Promoting patient-centred care in the management of allergic rhinitis in Asia-Pacific countries.

Background: Allergic rhinitis (AR) has a high burden of disease in the Asia-Pacific region (APAC). Although guidelines provide recommendations regarding the diagnosis and treatment of AR, it is increasingly being recognised that there are gaps in their implementation. Patient-centred care involves accounting for the specific needs and desires of patients as well as including the patient in the decision-making process, and this may provide a means to reduce these gaps and consequently the burden of AR. Methods: A group of 11 experts in immunology and otorhinolaryngology from APAC provided information regarding their practices and experiences in the management of AR through an online survey. The group then discussed the barriers and solutions for the implementation of patient-centred care across the patient journey in a face-to-face meeting. Results: Key barriers to the implementation of patient-centred care for AR in APAC included a lack of patient awareness of the condition and treatment options, low adherence to treatments, financial constraints for patients, and time constraints for physicians. The solutions proposed include improving the knowledge of the patients about their conditions, the use of shared decision-making, the consideration of patient characteristics when choosing treatments, and the use of outcome measures to aid the optimisation of patient care. We provide specific recommendations for clinical practice. Conclusion: A greater focus on patient-centred approaches has the potential to improve the management of AR in APAC. More emphasis should be placed on each patient's specific health needs and desired outcomes.

Correlation Between Vestibular Disorders and Superior Semicircular Dehiscence on High-resolution Computed Tomography at Tam Anh Ho Chi Minh General Hospital.

Objective: Superior semicircular canal dehiscence (SSCD) is a pathologic condition within the inner ear characterized by various vestibular manifestations. Numerous studies have reported an incidence rate of SSCD ranging from 3.6% to 9% in the general population. The objective of this medical study was to evaluate the prevalence of superior SSCD and investigate its correlation with vestibular symptoms among patients who underwent high-resolution computed tomography (HRCT) scans. To the best of our knowledge, there is limited research and awareness regarding SSCD in Vietnam. In addition, the secondary aim of our investigation is to assess the prevalence of SSCD in Vietnam and compare it with findings from previous studies worldwide. Methods: This retrospective study was conducted at Tam Anh Ho Chi Minh General Hospital from March 2022 to February 2024. Medical records and HRCT scans of the patients were collected. Patients were categorized into two groups: those with and without vestibular disorders. SSCD was defined as the absence of bone overlying the superior semicircular canal facing toward the dura of the middle cranial fossa. Statistical analysis was performed to determine the correlation between vestibular symptoms and the presence of SSCD. Results: A total of 362 patients (including 151 men and 211 women) were recruited. The prevalence of SSCD was 10.2% according to the HRCT scan results. The study found that 18.33% of patients with vestibular disorders had SSCD on HRCT scans, whereas only 6.2% of patients without vestibular disorders exhibited SSCD, indicating a significant association (p-value <0.001). Conclusions: These findings highlight the importance of considering SSCD as a potential etiology in patients presenting with vestibular symptoms and emphasize the diagnostic utility of HRCT.

Effect of Fish Oil and Linseed Oil on Intake, Milk Yield and Milk Fatty Acid Profile in Goats.

This study aimed to evaluate the effect of incorporating linseed oil and fish oil in the diet on intake, ruminal fermentation, milk yield, and milk fatty acid profiles in dairy goats. Four crossbred Saanen lactating goats in mid-lactation and milking 1.30 ± 0.28 g/day were used in a 4 × 4 Latin square design. The basal diet contained concentrate and Para grass (C:F 40:60). Treatments included a basal diet without oil supplementation (Ctrl) or with 2.5% linseed oil (LO2.5), 2.5% linseed oil and fish oil (3:2, w/w, LFO2.5), and 4.16% linseed oil and fish oil (3:2, w/w, LFO4.16). Diets had no effect on intake, milk yield, milk composition, or ruminal fermentation (p > 0.05). Compared with Ctrl, lower (p < 0.05) proportions of C10:0-C14:0 in milk fat were observed with LFO4.16. Compared with the Ctrl and linseed oil added alone, feeding LFO4.16 led to a greater (p < 0.01) concentration of C18:1 t11. Compared with both the Ctrl and LO2.5 diets, milk c9,t11 CLA was 4.53 and 2.94 times greater with the LFO4.16 diet. Compared with Ctrl and LO2.5 diets (0.06% and 0.08%), goats fed LFO2.5, and LFO4.16 had greater (p < 0.001) concentrations of C22:6n-3 (0.63% and 0.87%). Overall, the combined data suggested that including 4.16% linseed oil and fish oil in the diet of dairy goats was effective in improving the concentrations of health-promoting fatty acids in milk without affecting milk production.

Grape seed tannin extract and polyunsaturated fatty acids affect in vitro ruminal fermentation and methane production.

Condensed tannins (CT), one of the most ubiquitous compounds in the plant kingdom, can modulate ruminal nutrient metabolism. Objectives were to study potential interactions of CT and polyunsaturated fatty acids (PUFA) on ruminal fermentation, biohydrogenation (BH), and methane production. Ruminal fluid obtained from lactating Holstein Friesian cows was used. All experiments were carried out as a completely randomized design with the same mixed diet: control (60:40 forage:concentrate) without supplement (CON), 2.5% soybean oil (SBO), and SBO + grape seed tannin extract (GSTE) at 0.2%, 0.4%, 0.6%, or 0.8% dietary DM (ST0.2, ST0.4, ST0.6, and ST0.8, respectively). Compared with CON (84.7 mM), total VFA concentration was not affected by SBO, but decreased (P < 0.001) with ST0.8 vs. ST0.6 (75.3 vs. 78.3 mM). Relative to CON, methane production was depressed (P < 0.001) by 17.7% and 28.0% in ST0.4 and ST0.8. The highest (P < 0.001) mean concentrations of c9,t11 CLA and C18:1 t11 were observed with ST0.4 compared with CON, but there was no difference between SBO and CT-containing diets. Disappearance of C18:2 c9,c12 was 49.1% vs. 50.3% in CON vs. SBO, whereas it ranged from 39.9% to 46.3% in CT-containing diets after 2 h incubation (P < 0.001). Concentrations of c9,t11 CLA with supplemental SBO and ST0.8 nearly peaked (P < 0.001) at 2 h incubation, but this fatty acid peaked (P > 0.05) at 6 h incubation and remained higher (P < 0.001; 15.9-17.0 µg/mL) at 24 h incubation with ST0.2, ST0.4, and ST0.6 compared with other diets (13.5-14.5 µg/mL). Compared with CON (50.6 µg/mL), concentration of C18:1 t11 with SBO and CT-containing diets reached a peak (P < 0.001; 241-265 µg/mL) at 12 h incubation. Concentration of C18:0 was 171%-231% higher (P < 0.001) with SBO and CT relative to CON at 24 h incubation. Overall, these results demonstrated that PUFA in SBO are more effective in modulating ruminal BH and CH4 production when combined with CT. However, high doses of added CT can reduce ruminal VFA concentration. Thus, a level of 0.4% GSTE added to diets containing 2.5% PUFA from plant origin might be suitable for optimizing ruminal fermentation and BH of C18:2 c9,c12 to fatty acid intermediates that could have beneficial effects to human health.

Condensed tannins can modulate methane emissions and ruminal biohydrogenation, but effects depend on type and dose. We used an in vitro fermentation system to investigate the effect of increasing doses (0%, 0.2%, 0.4%, 0.6%, and 0.8% dry matter) of grape tannin seed extract (GSTE) in a diet supplemented at 2.5% dry matter with soybean oil on methane production and biohydrogenation. Feeding soybean oil and GSTE at 0.6% and 0.8% reduced content of ruminal volatile fatty acids. Methane production (mL/g dry matter) was lower in the diet containing GSTE at 0.4%. Inclusion of GSTE at 0.2% and 0.4% increased concentration of C18:2 c9,c112, C18:3n3, c9,t11 conjugated linoleic acid and total polyunsaturated fatty acids after 24 h of incubation. The present findings contribute to a better understanding of the effect of condensed tannins from grape seed extract on ruminal fermentation and biohydrogenation.

Partial substitution of fish oil for linseed oil enhances beneficial fatty acids from rumen biohydrogenation but reduces ruminal fermentation and digestibility in growing goats.

This study was performed to investigate effects of partial replacement of fish oil (FO) for linseed oil (LO) on digestibility, ruminal fermentation and biohydrogenation in growing goats. Experiment 1 was carried out in four growing male goats aged 6 months in a 4 × 4 Latin square design. Goats were fed a basal diet supplemented with 25 g/kg dry matter either LO alone or in combination with tuna FO. Treatments were developed by replacing FO for LO at ratios of 0, 5, 10 and 15 g/kg DM corresponding to FO-0, FO-5, FO-10 and FO-15, respectively. Experiment 2 was carried out in an in vitro incubation system including 12 fermenters with the same four treatments. Each fermenter consisted of 40 mL goat ruminal fluid, 160 mL warm buffer, 2 g mixed substrates, and 50 mg FO-0, FO-5, FO-10 or FO-15. Fish oil inclusion reduced (P < 0.05) digestibility and nitrogen retention in Experiment 1. Increasing doses of FO in the diet induced a strong drop (P < 0.001) in ruminal total volatile fatty acid (VFA) concentration and protozoa population at 3 h post incubation, but did not affect individual VFA proportions. Substitution of FO for LO decreased mean concentrations of C18:0 (P = 0.057), c-9,c-12 C18:2 and C18:3n-3 (P < 0.001), but increased (P < 0.001) C20:5n-3 and C22:6n-3. Feeding FO-10 enhanced formation of ruminal c-9,t-11 conjugated linoleic acid (CLA) concentration compared with FO-0. Overall, combined data suggest that to improve ruminal concentrations of C20:5n-3, C22:6n-3, and c-9,t-11 CLA for deposition in tissues or milk with minimal risk of affecting digestibility and ruminal fermentation, a dietary supplementation of 15 g/kg LO and 10 g/kg FO would be suitable.

Multicenter Study of Device-Associated Infection Rates, Bacterial Resistance, Length of Stay, and Mortality in Intensive Care Units of 2 Cities of Vietnam: International Nosocomial Infection Control Consortium Findings.

OBJECTIVE: The aim of the study was to report the results of the International Nosocomial Infection Control Consortium (INICC) study conducted from May 2008 to March 2015. METHODS: A device-associated healthcare-acquired infection surveillance study in three adult intensive care units (ICUs) and 1 neonatal ICU from 4 hospitals in Vietnam using U.S. the Centers for Disease Control and Prevention's National Healthcare Safety Network (CDC/NHSN) definitions and criteria as well as INICC methods. RESULTS: We followed 1592 adult ICU patients for 12,580 bed-days and 845 neonatal ICU patients for 4907 bed-days. Central line-associated bloodstream infection (CLABSI) per 1000 central line-days rate was 9.8 in medical/surgical UCIs and 1.5 in the medical ICU. Ventilator-associated pneumonia (VAP) rate per 1000 mechanical ventilator-days was 13.4 in medical/surgical ICUs and 23.7 in the medical ICU. Catheter-associated urinary tract infection (CAUTI) rate per 1000 urinary catheter-days was 0.0 in medical/surgical ICUs and 5.3 in the medical ICU. While most device-associated healthcare-acquired infection rates were similar to INICC international rates (4.9 [CLABSI]; 16.5 [VAP]; 5.3 [CAUTI]), they were higher than CDC/NHSN rates (0.8 [CLABSI], 1.1 [VAP], and 1.3 [CAUTI]) for medical/surgical ICUs, with the exception of CAUTI rate for medical/surgical ICU and CLABSI rate for the medical ICU. Because of limited resources of our Vietnamese ICUs, cultures could not be taken as required by the CDC/NHSN criteria, and therefore, there was underreporting of CLABSI and CAUTI, influencing their rates. Most device utilization ratios and bacterial resistance percentages were higher than INICC and CDC/NHSN rates. CONCLUSIONS: Device-associated healthcare-acquired infection rates found in the ICUs of our study were higher than CDC/NHSN US rates, but similar to INICC international rates. It is necessary to build more capacity to conduct surveillance and prevention strategies.