Objective The Ozaki procedure for aortic valve reconstruction was reported in 2014 with low mortality, a highly reproducible rate and a good midterm result. However, the procedure still requires conventional sternotomy to be accomplished. The aim of the study was to start an initial evaluation for the feasibility of the minimally invasive approach in combination with the Ozaki technique. Methods From January 06, 2017, to January 12, 2017, nine patients with severe aortic valve diseases underwent minimally invasive Ozaki procedure through an upper ministernotomy. The pericardium was harvested endoscopically using three trocars in different intercostal spaces. Then, a ministernotomy was performed and the Ozaki procedure was accomplished in a similar manner to the conventional technique. We analyzed the in-hospital mortality and complications of this group. Results The mean age was 47.4 years and 55.6% patients were female. The predominant pathology was chronic rheumatic valve disease (66.7%) and other patients were diagnosed with a bicuspid aortic valve. The mean aortic cross-clamp time was 106.8 minutes, the mean cardiopulmonary bypass time was 153.6 minutes, the mean ventilation time was 8.4 hours, and the mean intensive care unit time was 1.6 days. No mortality was recorded in our series, no conversion to full sternotomy was required, one patient experienced right hemothorax requiring drainage, and one patient required valve replacement. Intraoperative transesophageal echocardiography and predischarge transthoracic echocardiography showed five competent valves and three valves with trivial regurgitation, and no stenosis was detected. Conclusions Ministernotomy combined with Ozaki procedure might be feasible, as well as an alternative to conventional sternotomy. This approach is associated with low mortality and morbidity and may be beneficial in younger populations.

Mosquito-borne diseases (MBDs) are causing high morbidity and mortality for humans. Urban livestock keeping is still common in cities around the world. The animals may serve as reservoirs for zoonotic MBDs, which increase the risks for humans. Here we assess the knowledge and practices related to MBDs in households with livestock and without livestock and explore the perceptions of the health care sector about MBDs and livestock keeping in Hanoi city of Vietnam in a cross-sectional study. A quantitative survey was conducted including 513 households with and without livestock-keeping in six districts and complemented with qualitative surveys with four health staff from Hanoi Center of Disease Control and three district health centers. The quantitative survey indicated that the participants possessed basic knowledge on MBDs with an average score of 18.3 out of 35, of which non-livestock-keeping households had a better knowledge than households keeping livestock (p<0.05). Both household categories had low score, 3.5 out of 11, regarding preventive practices against MBDs. The negative binomial model showed that occupation and location of living were factors associated to the knowledge on MBDs. Farmers were likely to have better preventive practices as compared to office workers (p<0.05). Those who had better knowledge also had more adequate preventive practices against MBDs (p<0.001). The qualitative survey revealed that livestock keeping was determined as increasing risks of MBDs due to the increase of mosquito population. It is recommended that community campaigns to raise the awareness and change behavior on MBDs should be organized based on collaboration between the health sector and the veterinary sector for households with and without livestock living in central urban and peri-urban areas. Further studies are needed to confirm the association between urban livestock keeping and potential increasing risks of MBDs such as dengue and Japanese encephalitis.

Background:We aimed to evaluate the effectiveness and tolerability of Afatinib as first-line treatment of advanced epidermal growth factor receptor (EGFR) mutant non small cell lung cancer (NSCLC) in a real-world setting. Patients and methods: This is a retrospective study of Vietnamese patients with advanced EGFR-mutant NSCLC treated with first-line afatinib at the National Cancer Hospital from 1st January 2018 to 31st October 2020. Patients' demographic, clinical and treatment data were captured. Objective response rate (ORR), disease control rate (DCR), time to treatment failure (TTF) and tolerability were evaluated. We used Kaplan-Meier curve and log-rank test for survival, and Cox regression model for multivariate analysis. Results: A total of 44 patients were included. Common EGFR mutations (Del 19/L858R) were detected in 61% patients. Fifty percent of patients with uncommon mutations had compound mutations of G719X, L861Q and S768I. The ORR was 75% while DCR rate was 98%. The median TTF was 12.3 months (95% CI: 7.2-17.3); the mTTFs were 12.3 and 10.8 months for patients with common and uncommon mutations (p = 0.001), respectively, and 14.0 and 7.5 months for patients with Del 19 and L858R mutations (p = 0.067), respectively. Afatinib 30 mg once daily was the most common starting (77%) and maintenance (64%) doses. The mTTFs were 12.3 and 7.5 months for patients with 30 mg starting dose vs 40 mg dose (p = 0.256), respectively. Diarrhea, skin rash, paronychia and fatigue were observed in 32%, 30%, 25% and 9%, respectively. There was no grade 4 toxicity except three patients with grade 3 paronychia. Conclusions: First-line afatinib is beneficial for Vietnamese patients with advanced EGFR-mutant NSCLC with a good response rate and prolonged TTF with manageable adverse event profile. Baseline brain metastasis status and starting doses do not significantly impact TTF.

While investigating the death of a hippopotamus at a zoo in Hanoi, Vietnam, we isolated SARS-CoV-2 and sequenced the RNA-dependent RNA polymerase gene from different organs. Phylogenetic analysis showed that the SARS-CoV-2 strain was closely related to 3 human SARS-CoV-2 strains in Vietnam.

Background: Minimally invasive mitral valve replacement has become popular across the world. However, annular rupture and patientprosthetic mismatch (PPM) are still problematic, particularly in the Asian population. To avoid this, a predictor model could be beneficial. Our study aimed to assess the value of mitral valve diameters measured on TTE and CT scan on predicting the actual mitral prostheses. Methods: From January 2018 to December 2019, a total number of 96 patients underwent minimally invasive mitral valve replacement. The association between imaging measurements and the outcome was checked by scatter plot and Pearson's correlation coefficient. Univariable linear regression was used to build the prediction model. Results: The three strongest correlations for the whole population are the following features: Mean TTE diameter (0.702), mean diameter on CT lowest plane through the mitral annulus (0.679), and area-derived diameter on CT highest plane through the mitral annulus (0.665). The prosthetic size of the tissue valve group was more correlated to the calculated annulus diameters than that of the mechanical valve group. Tissue valve size predictor models based on these calculated diameters were 16.19 + 0.27 × d (r = 0.744), 12.74 + 0.44 × d (r = 0.756) and 12.79 + 0.38 × d (r = 0.730), respectively. Conclusion: Mitral prosthetic size could be predicted based on the mitral diameters measured on TTE and CT scan. The overall correlation coefficient varied from 0.665 (CT Scan) to 0.702 (TTE). These models performed better when applied to bioprosthesis.