Pretibial myxedema in Grave's disease: A case report and treatment review of the literature.

Key Clinical Message: Pretibial myxedema is a rare skin lesion in Grave's disease, which required topical glucocorticoid administration in long-term treatment. The patient's lesion has shrunk and become flatter than before treatment. Abstract: We present a case of biopsy-verified pretibial myxedema in a 70-year-old male patient with diagnosed hyperthyroidism and no prior history of Graves' disease. Topical corticosteroid and antithyroid drug administration led to successful resolution of the skin lesions. This case emphasizes the importance of considering pretibial myxedema even in atypical presentations of Graves' disease and underscores the value of prompt treatment.

Radiofrequency versus Ethanol Ablation for Single-Session Treatment of Benign Cystic Thyroid Nodules: A Short-Term Retrospective Study.

Objective: This study aims to compare 1-month's efficacy and safety of single-session ethanol ablation and radiofrequency ablation for treating both purely cystic nodules and predominantly cystic thyroid nodules. Materials and methods: This short-term retrospective study was approved by the Ethics Committee of the Institutional Review Board of Danang Family hospital, and written informed consent for procedures was obtained for all patients. Thirty-nine patients who presented with cystic thyroid nodules and met inclusion criteria were extracted from the computerized medical records. The internal fluid of cystic thyroid nodules was aspirated as much as possible. Ethanol ablation was performed using 18-gauge needles with 99.5% ethanol, and RFA used a cooled-electrode RFA system and 18-gauge internally cooled electrodes via the trans-isthmic approach, moving-shot technique. Nodule volume, therapeutic success rate, the largest diameter, thyroid function tests, and complications were evaluated and compared before and after treatment in each group. Results: Among 39 patients, 17 patients were undergone EA (mean age of 47.35 years; the proportion of female of 76.5%; purely thyroid cyst percentage of 41.4%) and 22 patients were undergone RFA (mean age of 46.63 years; the proportion of female of 86.4%; purely thyroid cyst percentage of 54.5%). Both treatment techniques showed a significant reduction of the largest diameter and nodule volume (p<0.05) without complications. RFA reduced nodule volume and the largest nodule size greater than EA treatment at 1-month post-ablation (p<0.05). In addition, the therapeutic success rate in the RFA group was higher than in the EA group. Conclusion: Both RFA and EA treatment with single-session confirm the efficacy and safety for cystic thyroid nodules at 1-month follow-up, RFA reduced greater in nodule volume and the largest nodule size than the EA treatment. Thus, the therapeutic success rate in the RFA group was higher than in the EA group.

Diabetes self-management and its associated factors among patients with diabetes in central Vietnam: A cross-sectional study.

OBJECTIVE: Diabetes self-management (DSM) enables maintenance of optimal individualized glycemic control for patients with diabetes through comprehensive lifestyle, medication adherence, and self-monitoring glucose level. This study aimed to evaluate DSM and to find associated factors among Vietnamese diabetes patients by using the Vietnamese version of Diabetes Self-Management Instrument (DSMI). METHODS: A cross-sectional study was conducted at a single hospital in the central Vietnam. DSM was assessed using the DSMI. The participant's socio-demographic and clinical features were obtained through face-to-face interviews and medical records. Multivariate linear regression was used to determine independent factors associated with total DSMI. RESULTS: The mean total DSM score based on DSMI self-administered questionnaire scores was 88.4 ± 22.1, with a range of 47 to 140. The mean self-integration, self-regulation, interaction with health professionals, self-monitoring blood glucose, and adherence to the prescribed regime were 24.8, 22.3, 21.6, 10.2, and 9.5, respectively. 48.1% of DM patients had good HbA1c control. Sex, educational status, BMI, waist circumference, medical nutrition therapy, and sufficient physical activities were factors independently predictive of DSMI total score. CONCLUSION: This study emphasizes that the DSM situation is seen to be average among DM patients with mean DSMI score 88.4 ± 22.1 and sex, educational status, BMI, waist circumference, medical nutrition therapy, and sufficient physical activities were independently predictive factors of DSMI total score. This evidence suggests that there is a need to enhance the effectiveness of DSM education programs among diabetic patients.

Efficacy and Safety of Radiofrequency Ablation for the Treatment of Autonomously Functioning Thyroid Nodules: A Long-Term Prospective Study.

OBJECTIVE: This study aims to evaluate the efficacy and safety of RFA in the AFTN treatment after 2 years of follow-up and to find the factors related to treatment responses through TSH level and VRR. MATERIALS AND METHODS: This long-term prospective study was conducted from September 2017 to April 2021 on 17 AFTNs treated with RFA. Clinical evaluations, thyroid function tests, thyroid scintigraphy, and ultrasonography examinations were performed at 1 month, 3 months, 6 months, and 24 months after ablation. The primary endpoint was the success rate of RFA in restoring the euthyroidism stage after 24 months of follow-ups; secondary outcomes were VRR and improvements of US parameters, clinical examinations, and complications. The Spearman rank correlation test was used to determine related factors with treatment response variables. RESULTS: At the 24 months after the procedure, symptom score, cosmetic score, vascularity grade, and nodule volume significantly decreased. The VRR reduced approximately 42.77%, 63.13%, 78.3%, and 95.65% after 1 month, 3 months, 6 months, and 24 months follow-up. All 17 patients were restored euthyroid state without taking ATDs. No major complications were collected. The last TSH level was significantly correlated with the age of patients (Spearman rho = -0.637, p = 0.008). The VRR was significantly correlated with age of patients (Spearman rho = 0.566, p = 0.018) and initial TSH (Spearman rho = 0.485, p = 0.048). CONCLUSION: RFA was demonstrated as a safe and effective option for AFTN treatment in long-term follow-up. It can be used as an alternative treatment with encouraging results.

Lidocaine-induced systemic toxicity complicating radiofrequency ablation of benign thyroid nodule procedure: A case report and review of literature.

The systemic toxicity of lidocaine is an extremely rare complication of thyroid RFA procedure, and it can be life-threatening. The quick recognization of its symptoms and intravenous use of lipid emulsion are essential to preventing mortality.

Efficacy and Safety of Single-Session Radiofrequency Ablation in Treating Benign Thyroid Nodules: A Short-Term Prospective Cohort Study.

OBJECTIVE: The aims of this study are to evaluate the safety and efficacy of RFA in the treatment of benign thyroid nodule(s) and to find independent factors related to the volume reduction rate of the nodule(s). MATERIALS AND METHODS: This short-term prospective study from a single medical center was conducted on 93 benign thyroid nodules in 93 patients treated with RFA. Two basic techniques were used: the trans-isthmic approach and moving-shot technique. Clinical and ultrasonography examinations were performed at 1- and 3-month follow-up after the treatment session. Primary outcomes included volume reduction ratio (VRR) at 1-month and 3-month follow-ups; secondary outcomes were therapeutic success rate and complications. Multiple linear regression analysis was used to determine independent factors associated with VRR. RESULTS: A final sample of 78 patients with 78 nodules, given participant rate 83.8% (including 60 solid nodules, 16 predominantly cystic nodules, and 2 thyroid cysts), was followed up for 3 months. The mean volume reduction ratio was 41.47% and 64.72% after 1-month and 3-month follow-ups, respectively. The therapeutic success rate was 30.8% at 1-month and 84.6% at 3-month follow-ups. Symptom score and cosmetic score improved significantly. There was no change in thyroid function tests. Two minor complications (transient voice change) were found. The multiple linear regression analysis showed that the internal component of the nodules significantly related to the VRR during the 3-month follow-up (ß = 23.00; 95%CI (7.59-38.45)). CONCLUSION: RFA was demonstrated as a safe and effective option for benign thyroid nodules treatment. It can be used as an alternative treatment with encouraging results.

Diabetes-Related Distress and Its Associated Factors Among Patients with Diabetes in Vietnam.

BACKGROUND: Psychometric properties are regarded as one of the significant contributors related to diabetes treatment efficacy. Diabetes-related distress (DD) is one of the emotional burdens. The aims of this study were to investigate the prevalence of DD and to determine its associated factors among Vietnamese diabetic patients. METHODS: A cross-sectional study was conducted at a single medical center in the central of Vietnam. A total of 138 eligible DM outpatients were invited and a total of 112 patients who completed the questionnaire were utilized in this analysis using convenience sampling. DD was assessed using the diabetes distress scale (DDS). The participant's sociodemographic and clinical information was obtained through face-to-face interviews and medical records. Multivariate logistic regression was used to determine independent factors associated with the presence of DD. RESULTS: Approximately, 12.5% of the patients experienced DD based on DDS self-administered questionnaire. The rates of mild/moderate and high distress were 8.0% and 4.5%, respectively. DD was found to be significantly higher in type 1 DM (p=0.04), insulin only in treatment regime (p=0.04), physical inactivities (p=0.02), times of mild hypoglycemia (time/month) (p=0.01), and fasting plasma glucose (mmol/l) (p=0.04). The occurrence of distress among DM patients was negatively correlated with their age and amount of physical exercise. Meanwhile, poor HbA1c control (HbA1c≥7%) was associated with an increased occurrence of diabetes distress. CONCLUSION: The findings of single medical center in Vietnam highlights that DD is prevalent among DM patients. It should be of marked concerns, particularly the type 1 diabetic patients, younger age, and poor glycemic control patients.

Hepatitis B Infection and Mother-to-Child Transmission in Haiphong, Vietnam: A Cohort Study with Implications for Interventions.

BACKGROUND: There is little data available on HBV infection and mother-to-child transmission (MTCT) in Vietnam. OBJECTIVE: This study is aimed at assessing the prevalence of HBV infection and the current situation of MTCT in Haiphong, Vietnam. METHODS: A transversal survey of 1721 pregnant women followed by an observational prospective cohort study of 183 HBV-infected women was conducted at Haiphong Gyneco-Obstetric Hospital. Women were followed up up to 12-month postpartum; use of prevention measures and the MTCT rate were evaluated. HBV infection in children was defined by a HBsAg-positive test at 12 months of age. RESULTS: At baseline, 183 of 1721 pregnant women (10.6%) tested HBsAg positive. Among them, 23.0% were HBeAg positive, 26.2% had a detectable load of HBV DNA, and 13.1% had a HBV DNA load ≥ 200,000 IU/mL. All women underwent MTCT prevention antiviral therapy. At delivery, 98.9% of newborns receive a HBV vaccine birth dose, and 82% received HBIG. At 12 months of age, 94.7% have received the scheduled HBV vaccines. Eight percent of infants born from followed-up women were HBsAg positive. The mother's HBeAg-positive status was associated with a higher risk of HBV infection in infants. CONCLUSION: The HBV prevalence and MTCT rates are high in Haiphong. A strong national plan to increase the access to preventive measures and to monitor results is needed in order to decrease this prevalence.

Undifferentiated pleomorphic sarcoma of the thyroid: A case report and ƚiterature review.

This report describes a patient who presented with a large thyroid nodule and compressive symptoms. Immunohistochemical staining showed diffuse marked reactivity for vimentin and focal reactivity for CD68 and Ki-67 that is compatible with primary undifferentiated pleomorphic sarcoma of the thyroid. This report emphasizes and discusses extremely rare thyroid cancer type.

Variation of Mitochondrial DNA HV1 AND HV2 of the Vietnamese Population.

BACKGROUND: The sequence polymorphism of mitochondrial DNA (mtDNA) hypervariable segment 1 (HV1) and hypervariable segment 2 (HV2) is studied and applied to genetic diversity and human evolution assessment, forensic genetics, consanguinity determination, and mitochondrial disease diagnosis. METHODS: The study identified the variations of HV1 and HV2 of 517 unrelated Vietnamese individuals in Kinh, Muong, Cham, and Khmer ethnic. We performed sequencing of two hypervariable segments of mitochondrial DNA: HV1 and HV2. RESULTS: Fifty haplogroups were identified in which F1a haplogroup frequency was highest at 15.7%, followed by B5a (10.8%), M (8.9%), and M7b1 (7.7%). The most frequently encountered SNPs in this study were A263G (100%), A73G (99.6%), 315insC (96%), 309insC (56%), C16223T (41%), and T16189C (39%). The genetic diversity was calculated at 99.83%, and the probability of random match of two individuals sharing the same mtDNA haplotype was 0.37%. CONCLUSION: We have assessed the genetic polymorphism of mtDNA HV1 and HV2 of 517 Kinh, Muong, Cham, and Khmer ethnic samples. The result will help in better understanding of Vietnamese's mitochondrial genome diversity and aid in population as well as forensic science.

Intra-familial transmission of Helicobacter pylori infection in children of households with multiple generations in Vietnam.

This community-based cross-sectional study in 533 participants from 135 households with multiple generations living in the same household aimed at investigating the relationship between Helicobacter pylori infection in children and the other household members. H. pylori infection in children was found significantly associated with the infection in mothers [OR (95% CI): 2.50 (1.19-5.26)], even after being adjusted for sex, age group and sibling number [adjusted OR (95% CI): 2.47 (1.12-5.47)]. It was also significantly associated with the infection in both parents [adjusted OR (95% CI): 4.14 (1.29-13.23)]. No significant association between H. pylori infection in the father, grandparent(s), uncle or aunt with that in their children was found. Results from the present study showed intra-familial transmission in a multi-generation population and supported the hypothesis of person-to-person transmission of H. pylori infection.

Usefulness and influence of age of a novel rapid monoclonal enzyme immunoassay stool antigen for the diagnosis of Helicobacter pylori infection in children.

A novel rapid monoclonal enzyme immunoassay stool antigen for Helicobacter pylori detection (Immunocard STAT!HpSA, Meridian Diagnostic Inc , Cincinnati, OH) was evaluated in 29 infected and 99 noninfected children. The overall sensitivity, specificity, and positive and negative predictive values were 86.2%, 92.9%, 78.1%, and 95.8%, respectively, with an accuracy of 91.4%. The highest performance was observed in children older that 10 years, with a sensitivity level of 100%, contrasting with a lower level, 75%, in those younger than 5 years. A good negative predictive value was observed in all age groups, particularly in older children achieving 100%.

Heterogeneous susceptibility of Helicobacter pylori isolated from a single biopsy in adults and children to metronidazole and clarithomycin

Growing increase in resistance of H. pylori strains to antibiotics of choice is identified worldwide, requiring further investigating susceptible characteristics of the germ to these agents. Objectives: To assess the resistance of H. pylori individual colonies from a single biopsy to metronidazole and clarithromycin. Methods: The E - test was used to determine the Minimum Inhibitory Concentrations (MICs) of these two antimicrobial drugs for ten H. pylori colonies isolated from an initial gastric biopsy culture from each of 14 adults and 14 children. Results: Among patients haboring HP strains resistant to these 2 antimicrobials, we observed heterogeneity in metronidazole resistance in 14/22 cases and in clarithromycin resistance in 3/13 cases. The number of resistant individual colonies ranged from 2/10 to 9/10 depending on subjects. Conclusions: In the same biopsy from both adults and children different colonies of H. pylori displayed different antimicrobial susceptibility patterns prior to anti - H. pylori treatment, rendering antibiogram interpretation difficult.

Helicobacter pylori infection in institutionalized children in Vietnam the importance of the first 3 years of residence

The study was aimed to assess the H. pylori infection rate and to investigate contributing factors among 105 orphans and 85 handicapped institutionalized children. H. pylori seropositivity was 71.4% (75/105) in the handicapped as compared to 41.3% (77/186) in the control. Orphan children were at the highest risk factor of affecting H. pylori in the first three years, but healthy orphan children were more likely to be infected in the first year of residence while handicapped children were more likely to be infected in the second and the third year of their residence. There was no link between lifestyle, health status and HP infection in both two groups of children

Influence of previous antibiotic use on helicobacter pylori seropositivity in children

At Bach Mai hospital,on 824 pediatric sutbjects aged 6 months – 15 years, the infuence of previously used antibiotics on serological results of the epidemiological diagnosis of Helicobacter pylory infection was evaluated. Among 731 studied children using antibiotics, there was HP (+) in 34,6%. There was no significant relation between the use/no use of antibiotics and HP infected. serological results.There was no same relation between the moment, the frequency,the duration and the antibiotherapy use with the results of serological diagnosis of HP infection

Cross-infection of Helicobacter pylori in multiple generation households in Northern Vietnam

Study on prevalence of HP(+) infection and the relationship between HP(+) among children and members in a multi-generation family through 189 children and 344 adults of 99 households. The results showed that, HP seropositivity was 67.4% in adults and 41.3% in children. Some risk factors were identified such as: The seropositive mother was the highest risk factor for HP seropositivity in children and the relationship between HP(+) among children and their mother was independent with other factors. The seropositive father increased HP infective risk in children, but seropostivity in mother was more important. Children's seropositivity was significantly increased in households with  3 children, in those with > 4 persons. No association was found between HP seropositivity in children and that in their grandparents and relatives