Serum Granulysin in Differentiation of Stevens-Johnson Syndrome/toxic Epidermal Necrolysis and Erythema Multiforme

BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are acute, life-threatening drug reactions, which lead to massive epidermal necrolysis. Granulysin plays an important role as a key mediator for keratinocyte apoptosis in these conditions. Erythema multiforme (EM) may have skin manifestation similar to SJS/TEN. AIMS: The aim of the study was to compare serum granulysin levels in patients with SJS/TEN and EM as well as to investigate a possible association between serum granulysin levels and the severity of SJS/TEN. METHODS: In total, 48 patients with SJS/TEN, 43 patients with EM, and 20 health controls (HCs) were enrolled. We measured serum granulysin levels using enzyme-linked immunosorbent assay. RESULTS: The average level of serum granulysin in the SJS/TEN patients was 23.0 ng/ml (range 1.2–144.6 ng/ml), significantly higher than that of EM group (20.1 ng/ml; range 8.5–121 ng/ml, p < 0.05) and HCs group (20.8 ng/ml; range 10.1–46.7 ng/ml, p < 0.05). Of 48 SJS/TEN patients, the 25 samples collected <6 days after onset showed higher level of serum granulysin (27.7 ng/ml; range 2.5–144.6 ng/ml) than those collected ≥6 days after onset (17.9 ng/ml; range 1.2–59 ng/ml; p > 0.05). No significant correlation was found between serum granulysin levels and the body surface area affected and the modified-SCORTEN. At the day of re-epithelialization, serum granulysin levels were not different compared with those at the day of hospitalization. CONCLUSIONS: Serum granulysin levels are significantly higher in SJS/TEN group than in EM group. After the onset, serum granulysin levels in patients with SJS/TEN are not a good biomarker to evaluate the severity of the diseases

TÀI NGUYÊN VỊ THẾ ĐẢO CỒN CỎ

Being a basaltic volcano, Con Co island is an isometric hill 2.3 km2 wide and 63 m high, located far 24 km from the mainland, and guards the entrance to the Gulf of Tonkin. It is isolated, but unique in location, and relatively closed to mainland. Despite its small size, the characteristics of morphology and spatial structures, geological composition, area, height, ecological landscape, dynamics and stability of the island... create great values of geo-natural position resources and favorable environment for island residents. Regarding geo - economic position resources, the island is a district under the Quang Tri province, a priority location for development of the country’s marine and island economy, and the economic centre at the entrance of the Gulf of Tonkin. This is also a convenient site for the development of marine economic sectors such as fishery, natural conservation, services - tourism and some others. In terms of geo-political position resources, the island has tremendous advantages for the sovereignty, sovereign rights and national interests at sea. As an outpost at the highly sensitive geo-political area, the Con Co island has the great value of defense, as a solid military base in the entrance of the Gulf of Tonkin and the most important link in the line of defense from coastal islands in the North Centre. It possesses many valuable cultural heritages, especially the heroic relics during the war against the US.Đảo Cồn Cỏ nguồn gốc núi lửa bazan, dạng đồi đẳng thước rộng 2,3 km2, cao 63 m, nằm cách xa bờ 24 km. Đảo có vị trí lẻ loi ở cửa vịnh Bắc Bộ và khá gần bờ Việt Nam. Mặc dù diện tích đảo nhỏ, nhưng các đặc điểm về hình thể và cấu trúc không gian, cấu tạo địa chất; diện tích, độ cao và cảnh quan sinh thái; động lực và tính ổn định... đã tạo ra giá trị lớn cho đảo về tài nguyên địa - tự nhiên và môi trường sinh cư thuận lợi cho các loài sinh vật và con người. Về giá trị vị thế địa - kinh tế, Cồn Cỏ thuộc đơn vị hành chính cấp huyện thuộc tỉnh Quảng Trị, là vị trí ưu tiên đối với phát triển kinh tế biển - đảo của đất nước; là vị trí trung tâm của không gian kinh tế khu cửa vịnh Bắc Bộ. Đây là một địa bàn thuận lợi cho phát triển các lĩnh vực kinh tế biển như thủy sản, bảo tồn biển, dịch vụ - du lịch cùng với các loại hình dịch vụ khác. Về giá trị vị thế địa - chính trị, đảo Cồn Cỏ có giá trị to lớn đối với việc bảo vệ các quyền và lợi ích quốc gia của Việt Nam trên biển. Là đảo tiền tiêu nằm trong vùng địa - chính trị nhạy cảm cao, đảo có giá trị lớn về phòng thủ, là một cứ điểm quân sự vững chắc ở vùng cửa vịnh Bắc Bộ và mắt xích quan trọng nhất trong phòng tuyến các đảo ven bờ Bắc Trung Bộ. Cồn Cỏ có các giá trị di sản văn hoá biển đảo, đặc biệt là những chiến tích anh hùng trong thời chiến tranh chống Mỹ

Assessment of Antioxidant and Antibacterial Activities of Lactobacillus farciminis HN11 as a Probiotic Candidate

Background and Objective: Lactobacillus farciminis is an obligate homofermentative bacterial species in fermented foods. Although other species such as Lactobacillus plantarum, Lactobacillus acidophilus, Lactobacillus casei and Lactobacillus rhamnosus in Lactobacillus genus have been well characterized, probiotic characteristics of Lactobacillus farciminis still need to investigate. Thus, the objective of this study was to investigate probiotic characteristics and antibacterial activity of Lactobacillus farciminis HN11 isolated from Solanum macrocarpon sauces in Hue city, Vietnam. Material and Methods: Lactobacillus farciminis HN11 was cultured in Rogosa and Sharpe media and antibacterial activity of the free-cell suspension was assessed against Escherichia coli, Vibrio parahaemolyticus K5, Vibrio parahaemolyticus KS-02, Vibrio owensii KS-05, Vibrio alginolyticus KS-08, Vibrio alginolyticus A1-1 and Staphylococcus aureus using agar well diffusion method. Various probiotic characteristics of the isolate including antibacterial and antioxidant activities, autoaggregation and coaggregation were assessed. Furthermore, hemolytic and amino-acid dercarboxylase activities were assessed for biosafety assessment. The strain abilities to resist sodium chloride and bile salts were assessed as well. Results and Conclusion: Lactobacillus farciminis HN11 exhibited significant resistance to NaCl and bile salts. The strain expressed high coaggregation abilities for Escherichia coli, significant autoaggregation abilities and antibacterial activities against Vibrio spp. and Escherichia coli. Antioxidant assessment showed that Lactobacillus farciminis HN11 contained high antioxidant activities. This strain was negative for hemolytic and amino-acid dercarboxylase activities. Moreover, ampicillin and chloramphenicol inhibited growth of Lactobacillus farciminis HN11. This study assessed characteristics of Lactobacillus farciminis HN11 and showed its great potentials as a probiotic in fermented foods, enhancing antioxidant and decreasing harmful foodborne bacteria. Although, encapsulation of the strain within acid resistance materials is suggested to better protect it against high-acid contents of the stomach. Conflict of interest: The authors declare no conflict of interest

Scurvy in the Tropics: Evidence for increasing non-adult micronutrient deficiency with the transition to agriculture in northern Vietnam

Objective: Scurvy in non-adults was assessed at the Pre-Neolithic site of Con Co Ngua and the Neolithic site of Man Bac in northern Vietnam to investigate nutritional stress during the agricultural transition in Mainland Southeast Asia (MSEA). Materials: One hundred and four human skeletons under the age of 20 years old were assessed. Methods: Lesions were recorded macroscopically and radiographically. Differential diagnosis using prior established paleopathological diagnostic criteria for scurvy was conducted. Results: There was no clear evidence for scurvy at Con Co Ngua and a high burden of scurvy was present at Man Bac (>79% diagnosed with probable scurvy). Scurvy levels were high across all non-adult ages at Man Bac indicating significant burden throughout childhood and adolescence. Conclusions: No scurvy at Con Co Ngua is consistent with widely available food sources at the peak of the Holocene thermal maximum. High levels of scurvy at Man Bac corresponds with decreased dietary diversity, high pathogen load, and increased population stress with the transition to agriculture around the time of the 4.2 ka desertification event. Significance: This is the first systematic population-level non-adult investigation of specific nutritional disease in MSEA and demonstrates an increase in nutritional stress during the Neolithic transition in northern Vietnam. Limitations: Subperiosteal new bone deposits can be due to normal growth in infants and young children, therefore, identification of scurvy in children under the age of 4 years needs to be considered critically. Suggestions for Further Research: Further work in diagnosing specific nutritional disease in other non-adult cohorts throughout MSEA is required

Overseas Treatment of Latent Tuberculosis Infection in US-Bound Immigrants.

Seventy percent of tuberculosis (TB) cases in the United States occur among non-US-born persons; cases usually result from reactivation of latent TB infection (LTBI) likely acquired before the person's US arrival. We conducted a prospective study among US immigrant visa applicants undergoing the required overseas medical examination in Vietnam. Consenting applicants >15 years of age were offered an interferon-γ release assay (IGRA); those 12-14 years of age received an IGRA as part of the required examination. Eligible participants were offered LTBI treatment with 12 doses of weekly isoniazid and rifapentine. Of 5,311 immigrant visa applicants recruited, 2,438 (46%) consented to participate; 2,276 had an IGRA processed, and 484 (21%) tested positive. Among 452 participants eligible for treatment, 304 (67%) initiated treatment, and 268 (88%) completed treatment. We demonstrated that using the overseas medical examination to provide voluntary LTBI testing and treatment should be considered to advance US TB elimination efforts

Forager and farmer evolutionary adaptations to malaria evidenced by 7000 years of thalassemia in Southeast Asia

Acknowledgements We would like to thank Dr. Ngo Anh Son, Mr. Bui Van Khanh and Ms. Nellissa Ling for their assistance with the radiographs. We are grateful to Dr. Dr. Nguyen Gia Doi for permission to extract histological samples. This work was supported by a National Geographic Early Career Grant (EC-54332R-18);Royal Society of New Zealand Skinner Fund Grant; University of Otago Doctoral Scholarship; Australian Research Council DP110101097 and FT120100299. Histologicalprocessing was funded by the Australian Research Council (DE190100068).Peer reviewedPublisher PD

The Effectiveness of Oral Mini-Pulse Methylprednisolonein - the Treatment of Alopecia Areata in Vietnam

BACKGROUND: Systemic corticosteroid is used to treat alopecia areata, but it is associated with side effects. Mini-pulse therapy is thought to be effective but able to reduce side effects. AIM: The study aimed to evaluate the effectiveness of oral mini-pulse methylprednisolone in the treatment of alopecia areata. METHODS: Patients received methylprednisolone 16 mg orally for 2 consecutive days every week. RESULTS: After 3 months, among patients, 40% recovered well, and 55.6% recovered fairly. After 6 months, 82.2% recovered well, 17.8% recovered fairly. No adverse events were detected, and the recurrence rate was low (2.2%). CONCLUSION: Oral mini-pulse methylprednisolone therapy is an effective and safe therapeutic option for alopecia areata without side effects, and the time of the treatment is short

Efficacy of Oral Isotretinoin in Combination with Desloratadine in the Treatment of Common Vulgaris Acne in Vietnamese Patients

AIM: To evaluate the efficacy of oral isotretinoin used alone and in combination with desloratadine in the treatment of moderate acne vulgaris. METHODS: A comparative clinical trial was undertaken to evaluate the efficacy of oral isotretinoin alone and in combination with desloratadine in the treatment of 62 moderate acne vulgaris patients. Patients were randomised into two groups with 31 patients in each group. Each studied group's patient took 20 mg isotretinoin and 5 mg desloratadine per day. In the control group, patients took only 20 mg isotretinoin per day. The treatment time was 16 weeks. The evaluation and follow-up were done at week 2, 4, 8, 12 and 16 of the treatment. RESULTS: The studied group had a better curative rate than the control group (45.2% versus 22.6%). The average number of inflammatory lesions in the studied group was significantly lower than the control group (0.19 versus 0.94). The mean GAGS score of the studied group was significantly lower than the control group (3.71 versus 6.52). Acne outbreaks rate of the studied group was lower than the control group (in week 2: 22.6% versus 45.2% and in week 4: 16.1% versus 38.7%, respectively). The rate of itchy was lower in the studied group. CONCLUSION: In the treatment of moderate acne vulgaris, oral isotretinoin in combination with desloratadine is more effective and has fewer side effects than using isotretinoin alone

Efficacy of Oral Isotretinoin in Combination with Desloratadine in the Treatment of Common Vulgaris Acne in Vietnamese Patients

AIM: To evaluate the efficacy of oral isotretinoin used alone and in combination with desloratadine in the treatment of moderate acne vulgaris. METHODS: A comparative clinical trial was undertaken to evaluate the efficacy of oral isotretinoin alone and in combination with desloratadine in the treatment of 62 moderate acne vulgaris patients. Patients were randomised into two groups with 31 patients in each group. Each studied group's patient took 20 mg isotretinoin and 5 mg desloratadine per day. In the control group, patients took only 20 mg isotretinoin per day. The treatment time was 16 weeks. The evaluation and follow-up were done at week 2, 4, 8, 12 and 16 of the treatment. RESULTS: The studied group had a better curative rate than the control group (45.2% versus 22.6%). The average number of inflammatory lesions in the studied group was significantly lower than the control group (0.19 versus 0.94). The mean GAGS score of the studied group was significantly lower than the control group (3.71 versus 6.52). Acne outbreaks rate of the studied group was lower than the control group (in week 2: 22.6% versus 45.2% and in week 4: 16.1% versus 38.7%, respectively). The rate of itchy was lower in the studied group. CONCLUSION: In the treatment of moderate acne vulgaris, oral isotretinoin in combination with desloratadine is more effective and has fewer side effects than using isotretinoin alone

The Efficacy of a Two-Fold Increase of H1-Antihistamine in the Treatment of Chronic Urticaria - the Vietnamese Experience

BACKGROUND: Chronic urticaria, a mast cell-driven condition, is common, debilitating and hard to treat. H1-antihistamines are the first line treatment of chronic urticaria, but often patients do not get satisfactory relief with the recommended dose. European guidelines recommend increased antihistamine doses up to four-fold. AIM: We conducted this study to evaluate the efficacy of increased H1-antihistamine doses up to two-fold in Vietnamese chronic urticaria patients. METHODS: One hundred and two patients with chronic urticaria were recruited for treatment with levocetirizine (n = 52) or fexofenadine (n = 50). Treatment started at the conventional daily dose of 5 mg levocetirizine or 180 mg fexofenadine for 2 weeks and then increased to 10 mg levocetirizine or 360 mg fexofenadine for 2 weeks if patients did not have an improvement in symptoms. At week 0, week 2 and week 4 wheal, pruritus, size of the wheal, total symptom scores, and associated side-effects were assessed. RESULTS: With the conventional dose, the total symptom scores after week 2 decreased significantly in both groups compared to baseline figures, i.e. 7.4 vs 2.3 for levocetirizine group and 8.0 vs 2.6 for fexofenadine group (p < 0.05). However, there were still 26 patients in each group who did not have improvements. Of these 26 patients, after having a two-fold increase of the conventional dose, 11.5% and 38.5% became symptom-free at week 4 in levocetirizine group and fexofenadine group, respectively. At week 4 in both groups, the total symptom scores had significantly decreased when compared with those at week 2 (2.8 ± 1.5 versus 4.7 ± 1.6 in levocetirizine group; 2.1 ± 1.9 versus 5.1 ± 1.4 in fexofenadine group). In both groups, there was no difference in the rate of negative side effects between the conventional dose and the double dose. CONCLUSION: This study showed that increasing the dosages of levocetirizine and fexofenadine by two-fold improved chronic urticaria symptoms without increasing the rate of negative side effects