Association Between Left Ventricular Strains and Cardiovascular Risk Factors in Type 2 Diabetic Patients: a Controlled Cross-sectional Study.

Background: Cardiovascular complications are the leading cause of death in diabetic patients. Speckle tracking echocardiography can early detect left ventricular systolic dysfunction even when normal ejection fraction. Objective: The study aims to evaluate left ventricular systolic function by Speckle tracking echocardiography and its relation with cardiovascular risk factors in type 2 diabetic patients. Methods: A controlled cross-sectional descriptive study was conducted on 150 patients (75 type 2 diabetic patients and 75 controls). Results: Type 2 diabetic patients had global longitudinal strain (-17.02±3.06%), global circumferential strain (-29.04±6.39%) were lower than the control group (p<0.05). Global longitudinal strain was correlated with systolic blood pressure (r=0.3), diastolic blood pressure (r=0.2), fasting plasma glucose (r=0.5), HbA1c (r=0.2), total cholesterol (r=-0.25), (p<0.05). Global circumferential strain was correlated with systolic blood pressure (r=0.2), diastolic blood pressure (r=0.2), HDL (r=-0.3), (p<0.05). Conclusion: Type 2 diabetic patients have reduced global longitudinal strain and global circumferential strain. The reduction of global longitudinal strain, global circumferential strain was correlated with cardiovascular risk factors (hypertension, not good glycemia control, increasing BMI, dyslipidemia).

HIV Prevalence and Factors Related to HIV Infection Among Transgender Women in Vietnam: A Respondent Driven Sampling Approach.

Transgender women are at higher risk of HIV infection, however, there is a lack of information about HIV infection and related factors among transgender women in Vietnam. From February 2018 to June 2018, 456 transgender women were recruited in the study using Respondent-Driven Sampling technique. Participants completed the computer-based questionnaire and were tested for HIV serostatus. Multivariable logistic regression was used to identify factors related to HIV infection. The prevalence of HIV infection was 77 (16.5%), of which 19 (24.7%) were not aware of their HIV-positive status prior to the study. Factors associated with HIV infection included popper use (aOR 2.01, p = 0.044) and having regular male partner(s) (aOR 0.42, p = 0.006). More efforts are needed to reduce the high prevalence of HIV infection, such as expanding the reach of HIV screening and prevention programs to the transgender women population, particularly for substance users.

Women living with HIV in Vietnam: desire for children, use of sexual and reproductive health services, and advice from providers.

In Vietnam, despite the possibility of living healthy sexual lives and bearing children due to the increasing availability of antiretroviral therapy and prevention of mother-to-child transmission services, HIV programming has given little attention to the sexual and reproductive health of people living with HIV. Our study explored factors influencing sexual and reproductive health decision-making, needs, rights and access to services for women living with HIV in Hai Phong and Ho Chi Minh City. Nearly half of the women were sexually active at the time of the study and 15% reported wanting a child or another child. Only 14% of women who did not want a child used contraceptive services in the last six months. More than 40% of women reported being advised, primarily by health care providers and family members, to abstain from sex, and more than 13% who were pregnant at the time of the study said that they had been advised to have an abortion. As with all women, women living with HIV must be informed of their sexual and reproductive rights and must have access to medically sound counseling and services to facilitate informed reproductive health decision-making. Sexual and reproductive health services are urgently needed for this population.

Integrating palliative care into HIV outpatient clinical settings: preliminary findings from an intervention study in Vietnam.

Symptom assessment and treatment for people living with HIV (PLHIV) cannot only lead to improvements in quality of life but contribute to combination antiretroviral adherence and early detection of virologic rebound. The majority of PLHIV in Vietnam receive their care in HIV outpatient settings, whereas very few clinics provide palliative care. The Ministry of Health has called for palliative care to be incorporated into existing HIV and cancer services, but there is limited guidance regarding how to operationalize integration. An HIV outpatient clinic palliative care intervention was tested in northern Vietnam to explore the accessibility, acceptability, and feasibility of integrated services. Primary outcome measures included changes in identification and treatment of pain and other symptoms, the prevalence of depression and anxiety, and perceived social support. The palliative care intervention included introduction of tools and mentoring to assess and treat pain and other symptoms as well as mental health and social support screening, counseling, and treatment services. The intervention resulted in significant changes in provider practice and service delivery. Providers and patients reported overall satisfaction with the intervention and resulting improvements in quality of care.