultrasound-guided percutaneous coronary intervention. The patients were hospitalized at the Vietnam National Heart Institute - Bach Mai Hospital between 2019 and 2020. Acute kidney injury incidence during hospitalization was the primary endpoint. Results A total of 99 patients were divided into two groups: the intravascular ultrasound-guided group (33 participants) and the angiography-guided group (66 participants). The mean ± SD contrast volume of each group was 95.2 ± 37.1 mL and 133.0 ± 36.0 mL for the ultrasound-guided and angiography-guided groups, with P < 0.0001. Intravascular imaging-guided percutaneous coronary intervention (IVUS-guided PCI) was associated with reduced acute kidney injury incidence during hospitalization: 0.0% vs. 12.12% and P = 0.049. Conclusions Intravascular ultrasound is a safe imaging tool that guides percutaneous coronary intervention and significantly reduces the rate of acute kidney injury compared to angiography alone. Patients who have a high chance of experiencing acute kidney injury benefit from using intravascular ultrasound.

Current advances in seagrass research: A review from Viet Nam.

Seagrass meadows provide valuable ecosystem services but are fragile and threatened ecosystems all over the world. This review highlights the current advances in seagrass research from Viet Nam. One goal is to support decision makers in developing science-based conservation strategies. In recent years, several techniques were applied to estimate the size of seagrass meadows. Independent from the method used, there is an alarming decline in the seagrass area in almost all parts of Viet Nam. Since 1990, a decline of 46.5% or 13,549 ha was found. Only in a few protected and difficult-to-reach areas was an increase observed. Conditions at those sites could be investigated in more detail to make suggestions for conservation and recovery of seagrass meadows. Due to their lifestyle and morphology, seagrasses take up compounds from their environment easily. Phytoremediation processes of Thalassia hemprichii and Enhalus acoroides are described exemplarily. High accumulation of heavy metals dependent on their concentration in the environment in different organs can be observed. On the one hand, seagrasses play a role in phytoremediation processes in polluted areas; on the other hand, they might suffer at high concentrations, and pollution will contribute to their overall decline. Compared with the neighboring countries, the total C org stock from seagrass beds in Viet Nam was much lower than in the Philippines and Indonesia but higher than that of Malaysia and Myanmar. Due to an exceptionally long latitudinal coastline of 3,260 km covering cool to warm water environments, the seagrass species composition in Viet Nam shows a high diversity and a high plasticity within species boundaries. This leads to challenges in taxonomic issues, especially with the Halophila genus, which can be better deduced from genetic diversity/population structures of members of Hydrocharitaceae. Finally, the current seagrass conservation and management efforts in Viet Nam are presented and discussed. Only decisions based on the interdisciplinary cooperation of scientists from all disciplines mentioned will finally lead to conserve this valuable ecosystem for mankind and biodiversity.

Genetic landscape of recessive diseases in the Vietnamese population from large-scale clinical exome sequencing.

Accurate profiling of population-specific recessive diseases is essential for the design of cost-effective carrier screening programs. However, minority populations and ethnic groups, including Vietnamese, are still underrepresented in existing genetic studies. Here, we reported the first comprehensive study of recessive diseases in the Vietnamese population. Clinical exome sequencing data of 4503 disease-associated genes obtained from a cohort of 985 Vietnamese individuals was analyzed to identify pathogenic variants, associated diseases and their carrier frequencies in the population. A total of 118 recessive diseases associated with 164 pathogenic or likely pathogenic variants were identified, among which 28 diseases had carrier frequencies of at least 1% (1 in 100 individuals). Three diseases were prevalent in the Vietnamese population with carrier frequencies of 2-12 times higher than in the world populations, including beta-thalassemia (1 in 23), citrin deficiency (1 in 31), and phenylketonuria (1 in 40). Seven novel pathogenic and two likely pathogenic variants associated with nine recessive diseases were discovered. The comprehensive profile of recessive diseases identified in this study enables the design of cost-effective carrier screening programs specific to the Vietnamese population.

Whole exome sequencing revealed a pathogenic variant in a gene related to malignant hyperthermia in a Vietnamese cardiac surgical patient: A case report.

INTRODUCTION: Malignant hyperthermia (MH) is a rare autosomal dominant pharmacogenetic disorder which known associated with some genes such as CACNA1S and RYR1. Using whole exome analysis, we aimed to find out the genetic variant data in a malignant hyperthermia patient undergoing cardiac surgery. PRESENTATION OF CASE: Patient was 59 years old male with dull left chest pain, mild breathing difficulty, thrombosis in the left atrium, mitral valve stenosis that needed a surgery to remove the thrombus and replace the mitral valve. After 5-h operation of left mitral heart valve replacement using both intravenous and inhaled anaesthetics, the patient showed suddenly hyperthermia (39.5 °C), low blood pressure (90/50 mmHg), heavy sweating, 1 mm dilated pupils on both sides, positive light reflection. Whole exome analysis showed 96,286 of SNPs including 11,705 of synonymous variants, 11,388 of missense variants, 106 of stop gained, and 39 of stop lost. One variant of RYR1 gene was found as mutation point at c.7048G > A (p.Ala2350Thr) known related to MH. DISCUSSION: This was a rare case of MH during cardiac surgery reported in Vietnam that might related to mutation point at c.7048G > A (p.Ala2350Thr) of RYR1 gene. CONCLUSION: Patient carried a mutant of RYR1 gene could possibly lead to MH development post anaesthesia of cardiac surgery.

Totally Endoscopic Cardiac Surgery for Atrial Septal Defect Repair on Beating Heart Without Robotic Assistance in 25 Patients.

OBJECTIVE: The aim of the study was to investigate the effectivity and safety of totally endoscopic cardiac surgery without robotic assistance for atrial septal defect (ASD) closure on beating hearts. METHODS: Twenty-five patients (adults/children: 15/10) underwent ASD closure using nonrobotically assisted totally endoscopic approach on beating heart. Three 5-mm trocars and one 12-mm trocar were used, only the superior vena cava is snared, filling the pleural and pericardial cavities with CO2, and the heart was beating during the surgery. Twenty-three patients had isolated secundum ASD (2 of which had severe tricuspid regurgitation) and two patients had ASD combined with partial anomalous pulmonary venous connection. All ASDs were closed using artificial patch, continuous suture; tricuspid regurgitations were repaired and the anomalous pulmonary veins were drained to the left atrium. RESULTS: No postoperative complications or deaths occurred. Mean ± SD operation time and mean cardiopulmonary bypass time were 267.2 ± 44.6 and 156.1 ± 33.6 min, respectively. These patients were extubated within the first 5 hours, and the volume of blood drainage on the first day was less than 80 mL. Four days after surgery, patients did not need analgesics and were able to return to normal activities 1 week postoperatively. CONCLUSIONS: Totally endoscopic operation for ASD closure on beating heart is safe, with short recovery period, and surgical scars are of high cosmetic value, especially in a woman and girl.

Temporal and spatial assessment of river surface water quality using multivariate statistical techniques: a study in Can Tho City, a Mekong Delta area, Vietnam.

The present study is an evaluation of temporal/spatial variations of surface water quality using multivariate statistical techniques, comprising cluster analysis (CA), principal component analysis (PCA), factor analysis (FA) and discriminant analysis (DA). Eleven water quality parameters were monitored at 38 different sites in Can Tho City, a Mekong Delta area of Vietnam from 2008 to 2012. Hierarchical cluster analysis grouped the 38 sampling sites into three clusters, representing mixed urban-rural areas, agricultural areas and industrial zone. FA/PCA resulted in three latent factors for the entire research location, three for cluster 1, four for cluster 2, and four for cluster 3 explaining 60, 60.2, 80.9, and 70% of the total variance in the respective water quality. The varifactors from FA indicated that the parameters responsible for water quality variations are related to erosion from disturbed land or inflow of effluent from sewage plants and industry, discharges from wastewater treatment plants and domestic wastewater, agricultural activities and industrial effluents, and contamination by sewage waste with faecal coliform bacteria through sewer and septic systems. Discriminant analysis (DA) revealed that nephelometric turbidity units (NTU), chemical oxygen demand (COD) and NH3 are the discriminating parameters in space, affording 67% correct assignation in spatial analysis; pH and NO2 are the discriminating parameters according to season, assigning approximately 60% of cases correctly. The findings suggest a possible revised sampling strategy that can reduce the number of sampling sites and the indicator parameters responsible for large variations in water quality. This study demonstrates the usefulness of multivariate statistical techniques for evaluation of temporal/spatial variations in water quality assessment and management.

Temperature as a risk factor for hospitalisations among young children in the Mekong Delta area, Vietnam.

BACKGROUND: The Mekong Delta is the most vulnerable region to climate change in South-East Asia; however, the association between climate and children's health has rarely been studied in this region. OBJECTIVE: We examined the short-term association between daily temperature and hospital admissions for all causes, gastrointestinal and respiratory infection, among young children in the Mekong Delta area in Vietnam. METHODS: Daily paediatric hospital admissions and meteorological data were obtained from January 2008 to December 2012. A time-series approach was used with a combination of a Poisson regression and constrained distributed lag models to analyse the data. The long-term and seasonal trends, as well as other time-varying covariates, were adjusted using spline functions. Temperature--pediatric admission relationship was evaluated by age-specific (0-2 and 3-5-year-olds) and cause of admission groupings. RESULTS: A 1°C increase in the 2-day moving average temperature was significantly associated with a 3.4% (95% CI 1.2% to 5.5%), 4.6% (95% CI 2.2% to 7.3%), 2.6% (95% CI 0.6% to 4.6%), 4.4% (95% CI 0.6% to 8.2%) and 3.8%(95% CI 0.4% to 7.2%) increase in hospital admissions with 0-2-year-old children, 3-5-year-old children, all causes, gastrointestinal infection and respiratory infection, respectively. The cumulative effects from 1-day to 6-day moving average temperature on hospital admissions were greater for 3-5-year-old children and gastrointestinal infection than for 0-2-year-old children and other causes. CONCLUSIONS: Temperature was found to be significantly associated with hospital admissions in young children with the highest association between temperature and gastrointestinal infection. The government agencies of Mekong Delta should implement measures to protect children from the changing temperature conditions related to climate change.

Association between climate factors and diarrhoea in a Mekong Delta area.

The Mekong Delta is vulnerable to changes in climate and hydrological events which alter environmental conditions, resulting in increased risk of waterborne diseases. Research exploring the association between climate factors and diarrhoea, the most frequent waterborne disease in Mekong Delta region, is sparse. This study evaluated the climate-diarrhoea association in Can Tho city, a typical Mekong Delta area in Vietnam. Climate data (temperature, relative humidity, and rainfall) were obtained from the Southern Regional Hydro-Meteorological Centre, and weekly counts of diarrhoea visits were obtained from Can Tho Preventive Medicine Centre from 2004 to 2011. Analysis of climate and health variables was carried out using spline function to adjust for seasonal and long-term trends of variables. A distributed lag model was used to investigate possible delayed effects of climate variables on diarrhoea (considering 0-4 week lag periods), then the multivariate Poisson regression was used to examine any potential association between climate factors and diarrhoea. The results indicated that the diarrhoea incidence peaked within the period August-October annually. Significant positive associations were found between increased diarrhoea and high temperature at 4 weeks prior to the date of hospital visits (IRR = 1.07; 95 % CI = 1.04-1.08), high relative humidity (IRR = 1.13; 95 % CI = 1.12-1.15) and high (>90th percentile) cumulative rainfall (IRR = 1.05; 95 % CI = 1.05-1.08). The association between climate factors and diarrhoea was stronger in rural than urban areas. These findings in the context of the projected changes of climate conditions suggest that climate change will have important implications for residential health in Mekong Delta region.

Artifact-free coronary magnetic resonance angiography and coronary vessel wall imaging in the presence of a new, metallic, coronary magnetic resonance imaging stent.

BACKGROUND: Coronary in-stent restenosis cannot be directly assessed by magnetic resonance angiography (MRA) because of the local signal void of currently used stainless steel stents. The aim of this study was to investigate the potential of a new, dedicated, coronary MR imaging (MRI) stent for artifact-free, coronary MRA and in-stent lumen and vessel wall visualization. METHODS AND RESULTS: Fifteen prototype stents were deployed in coronary arteries of 15 healthy swine and investigated with a double-oblique, navigator-gated, free-breathing, T2-prepared, 3D cartesian gradient-echo sequence; a T2-prepared, 3D spiral gradient-echo sequence; and a T2-prepared, 3D steady-state, free-precession coronary MRA sequence. Furthermore, black-blood vessel wall imaging by a dual-inversion-recovery, turbo spin-echo sequence was performed. Artifacts of the stented vessel segment and signal intensities of the coronary vessel lumen inside and outside the stent were assessed. With all investigated sequences, the vessel lumen and wall could be visualized without artifacts, including the stented vessel segment. No signal intensity alterations inside the stent when compared with the vessel lumen outside the stent were found. CONCLUSIONS: The new, coronary MRI stent allows for completely artifact-free coronary MRA and vessel wall imaging.

New metallic MR stents for artifact-free coronary MR angiography: feasibility study in a swine model.

RATIONALE AND OBJECTIVES: The objective of this study was to investigate the potential for artifact-free coronary magnetic resonance angiography (cMRA) in the presence of dedicated metallic MR stents in vitro and in a swine model. METHODS: All investigations were performed at 1.5 T, applying a standard cMRA gradient echo sequence with a T2 preparation pulse. Two prototypes of each hand-woven, mechanically woven, and lasered Aachen Resonance Coronary MR Stents made out of an MR-compatible metallic alloy and dilated to 2.5 mm and 4 mm were examined in a water bath. RESULTS: Artifact behavior was judged independently by 2 radiologists as showing "no artifacts" for all tested stent types. Signal-to-noise ratios inside and outside of the stents were measured yielding a Pearson correlation coefficient of 0.98 (y = 1.22 + 0.92x). Nineteen stents (8 hand woven, 3 mechanically woven, 8 lasered) were deployed in coronary arteries of 19 domestic pigs and were examined by cMRA. Artifact behavior of the stents was analyzed by measuring the signal-to-noise ratio at the stent positions and compared with signal-to-noise ratio measurements outside of the stents, yielding a Pearson correlation coefficient of 0.90 (y = -0.75 + 1.06x). CONCLUSIONS: All 3 prototypes of coronary MR stents allowed complete visualization of the stent lumen and consequently determination of stent patency by cMRA.

Free-breathing 3D steady-state free precession coronary MR angiography with radial k-space sampling: comparison with cartesian k-space sampling and cartesian gradient-echo coronary MR angiography--pilot study.

The authors compared radial steady-state free precession (SSFP) coronary magnetic resonance (MR) angiography, cartesian k-space sampling SSFP coronary MR angiography, and gradient-echo coronary MR angiography in 16 healthy adults and four pilot study patients. Standard gradient-echo MR imaging with a T2 preparatory pulse and cartesian k-space sampling was the reference technique. Image quality was compared by using subjective motion artifact level and objective contrast-to-noise ratio and vessel sharpness. Radial SSFP, compared with cartesian SSFP and gradient-echo MR angiography, resulted in reduced motion artifacts and superior vessel sharpness. Cartesian SSFP resulted in increased motion artifacts (P <.05). Contrast-to-noise ratio with radial SSFP was lower than that with cartesian SSFP and similar to that with the reference technique. Radial SSFP coronary MR angiography appears preferable because of improved definition of vessel borders.

Navigator-gated coronary magnetic resonance angiography using steady-state-free-precession: comparison to standard T2-prepared gradient-echo and spiral imaging.

RATIONALE AND OBJECTIVES: Recent developments of magnetic resonance imaging enabled free-breathing coronary MRA (cMRA) using steady-state-free-precession (SSFP) for endogenous contrast. The purpose of this study was a systematic comparison of SSFP cMRA with standard T2-prepared gradient-echo and spiral cMRA. METHODS: Navigator-gated free-breathing T2-prepared SSFP-, T2-prepared gradient-echo- and T2-prepared spiral cMRA was performed in 18 healthy swine (45-68 kg body-weight). Image quality was investigated subjectively and signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and vessel sharpness were compared. RESULTS: SSFP cMRA allowed for high quality cMRA during free breathing with substantial improvements in SNR, CNR and vessel sharpness when compared with standard T2-prepared gradient-echo imaging. Spiral imaging demonstrated the highest SNR while image quality score and vessel definition was best for SSFP imaging. CONCLUSION: Navigator-gated free-breathing T2-prepared SSFP cMRA is a promising new imaging approach for high signal and high contrast imaging of the coronary arteries with improved vessel border definition.