Acta Informatica Medica最新文献

Background: Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality worldwide, especially in low- and middle-income countries like Vietnam. Risk stratification models such as the original SCORE model have been widely used to guide preventive strategies. Recently, the updated SCORE2 model has been developed to enhance prediction accuracy by incorporating non-fatal events and recalibration for different European regions.

Objective: This study aims to compare the performance and applicability of SCORE2 versus the original SCORE in a Vietnamese population undergoing general health check-ups.

Methods: We conducted a cross-sectional study on individuals attending general health check-ups at Cho Ray Hospital, a leading tertiary hospital in Vietnam, from January 2024 to July 2024. Demographic, clinical, and laboratory data were collected to calculate cardiovascular risk scores using both the original SCORE and the updated SCORE2 models.

Results: Among 477 individuals undergoing general health check-ups, 317 patients met the inclusion criteria with a median age of 54.5 years (IQR: 47-62) and 35% were male. Risk stratification using the original SCORE model classified 87.1% as low-to-moderate risk, 9.1% as high risk, and 3.8% as very high risk. In contrast, SCORE2 reclassified 48.6% as low-to-moderate risk, while high and very high-risk categories increased to 35.6% and 15.8%, respectively (p < 0.001). Notably, 122 out of 276 patients (44.2%) initially classified as low-to-moderate risk by SCORE were reclassified by SCORE2 into higher risk categories - 101 (high risk) and 21 (very high risk). Similarly, 58.6% (n = 17) of patients classified as high risk by SCORE were upgraded to very high risk by SCORE2. SCORE2 also identified more high and very high-risk individuals under 50 years old, particularly among male patients.

Conclusion: Compared to the original SCORE model, SCORE2 significantly increased the detection of high and very high cardiovascular risk in Vietnamese individuals undergoing routine health check-ups. The findings suggest that SCORE2 may provide improved risk stratification, especially in younger and male populations, and may better support preventive cardiovascular strategies in clinical practice.

Background: Vascular endothelial growth factor (VEGF) plays a crucial role in bladder cancer progression. Brolucizumab, an anti-VEGF agent, has been studied in various diseases; however, its potential in bladder cancer remains largely unexplored.

Objective: This study aimed to analyze the molecular docking and dynamic stability of Brolucizumab as a VEGF inhibitor in bladder cancer.

Methods: Target protein and ligand data mining were conducted. Proteins were prepared by removing water molecules using Discovery Studio 2019. Ligand energy minimization was performed using Pyrx v.0.9.8. Protein-ligand docking was conducted, and protein-protein docking was performed using the HADDOCK server. The interactions between compounds and proteins were visualized with BioVia Discovery Studio 2019. Molecular dynamics simulations were carried out using the YASARA Dynamic program.

Results: Brolucizumab binding induced smaller conformational changes compared to VEGFR2 binding. When VEGFR2 interacted with the VEGFA-Brolucizumab complex, significant conformational changes occurred, suggesting an inhibitory and blocking effect of Brolucizumab. Bond relaxation was observed when Brolucizumab bound to VEGFA and VEGFR, initiating conformational changes as part of its inhibitory activity. Brolucizumab demonstrated strong and competitive binding to VEGFA, with greater affinity than VEGFR2.

Conclusion: Brolucizumab exhibits inhibitory and blocking activity against VEGFR2, suggesting its potential as a therapeutic agent in bladder cancer.

Background: The study investigates the expression of Carbonic Anhydrase-II (CA-II) antibodies in both blood and tissue samples to understand their systemic and local effects.

Objective: The research aims to identify effective dosages and assess the differences in antibody levels across various treatment groups of undescended testes Sprague Dawley model. To measure and compare the levels of CA-II antibodies in blood and tissue samples, determine the most effective dosage for reducing tissue CA-II levels, and analyze the systemic versus local impacts of these antibodies.

Methods: The study employed immunohistochemistry to assess CA-II antibody expression in undescended testes model of Sprague Dawley tissue and blood, with brown-colored cells indicating positive expression. Levene's test confirmed homogeneity of variance (p=0.660), allowing for ANOVA to identify significant differences in CA-II levels among groups (p=0.000). Tukey's post hoc test was used to pinpoint specific group differences. Results: The analysis revealed significant differences in CA-II expression between groups. The dosage of 10 mg/KgBB was found to be most effective in reducing tissue CA-II levels. Blood CA-II concentrations were consistently higher than tissue levels across all groups, indicating a strong systemic presence.

Conclusion: The study highlights the significant distinctions in CA-II antibody levels between blood and tissue samples. It underscores the importance of dosage in managing CA-II levels and the need to consider both systemic and local impacts in clinical settings. These findings provide a basis for future research into targeted therapies for conditions mediated by CA-II.

Background: The proportion of individuals utilizing the Internet has increased rapidly, and as a result, cyberbullying has garnered significant attention across various communities, emerging as a critical public health concern.

Objective: This study aimed to validate the Vietnamese version of the Cyberbullying Scale (CBS) within the Vietnamese context.

Methods: A cross-sectional study was conducted with 257 students at University of Medicine and Pharmacy, Vietnam National University (VNU-UMP) in Hanoi , Vietnam, from November 2023 to March 2024. The Cyberbullying Scale was administered through the RedCap software platform.

Result: Among the 257 students, 64.9% were female. The average time spent using social networks per day was 5.6 ± 3.3 hours. The factor loadings for all items ranged from 0.76 to 0.92. The Cronbach's Alpha coefficient was calculated to be 0.98. The final measurement model of the CBS-M demonstrated good fit with the data, yielding acceptable fit indices: Comparative Fit Index (CFI) = 0.93, Tucker-Lewis Index (TLI) = 0.91, Standardized Root Mean Square Residual (SRMR) = 0.03, and Root Mean Square Error of Approximation (RMSEA) = 0.06.

Conclusion: The Cyberbullying Scale was identified as a reliable and valid instrument for assessing cyberbullying in Vietnam.

Background: Subtotal cholecystectomy (SC) is considered a safe option for a bailout in the presence of a difficult laparoscopic cholecystectomy with a low incidence of complications.

Objective: This report aims to describe the challenges in diagnosing and managing remnant gallbladder.

Case presentation: Case 1 is a 31-year-old male who presented with right upper quadrant abdominal pain ten years following SC. Abdominal ultrasound (US) and computed tomography (CT) scan confirmed a ruminant gallbladder. He underwent successful completion of laparoscopic cholecystectomy. Case 2 is a 40-year-old male who was admitted as a case of ascending cholangitis. He had a history of subtotal cholecystectomy one year prior to his presentation. CT scan, Magnetic resonance cholangiography (MRCP), and US all confirmed the presence of a remnant gallbladder. The patient underwent endoscopic retrograde cholangiopancreatography (ERCP), followed by the completion of laparoscopic cholecystectomy.

Conclusion: Recurring symptoms due to the remnant gallbladder are often challenging to diagnose and treat. Herein, we highlight the importance of adequate preoperative investigations and surgical planning prior to intervention.

Background: T Measles is a viral, highly contagious disease from the group of rash fevers, which mainly affects children. Persons suffering from measles are considered contagious four days before and four days during the period of the appearance of measles, which favors its faster spread. Clinical observation and laboratory diagnostics are essential for monitoring the course of the disease in order to prevent complications.

Objective: Our study aimed to analyze the significance and usefulness of laboratory tests on admission to hospital in pediatric patients with measles.

Methods: This prospective study included children with confirmed measles infection who came accompanied by parents to the Infectious Disease Clinic of the Clinical Center of the University of Sarajevo during nine months. Data on age, sex, symptoms and results of laboratory analyzes (biochemical, hematological and coagulation) were recorded.

Results: The study included a total of 302 subjects, including 122 healthy controls and 180 measles patients. Significantly lower values observed for aPTT, absolute number of eosinophils and basophils, RBC, hemoglobin, hematocrit, MCV, MCH, MCHC in measles patients. Significantly higher values were observed for fibrinogen, D-dimer, WBC, neutrophils, lymphocytes, monocytes, RDW and MPV in measles patients in contrast to controls. Significantly higher values were also observed for serum chloride, glucose, CRP, AST, ALT and LDH values. AST/ALT, NLR, PLR, NPR, LMR, LCR, SII and AISI also showed significant differences in measles patients compared to controls.

Conclusion: The results of our study showed that laboratory tests have great significance and potential in measles in pediatric patients admitted to the hospital. Lymphocyte/C-reactive protein ratio also showed good diagnostic potential.

Background: This study was to determine risk factors and prognostic models for mortality in elderly patients with Stenotrophomonas maltophilia bacteremia.

Objective: The aim of this study was to address this gap, we conducted this study to investigate the predictors of mortality and develop prognostic models for clinical practice.

Methods: A retrospective study was conducted on 195 patients ≥ 60 years of age (median age 78 (68-85) years, 59.5 % male) at Thong Nhat National Teaching Hospital in Vietnam between January 1st, 2017 and December 31st, 2022. Patients who were treated in the hospital with the first positive blood culture for Stenotrophomonas maltophilia bacteremia were chosen for enrolment in this study. This investigation evaluated demographic and clinical characteristics and prognostic models for mortality.

Results: The mortality rate was 37.4 %. Multivariate analysis showed that the significant independent risk factors for mortality were age (aOR, 1.08; 95 % CI, 1.04-1.13; p < 0.001), SOFA score (aOR, 1.38; 95 % CI, 1.14-1.68; p < 0.001), and APACHE II score (aOR, 1.10, 95 % CI, 1.03-1.17; p = 0.005). Bayesian model averaging method identified four clinically applicable models: age combined with both SOFA score and APACHE II score (AUC 0.884, R2 0.564), age combined SOFA score (AUC 0.874, R2 0.516), age combined APACHE II score (AUC 0.800, R2 0.340), SOFA score combined APACHE II (AUC 0.846, R2 0.507).

Conclusion: Stenotrophomonas maltophilia bacteremia was severe in elderly patients with high mortality. Risk factors for mortality included age, SOFA, and APACHE II scores. The model comprising age, SOFA, and APACHE II scores has the best predictive ability. However, the model including age and SOFA score was also clinically valid and simple.

Background: Diverting ileostomy is widely used to mitigate the consequences of anastomotic leakage after low anterior resection for rectal cancer. While its protective role is well established, the optimal timing of ileostomy closure remains controversial, with traditional delayed reversal exposing patients to stoma-related morbidity and potential permanent diversion.

Objective: The aim of this review is to synthesize randomized controlled trial (RCT) and meta-analysis evidence on early ileostomy closure, assess safety and outcomes, and evaluate whether a shift toward earlier reversal is justified in selected patients.

Methods: A narrative review of the published literature was conducted, including randomized trials, prospective studies, and systematic reviews identified through PubMed, Scopus, and Google Scholar. Outcomes of interest included perioperative morbidity, stoma-related complications, quality of life, and functional results.

Results and discussion: Evidence from RCTs shows heterogeneity. Trials such as EASY, Kłęk, and Lasithiotakis support early closure, reporting comparable morbidity and reduced stoma-related complications, whereas Bausys, Elsner, and Fukudome caution against indiscriminate application due to increased septic and wound-related morbidity. Meta-analyses consistently indicate that early closure reduces stoma-related complications but increases wound infections, with overall morbidity largely comparable between groups. Patient selection, confirmation of anastomotic integrity, and oncologic treatment schedules are central to outcomes. Cost-effectiveness analyses and retrospective series further support potential system-level and quality-of-life benefits.

Conclusion: Current evidence suggests that early ileostomy closure is feasible and safe in carefully selected patients, reducing the burden of stoma-related morbidity without compromising oncologic treatment. However, it should not yet be routine practice, as risks of septic complications persist in unselected populations. Future multicenter RCTs with standardized definitions, uniform imaging protocols, and long-term functional and cost-effectiveness endpoints are needed to guide practice.

Background: Twin-to-twin transfusion syndrome (TTTS) is a severe complication in monochorionic twin pregnancies, leading to high perinatal morbidity and mortality. Fetoscopic laser photocoagulation (FLP) is the gold standard treatment; however, fetal demiseremains a concern. The soluble vascular endothelial growth factor receptors, sVEGFR-1 and sVEGFR-2, play a crucial role in regulating angiogenesis and vascular function. This study evaluates changes in sVEGFR-1 and sVEGFR-2 levels before and after FLP and explores their role in predicting fetal demise post-surgery.

Objective: Therefore, this study aims to evaluate pre- and post-surgical changes in sVEGFR-1 and sVEGFR-2 levels in TTTS cases treated with FLP and determine their predictive value for fetal demiseafter surgery. Methods: A prospective longitudinal study was done with 27 pregnant women with TTTS stage II-IV according to Quintero classification from 16 to 26 weeks of gestation undergoing FLS. Among them, 11 cases were carried out coagulation the placental vascular anastomoses, 16 cases were done ablation umbilical cord for the selective fetal reduction because of TTTS stage IV, selective intrauterine growth restriction (sIUGR) or proximate cord insertions. All the studies subject investigated the soluble levels of biomarkers. We quantified plasma levels of VEGF-R1, VEGF- R2 in twin pregnant with TTTS before and one week after surgery by ELISA. Many factors included maternal age, gestational age at surgery, stage of TTTS, placental location, level of polyhydramnios, FLS methods, sIUGR, amount of amniotic fluid drawn, duration of surgery, change of maternal circulating biomarker levels were analyzed to find out the association with fetal demise after FLS.

Results: Statistics showed that VEGF-R1 levels were significantly decreased after surgery and change in soluble VEGF-R1 levels after surgery had a difference between the group of fetal demise and non-fetal demise. ROC curve showed that degree of VEGF-R1 levels reduction after surgery were higher, the risk of fetal demise was bigger (AUC: 0.8472), in which, cut-off point of degree of VEGF-R1 levels reduction after surgery was 36.5% (sensitivity: 66.67%, specificity: 95.83%).

Conclusion: Our data suggest that change in VEGF-R1 after surgery could play a prognostic role of fetal demise after fetoscopic laser surgery.

Background: Breast cancer is a biologically heterogeneous disease with four major molecular subtypes that determine prognosis and treatment strategies. MRI-based radiomics provides a non-invasive method to predict these subtypes by quantifying tumor heterogeneity.

Objective: To develop and validate a logistic-regression model using MRI-derived radiomic features to predict four molecular subtypes of invasive breast cancer: luminal A (LA), luminal B (LB), HER2-enriched (HER2), and triple-negative breast cancer (TNBC).

Methods: A retrospective cohort of 169 patients with histologically proven invasive breast carcinoma who underwent pre-treatment dynamic contrast-enhanced MRI (DCE-MRI, 3.0 T) was analyzed. Tumors were manually segmented; radiomic texture features were extracted with LIFEx and standardized by z-score normalization. Feature selection was performed using L1-regularized logistic regression (LASSO). Four one-vs-rest logistic-regression models were trained with 5-fold cross-validation. Performance metrics included AUC, sensitivity, specificity, accuracy, and precision.

Results: The models achieved AUCs of 0.840 (TNBC), 0.788 (HER2), 0.661 (LA), and 0.635 (LB). TNBC showed the highest accuracy (0.923), whereas LB had the lowest sensitivity (0.393). Confusion matrices revealed good classification for TNBC and HER2 but frequent misclassification between LA and LB. TNBC-related features were largely intensity- and entropy-based.

Conclusion: MRI-derived radiomic signatures can non-invasively differentiate breast-cancer molecular phenotypes, with particularly strong performance for TNBC and HER2. Although LA-LB separation remains limited, the LASSO-logistic-regression framework offers moderate-to-high diagnostic accuracy and potential value as a complementary precision-oncology decision-support tool.