Viet Duc Hospital

This study aimed to assess the lasting effects of early-life dioxin exposure via breastfeeding on the endocrine and reproductive health of children at 14years of age, continuing a Vietnamese longitudinal cohort started in 2008. The participants were 68 mother-child pairs (38 from a dioxin hotspot and 30 from a non-exposure area). Serum steroid hormones in adolescents were quantified by liquid chromatography-tandem mass spectrometry and linked to their mother's breast milk dioxin congener levels collected within 4-16weeks postpartum. Secondary sexual characteristics in girls and testicular volume in boys were clinically assessed. The results showed sex-specific differences. In girls from the hotspot, body weight and head circumference were significantly lower than those in the non-exposure area and showed negative correlations with specific dioxin congeners and steroid hormones. Hormonal analysis revealed significantly lower levels of estrone and estradiol, but higher cortisol levels, in both exposed genders. Estrone and estradiol displayed negative correlations with dioxins, stronger in girls. Conversely, cortisol showed positive correlations with most dioxin congeners and total toxic equivalents (TEQs) in boys only. Additionally, allopregnanolone levels were higher and positively correlated with dioxin in boys, while androstenedione and androstanediol were significantly lower in hotspot girls. Notably, testicular volume in boys did not differ or correlate with dioxin exposure. In conclusion, lactational dioxin exposure might associated with long-term, sex-specific disruption of steroid hormone homeostasis and impaired physical growth during puberty, particularly in girls.

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.

This study aimed to describe the burden, pathogen distribution, antimicrobial resistance patterns, and selected clinical outcomes of intensive care unit (ICU)-acquired Gram-negative bacteria (GNB) infections in Vietnam, with exploratory comparative analyses of outcomes. A retrospective descriptive study with comparative analyses was conducted among 102 adult patients with culture-confirmed ICU-acquired GNB infections at E Hospital, Hanoi. Demographic, clinical, microbiological, and outcome data were extracted from medical records. Antimicrobial susceptibility testing was performed according to Clinical and Laboratory Standards Institute guidelines. Comparisons between outcome groups were assessed using chi-square test, with effect sizes quantified using Cramer's V. Pneumonia was the predominant infection (70.5%), followed by urinary tract (15.2%) and bloodstream infections (10.6%). GNB accounted for 68.3% of all hospital-acquired infections (HAIs), with Acinetobacter baumannii (43.4%), Pseudomonas aeruginosa (24.8%), and Klebsiella pneumoniae (13.9%) being the most frequent pathogens. The predominant pathogens exhibited extensive resistance to β-lactams, cephalosporins, and carbapenems. Susceptibility was largely retained only to colistin, tigecycline, and amikacin. Mechanical ventilation was significantly associated with death or a severe clinical outcome (p = 0.03; Cramer's V = 0.21). GNB dominate ICU-acquired infections in Vietnam and demonstrate alarming antimicrobial resistance, underscoring the urgent need for strengthened infection control and antimicrobial stewardship.

[This corrects the article DOI: 10.3389/bjbs.2025.15455.].

Background: Assisted oocyte activation (AOA) has been used to improve fertilization rates after intracytoplasmic sperm injection (ICSI) by artificially increasing oocyte calcium concentration. However, concerns remain about its potential long-term impact on child development. Limited data exist on developmental outcomes in children born after ICSI with AOA. This study investigated psychomotor development at 12 months of age in children born after ICSI with or without AOA. Methods: This prospective cohort study included 55 children born after frozen embryo transfer: 29 in the AOA group and 26 in the non-AOA group. At 12 months, parents completed the Ages and Stages Questionnaire, Third Edition (ASQ-3), and the Developmental Milestones Red Flags checklist, validated for assessing psychomotor development. Parents also reported their child’s physical characteristics (e.g., height and weight) and medical history, including hospital admissions and chronic illnesses. Outcomes included proportions of children with abnormal ASQ-3 scores, Red Flag signs, and adverse medical/growth outcomes. Results: Baseline parental and perinatal characteristics were comparable between groups. At 12 months, no significant differences were observed in the proportion of children with abnormal ASQ-3 scores across five developmental domains (communication, gross motor, fine motor, personal-social, and problem-solving skills). The prevalence of Red Flag signs and rates of illnesses, hospitalizations, and chronic conditions were also similar. However, children in the non-AOA group were significantly taller than those in the AOA group (77.1 ± 2.2 cm vs. 74.6 ± 4.0 cm; [Formula: see text] = 0.02). Conclusions: Children in the AOA group showed similar psychomotor development at 12 months compared to those in the non-AOA group.

ObjectivesTo evaluate the accuracy of the arterial oxygen partial pressure/inspired oxygen fraction (PaO2/FiO2) ratio in predicting mortality among acute respiratory distress syndrome (ARDS) patients in Vietnam.DesignA retrospective observational study.SettingA central hospital in Vietnam.ParticipantsAdult patients diagnosed with ARDS based on the Berlin definition and admitted to Bach Mai Hospital between August 2015 and August 2023. ARDS severity was converted from descriptive categories to the Berlin score, ranging from 1 (PaO2/FiO2>300 mm Hg) to 4 (PaO2/FiO2≤100 mm Hg).Primary outcomeAll-cause hospital mortality.ResultsOf 345 patients, 67.5% were male, and the median age was 55.0 years (IQR: 39.0–66.0). Hospital mortality was 61.2% (211/345). On the first day of admission, the PaO2/FiO2 ratio (areas under the receiver operating characteristic curves (AUROC): 0.585 (95% CI 0.522 to 0.649)) showed limited predictive ability for hospital mortality. Incorporating the PaO2/FiO2 ratio into the Berlin score did not substantially improve accuracy (AUROC: 0.578 (95% CI 0.516 to 0.641)). Both measures were less accurate than Sequential Organ Failure Assessment (SOFA) (AUROC: 0.650 (95% CI 0.590 to 0.711)), Acute Physiology and Chronic Health Evaluation II (APACHE II) (AUROC: 0.685 (95% CI 0.628 to 0.742)) and Confusion, Urea >7 mmol/L (20 mg/dL), Respiratory rate ≥30 breaths/min, Blood pressure (systolic <90 mm Hg or diastolic ≤60 mm Hg) and Age ≥65 years (CURB-65) (AUROC: 0.689 (95% CI 0.617 to 0.762)). Higher PaO2/FiO2 values (adjusted OR, AOR: 0.988 (95% CI 0.979 to 0.996)) were independently associated with lower mortality risk, while higher Berlin (AOR: 2.477 (95% CI 1.190 to 5.156)), SOFA (AOR: 1.278 (95% CI 1.102 to 1.482)), APACHE II (AOR: 1.236 (95% CI 1.108 to 1.379)) and CURB-65 (AOR: 7.142 (95% CI 2.581 to 19.763)) scores were associated with increased mortality risk.ConclusionsIn this study of ARDS patients in Vietnam, the PaO2/FiO2 ratio demonstrated limited discriminatory ability for hospital mortality, and incorporating it into the Berlin score did not meaningfully improve performance. While less accurate than SOFA, APACHE II and CURB-65 scores, the PaO2/FiO2 ratio and Berlin score remained independently associated with mortality risk. These findings should be interpreted cautiously, given the retrospective design, single-centre setting and potential selection bias; further validation in larger, multicentre studies is warranted.

Objective To evaluate the effects of exercise interventions on HbA1C, fasting blood glucose (FBG), lipid profiles, blood pressure, anthropometric components, insulin, Homeostasis Model Assessment for Insulin Resistance (HOMA-IR), and inflammatory markers among type 2 diabetes patients. Methods We conducted a meta-analysis of randomized control trials (RCTs). Seven electronic databases, namely CINAHL, the Cochrane Library, Embase, Ovid-Medline, PubMed, Scopus, and Web of Science were searched from inception to September 12, 2022 to identify RCTs assessing the effects of exercise for type 2 diabetes. Hedges’ g and 95% confidence interval (CI) were calculated as the pooled estimates using a random-effects model, and a two-sided P of &lt;0.05 was considered statistically significant. Moderator analyses were used to test the effect of potential moderators on trial effectiveness. Results In total, 126 RCTs involving 7155 people with type 2 diabetes were included. Exercise interventions significantly reduced the primary outcomes, HbA1C and FBG, with a Hedges’ g of -0.67 and -0.76 respectively. Significant effects on the secondary outcomes that included lipid profiles, blood pressure, anthropometric components, insulin, HOMA-IR, and inflammatory markers with Hedges’ g values ranging from -0.26 to -0.78. Moderator analyses revealed that the effect size for FBG significantly different among the four intervention types, and there was a significant association between FBG’s effect size and the percentage of men. Conclusions The results from this meta-analysis demonstrated the importance of exercise interventions on type 2 diabetes-related outcomes. BJMS, Vol. 24 No. 04 October’25 Page : 1260-1303