Subclinical Characteristics Research Articles

Streptococcus suis-Associated Meningitis in a Southern Region of Vietnam.

Streptococcus suis is the most common and severe cause of meningitis in Vietnam, but the recent data about epidemiological characteristics and sequelae are still inadequate. We performed a retrospective study to describe the epidemiology, clinical characteristics, and outcomes of patients with S. suis-associated meningitis. A retrospective study was carried out by searching records from the Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam, between January 2016 and January 2020. All data concerning epidemiological, clinical, and subclinical characteristics and treatment results were collected and analyzed. Over the study period, 153 cases were included in this study, with 95 cases occurring in the 2016-2017 period. The median age of all patients was 52 years (range, 29-90 years), and 70.6% of patients were male. Fifty-two patients (34%) were farmers, and the Mekong Delta was the region with the highest number of cases (60.1%). The most frequent manifestation of infection was fever (151/153, 98.7%), followed by hearing loss (64/153, 41.8%), and one patient (0.7%) died. All isolates remained susceptible to ceftriaxone, penicillin, vancomycin, and levofloxacin, whereas 99.2% of isolates were resistant to tetracycline. Occupational exposure to pigs and the consumption of contaminated food have been identified as primary risk factors associated with this zoonosis, and our study found no significant changes in epidemiological factors compared with past data. The Mekong Delta continues to be the most affected region for S. suis meningitis in southern Vietnam, with S. suis serotype 2 remaining the most relevant agent.

Pharmacotherapy review and clinical, sub-clinical characteristics in limb-girdle muscular dystrophy

Aims: Review pharmacotherapy in limb-girdle muscular dystrophy and describe clinical, and subclinical characteristics in patients of limb-girdle muscular dystrophy (LGMD). Methods: A meta-analysis with data in PubMed, up to May 2023 on the pharmacotherapy of LGMD combined with a cross-sectional study. Patients were diagnosed with LGMD according to the European Neuromuscular Centre (ENMC) in 1995 at E and Bach Mai Hospitals, from December 2022 to May 2023. Results: 21 studies in pharmacotherapy were conducted, and treatment therapies (glucocorticoid, biological antibody, gene therapy) initially showed safety and some effectiveness in muscular strength. There are some potential gene therapies. The clinical characteristic of collected 15 patients with LGMD was high onset age (20.7±12.5 years), and prolonged diagnosis time (6.3±5.5 years). Most patients showed signs of muscle weakness and muscle atrophy (100 and 86.7%), waddling gait, and Gower’s sign (93.3%). 100% of patients had increased creatine kinase (CK) of 1648.5±2235.8 U/l. Most patients had normal inflammatory indexes. On muscular histopathology, the majority of patients had muscle fiber degeneration, hypertrophy, fibrous tissue invasion, and fat infiltration (86.7%). Conclusions: Treatment therapies in LGMD initially showed safety and some effectiveness in muscular strength; the gene therapies are promising. Clinically, all patients showed signs of muscle weakness in the limb-girdle, most of them showed muscle atrophy, waddling gait, Gowers’ sign, increased CK, negative inflammatory markers, and muscle fiber degeneration on histopathology.

Application of Immunoblot assay (ANA 23 Profile) for detection of autoantibodies in systemic sclerosis

Objective: Examine the clinical and subclinical characteristics and the rate of autoantibodies in systemic sclerosis (SSc) using Immunoblot technique (ANA 23 Profile). Research subjects and methods: Cross-sectional descriptive study of 57 patients diagnosed with SSc according to the 2013 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria and were tested for autoantibodies using the Immunoblot technique (ANA 23 Profile) at the National Hospital of Dermatology and Venereology. Results: Among 57 SSc patients, the female/male ratio was 5/1. The average age of disease onset was 49.3±13.3, with 57.9% of patients over the age of 50. Diffuse SSc was the most common (70%). Raynaud was the most common symptom (98.2%), followed by gastroesophageal reflux (86%), and pulmonary fibrosis (70.2%). Heart and kidney damage were less frequently observed, accounting for 15.8 and 5.3%, respectively. Positive rates of the three major antibodies in SSc included anti-Scl-70 antibody (63.2%), anti-centromere antibody (17.5%), and anti-RNA polymer III antibody (12.3%), respectively. Scl-70 autoantibodies were mainly found in diffuse skin types (91.7%) while CENP autoantibodies were mainly found in localised skin types (90%) with p<0.05. RNAP III antibodies were mainly found in diffuse skin types (85.7%), however, this difference was not statistically significant (p>0.05). Conclusion: The presence of Scl-70 was related to the diffuse skin types while the presence of CENP was related to localised skin types.

Clinical, subclinical characteristics and treatment outcomes of patients with community - acquired pneumonia at risk of pes infection

This study aims to describe the clinical and subclinical characteristics and evaluate treatment outcomes of community-acquired pneumonia (CAP) patients at risk of Pseudomonas aeruginosa, extended-spectrum beta-lactamases-producing Enterobacteriaceae, methicillin-resistant Staphylococcus aureus (PES) infection. A cross-sectional descriptive study was conducted on 90 CAP patients with potential PES infection admitted to the Respiratory Department of Can Tho Central General Hospital in 2023. Most cases presented with symptoms, including moist rales (91.1%), increased cough (90%), dyspnea (86%), purulent sputum production (77.8%), and consolidation syndrome (71.1%). More than half of the cases exhibited fever (54.4%). A white blood cell count increase was typical (13.31 x 109 cells/L) and predominantly neutrophilic (81.3 ± 19.7%). Chest radiography predominantly showed bilateral infiltration (58.9%). PES pathogens were isolated in 30 patients (33.3%). The majority of cases did not respond to initial antibiotics (56.6%), most of the cases were stable and cured (accounting for 91.1%) with an average hospital stay of 8 days. Patients with CAP at risk of PES infection exhibit typical acute symptoms and laboratory features of conventional CAP. Most responded poorly to initial treatment, but the final treatment resulted in a very high rate of stability and cure.

SURVEY OF ELEVATED BLOOD PRESSURE IN CHILDREN

Background: Hypertension is one of the leading risk factors for death, one of the main risks of cardiovascular disease. Clinical characteristics of hypertension are diverse, the early detection of symptoms of hypertension contributes significantly to early diagnosis and treatment. In Can Tho, there is little research on hypertension in children. Objectives: Describe the clinical and subclinical characteristics of hypertensive children being treated at the Cardiology Department, Can Tho Children’s Hospital. Materials and methods: Analytical descriptive cross-sectional study on 96 pediatric patients diagnosed with hypertension at Can Tho Pediatrics Hospital. Research subjects: Pediatric patients (<16 years old) being treated at the department who are expected to have hypertension over a period of time. Sample selection criteria: Pediatric patients are expected to have hypertension determined according to the standards of the new Guidelines in Clinical Practice of the American Academy of Pediatrics (AAP) 2017. Exclusion criteria: Family members do not agree to allow the patient to participate in the study. Children are not appropriate for measuring BP due tocongenital anomalies: Ventricular septal defect, Atrial septal defect, Patent ductus arteriosus, Tetralogy of Fallot. Results: The common age group is under 13 years old (60.4%). The male and female gender ratio is approximately 2.1/1. The stage 2 hypertension classification is the most common (49.8%). The rate of neurological, gastrointestinal and cardiovascular symptoms was 59.4%, respectively; 19.8%; 24%. And there is no association between gastrointestinal, cardiovascular clinical symptoms and the grade of hypertension (p>0.05). Hyperlipidemia, HbA1C in children with hypertension accounted for a high rate of 47.1% and 50%. While in BUN disorder, proteinuria accounted for a low rate of 5.3% and 26.3%. No abnormalities were noted on renal Doppler ultrasound. The rate of abnormal results on echocardiography, chest X-ray and ECG was 53.3%; 23.3%;13.7% respectively.

Nghiên cứu đặc điểm lâm sàng, cận lâm sàng và đánh giá kết quả điều trị ở bệnh nhân động kinh sau chấn thương sọ não

Background: Post-traumatic epilepsy (PTE) results in a huge burden and reduces patients' quality of life. Understanding clinical, subclinical characteristics and assessing treatment results helps to improve management strategies for epilepsy after traumatic brain injury (TBI). Objectives: 1. To describe clinical and subclinical characteristics of patients with PTE at Vietnam - Cuba Friendship Dong Hoi Hospital. 2. To evaluate initial results of the treatment of PTE after 3 months. Methods: A cross-sectional descriptive study with follow-up on 58 patients with PTE receiving examination and treatment at Vietnam - Cuba Friendship Dong Hoi Hospital from April 2022 to June 2023. Results: Clinical: Late PTE (occurring > 1 week after TBI) accounted for 69% with 6.9% of first seizures occurred from 1 week - 6 months after TBI while 3.4% happened between 6 months - 1 year. Most seizures lasting less than 5 minutes (86.2%); 37.9% had ³ 1 seizure per month; 32.8% had 1 seizure weekly and daily attacks accounted for 24.1%. Focal seizure registered the majority (89.6%) while generalized seizures accounted for 10.4%; there was a difference in type of seizure between early PTE and late PTE. Subclinical: Abnormal electroencephalogram (EEG) was recorded in 24.1% of cases with following characteristics: diffuse slowing in both hemispheres (6.9%), localized slow waves (17.2%). Lesion location on CT/MRI: temple 53.4% and forehead 46.6%. Treatment results: 87.9% of TBI cases were treated conservatively and 12.1% were treated surgically. Antiepileptic medications: Depakin (62.5%), Tegretol (13.8%), Phenytoin (13.8%), Keppra (8.6%); treatment adherence rate was very high (89.7%). The recurrence rate was 37.9%, this was lower in the group of early PTE compared with late PTE (22.2% versus 45%). During 3 months of treatment, the majority had 1 - 4 seizures (72.2%) and 19.0% needed re-hospitalization. Neurological complications were recorded in 12.1% of cases. Aura happened in 43.1% of cases, more frequently in late PTE when compared with early PTE (50.0% and 27.8%, respectively). Conclusion: Prophylaxis of PTE should be considered in TBI patients having seizures without EEG abnormalities or in elderly patients with temporal and frontal lobe lesions.

Abstract P489: Intake of Fiber-Rich Foods is Favorably Associated With Cardiac Structure and Function: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Background: Abnormal cardiac phenotypes, including left ventricular (LV) structure and function, are subclinical characteristics, detectable before experiencing heart failure (HF) symptoms. Identifying lifestyle risk factors of abnormal cardiac phenotypes can help to prevent or slow down the progression to HF and ultimately reduce the burden of the aging heart. Therefore, we aimed to identify the associations of carbohydrate (CHO) quality and fiber-rich foods with LV structure and function. Methods: We studied 3,171 Black and White adults in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Dietary intake was assessed via Diet History and averaged across years 0 (1985-86), 7, and 20. CHO:fiber ratio was created to define CHO quality (greater CHO:fiber ratio representing lower CHO quality). The fiber-rich food score was created based on the servings of whole grains, fruits, vegetables, nuts, and legumes. LV structure and function measures were assessed via echocardiography at years 25 and 30 and were the dependent variables in linear repeated measures models, including random intercepts for individuals. CHO:fiber ratio was treated as a fixed effect. Results: Study participants were 25.1 (range: 18-30, SD: 3.61) years old on average at baseline, 57% (1,807 of 3,171) female, and 53% (1,678 of 3,171) White. Higher CHO quality ratio was favorably associated with global longitudinal strain (GLS); while the fiber-rich food score was favorably associated with LV mass index, GLS, and E/e’ ratio after adjusting for demographic and lifestyle characteristics (see table). Conclusions: Our study finding suggests that higher CHO quality is associated with better systolic function and greater intake of fiber-rich foods is associated with better LV structure and function, which support the Dietary Guidelines for Americans and the Dietary Guidance to Improve Cardiovascular Health by the AHA that recommend intakes of high-quality CHO foods such as whole grains, fruit, and vegetables.

The clinical, subclinical characteristics and treatment result of meningitis patients at Thai Nguyen National Hospital

Introduction: Meningitis is a devastating disease with a high case fatality rate, which can lead to serious long-term sequelae if not timely diagnosed, and treated.Objectives: Describing on the clinical, subclinical characteristics and analysing some factors related to the treatment results in meningitis patients at Thai Nguyen National Hospital.Methods: A cross-sectional descriptive study was conducted on 48 meningitis patients were treated at the Department of Neurology and Department of Tropical Diseases at Thai Nguyen National Hospital.Results: The average age of patients in the study was 43.27±15,31 (year); The percentage of male patients was 75,0%. The most common clinical symptom was headache (89.6%), fever (75%); The average white blood cell count in the CSF on admission was 509.92±681.27 (cells/ml) and at discharge was 94.42±102.60 (cells/ml); Protein in CSF on admission was 1.70±1.45 (g/L) and at discharge was 0.72±0.55 (g/L). The everage day of treatment was 12.57.Conclusion: The popularr symptoms of patients with bacterial meningitis are headache, fever, vomiting, nausea, constipation, and stiff neck. There was no relationship between age, gender, white blood cell count and white blood cell count in the CSF at admission to the number of treatment days in meningitis patients.

RESULTS OF TREATMENT FOR PAGET'S DISEASE OF THE BREAST AT THE NATIONAL CANCER HOSPITAL IN VIETNAM

Objectives: To describe the clinical and subclinical characteristics of patients with Paget's disease of the breast at The National Cancer Hospital and to evaluate the treatment outcomes of Paget's disease of the breast. Materials and methods: 46 patients were diagnosed and treated for Paget's disease of the breast in the Breast Surgery Department of The National Cancer Hospital from 2016 to 2020. Results: The average age was 60.6 ± 10.8. The common symptoms were nipple pain (76.1%) and nipple ulceration (65.2%). Paget's disease with invasive ductal carcinoma accounted for 37.0%, and Paget's disease with intraductal carcinoma accounted for 28.2%. The proportions of breast cancer stages 0, 1, 2, and 3 were 63.0%, 23.9%, 8.7%, and 4.4%, respectively. The proportions of total mastectomy and breast-conserving surgery were 97.8% and 2.2%, respectively. The 5-year overall survival and disease-free survival rates were 91.3% and 84.8%, respectively. Conclusions: A high proportion of Paget's disease of the breast cases are associated with underlying ductal carcinoma. Surgical treatment of Paget's disease has achieved positive outcomes in terms of overall survival and disease-free survival. Received 27 June 2023Revised 25 September 2023Accepted 28 November 2023

CLINICAL AND SUB-CLINICAL CHARACTERISTICS OF MENINGITIS CAUSED BY VARICELLA ZOSTER VIRUS

Encephalitis - meningitis today is still a serious public health problem with a high mortality rate.Objectives: To describe the clinical and subclinical characteristics of encephalitis-meningitis caused by Varicella zoster virus (VZV) in people from 15 years old.Material and methods: A retrospective descriptive research on 40 patients with encephalitis-meningitis diagnosed based on positive VZV PCR results in cerebrospinal fluid treated at the National Hospital of Tropical Diseases and Bach Mai Hospital from January 2020 to June 2023.Results: Common clinical manifestations of VZV meningitis are headache (90.6%), fever (59.4%), and nausea (43.8%). Common manifestations of encephalitis are behavioral and language disorders (75%), and fever (50%). In the cerebrospinal fluid, the median number of white blood cells in the two meningitis and encephalitis groups were 235.5 (100 - 440) cells/mL and 157 (46 - 497) cells/mL, respectively, of which white blood cells were lymphocytes predominate, protein of the two meningitis and encephalitis groups are 1.0 (0.5 - 1.6) G/L and 2.1 (0.9 - 5.7) G/L, respectively. We can find out brain damage on CT or MRI in the temporal lobe, frontal lobe, and insula lobe. In addition, demyelinating lesions occur in 25%.

CLINICAL AND SUBCLINICAL CHARACTERISTICS OF THE PATIENTS WITH DENGUE HEMORRHAGIC FEVER THAI NGUYEN

Objectives: Describe clinical and subclinical characteristics of patients with dengue hemorrhagic fever (DHF) in Thai Nguyen.Subjects and methods: Retrospective study on 43 patients diagnosed with DHF according to the standard of the Ministry of Health in 2019.Results: The most common age was 35 - ≤ 60, accounting for 25/43 (58.1%), the least common age was ≤ 16 years old (4.6%). The mean of age was 43.6 ± 16.5; Male (55.8%) was higher proportion than female (44.2%). Patients lived in 15/21 wards and 1/11 communes in Thai Nguyen city; 4/6 districts included Phu Binh, Vo Nhai, Dai Tu and Dong Hy. Patients had fever accounted for the highest rate of 100%, followed by bleeding 31/43 (72.1%), abdominal pain or tenderness10/43 (23.2%), vomiting 7/43 (16.3%), diarrhea (9.3%), pleural effusion and acites 4.6%. Patients with hematocrit 35 - 45% accounted for the highest proportion of 21/43 (48.8%); Next, hematocrit > 45% accounted for 20/43 (46.6%). Patients with low platelets 5 - < 50 accounted for the highestproportion of 22/43 (51.2%), followed by 20/43 (46.5%) of patients with platelets of 50 - < 150 G/L; No patient had platelets < 5 G/L. Patients with AST 40 - < 400 (U/L) accounted for the highest proportion of 35/43 (81.4%), 2/43 (4.6%) patients with AST ≥ 1000 (U/L). Patients with ALT 40 - < 400 (U/L) accounted for the highest proportion in the study 30/43 (69.8%), 1/43 (2.3%) patients had AST ≥ 1000 (U/L). 100% of patients in the study were cured and discharged from the hospital, with no deaths, of which: patients with DHF and DHF with warning signs accounted for the highest rate of 46.6%.

CLINICAL AND LABORATORY CHARACTERISTICS OF LIVER ABSCESS PATIENTS AT NGUYEN TRI PHUONG HOSPITAL

Background: Liver abscess is a common disease in tropical countries, including Vietnam. Nguyen Tri Phuong Hospital has treated many cases of liver abscesses since 2010. However, there has not been a research report summarizing the clinical and subclinical characteristics of liver abscess cases here. Subjects and methods: Retrospective study of patients diagnosed with a liver abscess at Nguyen Tri Phuong Hospital from January 2017 to December 2022. Results: There were 61 patients diagnosed with a liver abscess at the General Surgery Department of Nguyen Tri Phuong Hospital from January 2017 to December 2022 with the following characteristics: male/female ratio of 1.65/ first; average 56.1 ± 12.3 years old, history of diabetes accounted for 32.8%; The prominent clinical symptoms are fever (88.5%), right upper quadrant pain (85.2%). The average volume of liver abscess on ultrasound was 377.2 ± 50.4 ml, the liver abscess located in the right liver accounted for 73.4%, most of which was a single abscess (78.7%). Klebsiella pneumonia was cultured with the highest rate of 42.6% (26/61) Conclusion: Liver abscess is more common in the elderly, more in men than in women with common symptoms including fever and right upper quadrant pain. Klebsiella pneumoniae became the most common cause of the liver abscess.

Sleep loss, caffeine, sleep aids and sedation modify brain abnormalities of mild traumatic brain injury

Little evidence exists about how mild traumatic brain injury (mTBI) is affected by commonly encountered exposures of sleep loss, sleep aids, and caffeine that might be potential therapeutic opportunities. In addition, while propofol sedation is administered in severe TBI, its potential utility in mild TBI is unclear. Each of these exposures is known to have pronounced effects on cerebral metabolism and blood flow and neurochemistry. We hypothesized that they each interact with cerebral metabolic dynamics post-injury and change the subclinical characteristics of mTBI. MTBI in rats was produced by head rotational acceleration injury that mimics the biomechanics of human mTBI. Three mTBIs spaced 48 h apart were used to increase the likelihood that vulnerabilities induced by repeated mTBI would be manifested without clinically relevant structural damage. After the third mTBI, rats were immediately sleep deprived or administered caffeine or suvorexant (an orexin antagonist and sleep aid) for the next 24 h or administered propofol for 5 h. Resting state functional magnetic resonance imaging (rs-fMRI) and diffusion tensor imaging (DTI) were performed 24 h after the third mTBI and again after 30 days to determine changes to the brain mTBI phenotype. Multi-modal analyses on brain regions of interest included measures of functional connectivity and regional homogeneity from rs-fMRI, and mean diffusivity (MD) and fractional anisotropy (FA) from DTI. Each intervention changed the mTBI profile of subclinical effects that presumably underlie healing, compensation, damage, and plasticity. Sleep loss during the acute post-injury period resulted in dramatic changes to functional connectivity. Caffeine, propofol sedation and suvorexant were especially noteworthy for differential effects on microstructure in gray and white matter regions after mTBI. The present results indicate that commonplace exposures and short-term sedation alter the subclinical manifestations of repeated mTBI and therefore likely play roles in symptomatology and vulnerability to damage by repeated mTBI.

RP2-Associated X-linked Retinopathy: Clinical Findings, Molecular Genetics, and Natural History in a Large Cohort of Female Carriers

RP2-associated retinopathy typically causes severe early onset retinitis pigmentosa (RP) in affected males. However, there is a scarcity of reports describing the clinical phenotype of female carriers. We tested the hypothesis that RP2 variants manifest in female carriers with a range of functional and anatomic characteristics. Retrospective case series. Females with disease-causing variants in RP2 were identified from investigation of pedigrees affected by RP2 retinopathy. All case notes and results of molecular genetic testing, retinal imaging (fundus autofluorescence imaging, optical coherence tomography (OCT)), and electrophysiology were reviewed. Forty pedigrees were investigated. Twenty-nine pedigrees had obligate carriers or molecularly confirmed female members with recorded relevant history and/or examination. For 8 pedigrees, data were available only from history, with patients reporting affected female relatives with RP in 4 cases and unaffected female relatives in the other 4 cases. Twenty-seven females from 21 pedigrees were examined by a retinal genetics specialist. Twenty-three patients (85%) reported no complaints and had normal vision and 4 patients had RP-associated complaints (15%). Eight patients had normal fundus examination (30%), 10 had a tapetal-like reflex (TLR; 37%), 5 had scattered peripheral pigmentation (19%), and the 4 symptomatic patients had fundus findings compatible with RP (15%). All asymptomatic patients with normal fundus, TLR, or asymptomatic pigmentary changes had a continuous ellipsoid zone on OCT when available. The electroretinograms revealed mild to severe photoreceptor dysfunction in 9 of 11 subjects, often asymmetrical, including 5 with pattern electroretinogram evidence of symmetrical (n = 4) or unilateral (n = 1 subject) macular dysfunction. Most carriers were asymptomatic, exhibiting subclinical characteristics such as TLR and pigmentary changes. However, female carriers of RP2 variants can manifest RP. Family history of affected females with RP does not exclude X-linked disease. The phenotypic spectrum as described herein has prognostic and counselling implications for RP2 carriers and patients.

Evaluation of surgical treatment results in elderly patients with lumbar spinal stenosis

Background: Lumbar spinal stenosis in elderly patients is a common pathology and the biggest cause of the indication for spinal surgery. Our aims are to study clinical and subclinical characteristics and evaluate TLIF surgery results in elderly patients with lumbar spinal stenosis. Materials & methods: A total of 45 lumbar spinal stenosis patients were treated with TLIF surgery from June 2018 to March 2021. Using a follow-up, clinical descriptive research method. Evaluate before surgery and follow up until 1 year after operation. Results: The average age was 67.96 ± 5.701. The classification of patients admitted to hospital was 33.3% crippled and 66.7% paralyzed according to the ODI. MRI showed 91.1% absolute stenosis, 8,9% relative stenosis. There were no surgical accidents. The complication rate after surgery was 6.6%. 12 months after surgery, VAS back pain decreased to 1.16 ± 1.33, VAS leg pain decreased to 0.80 ± 0.99, JOA increased to 23.73 ± 3.61, ODI decreased to 26.89 ± 10.98. 93.3% recovery rate classified as excellent and good according to Hirabayashi. Conclusions: TLIF surgery on elderly patients brought good results. Key words: lumbar spinal stenosis; TLIF surgery; elderly patients; Japanese Orthopaedic Association score; Oswestry Disability Index.

Clinical and laboratory characteristics of perioperative patient's and follow-up after coronary artery bypass graft surgery with extracorporeal circulation

Objectives: Course of hospital stay post-coronary artery bypass graft (CABG) procedure has become increasingly shorter over the last few decades. However, after coronary artery bypass surgery, there is a certain rate of adverse events related to surgery and resuscitation. Therefore, we conducted this study with the goal of evaluating the clinical and subclinical characteristics of patients undergoing CABG surgery with extracorporeal circulation.
 Methods: A prospective method was used to study 171 consecutive patients undergoing CABG Surgery at Hanoi Heart Hospital from June 2016 to August 2018.
 Results: The group of stable coronary artery disease 119 (69.6%) patients, the group of acute coronary syndrome 52 (30.4%) patients. The men was 3.6 times higher than that of women (p<0.05). The Euroscore II score (0.6 – 6.42) and typical chest pain were higher in the acute coronary syndrome group (p<0.05). Acute coronary syndrome patient's had a higher rate of postoperative EF reduction than stable coronary artery disease patients (p < 0.05). Stable coronary artery disease patients had CK, CKMB, Troponin T hs increased postop than acute coronary syndrome patient's, ProBnP increased postop in both groups (p<0.05). The time of mechanical ventilation, use of inotropic drugs, and re-operating hemostasis were increased in the acute coronary syndrome group compared with stable coronary artery disease (p<0.05). The rate of reoperation for hemostasis (3.5%), the group of acute coronary syndromes patients was higher (7.7% vs 1.7%), the postoperative mortality rate was 2.3% up to 30 days.
 Conclusion: The men was higher than that of women, and heart failure increased postop than preop in both echocardiography and laboratory tests. Acute coronary syndrome patients had a higher rate of bleeding re-operating hemostasis than stable coronary artery disease patient's.

Early Sleep Differences in Young Infants with Autism Spectrum Disorder.

Children with autism spectrum disorder (ASD) experience greater sleep challenges than their neurotypical peers, but sleep patterns for infants later diagnosed with ASD are unknown. This study examined differences in total sleep duration and proportion of sleep experienced at night within the first 6 months of life among infants later diagnosed with ASD, infants who demonstrated subclinical characteristics of ASD and were classified as exhibiting the broad autism phenotype (BAP), and their typically developing (TD) peers. In addition, associations between infant sleep variables and developmental outcomes at 24 months were explored. Participants included 79 infants enrolled in a prospective, longitudinal study of the early development of ASD. Between ages 1 week and 6 months, participants completed a monthly retrospective 24-hour sleep log. At 24 months, participants received a comprehensive diagnostic evaluation, including the Autism Diagnostic Observation Schedule-2 and Mullen Scales of Early Learning and Vineland-II and were clinically characterized as ASD, BAP, or TD. When accounting for the influence of age, infants later diagnosed with ASD slept less within the 24-hour period than infants in TD or BAP groups from 0 to 6 months ( p = 0.04). Percentage of sleep experienced during nighttime hours did not significantly differ between groups from 0 to 6 months ( p = 0.25). Greater nighttime sleep percentage at 6 months predicted higher receptive language ( p < 0.001) and fine motor scores ( p < 0.0001) at 24 months. Total sleep duration at 6 months did not predict any developmental outcomes at 24 months. Findings suggest that differences in sleep may occur among autistic individuals earlier in life than previously documented and have cascading effects on development.

Diagnostic specificity of the child psychosis-risk screening system with a focus on the differentiation of schizophrenia spectrum disorders and neurodevelopmental disorders

BackgroundResearch on early psychosis has begun to identify psychiatric characteristics of the prodromal period of schizophrenia; however, subclinical characteristics of children in non-psychiatric fields have not been fully investigated. In our previous study, we developed the Child Psychosis-risk Screening System (CPSS).ObjectiveIn the present cross-sectional study, we attempted to identify the risk of developing psychosis in pediatric (n = 216) and psychiatric outpatients (n = 120), aged 6– 18 years, with the CPSS.MethodsAn analysis of variance of CPSS risk was performed in six diagnostic categories to examine specificity for each diagnosis. Receiver operating characteristic (ROC) curve analysis was conducted using the onset of schizophrenia spectrum as the outcome, and the discriminatory power and cut off values of the CPSS were determined. Logistic regression analysis was performed using clinical data to identify factors associated with the risk group (those at high risk of developing psychosis in the future) identified using the CPSS.ResultsThere were significant differences in risk variance among diagnostic categories (p &amp;lt; 0.001), especially between schizophrenia spectrum disorders (SSD) and neurodevelopmental disorders (p = 0.001). CPSS had sufficient discriminatory power for SSD diagnosis [area under the ROC curve = 0.853 (95% confidence interval: 0.774–0.931)]. The cut off value for the risk of SSD was determined to be 98.1%, achieving the best mean of the sum of sensitivity (90.9%) and specificity (84.0%). Cross-sectional logistic regression analysis showed that along with “SSD diagnosis,” “winter birth,” and “maltreatment” were factors associated with the risk group (odds ratio = 38.05 [p = 0.001], 2.30 [p = 0.016], and 0.12 [p = 0.024], respectively).ConclusionCPSS may have potential use in the early detection of psychosis and differentiation from neurodevelopmental disorders, but this study was small and further studies with larger sample sizes and longitudinal study designs are required prior to its use in routine clinical practice.

Low cardiac output syndrome after cardiac surgery with extracirculatory at cardiovascular center, E hospital

Background: Low cardiac output syndrome is one of the most severe complications after cardiac surgery, associated with 38% mortality, increased rates of respiratory complications, myocardial infarction, stroke, and heart failure. kidney and re-surgery. If the signs are detected early and diagnosed in time, the treatment will give better results.&#x0D; Objectives: Description of clinical, subclinical characteristics and evaluation of early results of treatment of patients with low cardiac output syndrome after cardiac surgery at Cardiovascular Center, E hospital.&#x0D; Methods: Retrospective report of 3 cases of low cardiac output syndrome with confirmed diagnosis, treatment and comparison with the literature.&#x0D; Results: From January 2022 to May 2023, 3 patients with low cardiac output syndrome were confirmed at the cardiovascular center, E hospital .The mortality rate is 66.7 % , mean age was 57.3 ±9.3 , mean preoperative EF 62 ±13.7 , mean postoperative cardiac index 1.5 ±0.2 l/ minute /m 2 , mean extracorporeal circulation time 172 ±63.4 minutes , mean aortic cross-clamp time 107 ±28.4 minutes&#x0D; Conclusion: Low cardiac output syndrome after surgery is a serious complication with high mortality risk. Doctors need to know the early signs for timely diagnosis and proper treatment to help patients recover best.

Clinical Features and Treatment Outcomes of COVID-19 Admissions in the Can Tho City Hospital of Tuberculosis and Respiratory Diseases, Vietnam: A Hospital-Based Observational Study.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is among the top global health crises. As confirmed by the Vietnam Ministry of Health on 25th January 2023, Vietnam had a cumulative total of more than 11.52 million COVID-19 patients, including 10.61 million recoveries and 43,186 deaths. This study aimed to describe the clinical and subclinical characteristics, treatment progress, and outcomes of 310 cases of SARS-CoV-2 infection. A total of 310 patients with medical records of SARS-CoV-2 were admitted to Can Tho City Hospital of Tuberculosis and Lung Diseases, Can Tho city, Vietnam, between July 2021 and December 2021. Demographic and clinical data, including laboratory examinations, of all the patients were collected and analyzed. The median duration of hospital stay was 16.4 ± 5.3 days. There were 243 (78.4%) patients with clinical symptoms of COVID-19 and 67 (21.6%) patients without clinical symptoms. The common symptoms included cough (71.6% of 310 patients), fever (35.4%), shortness of breath (22.6%), sore throat (21.4%), loss of smell/taste (15.6%), and diarrhea (14.4%). Regarding treatment outcomes, 92.3% of the patients were discharged from the hospital, 1.9% of the patients suffered a more severe illness and were transferred to a higher-level hospital, and 5.8% of the patients died. The RT-PCR results were negative in 55.2% of the patients, and 37.1% of the patients had positive RT-PCR results with Ct values of >30 on the discharge/transfer day. Multivariate logistic regression analyses showed that comorbidity and decreased blood pH were statistically significantly related to the treatment outcomes of the patients with COVID-19 (p < 0.05). This study provides useful information (i.e., the clinical characteristics and treatment outcomes) on the COVID-19 pandemic in Vietnam during its biggest outbreak; the information may be used for reference and for making improvements in the handling of future health crises.