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BackgroundSevere dengue with severe plasma leakage (SD-SPL) is the most frequent of dengue severe form. Plasma biomarkers for early predictive diagnosis of SD-SPL are required in the primary clinics for the prevention of dengue death.MethodologyAmong 63 confirmed dengue pediatric patients recruited, hospital based longitudinal study detected six SD-SPL and ten dengue with warning sign (DWS). To identify the specific proteins increased or decreased in the SD-SPL plasma obtained 6–48 hours before the shock compared with the DWS, the isobaric tags for relative and absolute quantification (iTRAQ) technology was performed using four patients each group. Validation was undertaken in 6 SD-SPL and 10 DWS patients.Principal findingsNineteen plasma proteins exhibited significantly different relative concentrations (p<0.05), with five over-expressed and fourteen under-expressed in SD-SPL compared with DWS. The individual protein was classified to either blood coagulation, vascular regulation, cellular transport-related processes or immune response. The immunoblot quantification showed angiotensinogen and antithrombin III significantly increased in SD-SPL whole plasma of early stage compared with DWS subjects. Even using this small number of samples, antithrombin III predicted SD-SPL before shock occurrence with accuracy.ConclusionProteins identified here may serve as candidate predictive markers to diagnose SD-SPL for timely clinical management. Since the number of subjects are small, so further studies are needed to confirm all these biomarkers.

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IntroductionDengue is a viral disease that spreads rapidly in the tropic and subtropic regions of the world and causes 22,000 deaths annually. In 2009, the World Health Organization (WHO) released a new classification of dengue infections, which divided them into three categories: dengue without warning sign (D), dengue with warning sign (DWS), and severe dengue (SD). However, researchers have been using different criteria to define persistent vomiting; therefore, we aimed to evaluate the ability of the number of vomiting times in early prediction of SD development among D/DWS patients.MethodA hospital-based cohort study was conducted in Ben Tre-south of Vietnam. We enrolled confirmed dengue patients with D and DWS at admission. The final classification was determined on the discharged day for every patient based on the classification of WHO 2009 without using vomiting symptom, using the receiver operating characteristic (ROC) curve to evaluate the ability of the number of vomiting times in early prediction of SD development among D/DWS patients.ResultThe prevalence of vomiting symptom was higher in SD group than D/DWS group (92 versus 46 %, p = 0.006), and the median of the number of vomiting times was higher in SD group than D/DWS group (2.5 versus 0, p = 0.001). To distinguish SD from D/DWS, the ROC curve of the number of vomiting episodes showed that the area under the curve was 0.77; with the cut point of two, the sensitivity and specificity were 92 and 52 %, respectively.DiscussionThe number of vomiting times could be a good clinical sign which can early predict SD from the group of D/DWS. We suggest the definition of persistent vomiting should be vomiting two times or more per day.

Background: The protective or pathogenic role of T lymphocytes during the acute phase of dengue virus (DENV) infection has not been fully understood despite its importance in immunity and vaccine development. Objectives: This study aimed to clarify the kinetics of T lymphocyte subsets during the clinical course of acute dengue patients. Study design: In this hospital-based cohort study, 59 eligible Vietnamese dengue patients were recruited and admitted. They were investigated and monitored for T cell subsets and a panel of clinical and laboratory parameters every day until discharged and at post-discharge from the hospital. Results: We described for the first time the kinetics of T cell response during the clinical course of DENV infection. Severe cases showed significantly lower levels of effector CD8 + T cells compared to mild cases at day −1 (p = 0.017) and day 0 (p = 0.033) of defervescence. After defervescence, these cell counts in severe cases increased rapidly to equalize with the levels of mild cases. Our results also showed a decline in total CD4 + T, Th1, Th1/17 cells during febrile phase of dengue patients compared to normal controls or convalescent phase. On the other hand, Th2 cells increased during DENV infection until convalescent phase. Cytokines such as interferon-γ, IL-12p70, IL-5, IL-23, IL-17A showed tendency to decrease on day 0 and 1 compared with convalescence and only IL-5 showed significance indicating the production during acute phase was not systemic.

Success is not final, failure is not fatal: it is the courage to continue that counts." "Thành công không phải là cuối cùng, thất bại không phải là chết người: lòng can đảm đi tiếp mới quan trọng."

Prader-Willi syndrome (PWS) is a complex multisystem genetic disorder due the lack of expression of paternally inherited imprinted genes on chromosome 15q11-13. Clinical presentation includes hypotonia, hyperphagia, obesity, hypogonadism, learning difficulty. We studied clinical and laboratory of patient diagnosed and treated in National Hospital of Pediatrics, Hanoi (NHP). This is descriptive study. We collected 26 patients diagnosed of PWS by FISH in NHP from December 2007 to April 2012 were recruited in the study. Male/female ratio was 6/1. Patients diagnosed before 5 years occupied 53.5%. 85.7% of patients were found to have hypotonia at age of 4.92.0 months. 86.4% of patients had hypherphagia at age of 20.711.1 months. In patients aged of > 2 years, height SDS was +8.74.7 SD compared to gender and age. The figure of BMI was +10.33 SD. 4/7 of patients aged ≥ 6 years had micropenis. 91.7% of patients had cryptorchidism. 4/24 of patients (14.3%) had type 2 diabetes mellitus. Based on clinical presentation, more PWS patients could be diagnosed and treated early.

The current experiment aimed to determine the effects of peptidoglycan, known as a prebiotic compound, on the growth, feed efficiency, and disease resistance in Nile tilapia. Fish at an initial body weight of 22.6 ± 0.3g were distributed into a 100 L-glass tank system. Peptidoglycans extracted from Lactobacillus sp. were added to commercial feed at ratios of 0, 5, and 10 g kg-1 diet corresponding to the PG0, PG5, and PG10 treatments, respectively. Fish were then fed at 4% their body weight for four weeks. After a 4-week trial, fish were infected with Streptococcus agalactiae at 50% the lethal dose (1.1×106 CFU mL-1), and monitored for 14 days. After 2 and 4 weeks of the feeding trial (T2 and T4) and on the second day of the bacterial challenge, fish blood samples were collected for hematological analysis. The results indicated that the dietary supplementation of peptidoglycan induced a positive effect on fish growth performance and the highest value was observed in the PG5 treatment. The lowest value of cumulative mortality was also observed in the PG5-fed fish indicating that the dietary supplementation at 5 g kg-1 diet supported the highest resistance to S. agalactiae. In conclusion, the beneficial effects of dietary supplementation of peptidoglycan extracted from Lactobacillus sp. were recorded on the growth performance and disease resistance in Nile tilapia.