(1) Background: Asthma exacerbations represent significant clinical events, however, the underlying inflammatory mechanisms and cytokine profiles in patients with frequent exacerbations remain incompletely understood; (2) Methods: In this prospective, cross-sectional study of 120 stable asthma patients, we compared the serum concentrations of eight key cytokines (IL-4, IL-12, IL-13, IL-17, IFN-α, IFN-γ, TNF-α, and IL-1β) between two groups: 60 patients with frequent exacerbations (≥ 2 events per year) and 60 matched controls with few exacerbations (1 event per year); (3) Results: Patients with frequent exacerbations showed significantly higher serum concentrations of IL-4 and IL-13 (p < 0.05), along with an increased prevalence of allergic history and comorbidities (chronic rhinosinusitis, GERD, OSA; all p < 0.05). The IgE levels correlated positively with IFN-α (rh = 0.26) and TNF-α (rh = 0.29), while the FeNO levels correlated with IL-17 (rh = 0.26) and IL-1β (rh = 0.33) (all p < 0.05); (4) Conclusions: Our findings identify a distinct cytokine signature in frequent exacerbators characterized by elevated IL-4 and IL-13 levels. The correlations between specific cytokines and established biomarkers suggest potential mechanisms underlying exacerbation susceptibility, which may inform targeted therapeutic strategies for this high-risk population.

(1) Background: Isoniazid resistance in Mycobacterium tuberculosis is primarily mediated by mutations in katG and inhA genes, yet the molecular characteristics of coding region mutations and their clinical correlations in Vietnamese patients remain incompletely understood; (2) Methods: We conducted a cross-sectional study analyzing exon mutations in katG and inhA genes using Sanger sequencing in 56 isoniazid-resistant pulmonary tuberculosis patients treated at the National Lung Hospital from January 2023 to June 2024, with comprehensive clinical and paraclinical data collection; (3) Results: Exon mutations in katG were detected in 11 patients (19.6%) and inhA in 7 patients (12.5%), with no concurrent mutations. The Ser315Thr mutation was present in all katG-positive cases (100%), while all inhA mutations were concentrated in codon cluster 233-240 with 63/96 being amino acid-changing variants. Patients with katG or inhA mutations had significantly higher rates of pulmonary rales compared to those without mutations (90.9% and 85.7% vs. 34.2%, p < 0.001), and inhA mutations were exclusively found in multidrug-resistant tuberculosis cases (p = 0.012); (4) Conclusions: Our findings identify codon cluster 233-240 as a novel inhA mutation hotspot in Vietnamese strains and demonstrate significant associations between specific mutations and disease severity. The exclusive presence of inhA mutations in MDR-TB cases and the correlation between genotype and clinical manifestations support the implementation of genotype-guided diagnostic and therapeutic strategies for isoniazid-resistant tuberculosis.

(1) Background: Asthma exacerbations represent significant clinical events, yet the underlying inflammatory mechanisms and cytokine profiles in patients with frequent exacerbations remain incompletely understood; (2) Methods: In this prospective, cross-sectional study of 120 stable asthma patients, we compared serum concentrations of eight key cytokines (IL-4, IL-12, IL-13, IL-17, IFN-α, IFN-γ, TNF-α, and IL-1β) between two groups: 60 patients with frequent exacerbations (≥2/year) and 60 matched controls with few exacerbations (1/year); (3) Results: Patients with frequent exacerbations showed significantly higher serum concentrations of IL-4 and IL-13 (p < 0.05), along with increased prevalence of allergic history and comorbidities (chronic rhinosinusitis, GERD, OSA; all p < 0.05). IgE levels correlated positively with IFN-α (rh = 0.26) and TNF-α (rh = 0.29), while FeNO levels correlated with IL-17 (rh = 0.26) and IL-1β (rh = 0.33) (all p < 0.05); (4) Conclusions: Our findings identify a distinct cytokine signature in frequent exacerbators characterized by elevated IL-4 and IL-13 levels. The correlations between specific cytokines and established biomarkers suggest potential mechanisms underlying exacerbation susceptibility, which may inform targeted therapeutic strategies for this high-risk population.

(1) Malaria remains a significant health threat to military and civilian personnel de-ployed to endemic regions. Despite recommended chemoprophylaxis, compliance var-ies substantially, potentially impacting clinical outcomes when infections occur. This study investigated the relationship between antimalarial prophylaxis compliance and disease severity among United Nations peacekeepers and associated personnel in South Sudan. (2) Methods: A prospective observational study was conducted at the Vietnam Level 2 Field Hospital in Bentiu, South Sudan from 2018-2024, analyzing 258 confirmed malaria cases. Patients were stratified based on prophylactic medication adherence: a prophylaxis group (n=140, including both regular and irregular users) and a non-prophylaxis group (n=118). Clinical manifestations, laboratory parameters, parasite density, and disease severity were compared between groups. (3) Results: De-spite similar rates of atypical fever presentations between groups (65.0% vs. 55.9%, p=0.14), significant differences emerged in disease severity and laboratory parameters. Non-adherence to prophylaxis was associated with increased risk of anemia (OR=2.81, 95%CI 1.27-6.25, p< 0.01), severe thrombocytopenia (OR=3.76, 95%CI 2.24-6.31, p< 0.01), and elevated liver enzymes (AST: OR=2.26, 95%CI 1.36-3.75, p< 0.001; ALT: OR=1.86, 95%CI 1.13-3.05, p< 0.01). Most importantly, prophylactic abstention signifi-cantly increased risk for malaria with warning signs (OR=2.33, 95%CI 1.25-4.34, p< 0.01) and high parasite density (OR=3.07, 95%CI 1.81-5.20, p< 0.001). All patients achieved parasitological clearance by day three post-treatment. (4) Conclusions: While antimalarial prophylaxis did not prevent infection in our cohort, it significantly re-duced disease severity, parasitemia, and laboratory abnormalities when breakthrough infections occurred. These findings emphasize the importance of prophylactic com-pliance among non-immune individuals in high-transmission settings, even when per-fect adherence cannot be achieved.

Background: Pulmonary hypertension is common in left-sided heart valve disease, with historical studies reporting mortality rates up to 31% in severe cases undergoing mitral valve surgery. This study evaluates the impact of severe pulmonary hypertension on outcomes of mechanical mitral valve replacement with posterior leaflet preservation by comparing results with patients having mild-to-moderate pulmonary hypertension. Methods: Prospective analysis of 86 patients with mitral valve disease undergoing mechanical valve replacement with posterior leaflet preservation from March 2015 to September 2016 was conducted. Patients were stratified by pulmonary artery pressure: severe (≥60 mmHg, n = 19) versus mild–moderate (35–59 mmHg, n = 67). Primary outcomes included mortality, complications, and functional recovery at 1, 6, and 12 months. Results: The cohort included 67 patients (77.9%) with mild–moderate pulmonary hypertension and 19 patients (22.1%) with severe pulmonary hypertension. Severe pulmonary hypertension patients demonstrated higher NYHA functional class (73.7% class III vs. 46.2%, p = 0.03), larger left atrial diameter (56.3 ± 9.8 vs. 49.5 ± 6.7 mm, p = 0.01), and higher mean pressure gradients (14.4 ± 5.3 vs. 11.3 ± 5.0 mmHg, p = 0.025). Mortality was 5.3% in the severe group versus 0% in the mild–moderate group (p = 0.331). Patients with severe pulmonary hypertension required longer ICU stays (6.3 ± 3.7 vs. 4.7 ± 2.2 days, p = 0.024) but showed no significant differences in ventilation time, reoperation rates, or major complications. At the 12-month follow-up, both groups achieved equivalent outcomes in pulmonary artery pressures, left ventricular function, and cardiac dimensions. Conclusion: In this study with a relatively small sample size, severe pulmonary hypertension was associated with significantly longer intensive care unit stay but not with higher mortality compared to mild–moderate pulmonary hypertension, with both groups attaining comparable functional and hemodynamic parameters at 12 months after mechanical mitral valve replacement with posterior leaflet preservation.