Duodenal neuroendocrine tumors (NETs) are subepithelial tumors that are difficult to remove endoscopically, particularly when located just beyond the pylorus. This paper reports a case of a successful endoscopic submucosal dissection (ESD) using open gastric peroral endoscopic myotomy (POEM) for a remnant duodenal NET detected after endoscopic mucosal resection (EMR). A 67-year-old male presented with a 5 mm remnant duodenal NET close to the pylorus after EMR for a duodenal polypoid lesion performed four months earlier. Duodenal ESD was performed under conscious sedation using I-type and IT II knives. The tumor adhered to the fibrotic tissue, and the submucosal cushion was insufficient. Open gastric POEM was performed concurrently during ESD, resulting in the complete resection of the NET. This case suggests that while challenging, open gastric POEM can serve as a valuable technique for endoscopic resection in cases of early gastric cancer or duodenal masses located around the pylorus.

BACKGROUND: In order to provide essential scientific evidence on the population's health status and social health determinants as well as the current capacity of the health care system in Vietnam to health policy makers and managers, Vietnam Ministry of Health, Hanoi University of Public Health, Hanoi Medical University, and Ho Chi Minh University of Medicine and Pharmacy collaborated with Seoul National University (Korea) and conducted a health system survey in the Quoc Oai district (of Hanoi capital) that represented northern rural Vietnam. METHODS: The study design was a cross-sectional study. The survey covered different topics (more than 200 questions) and was administered in three separate questionnaires: 1) Basic information of all household members; 2) Household characteristics; and 3) Individual characteristics. Socio-demographic characteristics among the households and individuals were collected from 2,400 households sampled by multi-stage cluster sampling method: more than 200 questions. RESULTS: The household size of Quoc Oai was larger than the national average and there was no significant difference in gender composition. In addition, the proportions of pre-elderly, age 55–64, and elderly group (65 years old and over) were higher than the national population statistics. In this context, demographic transition has begun in Quoc Oai. CONCLUSION: This study design description provides the basic information about a baseline survey of a future prospective cohort (as a part of a collaborative project on strengthening the health system in Vietnam) to the prospective data user of this survey.
Aged ; Cohort Studies ; Cross-Sectional Studies ; Delivery of Health Care ; Family Characteristics ; Health Policy ; Humans ; Methods ; Pharmacy ; Population Characteristics ; Population Dynamics ; Prospective Studies ; Public Health ; Seoul ; Surveys and Questionnaires ; Vietnam

Backgroud: The aim of this study is to update on antibiotic resistance of common pathogenical bacteria isolated in Hue University of Medicine and Pharmacy Hospital (Hue UMP Hospital). Methodology: Use of the agar disk diffusion method to test the susceptibility to antimicrobial agents of 3709 bacterial strains from infected patients hospitalized in Hue UMP Hospital in 2020 - 2022. Results: Among 3709 strains of pathogenical bacteria isolated, S.aureus was found with the rate of 29.9%, followed by E. coli (24.5%), Pseudomonas aeruginasa (17.8%), Enterococcus spp. (11.8%), Klebsiella spp (9.7%) and Acinetobacter spp (4.1%). The proportion of bacterial isolates has changed, but Staphylococcus aureus is still highest rate. S.aureus is resistant to many antibiotics, but MRSA strains have decreased significantly, from 73.3% in 2020 to 62.5% in 2022. Pseudomonas aeruginosa was resistant to some of the group A recommended antibiotics such as ceftazidime, piperacillin-tazobactam with the rate of 56.6% and 48.7%. The percentage of E. coli with ESBL strains (+) was at 28.2% - 30.3%. Enterococus spp strains are still sensitive to vancomycin (83.1% - 91.9%). The rate of Klebsiella ESBL (+) is only 6.9% to 8.2%. The strains of Acinetobacter spp were highly resistant to Piperacillin (100%) and Ceftriaxone (96.5%) but they are still sensitive to imipenems 70 - 71%, highly sensitive to Doxycillin (95.2%) and Cefotaxime (88.4%). Conclusion: Many bacterial strains are resistant to many commonly antibiotics. Providing timely, regular, and effective management of antibiotic resistance patterns for common pathogenic bacteria in hospitals, will help reduce the risk of bacterial resistance.