Purpose: Gastrostomy granulomas frequently occur in pediatric patients with gastrostomy tubes, yet there is a notable lack of comprehensive data on the efficacy and safety of various treatment modalities. Commonly used treatments, such as silver nitrate, are often painful and require frequent clinic visits, posing challenges for patients and families. Additionally, research on home-based treatments is limited, despite their potential to offer more convenient and less painful alternatives. This study addresses the need for well-designed comparisons of different treatment options. Methods: We conducted a prospective, open-label study at the Children’s Hospital of San Antonio, enrolling 36 pediatric patients aged 6 months to 17 years with gastrostomy tubes.Patients were randomized into two groups: one treated with topical silver nitrate and the other with table salt, excluding those on chemotherapy or with immunologic disorders.Granuloma sizes were measured at the study’s start with blinded physicians analyzing photographs to assess size reduction, and parent satisfaction surveys were conducted to evaluate treatment acceptability and side effects. Results: The median reduction in granuloma size was significantly greater in the table salt group (3.12 mm) compared to the silver nitrate group (2.25 mm) (Wilcoxon p-value=0.04).Parental satisfaction and confidence were high in both groups, with minor, self-limited skin irritation reported as a side effect. Conclusion The study suggests that table salt could be a feasible, non-inferior, and costeffective alternative to silver nitrate for treating gastrostomy granulomas in pediatric patients. Further research with a larger sample size is necessary to validate these findings.

The RET gene point mutation is the main molecular alteration involved in medullary thyroid carcinoma (MTC) tumorigenesis. Previous studies in Vietnam mainly consisted of case reports, with limited data on larger sample sizes. In this study, we investigated RET gene mutations in exons 10, 11, and 16 and analyzed clinicopathological features of a series of Vietnamese MTC patients. Methods: We collected 33 tissue samples from patients with MTC and analyzed RET mutations using the Sanger sequencing method. The relationship between hotspot RET mutations (exons 10, 11, 16) and clinicopathological features were investigated. Results: Among the 33 analyzed cases, 17 tumors (52%) harbored RET mutations in exon 10, 11, or 16. A total of 10 distinct genetic alterations were identified, including eight missense mutations and two short indels. Of these, seven were classified as pathogenic mutations based on previous publications, with p.M918T being the most frequent (4 cases), followed by p.C634R (3 cases) and p.C618R (3 cases). Mutations were significantly associated with specific histological patterns, such as the nested/insular pattern (p=.026), giant cells (p=.007), nuclear pleomorphism (p=.018), stippled chromatin (p=.044), and amyloid deposits (p=.024). No mutations were found in germline analyses, suggesting these were somatic alterations. Conclusions: Our results provided the first comprehensive analysis of RET mutations in Vietnamese MTC patients. The most frequent mutation was p.M918T, followed by p.C634R and p.C618R. Mutations in these three exons were linked to specific histopathological features. Information on mutational profiles of patients with MTC will further aid in the development of targeted therapeutics to ensure effective disease management.

Purpose: Gastrostomy granulomas frequently occur in pediatric patients with gastrostomy tubes, yet there is a notable lack of comprehensive data on the efficacy and safety of various treatment modalities. Commonly used treatments, such as silver nitrate, are often painful and require frequent clinic visits, posing challenges for patients and families. Additionally, research on home-based treatments is limited, despite their potential to offer more convenient and less painful alternatives. This study addresses the need for well-designed comparisons of different treatment options. Methods: We conducted a prospective, open-label study at the Children’s Hospital of San Antonio, enrolling 36 pediatric patients aged 6 months to 17 years with gastrostomy tubes.Patients were randomized into two groups: one treated with topical silver nitrate and the other with table salt, excluding those on chemotherapy or with immunologic disorders.Granuloma sizes were measured at the study’s start with blinded physicians analyzing photographs to assess size reduction, and parent satisfaction surveys were conducted to evaluate treatment acceptability and side effects. Results: The median reduction in granuloma size was significantly greater in the table salt group (3.12 mm) compared to the silver nitrate group (2.25 mm) (Wilcoxon p-value=0.04).Parental satisfaction and confidence were high in both groups, with minor, self-limited skin irritation reported as a side effect. Conclusion The study suggests that table salt could be a feasible, non-inferior, and costeffective alternative to silver nitrate for treating gastrostomy granulomas in pediatric patients. Further research with a larger sample size is necessary to validate these findings.

The RET gene point mutation is the main molecular alteration involved in medullary thyroid carcinoma (MTC) tumorigenesis. Previous studies in Vietnam mainly consisted of case reports, with limited data on larger sample sizes. In this study, we investigated RET gene mutations in exons 10, 11, and 16 and analyzed clinicopathological features of a series of Vietnamese MTC patients. Methods: We collected 33 tissue samples from patients with MTC and analyzed RET mutations using the Sanger sequencing method. The relationship between hotspot RET mutations (exons 10, 11, 16) and clinicopathological features were investigated. Results: Among the 33 analyzed cases, 17 tumors (52%) harbored RET mutations in exon 10, 11, or 16. A total of 10 distinct genetic alterations were identified, including eight missense mutations and two short indels. Of these, seven were classified as pathogenic mutations based on previous publications, with p.M918T being the most frequent (4 cases), followed by p.C634R (3 cases) and p.C618R (3 cases). Mutations were significantly associated with specific histological patterns, such as the nested/insular pattern (p=.026), giant cells (p=.007), nuclear pleomorphism (p=.018), stippled chromatin (p=.044), and amyloid deposits (p=.024). No mutations were found in germline analyses, suggesting these were somatic alterations. Conclusions: Our results provided the first comprehensive analysis of RET mutations in Vietnamese MTC patients. The most frequent mutation was p.M918T, followed by p.C634R and p.C618R. Mutations in these three exons were linked to specific histopathological features. Information on mutational profiles of patients with MTC will further aid in the development of targeted therapeutics to ensure effective disease management.

Purpose: Gastrostomy granulomas frequently occur in pediatric patients with gastrostomy tubes, yet there is a notable lack of comprehensive data on the efficacy and safety of various treatment modalities. Commonly used treatments, such as silver nitrate, are often painful and require frequent clinic visits, posing challenges for patients and families. Additionally, research on home-based treatments is limited, despite their potential to offer more convenient and less painful alternatives. This study addresses the need for well-designed comparisons of different treatment options. Methods: We conducted a prospective, open-label study at the Children’s Hospital of San Antonio, enrolling 36 pediatric patients aged 6 months to 17 years with gastrostomy tubes.Patients were randomized into two groups: one treated with topical silver nitrate and the other with table salt, excluding those on chemotherapy or with immunologic disorders.Granuloma sizes were measured at the study’s start with blinded physicians analyzing photographs to assess size reduction, and parent satisfaction surveys were conducted to evaluate treatment acceptability and side effects. Results: The median reduction in granuloma size was significantly greater in the table salt group (3.12 mm) compared to the silver nitrate group (2.25 mm) (Wilcoxon p-value=0.04).Parental satisfaction and confidence were high in both groups, with minor, self-limited skin irritation reported as a side effect. Conclusion The study suggests that table salt could be a feasible, non-inferior, and costeffective alternative to silver nitrate for treating gastrostomy granulomas in pediatric patients. Further research with a larger sample size is necessary to validate these findings.

Purpose: Gastrostomy granulomas frequently occur in pediatric patients with gastrostomy tubes, yet there is a notable lack of comprehensive data on the efficacy and safety of various treatment modalities. Commonly used treatments, such as silver nitrate, are often painful and require frequent clinic visits, posing challenges for patients and families. Additionally, research on home-based treatments is limited, despite their potential to offer more convenient and less painful alternatives. This study addresses the need for well-designed comparisons of different treatment options. Methods: We conducted a prospective, open-label study at the Children’s Hospital of San Antonio, enrolling 36 pediatric patients aged 6 months to 17 years with gastrostomy tubes.Patients were randomized into two groups: one treated with topical silver nitrate and the other with table salt, excluding those on chemotherapy or with immunologic disorders.Granuloma sizes were measured at the study’s start with blinded physicians analyzing photographs to assess size reduction, and parent satisfaction surveys were conducted to evaluate treatment acceptability and side effects. Results: The median reduction in granuloma size was significantly greater in the table salt group (3.12 mm) compared to the silver nitrate group (2.25 mm) (Wilcoxon p-value=0.04).Parental satisfaction and confidence were high in both groups, with minor, self-limited skin irritation reported as a side effect. Conclusion The study suggests that table salt could be a feasible, non-inferior, and costeffective alternative to silver nitrate for treating gastrostomy granulomas in pediatric patients. Further research with a larger sample size is necessary to validate these findings.

Purpose: Gastrostomy granulomas frequently occur in pediatric patients with gastrostomy tubes, yet there is a notable lack of comprehensive data on the efficacy and safety of various treatment modalities. Commonly used treatments, such as silver nitrate, are often painful and require frequent clinic visits, posing challenges for patients and families. Additionally, research on home-based treatments is limited, despite their potential to offer more convenient and less painful alternatives. This study addresses the need for well-designed comparisons of different treatment options. Methods: We conducted a prospective, open-label study at the Children’s Hospital of San Antonio, enrolling 36 pediatric patients aged 6 months to 17 years with gastrostomy tubes.Patients were randomized into two groups: one treated with topical silver nitrate and the other with table salt, excluding those on chemotherapy or with immunologic disorders.Granuloma sizes were measured at the study’s start with blinded physicians analyzing photographs to assess size reduction, and parent satisfaction surveys were conducted to evaluate treatment acceptability and side effects. Results: The median reduction in granuloma size was significantly greater in the table salt group (3.12 mm) compared to the silver nitrate group (2.25 mm) (Wilcoxon p-value=0.04).Parental satisfaction and confidence were high in both groups, with minor, self-limited skin irritation reported as a side effect. Conclusion The study suggests that table salt could be a feasible, non-inferior, and costeffective alternative to silver nitrate for treating gastrostomy granulomas in pediatric patients. Further research with a larger sample size is necessary to validate these findings.

The RET gene point mutation is the main molecular alteration involved in medullary thyroid carcinoma (MTC) tumorigenesis. Previous studies in Vietnam mainly consisted of case reports, with limited data on larger sample sizes. In this study, we investigated RET gene mutations in exons 10, 11, and 16 and analyzed clinicopathological features of a series of Vietnamese MTC patients. Methods: We collected 33 tissue samples from patients with MTC and analyzed RET mutations using the Sanger sequencing method. The relationship between hotspot RET mutations (exons 10, 11, 16) and clinicopathological features were investigated. Results: Among the 33 analyzed cases, 17 tumors (52%) harbored RET mutations in exon 10, 11, or 16. A total of 10 distinct genetic alterations were identified, including eight missense mutations and two short indels. Of these, seven were classified as pathogenic mutations based on previous publications, with p.M918T being the most frequent (4 cases), followed by p.C634R (3 cases) and p.C618R (3 cases). Mutations were significantly associated with specific histological patterns, such as the nested/insular pattern (p=.026), giant cells (p=.007), nuclear pleomorphism (p=.018), stippled chromatin (p=.044), and amyloid deposits (p=.024). No mutations were found in germline analyses, suggesting these were somatic alterations. Conclusions: Our results provided the first comprehensive analysis of RET mutations in Vietnamese MTC patients. The most frequent mutation was p.M918T, followed by p.C634R and p.C618R. Mutations in these three exons were linked to specific histopathological features. Information on mutational profiles of patients with MTC will further aid in the development of targeted therapeutics to ensure effective disease management.

Purpose: Simple virilizing congenital adrenal hyperplasia (SV-CAH) due to 21-hydroxylase deficiency (21-OHD) is an autosomal recessive disease caused by pathogenic variants of the CYP21A2 gene. Children with SV-CAH often experience delayed diagnosis, presenting with pseudo-precocious puberty in males and genital virilization in females. Genotyping is essential for diagnosis, treatment, optimization, and phenotype prediction. This study describes the clinical and genetic characteristics of SV-CAH to guide treatment strategies. Methods: From November 2016 to March 2023, 79 children (accounting for 34.3% of 230 CAH cases in the overall children’s cohort) from 75 families were classified as SV-CAH due to 21-OHD at the Vietnam National Children's Hospital. Forty-three children underwent CYP21A2 mutation analysis using multiplex ligation-dependent probe amplification and complete gene sequencing to detect pathogenic variants. Results: Median age at diagnosis was 4.5 years (interquartile range, 1 day–22.3 years). There were 38.0% males and 62.0% females. The most common symptoms were penile enlargement in males (53.3%) and clitoromegaly (87.8%) in females; the height standard deviation (SD) at diagnosis was 1.90±1.79 SD (-2.02 to 5.43) according to the World Health Organization; and bone age advancement was 4.65±2.59 years. Genetic analysis identified 21 pathogenic variants and 22 genotypes in 43 children. The most common variant was p.I173N (47.7%); the most common genotype was p.I173N/p.I173N (16.3%). Conclusion Children with SV-CAH are often diagnosed late. To avoid that, early genetic analysis should be prioritized, especially for children diagnosed through newborn screening programs. Determining the genotype is crucial for optimizing treatment strategies, ensuring personalized management, and avoiding overtreatment.

Background: The elderly are a population group that is particularly vulnerable to nutritional and digestive problems due to age-related physiological changes. In the hospital setting, where the elderly are treated as inpatients, gastrointestinal symptoms can become more complicated due to the impact of many factors related to the hospital environment such as changes in diet and use of multiple medications. In Vietnam, the population is aging rapidly, with the proportion of people over 60 years old increasing. This is a major challenge for the health system, especially in nutritional management and improving the quality of life of the elderly. Objectives: The study aims to describe the nutritional status, common gastrointestinal symptoms and the association between gastrointestinal symptoms disorders and nutritional status in elderly individuals receiving inpatient treatment. Methods: A cross-sectional descriptive study was conducted on 264 elderly patients at Hanoi Medical University Hospital from March 2023 to May 2024. Nutritional status was assessed using the BMI (WHO) and MNA, with ROME IV criteria employed to determine gastrointestinal symptoms, including functional dyspepsia, belching disorders, nausea, and vomiting disorders. Related factors considered were age, gender, and comorbidities. Results: The average age of the participants was 69.4±7.2 years. The rate of malnutrition or risk of malnutrition in the study subjects according to MNA was quite high, 12.5% and 70.1%, respectively. The prevalence of common digestive symptoms in elderly patients includes: 60.2% of elderly patients have symptoms of functional dyspepsia; 33.7% have symptoms of belching disorder; nausea and vomiting disorders account for 16.4%. According to MNA assessment, the proportion of elderly patients at risk of malnutrition and malnutrition with symptoms of gastrointestinal disorder was higher than the non-malnutrition group, the difference was statistically significant with p<0.05. Female participants often have digestive symptoms more often than male participants (p<0.05). Conclusion: Digestive symptoms are common in the elderly treated in a hospital. The incidence of gastrointestinal symptoms in the elderly is related to malnutrition.