Showing papers by "Hai phong University Of Medicine and Pharmacy published in 2014"

Integrated care pathways for airway diseases (AIRWAYS-ICPs).

Abstract: The objective of Integrated Care Pathways for Airway Diseases (AIRWAYS-ICPs) is to launch a collaboration to develop multi-sectoral care pathways for chronic respiratory diseases in European countries and regions. AIRWAYS-ICPs has strategic relevance to the European Union Health Strategy and will add value to existing public health knowledge by: 1) proposing a common framework of care pathways for chronic respiratory diseases, which will facilitate comparability and trans-national initiatives; 2) informing cost-effective policy development, strengthening in particular those on smoking and environmental exposure; 3) aiding risk stratification in chronic disease patients, using a common strategy; 4) having a significant impact on the health of citizens in the short term (reduction of morbidity, improvement of education in children and of work in adults) and in the long-term (healthy ageing); 5) proposing a common simulation tool to assist physicians; and 6) ultimately reducing the healthcare burden (emergency visits, avoidable hospitalisations, disability and costs) while improving quality of life. In the longer term, the incidence of disease may be reduced by innovative prevention strategies. AIRWAYS-ICPs was initiated by Area 5 of the Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing. All stakeholders are involved (health and social care, patients, and policy makers).

Contributions on the Modeling and Simulation of the Human Knee Joint with Applications to the Robotic Structures

Abstract: The main objective of this chapter is to develop a three-dimensional solid finite element model of the healthy knee joint to predict stresses in its individual components and to study the effects of the frontal plane tibio–femoral angle on the stress distribution in the knee cartilages and menisci. It was developed the geometric models of the joint which shows different tilt in varus and valgus with 5°, the joint being affected by osteoarthritis in the medial and lateral compartment. For geometric modeling of the human knee joint was used the embedded applications: Design Modeler, SpaceClaim under Ansys Workbench 14.5 software package. For each model a non-linear analysis was performed. The non-linearities are due to the presence of the contact elements modeled between components surfaces. The applied force was equal with 800 N. Finally the results obtained for normal knee and for OA knee joint are compared.

The role of IL-6 572 C/G, 190 C/T, and 174 G/C gene polymorphisms in children’s obesity

Abstract: The aim of this study was to establish the correlations between the polymorphisms of the genes interleukin (IL)-6 572, 190, and 174 in obese children. We assessed 222 hospitalized children divided into two groups: group I (control) included 110 patients with normal nutritional status, and group II consisted of 102 obesity patients. The two groups underwent IL-6 572 C/G, 190 C/T, and 174 G/C polymorphism testing, measurement of anthropometric parameters (mid-upper arm circumference and tricipital skinfold thickness), and paraclinical evaluation (protein, albumin, leptin, adiponectin, and vascular endothelial growth factor (VEGF)). We observed that phenotype CC was more frequent in obese children for IL-6 572 (p = 0.0001), whereas CG heterozygotes were more frequent in the obese group for the IL-6 190 gene (62.7 %; p = 0.0001). Leptin was dependent on IL-6 572 and IL-6 174 gene polymorphisms and albumin, whereas adiponectin was dependent on the IL-6 174 gene polymorphism. Body mass index (BMI), mid-upper arm circumference (MUAC), and tricipital skinfold thickness (TST) serum albumin levels correlated with C allele carriers of the IL-6 572 and IL-6 190 genes in children with obesity, whereas the CC genotype of IL-6 174 was a protective factor for obesity. Conclusion: Obesity is most frequently associated in children with IL-6 174 C allele carriers and with IL-6 190 C allele carriers.

REM sleep behavior disorder in Parkinson's disease.

Abstract: Rapid eye movement (REM) sleep behavior disorder (RBD) is a sleep disorder characterized by loss of normal muscle atonia during REM sleep with recurrent dream enactment and excessive motor activity. It is a frequent feature in patients with Parkinson’s disease (PD) and other alpha-synucleinopathies, and can occur at any stage of the disease. RBD could be considered a premotor clinical manifestation, and can antedate by many years the motor symptomatology. The prognostic value of RBD for the risk of developing PD still needs to be established. This review article focuses on the clinical aspects, screening and diagnostic criteria as well as therapeutic aspects of RBD in PD patients. Pathophysiological pathways are also briefly reviewed.

Work-related depression and associated factors in a shoe manufacturing factory in Haiphong City, Vietnam

Abstract: To determine the prevalence and associated factors of work-related depression among the employees of a shoe manufacturing factory in Haiphong City, Vietnam. We carried out this cross-sectional study among 420 workers in 2012 in Le Lai II Shoe Manufacturing Factory in Haiphong City, Vietnam using Karasek’s Job Content Questionnaire (JCQ) and the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM IV) tool for measuring depression. The study results show that a relatively high proportion of workers (20.7%) belongs to the high-strain group based on Karasek’s model. The prevalence of work-related depression among workers was relatively high (18.8%). The factors associated with depression at work were high psychological demand (adjusted OR = 3.0, 95% CI: 1.1–8.3), low social support (adjusted OR = 4.7, 95% CI: 1.2–12.8), inadequate work protection materials (OR = 4.1, 95% CI: 2.2–10.1) and work absenteeism (OR = 6.2, 95% CI: 2.5–18.9). Strengthening the social support network (involving supervisors and co-workers), reducing psychological job demand and assuring work protection materials at the workplace may highly facilitate reducing work-related depression.

Dying and Death in Some Roma Communities: Ethical Challenges

Abstract: The Roma people have specific values, therefore their views and beliefs about illness, dying and death are important to be known for health care providers caring for members of this community. The aim of this qualitative study based on 48 semi-structured interviews with Roma patients and caregivers in communities in two regions of Romania was to examine their selfdescribed behaviors and practices, their experiences and perceptions of illness, dying and death. Five more important themes about the Roma people facing dying and death have been identified: (1) The perception of illness in the community as reason for shame and the isolation that results from this, as well as the tendency for Roma people to take this on in their self image; (2) The importance of the family as the major support for the ill/dying individual, including the social requirement that family gather when someone is ill/dying; (3) The belief that the patient should not be told his/her diagnosis for fear it will harm him/her and that the family should be informed of the diagnosis as the main decision maker regarding medical treatment; (4) The reluctance of the Roma to decide on stopping life prolonging treatment; (5) The view of death as 'impure'. These results can be useful for health care providers working with members of the Roma community. By paying attention to and respecting the Roma patients' values, spirituality, and relationship dynamics, the medical staff can provide the most suitable healthcare by respecting the patients' wishes and expectations.

Orthopaedic and surgical features in the management of patients with haemophilia

Abstract: Haemophilia is a hereditary disease due to a defect of the X chromosome, which determines a faulty production of coagulation factor VIII in haemophilia A (85% of cases) and factor IX in haemophilia B. Three degrees of severity can be distinguished: low, with a deficient factor concentration greater than 5% of normal values, medium, with a concentration between 1 and 5%, and severe, comprising more than half of haemophilia cases, with a concentration of factor VIII or factor IX under 1% of normal. The evolution of haemophilic arthropathy is almost always from haemarthrosis to chronic synovitis and extended erosions of the articular surface, culminating in the final stage of articular destruction-chronic haemophilic arthropathy. This paper analyses the results of the treatment applied to a lot of one hundred and ten patients operated inside the our country's sole Compartment of Osteo-Articular Surgery of haemophiliac patients within the Clinic No. 2 of Orthopaedics and Traumatology between 2001 and 2013. This compartment was founded in 2001, being included in the Romanian Health Ministry's programme for financing the treatment for haemophilia. Within the aforementioned time period, a total of 158 patients from the entire country were consulted. From these, 110 patients underwent a series of surgical procedures, 112 in total. The age interval of the studied lot was between 9 and 45 years, with a maximum between 11 and 20 years. With replacement therapy and correct surgical indication, osteoarticular surgery in haemophiliacs, performed in a specialized centre by a multidisciplinary team, can give good results with acceptable risks.

Modeling and Finite Element Analysis of the Human Knee Joint Affected by Osteoarthritis

Abstract: The paper presents a complex three-dimensional model of the human knee joint, containing bones, ligaments, menisci, tibial and femoral cartilages. To investigate the role of the articular cartilage in the developing of the osteoarthritis, to analyze and simulate the biomechanical behavior of the human knee joint, a finite element analysis was performed. The non-linearities are due to the presence of the contact elements modeled between components surfaces and to the nonlinear properties of the cartilage, applying a load of 800 N and 1500 N, for 0o in flexion. The results show that misalignment (valgus variation) could damage the articular cartilage because they increase the stress magnitude, that progressively produce articular cartilage damage and it enhances the osteoarthritis phenomenon due to mechanical factors. The displacements and the Von Mises stress distributions on the cartilage and menisci for the virtual prototype, considering an angle of 10 degrees for valgus, are presented. The obtained values are comparable with the values obtained by other authors.

Ethical dilemmas in treating elderly patients at risk of polypragmasy and polypharmacy

Abstract: In this study we focused on the ethical dilemmas that confront physicians while approaching therapeutical management of elderly patients, especially those exposed to polypragmasy and iatrogeny. We explore the main universal ethical principles such as autonomy, beneficence, non-maleficence, justice and equity and the challenges the medical team faces while trying to reconcile them with several particular aspects characteristic to elderly patients such as: fragility, disability, comorbidity, cognitive and functional impairment, and a greater risk of polypharmacy, polypragmasy, and iatrogeny. Building a strong physician – patient relationship based on mutual trust and respect is the key to understanding the needs and desires of the elderly, which may be completely different from other age groups, and their possibilities to adhere to medical recommendations. Multidisciplinary teams, representing professionals from diverse disciplines coordinated by the general practitioner and/or the geriatrician should help solving difficult ethical dilemmas.

Postoperative cognitive disorder has to be included within informed consent of elderly patients undergoing total hip replacement

Abstract: Obtaining an informed consent is both a legal and a moral obligation before every surgery. Postoperative permanent cognitive disorder is a common complication in elderly people, influencing prognosis regarding mortality and quality of life, rarely mentioned in the informed consent form. MATERIALS AND METHODS: We performed a prospective study that included 50 patients, 65 or older who underwent total hip replacement (THR) between 2009 and 2012. Every patient was evaluated by MMSE in order to assess cognitive status; the evaluation was performed in a preoperatory stage, on a daily basis following surgery and as well 3 months after surgery. According to the results, patients were divided in two groups: group A - MMSE ≥ 25 and group B - MMSE < 25. RESULTS: Following MMSE testing we have identified 33 patients whose score was ≥ 25 (group A) and 17 patients with MMSE score < 25 (group B). Patients in group A had a mean MMSE of 27.8 pre-operatively, with no change at discharge and after 3 months postoperatively; in group B, the average obtained for preoperatory MMSE was 22.8 points, 20.82 (p = 0.0028) at discharge and lower at 3 months (p = 0.013). The factors that mostly influenced the cognitive status at 3 months postoperatory were the preoperatory MMSE value (p< 0.0001) and the value of cognitive status at the time of discharge (p<0.0001). CONCLUSIONS: The main post-surgery cognitive decline risk factor in geriatric patients is the pre-surgery cognitive status, and based on the data obtained, we are recommending a pre-surgery cognitive evaluation, as well as informing the patient over that possible complication following THR.

Extracorporeal shock waves lithotripsy versus retrograde ureteroscopy: is radiation exposure a criterion when we choose which modern treatment to apply for ureteric stones?

Abstract: The aim of this study is to compare two major urological procedures in terms of patient exposure to radiation. We evaluated 175 patients, that were subjected to retrograde ureteroscopy (URS) and extracorporeal shock waves lithotripsy (ESWL) for lumbar or pelvic ureteral lithiasis, at two urological departments. The C-arm Siemens (produced in 2010 by Siemens AG, Germany) was used for ureteroscopy. The radiological devices of the lithotripters used in this study in the two clinical centers had similar characteristics. We evaluated patient exposure to ionizing radiation by using a relevant parameter, the air kerma-area product (PKA; all values in cGy cm2), calculated from the radiation dose values recorded by the fluoroscopy device. PKA depends on technical parameters that change due to anatomical characteristics of each case examined, such as body mass index (BMI), waist circumference, and stone location. For the patients subjected to ESWL for lumbar ureteral lithiasis the mean of PKA (cGy cm2) was 509 (SD=180), while for those treated for pelvic ureteral lithiasis the mean of PKA was 342 (SD=201). In the URS group for lumbar ureteral lithiasis, the mean of PKA (cGy cm2) was 892 (SD=436), while for patients with pelvic ureteral lithiasis, the mean of PKA was 601 (SD=429). The patients treated by URS had higher exposure to ionizing radiation dose than patients treated by ESWL. The risk factors of higher radiation doses were obesity, exposure time, and localization of the stones.

Experimental Measurement of Flexion-Extension in Normal and Osteoarthritic Knee during Sit-to-Stand Movement

Abstract: The aim of this paper is to compare the range of motion of the sit-to-stand (STS) movement angles for the both knees: osteoarthritic (OA) left knee and healthy right knee, for seven subjects who performed an experimental test consisting of STS cycles on a chair. The acquisition system consists of two electro-goniometers, one for each leg, for making possible the simultaneously reading of data during experiments. The angular amplitudes of human knee flexion-extension during the STS cycles are obtained as data files. For each knee of all subjects were selected 8 consecutive cycles which were normalized by interpolation with cubic Spline functions, using MATLAB environment. The final medium STS cycle for both knees is obtained. Finally, statistical analyses are made and the results are presented. The maximum values of the knee angle for both knees of all seven subjects were compared and tested with an unpaired Student t-test, considering α=0.05. The p-values corresponding to this test are calculated using ANOVA. Based on the average anthropometric data the virtual model of a mannequin using SolidWorks software was developed, and then was transferred to ADAMS simulation environment in order to obtain the variation laws of reaction forces in the lower limb joints.

SEM Characterisation of a Tricalcium Phosphate – Chitosan - PMMA Cement

Abstract: Synthetic Polymers, both organic and inorganic, are used in a wide variety of biomedical applications. The polymers can be biodegradable or nondegradable. Chitosan (CH), which is a naturally biodegradable, non-toxic biopolymer obtained by the deacetylation of chitin, has been demonstrated to have an intrinsic activity against a wide spectrum of bacteria, filamentous fungi and yeast. Several investigators have studied reinforced tricalcium phosphate (TCP), Chitosan, polymethylmethacrylate (PMMA)/methyl methacrylate (MMA) as potential cement. In fact addition of TCP with chitosan to the cement can improve biocompatibility and also enhance the mechanical properties of the cement because of its both biocompatibility and osteoconductivity properties. Crystalline phase and microstructure of the cement with hydroxyapatite - poly (methyl-methacrylate) were characterized by scanning electron microscopy (SEM; FEI Company), with the purpose to draw solid conclusions about the influence of the particles size, form and uniform mixing on the chemical process. We acquired PMMA sorted according to granulometric size.

Evaluating efficacy and safety of paclitaxel polymeric micelle regimen in advanced and metastatic NSCLC patients in Hai Phong Oncology Centre Vietnam.

Abstract: e19085 Background: Cremophor EL, used to enhance drug solubility, may add to paclitaxel’s toxicities such as hypersensitivity reactions or peripheral neuropathy. This is to report the efficacy and ...

Hydrolytic Degradation of Dental Composites

Abstract: This study evaluated the hydrolytic degradation of two experimental (C1, C2) and two commercial composite (Tetric EvoCeram and Premise) prepared to be used in dental restorations. Two experimental composites and two commercial composites were undergoing hydrolytic degradation in three different medium: distilled water, artificial saliva and alcoholic solution (50/50). The samples were investigated immediately after polymerisation with halogen lamp Optilux 501 and after 33 days of immersion in all three medium, using Fourier transforms infrared analysis (FTIR). FT-IR spectra of samples from the same composite immersed in distilled water, artificial saliva and alcoholic solution, revealed mostly reducing the intensity of the characteristic peaks of Si-O-Si bond less Tetric composite immersed in artificial saliva, which peak intensity remains unchanged.

Synthesis of Nanoceria for Biomedical Applications

Abstract: Due to the unique property of cerium to easily switch oxidation states between Ce3 + and Ce4 + , cerium oxide has gained a considerable interest in the field of biomedicine as potential antioxidant agent exerting neuroprotective effects, as well. This work reports on the solvothermal synthesis and characterization of ultrasmall (<10 nm) ceria nanoparticles using oleylamine as solvent and capping agent.

Preliminary EEG Based Analysis of Few Acupoints Used in the Chronic Low Back Pain Treatment

Abstract: In order to uncover the acupuncture mechanism in the pain removal, the paper’s aim is to reveal specific changes in the EEG brain response to the acupuncture stimulation in three points (ST36, UB25 and DU3) specific to the chronic low back pain (CLBP) treatment.

Stresses and Displacements for Virtual Models of Healthy and Osteoarthritic Knee Joint

Abstract: This paper presents advanced modeling and simulation methods, using the latest generation of CAD-CAE applications. For the geometric modeling of human knee joint embedded applications as DesignModeler, SpaceClaim under Ansys Workbench software package were used. The objective of this study is to present our contributions on the modeling, simulations and finite element analysis of the healthy and osteoarthritic human knee joint in order to quantify and investigate its biomechanical behavior. The main objective of this article is to present a complex three-dimensional model of the healthy knee joint and of the osteoarthritic joint which shows a 15o tilt in varus, the joint being affected by osteoarthritis in both compartments, in order to predict stresses and displacements in their individual components. The applied forces were equal with 800 N and 1500 N. Finally the results obtained for normal knee and for OA knee joint are compared.

3D Analysis for Identification of the Proper Type of Post to Restore the Endodontic Treated Teeth

Abstract: . The problem of root fracture in case of prosthetically restored non-vital teeth is a common concern among clinicians. These fractures are caused by increasing the diameter of the root canal during the endodontic retreatment and occure on the dental arches in both the anterior and posterior area. Such treatment failures lead to extraction, therefore the physician’s goal is to limit as much as possible their occurrence. We used finite element analysis method to find out what type of corono-radicular restoration is more appropriate in order to avoid fractures. We selected two of the most commun posts used in our country: metallic NiCr casted RCR (corono-radicular reconstruction) and prefabricated fiberglass endodontic posts of various diameters and we analyzed the existing tensions in the dental structures that would predispose the root to fracture.

Translucence Study through New Experimental Hybrid Composites

Abstract: Translucence parameters for 3 series of experimental hybrid composites were investigated using three-chromatic coordinates such as L* a* b* CHROMA technique using a type C illuminant geometry with the scope of 8o. The materials of each series contain in the same ratio different copolymers and a filler mixture (simple and mixed hydroxyapatite-ZrO2 or SiO2 powders and glass powders with barium oxide, respective strontium oxide, or quartz powder). The purpose was to determine the effect of filler composition of composites on translucence. The analysis shows that these materials have more or less translucence. CHROMA determinations indicate that for the composite that has as filler quartz microparticles anh hydroxyapatite nanoparticles, the translucence registered is higher. Results leading to the idea that chemical composition and the size of inorganic phase are important to obtain translucent composite materials that have very natural in appearance. Keywords: translucence, hybrid composites, CHROMA method.

Circumferential Decompression with Posterior Instrumentation and Fusion by Lateral Extracavitary Approach – Effective Solution Aiding the Treatment of Infectious Spondylodiscitis

Abstract: The goal of this study is to assess the efficacy of one-stage surgical management for infectious spondylodiscitis by circumferential decompression with posterior instrumentation and fusion by lateral extracavitary approach. Between March 2010 and June 2012, 7 cases with bacterial spondylodiscitis were treated with one-stage circumferential decompression with posterior instrumentation and fusion. All cases were followed-up for an average of 11.3 months (range 6-18 months). The average preoperative kyphosis was 13° (range 9-29°), and the average postoperative kyphosis was 8° (range 3-18°). At final follow-up, minimal progression of kyphosis was seen, with an average kyphosis of 12° (range 4-22°). An average loss of correction of 4° was seen at final follow-up. One-stage surgical management for spondylodiscitis by circumferential decompression with posterior instrumentation and fusion was feasible and effective.