Suchergebnisse

Tran Viet Tien,1 Dinh Cong Pho,2 Le Thu Hong,3 Hien Pham Ba,4 Le Van Nam,1 Pham Ngoc Hung5,61Department of Infectious Diseases, Military Hospital 103, Vietnam Military Medical University, Hanoi City, Vietnam; 2Faculty of Medicine, Vietnam Military Medical University, Ha Dong District, Hanoi City, Vietnam; 3Department of Microbiology, Military Hospital 103, Vietnam Military Medical University, Hanoi City, Vietnam; 4Department of Infectious Diseases, Dong Da Hospital, Hanoi City, Vietnam; 5Department of Epidemiology, Vietnam Military Medical University, Hanoi City, Vietnam; 6Department of Training, Vietnam Military Medical University, Hanoi City, VietnamObjectives: To study the prevalence of drug resistance and genotype testing for HIV drug resistance on HIV/AIDS patients with first-line antiretroviral treatment failure at Dong Da Hospital, Hanoi, Vietnam.Patients and methods: Forty-seven patients in Dong Da Hospital, Hanoi, with confirmation of first-line antiretroviral therapy (ART) failure were enrolled in this study from June 2006 to December 2016. Both the protease and reverse transcriptase genes were amplified and sequenced using Trugene®, HIV-1 Genotyping Kit and OpenGene®, DNA system at the biomolecular laboratory of the National Institute of Hygiene and Epidemiology, Vietnam. The Stanford HIV database algorithm was used for interpretation of resistance data and genotyping.Results: Drug resistance mutations were 90.7% in patients with first-line treatment failure. Amongst patients with drug resistance mutation, 97.7% resisted to non-nucleoside reverse transcriptase inhibitors (NNRTIs), followed by nucleoside reverse transcriptase inhibitors (NRTIs, 95.3%) and protease inhibitors (PIs, 11.6%). Amongst the genetic mutations resistant to NNRTIs, G190S mutation was the highest (51.2%), K101HQ mutation was 39.5% and Y181I mutation was 34.9%. In genetic mutations to NRTIs, M184V mutation was 88.4%. In thymidine analogue mutations, K70R mutation was the most common (37.2%), followed by D67N, T215F and T69N mutations (27.9%, 27.9% and 25.6%, respectively). In genetic mutations in PIs, M36I and K20R mutations made up 9.3%. In NNRTIs, the prevalence of nevirapine resistance was 55.8%, and that of efavirenz resistance was 4.7%. In NRTIs, the ratio of lamivudine resistance was 93.0%, and that of zidovudine resistance was 9.3%. No lopinavir/ritonavir resistance was recorded.Conclusions: Drug resistance mutations in patients with first-line ART failure had a high prevalence of NNRTI and NRTI resistance but still susceptible to PIs.Keywords: HIV-1 drug resistance, first-line antiretroviral therapy failure, genetic mutation for drug resistance, virological failure

Nam Nguyen Van,1 Pham Ngoc Hung,2,3 Le Tien Dung,4 Le Viet Anh,1 Dinh Cong Pho,5 Bui Dang The Anh,2 Vu Anh Hai1 1Department of Thoracic Surgery, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 2Department of Epidemiology, Vietnam Military Medical University, Hanoi, Vietnam; 3Department of Training, Vietnam Military Medical University, Hanoi, Vietnam; 4Department of Thoracic Surgery, Phạm Ngá»c Thạch Hospital, Ho Chi Minh City, Vietnam; 5Department of Infection Control, Military Hospital 103, Vietnam Military Medical University, Hanoi, VietnamCorrespondence: Vu Anh HaiDepartment of Thoracic Surgery, Military Hospital 103, Vietnam Military Medical University, Ha Dong District, Hanoi, VietnamTel +84986112345Email vuanhhai.ncs@gmail.comBackground: Mid-term outcomes of video-assisted thoracoscopic surgery (VATS) lobectomy for early stage non-small cell lung cancer (NSCLC) in Vietnam should be evaluated and discussed.Methods: This prospective descriptive study was conducted on 94 patients with NSCLC under stages I–IIA who were treated with VATS from November 2011 to July 2014.Results: The median patient age was 55.5 ± 10.8 years. The rate of successful VATS for NSCLC treatment was 98.9%, and the conversion rate (from VATS to thoracotomy) was 1.1%. The operative time was 143.8 ± 38.9 minutes, the amount of blood loss was 194.8 ± 150.5 mL, and the postoperative complication rate was 10.6%. The ICU length stay was 2.8 ± 1.0 days, and the postoperative hospital length stay was 7.7 ± 2.1 days. Among the 89 patients with successful follow-up, one (1.1%) had a recurrent tumor, and ten (11.8%) had metastasis. The 1- and 2-year relative survival rates were 95.9% (3 deaths) and 80.8% (9 deaths), respectively.Conclusion: VATS treatment for early stage NSCLC is an effective method with safe outcomes. The mid-term outcomes were acceptable with 1- and 2-year relative survival rates of 95.9% and 80.8%, respectively.Keywords: video-assisted thoracoscopic surgery, VATS, non-small cell lung cancer, NSCLC, early-stage, short-term outcomes, mid-term outcomes

BACKGROUND: Lung volume reduction surgery (LVRS) was introduced to alleviate clinical conditions in selected patients with heterogenous emphysema. Clarifying the most suitable patients for LVRS remained unclear. AIM: This study was undertaken to specifically analyze the preoperative factor affecting to LVRS. METHODS: The prospective study was conducted at 103 Military Hospital between July 2014 and April 2016. Severe heterogenous emphysema patients were selected to participate in the study. The information, spirometry, and body plethysmographic pulmonary function tests in 31 patients who underwent LVRS were compared with postoperative outcomes (changing in FEV1 and CAT scale). RESULTS: Of the 31 patients, there was statistically significant difference in the outcome of functional capacity, lung function between two groups (FEV1 ≤ 50% and > 50%) (∆FEV1: 22.46 vs 18.32%; p = 0.042. ∆ CAT: 6.85 vs 5.07; p = 0.048). Changes of the FEV1 and CAT scale were no statistically significant differences in three groups residual volume. Patients with total lung capacity < 140% had more improved than others (∆FEV1: 23.81 vs 15.1%; p = 0.031). CONCLUSION: Preoperative spirometry and body plethysmographic pulmonary function tests were useful measures to selected severe heterogenous emphysema patients for LVRS. Patients with FEV1 ≤ 50%, TLC in the range of 100-140% should be selected.

The Son Trinh,1 Nguyen Ba Hung,2,3 Le Thi Thu Hien,2 Ngo Anh Tuan,4 Dinh Cong Pho,5 Quan Anh Dung,6 Duc Anh Do,7 Ha Duc Quang,2 Hoang Van Ai,1 Pham Ngoc Hung8,9 1Military Institute of Clinical Embryology and Histology, Vietnam Military Medical University, Hanoi, Vietnam; 2Andrology and Fertility Hospital of Hanoi - AF Hanoi, Hanoi, Vietnam; 3Vinmec Times City International Hospital, Hanoi, Vietnam; 4Department of Health Economics, Vietnam Military Medical University, Hanoi, Vietnam; 5Department of Infection Control, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 6Faculty of Medicine, Vietnam Military Medical University, Hanoi, Vietnam; 7Faculty of Medicine, University of Medical Sciences of Revolutionary Armed Force (UCIMED de Las FAR), Marianao, Havana, Cuba; 8Department of Epidemiology, Vietnam Military Medical University, Hanoi, Vietnam; 9Department of Training, Vietnam Military Medical University, Hanoi, VietnamCorrespondence: Pham Ngoc HungVietnam Military Medical University, Ha Dong District, Hanoi, 100000, VietnamTel +84939613388Email pnhungqy@vmmu.edu.vnBackground: In this study, we evaluated MHH patients who wished to preserve fertility, assessing the efficacy of a short course (12 months) of a combined hCG +clomiphene citrate.Materials and Methods: The cross-sectional study included 19 patients with hypogonadotropic hypogonadism who were admitted to the Andrology and Fertility Hospital of Hanoi between March 2016 and March 2018. Using hCG every three days in combination with clomiphene citrate 25mg per day until normal testosterone levels are reached, maintain the dose until spermatozoa are present.Results: The mean age was 30.2 ± 5.6. Differences in penis length between the time before and after treatment were significant (p=0.005). The average dose of hCG using in our study was 5579 ± 1773.7 IU. After treatment 6 months and 12 months, the changes in clinical features in all patients and the total hypogonadotropic hypogonadism group were statistically significant (p< 0.001). In particular, the differences in testosterone hormone levels in the partial hypogonadotropic hypogonadism group were also statistically significant (p=0.03). No adverse event was observed in our study. The number of patients appearing sperm in the semen is 9 patients (47.4%) after 12 months, but most of the sperm were completely deformed (< 1%), and the average motility in the progressive motility group was below 8%.Conclusion: In conclusion, a combination of hCG and clomiphene citrate may be an option for MHH patients who desired fertility. After 12 months, 47.4% of patients have sperm in semen but almost all of them were deformity. Hormone profile and secondary sexual characteristics improved significantly. There was no adverse event in our study that considered it as safe therapy.Keywords: male hypogonadotropic hypogonadism, MHH, total HH, total hypogonadotropic hypogonadism, partital HH, partial hypogonadotropic hypogonadism, clomiphene citrate, CC, human chorionic gonadotropin, hCG, treatment