Spontaneous dissections of visceral arteries without aortic involvement are very rare. The etiologies of these entities are unclear and their clinical managements remain controversial. We report a case of spontaneous multiple dissections affecting 4 visceral arteries including the superior mesenteric artery, the celiac artery and the bilateral renal arteries. The patient was managed conservatively and endovascularly. The clinical manifestation markedly improved and laboratory tests returned to normal limits within 1 week. The regular follow-up suggested a good clinical and radiological outcome until 84 months.
Arteries* ; Celiac Artery ; Endovascular Procedures ; Follow-Up Studies ; Humans ; Mesenteric Artery, Superior ; Renal Artery

Background: This study examined the clinical application of the modified computed tomography severity index (MCTSI) and retroperitoneal extension classification (REC) in the evaluation of acute pancreatitis (AP) among Vietnamese patients. Methods: Data from 115 patients with AP between January 2022 and February 2024 were retrospectively analyzed. AP was diagnosed using the revised Atlanta classification (RAC) criteria. All computed tomography images were assessed by two abdominal radiologists with over 10 years of experience. Patients with AP secondary to blunt abdominal trauma were excluded. Results: The mean patient age was 49.8 ± 16.7 years, and the male:female ratio was 2.7:1. Necrotizing AP was observed in 24.3% of cases and extrapancreatic complications in 35.7%. Pancreatic and peripancreatic fluid collections were noted in 68.7% of cases, including 39.1% with acute peripancreatic fluid collection, 7.8% pseudocyst, 21.7% acute necrotic collection, and 4.3% walled-off necrosis. Based on MCTSI, the rates of mild, moderate, and severe AP were 28.7%, 53.9%, and 17.4%, respectively. Grades I, II, III, IV, and V REC represented 55.7%, 13.0%, 19.1%, 5.2%, and 7.0% of patients, respectively. MCTSI and REC were correlated with RAC in the evaluation of AP severity. Multivariate regression analysis revealed MCTSI to be an independent predictor of severe AP (odds ratio, 2.719; 95% confidence interval, 1.149–6.437; P = 0.023). MCTSI > 7 was the cutoff for predicting severe AP, with a sensitivity of 83.3%, specificity of 86.2%, and area under the curve of 0.944 (P < 0.001). Compared to the non-severe group, those with severe AP according to MCTSI had a longer hospitalization period (11 [9.25–16.75] days vs. 9 [6.50–12.00] days), a higher intensive care unit admission rate (30.0% vs. 3.2%), and greater mortality (15.0% vs. 1.1%). Conclusion In the assessment of AP severity, MCTSI and REC were correlated with RAC. MCTSI was an independent predictor of severe AP.

Background: This study examined the clinical application of the modified computed tomography severity index (MCTSI) and retroperitoneal extension classification (REC) in the evaluation of acute pancreatitis (AP) among Vietnamese patients. Methods: Data from 115 patients with AP between January 2022 and February 2024 were retrospectively analyzed. AP was diagnosed using the revised Atlanta classification (RAC) criteria. All computed tomography images were assessed by two abdominal radiologists with over 10 years of experience. Patients with AP secondary to blunt abdominal trauma were excluded. Results: The mean patient age was 49.8 ± 16.7 years, and the male:female ratio was 2.7:1. Necrotizing AP was observed in 24.3% of cases and extrapancreatic complications in 35.7%. Pancreatic and peripancreatic fluid collections were noted in 68.7% of cases, including 39.1% with acute peripancreatic fluid collection, 7.8% pseudocyst, 21.7% acute necrotic collection, and 4.3% walled-off necrosis. Based on MCTSI, the rates of mild, moderate, and severe AP were 28.7%, 53.9%, and 17.4%, respectively. Grades I, II, III, IV, and V REC represented 55.7%, 13.0%, 19.1%, 5.2%, and 7.0% of patients, respectively. MCTSI and REC were correlated with RAC in the evaluation of AP severity. Multivariate regression analysis revealed MCTSI to be an independent predictor of severe AP (odds ratio, 2.719; 95% confidence interval, 1.149–6.437; P = 0.023). MCTSI > 7 was the cutoff for predicting severe AP, with a sensitivity of 83.3%, specificity of 86.2%, and area under the curve of 0.944 (P < 0.001). Compared to the non-severe group, those with severe AP according to MCTSI had a longer hospitalization period (11 [9.25–16.75] days vs. 9 [6.50–12.00] days), a higher intensive care unit admission rate (30.0% vs. 3.2%), and greater mortality (15.0% vs. 1.1%). Conclusion In the assessment of AP severity, MCTSI and REC were correlated with RAC. MCTSI was an independent predictor of severe AP.

Background: This study examined the clinical application of the modified computed tomography severity index (MCTSI) and retroperitoneal extension classification (REC) in the evaluation of acute pancreatitis (AP) among Vietnamese patients. Methods: Data from 115 patients with AP between January 2022 and February 2024 were retrospectively analyzed. AP was diagnosed using the revised Atlanta classification (RAC) criteria. All computed tomography images were assessed by two abdominal radiologists with over 10 years of experience. Patients with AP secondary to blunt abdominal trauma were excluded. Results: The mean patient age was 49.8 ± 16.7 years, and the male:female ratio was 2.7:1. Necrotizing AP was observed in 24.3% of cases and extrapancreatic complications in 35.7%. Pancreatic and peripancreatic fluid collections were noted in 68.7% of cases, including 39.1% with acute peripancreatic fluid collection, 7.8% pseudocyst, 21.7% acute necrotic collection, and 4.3% walled-off necrosis. Based on MCTSI, the rates of mild, moderate, and severe AP were 28.7%, 53.9%, and 17.4%, respectively. Grades I, II, III, IV, and V REC represented 55.7%, 13.0%, 19.1%, 5.2%, and 7.0% of patients, respectively. MCTSI and REC were correlated with RAC in the evaluation of AP severity. Multivariate regression analysis revealed MCTSI to be an independent predictor of severe AP (odds ratio, 2.719; 95% confidence interval, 1.149–6.437; P = 0.023). MCTSI > 7 was the cutoff for predicting severe AP, with a sensitivity of 83.3%, specificity of 86.2%, and area under the curve of 0.944 (P < 0.001). Compared to the non-severe group, those with severe AP according to MCTSI had a longer hospitalization period (11 [9.25–16.75] days vs. 9 [6.50–12.00] days), a higher intensive care unit admission rate (30.0% vs. 3.2%), and greater mortality (15.0% vs. 1.1%). Conclusion In the assessment of AP severity, MCTSI and REC were correlated with RAC. MCTSI was an independent predictor of severe AP.

Objectives: The coronavirus disease 2019 (COVID-19) pandemic has increased the workload of healthcare workers (HCWs), impacting their health. This study aimed to assess sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and identify factors associated with poor sleep among HCWs in Vietnam during the COVID-19 pandemic. Methods: In this cross-sectional study, 1000 frontline HCWs were recruited from various healthcare facilities in Vietnam between October 2021 and November 2021. Data were collected using a 3-part self-administered questionnaire, which covered demographics, sleep quality, and factors related to poor sleep. Poor sleep quality was defined as a total PSQI score of 5 or higher. Results: Participants’ mean age was 33.20±6.81 years (range, 20.0-61.0), and 63.0% were women. The median work experience was 8.54±6.30 years. Approximately 6.3% had chronic comorbidities, such as hypertension and diabetes mellitus. About 59.5% were directly responsible for patient care and treatment, while 7.1% worked in tracing and sampling. A total of 73.8% reported poor sleep quality. Multivariate logistic regression revealed significant associations between poor sleep quality and the presence of chronic comorbidities (odds ratio [OR], 2.34; 95% confidence interval [CI], 1.17 to 5.24), being a frontline HCW directly involved in patient care and treatment (OR, 1.59; 95% CI, 1.16 to 2.16), increased working hours (OR, 1.84; 95% CI,1.37 to 2.48), and a higher frequency of encountering critically ill and dying patients (OR, 1.42; 95% CI, 1.03 to 1.95). Conclusions The high prevalence of poor sleep among HCWs in Vietnam during the COVID-19 pandemic was similar to that in other countries. Working conditions should be adjusted to improve sleep quality among this population.

Iodine-131 is a radioisotope that is routinely used for the treatment of differentiated thyroid cancer after total or near-total thyroidectomy. However, there is some evidence that iodine-131 can induce liver injury . Here we report a rare case of drug-induced liver injury (DILI) caused by iodine-131 in a patient with regional lymph node metastasis after total thyroidectomy. A 47-year-old woman was admitted with elevated liver enzymes and symptoms of general weakness and nausea. Ten weeks earlier she had undergone a total thyroidectomy for papillary thyroid carcinoma and had subsequently been prescribed levothyroxine to reduce the level of thyroid-stimulating hormone. Eight weeks after surgery she underwent iodine-131 ablative therapy at a dose of 100 millicuries, and subsequently presented with acute hepatitis after 10 days. To rule out all possible causative factors, abdominal ultrasonography, endoscopic ultrasonography (on the biliary tree and gall bladder), and a liver biopsy were performed. DILI caused by iodine-131 was suspected. Oral prednisolone was started at 30 mg/day, to which the patient responded well.
Abdomen/diagnostic imaging ; Chemical and Drug Induced Liver Injury/*diagnosis/drug therapy ; Female ; Humans ; Iodine Radioisotopes/chemistry ; Lymph Nodes/pathology ; Lymphatic Metastasis ; Middle Aged ; Prednisolone/therapeutic use ; Thyroid Neoplasms/drug therapy/surgery ; Thyroidectomy ; Thyroxine/therapeutic use ; Ultrasonography