1.Anesthetic neurotoxicity in the developing brain: an update on theinsights and implications for fetal surgery
Denise CINQUEGRANA ; Sri Harsha BOPPANA ; David BERMAN ; Truc-Anh T. NGUYEN ; Ahmet A. BASCHAT ; Jamie MURPHY ; C. David MINTZ
Anesthesia and Pain Medicine 2024;19(Suppl 1):S96-S104
This review describes an in-depth analysis of the neurotoxicity associated with the anesthetic agents used during fetal surgery, intending to highlight the importance of understanding the effects of general anesthetics on the developing brain, particularly in the context of open fetal surgery, where high doses are applied to facilitate surgical access and augment uterine relaxation. We examined evidence from preclinical studies in rodents and primates, along with studies in human subjects, with the results collectively suggesting that general anesthetics can disrupt brain development and lead to long-lasting neurological deficits. Our review underscores the clinical implications of these findings, indicating an association between extensive anesthetic exposure in early life and subsequent cognitive deficits. The current standard of anesthetic care for fetal surgical procedures was scrutinized, and recommendations have been proposed to mitigate the risk of anesthetic neurotoxicity. These recommendations emphasize the need for careful selection of anesthetic techniques to minimize fetal exposure to potentially harmful agents. In conclusion, while the benefits of fetal surgery in addressing immediate risks often outweigh the potential neurotoxic effects of anesthesia, the long-term developmental impacts nevertheless warrant consideration. Our analysis suggests that the use of general anesthetics in fetal surgery, especially at high doses, poses a significant risk of developmental neurotoxicity. As such, it is imperative to explore safer alternatives, such as employing different methods of uterine relaxation and minimizing the use of general anesthetics, to achieve the necessary surgical conditions. Further research, particularly in clinical settings, is essential to fully understand the risks and benefits of anesthetic techniques in fetal surgery.
2.Anesthetic neurotoxicity in the developing brain: an update on theinsights and implications for fetal surgery
Denise CINQUEGRANA ; Sri Harsha BOPPANA ; David BERMAN ; Truc-Anh T. NGUYEN ; Ahmet A. BASCHAT ; Jamie MURPHY ; C. David MINTZ
Anesthesia and Pain Medicine 2024;19(Suppl 1):S96-S104
This review describes an in-depth analysis of the neurotoxicity associated with the anesthetic agents used during fetal surgery, intending to highlight the importance of understanding the effects of general anesthetics on the developing brain, particularly in the context of open fetal surgery, where high doses are applied to facilitate surgical access and augment uterine relaxation. We examined evidence from preclinical studies in rodents and primates, along with studies in human subjects, with the results collectively suggesting that general anesthetics can disrupt brain development and lead to long-lasting neurological deficits. Our review underscores the clinical implications of these findings, indicating an association between extensive anesthetic exposure in early life and subsequent cognitive deficits. The current standard of anesthetic care for fetal surgical procedures was scrutinized, and recommendations have been proposed to mitigate the risk of anesthetic neurotoxicity. These recommendations emphasize the need for careful selection of anesthetic techniques to minimize fetal exposure to potentially harmful agents. In conclusion, while the benefits of fetal surgery in addressing immediate risks often outweigh the potential neurotoxic effects of anesthesia, the long-term developmental impacts nevertheless warrant consideration. Our analysis suggests that the use of general anesthetics in fetal surgery, especially at high doses, poses a significant risk of developmental neurotoxicity. As such, it is imperative to explore safer alternatives, such as employing different methods of uterine relaxation and minimizing the use of general anesthetics, to achieve the necessary surgical conditions. Further research, particularly in clinical settings, is essential to fully understand the risks and benefits of anesthetic techniques in fetal surgery.
3.Anesthetic neurotoxicity in the developing brain: an update on theinsights and implications for fetal surgery
Denise CINQUEGRANA ; Sri Harsha BOPPANA ; David BERMAN ; Truc-Anh T. NGUYEN ; Ahmet A. BASCHAT ; Jamie MURPHY ; C. David MINTZ
Anesthesia and Pain Medicine 2024;19(Suppl 1):S96-S104
This review describes an in-depth analysis of the neurotoxicity associated with the anesthetic agents used during fetal surgery, intending to highlight the importance of understanding the effects of general anesthetics on the developing brain, particularly in the context of open fetal surgery, where high doses are applied to facilitate surgical access and augment uterine relaxation. We examined evidence from preclinical studies in rodents and primates, along with studies in human subjects, with the results collectively suggesting that general anesthetics can disrupt brain development and lead to long-lasting neurological deficits. Our review underscores the clinical implications of these findings, indicating an association between extensive anesthetic exposure in early life and subsequent cognitive deficits. The current standard of anesthetic care for fetal surgical procedures was scrutinized, and recommendations have been proposed to mitigate the risk of anesthetic neurotoxicity. These recommendations emphasize the need for careful selection of anesthetic techniques to minimize fetal exposure to potentially harmful agents. In conclusion, while the benefits of fetal surgery in addressing immediate risks often outweigh the potential neurotoxic effects of anesthesia, the long-term developmental impacts nevertheless warrant consideration. Our analysis suggests that the use of general anesthetics in fetal surgery, especially at high doses, poses a significant risk of developmental neurotoxicity. As such, it is imperative to explore safer alternatives, such as employing different methods of uterine relaxation and minimizing the use of general anesthetics, to achieve the necessary surgical conditions. Further research, particularly in clinical settings, is essential to fully understand the risks and benefits of anesthetic techniques in fetal surgery.
4.Anesthetic neurotoxicity in the developing brain: an update on theinsights and implications for fetal surgery
Denise CINQUEGRANA ; Sri Harsha BOPPANA ; David BERMAN ; Truc-Anh T. NGUYEN ; Ahmet A. BASCHAT ; Jamie MURPHY ; C. David MINTZ
Anesthesia and Pain Medicine 2024;19(Suppl 1):S96-S104
This review describes an in-depth analysis of the neurotoxicity associated with the anesthetic agents used during fetal surgery, intending to highlight the importance of understanding the effects of general anesthetics on the developing brain, particularly in the context of open fetal surgery, where high doses are applied to facilitate surgical access and augment uterine relaxation. We examined evidence from preclinical studies in rodents and primates, along with studies in human subjects, with the results collectively suggesting that general anesthetics can disrupt brain development and lead to long-lasting neurological deficits. Our review underscores the clinical implications of these findings, indicating an association between extensive anesthetic exposure in early life and subsequent cognitive deficits. The current standard of anesthetic care for fetal surgical procedures was scrutinized, and recommendations have been proposed to mitigate the risk of anesthetic neurotoxicity. These recommendations emphasize the need for careful selection of anesthetic techniques to minimize fetal exposure to potentially harmful agents. In conclusion, while the benefits of fetal surgery in addressing immediate risks often outweigh the potential neurotoxic effects of anesthesia, the long-term developmental impacts nevertheless warrant consideration. Our analysis suggests that the use of general anesthetics in fetal surgery, especially at high doses, poses a significant risk of developmental neurotoxicity. As such, it is imperative to explore safer alternatives, such as employing different methods of uterine relaxation and minimizing the use of general anesthetics, to achieve the necessary surgical conditions. Further research, particularly in clinical settings, is essential to fully understand the risks and benefits of anesthetic techniques in fetal surgery.
5.Anesthetic neurotoxicity in the developing brain: an update on theinsights and implications for fetal surgery
Denise CINQUEGRANA ; Sri Harsha BOPPANA ; David BERMAN ; Truc-Anh T. NGUYEN ; Ahmet A. BASCHAT ; Jamie MURPHY ; C. David MINTZ
Anesthesia and Pain Medicine 2024;19(Suppl 1):S96-S104
This review describes an in-depth analysis of the neurotoxicity associated with the anesthetic agents used during fetal surgery, intending to highlight the importance of understanding the effects of general anesthetics on the developing brain, particularly in the context of open fetal surgery, where high doses are applied to facilitate surgical access and augment uterine relaxation. We examined evidence from preclinical studies in rodents and primates, along with studies in human subjects, with the results collectively suggesting that general anesthetics can disrupt brain development and lead to long-lasting neurological deficits. Our review underscores the clinical implications of these findings, indicating an association between extensive anesthetic exposure in early life and subsequent cognitive deficits. The current standard of anesthetic care for fetal surgical procedures was scrutinized, and recommendations have been proposed to mitigate the risk of anesthetic neurotoxicity. These recommendations emphasize the need for careful selection of anesthetic techniques to minimize fetal exposure to potentially harmful agents. In conclusion, while the benefits of fetal surgery in addressing immediate risks often outweigh the potential neurotoxic effects of anesthesia, the long-term developmental impacts nevertheless warrant consideration. Our analysis suggests that the use of general anesthetics in fetal surgery, especially at high doses, poses a significant risk of developmental neurotoxicity. As such, it is imperative to explore safer alternatives, such as employing different methods of uterine relaxation and minimizing the use of general anesthetics, to achieve the necessary surgical conditions. Further research, particularly in clinical settings, is essential to fully understand the risks and benefits of anesthetic techniques in fetal surgery.
6.Explore patients’s expectations towards primary care and related factors at Family Medicine Clinic, Hue University of Medicine and Pharmacy
Thi Hoa NGUYEN ; Thi Cuc NGUYEN ; Thi Phuong Thuy HO ; Thi Xuan Thuy HO ; Thi Truc Ly TRAN ; Duc Toan VO ; Minh Tam NGUYEN
Hue Journal of Medicine and Pharmacy 2023;13(7):83-92
Background: One of the most important elements for improving the primary care quality is to meet the growing needs of patients and to increase patient satisfaction. In-depth studies on patients’ expectation is vital for healthcare facilities to achieve a more reliable and valid healthcare outcome. This study aims: to explore people’s expectations towards primary care services and related factors at Family Medicine Clinic, Hue University of Medicine and Pharmacy. Methods: A mixed method study on 308 patients visiting the Family Physician Clinic, Hue University of Medicine and Pharmacy. Results: The most important aspects were: “Doctor provides correct diagnoses and cure it.”, “Doctor provides careful examination”, “Doctor takes full history taking”, “Doctor clearly explains diagnosis and treatment plan”, “List of medication covered by health insurance is enough and qualified”, “Doctor/healthcare worker ensures patient confidentiality” and “Healthcare workers are friendly”. There were differences in the expectations of prioritizing primary care services in different target groups. Younger patients groups placed more expectations on facility factors than older patient groups; Patients in different occupational groups differed in their expectations of healthcare workers and the quality of medical care.Conclusion: Factors related to health care workers and quality of medical care were the most prioritizing expectations at the Family Medicine Clinic. It is necessarry to improve primary care services to meet the expectations of different target groups.
7.Energy-dispersive X-ray spectroscopic investigation of a fractured non-submerged dental implant associated with abutment fracture
Truc Thi Hoang NGUYEN ; Mi Young EO ; Kezia Rachellea MUSTAKIM ; Mi Hyun SEO ; Hoon MYOUNG ; Soung Min KIM
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2023;49(1):43-48
The biocompatibility and durability of implant fixtures are major concerns for dentists and patients. Mechanical complications of the implant include abutment screw loosening, screw fracture, loss of implant prostheses, and implant fracture. This case report aims to describe management of a case of fixture damage that occurred after screw fracture in a tissue level, internal connection implant and microscopic evaluation of the fractured fixture. A trephine bur was used to remove the fixture, and the socket was grafted using allogeneic bone material. The failed implant was examined by scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS), which revealed a fractured fixture with both normal and irregular bone patterns. The SEM and EDS results give an enlightenment of the failed fixture surface micromorphology with microfracture and contaminated chemical compositions. Noticeably, the significantly high level of gold (Au) on the implant surface and the trace amounts of Au and titanium (Ti) in the bone tissue were recorded, which might have resulted from instability and micro-movement of the implant-abutment connection over an extended period of time. Further study with larger number of patient and different types of implants is needed for further conclusion.
8.Assessment of In vitro Antioxidant, Antidiabetic and Cytotoxic Activities of Sphaeranthus africanus Extracts
Tran Thi HUYEN ; Julien DUJARDIN ; Nguyen Thi THU HUONG ; Chung Thi MY DUYEN ; Nguyen Hoang MINH ; Ha Quang THANH ; Dao Tran MONG ; Ly Hai TRIEU ; Nguyen Mai TRUC TIEN ; Mai Thanh CHUNG ; Nguyen Nhat MINH ; Nguyen Thi NGOC DAN ; Huynh LOI
Natural Product Sciences 2023;29(2):98-103
Sphaeranthus africanus is commonly used as a traditional remedy for sore throats and pain treatment in Vietnam. The aerial parts have been studied for its anti-inflammatory and anti-proliferative properties. However, the antioxidant and antidiabetic potential of the plant has not been explored. In this work, hydrophilic extracts of the plant's aerial parts were prepared in order to investigate its antioxidant and anti-diabetic properties. Also, the cytotoxicity of the root was evaluated and compared to that of the aerial parts. All of the extracts inhibited lipid peroxidation with IC 50 values ranging from 2.05 to 3.56 µg/mL, indicating substantial antioxidant activity. At an IC 50 value of 4.80 μg/mL, the 50% ethanol extract exhibited the most potent inhibition of α-glucosidase. The cytotoxic activity of root extracts is 2 to 5-fold less than that of the aerial parts. Nevertheless, dichloromethane and ethyl acetate extracts of the root demonstrated a selective effect on leukemia cells, with no harm towards the normal HEK-293 cell line. This work provides a scientific support for the antioxidant and antidiabetic activity of the plant. Hence, it may find a promising material for the development of novel antioxidant and antidiabetic agents. More research can be conducted on the phytochemistry and anticancer activities of the plant’s root.
9.Analysis of acute sinusitis-related early failed implant surface: a combined histological, electron microscopy, and X-ray spectroscopy approach
Truc Thi Hoang NGUYEN ; Mi Young EO ; Mi Hyun SEO ; Soung Min KIM
Maxillofacial Plastic and Reconstructive Surgery 2022;44(1):18-
Background:
Even though dental implants are a reliable choice for dental rehabilitation, implant failures due to various etiologies have been reported. Early implant failures account for 2 to 6% of installed implants and are reported to have a higher rate than late failures, regardless of loading time. We herein report three cases of acute sinusitis and early implant failure with implants that failed within 1 month after installation. The aim of this study was to evaluate the surface properties of early failed implants and peri-implant tissue to determine the early osseointegration pattern in acute sinusitis-related failed implants as well as the possible role of surface contamination in the failure of osseointegration.
Results:
A combined histological, electron microscopy, and X-ray spectroscopy approach was used to characterize the surface of non-osseointegrated titanium implants and the surrounding biological tissues. Morphologic scanning electron microscopy revealed a heterogeneous surface and irregular osseointegration. The implant surface was covered mostly by carbon- and oxygen-rich organic matter. Energy-dispersive X-ray spectroscopy surface analysis of three implants showed the incorporation of some contaminants in both the upper and apical regions. Carbon, nitrogen, sodium, silicon, chlorine, sulfur, gold, and zirconium were detected on the surface of one or more failed implants. Fibrosis, lymphocytic, and macrophage infiltrates and a high activation of osteoclasts surrounding the bone graft particles were detected in the surrounding tissues.
Conclusions
The etiology and mechanism of early implant failure, especially in sinus-related cases, as well as the proper management interventions to minimize the rate of early implant failures, are of great concern. No matter how confident and accurate the surgeon’s operation, there may be unknown errors in the whole procedure that no one knows about. Rather than errors related to the implant surface, it is expected that there were invisible problems during the evaluation of the patient’s own unique sinus mucosal inflammation or the operator’s own procedure. Furthermore, well-designed researches are necessary to reveal the effect of material-related factors on acute sinus complication and early implant failure.
10.Laparoscopic Hartmann reversal: experiences from a developing country
Dung Anh NGUYEN ; Tuong-Anh MAI-PHAN ; Truc Thanh THAI ; Hai Van NGUYEN
Annals of Coloproctology 2022;38(4):297-300
Purpose:
Laparoscopic surgery is considered a promising approach for Hartmann reversal but is also a complicated major surgical procedure. We conducted a retrospective analysis at a city hospital in Vietnam to evaluate the treatment technique and outcomes of laparoscopic Hartmann reversal (LHR).
Methods:
A colorectal surgery database in 5 years between 2015 and 2019 (1,175 cases in total) was retrieved to collect 35 consecutive patients undergoing LHR.
Results:
The patients had a median age of 61 years old. The median operative time was 185 minutes. All the procedures were first attempted laparoscopically with a conversion rate of 20.0% (7 of 35 cases). There was no intraoperative complication. Postoperative mortality and morbidity were 0 and 11.4% (2 medical, 1 deep surgical site infection, and 1 anastomotic leak required reoperation) respectively. The median time to first bowel activity was 2.8 days and median length of hospital stay was 8 days.
Conclusion
When performed by skilled surgeons, LHR is a feasible and safe operation with acceptable morbidity rate.

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