Pembrolizumab-induced Stevens-Johnson syndrome/Toxic Epidermal Necrolysis in a Vietnamese patient with nonsmall-cell lung cancer.

Chemoimmunotherapy is an effective therapy for an individual with nonsmall-cell lung cancer (NSCLC) without anaplastic lymphoma kinase or epidermal growth factor receptor mutations. However, it can also be related to adverse cutaneous reactions such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) with high morbidities and mortality rates. We present a case of a 65-year-old male with NSCLC who underwent first-line chemotherapy with paclitaxel, carboplatin, and pembrolizumab, which was later followed by a second cycle of the same therapies. The patient developed a fever and rash 12 days after the second cycle. Pembrolizumab was strongly suspected as the culprit medication because cutaneous reactions to this drug have been frequently reported and threw other medications used as less likely candidates. This is the first case reported in Vietnam of SJS/TEN related to pembrolizumab and contributes to our knowledge of severe skin reactions associated with immune checkpoint inhibitors.

A unique genetic variation with respect to blast (Pyricularia oryzae Cavara) resistance in rice (Oryza sativa L.) varieties in Vietnam.

A unique genetic variation with respect to blast resistance was clarified in 201 rice accessions from Vietnam. These accessions were classified into three clusters-A, B1, and B2-based on their reactions to 26 standard differential blast isolates selected in Vietnam. Cluster A was the dominant cultivar group in Vietnam and the most susceptible of the three clusters. Cluster B1 was the smallest group and the most resistant. Cluster B2 was the second-most dominant group and of intermediate resistance between clusters A and B1. The percentages of accessions comprising each cluster varied by region and area. Accessions in cluster A were distributed widely throughout Vietnam and had the highest frequencies in both the Central and North regions. Accessions in cluster B2 were found with highest frequencies in the mountainous and intermediate areas of the North region. Accessions in cluster B1 were found with highest frequencies in the Central region and Red River Delta area (North region). These results suggest that rice accessions in Vietnam were basically susceptible (cluster A) or of intermediate resistance (cluster B2), and that high-resistance cultivars were mainly distributed in the low altitude areas, such as the Red River Delta area and Central region.

Patients' Fear, Stress, and Anxiety Toward Attending Dental Visits During the COVID-19 Pandemic.

Purpose: The COVID-19 pandemic interrupted dental care for individuals due to dental practice closures beginning in March 2020. The purpose of this study was to investigate the relationships between fear or stress related to COVID-19, dental anxiety and attending dental visits among adults in the United States (US).Methods: A cross-sectional survey research design was used with a non-probability sample of adults residing in the US. Three validated scales, the COVID-19 Stress Scale (CSS), Fear of COVID-19 Scale (FCV-19S) and Modified Dental Anxiety Scale (MDAS), were used for the electronically delivered survey instrument. A crowdsourcing platform was used to recruit participants over the age of 18, residing in the US. Descriptive, correlation, and multiple regression tests were used for data analysis.Results: A total of 308 participants opened the survey with a 97% completion rate (n=299). Time since the last dental visit was positively correlated with all measurement scale scores (p<0.01). Males had statistically significant higher scores on the CSS traumatic stress (p=0.002) and checking (p=0.001) sub-scales. Participants with bachelor and master's degrees had significantly higher scores across FCV-19S and CSS subscales.Conclusion: Individuals with dental anxiety were more likely to exhibit higher levels of fear and anxiety about COVID-19 transmission, resulting in delays in seeking dental care. Dental professionals should address patient concerns about the safety of dental settings and the infection control measures in place to prevent the transmission of COVID-19 in dental settings. Public health entities and professional organizations need to promote messaging about the measures in place to deliver safe oral health care.

Healthcare systems and professionals are key to improving health literacy in chronic kidney disease.

BACKGROUND: Comorbidity is prevalent in people with chronic kidney disease (CKD) and this status burdens one's health literacy skills to understand about their health, make decisions, and to adhere with treatment. OBJECTIVES: To examine health literacy in people with CKD and comorbidities. DESIGN: A cross-sectional study was conducted between November 2018 and April 2019. PARTICIPANTS: Convenience sampling recruited 367 adults with CKD and at least one comorbid disease. MEASUREMENTS: Data were collected using the 9-domain Health Literacy Questionnaire. Demographic and clinical characteristics were also collected. Charlson Comorbidity Index calculated comorbidity status. Parametric tests were used to distinguish health literacy between various groups. RESULTS: Participants' average age was 58.8 years, 54.7% had CKD Grade 5, 72.5% had a severe comorbidity index (≥6), and nearly 40% were on haemodialysis. Lower health literacy proportions were found in domains related to Healthcare providers' support (58.3%) and Appraisal of health information (38.4%). Lower levels of education, income, or living in rural areas were each significantly more likely to contribute to lower health literacy levels (range 4-7 domains). Greater comorbidity severity was also significantly associated with lower health literacy in two domains. CONCLUSION: People with CKD had difficulties in various health literacy domains primarily related to communication and critical appraisal. These domains can be improved by healthcare professionals and changes in hospital policies. Due to frequent contact with patients in kidney services, renal clinicians have a crucial role in ensuring greater communication occurs as this will better assist patients to understand their healthcare needs.

Health literacy profiles of adults with multiple chronic diseases: A cross-sectional study using the Health Literacy Questionnaire.

Health literacy is multidimensional, comprising functional, communicative, and critical thinking dimensions. Understanding health literacy is crucial for clinicians to develop effective health education strategies. In this study, we examined the multiple dimensions of health literacy in Vietnamese adults with chronic comorbidities. A cross-sectional sample of 600 patients, aged ≥18 years with a diagnosis of at least two chronic diseases (cardiovascular conditions, chronic kidney disease, or diabetes), completed the Health Literacy Questionnaire, an instrument assessing nine distinct domains. Descriptive and parametric tests were performed to analyze the health literacy levels for various demographic characteristics. Generalized linear models using backward modelling explored factors associated with higher health literacy. The lowest scoring domains were "Healthcare provider support" and "Appraisal of health information." In multivariate models greater health literacy was associated with those <65 years, having a postsecondary degree or higher level of education, greater income, urban residence, being cared for by spouses/children, and having fewer comorbidities. To improve health literacy, clinicians in primary and acute healthcare settings should build supportive relationships with patients and assist them with understanding and appraising health information.