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Introduction: Transthyretin (ATTR) amyloidosis is a severe rare disease with wide range of characters without specific symptoms including the damage to the peripheral nervous system and cardiac involvement. Case report: A 60-year-old female patient represented with weakness and paresthesia in the distal parts of the lower limbs, impeding walking for 2 years. Initially, symptoms were considered as a manifestation of degenerative stenosis of the lumbar spine, decompressive laminectomy was performed but the symptoms after surgical treatment persisted. Based on data from clinical and electroneuromyographic examinations, axonal sensorimotor polyneuropathy was diagnosed. Genetic testing of the patient, her elder sister, son and daughter using the Sanger sequencing method detected a variant of the nucleotide sequence in the fourth exon of the transthyretin gene (Chr18: 29178562, rs148538950, NM_000371.3: c.G368A: p. Arg123His) in the heterozygous state. A subcutaneous fatty tissue biopsy of abdominal wall with a Congo red stain and polarized light examination revealed amyloid microdeposits, grade CR 1+ (minimal deposits), confirmed the diagnosis of familial ATTR-amyloidosis. Echocardiography revealed concentric left ventricular wall thickening with normal end diastolic size and volume, preserved ejection fraction, left atrial enlargement, pulmonary hypertension and type 1 diastolic dysfunction. Specific anti-amyloid therapy — tafamidis was prescribed. Conclusion: In patients with peripheral polyneuropathy and left ventricular hypertrophy of unknown etiology, a complex examination is necessary for the timely detection and treatment of amyloid polyneuropathy and cardiomyopathy.

Chronic heart failure (CHF) occurs in 4.3-28% of patients with diabetes mellitus and is most often associated with the presence of coronary heart disease, arterial hypertension and the direct adverse effects of insulin-resistance, hyperinsulinemia and hyperglycemia on the myocardium. Diabetes mellitus occurs in 12-47% of patients with CHF and can develop within several years after a diagnosis of HF in 22% of patients due to insulin-resistance of failure tissues. The presence of diabetes mellitus leads to a greater severity of clinical symptoms and hospitalization rate, worsening of quality of life and prognosis in CHF. A decreased left ventricular ejection fraction is an independent predictor of the poor prognosis in the patients with diabetes mellitus. The algorithm of the treatment of CHF in the patients with and without diabetes mellitus is not fundamentally different, but it requires taking into account the metabolic effects of the prescribed drugs. Angiotensin receptor-neprilysin inhibitor are increasingly used in clinical practice and are gradually replacing angiotensin-converting enzyme inhibitors and sartans in CHF both without diabetes mellitus and in its presence. Recently, the effectiveness of type 2 sodium glucose cotransporter inhibitors has been proven in patients with CHF with and without diabetes mellitus. This review is devoted to the relationship of diabetes mellitus and CHF, as well as the approaches to the management of such comorbid patients.

Cardiac amyloidosis (amyloid cardiomyopathy) is a disease damage to the heart caused by extracellular amyloid deposition. In some cases, there may be local damage to the structures of the heart, for example, the atria; more often, heart damage is part of a systemic (generalized) pathology. Depending on the amyloid precursor protein, 36 types of amyloidosis are described, among which hereditary and acquired forms are distinguished. Cardiac amyloidosis is diagnosed 1) in the case of the amyloid infiltration in the myocardial bioptates or 2) in the case of non-cardiac amyloid deposition and the left ventricular wall thickening >12 mm without arterial hypertension and other reasons. The heart is most often affected in AL-, ATTR-, AA-, AANF-types of amyloidosis. Cardiac amyloidosis should be considered in patients with a heart failure with an unclear etiology, especially with preserved left ventricular ejection fraction, refractory to treatment, with proteinuria and CKD 4-5, in patients with idiopathic atrial fibrillation and conduction disturbances, in patients with left ventricular wall thickening of unclear etiology, low ECG voltage, unexplained arterial hypotension and pulmonary hypertension. Screening for cardiac amyloidosis should include non-invasive methods such as electrophoresis and immunofixation of blood and urine proteins, the free light lambda and kappa chains of immunoglobulins, 99Tc-DPD scintigraphy, genetic testing (if hereditary variants of amyloidosis are suspected), as well as a histological examination of biopsy samples stained with Congo red and polarizing microscopy.

Background and Aims: A panel of experts (the Poseidon Group) introduced a new and more detailed stratification for poor ovarian responders in order to predict the prognosis of IVF outcome according to the sensitivity to FSH. However, various arguments about the management strategy of these patients still remain, including the convenience and the cost. Therefore, this study was conducted to compare the efficacy of mild and conventional GnRH antagonist ovarian stimulation prescribed in patients classified in Poseidon Group 4.Methods: This retrospective cohort study included 359 poor responder patients (Poseidon Group 4) treated with mild or conventional GnRH antagonist stimulation regimens from 8/2017 to 7/2019 at Tam Anh Hospital ART Center. The main outcomes were the index of Follicular Output Rate (FORT) or Follicle to Oocyte Index (FOI), the number of day-2 embryos and top-quality embryos obtained. The t-test and Mann–Whitney U test in SPSS v25.0 was used to analyze the continuous data and Chi-squared/Exact test was used for binary variables. Multiple linear regression analysis was done by using Stata versions 15.0 to measure association between primary endpoints with stimulation regimen controlled for covariates and possible confounding factors.Results: In the overall group of poor responders, the conventional GnRH antagonist protocol performed better than the mild protocol. Subsequently, data were analyzed according to the AFC. In women with AFC < 3, no significant differences were observed between the 2 regimens regarding FORT (p = 0.71), FOI (p = 0.12), the number of day-2-embryos (p = 0.052) and the number of top-quality embryos (p = 0.26). In contrast, in women with AFC ≥ 3, mild stimulation regimen resulted in significantly poorer outcome compared to the conventional GnRH antagonist regimen, regarding FORT (p < 0.01), FOI (p < 0.01), the number of day-2-embryos (p < 0.01) and top-quality embryos (p = 0.01).Conclusions: Considering poor responders classified in Poseidon Group 4, both ovarian stimulation regimens resulted in similar outcome for patients with a very low ovarian reserve (AFC < 3). In contrast, the GnRH conventional antagonist protocol with maximum initial FSH dose (300–375 IU/day) and supplementary LH (75–150 IU/day) was more effective than the mild one for patients whose ovarian reserve was less reduced. The Clinical Trial was approved by the Ethnical Biomedical Research Committee Tam Anh General Hospital.

Uroflowmetry is a simple test measuring the volume of voided urine in a period of time. Being the only non-invasive test among urodynamic methods, it is most commonly ordered by urologists to evaluate the urination of patients, especially in males over 50 years old with lower urinary tract symptoms (LUTS). In Vietnam, however, the test is only available in urology department in large hospitals or medical diagnostic centers as it is relatively new in the field and the cost of a uroflowmeter device is still very high. Aiming to make the device more affordable to urologists and clinics and thus increase accessibility of Vietnamese patients to the test, the engineers from Biomedical Engineering Department, Ho Chi Minh International University have developed IUROF, an electronic uroflowmeter. This device allows patients to perform the uroflowmetry at home; the results and data are collected in a memory card and sent to physicians. The objective of this study is to evaluate the accuracy and reliability of IUROF by comparing it with the Andromeda Helix, a commercialized uroflowmeter device currently used in hospitals. The study was conducted at MEDIC Healthcare Center (Vietnam) in three months. A total of 40 males (57.6 ± 10.1 years of age) with LUTS were eligible and agreed to participate in the study. After signing the informed consent, the patients took turn to urinate into the IUROF and Andromeda Helix. The order of testing by the two devices altered across patients. As a result, the mean difference of Qmax was 0.05 ml/s, Qave was 0.6 ml/s, Vvoid was 0.9 ml, and tvoid was 0.2 s between the two devices. All of these differences were not statistically significant (p > 0.05). The Intra-class Correlation Coefficient (ICC) of Qmax was 0.891, showing the high level of reliability of the IUROF as compared to the Andromeda Helix. The results show that the IUROF is technically comparable to the Andromeda Helix. This has an important implication for a product developed in a university laboratory to be commercialized in the market.

This paper presents a study on the optimal design of vehicle structure for improving the small-overlap rating, based on a computer-based crash simulation model. Two reinforced component models such as longitudinal reinforcement and rocker panel reinforcement were developed for the small-overlap frontal impact simulation following the real test conditions. The crash simulation results were used to evaluate the overall vehicle structure through a comparison of intrusion measurements with the rating guidelines of the Insurance Institute for Highway Safety. The response surface method (RSM) was conducted to optimal vehicle structures in order to improve the small-overlap rating. The RSM function proposed the optimal values of the variables as the new design. The crash analysis results showed that the serious damage to the vehicle structure occurred when the minivan model collided with barrier model at 25% overlap. In this study, the grade of the overall structure was upgraded from “poor” to “acceptable” in the case of Flat 150 (the Flat barrier with a 150 mm radius and 25% overlap).

This paper presents an analysis of the vehicle structural performance in the event of a small-overlap frontal impact (SOFI), based on a computer-based crash simulation model. The vehicle model was used for SOFI simulation according to real small-overlap test conditions. The crash simulation results were used to evaluate the overall vehicle structure through a comparison of intrusion measurements with the rating guidelines of the Insurance Institute for Highway Safety. The parts sensitive to a small-overlap crash were confirmed. Thickness optimization was conducted to strengthen the rocker panel, A-pillar, and lower hinge pillar in order to improve the vehicle structural performance in the event of a SOFI. The best values among the variables were chosen for the new design. The crash analysis using finite element models showed that the most serious deformation occurred to the A-pillar. In this study, the grade of the overall structure was changed from “poor” to “marginal”.

Study question Is corifollitropin alfa 150 μg equivalent to follitropin beta 300 IU/day for controlled ovarian hyperstimulation (COS) in older women weighing ≥50 kg undergoing IVF and/or ICSI in Vietnam? Summary answer Corifollitropin alfa 150 μg was equivalent to follitropin beta 300 IU/day with respect to the number of oocytes retrieved, the ongoing, cumulative and live birth rates and obstetric outcomes. What is known already Corifollitropin alfa is a recombinant FSH (rFSH) preparation with slow absorption and a long half-life allowing administration of a single dose for COS lasting 7 days. Several randomized, controlled clinical trials have reported that COS with corifollitropin alfa is associated with similar outcomes compared with COS using daily rFSH. However, limited data are available in Asian patients. Study design size duration This randomized controlled trial was conducted at a single large IVF centre in Vietnam from June 2015 to August 2016. A total of 400 patients were included, 200 in each treatment group. The primary outcome measure was the number of oocytes retrieved. Patients were followed for 1 year after randomization. Participants /materials setting methods Participants aged 35-42 years with a body weight ≥50 kg who were undergoing an IVF cycle were randomized to undergo COS with a single dose of corifollitropin alfa 150 μg on Day 2 or 3 of the menstrual cycle, or follitropin beta 300 IU/day for 7 days starting on Day 2 or 3 of the menstrual cycle. All underwent ICSI according to standard institutional protocols. A beta hCG test was performed 17 days after ovum pick-up, and positive tests were confirmed on vaginal and/or abdominal ultrasound at 5-6 weeks after embryo transfer (clinical pregnancy) and at ≥10 weeks (ongoing pregnancy). Rates of ovarian hyperstimulation syndrome, and maternal and foetal outcomes after one cycle of ICSI were monitored over 12 months. Main results and the role of chance Patients in the corifollitropin alfa and follitropin beta groups were well matched at baseline (mean age 37.5 ± 1.9 vs 37.7 ± 2.0 years, mean body weight 53.7 ± 5.4 vs 52.5 ± 4.8 kg). There was no significant difference between the corifollitropin alfa and follitropin beta groups in the number of oocytes retrieved (11.4 ± 5.9 vs 10.8 ± 5.8; P = 0.338). The ongoing pregnancy rate (31.5 vs 32.0%; P = 0.99) and live birth rate (30.5 vs 32.0%; P = 0.83) (both per initiated cycle at 12 months after randomization) were also similar in the two treatment groups. Complication rates were low and similar in the corifollitropin alfa and follitropin beta groups, and there were no significant between-group differences in obstetric outcomes. Limitations reasons for caution This study had an open-label design, and therefore, the potential for bias cannot be excluded. The findings are only applicable to patient populations with similar characteristics to those enroled in the study. Wider implications of the findings This study adds to the body of evidence supporting the equivalence of corifollitropin alfa and follitropin beta for COS in a variety of patients undergoing IVF and/or ICSI. The ability to provide COS with corifollitropin alfa has the potential to reduce the burden of treatment for patients. Study funding/competing interests This study was supported by Merck Sharp and Dohme. The authors state that they have no financial or commercial conflicts of interest. Trial registration number The trial was registered with clinicaltrials.gov (NCT02466204). Trial registration date 2 June 2015. Date of first patient’s enrolment 19 June 2015.

This paper compares contemporary developments in social work in Vietnam with the United Kingdom (UK). Three areas of comparison form the focus of the paper: the role of the paraprofessional, the potential of vocational education and the different expectations of social work in the 21st century.

It has been demonstrated that 5-HT(1A) receptors play an important role in the pathophysiology of schizophrenia. Because Gastrodia elata Bl (GE) modulates the serotonergic system, we examined whether GE could affect phencyclidine (PCP)-induced abnormal behavior in mice. Repeated treatment with PCP increased immobility time, while it decreased social interaction time and recognition memory. PCP-induced abnormal behaviors were significantly attenuated by GE, and these effects were comparable to those of 8-OH-DPAT, a 5-HT(1A) receptor agonist. Furthermore, GE-mediated effects were counteracted by WAY 100635, a 5-HT(1A) receptor antagonist. Our results suggest that the antipsychotic effects of GE are, at least in part, mediated via activation of 5-HT(1A) in mice.

Metallic nano-antennas have been shown to be an excellent candidate for enhancing and directing optical emission from semiconductor based quantum dots (QD). QD photoluminescence (PL) enhancement is achieved by placing a suitably orientated QD in the near-field of a resonant metallic nano-antenna. Through the careful design of an optical Vee-antenna, two distinct visible resonances can be obtained, enabling the polarization dependant enhancement of two different QD sources, thus producing a polarization-to-colour transformation at the nano-scale. Possible future applications include an optical nano-scale demultiplexer device.

It has been recognized that Gastrodia elata Bl (GE), an oriental herb medicine, ameliorates various neurological disorders, that GE modulates the monoaminergic and GABAergic systems, and that GE possess antioxidant activities. We examined whether GE affects methamphetamine (MA)-induced striatal dopaminergic toxicity in mice. Treatment with MA (7.5 mg/kg, i.p. × 4) resulted in significant decreases in behavioural activity (as shown by locomotor activity and rota rod performance), dopamine level, tyrosine hydroxylase (TH) activity, and TH protein expression (as evaluated by immunocytochemistry and western blot analysis). In addition, MA treatment showed significant increases in lipid peroxidation [as evaluated by 4-hydroxy-2-nonenal (4-HNE) expression and malondialdehyde formation], protein oxidation (as shown by protein carbonyl expression and its formation), and reactive oxygen species (ROS) formation. Treatment with GE significantly attenuates MA-induced behavioural and dopaminergic impairments, and oxidative stresses in a dose-dependent manner. Our results suggest that GE treatment shows anti-dopaminergic effects in response to MA insult via, at least in part, inhibiting oxidative stresses in the striatum of the mice.

Background There are several tests available for the long-term evaluation of exercise capacity. Of these tests, the 10 m and 20 m Shuttle Tests can be performed in CF patients but they may be either too short or too long in patients who are doing fine or who are very ill, respectively. The aim of this study was to assess the feasibility of a 15 m Shuttle Test (15MST) in CF children, adults and lung transplant recipients (LTR). Methods and Patients Forty-one stable patients performed a 15MST: 19 CF children (FEV1 83±13% pred), 16 CF adults (FEV1 67±23%) and 6 LTR (FEV1 83±14%). Results In CF children, level variability (LV) was between 4 and 12, performed distance was 654±253 m, extrapolated VO 2 max (eVO 2 max) was 43±3 ml/kg/min, heart rate (HR) was 133±15 bpm, SaO 2 was 97±1% and dyspnea score (Borg Scale) was 5±3. In CF adults, LV was between 2 and 10, performed distance 611±334 m, eVO 2 max 30±6 ml/kg/min, HR 159±17 bpm, SaO 2 89±6% and dyspnea score 8±1. In LTR, LV was between 2 and 5, performed distance 330±117 m, eVO 2 max 20±13 ml/kg/min, HR 140±14 bpm, SaO 2 96±1% and dyspnea score 8±1. Conclusion The 15MST is feasible and usable in CF children and adults as well as LTR patients. It can be an alternative to 10 m and 20 m Shuttle Tests but it must still be validated. This work was supported by a grant from the Belgian Cystic Fibrosis Association and is part of our educational project ‘Just move it! move it!'.

Background Road traffic injury (RTI) is the leading cause of death and disability in the world. Drink–driving is one of risk factor of fatal injury related traffic road in the world and in Viet Nam. Objectives and Methods Determine blood alcohol concentration (BAC) of RTIs patients in 2 phases in 5 hospitals. Phase 1 (5 months) with 1453 patients, phase 2 (6 months) with 2640 patients was conducted pre and post-intervention of IEC campaign on drinking–driving. RTIs patient was taken blood for BAC testing. Results RTIs patients in phase 2 with high BAC in tendency decrease, BAC Significance It is vital to continue strengthening interventions; developing regulations of using and selling alcohol, focusing on age of 20–29; monitoring and checking random alcohol on the highways, from 19:00; conducting researches on RTIs and drinking for recommendations.

In Vietnam, road traffic injury is the leading cause of injuries with about 12 000 death cases per year. The prehospital care is still a new issue in the injury prevention work. Village health workers (VHWs) and health volunteers are considered as first tiers of prehospital care in Vietnam. Therefore, it is necessary to assess the injury emergency response capacity of village health workers and volunteers in order to strengthen their capacity. Methodology Cross sectional and qualitative methods including interview of 3000 VHWs and volunteers in 60 communes in Vietnam. Result Nearly 70% of volunteer and VHW graduated from middle school and high school. In 60 communes, the main cause of injury mortality during 2007–2008 was road traffic 64.5%. There were three death cases due to RTA in each commune in average. The VHW and volunteers provided prehospital care for 10% of road traffic injury (equal about 400 cases) per year in all cities/provinces. Only 16% of volunteers are equipped with essential tools for providing injuries and accident emergency care. 74.5% of volunteers and VHW had seen traffic accidents. 36.7% of volunteers had experiences with traffic injury emergency care. 22% of volunteers/VHW had reported on injuries and accidents; 31.2% of volunteers/VHW had participated in training courses for injuries emergency care and 37.7% of them had got training from local hospitals. Conclusion Volunteers and VHW should be provided training, essential emergency trauma care equipments for road traffic injuries.

To determine the influence of renal failure on the pharmacokinetics and neuromuscular blockade of Org NC 45 (Norcuron), a new monoquaternary homologue of pancuronium, 13 patients under halothane and nitrous oxide anesthesia were studied. Org NC 45 was administered by 2-min infusion in doses of 0.28 mg kg-1 (normal renal function group, n = 4) and 0.14 mg kg-1 (renal failure group, n = 5). Four additional patients with normal renal function were given Org NC 45 0.14 mg kg-1 to determine the onset, duration and recovery rate of neuromuscular blockade. The serum concentration of Org NC 45 was determined by normal-phase high performance liquid chromatography (sensitivity 50 ng ml-1), and a two-compartment open pharmacokinetic model was fitted to resulting data. Estimates of distribution half-life (T 1/2 alpha), elimination half-life (T 1/2 beta), volume of distribution at steady state (Vss) and clearance of Org NC 45 did not differ significantly between patients with normal renal function and those with renal failure. The onset, duration and recovery rate times of the neuromuscular blockade by Org NC 45 0.14 mg kg-1 in patients with normal renal function and those with renal failure did not differ significantly.

The urinary excretion of ORG NC 45 (Vecuronium) and of pancuronium was studied in unanesthetized rats and the biliary excretion was studied in anesthetized rats. Urine and bile were analyzed for unchanged drug by a new and specific mass spectrometric assay. Pancuronium was eliminated primarily in th