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Marolleau J, Nguyen TA, Doucet L, Coste A, Schoentgen N, Rousseau B, Valeri A, Fournier G. [Morbidity of extended pelvic lymphadenectomy during robot-assisted laparoscopic prostatectomy for localized cancer prostate]. Prog Urol 2022; 32:1455-1461. [PMID: 36088200 DOI: 10.1016/j.purol.2022.07.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/02/2022] [Accepted: 07/18/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To assess the morbidity specific of extended pelvic lymphadenectomy during robot-assisted laparoscopic radical prostatectomy in a 8 year retrospective study. MATERIAL We carried out a single-center, single-surgeon retrospective study on 342 consecutive patients who underwent a robot-assisted laparoscopic radical prostatectomy and extended pelvic lymphadenectomy, from July 2010 to March 2018. Postoperative complications were recorded up to 3 months after the operation. RESULTS Thirty (8.8%) patients had at least one complication related to lymphadenectomy including 1 vascular injury (0.3%), 7 injuries of the obturator nerve (2%), 5 venous thromboembolic complications (1.5%) including 4 pulmonary embolisms, 10 symptomatic lymphoceles (2.9%) and 8 lymphoedemas (2.3%). Of these complications, 13 were classified Clavien 1 (43.3%), 8 Clavien 2 (26.7%), 7 Clavien 3a (23.3%) and 2 Clavien 3b (6.7%). In univariate analysis a high age (P=0.04), high BMI (P<0.01) and pT stage (P=0.02) were significantly associated with complication whereas in multivariate analysis, only age (P=0.02) and BMI (P<0.01) lived were. In univariate analysis high BMI (P=0.04) and lymph node involvement (P=0.04) were associated with lymphatic complication. We did not find any other specific risk factor for the other complications. CONCLUSION With 8.8% of overall complications related to lymphadenectomy and 5% of complication classified Clavien grade 2 or higher, extended pelvic lymphadenectomy was not very morbid. Age and BMI were risk factors for a overall complication. BMI and lymph node involvement were risk factors for lymphatic complications. LEVEL OF PROOF 4.
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Affiliation(s)
| | - T A Nguyen
- Service d'urologie, CHU, Brest, France; Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale, Brest, France; LaTIM, Inserm, UMR 1101, Université de Bretagne Occidentale, Brest, France
| | - L Doucet
- Laboratoire d'anatomo-pathologie, CHU, Brest, France
| | - A Coste
- LaTIM, Inserm, UMR 1101, Université de Bretagne Occidentale, Brest, France; Service de médecine infectieuse et tropicale, CHU, Brest, France
| | | | | | - A Valeri
- Service d'urologie, CHU, Brest, France; Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale, Brest, France; LaTIM, Inserm, UMR 1101, Université de Bretagne Occidentale, Brest, France; CeRePP, Paris, France
| | - G Fournier
- Service d'urologie, CHU, Brest, France; Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale, Brest, France; LaTIM, Inserm, UMR 1101, Université de Bretagne Occidentale, Brest, France; CeRePP, Paris, France
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2
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Phan KS, Ha PT, Do HN, Nguyen TA, Bui TQ, Pham HN, Le MH, Le TTH. Dual Loading of Doxorubicin and Magnetic Iron Oxide into PLA-TPGS Nanoparticles: Design, in vitro Drug Release Kinetics, and Biological Effects on Cancer Cells. ChemMedChem 2021; 16:3615-3625. [PMID: 34523806 DOI: 10.1002/cmdc.202100535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 09/10/2021] [Indexed: 11/12/2022]
Abstract
The multifunctional nano drug delivery system (MNDDS) has much revolutionized in cancer treatment, aiming to eliminate many disadvantages of conventional formulations. This paper herein proposes and demonstrates MNDDS inspired by poly(lactide)-tocopheryl polyethylene glycol succinate (PLA-TPGS) copolymer co-loaded Doxorubicin and magnetic iron oxide nanoparticles (MIONs) with a 1 : 1 (w/w) optimal ratio. In vitro drug release kinetics of Doxorubicin from this nanosystem fitted best to the Weibull kinetic model and can be described by the classical Fickian diffusion mechanism under acidic pH conditions. The combination of MIONs and Doxorubicin in the PLA-TPGS copolymer has maintained the fluorescence properties of Doxorubicin and good cell penetration, especially inside the nucleus and its vicinity. Moreover, different cell cycle profiles were observed in HeLa cell lines treated with MNDDSs.
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Affiliation(s)
- Ke Son Phan
- Graduate University of Science and Technology, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet Road, Cau Giay District, Hanoi, Vietnam.,Institute of Materials Science, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet Road, Cau Giay District, Hanoi, Vietnam
| | - Phuong Thu Ha
- Institute of Materials Science, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet Road, Cau Giay District, Hanoi, Vietnam
| | - Huu Nghi Do
- Institute of Natural Products Chemistry, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet Road, Cau Giay District, Hanoi, Vietnam
| | - Trung Anh Nguyen
- Hanoi Medical University, 1 Ton That Tung, Dong Da District, Hanoi, Vietnam
| | - Thuc Quang Bui
- Hanoi Medical University, 1 Ton That Tung, Dong Da District, Hanoi, Vietnam
| | - Hong Nam Pham
- Institute of Materials Science, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet Road, Cau Giay District, Hanoi, Vietnam
| | - Mai Huong Le
- Institute of Natural Products Chemistry, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet Road, Cau Giay District, Hanoi, Vietnam
| | - Thi Thu Huong Le
- Institute of Materials Science, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet Road, Cau Giay District, Hanoi, Vietnam.,Faculty of Natural Resources and Environment, Vietnam National University of Agriculture, Trau Quy, Gia Lam District, Hanoi, Vietnam
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Ha MT, Ho TAT, Nguyen AN, Nguyen TA. Characteristics of severe malaria in hospitalized children in Ho Chi Minh City from 2012 to 2019. Trop Biomed 2021; 38:371-376. [PMID: 34508346 DOI: 10.47665/tb.38.3.082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
In Vietnam, severe malaria is currently rare but is a life-threatening disease. It may be misdiagnosed with other common diseases. This descriptive study aimed to characterize severe malaria and its clinical aspects, as well as outcomes of infected pediatric patients to improve case management. The case-series study was carried out based on medical records of children aged between one month and 15 years with malaria diagnosed by blood smear or rapid diagnostic test. Chi-squared test with the p values less than 0.05 were considered statistically significant. There were 47 cases enrolled in the study. The prevalence of severe malaria was 29.8% (57.1% in children under five). The morbidity was 71.4% in male and 28.6% in female. Common clinical signs of severe malaria were fever (100%), severe anemia (21.4%), hepatomegaly (85.7%), and splenomegaly (71.4%). Common biological abnormalities in severe malaria were anemia, thrombocytopenia, increased liver enzymes, and high CRP level. The severe malaria was mainly caused by P. falciparum (100%). The age range for those infected with P. falciparum was 6.5 ± 4.5 years (min 0.3; max 14.9). The successful rate of treatment was 92.9% with artesunate. Antimalarial treatment time was 9.0 (6 - 12) days for severe malaria, which was twice as many as that for non-severe malaria (p = 0.067). The current clinical and biological findings of severe malaria are different from those in previous times, which make it easy to be overlooked. Therefore, it's important to perform malaria diagnostic tests when there're clinical suggestions of severe malaria, including fever, hepatomegaly or splenomegaly.
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Affiliation(s)
- M T Ha
- University of Medicine and Pharmacy at Ho Chi Minh City, 700000 Ho Chi Minh City, Vietnam
| | - T A T Ho
- Khanh Hoa General Hospital, Nha Trang City, 650000 Khanh Hoa Province, Vietnam
| | - A N Nguyen
- University of Medicine and Pharmacy at Ho Chi Minh City, 700000 Ho Chi Minh City, Vietnam
| | - T A Nguyen
- Molecular Biomedical Center, University Medical Center - Campus 2, 700000 Ho Chi Minh City, Vietnam
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4
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Redwood L, Mitchell EMH, Viney K, Snow K, Nguyen TA, Dung LAT, Nguyen VN, Fox GJ. Depression, stigma and quality of life in people with drug-susceptible TB and drug-resistant TB in Vietnam. Int J Tuberc Lung Dis 2021; 25:461-467. [PMID: 34049608 DOI: 10.5588/ijtld.20.0952] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Drug resistance poses a major barrier to global control of TB - a leading infectious cause of death. Depression and stigma occur commonly among people with TB. However, the relationship between drug-resistant forms of TB, depression and stigma are not well understood.OBJECTIVE: To compare depression, stigma and health-related quality of life (HRQoL), among people with drug-susceptible TB (DS-TB) and multidrug-resistant TB (MDR-TB).METHODS: A cross-sectional study of people treated for DS-TB and MDR-TB in four provinces of Vietnam. The survey included a stigma scale (Vietnamese Tuberculosis Stigma Scale), depression scale (9-item Patient Health Questionnaire) and HRQoL scale (Functional Assessment of Chronic Illness Therapy - Tuberculosis). Differences between the two populations were compared using linear regression.RESULTS: Eighty-one people with DS-TB and 315 people with MDR-TB participated in the study. People with MDR-TB had a higher prevalence of depression than those with DS-TB (difference 17.8%, χ² 8.64). The mean depression and stigma scores were higher for people with MDR-TB than those with DS-TB (adjusted difference [AD] 8.6 and 7.6 respectively). People with MDR-TB reported lower HRQoL than those with DS-TB (AD -23.8).CONCLUSION: Depression and stigma are common among people with TB in Vietnam. Strategies to prevent and treat depressive symptoms and stigma in people with TB are critical to a holistic, patient-centred approach to care.
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Affiliation(s)
- L Redwood
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia, Woolcock Institute of Medical Research, Hanoi, Vietnam
| | - E M H Mitchell
- Department of Public Health, Institute for Tropical Medicine, Antwerp, Belgium
| | - K Viney
- Research School of Population Health, Australian National University, Canberra ACT, Australia, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden, School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - K Snow
- School of Population and Global Health University of Melbourne, Melbourne, VIC, Australia
| | - T A Nguyen
- Woolcock Institute of Medical Research, Hanoi, Vietnam
| | - L A T Dung
- Woolcock Institute of Medical Research, Hanoi, Vietnam
| | - V N Nguyen
- National Tuberculosis Programme, Hanoi, Vietnam
| | - G J Fox
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia, Woolcock Institute of Medical Research, Hanoi, Vietnam
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Fox GJ, Johnston JC, Nguyen TA, Majumdar SS, Denholm JT, Asldurf H, Nguyen CB, Marks GB, Velen K. Active case-finding in contacts of people with TB. Int J Tuberc Lung Dis 2021; 25:95-105. [PMID: 33656420 DOI: 10.5588/ijtld.20.0658] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Exposure to people with TB substantially elevates a person's risk of tuberculous infection and TB disease. Systematic screening of TB contacts enables the early detection and treatment of co-prevalent disease, and the opportunity to prevent future TB disease. However, scale-up of contact investigation in high TB transmission settings remains limited.METHODS: We undertook a narrative review to evaluate the evidence for contact investigation and identify strategies that TB programmes may consider when introducing contact investigation and management.RESULTS: Selection of contacts for priority screening depends upon their proximity and duration of exposure, along with their susceptibility to develop TB. Screening algorithms can be tailored to the target population, the availability of diagnostic tests and preventive therapy, and healthcare worker expertise. Contact investigation may be performed in the household or at communal locations. Local contact investigation policies should support vulnerable patients, and ensure that drop-out during screening can be mitigated. Ethical issues should be anticipated and addressed in each setting.CONCLUSION: Contact investigation is an important strategy for TB elimination. While its epidemiological impact will be greatest in lower-transmission settings, the early detection and prevention of TB have important benefits for contacts and their communities.
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Affiliation(s)
- G J Fox
- Faculty of Medicine and Health, Sydney Medical School, University of Sydney, Sydney, NSW, Woolcock Institute of Medical Research, Glebe, NSW, Australia
| | - J C Johnston
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - T A Nguyen
- Woolcock Institute of Medical Research, Glebe, NSW, Australia
| | - S S Majumdar
- Burnet Institute, Melbourne, VIC, Centre for International Child Health, Department of Paediatrics University of Melbourne and Murdoch Children's Research Institute, Melbourne, VIC
| | - J T Denholm
- Doherty Institute, University of Melbourne, Melbourne, VIC, Victorian Tuberculosis Program, Melbourne Health, Melbourne, VIC, Australia
| | - H Asldurf
- School of Epidemiology & Public Health, University of Ottawa, Ottawa, ON, Canada
| | - C B Nguyen
- Woolcock Institute of Medical Research, Glebe, NSW, Australia
| | - G B Marks
- Woolcock Institute of Medical Research, Glebe, NSW, Australia, South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - K Velen
- Faculty of Medicine and Health, Sydney Medical School, University of Sydney, Sydney, NSW, Woolcock Institute of Medical Research, Glebe, NSW, Australia
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Hinton L, Nguyen H, Nguyen HT, Harvey DJ, Nichols L, Martindale‐Adams J, Nguyen BT, Nguyen BTT, Nguyen AN, Nguyen CH, Nguyen TTH, Nguyen TL, Nguyen ATP, Nguyen NB, Tiet QQ, Nguyen TA, Nguyen PQ, Nguyen TA, Pham T. Advancing family dementia caregiver interventions in low- and middle-income countries: A pilot cluster randomized controlled trial of Resources for Advancing Alzheimer's Caregiver Health in Vietnam (REACH VN). Alzheimers Dement (N Y) 2021; 6:e12063. [PMID: 33532542 PMCID: PMC7825546 DOI: 10.1002/trc2.12063] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 06/23/2020] [Accepted: 07/09/2020] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Low- and middle-income countries have rapidly increasing numbers of people with dementia, yet little evidence on family caregiving interventions. We tested the preliminary efficacy and feasibility of a family caregiving intervention in northern Vietnam. METHODS Nine clusters comprising 60 family caregivers were randomized to a culturally adapted version of a four- to six-session, multicomponent intervention delivered in-home over 2 to 3 months, or enhanced control. Eligible caregivers were ≥18 years of age and scored ≥6 on the Zarit Burden Inventory (ZBI). RESULTS Fifty-one caregivers (85%) completed the study. Using analysis of covariance with 3-month assessment as the outcome and baseline assessment as a covariate, intervention group caregivers had an average ZBI (primary outcome) score 1.2 standard deviation (SD) lower (P = .02) and Patient Health Questionnaire-4 (psychological distress) score 0.7 SD lower (P = .03) than controls. DISCUSSION In the first study of its kind in Vietnam, a culturally adapted, manualized, family caregiver intervention was both efficacious and feasible.
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Affiliation(s)
- Ladson Hinton
- Department of Psychiatry and Behavioral SciencesUniversity of CaliforniaDavisCaliforniaUSA
| | - Huong Nguyen
- Department of Religious StudiesUniversity of South CarolinaColumbiaSouth CarolinaUSA
| | - Hung Trong Nguyen
- Vietnam National Geriatric HospitalHanoiVietnam
- Hanoi Medical UniversityHanoiVietnam
| | - Danielle J Harvey
- Department of Public Health SciencesUniversity of CaliforniaDavisCaliforniaUSA
| | - Linda Nichols
- Caregiver CenterVeterans Affairs Medical CenterMemphisTennesseeUSA
- Department of Preventive MedicineUniversity of Tennessee Health Sciences CenterMemphisTennesseeUSA
| | - Jennifer Martindale‐Adams
- Caregiver CenterVeterans Affairs Medical CenterMemphisTennesseeUSA
- Department of Preventive MedicineUniversity of Tennessee Health Sciences CenterMemphisTennesseeUSA
| | | | | | | | | | | | | | | | | | - Quyen Q. Tiet
- California School of Professional Psychology at Alliant International UniversitySan FranciscoCaliforniaUSA
| | | | | | - Trung Anh Nguyen
- Vietnam National Geriatric HospitalHanoiVietnam
- Hanoi Medical UniversityHanoiVietnam
| | - Thang Pham
- Vietnam National Geriatric HospitalHanoiVietnam
- Hanoi Medical UniversityHanoiVietnam
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Nguyen TA, Dang TH, Tran K, Kim GB, Brodaty H, Pham T, Pham TL, Crotty M, Kurrle S, Hinton L, Esterman A, Nguyen TA, Roughead EE. Dementia in Vietnam: A situational analysis. Alzheimers Dement 2020. [DOI: 10.1002/alz.039252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Tuan Anh Nguyen
- University of South Australia Adelaide Australia
- Health Strategy and Policy Institute of Vietnam Hanoi Viet Nam
| | - Thu Ha Dang
- University of South Australia Adelaide Australia
| | - Kham Tran
- University of South Australia Adelaide Australia
| | | | - Henry Brodaty
- Centre for Healthy Brain Ageing UNSW Sydney Australia
| | - Thang Pham
- National Geriatric Hospital of Vietnam Hanoi Viet Nam
| | | | | | | | - Ladson Hinton
- University of California Davis School of Medicine Sacramento CA USA
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Fiard G, Norris JM, Nguyen TA, Stavrinides V, Olivier J, Emberton M, Moore CM. What to expect from a non-suspicious prostate MRI? A review. Prog Urol 2020; 30:986-999. [PMID: 33008718 DOI: 10.1016/j.purol.2020.09.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/06/2020] [Accepted: 09/04/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Many guidelines now recommend multiparametric MRI (mpMRI) prior to an initial or repeat prostate biopsy. However, clinical decision making for men with a non-suspicious mpMRI (Likert or PIRADS score 1-2) varies. OBJECTIVES To review the most recent literature to answer three questions. (1) Should we consider systematic biopsy if mpMRI is not suspicious? (2) Are there additional predictive factors that can help decide which patient should have a biopsy? (3) Can the low visibility of some cancers be explained and what are the implications? SOURCES A narrative review was performed in Medline databases using two searches with the terms "MRI" and "prostate cancer" and ("diagnosis" or "biopsy") and ("non-suspicious" or "negative" or "invisible"); "prostate cancer MRI visible". References of the selected articles were screened for additional articles. STUDY SELECTION Studies published in the last 5 years in English language were assessed for eligibility and selected if data was available to answer one of the three study questions. RESULTS Considering clinically significant cancer as ISUP grade≥2, the negative predictive value (NPV) of mpMRI in various settings and populations ranges from 76% to 99%, depending on cancer prevalence and the type of confirmatory reference test used. NPV is higher among patients with prior negative biopsy (88-96%), and lower for active surveillance patients (85-90%). The PSA density (PSAd) with a threshold of PSAd<0.15ng/ml/ml was the most studied and relevant predictive factor used in combination with mpMRI to rule out clinically significant cancer. Finally, mpMRI-invisible tumours appear to differ from a histopathological and genetic point of view, conferring clinical advantage to invisibility. LIMITATIONS Most published data come from expert centres and results may not be reproducible in all settings. CONCLUSION mpMRI has high diagnostic accuracy and in cases of negative mpMRI, PSA density can be used to determine which patient should have a biopsy. Growing knowledge of the mechanisms and genetics underlying MRI visibility will help develop more accurate risk calculators and biomarkers.
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Affiliation(s)
- G Fiard
- UCL Division of Surgery and Interventional Science, University College London, London, UK; Department of Urology, University College London Hospital NHS Foundation Trust, London, UK; Department of Urology, Grenoble Alpes University Hospital, Grenoble, France; Université Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, Grenoble, France.
| | - J M Norris
- UCL Division of Surgery and Interventional Science, University College London, London, UK; Department of Urology, University College London Hospital NHS Foundation Trust, London, UK
| | - T A Nguyen
- Department of urology, université de Brest, CHRU, Brest, France
| | - V Stavrinides
- UCL Division of Surgery and Interventional Science, University College London, London, UK; Department of Urology, University College London Hospital NHS Foundation Trust, London, UK
| | - J Olivier
- UCL Division of Surgery and Interventional Science, University College London, London, UK; Department of urology, Lille university, CHU Lille, Lille, France
| | - M Emberton
- UCL Division of Surgery and Interventional Science, University College London, London, UK; Department of Urology, University College London Hospital NHS Foundation Trust, London, UK
| | - C M Moore
- UCL Division of Surgery and Interventional Science, University College London, London, UK; Department of Urology, University College London Hospital NHS Foundation Trust, London, UK
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Nguyen TBP, Nguyen TA, Luu BK, Le TTO, Nguyen VS, Nguyen KC, Duong KD, Nguyen HB, Nguyen NL, Fox GJ, Nguyen NV, Marks GB. A comparison of digital chest radiography and Xpert ® MTB/RIF in active case finding for tuberculosis. Int J Tuberc Lung Dis 2020; 24:934-940. [PMID: 33156761 DOI: 10.5588/ijtld.19.0764] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE: To compare two community screening tests for TB: sputum examination using Xpert® MTB/RIF and chest radiography (CXR).METHOD: Men aged ≥15 years and women aged >45 years living in 96 sub-communes in Ca Mau, Viet Nam, were invited to provide a single sputum specimen that was tested using Xpert. Participants were also invited to attend a nearby location for digital radiography. Participants whose sputum was Xpert MTB-positive or whose CXR was reported as 'consistent with TB´ were requested to provide two further sputum specimens for culture. The sensitivities of the two tests for detecting TB (defined as sputum culture-positive for Mycobacterium tuberculosis) were compared.RESULTS: There were 72 985 eligible participants, of whom 57 597 (78.9%) participated in Xpert screening, 12 752 (17.5%) had CXR and 11 235 (15.4%) had both tests. We estimated that there were 59 cases of TB, of whom 20 were Xpert MTB-positive (programmatic sensitivity 34.0%) and 47 had CXR reported as 'consistent with TB´ (sensitivity 80.0%, P < 0.0001).CONCLUSION: In community-wide screening for TB, CXR is more sensitive than a single spontaneously expectorated sputum sample tested using Xpert, but it has a substantially lower participation rate.
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Affiliation(s)
- T B P Nguyen
- Woolcock Institute of Medical Research, Hanoi, Viet Nam
| | - T A Nguyen
- Woolcock Institute of Medical Research, Hanoi, Viet Nam, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - B K Luu
- Woolcock Institute of Medical Research, Hanoi, Viet Nam
| | - T T O Le
- Woolcock Institute of Medical Research, Hanoi, Viet Nam
| | - V S Nguyen
- National TB Control Programme, Hanoi, Centre for Social Disease Control, Ca Mau
| | - K C Nguyen
- National Lung Hospital, Hanoi, Hanoi Medical University, Hanoi
| | - K D Duong
- University of Medicine and Pharmacy, Ho Chi Minh city, Viet Nam
| | - H B Nguyen
- National TB Control Programme, Hanoi, National Lung Hospital, Hanoi, Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France
| | - N L Nguyen
- Global Tuberculosis Program, World Health Organization, Geneva, Switzerland
| | - G J Fox
- Woolcock Institute of Medical Research, Hanoi, Viet Nam, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - N V Nguyen
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia, National TB Control Programme, Hanoi, National Lung Hospital, Hanoi, Hanoi Medical University, Hanoi
| | - G B Marks
- Woolcock Institute of Medical Research, Hanoi, Viet Nam, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia, South Western Sydney Clinical School, University of NSW, Sydney, NSW, Australia
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10
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Fox GJ, Nguyen VN, Dinh NS, Nghiem LPH, Le TNA, Nguyen TA, Nguyen BH, Nguyen HD, Tran NB, Nguyen TL, Le TN, Nguyen VH, Phan TL, Nguyen KC, Ho J, Pham DC, Britton WJ, Bestrashniy JRBM, Marks GB. Post-treatment Mortality Among Patients With Tuberculosis: A Prospective Cohort Study of 10 964 Patients in Vietnam. Clin Infect Dis 2020; 68:1359-1366. [PMID: 30202910 DOI: 10.1093/cid/ciy665] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 08/14/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Tuberculosis is the leading infectious cause of death. Steep reductions in tuberculosis-related mortality are required to realize the World Health Organization's "End Tuberculosis Strategy." However, accurate mortality estimates are lacking in many countries, particularly following discharge from care. This study aimed to establish the mortality rate among patients with pulmonary tuberculosis in Vietnam and to quantify the excess mortality in this population. METHODS We conducted a prospective cohort study among adult patients treated for smear-positive pulmonary tuberculosis in 70 clinics across Vietnam. People living in the same households were recruited as controls. Participants were re-interviewed and their survival was established at least 2 years after their treatment with an 8-month standardized regimen. The presence of relapse was established by linking identifying data on patients and controls to clinic registries. Verbal autopsies were performed. The cumulative mortality among patients was compared to that among a control population, adjusting for age and gender. RESULTS We enrolled 10964 patients and 25707 household controls. Among enrolled tuberculosis patients, 9% of patients died within a median follow-up period of 2.9 years: 342 (3.1%) during treatment and 637 (5.8%) after discharge. The standardized mortality ratio was 4.0 (95% confidence interval 3.7-4.2) among patients with tuberculosis, compared to the control population. Tuberculosis was the likely cause of death for 44.7% of these deceased patients. CONCLUSIONS Patients treated for tuberculosis had a markedly elevated risk of death, particularly in the post-treatment period. Interventions to reduce tuberculosis mortality must enhance the early detection of drug-resistance, improve treatment effectiveness, and address non-communicable diseases.
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Affiliation(s)
- G J Fox
- Faculty of Medicine and Health, University of Sydney, Australia.,Woolcock Institute of Medical Research, Glebe, New South Wales, Australia
| | - V N Nguyen
- National Lung Hospital, Ba Dinh, Hanoi, Vietnam
| | - N S Dinh
- National Lung Hospital, Ba Dinh, Hanoi, Vietnam
| | - L P H Nghiem
- Woolcock Institute of Medical Research, Glebe, New South Wales, Australia
| | - T N A Le
- National Lung Hospital, Ba Dinh, Hanoi, Vietnam
| | - T A Nguyen
- Woolcock Institute of Medical Research, Glebe, New South Wales, Australia
| | - B H Nguyen
- National Lung Hospital, Ba Dinh, Hanoi, Vietnam.,Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France
| | - H D Nguyen
- Pham Ngoc Thach Hospital, Ho Chi Minh City, Vietnam
| | - N B Tran
- Woolcock Institute of Medical Research, Glebe, New South Wales, Australia
| | - T L Nguyen
- Woolcock Institute of Medical Research, Glebe, New South Wales, Australia
| | - T N Le
- Woolcock Institute of Medical Research, Glebe, New South Wales, Australia
| | - V H Nguyen
- Woolcock Institute of Medical Research, Glebe, New South Wales, Australia
| | - T L Phan
- Woolcock Institute of Medical Research, Glebe, New South Wales, Australia
| | - K C Nguyen
- National Lung Hospital, Ba Dinh, Hanoi, Vietnam.,Hanoi Medical University, Hanoi, Vietnam
| | - J Ho
- Faculty of Medicine and Health, University of Sydney, Australia
| | - D C Pham
- Woolcock Institute of Medical Research, Glebe, New South Wales, Australia
| | - W J Britton
- Faculty of Medicine and Health, University of Sydney, Australia.,Centenary Institute of Cancer Medicine and Cell Biology, University of Sydney, Camperdown, New South Wales, Australia
| | | | - G B Marks
- Woolcock Institute of Medical Research, Glebe, New South Wales, Australia.,South Western Sydney Clinical School, University of New South Wales, Kensington, New South Wales, Australia
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11
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Alsdurf H, Oxlade O, Adjobimey M, Ahmad Khan F, Bastos M, Bedingfield N, Benedetti A, Boafo D, Buu TN, Chiang L, Cook V, Fisher D, Fox GJ, Fregonese F, Hadisoemarto P, Johnston JC, Kassa F, Long R, Moayedi Nia S, Nguyen TA, Obeng J, Paulsen C, Romanowski K, Ruslami R, Schwartzman K, Sohn H, Strumpf E, Trajman A, Valiquette C, Yaha L, Menzies D. Resource implications of the latent tuberculosis cascade of care: a time and motion study in five countries. BMC Health Serv Res 2020; 20:341. [PMID: 32316963 PMCID: PMC7175545 DOI: 10.1186/s12913-020-05220-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 04/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The End TB Strategy calls for global scale-up of preventive treatment for latent tuberculosis infection (LTBI), but little information is available about the associated human resource requirements. Our study aimed to quantify the healthcare worker (HCW) time needed to perform the tasks associated with each step along the LTBI cascade of care for household contacts of TB patients. METHODS We conducted a time and motion (TAM) study between January 2018 and March 2019, in which consenting HCWs were observed throughout a typical workday. The precise time spent was recorded in pre-specified categories of work activities for each step along the cascade. A linear mixed model was fit to estimate the time at each step. RESULTS A total of 173 HCWs in Benin, Canada, Ghana, Indonesia, and Vietnam participated. The greatest amount of time was spent for the medical evaluation (median: 11 min; IQR: 6-16), while the least time was spent on reading a tuberculin skin test (TST) (median: 4 min; IQR: 2-9). The greatest variability was seen in the time spent for each medical evaluation, while TST placement and reading showed the least variability. The total time required to complete all steps along the LTBI cascade, from identification of household contacts (HHC) through to treatment initiation ranged from 1.8 h per index TB patient in Vietnam to 5.2 h in Ghana. CONCLUSIONS Our findings suggest that the time requirements are very modest to perform each step in the latent TB cascade of care, but to achieve full identification and management of all household contacts will require additional human resources in many settings.
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Affiliation(s)
- H Alsdurf
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - O Oxlade
- McGill International TB Centre, McGill University, 5252 Boulevard de Maisonneuve, Room 3D.58, Montreal, QC, Canada.,Respiratory Epidemiology and Clinical Research Unit (RECRU), McGill University, Montreal, QC, Canada
| | - M Adjobimey
- Programme National contre la Tuberculose-Bénin, Centre National Hospitalier Universitaire de Pneumo-Phtisiologie-Cotonou, Cotonou, Benin
| | - F Ahmad Khan
- McGill International TB Centre, McGill University, 5252 Boulevard de Maisonneuve, Room 3D.58, Montreal, QC, Canada
| | - M Bastos
- Respiratory Epidemiology and Clinical Research Unit (RECRU), McGill University, Montreal, QC, Canada.,Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - A Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.,McGill International TB Centre, McGill University, 5252 Boulevard de Maisonneuve, Room 3D.58, Montreal, QC, Canada
| | - D Boafo
- Chest Clinic, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - T N Buu
- Woolcock Institute of Medical Research, Hanoi, Vietnam
| | - L Chiang
- Provincial Tuberculosis Services, British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - V Cook
- Provincial Tuberculosis Services, British Columbia Centre for Disease Control, Vancouver, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - D Fisher
- Division of Respiratory Medicine, University of Calgary, Calgary, AB, Canada
| | - G J Fox
- The Faculty of Medicine and Health, The University of Sydney Central Clinical School, The University of Sydney, Sydney, NSW, Australia
| | - F Fregonese
- McGill International TB Centre, McGill University, 5252 Boulevard de Maisonneuve, Room 3D.58, Montreal, QC, Canada
| | - P Hadisoemarto
- Department of Public Health, Faculty of Medicine, TB-HIV Research Center, Universitas Padjadjaran, Bandung, Indonesia
| | - J C Johnston
- Provincial Tuberculosis Services, British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - F Kassa
- Programme National contre la Tuberculose-Bénin, Centre National Hospitalier Universitaire de Pneumo-Phtisiologie-Cotonou, Cotonou, Benin
| | - R Long
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - S Moayedi Nia
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC, Canada
| | - T A Nguyen
- Woolcock Institute of Medical Research, Hanoi, Vietnam
| | - J Obeng
- Chest Clinic, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - C Paulsen
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - K Romanowski
- Provincial Tuberculosis Services, British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - R Ruslami
- Department of Biomedical Sciences, Division of Pharmacology & Therapy, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - K Schwartzman
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.,McGill International TB Centre, McGill University, 5252 Boulevard de Maisonneuve, Room 3D.58, Montreal, QC, Canada.,Respiratory Epidemiology and Clinical Research Unit (RECRU), McGill University, Montreal, QC, Canada
| | - H Sohn
- Department of Epidemiology, John Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - E Strumpf
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - A Trajman
- Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - C Valiquette
- McGill International TB Centre, McGill University, 5252 Boulevard de Maisonneuve, Room 3D.58, Montreal, QC, Canada
| | - L Yaha
- Programme National contre la Tuberculose-Bénin, Centre National Hospitalier Universitaire de Pneumo-Phtisiologie-Cotonou, Cotonou, Benin
| | - D Menzies
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada. .,McGill International TB Centre, McGill University, 5252 Boulevard de Maisonneuve, Room 3D.58, Montreal, QC, Canada. .,Respiratory Epidemiology and Clinical Research Unit (RECRU), McGill University, Montreal, QC, Canada.
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12
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Ho J, Nguyen PTB, Nguyen TA, Tran HK, Nguyen VS, Nhung NV, Hoa NB, Phong TN, Luu BK, Nguyen TMH, Fox GJ, Marks GB. The role of macroscopic sputum quality assessments to optimise sputum testing for tuberculosis. Int J Tuberc Lung Dis 2017; 20:319-22. [PMID: 27046711 DOI: 10.5588/ijtld.15.0620] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Community-wide active case finding for tuberculosis (TB) using Xpert® MTB/RIF as the primary screening tool, Ca Mau Province, Viet Nam. OBJECTIVES To determine whether macroscopic sputum quality characteristics (sputum colour and volume) can be used to predict Xpert MTB-negative sputum and hence exclude sputum samples from testing. DESIGN Field staff conducted household visits to approximately 51,200 adults in 58 villages randomly selected from throughout the province. Sputum samples from all screened participants who were able to produce ⩾1 ml sputum underwent macroscopic sputum assessment and were tested with Xpert. RESULTS Of the 21,624 sputum samples tested, 159 (0.74%) were Xpert MTB-positive; 93% of the samples were 1-2 ml and nearly all were mucoid (93%) or mucopurulent (5.7%). One salivary sample was Xpert MTB-positive (2.0% of all salivary samples). The lowest positive predictive value for any sputum volume or colour characteristic was 0.66%. This was not substantially different from the overall prevalence of positive sputum Xpert MTB (0.74%). CONCLUSION Sputum colour and volume cannot be used to predict the presence or absence of M. tuberculosis in sputum detected using Xpert. These sputum quality parameters cannot therefore be used to exclude sputum samples from testing for TB.
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Affiliation(s)
- J Ho
- Woolcock Institute of Medical Research, Hanoi, Viet Nam; South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
| | - P T B Nguyen
- Woolcock Institute of Medical Research, Hanoi, Viet Nam
| | - T A Nguyen
- Woolcock Institute of Medical Research, Hanoi, Viet Nam
| | - H K Tran
- Ca Mau Centre for Social Disease Prevention, Ca Mau, Viet Nam
| | - V S Nguyen
- Ca Mau Centre for Social Disease Prevention, Ca Mau, Viet Nam
| | - N V Nhung
- National Tuberculosis Programme, Hanoi, Viet Nam
| | - N B Hoa
- Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France
| | - T N Phong
- Woolcock Institute of Medical Research, Hanoi, Viet Nam
| | - B K Luu
- Woolcock Institute of Medical Research, Hanoi, Viet Nam
| | - T M H Nguyen
- Woolcock Institute of Medical Research, Hanoi, Viet Nam
| | - G J Fox
- Woolcock Institute of Medical Research, Hanoi, Viet Nam; Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada
| | - G B Marks
- Woolcock Institute of Medical Research, Hanoi, Viet Nam; South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
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13
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Ovejero D, Lim YH, Boyce AM, Gafni RI, McCarthy E, Nguyen TA, Eichenfield LF, DeKlotz CMC, Guthrie LC, Tosi LL, Thornton PS, Choate KA, Collins MT. Cutaneous skeletal hypophosphatemia syndrome: clinical spectrum, natural history, and treatment. Osteoporos Int 2016; 27:3615-3626. [PMID: 27497815 PMCID: PMC6908308 DOI: 10.1007/s00198-016-3702-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 07/06/2016] [Indexed: 12/01/2022]
Abstract
UNLABELLED Cutaneous skeletal hypophosphatemia syndrome (CSHS), caused by somatic RAS mutations, features excess fibroblast growth factor-23 (FGF23) and skeletal dysplasia. Records from 56 individuals were reviewed and demonstrated fractures, scoliosis, and non-congenital hypophosphatemia that in some cases were resolved. Phosphate and calcitriol, but not skin lesion removal, were effective at controlling hypophosphatemia. No skeletal malignancies were found. PURPOSE CSHS is a disorder defined by the association of epidermal and/or melanocytic nevi, a mosaic skeletal dysplasia, and an FGF23-mediated hypophosphatemia. To date, somatic RAS mutations have been identified in all patients whose affected tissue has undergone DNA sequencing. However, the clinical spectrum and treatment are poorly defined in CSHS. The purpose of this study is to determine the spectrum of the phenotype, natural history of the disease, and response to treatment of hypophosphatemia. METHODS Five CSHS subjects underwent prospective data collection at clinical research centers. A review of the literature identified 45 reports that included a total of 51 additional patients, in whom the findings were compatible with CSHS. Data on nevi subtypes, bone histology, mineral and skeletal disorders, abnormalities in other tissues, and response to treatment of hypophosphatemia were analyzed. RESULTS Fractures, limb deformities, and scoliosis affected most CSHS subjects. Hypophosphatemia was not present at birth. Histology revealed severe osteomalacia but no other abnormalities. Skeletal dysplasia was reported in all anatomical compartments, though less frequently in the spine; there was no clear correlation between the location of nevi and the skeletal lesions. Phosphate and calcitriol supplementation was the most effective therapy for rickets. Convincing data that nevi removal improved blood phosphate levels was lacking. An age-dependent improvement in mineral abnormalities was observed. A spectrum of extra-osseous/extra-cutaneous manifestations that included both benign and malignant neoplasms was present in many subjects, though osteosarcoma remains unreported. CONCLUSION An understanding of the spectrum, natural history, and efficacy of treatment of hypophosphatemia in CSHS may improve the care of these patients.
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Affiliation(s)
- D Ovejero
- Skeletal Clinical Studies Unit, Craniofacial and Skeletal Disease Branch, National ADDRESSES, references BRACKETS, National Institute of Dental and Craniofacial Research, National Institutes of Health, 30 Convent Drive, Room 228, MSC 4320, Bethesda, MD, 20892-4320, USA
- Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Y H Lim
- Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA
| | - A M Boyce
- Skeletal Clinical Studies Unit, Craniofacial and Skeletal Disease Branch, National ADDRESSES, references BRACKETS, National Institute of Dental and Craniofacial Research, National Institutes of Health, 30 Convent Drive, Room 228, MSC 4320, Bethesda, MD, 20892-4320, USA
| | - R I Gafni
- Skeletal Clinical Studies Unit, Craniofacial and Skeletal Disease Branch, National ADDRESSES, references BRACKETS, National Institute of Dental and Craniofacial Research, National Institutes of Health, 30 Convent Drive, Room 228, MSC 4320, Bethesda, MD, 20892-4320, USA
| | - E McCarthy
- Department of Pathology, The Johns Hopkins University, Baltimore, MD, USA
| | - T A Nguyen
- Albert Einstein College of Medicine, Bronx, NY, USA
- Departments of Dermatology and Pediatrics, San Diego and Rady Children's Hospital, University of California, San Diego, CA, USA
| | - L F Eichenfield
- Departments of Dermatology and Pediatrics, San Diego and Rady Children's Hospital, University of California, San Diego, CA, USA
| | - C M C DeKlotz
- Division Dermatology, Department of Medicine and Department of Pediatrics, Georgetown University Medical Center, Washington, DC, USA
| | - L C Guthrie
- Skeletal Clinical Studies Unit, Craniofacial and Skeletal Disease Branch, National ADDRESSES, references BRACKETS, National Institute of Dental and Craniofacial Research, National Institutes of Health, 30 Convent Drive, Room 228, MSC 4320, Bethesda, MD, 20892-4320, USA
| | - L L Tosi
- Bone Health Program, Division of Orthopaedics and Sports Medicine, Children's National Health System, Washington, DC, USA
| | - P S Thornton
- Department of Endocrinology and Diabetes, Cook Children Medical Center, Fort Worth, TX, USA
| | - K A Choate
- Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA
| | - M T Collins
- Skeletal Clinical Studies Unit, Craniofacial and Skeletal Disease Branch, National ADDRESSES, references BRACKETS, National Institute of Dental and Craniofacial Research, National Institutes of Health, 30 Convent Drive, Room 228, MSC 4320, Bethesda, MD, 20892-4320, USA.
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14
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Abstract
Critical Casimir forces attract increasing interest due to their opportunities for reversible particle assembly in soft matter and nano science. These forces provide a thermodynamic analogue of the celebrated quantum mechanical Casimir force that arises from the confinement of vacuum fluctuations of the electromagnetic field. In its thermodynamic analogue, solvent fluctuations, confined between suspended particles, give rise to an attractive or repulsive force between the particles. Due to its unique temperature dependence, this effect allows in situ control of reversible assembly. Both the force magnitude and range vary with the solvent correlation length in a universal manner, adjusting with temperature from fractions of the thermal energy, k B T, and nanometre range to several ten kT and micrometer length scale. Combined with recent breakthroughs in the synthesis of complex particles, critical Casimir forces promise the design and assembly of complex colloidal structures, for fundamental studies of equilibrium and out-of-equilibrium phase behaviour. This review highlights recent developments in this evolving field, with special emphasis on the dynamic interaction control to assemble colloidal structures, in and out of equilibrium.
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Affiliation(s)
- V D Nguyen
- Van der Waals-Zeeman Institute, University of Amsterdam, The Netherlands. Physical Chemistry and Soft Matter, Wageningen University, Wageningen, The Netherlands
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15
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Vitry AI, Nguyen TA, Ramsay EN, Caughey GE, Gilbert AL, Shakib S, Ryan P, Esterman A, McDermott RA, Roughead EE. General practitioner management plans delaying time to next potentially preventable hospitalisation for patients with heart failure. Intern Med J 2015; 44:1117-23. [PMID: 24942781 DOI: 10.1111/imj.12512] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Accepted: 06/05/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Several studies have shown that the Australian Medicare-funded chronic disease management programme can lead to improvements in care processes. No study has examined the impact on long-term health outcomes. AIMS This retrospective cohort study assessed the association between provision of a general practitioner management plan and time to next potentially preventable hospitalisation for older patients with heart failure. METHODS We used the Australian Government Department of Veterans' Affairs (DVA) claims database and compared patients exposed to a general practitioner management plan with those who did not receive the service. Kaplan-Meier analysis and Cox proportional hazards models were used to compare time until next potentially preventable hospitalisation for heart failure between the exposed and unexposed groups. RESULTS There were 1993 patients exposed to a general practitioner management plan and 3986 unexposed patients. Adjusted results showed a 23% reduction in the rate of potentially preventable hospitalisation for heart failure at any time (adjusted hazard ratio, 0.77; 95% confidence interval, 0.64 to 0.92; P = 0.0051) among those with a general practitioner management plan compared with the unexposed patients. Within one year, 8.6% of the exposed group compared with 10.7% of the unexposed group had a potentially preventable hospitalisation for heart failure. CONCLUSIONS A general practitioner management plan is associated with delayed time to next potentially preventable hospitalisation for heart failure.
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Affiliation(s)
- A I Vitry
- Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, University of South Australia, Adelaide, Australia
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16
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Affiliation(s)
- T A Nguyen
- Division of Dermatology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, U.S.A
| | - P S Patel
- Division of Dermatology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, U.S.A
| | - K V Viola
- Division of Dermatology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, U.S.A
| | - A J Friedman
- Division of Dermatology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, U.S.A.,Department of Physiology and Biophysics, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, U.S.A
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17
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Taylor EV, Nguyen TA, Machesky KD, Koch E, Sotir MJ, Bohm SR, Folster JP, Bokanyi R, Kupper A, Bidol SA, Emanuel A, Arends KD, Johnson SA, Dunn J, Stroika S, Patel MK, Williams I. Multistate outbreak of Escherichia coli O145 infections associated with romaine lettuce consumption, 2010. J Food Prot 2013; 76:939-44. [PMID: 23726187 DOI: 10.4315/0362-028x.jfp-12-503] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Non-O157 Shiga toxin-producing Escherichia coli (STEC) can cause severe illness, including hemolytic uremic syndrome (HUS). STEC O145 is the sixth most commonly reported non-O157 STEC in the United States, although outbreaks have been infrequent. In April and May 2010, we investigated a multistate outbreak of STEC O145 infection. Confirmed cases were STEC O145 infections with isolate pulsed-field gel electrophoresis patterns indistinguishable from those of the outbreak strain. Probable cases were STEC O145 infections or HUS in persons who were epidemiologically linked. Case-control studies were conducted in Michigan and Ohio; food exposures were analyzed at the restaurant, menu, and ingredient level. Environmental inspections were conducted in implicated food establishments, and food samples were collected and tested. To characterize clinical findings associated with infections, we conducted a chart review for case patients who sought medical care. We identified 27 confirmed and 4 probable cases from five states. Of these, 14 (45%) were hospitalized, 3 (10%) developed HUS, and none died. Among two case-control studies conducted, illness was significantly associated with consumption of shredded romaine lettuce in Michigan (odds ratio [OR] = undefined; 95% confidence interval [CI] = 1.6 to undefined) and Ohio (OR = 10.9; 95% CI = 3.1 to 40.5). Samples from an unopened bag of shredded romaine lettuce yielded the predominant outbreak strain. Of 15 case patients included in the chart review, 14 (93%) had diarrhea and abdominal cramps and 11 (73%) developed bloody diarrhea. This report documents the first foodborne outbreak of STEC O145 infections in the United States. Current surveillance efforts focus primarily on E. coli O157 infections; however, non-O157 STEC can cause similar disease and outbreaks, and efforts should be made to identify both O157 and non-O157 STEC infections. Providers should test all patients with bloody diarrhea for both non-O157 and O157 STEC.
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Affiliation(s)
- E V Taylor
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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Nguyen TA, Picot C, Tran TL, Carpentier FG, Roudot AC, Parent-Massin DM. Evaluation of shellfish consumption in Nha Trang City, Southern coastal Vietnam. Malays J Nutr 2012; 18:37-45. [PMID: 23713228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
INTRODUCTION Shellfish consumption may be a significant pathway to food contaminants such as heavy metals, pesticides and phycotoxins. Currently, little information exists about consumption of shellfish in Vietnam. Such data could be of interest in terms of nutritional value or risk assessment. METHODS Consumption of shellfish was assessed using a food frequency questionnaire and validated by a 7-day recall method. Approximately 1% of the city population of Nha Trang was selected yielding a final sample of 440 participants. The participants were above 18 years of age, in apparently good health and were shellfish consumers. RESULTS In South coastal Vietnam, the types of shellfish most consumed are green mussel, squid, crab and shrimp. The mean consumption rates of the bivalves, crustaceans, gastropods, cephalopods, echinoderms and all shellfish combined were 39.3, 20.9, 16.4, 11.2, 0.3 and 88.1 g/person/day, respectively. The consumption rate was slightly higher in the age group of 30-54 years, than in the younger (18-29 years) and older (55 years and above) age groups. Shellfish is essentially purchased in the markets and temporary markets, and mostly consumed during the dry season. CONCLUSION Shellfish consumption in the Southern coastal region of Vietnam is high compared to consumption levels in other countries; it is also high compared to consumption levels of Vietnamese emigrants. Such data may be useful for further investigation on nutrition perspectives and in term of risk assessment of shellfish contaminants.
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Affiliation(s)
- T A Nguyen
- Department of Food Quality Management and Safety, Faculty of Food Processing Technology, Nha Trang University, 2 Nguyen Dinh Chieu, Nha Trang, Vietnam
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Abstract
Subcutaneous estrogen pellet implantation is commonly practiced to induce tumor promotion in nude (Nu-FOXn1(nu)) mice for xenograft tumor modeling. Twelve of 23, 18-week-old nude mice developed dysuria after estrogen pellet implantation. Physical examination revealed variably distended abdomens with palpable distended bladders. All mice were euthanatized and postmortem examinations were made. Blood samples of the mice were collected, and serum estrogen concentration was measured. Postmortem examination revealed variable dilation of the urinary bladder and unilateral or bilateral dilations of ureters and kidneys. Microscopically, 12 of 23 mice and 13 of 23 mice showed dilated urinary bladder and hydronephrosis, respectively.
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Affiliation(s)
- G Gakhar
- Department of Diagnostic Medicine/Pathology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
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20
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Abstract
HIV testing is an essential component of PMTCT. It can be offered to pregnant women through different testing models, ranging from voluntary counseling and testing (VCT) to routine and mandatory testing. This study was conducted in Hanoi, Vietnam, where HIV-prevalence is low among the general population, but high among young, urban, sexually active, male intravenous drug users. Women who want to deliver in a state hospital are routinely tested for HIV in the absence of well-defined opt-out procedures. In-depth interviews with a convenience sample of 38 seropositive pregnant women and mothers and 53 health workers explored the acceptability of routine testing. Patients and healthcare workers appeared to accept routine 'blood' tests (including HIV tests) because they feel uncomfortable discussing issues specific to HIV/AIDS. To avoid having to inform women directly about their HIV status, health workers at routine testing sites rely on the official notification system, shifting the responsibility from the hospitals to district and commune health staff. The notification system in Hanoi informs these local officials about the HIV status of people living in their catchment area without patients' consent. Our study shows that this non-confidential process can have serious social, economic and health consequences for the HIV-positive women and their children.
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Affiliation(s)
- P Oosterhoff
- Medical Committee Netherlands Vietnam, Hanoi, Vietnam.
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21
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Mebatsion HK, Verboven P, Ho QT, Mendoza F, Verlinden BE, Nguyen TA, Nicolaï BM. Modelling fruit microstructure. Commun Agric Appl Biol Sci 2006; 71:203-7. [PMID: 17191506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Affiliation(s)
- H K Mebatsion
- BIOSYST-MeBioS, Katholieke Universiteit Leuven, W. De Croylaan 42, BE-3001 Leuven, Belgium
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22
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Yoshinaga M, Phan TG, Nguyen TA, Yan H, Yagyu F, Okitsu S, Müller WEG, Ushijima H. Changing distribution of group A rotavirus G-types and genetic analysis of G9 circulating in Japan. Arch Virol 2005; 151:183-92. [PMID: 16086098 DOI: 10.1007/s00705-005-0604-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2005] [Accepted: 06/02/2005] [Indexed: 10/25/2022]
Abstract
A total of 1,797 fecal specimens from infants and children with acute gastroenteritis in Japan from July 2000 to June 2003 were tested for group A rotavirus by ELISA, RT-PCR, RNA-PAGE and latex agglutination methods. Of these, 439 were found to be positive for group A rotavirus and this presented 24.4%. In 2000-2001, G1 was the most prevalent (45.5%) followed by G2 (32.5%), G3 (12.3%), G9 (5.9%) and G4 (2.6%). However, G2 was found predominant with 40% in the following year (2001-2002). Interestingly, G9 had a rapid increase of infection up to 17.8%. In 2002-2003, G3 dominated over other G-types with 34%. Another interesting feature of the study was the demonstration of great genetic diversity among G9 strains in Japan. Worth of note was the first prevalence pattern of rotavirus G-types with an increase of G2, G3 as well as G9 and a decrease of G1 during the 20 year-survey of rotavirus infection in Japan.
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Affiliation(s)
- M Yoshinaga
- Department of Developmental Medical Sciences, Institute of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Akihara S, Phan TG, Nguyen TA, Hansman G, Okitsu S, Ushijima H. Existence of multiple outbreaks of viral gastroenteritis among infants in a day care center in Japan. Arch Virol 2005; 150:2061-75. [PMID: 15841336 DOI: 10.1007/s00705-005-0540-y] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2004] [Accepted: 03/11/2005] [Indexed: 10/25/2022]
Abstract
A total of 921 fecal specimens collected from 44 infants in a day care center (DCC) in Tokyo, Japan during June 1999 to July 2000 were tested for the presence of rotavirus, norovirus, sapovirus, astrovirus and adenovirus by reverse-transcription-multiplex polymerase chain reaction (RT-multiplex PCR) and sequence analysis. Of 88 fecal specimens from infants with acute gastroenteritis, 51.1% (45) were found to be positive for diarrheal viruses. Astrovirus was the most prevalent (15.9%, 14 of 88), followed by norovirus GII (14.8%, 13 of 88), adenovirus (12.5%, 11 of 88), and sapovirus (2.3%, 2 of 88). Viral mixed infection accounted for 5.7% (5 of 88). Interestingly, 230 of 833 (27.6%) fecal specimens collected from asymptomatic infants were also infected with diarrheal viruses. Of these, astrovirus, norovirus GII, adenovirus and sapovirus were identified in 53, 46, 96 and 22 fecal specimens (23%, 20%, 41.7%, and 9.6%, respectively). Moreover, 13 of 833 (1.6%) normal specimens showed mixed viral infections. Surprisingly, no rotavirus (known as the most common causative agent of acute gastroenteritis in DCCs) was detected in those subjects. Another interesting feature was the demonstration of five separate outbreaks of acute gastroenteritis identified in a single DCC. Outbreak A was associated with both astrovirus serotype 1 and norovirus GII/3 (known as Toronto virus cluster); Outbreak B with adenovirus 12; Outbreak C with norovirus GII/4 (Lordsdale virus cluster); Outbreak D with sapovirus GIV and Outbreak E with astrovirus serotype 1. To our knowledge, this is the first proof of multiple outbreaks of viral gastroenteritis in Japanese infants in a single DCC. Our results confirm the presence as well as the importance of these viruses and warn of the threat they pose.
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Affiliation(s)
- S Akihara
- Department of Developmental Medical Sciences, Institute of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Phan TG, Nguyen TA, Nishimura S, Nishimura T, Yamamoto A, Okitsu S, Ushijima H. Etiologic agents of acute gastroenteritis among Japanese infants and children: virus diversity and genetic analysis of sapovirus. Arch Virol 2005; 150:1415-24. [PMID: 15789264 DOI: 10.1007/s00705-005-0514-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2004] [Accepted: 02/01/2005] [Indexed: 10/25/2022]
Abstract
A total of 371 fecal specimens from infants and children with acute gastroenteritis in Maizuru, Tokyo and Osaka, Japan from July 2002 to June 2003 were tested for the presence of diarrheal viruses by reverse transcription-polymerase chain reaction (RT-PCR), reverse passive hemagglutination (PRHA), RNA-polyacrylamide gel electrophoresis (PAGE), latex agglutination and sequence analysis methods. Among diarrheal viruses detected, group A rotavirus was the most prevalent (42.2%) followed by norovirus (28.9%), group C rotavirus (8.4%), sapovirus (6.7%), adenovirus (5.3%) and astrovirus (0.9%), respectively. There was the high rate (7.6%) of viral mixed infections. Sapovirus was classified into 6 genotypes (GI/1, GI/4, GI/5, GI/6 and GII/1 and one novel tentatively called GII/5). It is noteworthy that genogroup II sapovirus can be classified into 5 genotypes. Our findings confirmed the presence of many diarrheal viruses co-circulating among Japanese infants and children and showed the great genetic diversity among sapoviruses.
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Affiliation(s)
- T G Phan
- Department of Developmental Medical Sciences, Institute of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Phan TG, Nguyen TA, Yan H, Okitsu S, Ushijima H. A novel RT-multiplex PCR for enteroviruses, hepatitis A and E viruses and influenza A virus among infants and children with diarrhea in Vietnam. Arch Virol 2005; 150:1175-85. [PMID: 15645373 DOI: 10.1007/s00705-004-0465-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2004] [Accepted: 11/10/2004] [Indexed: 10/25/2022]
Abstract
A novel reverse transcription-multiplex polymerase chain reaction (RT-multiplex PCR) assay that can detect enteroviruses, hepatitis A and E viruses and influenza A virus from various hosts (avian species, human, swine and horse) was developed. The identification of that group of viruses was performed with the mixture of four pairs of published specific primers (F1 and R1, P3 and P4, 2s and 2as, MMU42 and MMU43) for amplifying viral genomes and specifically generated four different amplicon sizes of 440, 267, 146 and 219 bp for enteroviruses, hepatitis A and E viruses and influenza A virus, respectively. A total of 276 fecal specimens (previously screened for rotavirus, adenovirus, norovirus, sapovirus and astrovirus-negative) from infants and children admitted into hospital with acute gastroenteritis in Ho Chi Minh city, Vietnam during October 2002 and September 2003 were collected and further tested for the presence of those viruses by RT-multiplex PCR. Enteroviruses were identified in 27 specimens and this represented 9.8%. No hepatitis A and E viruses and influenza A virus was found among these subjects. The sensitivity and specificity of RT-multiplex PCR were also assessed and demonstrated the strong validation against RT-monoplex PCR. Taken together, the findings clearly indicated that this novel RT-multiplex PCR is a simple and potential assay for rapid, sensitive, specific and cost-effective laboratory diagnosis to investigate molecular epidemiology of acute gastroenteritis caused by enteroviruses, hepatitis A and E viruses and influenza A virus. This report is the first, to our knowledge, detecting these kinds of viruses in diarrheal feces from infants and children in Vietnam.
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Affiliation(s)
- T G Phan
- Department of Developmental Medical Sciences, Institute of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Phan TG, Okame M, Nguyen TA, Nishio O, Okitsu S, Ushijima H. Genetic diversity of sapovirus in fecal specimens from infants and children with acute gastroenteritis in Pakistan. Arch Virol 2004; 150:371-7. [PMID: 15480859 DOI: 10.1007/s00705-004-0401-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2004] [Accepted: 07/14/2004] [Indexed: 11/24/2022]
Abstract
A total of 517 fecal specimens collected from infants and children with acute gastroenteritis in Karachi city, Pakistan during 1990-1994 were examined for the presence of sapovirus by RT-PCR and sequence analysis methods. Sapovirus was identified in 17 of 517 (3.2%) specimens. Sapovirus was further clustered into three distinct genogroups (I, II and IV) and these presented 70.6%, 23.5% and 5.9%, respectively. Our results clearly indicated that sapovirus could be classified into 7 GI and 4 GII genotypes. It was noteworthy to point out that sapovirus detected among Pakistani infants and children with acute gastroenteritis demonstrated the great genetic diversity and presented novel sapovirus genotypes.
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Affiliation(s)
- T G Phan
- Department of Developmental Medical Sciences, Institute of International Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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Vaughan J, Ngamtrakulpanit L, Pajewski TN, Turner R, Nguyen TA, Smith A, Urban P, Hom S, Gaston B, Hunt J. Exhaled breath condensate pH is a robust and reproducible assay of airway acidity. Eur Respir J 2004; 22:889-94. [PMID: 14680074 DOI: 10.1183/09031936.03.00038803] [Citation(s) in RCA: 188] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Exhaled breath condensate (EBC) pH is low in several lung diseases and it normalises with therapy. The current study examined factors relevant to EBC pH monitoring. Intraday and intraweek variability were studied in 76 subjects. The pH of EBC collected orally and from isolated lower airways was compared in an additional 32 subjects. Effects of ventilatory pattern (hyperventilation/hypoventilation), airway obstruction after methacholine, temperature (-44 to +13 degrees C) and duration of collection (2-7 min), and duration of sample storage (up to 2 yrs) were examined. All samples were collected with a disposable condensing device, and de-aerated with argon until pH measurement stabilised. Mean EBC pH (n=76 subjects, total samples=741) was 7.7+/-0.49 (mean+/-SD). Mean intraweek and intraday coefficients of variation were 4.5% and 3.5%. Control of EBC pH appears to be at the level of the lower airway. Temperature of collection, duration of collection and storage, acute airway obstruction, subject age, saliva pH, and profound hyperventilation and hypoventilation had no effect on EBC pH. The current authors conclude that in health, exhaled breath condensate pH is slightly alkaline, held in a narrow range, and is controlled by lower airway source fluid. Measurement of exhaled breath condensate pH is a simple, robust, reproducible and relevant marker of disease.
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Affiliation(s)
- J Vaughan
- Division of Pediatric Respiratory Medicine, University of Virginia, Charlottesville, Virginia 22908, USA
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Moscarello MA, Mak B, Nguyen TA, Wood DD, Mastronardi F, Ludwin SK. Paclitaxel (Taxol) attenuates clinical disease in a spontaneously demyelinating transgenic mouse and induces remyelination. Mult Scler 2002; 8:130-8. [PMID: 11990870 DOI: 10.1191/1352458502ms776oa] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Treatment with paclitaxel by four intraperitoneal injections (20 mg/kg) 1 week apart attenuated clinical signs in a spontaneously demyelinating model, if given with onset of clinical signs. If given at 2 months of age (1 month prior to clinical signs), disease was almost completely prevented The astrogliosis, prominent in our model, was reversed by paditaxel as determined by astrocyte counts and quantitation of GFAP. Electron microscopic examination of affected regions at 2.5 months demonstrated that the myelin was generally normal. By 4 months of age, demyelination was common in the superior cerebellar peduncle, maximal at 6 months, but continued to 8 months. In addition to myelin vacuolation and nude axons, the presence of many thin myelin sheaths suggested remyelination or partial demyelination. Although no evidence of oligodendrocyte loss was seen, nuclear changes were observed. To substantiate that remyelination was occurring, we measured MBP (18.5 kDa), MBP-exon II, Golli-MBP, TP8, Golli-MBP-J37, platelet-derived growth factor alpha (PDGFR alpha) and sonic hedgehog (SHH). Of these TP8, PDGFR alpha and SHH were up-regulated in the untreated transgenic. After paditaxel treatment, MBP-Exon II, TP8, PDGFR alpha and SHH were further up-regulated. We concluded that some of the effects of paditaxel were to stimulate proteins involved in early myelinating events possibly via a signal transduction mechanism.
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Affiliation(s)
- M A Moscarello
- Department of Structural Biology, The Hospital for Sick Children, Toronto, Ontario, Canada.
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Liesenfeld O, Nguyen TA, Pharke C, Suzuki Y. Importance of gender and sex hormones in regulation of susceptibility of the small intestine to peroral infection with Toxoplasma gondii tissue cysts. J Parasitol 2001; 87:1491-3. [PMID: 11780848 DOI: 10.1645/0022-3395(2001)087[1491:iogash]2.0.co;2] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
This study was performed to investigate whether the gender and sex hormones play a role in susceptibility of the small intestine of mice to peroral infection with Toxoplasma gondii tissue cysts. Female animals died significantly earlier than males, and early mortality of females was associated with greater numbers of tachyzoites and severe necrosis in their small intestines. Treatment of female mice with testosterone resulted in markedly reduced intestinal parasite numbers and pathology. Thus, the gender and sex hormones are important factors for determining susceptibility of the small intestine to T. gondii infection.
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Affiliation(s)
- O Liesenfeld
- Department of Immunology and Infectious Diseases, Research Institute, Palo Alto Medical Foundation, California 94301, USA
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Abstract
AIMS To assess the prevalence of HIV infection among young drug users in Haiphong and, secondarily, to document the current patterns of drug use and sexual behavior in them. Design, setting and participants. A cross-sectional survey of drug users 15-30 years old, identified from police lists and by the snowballing method between March 15 and May 30, 1999, was conducted in Haiphong City. MEASUREMENTS Subjects (n = 520: 514 males and six females) were interviewed and donated blood specimens for HIV-1 antibody testing. FINDINGS Mean age of the subjects was 25 years (range 15-30 years). The prevalence of HIV among injecting drug users (IDUs) was 74% and among drug users not reporting injecting was 46% (92/201). Sixty-one per cent (319) reported injecting drugs. Among injectors, 72% used heroin, and 68% had shared needles. Factors related to the presence of HIV antibody among IDUs were sharing needles (OR: 4.12) and injecting more than 31 times per month (OR: 2.37). Extramarital sex within the last 6 months was reported by 44% of single and 24% of married IDUs. CONCLUSION The high HIV-1 prevalence in drug users and their frequent sexual mixing with the non-drug-using population suggests that preventive interventions for reduction of high-risk drug taking and sexual activities are urgently needed in these populations. Interventions through public sexually transmitted infection (STI) clinics are unlikely to have much impact, as only 16% of IDUs with an STI attended a public STI clinic.
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Affiliation(s)
- T A Nguyen
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
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Luo S, Nguyen TA, Cartier GE, Olivera BM, Yoshikami D, McIntosh JM. Single-residue alteration in alpha-conotoxin PnIA switches its nAChR subtype selectivity. Biochemistry 1999; 38:14542-8. [PMID: 10545176 DOI: 10.1021/bi991252j] [Citation(s) in RCA: 93] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
alpha-Conotoxins are disulfide-rich peptides that are competitive antagonists of nicotinic acetylcholine receptors (nAChRs). Despite their small size, different alpha-conotoxins are able to discriminate among different subtypes of mammalian nAChRs. In this report, the activity of two peptides from the venom of Conus pennaceus, alpha-conotoxins PnIA and PnIB, are examined. Although the toxins differ in only two residues, PnIA preferentially blocks alpha3beta2 nAChRs, whereas PnIB prefers the alpha7 subtype. Point mutation chimeras of these alpha-conotoxins were synthesized and their activities assessed on Xenopus oocytes expressing specific nAChRs. Change of a single residue, Ala10 to Leu, in PnIA (to form PnIA [A10L]) converts the parent peptide from alpha3beta2-preferring to alpha7-preferring; furthermore, PnIA [A10L] blocks the alpha7 receptor with an IC(50) (12.6 nM) that is lower than that of either parent peptide. Kinetic analysis indicates that differences in affinity among the analogues are primarily due to differences in off-rate, with PnIA [A10L]'s interaction with alpha7 having the smallest off-rate (k(off) = 0.17 min(-)(1)). Thermodynamic analysis indicates that Leu10 enhances the peptide's interaction with alpha7, but not alpha3beta2, receptors, whereas Ser11 (in PnIA [N11S]) reduces its affinity for both alpha7 and alpha3beta2 nAChRs.
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Affiliation(s)
- S Luo
- Department of Biology, University of Utah, Salt Lake City, Utah 84112, USA
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Nguyen TA, Hoivik D, Lee JE, Safe S. Interactions of nuclear receptor coactivator/corepressor proteins with the aryl hydrocarbon receptor complex. Arch Biochem Biophys 1999; 367:250-7. [PMID: 10395741 DOI: 10.1006/abbi.1999.1282] [Citation(s) in RCA: 113] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
MCF-7 human breast cancer cells express the aryl hydrocarbon receptor (AhR), and treatment with AhR agonists such as 2,3,7, 8-tetrachlorodibenzo-p-dioxin (TCDD) inhibits estrogen receptor (ER)-mediated responses. This study investigates physical and functional interactions of the AhR complex with a prototypical coactivator (estrogen receptor associating protein 140, ERAP 140) and corepressor (silencing mediator for retinoic acid and thyroid hormone receptor, SMRT) for ER and other members of the nuclear receptor superfamily. The AhR, AhR nuclear translocator (Arnt), and AhR/Arnt proteins were coimmunoprecipitated with 35S-ERAP 140 and 35S-SMRT and, in gel mobility shift assays, AhR/Arnt binding to 32P-dioxin response element (DRE) was enhanced by ERAP-140 and inhibited by SMRT; supershifted bands were not observed. In transactivation assays, coactivator and corepressor proteins enhanced or inhibited AhR-mediated gene expression; however, these responses varied with the amount of coactivator/corepressor expression. These results confirmed functional and physical interactions of AhR/Arnt with ERAP 140 and SMRT in breast cancer cells.
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Affiliation(s)
- T A Nguyen
- Department of Veterinary Physiology and Pharmacology, Texas A&M University, College Station, Texas, 77843-4466, USA
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Liesenfeld O, Kang H, Park D, Nguyen TA, Parkhe CV, Watanabe H, Abo T, Sher A, Remington JS, Suzuki Y. TNF-alpha, nitric oxide and IFN-gamma are all critical for development of necrosis in the small intestine and early mortality in genetically susceptible mice infected perorally with Toxoplasma gondii. Parasite Immunol 1999; 21:365-76. [PMID: 10417671 DOI: 10.1046/j.1365-3024.1999.00237.x] [Citation(s) in RCA: 120] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
We previously reported that genetic susceptibility of mice to peroral infection with T. gondii is associated with CD4+ T cell-dependent, interferon (IFN)-gamma-mediated necrosis of their small intestine. We examined the role of tumour necrosis factor (TNF)-alpha and nitric oxide (NO), in addition to IFN-gamma. At 7 days after infection, a marked increase in CD4+ T cells was observed in lamina propria mononuclear cells (LPC) of the small intestine as compared with normal mice, and significantly greater amounts of mRNA for IFN-gamma, TNF-alpha, and inducible NO synthase (iNOS) were detected in LPC of the small intestine of infected than uninfected animals. Treatment of infected mice with anti-TNF-alpha monoclonal antibody (mAb) or the iNOS inhibitor, aminoguanidine, prevented necrosis and prolonged time to death. Infected iNOS-targeted mutant mice did not develop the disease whereas infected, control mice did. Treatment with anti-TNF-alpha mAb did not affect the expression of IFN-gamma in the LPC but inhibited expression of iNOS in the infected mice, indicating the role of TNF-alpha in the induction of iNOS. These results suggest that NO induced by a combination of IFN-gamma and TNF-alpha through activation of iNOS is a critical mediator of intestinal pathology and contributes to early mortality in genetically susceptible mice.
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Affiliation(s)
- O Liesenfeld
- Department of Immunology and Infectious Diseases, Research Institute, Palo Alto Medical Foundation, Palo Alto, CA 94301, USA
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Abstract
We have measured the expression and activity of peptidylarginine deiminase (PAD, EC 3.5.3.15), the enzyme responsible for converting arginyl residues in proteins to citrullines, in normal mouse brain homogenate. PAD transcripts were detected as early as five days and were maximal at one month of age. The enzyme protein was also detected at 5 days in an antibody dependent assay and was maximal at 2 months of age, 1 month later than the maximum expression of transcripts. As expected, enzyme activity had a similar developmental profile to that of the enzyme protein. In isolated mouse brain compact myelin, the activity was highest at 15 days and fell rapidly to 15% of this level by 1-2 months. In the 'loose' myelin fraction (heavy myelin) it remained at the same high level form from 15 days to 8 months. The activity in compact myelin was about 15 times greater than the activity in brain homogenate, suggesting much of the enzyme was localized to myelin.
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Affiliation(s)
- L B Pritzker
- Structural Biology and Biochemistry, The Hospital for Sick Children, Toronto, Ontario, Canada
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Cao XT, Kneen R, Nguyen TA, Truong DL, White NJ, Parry CM. A comparative study of ofloxacin and cefixime for treatment of typhoid fever in children. The Dong Nai Pediatric Center Typhoid Study Group. Pediatr Infect Dis J 1999; 18:245-8. [PMID: 10093945 DOI: 10.1097/00006454-199903000-00007] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Despite concerns about safety in children, fluoroquinolone antibiotics have become the treatment of choice in patients with multidrug-resistant typhoid fever in Vietnam. However, quinolone-resistant strains of Salmonella typhi have recently been reported from Vietnam; and if quinolone resistance becomes established, alternative oral treatment options will be needed. OBJECTIVE Cefixime, an orally administered third generation cephalosporin, was compared with ofloxacin for the treatment of uncomplicated typhoid fever in children. METHODS In an open trial children with suspected typhoid fever were randomized to receive either ofloxacin (10 mg/kg/day in two divided doses) for 5 days or cefixime (20 mg/kg/day in two divided doses) for 7 days. RESULTS S. typhi was isolated from 82 patients (44 in the cefixime group, 38 in the ofloxacin group) and 70 (85%) of the isolates were multidrug-resistant. Median (95% confidence interval, range) fever clearance times were 4.4 (4 to 5.2, 0.2 to 9.9) days for ofloxacin recipients and 8.5 (4.2 to 9, 1.8 to 15.2) days for cefixime-treated patients (P < 0.0001). There were 11 treatment failures (10 acute and one relapse) in the cefixime group and 1 acute treatment failure in the ofloxacin group (mean difference, 22%; 95% confidence interval, 9 to 36%). CONCLUSION Short course treatment with cefixime may provide a useful alternative treatment in cases of uncomplicated typhoid fever in children, but it is less effective than short course treatment with ofloxacin.
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Affiliation(s)
- X T Cao
- Dong Nai Pediatric Centre, Bien Hoa City, Dong Nai Province, Vietnam
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Abstract
BACKGROUND Osteopontin is a tubular-derived glycoprotein with macrophage chemoattractant properties. Our previous observations demonstrate that osteopontin is involved in the accumulation of macrophages within the renal cortex of rats following unilateral ureteral obstruction (UUO). METHODS The present study performed Northern and Western blot analyses of isolated proximal tubular cells exposed to exogenous angiotensin II, and cultured rat proximal tubular cells subjected to one hour of cyclic mechanical stretch, which provided insight into mechanisms involving the proximal tubular renin-angiotensin system in the increased expression of cortical osteopontin following hydronephrosis. RESULTS In situ hybridization, using a 35S-labeled antisense riboprobe, showed osteopontin mRNA transcription localized to the cortical tubules of the obstructed kidney. Freshly isolated proximal tubules incubated with angiotensin II (10-5 M) for one hour had increased osteopontin mRNA and protein expression by Northern and Western blot analyses, respectively. Pre-treatment of proximal tubules with losartan (10-5 M) for one hour prior to the addition of exogenous angiotensin II (10-5 M) decreased osteopontin mRNA and protein expression. Rat proximal tubule cells subjected to cyclic mechanical stretch for one hour exhibited a 2.1-fold increment in osteopontin mRNA levels, which was normalized following pre-treatment with losartan. CONCLUSIONS This study provides evidence that angiotensin II, produced by the proximal tubule in the obstructed kidney as a result of mechanical injury, possibly mechanical stretch, may stimulate angiotensin II type I receptor activation, leading to up-regulated osteopontin expression and secretion by the proximal tubule, thereby facilitating macrophage recruitment into the renal interstitium.
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Affiliation(s)
- J R Diamond
- Departments of Medicine and Cellular and Molecular Physiology and Department of Surgery, Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
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Abstract
A retrospective review of 48 consecutive morbidly obese patients with urolithiasis who were treated successfully by endoscopic modalities over 3.5 years was performed. Of the 73 endoscopic procedures, 48 were ureteroscopic laser lithotripsy (UL), 4 were ureteroscopic basket extraction, and 21 were percutaneous nephrolithotripsy (PCNL). The patients' weight ranged from 205 to 385 lbs. (average 286 lbs.). Their abdominal girth ranged from 53 to 65 inches (average 59 inches). Twenty-six patients had one procedure, eight patients had bilateral procedures, eleven patients had two procedures, and three patients had three procedures with utilization of either multiple ureteroscopic treatments or the combination of percutaneous and ureteroscopic techniques. The stone-free rate after one procedure was 77.8% for UL and 60% for PCNL. The stone-free rate after planned repeat procedures was 97% for UL/UL and 89% for PCNL/UL. There were two minor complications. Forty-eight procedures were performed on an outpatient basis, and the remaining 25 procedures necessitated hospital admission (average 3.6 days). Morbidly obese patients with urolithiasis who are unable to have SWL because of their body weight and abdominal girth can be treated successfully with UL, ureteroscopic basket extraction, and PCNL with efficacy comparable to that in patients of normal weight and with minimal morbidity. Many renal calculi were treated with UL alone with a high success rate.
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Affiliation(s)
- T A Nguyen
- Section of Urology, The Milton S. Hershey Medical Center, Penn State Geisinger Health System, Hershey, Pennsylvania, USA
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Kulak JM, Nguyen TA, Olivera BM, McIntosh JM. Alpha-conotoxin MII blocks nicotine-stimulated dopamine release in rat striatal synaptosomes. J Neurosci 1997; 17:5263-70. [PMID: 9204910 PMCID: PMC6793802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Activation of presynaptic nicotinic acetylcholine receptors (nAChRs) can induce the release of neurotransmitters such as dopamine and norepinephrine in the CNS. Accumulating evidence suggests that distinct nAChR subtypes are involved; however, it has been difficult to determine the subunit composition of these receptors, in part because of the lack of a sufficient variety of selective nAChR ligands. We present experimental data that at least two different nAChR complexes are involved in dopamine release, one of which has an alpha3/beta2 subunit interface. The recently discovered peptide alpha-conotoxin MII is a potent and selective inhibitor of rat nAChRs containing an interface formed by alpha3 and beta2 subunits. We used this peptide to examine nicotine-stimulated release of dopamine from rat striatal synaptosomes and of norepinephrine from hippocampal synaptosomes. MII (100 nM) blocks 34-49% of the nicotine-stimulated dopamine release, but not dopamine release evoked by elevated [K+]. Furthermore, two peptides structurally related to alpha-conotoxin MII, namely alpha-conotoxin MI (selective for alpha1beta1gammadelta nAChRs) and alpha-conotoxin ImI (selective for alpha7-containing nAChRs), have no effect on nicotine-stimulated dopamine release. The results indicate that one third to half of the dopamine release in the striatal preparation is mediated by nAChRs with an alpha3/beta2 subunit interface. In contrast, </=10% of nicotine-stimulated release of norepinephrine from hippocampal synaptosomes is modulated by nAChRs with alpha3/beta2 subunit interfaces.
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Affiliation(s)
- J M Kulak
- Department of Biology, University of Utah, Salt Lake City, Utah, 84112, USA
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Suzuki Y, Rani S, Liesenfeld O, Kojima T, Lim S, Nguyen TA, Dalrymple SA, Murray R, Remington JS. Impaired resistance to the development of toxoplasmic encephalitis in interleukin-6-deficient mice. Infect Immun 1997; 65:2339-45. [PMID: 9169772 PMCID: PMC175324 DOI: 10.1128/iai.65.6.2339-2345.1997] [Citation(s) in RCA: 105] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The role of interleukin-6 (IL-6) in the pathogenesis of toxoplasmic encephalitis (TE) was examined by using IL-6-targeted mutant (IL-6(-/-)) mice. At 4 and 8 weeks after infection with the ME49 strain of Toxoplasma gondii, significantly greater numbers of T. gondii cysts and areas of inflammation associated with tachyzoites were observed in brains of IL-6(-/-) mice than in those of control mice. Large areas of necrosis were observed only in brains of IL-6(-/-) mice. Tachyzoites were frequently detected in the areas of necrosis, suggesting that necrosis was caused by proliferation of the parasite. These results indicate that IL-6 is protective against development of TE by preventing formation of T. gondii cysts and proliferation of tachyzoites in brains of infected mice. Whereas in brains of control mice, large numbers of inflammatory cells were always observed in areas where tachyzoites were detected, in brains of IL-6(-/-) mice, only small numbers of inflammatory cells were observed in many areas with tachyzoites. Lymphocyte preparations isolated from brains of infected control mice had significantly higher ratios of gamma/delta T cells and CD4+ alpha/beta T cells but lower ratios of CD8+ alpha/beta T cells compared to those of infected IL-6(-/-) mice. There were no differences in the ratios of these T-cell subsets in spleens between these mice. The amounts of mRNA for gamma interferon (IFN-gamma) detected by reverse transcriptase PCR were significantly smaller in brains of IL-6(-/-) mice than in those of control mice, whereas amounts of IL-10 mRNA were greater in the former than in the latter. IL-6 mRNA was detected only in infected control mice. The protective activity of IL-6 against development of TE appears to be through its ability to stimulate IFN-gamma production and induce infiltration and accumulation of different T-cell subsets in brains of infected mice.
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Affiliation(s)
- Y Suzuki
- Department of Immunology and Infectious Diseases, Research Institute, Palo Alto Medical Foundation, California 94301, USA.
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Decter RM, Furness PD, Nguyen TA, McGowan M, Laudermilch C, Telenko A. Reproductive understanding, sexual functioning and testosterone levels in men with spina bifida. J Urol 1997; 157:1466-8. [PMID: 9120984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE We assessed the sexual functioning and understanding in men with myelodysplasia. MATERIALS AND METHODS Of the 378 patients with myelodysplasia followed at our multidisciplinary clinic 170 are adults, including 58 men older than 18 years. A total of 57 men was available for interview. A questionnaire was administered to determine patient educational level, sexual understanding, sexual function and marital status, and serum testosterone levels were measured. RESULTS The majority of the patients learned about sexual reproduction from school classes with 48 (84%) having achieved a twelfth grade education or higher. A total of 41 patients (72%) accurately described the basic concepts of reproductive physiology. Penile erections were experienced by 41 men (72%) including 27 (66%) who ejaculated with erection. Three patients ejaculated without erection. Sexual intercourse was attempted by 20 men (35%). Of the 11 patients (19%) who attempted to father children 8 (14%) were successful. Twelve patients (21%) have been married, including 2 who are divorced. Serum testosterone levels in 44 patients were normally distributed. CONCLUSIONS Sexual reproductive understanding, and erectile and ejaculatory function are present in many men with myelodysplasia. The level of the neurological lesion was not predictive of erectile or ejaculatory function but it appears that reproductive potential is favored by lower and less severe lesions. All but 1 of the 8 patients who fathered children had an L5 or sacral neurological level lesion, each was ambulatory and none had a ventriculoperitoneal shunt at the time of conception. These data may prove useful when counseling patients and their parents about eventual sexual performance.
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Affiliation(s)
- R M Decter
- Department of Surgery, Milton S. Hershey Medical Center, Pennsylvania State University College of Medicine, Hershey, USA
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Tassin X, Nguyen TA, Godlewski G, Ould Said A, Joujoux JM, Dubois JB. [Giant cystadenocarcinoma of pancreatic origin and supra-mesocolic topography]. Ann Gastroenterol Hepatol (Paris) 1991; 27:207-10. [PMID: 1746873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The authors report a case of pancreatic cystadenocarcinoma developed within a few days as a voluminous cyst of the left hypochondriac region, pushing away the organs of the supramesocolic zone. The tumor removal is easily performed because it was surrounded by a fibrotic capsule and their was no precise attach to the neighbouring organs. Diagnosis is carried out by microscopic examination revealing a tubulo-papillary cystadenocarcinoma of the pancreas. Quasi synchronous apparition of disseminated hepatic metastases advocates for heavy malignancy and justifies intrahepatic chemotherapy.
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Affiliation(s)
- X Tassin
- Département de Chirurgie Digestive et de Cancérologie Digestive, Hôpital Caremeau, CHR de Nimes, Montpellier
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Pokrovskiĭ VI, Nguyen TA, Godovannyĭ BA. [Dengue hemorrhagic fever in the developing countries of southeast Asia]. Zh Mikrobiol Epidemiol Immunobiol 1986:99-102. [PMID: 2878544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Pokrovskiĭ VI, Nguyen TA, Godovannyĭ BA. [Filariasis in the developing countries of southeast Asia]. Med Parazitol (Mosk) 1986:47-50. [PMID: 3762497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Ruiz-Ceretti E, Nguyen TA, Schanne OF, Caille JP. An electrogenic component of resting potential in rabbit ventricular muscle? Am J Physiol 1981; 240:C28-34. [PMID: 6257115 DOI: 10.1152/ajpcell.1981.240.1.c28] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The resting potential and the intracellular Na and K concentrations (Nai, Ki) were determined at several extracellular K concentrations (Ko) between 0.5 and 18 mM and after inhibition of the sodium pump with 0.5 microM ouabain. Exposure to low Ko (0.5 mM) produced a transient hyperpolarization (from -80 to -100 mV) followed by a depolarization that led to a stable potential of -60 mV within 25 min. Similar potential levels were observed in the presence of ouabain regardless of the Ko/Ki ratio. Intracellular sodium increased at Ko < 5 mM, whereas Ki rose at Ko less than or equal to 1.0 mM. Because of the large decrease of Ki at Ko = 0.5 mM, Ko/Ki was the same at 0.5 and 1 mM. However, the resting potentials at the steady state differed by 50 mV at these concentrations. A PNa/PK of 0.032 for the control conditions was obtained with the Mullins-Noda equation using 2.5 as the Na-K coupling ratio. This PNa/PK value yielded a Goldman potential of -69 mV; so we estimated that electrogenic sodium extrusion contributed -10 mV to the resting potential. The size of the electrogenic potential increased as Ko was lowered from 5 to 1 mM. This finding suggests that the control of the Na-K coupling ratio may be independent of the mechanism that controls the pumping rate.
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