Hanoi Lung Hospital

Rapid control of hemorrhage is essential in emergency and surgical settings. Chitosan-based hemostats act primarily through electrostatic interactions with blood components and can function even when the intrinsic coagulation pathway is impaired. This study aims to evaluate the in vitro coagulation performance of a domestically developed chitosan-based emergency hemostatic sponge (EHS) compared with a commercial chitosan dressing (Axiostat®). Red blood cell (RBC) adhesion was assessed by scanning electron microscopy. Whole-blood interaction and absorption were quantified by gravimetric uptake and by residual free-RBC absorbance at 540 nm. Whole-blood clotting kinetics (5–15 min) and clotting blood time (CBT) were measured using citrated rabbit blood. Plasma coagulation parameters (PT, APTT, fibrinogen) were assessed in rabbit platelet-poor plasma after 10, 20 and 30 min incubation with the test materials. EHS promoted dense RBC adhesion on the sponge surface. Blood uptake was 712.6 ± 58.0 mg for EHS and 704.8 ± 37.2 mg for Axiostat® (p > 0.05). In the clotting-kinetics assay, residual free-RBC absorbance decreased markedly for both materials (e.g., at 10 min: 0.031 ± 0.005 for EHS vs 0.737 ± 0.009 in the control; p < 0.001). CBT was significantly shorter with EHS (213.2 ± 5.4 s) and Axiostat® (214.9 ± 6.0 s) than with no material (535.3 ± 8.1 s; p < 0.001). PT and fibrinogen did not differ significantly among groups, whereas APTT was significantly reduced in both material groups compared with the control (p < 0.01). EHS demonstrates effective in vitro hemostatic activity comparable to a commercial chitosan dressing, mainly through cellular interactions and acceleration of clot formation, supporting further evaluation in clinically relevant bleeding models.

Nearly 300 million people globally require humanitarian assistance, primarily due to conflicts and complex emergencies (CE). Modern conflicts are increasingly prolonged, deadly and frequent, severely disrupting health systems and hindering the provision of quality tuberculosis (TB) care. Managing drug-resistant TB (DR-TB) in these settings is particularly challenging. War and post-war conditions could potentially amplify resistance. However, evidence on DR-TB in CE-affected countries remains scarce. A scoping review, including grey literature and consultation with implementing agencies, was conducted to analyse published experiences worldwide in delivering DR-TB care in CE. The review included 16 peer-reviewed articles and 11 reports. Countries affected by war exhibit multiple risk factors for amplifying TB resistance. DR-TB management in CE is ongoing, yet diagnostic access is limited, with notification rates below 20% of estimated cases. Treatment success rates among those diagnosed are comparable to global averages. Innovative approaches, such as molecular tests, shorter regimens and patient-centred approaches, have achieved higher success rates. Information on vulnerable populations, including internally displaced persons, prisoners and children, remains minimal. Only one country had reliable information on DR-TB in prisoners (Iraq), accounting for one-third of the national resistant cohort. Most CE countries rely on external funding for DR-TB programmes. Like in other infectious diseases, war significantly alters DR-TB dynamics in affected countries and bordering or refugee-hosting countries, threatening progress towards TB elimination and exacerbating the global antimicrobial resistance crisis. While innovations have improved the feasibility of DR-TB care in CE, access remains severely constrained. Identified risk factors, challenges and priorities underscore the need for expanded TB support and targeted research, particularly for vulnerable populations in CE scenarios.

Dengue fever (DF) is a viral infection transmitted between humans by Aedes mosquitoes. To identify DF and evaluate severity, serological tests and clinical parameters are commonly used, but these may not be available in small local hospitals or subjective. The study aimed to identify the correlation of changes in complete blood count, including white blood cells (WBC), red blood cells (RBC), and platelet with severity of DF. This is a cross-sectional study, conducted at Bach Mai Hospital between October 2023 and February 2024. Data was imported to Excel then transferred to SPSS for analysis using the ANOVA or paired t-test. The study included 182 patients with a mean age of 41.1 ± 20.77 years (age range: 3-95). Patients with severe DF had significantly higher WBC counts and the neutrophil percentage compared to those with mild DF and DF with warning signs (P < .05). Patients with severe DF had a significantly lower lymphocyte percentage and the RBC count compared to those with mild DF and DF with warning signs (P < .05). Hematocrit values were similar across all groups (P > .05) and platelet counts were relatively similar across the groups (P > .05). Patients with severe DF had significantly higher WBC and neutrophil percentages, as well as lower lymphocyte and RBC counts, compared to those with non-severe DF. Significant changes in these parameters can help identify patients at risk of severe DF, allowing for timely intervention in small local hospitals.

Background:Sputum collection for tuberculosis (TB) diagnosis poses challenges for children, people living with HIV, and those who struggle with sputum production. Tongue swab-based molecular testing offers a promising non-invasive alternative, but person-centered research on acceptability is limited.Methods:We conducted a pragmatic survey across eight countries (Vietnam, Philippines, South Africa, Nigeria, Zambia, India, Uganda, Peru) among people with presumptive TB attending primary care facilities. Participants provided both tongue swab and sputum samples, then completed a 5–10 minute survey about their collection preferences.Results:From October 2023 to July 2024, 1,297 participants were enrolled (median age 43 years, 45% female, 13% HIV-positive). Overall, 61% (95% CI: 58–64%) preferred tongue swab collection compared to 22% (95% CI: 20–25%) who preferred sputum collection and 17% (95% CI: 15–19%) with no preference. Preference for tongue swab was consistent across demographic and clinical subgroups, with country-level variation ranging from 47% in South Africa to 74% in Zambia and Nigeria.Conclusion:Strong preference for tongue swab over sputum collection among individuals with presumptive TB supports this diagnostic innovation’s potential to overcome barriers to timely TB testing, particularly for populations struggling with sputum production.

PURPOSE Circulating tumor DNA (ctDNA) is a novel biomarker to monitor treatment response and predict cancer recurrence. However, the real-world performance of ctDNA monitoring is not well characterized in underrepresented populations such as the Southeast Asians. METHODS This retrospective analysis included patients with cancer who had commercial ctDNA tests (K-Track, Gene Solutions, Vietnam) between August 2022 and December 2023. A personalized tumor-informed ctDNA assay was performed for 623 patients and 815 plasma samples to quantify ctDNA before and after treatment. Clinical data of minimum 6 months after the last ctDNA test were available for 263 early-stage patients to analyze the prognostic value of ctDNA. RESULTS In the early-stage I-III, preoperative ctDNA detection rates were 66.7%, 84.6%, 54.3%, 52.6%, 93.3%, and 75.0% for lung, colorectal, breast, gastric, liver, and ovarian cancers, respectively. After surgery, 84.4% (38/45) of patients with recurrence had ctDNA detected in the plasma, while 96.3% (210/218) of patients with no recurrence had negative results. Postoperative ctDNA positivity significantly increased the risk of recurrence ( P &lt; .001) in lung (hazard ratio [HR], 71.3 [95% CI, 17.6 to 287.8]), colorectal (HR, 44.3 [95% CI, 11.3 to 173.2]), breast (HR, 37.6 [95% CI, 3.09 to 456.8]), and gastric (HR, &gt;100 [95% CI, 26.9 to &gt;100.0) cancers. In the metastatic stage IV, pretreatment ctDNA detection rates were 80.0%, 87.7%, 73.3%, 70.6%, 91.7%, and 81.8% for lung, colorectal, breast, gastric, liver, and ovarian cancers, respectively. Case studies were presented to demonstrate utilization of ctDNA at all cancer stages. CONCLUSION ctDNA was a strong prognostic biomarker to monitor patients during cancer management.