Measles Outbreak in Pediatric Oncology Patients at Hue Central Hospital

AIM: Measles outbreak in the immunocompromised population is a big challenge to interrupt endemic transmission. This study aimed to investigate of measles in pediatric oncology patients and find the reason behind the outbreak. METHODS: A descriptive study was conducted on 11 pediatric oncology patients with measles. We collected demographic, epidemiological, and clinical data. Most of suspected measles cases were done measles immunoglobulin M test and clinical data were followed up and analyzed by SPSS. RESULTS: From April 20, 2018, to July 10, 2019, a total of 11 patients with malignancies were notified to develop measles in Hue. Of these 11 patients with the median age of 4.0 years (range: 1–9 years), two patients had not received any dose of measles vaccine, five patients received two doses, and four patients had received 1 dose of measles vaccine; all patients had fever with the median fever of 39°C (range: 38.5–39.5), the median fever duration was 7 days. All patients had cough and rash, three patients had pneumonia complication and two patients had elevated liver transaminase levels. All patients had hospital visits or were hospitalized before measles onset, with the median time: 10 days (range: 7–24 days); all patients were likely to expose each other. All 11 patients recovered. CONCLUSIONS: The measles outbreak was occurred among children with cancer, especially for children without prior measles vaccine or without two prior doses. Moreover, even children received two prior dose vaccine, their immunocompromised status caused them to be infected. There was not a different area for outpatient and inpatient in the hospital, so measles transmission occurred

A Retrospective Cohort Study of Kawasaki Disease in Hue Central Hospital for 10 Years (2010-2019)

INTRODUCTION: Kawasaki disease (KD) is an acute self-limited systemic vasculitis of unknown etiology which affects mainly children <5 years of age. If the disease is left untreated, it can lead to serious complications such as inflammation of the blood vessels. AIM: We aim to evaluate the clinical and laboratory findings and response to therapy of KD at Hue Central Hospital. METHODS: This is a retrospective study of patients with KD at Pediatric Center of Hue Central Hospital between January 2010 and December 2019. Clinical and laboratory examinations as well as the echocardiograms finding were analyzed. RESULTS: All patients were under 5 years old, in which boys were more than girls. Fever lasting over 5 days, changing in the mouth mucosa, and peripheral extremities were seen in all patients. About 73.2% had bilateral conjunctivitis and 78.0% had rash. About 42.3% of patients had cervical lymphadenopathy. Laboratory findings were noted with 84.5% of patients had hyperleukocytosis (>12,000/ mm3), 76.2% of patients had high serum C-reactive protein (CRP) levels (>100 mg/dl), 56% of patients had erythrocyte sediment rate >60 mm in the 1st h, and 34.5% of patients had thrombocytosis (platelet count >500,000/mm3) at the time of diagnosis. About 26.2% of patients had coronary artery lesions. Most patients (84.4%) had good outcome since the first dose of gamma-globulin and 13% of patients needed the second dose. There was a significant correlation between coronary artery abnormalities and no or late treatment of gamma-globulin. CONCLUSION: KD was very common in children under 5 years old with the high rate of coronary artery lesion. Treatment with gamma-globulin on or before 10 days of fever resulted in better coronary outcomes and decreased the total length of time of clinical symptoms

Disorders of sex development : insights from targeted gene sequencing of a large international patient cohort

Background: Disorders of sex development (DSD) are congenital conditions in which chromosomal, gonadal, or phenotypic sex is atypical. Clinical management of DSD is often difficult and currently only 13% of patients receive an accurate clinical genetic diagnosis. To address this we have developed a massively parallel sequencing targeted DSD gene panel which allows us to sequence all 64 known diagnostic DSD genes and candidate genes simultaneously. Results: We analyzed DNA from the largest reported international cohort of patients with DSD (278 patients with 46, XY DSD and 48 with 46, XX DSD). Our targeted gene panel compares favorably with other sequencing platforms. We found a total of 28 diagnostic genes that are implicated in DSD, highlighting the genetic spectrum of this disorder. Sequencing revealed 93 previously unreported DSD gene variants. Overall, we identified a likely genetic diagnosis in 43% of patients with 46, XY DSD. In patients with 46, XY disorders of androgen synthesis and action the genetic diagnosis rate reached 60%. Surprisingly, little difference in diagnostic rate was observed between singletons and trios. In many cases our findings are informative as to the likely cause of the DSD, which will facilitate clinical management. Conclusions: Our massively parallel sequencing targeted DSD gene panel represents an economical means of improving the genetic diagnostic capability for patients affected by DSD. Implementation of this panel in a large cohort of patients has expanded our understanding of the underlying genetic etiology of DSD. The inclusion of research candidate genes also provides an invaluable resource for future identification of novel genes

Long-Term Outcome of Childhood Acute Myeloid Leukemia: A 10-Year Retrospective Cohort Study

Аcute Myelоid Leukemiа (АML) in children is а serious disease. With a prоper treаtment, а lоng-term survivаl rаte аbоve 50% is typicаl. Befоre 2010, аll the АML pаtients died in оur hоspitаl, аnd аbаndоnment rаte wаs mоre thаn 50%. The аims оf this study аre tо explоre the lоng-term оutcоme оf newly childhood acute myeloid patients treаted аt Hue Centrаl Hоspitаl frоm 2010 tо 2019.A retrоspective study was conducted on 98 children with АML who аdmitted Hue Central Hospital frоm Jаnuаry 2010 tо December 2019. The diаgnоsis wаs cоnfirmed by mоrphоlоgicаl FАB criteriа, cytоchemistry аnd immunоphenоtype. Pаtients were treаted with using mоdified АML 7-3 Regimen. Sоciаl suppоrts were prоvided tо pаtients/fаmilies. А tоtаl оf 98 children with АML were аnаlyzed with meаn аge оf 5.6 yeаrs rаnging frоm 3 mоnths tо 15 yeаrs. The mаle tо femаle rаtiо wаs 1.8:1. The оverаll cоmplete remissiоn rаte after inductiоn were 82.6%. Pаtients аccоunted fоr 46 (46.9%) hаd relаpses which оccurred in during chemоtherаpy n=27 (27,6%), аfter finishing chemоtherаpy n=19(19,4%). Оverаll survivаl аt 3 yeаrs were 23.2%. The event-free survivаl аt 3 yeаrs were 20.2%. Аbаndоnment cаses were 4 (4.1%). During the period study, abаndоnment hаs been reduced successfully with hоlistic strаtegies such аs finаnciаl suppоrt, mаnаging fаmily grоup, prоviding educаtiоn, eаrly fоllоw-up оf pаtients whо missed аppоintments аnd free аccоmmоdаtiоn neаr hоspitаl fоr pаtients/fаmilies. However, with a high rate patient achieved complete remission after induction phase (82.6%), but the overal survival and event-free survival at 3 years were still low in my hospital (23.2 % and 20.2% respectively). It reflected that it was very difficult to treat successfully AML in lowand middle-income countries. We are considering the way how to improve the quality treatment for childhood acute myeloid leukemia in my hospital

Melanotic neuroectodermal tumor of infancy

Introduction: Melanotic neuroectodermal tumor of infancy (MNTI) is a rare, rapidly growing pigmented neoplasm of neural crest origin generally arising in infants during the first year of life. Case: We report a 15-month old male who presented with a 2-month history of a rapidly growing mass in the anterior. A biopsy showed melanotic neuroectodermal tumor, and complete resection with negative margins was subsequently achieved. The patient is in remission at 11 months from surgery. Conclusion: Due to its rapid growth potential and locally destructive behaviour, early diagnosis is extremely important to limit local expansion. The treatment of choice for melanotic neuroectodermal tumor of infancy (MNTI) is surgical excision. Keywords: Melanotic neuroectodermal tumor, Infanc

Aetiologies of central nervous system infection in Viet Nam: a prospective provincial hospital-based descriptive surveillance study.

Infectious diseases of the central nervous system (CNS) remain common and life-threatening, especially in developing countries. Knowledge of the aetiological agents responsible for these infections is essential to guide empiric therapy and develop a rational public health policy. To date most data has come from patients admitted to tertiary referral hospitals in Asia and there is limited aetiological data at the provincial hospital level where most patients are seen.We conducted a prospective Provincial Hospital-based descriptive surveillance study in adults and children at thirteen hospitals in central and southern Viet Nam between August 2007-April 2010. The pathogens of CNS infection were confirmed in CSF and blood samples by using classical microbiology, molecular diagnostics and serology.We recruited 1241 patients with clinically suspected infection of the CNS. An aetiological agent was identified in 640/1241 (52%) of the patients. The most common pathogens were Streptococcus suis serotype 2 in patients older than 14 years of age (147/617, 24%) and Japanese encephalitis virus in patients less than 14 years old (142/624, 23%). Mycobacterium tuberculosis was confirmed in 34/617 (6%) adult patients and 11/624 (2%) paediatric patients. The acute case fatality rate (CFR) during hospital admission was 73/617 (12%) in adults and to 42/624 (7%) in children.Zoonotic bacterial and viral pathogens are the most common causes of CNS infection in adults and children in Viet Nam

Pathogens of bacterial meningitis by age group (excluding dual infection cases).

<p>Laboratory confirmed aetiology per agegroup (bars) for patients meeting the case definition of bacterial meningitis. “Unknown aetiology” corresponds to patients with a diagnosis of probable bacterial meningitis.</p

Pathogens of viral encephalitis/meningitis by age group (excluding dual infection cases).

<p>Laboratory confirmed aetiology per agegroup (bars) for patients meeting the case definition of viral meningitis/encephalitis (excluding dual infection cases). “Unknown aetiology” corresponds to patients with a diagnosis of probable viral encephalitis/meningitis.</p

Demographic data, clinical diagnosis and outcome of patients with CNS infection enrolled in the study.

1<p>Cambodia, Laos.</p>2<p>Cham, Co Tu, Dao, H’Mong, Jarai, M’Nong, Mong, Nung, Pa Ko, STieng, Ta Oi, Tay, Thai, Xo Dang, Van Kieu, Chinese and Laotian.</p>3<p>Chi-squared test or Fisher’s exact test (when one or more of the expected count is less than 5).</p