Polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans in blood samples from historically herbicide-sprayed areas and rural and industrialized unsprayed areas in Vietnam.

We investigated dioxin concentrations in the blood of residents living in areas with different sources of dioxin pollution in Vietnam. A total of 823 individual blood samples were collected in 2014-2015 from residents of 16 provinces in Vietnam who were born between 1972 and 1976, and who lived in rural unsprayed areas (the control area), industrialized unsprayed areas (the industrialized area), and areas in which herbicides were sprayed during the Vietnam War (the sprayed area). After blood collection, pooled samples were obtained by combining 10-25 individual samples by age and sex for each area. A total of 6, 10, and 26 pooled blood samples were obtained for the control area, industrialized area, and sprayed area, respectively. The concentrations of 17 polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans were quantified in each pooled blood sample. The concentrations of TCDD, 1,2,3,7,8,9-HxCDD, 1,2,3,7,8-PeCDF, and OCDF were significantly higher in the sprayed area than in the unsprayed area, which comprised the control and industrialized areas. The toxic equivalents of PCDDs, TCDD, 1,2,3,7,8-PeCDF, and 1,2,3,6,7,8-HxCDF were significantly higher in the sprayed area than in the control area. No significant difference in dioxin concentration was found between the sprayed and industrialized areas after adjusting for sex. The 1,2,3,6,7,8-HxCDF concentration was significantly higher in the industrialized area than in the control area. The findings indicate that there are different dioxin congener blood profiles in residents of industrialized areas and areas in which herbicides were historically sprayed during the Vietnam War.

A Comparison of the National Institutes of Health Stroke Scale and the Gugging Swallowing Screen in Predicting Stroke-Associated Pneumonia.

BACKGROUND: There have been many scales to predict pneumonia in stroke patients, but they are so complex, making it difficult to apply in practice. Therefore, we conducted this study to assess the role of the National Institutes of Health Stroke Scale (NIHSS) and the Gugging Swallowing Screen (GUSS) in predicting stroke-associated pneumonia (SAP). These scales are routinely used in stroke patients. Therefore, their application in predicting SAP risk will be of high value in clinical practice. There has been no previous study evaluating the effectiveness of SAP risk prediction for each of these scales. AIM: This study aimed to compare the value of NIHSS and GUSS in SAP prediction and their convenience in clinical practice. METHODS: It was a cohort study. The receiver operating characteristics (ROC) curves were constructed to assess the sensitivity (Se) and specificity (Sp) of the scales. Area under the curves (AUC) were calculated, and we compared them. RESULTS: NIHSS had a medium value of predictor of SAP with AUC 0.764 (95% CI 0.735-0.792), 65.4% Se, 76.5% Sp. GUSS had good value in predicting SAP with AUC 0.858 (95% CI 0.833-0.880), 80.5% Se, 80.1% Sp. Pairwise comparison of ROCs curves demonstrated that the difference between two AUCs was significant (p < 0.01). Performing GUSS required 24.5 ± 6.7 minutes, 2.5 times longer than NIHSS (9.9 ± 2.0 minutes). CONCLUSION: GUSS had a better predictive value of SAP than NIHSS. But NIHSS was more convenient in clinical practice because of its simple instrument and quick performance.