Study protocol for the Healthier Wealthier Families (HWF) pilot randomised controlled trial: testing the feasibility of delivering financial counselling to families with young children who are identified as experiencing financial hardship by community-based nurses.

INTRODUCTION: Poverty and deprivation can harm children's future health, learning, economic productivity and societal participation. The Australian Healthier Wealthier Families project seeks to reduce the childhood inequities caused by poverty and deprivation by creating a systematic referral pathway between two free, community-based services: universal, well-child nursing services, which provide health and development support to families with children from birth to school entry, and financial counselling. By adapting the successful Scottish 'Healthier Wealthier Children' model, the objectives of this Australian pilot are to test the (1) feasibility of systematising the referral pathway, and (2) short-term impacts on household finances, caregiver health, parenting efficacy and financial service use. METHODS AND ANALYSIS: This pilot randomised controlled trial will run in three sites across two Australian states (Victoria and New South Wales), recruiting a total of 180 participants. Nurses identify eligible caregivers with a 6-item, study-designed screening survey for financial hardship. Caregivers who report one or more risk factors and consent are randomised. The intervention is financial counselling. The comparator is usual care plus information from a government money advice website. Feasibility will be evaluated using the number/proportion of caregivers who complete screening, consent and research measures, and access financial counselling. Though powered to assess feasibility, impacts will be measured 6 months post-enrolment with qualitative interviews and questionnaires about caregiver-reported income, loans and costs (adapted from national surveys, for example, the Household, Income and Labour Dynamics in Australia Survey); health (General Health Questionnaire 1, EuroQol five-dimensional questionnaire, Depression, Anxiety, Stress Scale short-form); efficacy (from the Longitudinal Study of Australian Children); and financial service use (study-designed) compared between arms. ETHICS AND DISSEMINATION: Ethics committees of the Royal Children's Hospital (HREC/57372/RCHM-2019) and South West Sydney Local Health District (2019/ETH13455) have approved the study. Participants and stakeholders will receive results through regular communication channels comprising meetings, presentations and publications. TRIAL REGISTRATION NUMBER: ACTRN12620000154909; prospectively registered. Pre-results.

Cholera returns to southern Vietnam in an outbreak associated with consuming unsafe water through iced tea: A matched case-control study.

BACKGROUND: After more than a decade of steadily declining notifications, the number of reported cholera cases has recently increased in Vietnam. We conducted a matched case-control study to investigate transmission of cholera during an outbreak in Ben Tre, southern Vietnam, and to explore the associated risk factors. METHODOLOGY/PRINCIPAL FINDINGS: Sixty of 71 diarrheal patients confirmed to be infected with cholera by culture and diagnosed between May 9 and August 3, 2010 in Ben Tre were consecutively recruited as case-patients. Case-patients were matched 1:4 to controls by commune, sex, and 5-year age group. Risk factors for cholera were examined by multivariable conditional logistic regression. In addition, environmental samples from villages containing case-patients were taken to identify contamination of food and water sources. The regression indicated that drinking iced tea (adjusted odds ratio (aOR) = 8.40, 95% confidence interval (CI): 1.84-39.25), not always boiling drinking water (aOR = 2.62, 95% CI: 1.03-6.67), having the main source of water for use being close to a toilet (aOR = 4.36, 95% CI: 1.37-13.88), living with people who had acute diarrhea (aOR = 13.72, 95% CI: 2.77-67.97), and little or no education (aOR = 4.89, 95% CI: 1.18-20.19) were significantly associated with increased risk of cholera. In contrast, drinking stored rainwater (aOR = 0.17, 95% CI: 0.04-0.63), eating cooked seafood (aOR = 0.27, 95% CI: 0.10-0.73), and eating steamed vegetables (aOR = 0.22, 95% CI: 0.07-0.70) were protective against cholera. Vibrio cholerae O1 Ogawa carrying ctxA was found in two of twenty-five river water samples and one of six wastewater samples. CONCLUSIONS/SIGNIFICANCE: The magnitude of the cholera outbreak in Ben Tre was lower than in other similar settings. This investigation identified several risk factors and underscored the importance of continued responses targeting cholera prevention in southern Vietnam. The association between drinking iced tea and cholera and the spread of V. cholerae O1, altered El Tor strains warrant further research. These findings might be affected by a number of limitations due to the inability to capture asymptomatic or mildly symptomatic infections, the possible underreporting of personal unhygienic behaviors, and the purposive selection of environmental samples.

National surveillance for influenza and influenza-like illness in Vietnam, 2006-2010.

Influenza virus infections result in considerable morbidity and mortality both in the temperate and tropical world. Influenza surveillance over multiple years is important to determine the impact and epidemiology of influenza and to develop a national vaccine policy, especially in countries developing influenza vaccine manufacturing capacity, such as Vietnam. We conducted surveillance of influenza and influenza-like illness in Vietnam through the National Influenza Surveillance System during 2006-2010. At 15 sentinel sites, the first two patients presenting each weekday with influenza-like illness (ILI), defined as fever and cough and/or sore throat with illness onset within 3 days, were enrolled and throat specimens were collected and tested for influenza virus type and influenza A subtype by RT-PCR. De-identified demographic and provider reported subsequent hospitalization information was collected on each patient. Each site also collected information on the total number of patients with influenza-like illness evaluated per week. Of 29,804 enrolled patients presenting with influenza-like illness, 6516 (22%) were influenza positive. Of enrolled patients, 2737 (9.3%) were reported as subsequently hospitalized; of the 2737, 527 (19%) were influenza positive. Across all age groups with ILI, school-aged children had the highest percent of influenza infection (29%) and the highest percent of subsequent hospitalizations associated with influenza infection (28%). Influenza viruses co-circulated throughout most years in Vietnam during 2006-2010 and often reached peak levels multiple times during a year, when >20% of tests were influenza positive. Influenza is an important cause of all influenza-like illness and provider reported subsequent hospitalization among outpatients in Vietnam, especially among school-aged children. These findings may have important implications for influenza vaccine policy in Vietnam.

National influenza surveillance in Vietnam, 2006-2007.

In 2006, national influenza surveillance was implemented in Vietnam. Epidemiologic and demographic data and a throat swab for influenza testing were collected from a subset of outpatients with influenza-like illness (ILI). During January 1, 2006 through December 31, 2007, of 184,521 ILI cases identified at surveillance sites, 11,082 were tested and 2112 (19%) were positive for influenza by reverse transcription polymerase chain reaction. Influenza viruses were detected year-round, and similar peaks in influenza activity were observed in all surveillance regions, coinciding with cooler and rainy periods. Studies are needed to ascertain the disease burden and impact of influenza in Vietnam.

Tumour-promoting activity of altered WWP1 expression in breast cancer and its utility as a prognostic indicator.

WWP1 is a ubiquitin ligase, associated with the post-translational regulation of several tumour-promoting and tumour suppressor proteins. Here we show that WWP1 expression is up-regulated in a subset of breast tumour cell lines and primary breast tumours. We overexpressed WWP1 in MCF10A breast epithelial cells and demonstrated increased cell growth and anchorage-independent colony formation. RNAi knockdown of WWP1 expression in T47D and MCF7 breast tumour cell lines reduced anchorage-independent colony formation. We used WWP1 protein expression levels, in combination with its sub-cellular localization, to classify breast tumours into four categories. Surprisingly, a category with low/absent WWP1 expression displayed a consistently worse prognosis compared with WWP1-expressing tumours. Importantly, the association with disease-free survival was independent of the status of other commonly used prognostic indicators. Thus, WWP1 is a prognostic marker and may be a potential therapeutic target for a subset of breast tumours.

Marinobacter aquaeolei sp. nov., a halophilic bacterium isolated from a Vietnamese oil-producing well.

Several strains of moderately halophilic and mesophilic bacteria were isolated at the head of an oil-producing well on an offshore platform in southern Vietnam. Cells were Gram-negative, non-spore-forming, rod-shaped and motile by means of a polar flagellum. Growth occurred at NaCl concentrations between 0 and 20%; the optimum was 5% NaCl. One strain, which was designated VT8T, could degrade n-hexadecane, pristane and some crude oil components. It grew anaerobically in the presence of nitrate on succinate, citrate or acetate, but not on glucose. Several organic acids and amino acids were utilized as sole carbon and energy sources. The major components of its cellular fatty acids were C12:0 3-OH, C16:1, omega 9c, C16:0 and C18:1 omega 9c. The DNA G + C content was 55.7 mol%. 16S rDNA sequence analysis indicated that strain VT8T was closely related to Marinobacter sp. strain CAB (99.8% similarity) and Marinobaster hydrocarbonoclasticus (99.4% similarity). Its antibiotic resistance, isoprenoid quinones and fatty acids were similar to those of Marinobacter hydrocarbonoclasticus and Pseudomonas nautica. However, the whole-cell protein pattern of VT8T differed from that of other halophilic marine isolates, including P. nautica. DNA-DNA hybridization indicated that the level of relatedness to Marinobacter hydrocarbonoclasticus was 65% and that to P. nautica was 75%. Further differences were apparent in Fourier-transformed IR spectra of cells and lipopolysaccharide composition. It is proposed that VT8T should be the type strain of a new species and should be named Marinobacter aquaeolei. P. nautica may have been misclassified, as suggested previously, and may also belong to the genus Marinobacter.

Characterization of petroleum-degrading bacteria from oil-contaminated sites in Vietnam.

Four petroleum-degrading bacterial strains, 2TN-NB, 6TBX-CL, MVK2-5, and XCK, were isolated from various oil-contaminated sites in Vietnam. Determination of the nucleotide sequence of the gene encoding 16S rRNA allowed 2TN-NB to be identified as Acinetobacter sp. and the other three stains as Pseudomonas sp. Among the four isolates, 2TN-NB was most effective in degrading crude oil: in 1 d, it degraded 95% of the crude oil in the culture medium (5%, v/v). The isolated strains could also degrade a sulfur-containing aromatic hydrocarbon, dibenzothiophene (DBT), with low efficiency. Except for MVK2-5, which degraded crude oil least efficiently, the isolates produced biosurfactants in amounts sufficient for structural analysis. FT-IR measurement suggested that strains 6TBX-CL and XCK produced glycolipid-type biosurfactants while that produced by 2TN-NB was of the polysaccharide type.

[A difficult therapeutic dilemma: pneumoperitoneum in severe blunt injuries treated by respiratory or cardiorespiratory resuscitation]. / Un difficile dilemme thérapeutique: le pneumopéritoine dans les graves traumatismes fermés traités par réanimation respiratoire ou cardio-respiratoire.

In the particular context of severe blunt trauma treated with cardiorespiratory resuscitation or, more simply, with positive-pressure ventilation, the occurrence of pneumoperitoneum always raises difficult problems of etiological diagnosis, which in turn lead to a difficult dilemma on the treatment to adopt. In fact, while the air released by the alveolar baro-trauma can, once a given pressure is exceeded, migrate into the retroperitoneum and produce a non-surgical pneumascos (for which the other possible causes are far more exceptional, and rather are unpleasant surprises, such as this orogenital induced PPT in Gantt's female patient, conversely the pressurized air from true ruptures of intraabdominal hollow organs may migrate into the mediastinum and cause a thoracic air leakage syndrome that perfectly simulates this pulmonary baro-trauma. Therefore all the paraclinical means required must be used to confirm--or rule out--this diagnosis of perforation, which demands emergency surgery. However, if there is any doubt, the consensus is that emergency surgery is recommended as it is better to accept blank laparotomy than to oversee a gastrointestinal rupture with all its severe complications of evolution.

Surgery and chemotherapy. A new method of treatment for squamous cell bronchial carcinoma.

Between April, 1981, and December, 1982, 32 patients with squamous cell bronchial carcinoma were treated with a chemotherapy regimen followed by operation. The preoperative chemotherapeutic agents used were cisplatin, bleomycin, and mitomycin C. A thoracotomy was performed 3 to 4 weeks after the last day of the last treatment. Of the 29 undergoing resection, three (10.3%) had no tumor cells in the resected specimen and four (12.5%) had only a few neoplastic microcenters in tissue necrosis or fibrosis. We suggest that the use of this new chemotherapy combination with surgical resection provides excellent palliation, increases resectability, and has a potential for increasing the cure rate in squamous cell carcinoma of the lung.

[Solitary fibrous tumors of the visceral pleura. 5 cases]. / Tumeurs fibreuses solitaires de la plèvre viscérale. Cinq observations.

Five new cases of solitary fibrous mesothelioma of the visceral pleura support this review of the literature. Well encapsulated and usually pediculated, these tumours remain asymptomatic for a long time and are in most cases an incidental finding on radiographs of the chest. The precise site of the tumour can be identified by artificial pneumothorax. Some large tumours are accompanied by extrathoracic signs, i.e. hypoglycemia and hypertrophic pulmonary osteoarthropathy. Histological examination discloses whorls of collagen fibres with scattered spindle-shaped cells. Electron microscopy reveals characteristic features of both fibroblasts and mesothelial cells. Complete surgical removal is the best treatment of localized fibrous mesotheliomas of the visceral pleura. Post-surgical recurrences are rare, and late recurrences (up to 16 years after excision) are usually benign and of good prognosis.

[Branchiomeric mediastinal chemodectoma: a case report and literature review]. / Chémodectomes médiastinaux branchiomériques. A propos d'un cas et revue de la littérature.

Among non-chromaffin paragangliomas, the so-called aorticopulmonary or branchiomeric mediastinal chemodectomas are very rare tumors. A case is reported, and 57 similar cases described in the literature are reviewed. As recommended by Olson, a separate group was instituted of 21 cases of the so-called posterior mediastinal or aorticosympathetic group of the costovertebral groove. In principle, aorticopulmonary chemodectomas are non-functional, and in 9 out of 10 cases follow a slow and benign course extending over many, or even tens of years. In contrast to carotid and jugular paragangliomas they are rarely multifocal: when this is the case it is difficult to confirm the presence of metastases, this being however the most reliable criterion of their malignancy. The fortuitous discovery on a radiography of a tumor of the anterior and middle compartments of the upper mediastinum should invoke the presence of an aorticopulmonary chemodectoma, and lead to arteriography of the aortic arch region. Diagnosis is made essentially by pathological examination. Treatment is exclusively by surgical excision, and this was complete in nearly half of the cases treated. Prognosis is not hopeless after partial removal, however, and a relatively comfortable survival can be obtained extending over many years.

[A familial case of thoracic outlet syndrome. Clinical, radiological study with treatment (author's transl)]. / Un cas familial de côte cervicale. Etude clinique, radiologique et thérapeutique.

The authors report the clinical and radiological study and the treatment of a fifteen members family (the two parents and their thirteen children) affected with a thoracic outlet syndrome secondary to a cervical rib and or an apophysomegaly of the seventh cervical vertebra. On the fifteen people considered, the father being deceased has not been examined but has an evocative clinical history. The mother has a clinical impairment with a late beginning and no radiological sign. Twelve children have clinical and radiological signs, one has radiological without clinical signs. Three children underwent a surgical treatment, the others only medical treatment. There is no satisfactory correlation between the clinical features and electrical investigations (electromyography, nerve conduction studies) and radiological examinations. The semiology is vascular, neurologic or mixt. Roos test seems more reliable than that of Adson, Calb and Roth, and Saunders. Eight grand-children out of fourty have been examined. Five have clinical and radiological signs, three have casual radiological signs. The radiological impairment of this family contrasts with the normal frequency of cervical anomalies in the population which is 0,12 to 1%. The family impairment of the thoracic outlet syndrome is rarely reported.

[The atrio-ventricular junction: descriptive aspects]. / La jonction atrio-ventriculaire aspect descriptif.

An attempt is made to give a new, revised and more adapted description of the atrio-ventricular junction. This description is based on our personal observations and on data collected from the anatomical and embryological literature of the last 30 years. A fibrous layer interrupting muscle continuity exists between the atria and the ventricles. This non conductive fibrous structure - classically referred to as an Atrio-Ventricular Ring - is not a tendinous ring (LOWER) or a cordlike annulus: it is a fragile lamina which also serves as anchorage for the A-V valves. In no way, can it provide a secure site for the placement of sutures in valve surgery. Both on mitral and tricuspid sides, the so-called A-V ring has a crescentic shape rather than an oval or circular shape. It is best divided into two segments for descriptive purposes: an aorto-septal and a scissural segment: The aorto-septal segment (antero-medial) is thicker and tougher. It presents close, important and dangerous relation-ships - with the postero-lateral part of the aortic root, - and with the vital structures located in the complex junctional zone of the 4 heart cavities (carrefour des cavités cardiaques). The scissural segment (postero-lateral) which forms the deepest part of the A-V fissure, is represented, on both sides, by the subvalvular lamina. This horseshoe shaped lamina is thin and fragile. It is easily stretched following the A-V ostium enlargement, resulting in functional mitral or tricuspid insufficiency.

[Gastro-duodenal artery arising from the superior mesenteric artery]. / Artère gastro-duodénale naissant de la mésentérique supérieure.

These exceptional anomalies of the gastro-duodenal (G.D.) arteries provide a better understanding of certain very odd vessels found on coeliac or superior mesenteric arteries selective arteriography. In our series of 400 dissected bodies, a typical origin of the G.D. artery from the superior mesenteric artery is noted in 4 cases : the aberrant vessel is identified as a G.D. artery because of a) its course, b) and its two usual terminal divisions : superior pancreatico-duodenal and right gastro-epiploic arteries. On the other hand, we have 10 cases of G.D. artery arising from both coeliac hepatic and superior mesenteric arteries with:--a dominant hepatic branch in 6,--a dominant mesenteric branch in 3,--and a balanced origin in 1. A G.D. artery looping around the common bile duct to reach the anterior surface of the pancreas (Michels) was never seen in this series.

[First cases of surgical pulmonary cryptococcosis in Vietnam]. / Premiers cas de cryptococcose pulmonaire chirurgicale au Vietnam

Two cases of tumoral isolated pulmonary cryptococcosis are reported. The rarity of the facts explains that diagnosis is usually surgical, the inflammatory and necrotic pseudo-tumour swarming with yeast-like micro-organisms, easily recognizable by their thick gelatinous capsules.

[Small veins of the heart auricle]. / Les petites veines des oreillettes

A rich venous network in the atria of the human heart, has been demonstrated by the "corrosion-fouille" technic with direct injection. The atrial veins may be arranged in 2 main groups:--the group of the Coronary Sinus for the left atrium.--the group of venae cordis parva for the right atrium (1), the interatrial septum and the neighbouring parts of the left atrium. The venae cordis parva may be subdivided into:--those descending to the right atrio-ventricular sulcus and ending in the right atrium or in a "right coronary collecting channel" (2) (small cardiac vein, Adachi common channel, Parsonnet subendocardial vein of the right atrium).--and those opening by the Lannelongue foramina into the right atrium. Are described 4 principal foramina and veins, arranged in 2 groups:--the group of the S.V.C. ostium, corresponding to the Superior Atrio-Septo-Nodal artery, with 3 veins, the Anterior Lateral vein (or vein of the cavo-auricular notch) for the Sino-Atrial node, descending along the sulcus terminalis, the Anterior Superior and Posterior Superior veins for the interatrial septum, the adjacent parts of the right and left atria. The large ramus from the top of the left atrium, a tributary of the Posteror Superior Vein, corresponds to the homonymous collateral of the Superior A.S.N. artery.--the group of the Coronary Sinus ostium, corresponding to the Inferior A.S.N. arteries, with the Anterior Inferior vein, returning blood from the A-V node region. Of these 4 veins, only one originates on the lateral side of the S.V.S. ostium; the 3 remaining lie on the interatrial septum, near the corresponding angles: Anterior-Superior, Posterior-Superior and Anterior-Inferior.