Beschwerdekontrolle bei Patienten mit Mastozytose unter aktuell verfügbaren medikamentösen Therapien

Die Mastozytose ist eine seltene heterogene Erkrankung und die Mehrheit der erwachsenen Patienten leidet häufig an den Symptomen aus Mastzellen. Trotz ständiger Fortschritte in der Erforschung dieser Erkrankung gibt es bislang keine kurative Therapie. Die konventionelle Behandlung ist symptombezogen und besteht aus Wirkstoffen, die die Wirkung von Mastzellmediatoren antagonisieren, die Mediatorsekretion inhibieren oder die Mastzellproliferation modulieren. Fortschritte im molekularen Verständnis der Pathophysiologie liefern neue Therapieansätze mit neueren Tyrosinkinaseinhibitoren. Behandlungsempfehlungen sind nicht evidenzbasiert und basieren vielmehr auf Expertenmeinungen, die auf Erfahrungen der Behandler mit anderen allergologischen Therapien beruhen. Bisher existieren einige Studien zur Lebensqualität bei Mastozytose, es gibt jedoch noch keine systematische Erfassung, wie gut die Patienten versorgt sind. In der prospektiven Querschnittsbefragung wurde die Wirksamkeit der aktuell für die Behandlung der Mastozytose eingesetzten Therapieverfahren und die Zufriedenheit der Patienten mit ihrer individuellen Therapie analysiert. Zunächst erfolgte eine Erhebung der demografischen Daten und Therapieverfahren. Die Patienten gaben eine subjektive Einschätzung ihrer Beschwerdekontrolle, Therapiezufriedenheit und Wunsch nach Therapieverbesserung an. Zur Untersuchung der Beschwerdekontrolle und Lebensqualität bekamen sie einen Symptomfragebogen zur individuellen Einschätzung der aktuellen Behandlung (MAS), einen validierten Fragebogen zur Erfassung der Lebensqualität bei Mastozytose (MC-QoL), eine Patientenbewertung über die Krankheitsschwere (PGA-’disease severity’) und Beeinträchtigung (PGA-QoL) in den vergangenen zwei Wochen sowie den SF-12 Fragebogen. Von 214 verschickten Fragebögen konnten 76 Bögen ausgewertet werden. Trotz Rekrutierung aus der Mastozytose-Sprechstunde der Charité-Universitätsmedizin Berlin nutzten lediglich 51,3 % der Befragten eine medikamentöse Behandlung. Im Vergleich zu Patienten ohne Medikamenteneinnahmen hatten sie sowohl stärkere Beschwerden als auch eine stärkere Einschränkung der Lebensqualität. Die Einschränkung der Lebensqualität betraf die Symptome, das Sozialleben/die Funktionsfähigkeit und die Hautbeschwerden, nicht aber die Emotionen. Insgesamt waren sie signifikant unzufriedener und wünschten häufiger eine Therapieverbesserung. Die am häufigsten eingesetzte Therapie war mit 94,9 % eine Behandlung mit Antihistaminika der 2. Generation. 32,4 % nahmen diese in Standarddosis ein, 59,4 % nutzten die Empfehlung einer Erhöhung der Standarddosis, wovon 13,5 % das Vierfache ausschöpften. Die Anzahl der Tabletten nahm mit der Beschwerdestärke sowie damit verbundender Einschränkung der Lebensqualität zu. Bei vielen Patienten führte selbst eine Erhöhung der Dosis auf das Vierfache der Standarddosis nicht zu einer ausreichenden Symptomkontrolle. Die Ergebnisse verdeutlichen, dass die zurzeit vorhandenen unterschiedlichen Therapieverfahren zur Behandlung der verschiedenen Mastozytosekategorien oftmals nicht ausreichend sind um eine zufriedenstellende Symptomkontrolle zu erzielen. Die Therapie der Mastozytose stellt nach wie vor eine Herausforderung dar und erfordert ein besseres sowie umfassenderes Verständnis über die Erkrankung und ihre Therapie.Mastocytosis is a rare heterogeneous disease and the majority of adult patients often suffer from symptoms caused by mediator release from mast cells. Despite constant progresses in mastocytosis research, there is still no curative treatment. The conventional treatment is symptomatic and relies on agents that antagonize the effects of mast cell mediators, inhibit mediator secretion or modulate mast cell proliferation. Advances in the molecular pathophysiology have provided new therapeutic approaches with novel tyrosine kinase inhibitors. Treatment recommendations are not evidence-based, but rather based on expert opinions in allergic diseases. There are some studies on quality of life in mastocytosis patients, but there is not yet any systematic assessment of therapeutic outcomes. The prospective cross-sectional survey analyzed the efficacy of current treatment methods for mastocytosis and the patient satisfaction with their individual treatment. First demographic data and treatment methods were collected. Subjective evaluation of symptom control, therapy satisfaction and request for therapy improvement were reported by patients. To study symptom management and quality of life, patients were given a Symptom Questionnaire for an individual assessment of the current treatment (MAS), a validated Mastocytosis Quality of Life Questionnaire (MC-QoL), a patient global assessment of disease severity (PGA disease severity) and impairment (PGA-QoL) during the previous 2 weeks and the SF-12 Survey. In total 214 questionnaires were sent, to which 76 could be evaluated. Despite patient recruitment from the outpatient clinic at Charité-Universitätsmedizin Berlin, only 51,3 % used a medicinal treatment. In comparison to patients without medication, they had more severe symptoms as well as a greater impairment of quality of life, which affected symptoms, social life/functioning and skin, but not emotions. Overall they were significantly less satisfied and more frequently wanted therapeutic improvement. Second-generation antihistamines were with 94,9 % the most commonly used therapy. 32,4 % took the usual daily dose and 59,4 % received an increased dose, of which 13,5 % increased up to 4-fold. The number of tablets increased with higher burden and activity of symptoms as well as related impairment of quality of life. For many patients, an increase even up to 4-fold did not lead to a sufficient symptom improvement. The results suggest, that the currently existing various treatment methods for different mastocytosis subgroups often cannot achieve a satisfactory symptom control. Mastocytosis still remains a challenge and needs a better and more comprehensive understanding of the disease and its therapy

The effect of emotional intelligence on the performance of auditors

This study aims to evaluate the impact of effective emotional intelligence on the work of auditors in Ho Chi Minh City, Ho Chi Minh. The authors conducted a survey for 355 auditors at companies and organizations operating in the field of auditing. The results show that there were 4 factors of emotional intelligence that affect job performance, arranged in the following sequence: (1) Perception of emotions, (2) Positive thinking with emotions, (3) Understand emotions, (4) Control emotions. This is the basis for the authors to give some implications to improve the emotional intelligence characteristics of auditors towards work efficiency

Investigation of anti-inflammatory lignans from the leaves of Symplocos sumuntia Buch-Ham ex D Don (Symplocaceae)

Purpose: To investigate the anti-inflammatory activity of Symplocos sumuntia Buch.-Ham. ex D. Don and identify the main secondary metabolites responsible for this effect.Methods: The in vitro anti-inflammatory activity of the plant extract and isolated compounds was determined in terms of the ability to inhibit the production of nitric oxide (NO), and expressions of iNOS and COX-2 proteins in RAW264.7 cells stimulated by lipopolysaccharide (LPS). Compounds were isolated and identified by spectroscopic methods.Results: The methanol extract of S. sumuntia leaves showed strong inhibitory effects on nitric oxide (NO) production and expression of iNOS and COX-2 in LPS-induced RAW264.7 cells. A phytochemical assay-guided fractionation of the methanol extract of S. sumuntia leaves led to the isolation of four lignans which are arctigenin (1), matairesinol (2), monomethylpinoresinol (3) and pinoresinol (4). These compounds were identified for the first time from S. sumuntia. All four compounds inhibited the production of nitric oxide (NO), with arctigenin showing the most potent activity with half-maximal inhibitory concentration (IC50) value of 4.08 μM.Conclusion: S. sumuntia is a promising source of anti-inflammatory agents, which may clarify to the therapeutic use of this plant in Vietamese traditional medicine.Keywords: Symplocos sumuntia, Symplocos caudata, Lignan, Arctigenin, Anti-inflammator

ANNOUNCEMENT OF THE SUSTAINABLE DEVELOPMENT REPORT OF VIETNAMESE HOTEL ENTERPRISES

The purpose of this study is to examine the factors affecting the publication of sustainability reports from the perspective of managers at 4-5 star hotels in Vietnam. Issues of corporate size, profitability, legal regulation, corporate governance and technology of the company were mentioned as factors that may affect the publication of the report on sustainable development. The author has synthesized the relevant background theory as well as previous outstanding studies on the issue of publishing sustainable development reports. SPSS 20 software was used to test the relationship between the factors affecting the publication of the Sustainable Development Report based on the manager's point of view. The results of the study show that the factors of business size, profitability, and legal regulations all affect the publication of sustainable development reports at 4-5 star hotels in Vietnam. A new finding of this study is that the two factors of corporate governance and the company's technology combine into a public governance factor based on technology and it is the technology that has the strongest influence on the publication of the Sustainable Development Report. The study once again confirms the relationship between the factors affecting the publication of the Sustainable Development Report and is a document to help researchers understand better in the research context in Vietnam, one of the leading countries in the world developing countries and have limited access to and use of secondary data

Optimization of culture conditions of Streptomyces antibioticus strain 1083 to improve the antimicrobial activity against Aeromonas hydrophila

Fish is a healthy, high protein and low fat food that encourages the health and growth of people, especially children. However, in fact fish is very sensitive to many diseases which affects the productivity and quality of fish. Therefore, identifying the cause of the diseases and finding preventive measures become an urgent task today. In the previous study, we isolated Streptomyces antibioticus strain 1083 that has the ability to antagonize Aeromonas hydrophila - a pathogenic bacterium in fish. Based on the obtained results, we continue to perform this study to determine optimal conditions for the culture of S. antibioticus strain 1083 in order to produce antimicrobial compounds against A. hydrophila. The production of antagonists by the strain 1083 was optimized by controlling the condition of different inoculations such as media, pH, temperature and incubation period. The results indicated that International Streptomyces Project 2 (ISP2) was the best medium for S. antibioticus strain 1083 to produce the highest antimicrobial activity against A. hydrophila with 32 mm in diameter of inhibited zone. The actinomycete strain 1083 could express the maximum antimicrobial activity when they were incubated in shaker incubator (200rpm) at 40oC with pH8 in 8 days. The ability of the actinomycete strain in antagonism against A. hydrophila was evaluated by adding different culture medium volume of S. antibioticus strain 1083. With adding 10% cultured solution volume of S. antibioticus strain 1083 into the culture medium of A. hydrophila, after 1 day of inoculation the number of pathogenic bacteria cells were completely eliminated

Constituents from stem barks of Anacolosa poilanei Gagnep. (Olacaceae)

Four compounds were isolated from the stem barks of Anacolosa poilanei Gagnep. Theirs structures were established by spectroscopic analysis including MS and NMR. Accordingly, the isolates were identified as trichadenic acid B (1), trichadonic acid (2), amentoflavone (3) and β-sitosterol (4)

Risk assessment, implementation of occupational health, safety and hygiene in small and medium manufacturing enterprises: A case study in central Vietnam

This study aims to identify and evaluate the influence of the factors affecting the implementation of occupational health and safety of employees and employers and its impact on occupational health and safety and legalize risk assessment in small and medium-sized manufacturing enterprises in central Vietnam through the survey among 246 business representatives and data processing through the software SPSS 20 and AMOS 20. The results show that there are 3 factors affecting the implementation of occupational health, safety and hygiene. In order: (1) Safety regulations and instructions; (2) Occupational health, safety policy and (3) Occupational health and safety training. There is no relationship between the impacts on the implementation of occupational health and safety of the employer. In addition, a very interesting finding about the relationship of factors implementing occupational health and safety of employers was a positive influence on the legalization of risk assessment activities. On the basis of these results, employees, business owners and state management agencies will have grounds to offer useful solutions in risk assessment in order to better perform safety work and occupational health

Bringing social and cultural considerations into environmental management for vulnerable coastal communities: Responses to environmental change in Xuan Thuy National Park, Nam Dinh Province, Vietnam

This paper elaborates the importance of considering social and cultural factors within management responses to environmental change in coastal areas. The case study taken is Xuan Thuy National Park in Nam Dinh Province, Vietnam. This is a marginalised coastal area where rising sea levels, increasing storm surges and saltwater intrusion place pressure on coastal ecosystems, yet where communities continue to rely on these same ecosystems for agriculture- and aquaculture-related livelihoods. We interview stakeholders in Xuan Thuy National Park, connecting these with a narrative review of existing research into social and environmental change in the park to understand research gaps and challenges for vulnerable coastal areas like the Nam Dinh coast. Based on our findings, we suggest that whilst the effects of a changing environment on physical health and economic activity are increasingly well understood, effects on wellbeing and social relations can be even more immediate and profound in daily living. In turn, we argue environmental management has a crucial role to play not only for ecosystem-based adaptation, but also in sustaining wellbeing and allowing culturally meaningful practices to continue – especially in coastal regions where changes can be even more intense and immediate. However, we caution that whilst techno-scientific solutions grounded in environmental management do have significant potential in reducing impacts of extreme events and slower-onset environmental changes, they must not divert attention away from structural issues that can make some people or areas more vulnerable in the first instance

Safety and efficacy of fluoxetine on functional outcome after acute stroke (AFFINITY): a randomised, double-blind, placebo-controlled trial

Background Trials of fluoxetine for recovery after stroke report conflicting results. The Assessment oF FluoxetINe In sTroke recoverY (AFFINITY) trial aimed to show if daily oral fluoxetine for 6 months after stroke improves functional outcome in an ethnically diverse population. Methods AFFINITY was a randomised, parallel-group, double-blind, placebo-controlled trial done in 43 hospital stroke units in Australia (n=29), New Zealand (four), and Vietnam (ten). Eligible patients were adults (aged ≥18 years) with a clinical diagnosis of acute stroke in the previous 2–15 days, brain imaging consistent with ischaemic or haemorrhagic stroke, and a persisting neurological deficit that produced a modified Rankin Scale (mRS) score of 1 or more. Patients were randomly assigned 1:1 via a web-based system using a minimisation algorithm to once daily, oral fluoxetine 20 mg capsules or matching placebo for 6 months. Patients, carers, investigators, and outcome assessors were masked to the treatment allocation. The primary outcome was functional status, measured by the mRS, at 6 months. The primary analysis was an ordinal logistic regression of the mRS at 6 months, adjusted for minimisation variables. Primary and safety analyses were done according to the patient's treatment allocation. The trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12611000774921. Findings Between Jan 11, 2013, and June 30, 2019, 1280 patients were recruited in Australia (n=532), New Zealand (n=42), and Vietnam (n=706), of whom 642 were randomly assigned to fluoxetine and 638 were randomly assigned to placebo. Mean duration of trial treatment was 167 days (SD 48·1). At 6 months, mRS data were available in 624 (97%) patients in the fluoxetine group and 632 (99%) in the placebo group. The distribution of mRS categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio 0·94, 95% CI 0·76–1·15; p=0·53). Compared with patients in the placebo group, patients in the fluoxetine group had more falls (20 [3%] vs seven [1%]; p=0·018), bone fractures (19 [3%] vs six [1%]; p=0·014), and epileptic seizures (ten [2%] vs two [<1%]; p=0·038) at 6 months. Interpretation Oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and epileptic seizures. These results do not support the use of fluoxetine to improve functional outcome after stroke

Mineral compositions of magmatic dikes cutting across Khe Phen granites (Huong Tra, Thua Thien Hue, Central Vietnam)

The Khe Phen granite quarry located in Huong Tra district (Thua Thien Hue province) has been confirmed as a part of the Ba Na granitoid complex (G/K2bn), mostly composed of two-mica granite and porphyritic granite. Field survey data show that the granites here are cut across by five distinct narrow dikes (about 50–70 cm wide), including granite pegmatite, granite aplite, aplite, granodiorite, and lamprophyre. The mineral compositions of the granite pegmatite and aplite dikes are similar to those of the host granite, which is mainly comprised of quartz (27–35%), orthoclase (45–58%), plagioclase (4–15%), biotite (1–3%), and a few opaque minerals. Meanwhile, the granodiorite and lamprophyre dikes are melanocratic and compositionally much more mafic, particularly lamprophyre, evidenced by a presence of hornblende (50–55%), plagioclase (33–40%), quartz (3–15%), calcite (5–17%), etc. The origin and emplacement age of the latter dikes have not been reported so far and thus, are needed for further studies based on geochemical and isotopic data