bluuebunny/crossref_metadata_2025 huggingface dataset:
STUDY ON RELATION BETWEEN TRADITIONAL PROGNOSIS FACTORS AND HORMONE RECEPTORS STATUS, KI-67, HER2 IN INVASIVE BREAST CARCINOMA
Authors: Dang Cong Thuan , Phan Thi Thu Thuy , Tran Nam Dong , Ngo Cao Sach , Vo Thi Hong Van
Published: March 2020

Objectives: To examine histopathologic features and hormone receptors status, Ki-67 and HER2 in invasive breast carcinoma at Hue University Hospital to evaluating the relation between tumor size, histological grade, lymph node metastasis status, disease stage and the expression of steroid hormone receptors status, Ki-67 and HER2 in invasive breast carcinoma.
Materials and methods: From May 2015 to April 2016, samples were collected from 96 breast carcinoma patients. Histopathologic samples were stained by Hematoxylin-Eosin and immunohistochemistry staining at Pathology Department, Hue University Hospital. R
esults: Most invasive breast carcinoma patients were among the age of 50-59 (39.6%), invasive ductal carcinoma (82.3%), tumor size ≤2cm (54.2%), histological grade II (60.2%), lymph node metastasis (53.1%), disease stage II (51%); ER(+) 46.9%, PR(+) 49.0%, Ki-67(+) 77.1%, HER2(+) 30.2% of cases.
Conclusion: There were a positive correlation between histological grade with the HER2 expression (p<0.05) in invasive breast carcinoma.

Key words: invasive breast carcinoma, immunohistochemistry, tumor size, histological grade, lymph node metastasis, disease stage
CAPACITY AND CONFIDENCE IN PERFORMING CLINICAL PROCEDURES AMONG PRIMARY CARE TEAMS IN THE CENTRAL REGION OF VIETNAM
Authors: Vo Duc Toan , Nguyen Minh Tam
Published: March 2020

Background and Aim: To develop primary care services is one of the top priorities of the health sector in Vietnam. In recent years, the Government and the Ministry of Health have made great efforts to strengthen and improve the quality of healthcare services at the grassroof level. However, several studies showed that the needs for healthcare remained unmet at primary care level. This study aimed to examine the gaps in competency and confidence of the primary care team in delivery of clinical procedures.
Methods: A crosssectional descriptive study was conducted in 49 commune health centers (CHCs) of 3 provinces. The health care teams reported their ability and confidence to perform the list of clinical procedures based on the regulation on clinical procedures performed at the CHC issued by the Ministry of Health.
Results: The average number of procedures performed by the CHCs was 46,4/109 procedures. There were 65.3% of CHCs performed less than 50% of assigned techniques, and only 28.6% CHCs performed 50-80% of assigned techniques. The confidence of CHC teams was high in performing procedures of Resuscitation, Internal Medicine, Pediatrics and OBGYN.
Conclusion: There is a substantial gap in the capability to perform clinical procedures among CHC team. The confidence in performing essential procedural skills varied among procedures, depending on clinical experience and the types of procedure. Our results show a strong call to develop training programs that fit to the competency standards of primary care team in order to enhance the capacity and confidence of health staff in healthcare delivery at grassroots level.

Key words: Health care, Thua Thien Hue, Quang Tri
STUDY OF CLINICAL AND SUBCLINICAL CHARACTERISTICS IN NEONATAL HYPERBILIRUBINEMIA
Authors: Nguyen Thi Thanh Binh , Tran Thi Phuong Thao , Phan Hung Viet
Published: March 2020

Background: Neonatal hyperbilirubinemia is a common clinical problem encountered during the neonatal period, especially in the first week of life. It is a multifactorial disorder with many symptoms. Most of these cases are benign but it is important to identify those babies at risk of acute bilirubin encephalopathy and kernicteurs or chronic encephalopathy. Jaundice may also be a sign of a serious underlying illness.
Objectives: Describe and examine the relationship between clinical characteristics with laboratory tests of indirect hyperbilirubinemia in neonatal.
Methods: A cross-sectional descriptive. A convenient sample includes 124 patients under 28 days old had jaundice and were treated at Neonatal room, Hospital of Hue University of Medicine and Pharmacy from 05/2015 to 06/2016.
Results: The proportion of male/female is 1.3/1. 66.9% is in term infants. 73.4% onset of jaundice in 24 - 72 hours of age. 67.7% had jaundice all the body before were taken to neonatal room. 47.6% cases were caused by neonatal infection. 93.5% cases had total serum bilirubin < 340 µmol/L. It has a weak positive correlation between the degree of clinical jaundice with level of total serum bilirubin. 31/124 cases suspected ABO incompatibility but Coombs test were negative, however they had high rate of anemia than the others is 13.2 times (p<0.01).
Conclusions: Indirect hyperbilirubinemia in neonatal is usually detected when the baby had jaundice to hands and feet. Therefore precautionary measure should be adopted by both parents and clinicians to diagnose and treat the disease properly.

Key words: jaundice, hyperbilirubinemia, neonatal
THE VALUE OF PROGNOSTIC FACTORS IN CONTROLLED OVARIAN STIMULATION FOR IVF CYCLES
Authors: Ho Thi Thanh Tam , Le Minh Tam , Truong Quang Vinh , Cao Ngoc Thanh
Published: March 2020

Objective: To evaluate prognostic values for ovarian response of age, AFC, baseline hormonal profile and Estradiol concentration in ovarian stimulation process for art cycles.
Method: Retrospective cohort.
Materials: Patients treated in vitro fertilization, is ovarian stimulated with antagonist protocol, at the Center for Reproductive Endocrinology and Infertility - Hue University Hospital, from 9/2013 to 9/ 2016.
Results: Women with ≤5 oocytes retrieved had the average value of the parameters: AFC 6.0±3.04, FSH 9.01±2.95 mIU/ml, AMH 1.63±1.45 ng/ml, and E2N7 617.27±440.84 pg/ml. Those with >15 oocytes retrieved had the average value of the parameters: AFC 12.91±4.52, FSH 6.06±2.03 mIU/ml, AMH 7.37±15.79 ng/ml, E2N7 1612.11±612.83 pg/ml, E2NhCG 2889.62±1732.98 pg/ml, and average number of follicles ≥12mm on day 7 was 7.70±6.35. Correlation coefficients between number of oocytes retrieved and AFC, AMH and FSH N2-3, age were 0.62; 0.48; -0.39; -0.22, respectively; and the correlation coefficients between number of oocytes retrieved and E2N7, number of follicles ≥12mm on day 7, number of follicles ≥14mm on day 9 were 0.58; 0.3; 0.7, respectively. Threshold value of E2 on day 7 ≤ 823 pg/ml predicted number of oocytes retrieved ≤5 with sensitivity 78.9%, specificity 65%. Threshold value of E2 on day 7 > 1098 pg/ml predicted number of oocytes retrieved >15 with sensitivity 81.0%, specificity 73.9%. Basal LH, E2 are not related to ovarian response.
Conclusions: AFC, FSH on days 2-3 and AMH were prognostic values of number of oocytes retrieved in the ovarian stimulation cycle. Of which, AFC was the best prognostic factor in the same treatment cycle; age had lower level of prognosis than parameters evaluating ovarian reserve. E2 on day 7 was able to prognosis few or too many oocytes retrieved, number of follicles ≥12mm on day 7 was able to prognosis too many oocytes retrieved but not for few or moderate oocytes retrieved. Number of follicle ≥14mm and E2 on day 9 were good for prognosing all three levels of oocytes retrieved.

Key words: Number of oocytes retrieved, AFC, AMH, FSH D2-3, estradiol D7, estradiol DhCG
KNOWLEDGE, ATTITUDE, AND PRACTICE TOWARD PERIODIC MEDICAL CHECKUP AMONG ADULTS IN HUE CITY IN 2016
Authors: Truong Cong Hieu , Nguyen Minh Tam
Published: March 2020

Objectives: Periodic medical checkup (PMC) is a common and effective form of preventive medicine while the practice of this in Vietnam is still limited and with low attention and awareness. There are not many existing studies of PMC in Vietnam. This study aimed to study on the knowledge, attitude and practice of PMC as well as to understand the related factors of PMC.
Methods: A cross-sectional study on 1.002 people aged 18 and over in Hue city, using a structured questionnaire was conducted.
Results: 42.6% of the respondents had good general knowledge. 92.4% of people thought that all people needed to have PMC but only 41.8% of participants had good attitude for PMC. There were 21.2% of people performing PMC in the last12 months. Blood tests were the most common procedure peformed by the participants (86.8%), followed by general abdominal ultrasonography (75.5%) and internal medicine (74.1%). Education levels, occupation, income level and owning health insurance card were associated to the practice of PMC (p <0.05).
Conclusions: The study showed a high percentage of people having good knowledge and attitude of PMC and a low percentage of those having good practice of PMC. Therefore, it is necessary to develop strategies and policies in order to encourage people to get PMC as well as to enhance the communication and raise the awareness of people on PMC

Key words: Knowledge, attitude, practice, periodic medical checkup
ARFI ELASTOGRAPHY IN THE DIAGNOSIS OF FOCAL BREAST LESIONS
Authors: Vo Thi Kim Yen , Nguyen Phuoc Bao Quan , Nguyen Thanh Thao
Published: March 2020

Objective: To describe the sonographic characteristics of the focal breasst lesions using Acoustic Radiation Force Impulse Imaging (ARFI), and to evaluate the role of ARFI technique in combination with 2D Ultrasound in diagnosing focal breast lesions.
Methods: 2D Ultrasound and ARFI Elastography were caried out in 52 patients who have focal lesions of breast. Images of 2D Ultrasound were classified according to ACR 2013. ARFI Elastography was performed by 2 techniques: “Virtual Touch HD tissue imaging” in order to image of strain distribution and “Virtual Touch HD Tissue quantification imaging” to measure the shear wave velocity (SWV) in the tissue. Strain distribution was classified according to Ako Itoh scale. SWV were measured in 4 positions: internal the lesion (SWVi), boundary zone (SWVb), glandular tissue and fatty tissue next to lesion (SWg and SWf). According to the results of pathology, we determine and compare the value between 2D Ultrasound plus ARFI elastography and 2D Ultrasound alone.
Results: 52 patients with breast focal lesions: 22 malignant tumors and 30 benign tumors. Mean Ako Itoh scale of benign tumors were 2.19 ± 1.13 and malignant tumors were 4.72 ± 0.55; the cut-off value was between E3 và E4. SWVi, SWVb, SWVf, SWVg of benign tumors were lower than malignant tumors with cut-off values were 3.32 m/s; 6.01m/s; 1.08m/s; 2.37m/s, respectively. 2D Ultrasound plus ARFI Elastography: Se 100%, Sp 90%, PPV 88%, NPV 100%, Acc 94.2% (p<0.001, K = 0.884).
Conclutions: In addition to the morphologic characteristics of breast lesions, ARFI provides information about lesion’s tissue elasticity, which can be a useful tool to differentitate malignant lesions from benign ones.

Key words: elastography, focal breast lesions, Acoustic Radiation Force Impulse Imaging
CLINICAL, PARACLINICAL FEATURES AND TREATMENT RESULT OF KAWASAKI DISEASE AT&NBSP; PEDIATRICS CENTER AT&NBSP; HUE CENTRAL HOSPITAL
Authors: Phan Hung Viet , Nguyen Ngoc Minh Chau
Published: March 2020

Objectives: To describe clinical and paraclinical features and treatment result of Kawasaki disease.
Methods: The study is based on 34 children with Kawasaki disease treated at the Pediatric center of Hue Central Hospital from 1/2012-6/2013. Clinical examination, subclinical tests were done for each child at the time of diagnosis and every week after treatment.
Results: 100% of children were under 5 years old, in which boys were more than girls, and 47.1% of patients lived in Hue. 100% of patients had fever over 5 days, bilateral conjunctivitis, changes in the mouth mucosa, changes in the peripheral extremities and rash. 41.2% of patients had cervical lymphadenopathy. Paraclinical manifestations were notably with 100% of patients had leukocytosis, 70.6% of patients had serum CRP levels > 30 mg/l, 55.9% of patients had ESR > 60 mm in first hour, 29.4% of patients had thrombocytosis over 500.000/mm3 at the time of positive diagnostic. 32.4% of patients had coronary artery lesions, 5.8% of patients had mitral regurgitation and pericardial effusion. 87.5% of patients had favorable progression after treatment with 1 single dose of gammaglobulin 2 g/kg. 12.5% of patients require treatment with second dose gammaglobulin.
Conclusion: Kawasaki disease is very common in children <5 years old, the rate of coronary artery lesion is very high 32.4%. Favorable progression after treatment with high-dose gamaglobulin.

Key words: Kawasaki disease, clinical manifestations; intravenous immunoglobulin treatment
OUTCOME OF SPHINCTER PRESERVING RECTAL RESECTION FOR LOW RECTAL CANCER
Authors: Truong Vinh Quy , Pham Anh Vu , Le Quang Thuu
Published: March 2020

Purpose: To evaluate the functional outcome of sphincter-preserving rectal resection for low rectal cancer.
Materials and Methods: From April 2009 to January 2016, there are 52 patients who underwent sphincter-preserving rectal resection with total mesorectal excision with low rectal cancer (<6cm from the anal verge) at Hue Central Hospital, Hue, Vietnam.
Results: the average age 62.7 ± 12.8, the distance of tumor from anal verge include four group (≤ 3cm 1.9%; 3 to ≤ 4cm 17.3%; 4 to ≤ 5cm 34.6%; > 5 cm). T stage T1/ T2/T3: 1.9%/28.8%/69.2%. The following time is 33.8 ± 18.9 month. Overall recurrence was 13/18(27.1%), local recurrence was 5 (10.4%). Total survival was 40.5 ± 2.9 month. Technique: intersphincteric preservation 14 (26.9%), low anterior resection 17 (32.7%) and pull-through procedure 21 (40.4%). The distance of anatomosis from anal verge: from 1 to ≤ 2 cm:14 (26.9%); from 2 to ≤ 3cm: 21 (40.4%); from 3 to ≤ 4 cm: 17 (32.7%). Bowels movement of 3 month: 4.7 ± 3.2 and 12th month: 2.7 ± 1.6 (p< 0.01).
Conclusions: Sphincterpreserving rectal resection using may provide a good continence and oncologic safety. The patients are acceptable with the results of functional outcomes.

Key words: Low rectal cancer, sphincter-preserving
CLINICAL SYMPTOMS, ULTRASOUND AND HISTOPATHOLOGY OF TUMORLIKE LESIONS OF THE BLADDER.
Authors: Nguyen Van Mao , Nguyen Thi Bich Chi
Published: March 2020

Background: Bladder cancer is one of the most frequent type of urinary cancer which has been ever increasing. For the better treatment, the early discovery and definite diagnosis of this disease played an important role. Objective: To describe some clinical symptoms and ultrasound features of tumorlike lesions of the bladder. To diagnose and classify the histopathology of tumorlike lesions of the bladder.
Materials, method: cross - sectional study on 64 cases in Hue University Hospital and Hue central hospital from April, 2016 to February, 2017.
Results: Hematuria was the most common reason that patients went to hospital (79.7%). Lower abdominal pain and irritation during urination accounting for 9.4% and 6.2% respectively. Only 3 patients with bladder cancer were accidentally discovered through periodic health examination (4.7%). The characteristics of hematuria in bladder tumor was flesh red urine (62.5%) and total hematuria (60.7%). With ultrasonography, the results of 64 patients were divided in 3 groups as follow: bladder tumor, which was the highest rate 87.5%, bladder polyp was 3.1% and focal bladder wall thickening was 9.4%. Of which, the vast majority of these ultrasound images was tumor - like lesions protruding in the lumen of the bladder (75%), the rest was wall thickening lesions (25%). Tumors were different in size, the biggest tumor was 7cm in diameter and the smallest was 0.6cm. Those with the diameter 3cm or bigger accounting for 42.2%, the smaller was 57.8%. Most cases have only one lesion (62.5%) and at lateral wall (46.6%). Histopathologically, cancer was 59/64 case (92.2%): urothelial carcinoma was 98.3 %, squamous cell carcinomawas 1.7% and 5 cases (7.8%) were benign. Most cancerous cases were poorly differentiated, grade II (50.9%) and grade III (32.2%). The stage T1NxMx was 20.3% and worse than T2MxNx was 79.7%.
Conclusion: hematuria was the most popular symptom, suggesting bladder cancer. Clinical diagnosing bladder cancer was not high sensitive (61.01%). Ultrasound could detect bladder tumor with high sensitive (89.8%). These patients also needed histopathology classification to diagnose and finally choose the best method for the appropriate treatment.

Key words: bladder cancer, histopathology, ultrasound, uroepithelial carcinoma, hematuria
THE ASSOCIATION OF THE COMBINATION OF TP53 GENE CODON 72 POLYMORPHISM AND HELICOBACTER PYLORI INFECTION WITH GASTRIC CANCER
Authors: Ha Thi Minh Thi , Tran Van Huy , Nguyen Viet Nhan
Published: March 2020

Background: The interaction of environment factor and host factor plays the important role in the pathogenesis of gastric cancer (GC). This study aimed to evaluate the association of the combination of TP53 gene codon 72 polymorphism and the H. pylori infection with GC risk. Patients and methods: 112 patients with GC and 136 patients without GC were extracted DNA from specimens of gastric mucosa, then were determined TP53 gene codon 72 polymorphism by PCR-RFLP and diagnosed H. pylori infection by PCR with ureC gene-specific primers.
Results: There was no significant association between TP53 gene codon 72 polymorphism and GC risk, as well as between H. pylori infection and GC risk. The combination of two factors (TP53 gene codon 72 polymorphism and H. pylori infection) was found to be associated with GC risk: The combination of Pro/Pro genotype and H. pylori (+) was the GC risk factor, OR = 2.62 (95%CI: 1.20–5.71) as compared to other combinations. In the group of H. pylori-positive patients, Pro/Pro genotype was the GC risk factor, OR = 2.42 (95%CI: 1.05 – 5.59) as compared to (Arg/Arg + Arg/Pro) group, and OR = 3.48 (95%CI: 1.23 – 9.78) as compared to Arg/Arg genotype. Conclusion: The factors of TP53 gene codon 72 polymorphism and H. pylori infection were not associated with GC risk as assessed separately, but they had the interaction associated with GC risk.

Key words: TP53 gene codon 72 polymorphism, Helicobacter pylori, gastric cancer
THE RISK FACTORS OF MOLAR PREGNANCY
Authors: Le Lam Huong
Published: March 2020

Objectives: Molar pregnancy is the gestational trophoblastic disease and impact on the women’s health. It has several complications such as toxicity, infection, bleeding. Molar pregnancy also has high risk of choriocarcinoma which can be dead.
Aim: To assess the risks of molar pregnancy.
Materials and Methods: The case control study included 76 molar pregnancies and 228 pregnancies in control group at Hue Central Hospital.
Results: The average age was 32.7 ± 6.7, the miximum age was 17 years old and the maximum was 46 years old. The history of abortion, miscarriage in molar group and control group acounted for 10.5% and 3.9% respectively, with the risk was higher 2.8 times; 95% CI = 1.1-7.7 (p<0.05). The history of molar pregnancy in molar pregnancy group was 9.2% and the molar pregnancy risk was 11.4 times higher than control group (95% CI = 2.3-56.4). The women having ≥ 4 times births accounted for 7.9% in molar group and 2.2% in control group, with the risk was higher 3.8 times, 95% CI= 1.1-12.9 (p<0.05). The molar risk of women < 20 and >40 years old in molar groups had 2.4 times higher than (95% CI = 1.1 to 5.2)h than control group. Low living standard was 7.9% in molar group and 1.3% in the control group with OR= 6.2; 95% CI= 1.5-25.6. Curettage twice accounted for 87.5%, there were 16 case need to curettage three times. There was no case of uterine perforation and infection after curettage.
Conclusion: The high risk molar pregnancy women need a better management. Pregnant women should be antenatal cared regularly to dectect early molar pregnancy. It is nessecery to monitor and avoid the dangerous complications occuring during the pregnancy.

Key words: Molar pregnancy, pregnancy women
COST ANALYSIS OF HOME BASED REHABILITATION FOR THE DISABLED AFTER STROKE IN HUE CITY
Authors: Nguyen Hoang Lan
Published: March 2020

Introduction: the study was conducted with objectives to estimate economic cost of home-based rehabilitation (HBR) for the disabled after stroke in Hue city and to identify factors affecting the cost.
Methodology: This is a descriptive crossectional study. 125 the disabled after stroke who were using CBR services in Hue city for a period of 6 months to 24 months were interviewed based on a structure questionnaire. Monthly economic cost for rehabilitation was estimated. Multivariate linear regression model is used to identify factors affecting the total cost.
Results: Monthly average total cost for rehabilitation at home is 4.149.452 VND (SD 2.936.076) per participant; in which average medical direct cost is 1.583.600 VND (SD 1.669.083); average non-medical direct cost is 693.600 VND (SD 671.030); average indirect cost is 1.872.252 VND (SD 2.202.139). HBR that was provided by therapists incurred highest total cost. The higher age of participants are, the lower total cost is (p< 0.05).
Conclusion: Indirect cost accounted for the highest proportion of the total cost for home based rehabilitation monthly. A study on cost effectiveness evaluation of rehabilitation models is necessary to help participants make decision in line available resources of households.

Key words: rehabilitation, stroke, disable, economic cost
PREDICTORS THE RISK OF SYMPTOMATIC INTRACEREBRAL HEAMORHAGE AFTER THROMBOLYTIC THERAPY WITH RECOMBINANT TISSUE PLASMINOGEN ACTIVATOR IN ACUTE ISCHEMIC STROKE
Authors: Nguyen Dinh Thuyen , Mai Duy Ton , Dao Viet Phuong , Nguyen Anh Tuan
Published: March 2020

Objective: to evaluate predictors the risk of symptomatic intracerebral heamorrhage after thrombolytic therapy with recombinant tissue plasminogen activator in acute ischemic stroke.
Methods: observative study on 54 patients with acute ischemic stroke at Emergency Department, Bach Mai hospital from 01/2010 to 10/2016.
Results: Predictors the risk of symptomatic intracerebral heamorrhage were: age above 70 (OR 2,76; 95% CI 0,73 – 10,52; p = 0,12), time from onset to treatment (OR 1,03; 95% CI 0,34 – 3,13; p = 0,95), systolic blood pressure ≥ 140 mmHg (OR 2,0; 95% CI 0,61 – 6,51; p = 0,24), NIHSS score above 12 (OR 3,13; 95% CI 0,63 – 15,51; p = 0,138), glycemia above 10 mmol/l (OR 8,94; 95% CI 1,51 – 51,73; p = 0,003), fibrillation atrial (OR 1,49; 95% 0,49 – 4,56; p = 0,33), history of diebete (OR 6,4; 95% CI 0,67 – 61,03; p = 0,06), history of anticoagulation (OR 1,07; 95% CI 0,22 – 5,11; p = 0,63), history of cerebral infarction (OR 1,49; 95% CI 0,183 – 12,184; p = 0,707), sign of early brain CT (OR 6,14; 95% CI 1,01 – 39,93; p = 0,048).
Conclusion: glucose above 10 mmol/l and sign of early brain CT were predictors the risk of symptomatic intracerebral heamorrhage after thrombolytic therapy with recombinant tissue plasminogen activator in acute ischemic stroke.

Key words: stroke, thrombolysis, predictor, heamorrhage conversion
ACCURACY OF PREDICTED RESTING ENERGY EXPENDITURE ON PATIENTS WITH INVASIVE MECHANICAL VENTILATION
Authors: Do Ngoc Son , Vu Son Tung , Nguyen Van Chi
Published: March 2020

Objectives: to compare the accuracy among the resting energy expenditure (REE) calculated by using prediction equations by Harris – Benedict (H-B), Harris – Benedict with stress factor 1.2 (H-Bx1.2), Penn State 2003 (PS2003), 25kcal/kg and 30 kcal/kg versus REE measured by indirect calorimetry (IC).
Patients: 40 mechanically ventilated patients from the Emergency Department at Bach Mai Hospital between April 2016 and October 2016.
Methods: a prospective observatory study. REE of all patients were measured by IC and compared with REE calculated by prediction equations. Pearson ratio was used to assess correlation between measured and calculated REE.
Results: the accuracy of the estimated equation was 37.5% (H-B); 35% (H-Bx1.2); 47.5% (PS2003); 25% (25kcal/kg); 32.5% (30 kcal/kg). Penn State 2003 was estimated accurately in 60% among female patients and 64.7% among patients with BMI<18.5. There was a proportional correlation between H-B and H-Bx1.2 (r=0.56; p<0.001) and PS2003 (r=0.48; p<0.001) and 25kcal/kg and 30 kcal/kg (r=0.48; p<0.001).
Conclusions: Among prediction equations vs IC, PS2003 had the highest accuracy and correlation, therefore, it should be the tool of choice on the critically ill patients who were female and/or whose BMI <18.5 where IC was not available.

Key words: Energy expenditure, indirect calorimetry, critically ill patients, prediction equations, invasive mechanical ventilation.
DEEP VENOUS THROMBOSIS (DVT) IN INTENSIVE CARE UNIT (ICU) AND PREVENTION
Authors: Mai Duc Thao , Dang Quoc Tuan
Published: March 2020

Purpose: To determine the rate of Deep Venous Thrombosis (DVT) in intensive care unit (ICU) patients. Effective DVT prophylaxis with low-molecular-weight heparin in ICU patients.
Materials and method: Descriptive Study. 120 patients were admitted ICU from June, 2016 to January, 2016. with age > 18 years, APACHE II score> 18 and is expected to lie ≥ 6 days of treatment, and quantitative D-dimer, doppler ultrasound lower limb venous doppler have pressed. Follow up and re-test the Doppler ultrasound scan after 7 days, 14 days, 21 days and end after 1 month.
Results:
(i) In our study the rate of DVT is 46.7%, which essentially undetectable at the time of admission of patients at 76.8% and 23.2% being in the days following.
(ii) 34% of patients are used prophylactic DVT, The incidence of DVT in the group prophylaxis is lower than with no prophylaxis, this is statistically significant with P <0.001.
Conclusion:
(i) The incidence of DVT in ICU patients in the study 46.7%.
(ii) 34% of patients with DVT prophylaxis, DVT prophylaxis is effective with P <0.001.

Key words: Incidence, deep vein thrombosis, prevention
MECHANICAL VENTILATION IN PATIENTS BITTEN BY BUNGARUS CANDIDUS
Authors: Dinh Quang Kien , Ngo Duc Ngoc
Published: March 2020

Background: Bungarus candidus is a common accident, leading to respiratory failure due to respiratory muscle paralysis. Artificial ventilation is an essential intervention to cure.
Objective: Assess results of artificial ventilation in patients bitten by Bungarus candidus.
Subjects and Methods: The ventilation method is volume control with 2 different Vt levels: Vt 8-10ml/kg with PEEP 5cmH2O versus Vt 12-15ml/kg with out PEEP. To describe figures of ventilation, complication and microbiology causes of pneumonia.
Results: 64 patients were put on ventilation. Average time of artificial ventilation was 9.8±7.1 days. Complications were due to ventilator-associated pneumonia (59.4%), the most common is Acinetobater baumanii 45%, followed by P. aeruginosa, K. pneumoniae, S. and Candida albicans. Complete recovery is 94%, sequelae is 3% and mortality is 3%. Sequelae and mortality mainly is due to respiratory failure and complications associated with mechanical ventilation.
Conclusion: High Vt 12-15ml/kg mode is less atalectasis than Vt 8-10ml/kg with PEEP 5cmH2O. Complications mainly related to ventilator-associated pneumonia, the most common etiology is A.baumanii.

Key words: Bungarus candidus, mechanical ventilation, respiratory muscle paralysis, complications.
CLINICAL AND LABORATORY CHARACTERISTICS IN LEAD POISONING CHILDREN IN POISON CONTROL CENTER BACH MAI HOSPITAL
Authors: Be Hong Thu , Ngo Duc Ngoc
Published: March 2020

Background: Lead poisoning is a common emergency in the worldwide. When exposure in the body, lead will affect most organs and systems such as neurologic, hematologic, renal, gastrointestinal, bone, immune. In particular, children with lead poisoning can be severe as convulsions, coma, meningitis, kidney failure.
Objective: Evaluate the clinical, Laboratory of children with lead poisoning treated at the Poison Control Center in Bach Mai Hospital.
Methodology: Retrospective descriptive study with 108 patients at the Poison Control Center in Bach Mai Hospital from 3/2012 to 9/2013.
Results: The first symptoms after lead exposure: seizure (26.9%), vomiting (5.6%), diarrhea (4.6%). The intensity of symptoms correlated with lead serum level (p<0.05). The mean serum lead level were 56,1 µg/dl; mean urine lead level were 0.08 g/l, maximum concentration was 0,46 g/l. A half of cases have mild and morderate anemia, it had correlation with serum lead level. There were 20 patients (33%) had epilesy wave form in encephalo-electro-graphies.
Conclusion: It is necessary to assess sign and symtoms of neurologic (seizures, li packages, irritability, cranial nerve paralysis, decreased motor spirit), gastrointestine (vomiting, diarrhea, abdominal pain), hematologic (anemia mild to moderate) for the early diagnosis of lead poisoning, avoid heavy complications in children.

Key words: Lead poisoning, children, clinical and paraclinical lead poisoning.
STUDY ON THE APPLICATION OF ISS AND RTS FOR THE EVALUATION OF SEVERITY OF TRAUMATIC PATIENTS TREATED IN BACH MAI HOSPITAL
Authors: Do Ngoc Son , Pham Quang Anh , Tran Hieu Hoc
Published: March 2020

Background: Injury is a common surgical emergency causing serious burden for patients and the society. Accurate diagnosis and prognosis of trauma patients are helpful in the treatment of these patients.
Objectives: To apply ISS and RTS for the evaluation of the severity of trauma patients admitted Emergency room of Surgery Department, Bach Mai Hospital.
Subjects and methods: A retrospective study on 194 trauma patients treated at the Emergency room of the Surgery Department, Bach Mai Hospital from 8/2015 to 12/2016.
Results: There were total 194 patients, 131 males (67.5%), 63 females (32.5%). The average age was 41.7±18.7. Median RTS score was 7.84 in 96.6% of the patients with corresponding survival probability was 0.988. There was 114 minor case (59.7%), 59 moderate case (30.9%), 16 severe case (8.4%), 2 critical case (1.1%) and 0 unsurvivable case based on the ISS classification. There was no significant difference in ISS between preservation and surgical group.
Conclusion: Most of our patients was mild and moderate. Severity scores such as RTS and ISS were useful in these patients.

Key words: Injury, ISS, RTS, preservation, surgery
THE APPLICATION OF THE NEW 2015 AHA GUIDELINES ON UPDATE FOR CARDIOPULMONARY RESUSCITATION AND EMERGENCY CARDIOVASCULAR CARE: ON OCCASION OF A SUCCESSFUL CASE AT HANOI MEDICAL UNIVERSITY HOSPITAL
Authors: Hoang Bui Hai , Vu Dinh Hung
Published: March 2020

Cardiac arrest is associated with high mortality if without early diagnosis and cardiopulmonary resuscitation. Each minute without emergency cardiopulmonary resuscitation (CPR), the patient’s chance of survival is reduced by ten percent, even if properly resuscitated but not recirculated, the chance of survival is reduced by four percent. Therefore, CPR should be ferformed as soon as patient is diagnosed with cardiac arrest with the signs of unconsciousness, apnea, loss of carotid pulse and inguinal pulse. Chest compression plays an important role in the success of CPR. There is emphasis on the characteristics of high-quality CPR: compressing the chest at an adequate rate and depth, allowing complete chest recoil after each compression, minimizing interruptions in compressions, and avoiding excessive ventilation. Emergency coronary angiography is recommended for all patients with ST elevation and for hemodynamically or electrically unstable patients without ST elevation for whom a cardiovascular lesion is suspected. All adult patients with return of spontaneous circulation after cardiac arrest should have targeted temperature management (TTM) to prevent poor neurologic outcome.
Key words: Cardiac arrest, targeted temperature management, the 2015 AHA Guideline on CPR and ECC
COMPARE THE VALUE OF ESKELINEN, MODIFIED ALVARADO, TZANAKIS AND OHMANN SCORES IN ACUTE APPENDITITIS DIAGNOSIS
Authors: Ngo Duc Ngoc
Published: March 2020

Background: Acute appendititis is the common emergency. However, misdiagnosis and mistaken diagnosis can be made. Appendititis scales were built for more accurately diagnosis. How to choose a good scales for appendititis diagnosis is still questioning.
Objective: Compare the value of Eskelinen, modified Alvarado, Tzanakis and Ohmann scores in acute appendititis diagnosis.
Subjects and methods: A prospective observational study. Our study included patients had the clincal symptoms and signs of appendititis amitted Emergency Department Bach Mai Hospital.
Results: 52 patients had clinical appendititis symptoms and signs were included in this study with 13 males and 39 females. AUROC of modified Alvarado, Ohmann, Eskelinenn, Tzanakis were 0.905, 0.826, 0.769, 0.800 at each scale’s cut-off points, respectively.
Conclusion: In this study, Ohmann scale had the highest sensitivity (95.56%), however modified Avalrado was most accuracy with AUROC= 0.905. Tzanakis scale had lowest senstivity (78.26%). Therefore, in clinical pratice, somehow Ohmann and modified Alvarado scales are better than others in diagnosis appendititis.

Key words: acute appenditits, modified Alvarado, Ohmann
SEVERITY AND MORTALITY PREDICTION IN ACUTE PARAQUAT POISONING BY SERUM PARAQUAT QUANTITIVE TEST
Authors: Ngo Duc Ngoc
Published: March 2020

Introduction: Acute paraquat poisoning is common in Vietnam. Mortality and severity prediciton of acute paraquat poisoning patient is difficult. Serum paraquat concentration is a useful prognostic fatal value.
Objective: Apply quantitative test for serum paraquat concentration to determine the severity and prognose in acute paraquat poisoning patients.
Subjects and methods : An observational analytic study included acute paraquat poisoning patients were treated at Poison Control Center of Bach Mai hospital from 4/2015 to 5/2016.
Results: 92 patients were included, with 52.6% males and 47,4% females. The average age of the patients was 34.2 ± 14.5. Fifty-two patients were reported dead (62.37%). The patients classifed as survial group were detected to get serum paraquat concentration to be significantly lower than other patients in dead group (2.6 ± 4.92 in comparision with 23.8 ± 27.64, p<0.001), serum paraquat concentration was not correlated with PSS level (p>0.05). SIPP scale was evaluated to be efficient in dead prognosis. The AUROC of SIPP scale was 0.860, p<0.001 (95% CI: 0.782 – 0.938). The value of SIPP = 15 had highest sensitivity and specificity (0.750, 0.767, respectively).
Conclusion: Serum paraquat concentration was determined the effective values in estimating the severity and dead prognosis. SIPP Scale was useful for mortality prognosis.

Key words: Acute Paraquat poisoning, serum Paraquat concentration
EFFECT OF CONTINUOUS TRANSCRANIAL DOPPLER ON THROMBOLYSIS IN ISCHEMIC STROKE DUE TO ACUTE MIDDLE CEREBRAL ARTERY OCCLUSION
Authors: Tran Quang Thang , Nguyen Dat Anh , Nguyen Van Chi , Le Van Thinh , Dao Viet Phuong , Mai Duy Ton
Published: March 2020

Purpose: Recombinant tissue plasminogen activator (rtPA) activity may be enhanced with ultrasound, 2 MHz transcranial Doppler (TCD). We performed the trial to determine the efficacy of ultrasound-enhanced thrombolysis compared to the current standard of care (intravenous rtPA).
Subjects and methods: We treated 80 patients who had acute ischemic stroke due to occlusion of the middle cerebral artery with intravenous rtPA within 4.5 hours after the onset of symptoms. The patients were randomly assigned to receive continuous 2-MHz transcranial Doppler ultrasonography (the target group) or placebo (the control group). The primary combined end point was complete recanalization as assessed by transcranial Doppler ultrasonography and dramatic clinical recovery at 2 hours. Complete recanalization was defined as thrombolysis in brain ischemia (TIBI) flow grades 4-5. Secondary end points included recovery at 24 hours, a favorable outcome at three months.
Results: A total of 80 patients were randomly assigned to receive continuous ultrasonography (40 patients) or placebo (40 patients). Complete recanalization and dramatic clinical recovery within two hours after the administration of a rtPA bolus occurred in 13 patients in the target group (32,5%), as compared with 8 patients in the control group (20%) (P=0.038). At three months, 22 patients in the target group who were eligible for follow-up analysis (55%) and 13 in the control group (32,5%) had favorable outcomes (as indicated by a score of 0 to 1 on the modified Rankin scale) (P=0.012). Intracerebral hemorrhage occurred in five patients in the target group and in four in the control group.
Conclusion: In patients with acute ischemic stroke due to occlusion of the middle cerebral artery, continuous transcranial Doppler augments rtPA-induced arterial recanalization, with an increased rate of recovery from stroke, as compared with placebo. Continuous 2-MHz transcranial Doppler ultrasonography for 2 hours is safe.

Key words: Stroke, transcranial Doppler, tissue plasminogen activator
CHARACTERISTICS OF DEMOGRAPHIC AND CLINICAL MANIFESTATIONS OF TRAUMATIC IN PATIENTS ADMITED AT THONG NHAT HOSPITAL
Authors: Le Bao Huy , Le Cong Thuyen , Hoang Van Quang , Trinh Tran Quang , Vo Ngoc Thong
Published: March 2020

Background: Trauma is the most common cause of death in labor population. Polytrauma, especially hypovolemic shock and trauma brain injury, has higher mortality rate than the others.
Objectives: We conducted this study to determine demographic, cause and clinical manifestations of traumatic inpatients at Thong Nhat hospital.
Method: A prospective study was done on traumatic patients at department of Emergency Medicine from January to June 2016.
Results: 672 traumatic patients were enrolled, The mean age was 48.84, male : female ratio 2:1. Labor population was prominant with 67.7%. Traffic accident was 306 cases (45.2%). The common traumatic sites were extremity injury, head trauma with 61.9%; 23.5%, respectively. ISS and Glasgow score indicated the prediction to mortality. Death and severe disability were 1.9%.
Conclusions: Traumatic patients were young, mainly in labor population. Male was more common than female.Traffic accident was common cause. Extremity injury was the most common traumatic site.

Key words: Trauma patient, ISS score, Deparment of Emergency Medicine
CHARACTERISTICS OF MODERATE AND SEVERE HEAD INJURIES AT EMERGENCY DEPARTMENT HUE CENTRAL HOSPITAL
Authors: Hoang Trong Ai Quoc , Ton That Hoang Quy , Vo Dang Tri , Hoang Thi Kim Tram , Chau Thi Thanh Nga
Published: March 2020

Background: Head injury is one of common trauma at ED. It is also main cause of dead and disability of trauma. In Vietnam, accident traffic is most common cause of head injury. ED admits a large number of moderate and severe head injury patients everyday. These injuries can result in physical and mental consequences because of traumatic brain injury (TBI); burden to family and society. However, there is not a consensus in statistics of cause, severe symptom, risk factors to severity and short-term outcome at these patients.
Objectives: assessement of cause, symptom and risk factors of moderate and severe head injuries as well as presentations of CT scanner.
Materials and Methods: This is a cross sectional study. Population of interest: Patients with trauma who transported to ED of Hue Central Hospital and classified as moderate and severe head injuries were chosen conveniently into the study. Inclusion criteria: Patients with trauma by any reason; Glasgow score≤13, Sample size: There was not limitation of case number.
Results: There were 50 patients with severe and moderate head injury. Main cause of trauma was traffic accident (92.2%). Patients were transported to ED by private vehicles (84,3%). Mean age of male was 38.20±14.28, female was 33.00±17.82 (p>0.05). Most of accident were not witnessed by family and not rescued by bystanders. There was an evaluable concentration of plasma ethanol in 88.2% of patients with mean level of 33.99±21.88 mmol/L in male and 12.90±19.98 mmol/L in female (p<0.05). Ethanol levels in severe head trauma were lower than ones in moderate head trauma (p<0.001). Ethanol levels were not different in patients with different lesions on CT scanners (p>0.05). It existed a correlation between Glasgow score and ethanol levels (r=0.43, p<0.01). Expired rate of patient at ED was 21.6%.
Conclusion: Main cause of trauma was traffic accident (99.2%). There were 88.2% of patients used ethanol before trauma; 15.7% of patients were transported by ambulance. There were 64.7% with headache; amnesia of accident 82.4%; vomiting 78.4%; scalp wound 45.1%; ear bleeding 7.8%; nose bleeding 7.8%; raccoon eye 19.6%. It did not exist a difference of ethanol levels in different lesions on head CT scanner. Expired rate of patient at ED was 21.6%.

Key words: head injury, traffic accident, ethanol, Glasgow
Coordination of long-term data management in the Gulf of Mexico: Lessons learned and recommendations from two years of cross-agency collaboration
Authors: Keating Kathryn , Gloekler Melissa , Kinner Nancy , Mesick Sharon , Peccini Michael , Shorr Benjamin , Showalter Lauren , Henkel Jessica
Published: March 2020

This paper presents a summary of collaborative work, lessons learned, and suggestions for next steps in coordinating long-term data management in the Gulf of Mexico in the years following the Deepwater Horizon oil spill (DWH). A decade of increased research and monitoring following the DWH has yielded a vast amount of diverse data collected from response and assessment efforts as well as ongoing restoration efforts. To maximize the benefits of this data through proper management and coordination, a cross-agency and organization Long-Term Data Management (LTDM) working group was established in 2017 with sponsorship from NOAA’s Office of Response and Restoration (OR&R) and NOAA’s National Marine Fisheries Service Restoration Center (NMFS RC) and facilitated by the University of New Hampshire’s Coastal Response Research Center. This paper will describe the LTDM working group’s efforts to foster collaboration, data sharing, and best data management practices among the many state, federal, academic and non-governmental entities working to restore and improve the coastal environment in the Gulf following the DWH. Through collaborative workshops and working groups, participants have helped to characterize region-specific challenges, identify areas for growth, leverage existing connections, and develop recommended actions for stakeholders at all organizational levels who share an interest in data coordination and management activities.
Gulf-wide data synthesis for restoration planning: Utility and limitations
Authors: Moss Leland , Carruthers Tim , Bienn Harris , Mcinnis Adrian , Dausman Alyssa
Published: March 2020

Multiple funding mechanisms support restoration across the northern Gulf of Mexico. To maximize environmental, societal, and financial benefits of these investments, best use of available science is needed to inform project prioritization and planning processes. Synthesizing available data across the northern Gulf of Mexico can provide information on potential threats to, and benefits from, projects or suites of projects. To achieve this, subject matter experts from Alabama, Florida, Louisiana, Mississippi and Texas were identified with recommendations from each of the RESTORE Act Centers of Excellence. These experts provided known sources of Gulf-wide data and recommended metrics that would be most informative, resulting in 40 threat, 19 habitat and 10 community primary data layers. Two tessellated geospatial hexagon grids were generated to provide uniform coverage that encompassed a 25-mile buffer of the Coastal Zone Management Act (CZMA) boundary at a spatial grid resolution of 100 km2 and 1 km2. The two resultant grid domains included all counties in the five Gulf states determined by the National Oceanic and Atmospheric Administration (NOAA) as contributing to coastal watersheds. The varying grid resolutions allowed for data to be spatially visualized both at a broad Gulf-wide scale on the 100 km2 grid as well as at a regional and project level scale on the 1 km2 grid. The data layers were synthesized into combined layers of potential stress, potential ecological benefits, and potential community benefits. These layers support broad scale prioritization for restoration efforts, based on likelihood of success and desired outcomes. The synthesized data were discussed in the context of the five goals and four priority criteria of the Gulf Coast Ecosystem Restoration Council’s (RESTORE Council) aim of using best available science (BAS) to guide future funding for restoration at large and small scales.
Ecological benefits of the Bahia Grande Coastal Corridor and the Clear Creek Riparian Corridor acquisitions in Texas
Authors: Land Sheri
Published: March 2020

In response to the 2010 Deepwater Horizon (DWH) oil spill, Congress passed the RESTORE Act to provide funding for coastal restoration and recovery for the affected Gulf Coast states: Alabama, Florida, Louisiana, Mississippi, and Texas. The Act is intended to protect and restore the natural and economic resources of the Gulf of Mexico and the U.S. Gulf Coast. The environmental and economic injuries caused by the spill were extensive. The legal aftermath of the spill will require the parties responsible to pay substantial damages to address these injuries. Through the RESTORE Act, Congress allocated 80% of the administrative and civil penalties related to the spill to the states and the federal government to restore and revitalize the Gulf Coast. A portion of the RESTORE Act allocation comes directly to Texas. This article focuses on two Texas RESTORE Council-Selected Restoration Component projects funded under the Initial Funded Priorities List (FPL1).
Ecosystem restoration in Louisiana — a decade after the Deepwater Horizon oil spill
Authors: Khalil Syed , Grandy Gregory , Raynie Richard
Published: March 2020

Louisiana has a long history of coastal management and restoration actions with multiple projects implementing common approaches. Traditionally, most of the restoration efforts have been ongoing in Louisiana by state and federal agencies through the Coastal Wetlands Planning, Protection and Restoration Act (CWPPRA). These activities are now being expanded significantly through additional funding and implementing entities such as the Resources and Ecosystems Sustainability, Tourist Opportunities, and Revived Economies of the Gulf Coast States (RESTORE) Act of 2012 Council, National Resource and Damage Assessment (NRDA) through the Louisiana Trustee Implementation Group (LA TIG), and the National Fish and Wildlife Foundation (NFWF). Considering a broader ecosystem or landscape context for implemented restoration projects can provide a framework for emphasizing commonality of restoration goals. Such a framework allows for multiple benefits of restoration efforts to be quantified, including prioritized natural resources, ultimately assessing the effectiveness of large-scale restoration efforts in coastal Louisiana. Three disasters have completely changed the trajectory of Louisiana’s coastal resto- ration and protection program. Hurricanes Katrina and Rita (2005) compelled the state to take serious note of the vagaries of nature, especially high-energy events like hurricanes, and to develop a comprehensive/robust coastal protection and restoration plan. Five years later, the Deepwater Horizon (DWH) oil spill exposed the fragility of the Louisiana coast but at the same time penalty monies provided much needed funding to implement the state’s coastal protection and restoration plans. This paper provides a high-level assessment of project implementation and makes the case that Louisiana could move quickly in the implementation of various restoration plans because robust and comprehensive restoration plans were previously developed and are available. Here, it must be appreciated that for the first time, dedicated funding is available not only for regional programmatic monitoring to implement adaptive management, but also for development of the art and science of restoration. It is also suggested that for efficient and cost effective implementation of Louisiana’s Coastal Master Plan federal agencies must work in tandem with the state/CPRA who not only bring the most comprehensive plan but expertise along with institutional knowledge to the table.