Tạp chí của Trường Đại học Y Dược Phạm Ngọc Thạch
A Case of Livedoid Vasculopathy with Rapid Response to Rivaroxaban: Case Report and Current Treatment Overview
Introduction: Livedoid vasculopathy (LV) is a rare chronic microvascular disorder characterized by persistent skin ulcers and atrophie blanche. It is often misdiagnosed as other conditions such as chronic venous insufficiency or necrotizing vasculitis. Case presentation: A 42-year-old woman presented with painful erythematous patches and superficial ulcers affecting both her lower limbs. She was initially treated for chronic venous insufficiency and later for nonspecific necrotizing vasculitis, but without improvement. Skin biopsy confirmed the diagnosis of livedoid vasculopathy. The patient did not respond to corticosteroids but showed rapid improvement after switching to oral rivaroxaban, with dry ulcers, reduced pain, and fading erythema observed after 7 days. Conclusion: This case highlights the essential role of skin biopsy in accurately diagnosing LV and the effectiveness of targeted anticoagulant therapy with rivaroxaban in achieving rapid symptom relief. DOI: 10.59715/pntjmp.5.2.23
Folliculitis following hair removal using Intense Pulsed Light: Successful management with 1927 nm Thulium laser - A case report
Background: Hair holds significant aesthetic value; however, unwanted hair growth often negatively impacts psychological well-being and quality of life. Energy-based devices (EBDs), such as lasers and intense pulsed light (IPL), are currently effective and popular solutions for hair removal with few complications. Nevertheless, post-treatment folliculitis can occur, adversely affecting skin health and reducing patient satisfaction with the procedure. Case Report: A 22-year-old male (Fitzpatrick skin type IV) presented with acne vulgaris accompanied by pseudofolliculitis barbae. He was initially treated with topical medications combined with IPL hair removal. Following the second IPL session, the patient experienced a massive pustular flare-up. Initial management with IPL in acne mode yielded an incomplete response. Subsequent combination therapy with a 1927 nm Thulium laser resulted in rapid inflammation reduction within 7 days. Clinical outcomes showed significant remission of symptoms alongside a reduction in hair density, meeting the patient's therapeutic goals. Conclusions: Folliculitis following hair removal using IPL or other EBDs is a rare and transient complication but requires careful clinical assessment and device parameter adjustment for prevention. Therapeutic interventions, utilizing topical agents or EBDs such as the 1927 nm Thulium laser originally indicated for acne can significantly improve the condition should complications arise. Further research is needed to optimize treatment parameters, particularly for Asian skin types, to maximize hair removal efficacy without compromising the patient's quality of life. DOI: 10.59715/pntjmp.5.2.22
Ethical decision-making in abortion for a perimenopausal woman with unintended pregnancy: A case report
Background: Abortion decision-making is ethically complex, particularly in perimenopausal women with cardiovascular comorbidities. Understanding the clinical and ethical challenges in such cases is essential for patient-centred care. Case presentation: We report a case of a 51-year-old perimenopausal woman with myocardial infarction-related mitral regurgitation who presented with an unintended 10-week pregnancy. She experienced significant anxiety and psychological distress due to the unexpected pregnancy and moral conflict regarding abortion. Clinical evaluation, including ultrasound, confirmed a viable foetus with normal cardiac activity. Using the four-box approach, medical indications, patient preferences, quality of life, and contextual factors were systematically assessed to support ethically sound and patient-centred decision-making. Conclusions: This case highlights the importance of integrating ethical frameworks into clinical care when managing complex reproductive decisions in patients with high-risk comorbidities. The structured four-box approach facilitates informed, safe, and ethically responsible care while respecting patient autonomy. DOI: 10.59715/pntjmp.5.2.21
Tram Thi Bich Nguyen, Riksa Wibawa Resna
Application of electrical impedance tomography in an obese patient with ARDS
This clinical case report detailed a 60-year-old obese female (BMI 44 kg/m²) with severe ARDS. The patient underwent mechanical ventilation with PEEP 16 cmH₂O, but due to obesity and high PEEP, CT imaging was not feasible. Bedside Electrical Impedance Tomography (EIT) was employed for lung function monitoring. Continuous EIT assessed regional lung ventilation, analyzing impedance changes to evaluate lung homogeneity and regional ventilation delay. Initial findings revealed significant inhomogeneity and regional ventilation delay. However, with EIT monitoring and adjustments to ventilator settings, coupled with physical therapy, the patient's regional ventilation gradually improved. After 7 days, the patient was successfully weaned off mechanical ventilation. This case demonstrated the utility of bedside EIT in monitoring lung function in severe ARDS patients, especially those with obesity. Real-time, non-invasive assessment of regional lung ventilation facilitated optimized ventilator settings and improved outcomes. DOI: 10.59715/pntjmp.5.2.20
Nguyen Thi Hoang Anh, Do Quoc Huy, Pham Quoc Dung, Nguyen Hong Truong
TNF-α inhibitory potential of bioactive compounds from Caesalpinia sappan L.: A virtual screening study
Background: Tumor necrosis factor alpha (TNF-α) is a multifunctional proinflammatory cytokine that plays a crucial role in many pathological conditions such as inflammation, autoimmune diseases, and cancer. There is a large body of evidence that Caesalpinia sappan L. extract inhibits the TNF-α signaling pathway. Nevertheless, no studies evaluating the TNF-α inhibitory capacity of bioactive metabolites in C. sappan have been reported to date, and the mechanism of this process remains unclear. This study assessed the in silico binding ability of bioactive compounds in C. sappan with TNF-α through molecular docking simulation. Methods: The secondary metabolite structures reported from C. sappan were retrieved from the PubChem database. A model of molecular docking simulation was constructed based on the crystal structure of TNF-α and the small molecule SPD304 with the PDB ID 2AZ5 (rcsb.org/structure/2AZ5). A high throughput docking campaign was conducted by using Autodock Vina with a simple bash script. The optimal docking pose of each compound was visually analyzed using BIOVIA Discovery Studio Visualizer. Results: Most of the compounds in C. sappan showed good in silico binding ability to TNF-α. The fifteen metabolites were recognized as potential TNF-α inhibitors with better binding energy than the reference ligand SPD304. Neoprotosappanin was discovered as the best potential structure with a binding energy of -10.06 kcal/mol and meaningful in silico interactions with TNF-α. Conclusions: Bioactive compounds from sappanwood may have the potential to inhibit TNF-α. The most promising compounds should be further evaluated by molecular dynamics simulations and predicted pharmacokinetic and toxicological properties before performing in vitro assays. Background: Tumor necrosis factor alpha (TNF-α) is a multifunctional proinflammatory cytokine that plays a crucial role in many pathological conditions such as inflammation, autoimmune diseases, and cancer. There is a large body of evidence that Caesalpinia sappan L. extract inhibits the TNF-α signaling pathway. Nevertheless, no studies evaluating the TNF-α inhibitory capacity of bioactive metabolites in C. sappan have been reported to date, and the mechanism of this process remains unclear. This study assessed the in silico binding ability of bioactive compounds in C. sappan with TNF-α through molecular docking simulation. Methods: The secondary metabolite structures reported from C. sappan were retrieved from the PubChem database. A model of molecular docking simulation was constructed based on the crystal structure of TNF-α and the small molecule SPD304 with the PDB ID 2AZ5 (rcsb.org/structure/2AZ5). A high throughput docking campaign was conducted by using Autodock Vina with a simple bash script. The optimal docking pose of each compound was visually analyzed using BIOVIA Discovery Studio Visualizer. Results: Most of the compounds in C. sappan showed good in silico binding ability to TNF-α. The fifteen metabolites were recognized as potential TNF-α inhibitors with better binding energy than the reference ligand SPD304. Neoprotosappanin was discovered as the best potential structure with a binding energy of -10.06 kcal/mol and meaningful in silico interactions with TNF-α. Conclusions: Bioactive compounds from sappanwood may have the potential to inhibit TNF-α. The most promising compounds should be further evaluated by molecular dynamics simulations and predicted pharmacokinetic and toxicological properties before performing in vitro assays. DOI: 10.59715/pntjmp.5.2.19
Le Nhat Linh, Nguyen Thi Phuong Thao, Nguyen Dang Thoai
Comparing Dinoprostone and Oxytocin for labor induction in pregnancies ≥ 37 weeks with prelabor rupture of membranes at Hung Vuong Hospital
Background: Prelabor rupture of membranes (PROM) at term is associated with increased maternal and neonatal infection risks, and induction of labor (IOL) is recommended to improve pregnancy outcomes. Dinoprostone and oxytocin are commonly used for IOL; however, direct comparative evidence in Vietnam remains limited. Methods: This retrospective cohort study included 140 term pregnant women (≥ 37 weeks’ gestation) with PROM who underwent IOL at Hung Vuong Hospital between January 2023 and February 2025. Seventy women were assigned to each group dinoprostone and oxytocin. The primary outcome was successful IOL, defined as achieving a Bishop score ≥ 7 or entering active labor (cervical dilation ≥ 4 cm) within 24 hours. Secondary outcomes included mode of delivery, induction-to-delivery interval, and maternal and neonatal outcomes. Multivariable regression models were used to adjust for potential confounders. Results: The overall successful IOL rate was 73.6% (95% CI, 65.5-80.7). After adjustment for parity and Bishop score, there was no significant difference in IOL success between the oxytocin and dinoprostone groups (adjusted RR = 1.21; 95% CI, 0.99-1.47). The vaginal delivery rate was higher in the oxytocin group than in the dinoprostone group (64.3%, 95% CI 51.9-75.4 vs 40.0%, 95% CI 28.4-52.4); and oxytocin was independently associated with a higher likelihood of vaginal delivery (adjusted RR = 1.47; 95% CI, 1.05-2.06). Dinoprostone was associated with a shorter induction-to-delivery interval, mainly due to a shorter time from treatment initiation to successful IOL (HR = 1.96; 95% CI, 1.29-2.99). Maternal complications were uncommon and neonatal outcomes were comparable between groups. Conclusions: In term pregnancies with PROM, dinoprostone and oxytocin showed comparable effectiveness and safety for achieving successful IOL. Oxytocin was associated with a higher likelihood of vaginal delivery, whereas dinoprostone was associated with a shorter induction duration. However, the retrospective design and single-center setting may limit causal inference and generalizability of the findings. These results support individualized selection of induction methods based on clinical context. DOI: 10.59715/pntjmp.5.2.18
Nguyen Thi Kim Ngan, Pham Huynh Phuc Hung, Le Quang Thanh, Huynh Nguyen Khanh Trang
Evaluation of the Effectiveness of Auricular Acupuncture in the Treatment of Insomnia in Patients with Chronic Pain at TTH Quang Binh General Hospital
Background: Insomnia is a common disorder characterized by a persistent reduction in sleep quality and/or sleep duration over a certain period, in which impaired sleep quality has greater diagnostic significance than sleep duration. This condition is highly prevalent among patients with chronic pain, leading to reduced quality of life and difficulties in pain control, with reported prevalence rates up to 72.8%. Among current therapeutic approaches, auricular acupuncture-a modality of Traditional Medicine is considered a potential, convenient, and effective complementary therapy. This provides the rationale for conducting a study to evaluate the effects of auricular acupuncture on insomnia in patients with chronic pain. Objectives: 1. To investigate selected clinical characteristics of insomnia in patients with chronic pain; 2. To evaluate the therapeutic effects of auricular acupuncture on insomnia in the study population and identify related factors. Subjects and Methods: A total of 72 patients who presented for outpatient and inpatient treatment at the Department of Traditional Medicine and Rehabilitation 1, TTH Quang Binh General Hospital, and met the inclusion criteria, were enrolled. Patients were allocated into two comparable groups with respect to age, sex, and pain intensity. Both groups received standard analgesic treatment according to a unified protocol; Group I additionally received treatment for insomnia using auricular acupuncture. The study was designed as a controlled clinical intervention with pre- and post-treatment comparisons. Results: Sleep onset latency decreased by 38.61 minutes, total sleep duration increased by 2.46 hours, and the Pittsburgh Sleep Quality Index (PSQI) score decreased by 8.78 points. No significant differences were observed with respect to age, sex, or types of musculoskeletal disorders. However, a significant association was found between pain intensity and the degree of PSQI score reduction. Conclusions: Auricular acupuncture is clinically effective in the treatment of insomnia in patients with chronic pain. Management of chronic pain contributes to improvement in insomnia, and conversely, improvement in sleep quality facilitates better pain control. DOI: 10.59715/pntjmp.5.2.17
Anxiety, depression, and associated factors among 12th-grade students at Trung Vuong High School, Ho Chi Minh city
Background: Anxiety and depression are important contributors that hinder adolescents’ academic functioning, limit their capacity to develop social relationships, and are associated with reduced quality of life. Methods: A cross-sectional study involving 626 12th-grade students at Trung Vuong High School was conducted to determine the prevalence of anxiety and depression and to examine associated factors. The 21-item Depression, Anxiety and Stress Scale (DASS-21) was used to assess symptoms of anxiety and depression. Results: The prevalence of students exhibiting symptoms of anxiety and depression was 64.4% and 54.6%, respectively. Factors associated with anxiety and depression included family conflict, frequency of being compared with other peers by parent(s), excessively high parental expectations, frequency of self-perceived academic pressure, frequency of pre-examination stress, frequency of pressure to gain university admission, difficulties in peer relationships, and feelings of inferiority compared with peers. Conclusions: Schools and parents should provide ongoing encouragement and support for twelfth-grade students’ learning, while minimizing undue pressure and social comparison, particularly in the period preceding the National High School Graduation Examination. DOI: 10.59715/pntjmp.5.2.16
Le Hong Hoai Linh, Huynh Le Lan Hien, Dang Bao Dang
Systemic inflammation and associated factors in truncal versus facial acne in young adults: an analytical cross-sectional study
Background: Acne is a common skin condition in young adults. It affects appearance, psychological well-being, and overall health. Recently, a paradigm shift has suggested that acne is not merely a localized follicular disorder but may be significantly driven by systemic inflammation. Evidence is growing that truncal acne is linked to systemic inflammation and lipid metabolism disorders; however, the specific link between systemic inflammatory markers, metabolic features, and the distribution of acne lesions (truncal versus facial) remains underexplored. Methods: An analytical cross-sectional descriptive study was conducted on 75 patients diagnosed with acne who received treatment at Ho Chi Minh City Dermatology Hospital in June 2025. Patients were divided into two groups: a facial acne group (n = 40) and a truncal acne group (n = 35). Anthropometry, lifestyle, and skin care habits were collected via a questionnaire. Blood test results were obtained through laboratory software. Results: A study of 75 patients (mean age 18.2 ± 3.5, with 81.3% being students) found that 100% of cases of truncal acne were accompanied by lesions on the face, with the back being the most common site on the trunk. The group of patients with truncal acne had a significantly higher BMI (22.6 ± 3.9), was more common in males (OR = 4.64, 95% CI: 1.74 – 12.37, p = 0.002), had an earlier age of onset (mean = 14; OR = 0.76, 95% CI: 0.61 – 0.93, p = 0.009), and had a longer duration of illness compared to the group with facial acne only. In terms of laboratory findings, truncal acne was associated with elevated NLR and PLR; each unit increase in NLR was associated with a 5.45 higher odds of truncal acne (95% CI: 1.80 – 18.7, p = 0.003), alongside increased total cholesterol levels and reduced HDL-C (OR = 0.13, 95% CI: 0.02 – 0.91, p = 0.04). Conclusions: Truncal acne accounts for 46.7% of acne patients, characterized by a broader distribution pattern (present in 100% of cases) and primarily affects the back. Clinically, the condition is most commonly seen in males with a high BMI, has an early onset (average age of 14), and a prolonged course. Biologically, the condition is characterized by systemic inflammation (elevated NLR) and dyslipidemia (elevated total cholesterol, reduced HDL cholesterol). DOI: 10.59715/pntjmp.5.2.15
Le Thanh Buu, Trinh Thi Ngoc Ai, Nguyen Thi Thanh Truc
Pain-reducing effects of auricular acupuncture in cold-damp-type knee osteoarthritis: A randomized controlled trial
Background: Effective, low-risk adjuncts for knee osteoarthritis (KOA) are needed. We evaluated whether adjunctive auricular acupuncture (AA) improves pain and function in patients with cold-damp-type KOA. Methods: In a single-center, randomized, single-blind, controlled trial, 124 adults (≥40 years) with radiographic primary KOA and baseline VAS ≥6 were randomized 1:1 to receive standard care (electroacupuncture, shortwave diathermy, and Duhuo Jisheng decoction tablets) with either weekly AA at Shenmen, Sympathetic, and Knee auricular points for 4 weeks (n=62) or sham auricular patches (n=62). Co-primary outcomes were change in VAS (0-10) and proportion achieving pain-free status (VAS ≤1) at week 4; secondary outcomes included WOMAC subscales and responder thresholds (≥30% and ≥50% WOMAC reduction). Results: Mean VAS reduction was greater in the AA group than control (-4.84 ±0.22 vs -3.43 ±0.16; between-group p=0.009). Mean total WOMAC change favored AA (-42.64 ±1.74 vs -26.39 ±1.28; p=0.009). Pain-free status at week 4 occurred in 15/62 (24.2%) AA versus 3/62 (4.8%) control (RR 4.8; 95% CI 1.4-16.2; p=0.002). Clinically meaningful functional response (≥50% WOMAC) was 37/62 (59.7%) versus 7/62 (11.3%) (RR 5.3; 95% CI 2.5-11.2; p<0.001). No intervention-related adverse events were reported. Conclusions: Weekly AA added to standard therapy produced greater short-term pain relief and functional gains with excellent safety. Confirmatory multicenter trials with longer follow-up are warranted. DOI: 10.59715/pntjmp.5.2.14
Doan Quang Nguyen, Pham Thi Minh, Nguyen Thi Thanh Thao, Lieu Khiet Tieu Hoa
Development of a procedure for the determination of magnesium and calcium in pharmaceutical preparations by atomic absorption spectrometry (AAS)
Objective: To establish and validate an F-AAS procedure for the simultaneous quantification of Mg and Ca in oral solutions. Subjects and Methods: An oral solution containing calcium glycerophosphate and magnesium gluconate was used. Sample treatment (mineralization) was optimized using Response Surface Methodology (RSM) with a Box-Behnken Design (BBD), surveying HNO3 concentration (1–3 M), digestion time (10–30 min), and temperature (50–70°C) for maximum recovery Method validation was performed in accordance with the ICH Q2 (R1) guidelines and Ministry of Health standards. Results: Optimal sample treatment conditions were 1.7 M HNO3, 11 minutes, and 54°C. F-AAS showed high specificity and was unaffected by excipients. The linearity range had r ≥ 0.998. Accuracy (recovery) was 99.64%–103.76% for Mg and 97.04%–106.22% for Ca. Precision (RSD) was ≤ 2%. F-AAS demonstrated higher precision and fewer errors than complexometric titration. Conclusion: This study successfully established a high-precision F-AAS protocol for the simultaneous quantification of Ca and Mg in complex oral solutions. The primary novelty lies in the application of a Box-Behnken Design (BBD) to rigorously optimize the wet digestion process, ensuring total analyte release from organic matrices with minimal acid consumption and time. By addressing the specific challenges of complex organic matrices and simultaneous determination, this method provides a superior and more efficient alternative to traditional pharmaceutical analysis, significantly enhancing quality control standards for such liquid formulations. DOI: 10.59715/pntjmp.5.2.13
Le Thi Thanh Thao, Nguyen Vu Quan, Ha Khang Dat, Truong Quoc Ky
ChatCVHT: An academic advising chatbot based on semantic retrieval, with topic routing and confidence threshold calibration
Academic advisors in higher education must respond to a high volume of student questions about regulations, training policies, and study planning, many of which share the same intent but differ in wording. While chatbots can scale academic support, a key risk is providing incorrect answers when queries are ambiguous or weakly supported by available evidence. We developed ChatCVHT, an academic advising chatbot that combines semantic retrieval with topic-based routing using a knowledge base of 748 question–answer pairs across eight topics. The system separates topic classification from document retrieval and introduces a confidence-based decision layer that jointly considers similarity scores, the score margin between top candidates, and predicted topic confidence to decide whether to answer or request clarification. In our experiments, multilingual-e5-small achieved stable retrieval performance (Recall@10 = 0.9782; MRR@10 = 0.8841), and multilingual-e5-small with a Logistic Regression classifier (L2 regularization, C = 3) reached Macro-F1 = 0.982 and Accuracy = 0.9853 for topic classification (5-fold cross-validation). When integrated end-to-end, the decision layer withheld responses for ~7% of queries to prioritize clarification under uncertainty, while maintaining Recall@10 = 0.916 and MRR@10 = 0.8418. Overall, ChatCVHT adopts a conservative strategy that balances coverage and reliability and supports safer deployment of academic advising chatbots where factual accuracy is critical. DOI: 10.59715/pntjmp.5.2.12
Nguyen Trong Hien, Phung Quang Vinh, Le Thien Khiem, Dang Bao Dang, Nguyen Minh Tuan
Machine learning prediction of severe knee osteoarthritis from routine data: performance, interpretability, and decision curve analysis
Background: Early identification of severe knee osteoarthritis (KOA) usually relies on X-ray imaging, but this is not always possible in healthcare facilities with limited resources. Estimating KOA severity from routine clinical and biochemical data may help clinicians decide when to request imaging and when to refer patients. Methods: A retrospective study was conducted on 189 patients with KOA whose severity was classified according to the Kellgren–Lawrence scale. Four machine learning models (i.e., logistic regression, Random Forest, XGBoost and SVM) were developed based on 15 routine variables. SHAP analysis was used to interpret the model and to select a reduced set of 10 variables. Performance was evaluated using five-fold stratified cross-validation and an independent test set of 20%. Decision curve analysis (DCA) was used to evaluate clinical benefit. Results: The models showed moderate discriminative ability in cross validation (AUPRC 0.44 to 0.52; ROC AUC 0.54 to 0.62). The SHAP optimised logistic regression model achieved the best performance on the test set (AUPRC 0.70; ROC AUC 0.81). Important variables included serum uric acid, BMI, age, and renal function. Decision curve analysis showed a positive net benefit across clinically relevant risk thresholds. Conclusion: A simple and interpretable logistic regression model based on routine data may help predict severe KOA and prioritise X-ray indication. Further validation studies with large multicenter samples are needed. DOI: 10.59715/pntjmp.5.2.11
Nguyen Trong Hien, Nguyen Minh Tuan, To Nam Kien
The prevalence of TikTok addiction and its association with Depression, Anxiety and Stress in public health and nutrition students in Pham Ngoc Thach Medical University in Vietnam: a cross-sectional study
Background: Social media platforms, particularly the short-video application TikTok, have become integrated to youngsters’ lives. While offering benefits, excessive use can lead to problematic behaviors characteristic of a behavioral addiction, which has been linked to adverse mental health outcomes. This issue is of particular concern among university students in high-pressure academic fields. However, there is a significant gap in the literature regarding the prevalence of TikTok addiction and its mental health relationship in public health and nutrition students in Pham Ngoc Thach medical university, Vietnam. Objectives: This study aimed to determine the prevalence of TikTok addiction and to investigate its association with symptoms of depression, anxiety, and stress among undergraduate students at the Faculty of Public Health, Pham Ngoc Thach University of Medicine. Methods: A cross-sectional study was conducted between March and May 2025, involving 269 undergraduate students from the Faculty of Public Health. Participants completed a self-administered online questionnaire that collected sociodemographic data and information on TikTok usage. TikTok addiction was assessed using the Bergen Social Media Addiction Scale (BSMAS), while mental health symptoms were measured with the Depression, Anxiety, and Stress Scale-21 (DASS-21). Data were analyzed using descriptive statistics, Chi-square tests, and Prevalence Ratios (PR) with 95% confidence intervals (CI) to quantify associations. Results: The prevalence of TikTok addiction among the surveyed students was 6.7% (n =18; 95% CI: 4.1%–10.2%). In the association analysis (n=251), TikTok addiction was significantly associated with a higher prevalence of both depression (PR = 1.48, 95% CI: 1.05–2.08, p = .035) and stress (PR = 2.44, 95% CI: 1.76–3.37, p < .001). No significant association was observed between TikTok addiction and anxiety (PR = 1.18, 95% CI: 0.90–1.54, p = .247). Conclusion: A notable minority of public health students exhibit symptoms of TikTok addiction, a condition statistically associated with a higher prevalence of depression and stress. These findings highlight the need for targeted mental health support and digital wellness interventions within this specific student population to mitigate the negative psychological impacts of problematic social media use. DOI: 10.59715/pntjmp.5.2.10
Le Thi Thanh Binh, Hoang Thi Diem Phuong
Experiences with body shaming in first-year students at Pham Ngoc Thach University of Medicine and associated factors
Background: Body shaming is gradually becoming a matter of concern as ridicule regardless of age or gender is gradually becoming more common in the community. This cross-sectional study was conducted to investigate the prevalence and related factors of mocking about appearance for freshmen at Pham Ngoc Thach University of Medicine in 2021. Method: 328 students from 9 majors at Pham Ngoc Thach University of Medicine were recruited in 2021 – 2022. Statistical analysis included Chi-square tests and logistic regression models to identify factors associated with body shaming and The body shaming variable was measured through self-report regarding whether or not the participant experienced body shaming over the past year. Results: The prevalence of body shaming was found to be 33.2%, among these, weight-related teasing was the most common type, accounting for 67%. Related factors include BMI and weight of women, type of family, low self-esteem and feeling about high school. Conclusion: The study determined the prevalence of body shaming and its associated factors. This is the first study to investigate the prevalence of body shaming among university students and its associated factors in this population, and thus, it may serve as a useful reference for future research. DOI: 10.59715/pntjmp.5.2.9
Nguyen Ngoc Nhu Phuong, Duong Thi Anh Dao, Do Thi Lan Anh
The value of diffusion-weighted and T2W-weighted magnetic resonance imaging in evaluate extracapsular extension in prostate cancer
Objective: The objective of our study was to evaluate the value of diffusion and T2-Weighted on magnetic resonance imaging for predicting extracapsular extension (ECE) in patients with prostate cancer. Materials and methods: We evaluated ECE with T2-weighted imaging based on the Prostate Imaging Reporting and Data System (PI-RADS). The results we confirm by surgical pathology. We compared MRI characteristics between patients with ECE Prostate carcinoma (PA), and those without ECE Prostate carcinoma (pica) using independent sample t-tests, Chi- square tests, as appropriate. Analyzing ROC curve to find the value of T2W score in ECE and those without ECE to have a high specificity for ECE of prostate cancer. Results: Age mean in ECE PCa was 67.03 ± 7.26. ECE PCa had 54.55%. Patients with ECE PCa have mean T2 scores was 3.64 ± 1.29, mean ADC values was 494.58 ± 95.06x10-6 mm2/s, mean ADC ratio was 39.45 ± 9,05%. On ROC curve, using the discrimination threshold of T2W score > 2, AUC was 0.938, sensitivity 83.3%, specificity was 96.7%, positive predictive value was 96.8%, negative predictive value was 82.9%, mean ADC value was 477.41 ± 86.48x10-6 mm2/s, mean ADC ratio was 38.37 ± 8.68%. Conclusion: MRI is benefit from evaluate extracapsular extension (ECE) in patients with prostate cancer. T2W score > 2, AUC is 0.938, sensitivity 83.3%, specificity is 96.7%, positive predictive value is 96.8%, negative predictive value is 82.9%, mean ADC value is 477.41 ± 86.48 x10-6 mm2/s, mean ADC ratio is 38.37 ± 8.68%. DOI: 10.59715/pntjmp.5.2.8
Prevalence of Comorbidities and Their Association with Disease Severity in Patients with Stable Chronic Obstructive Pulmonary Disease
Background: Comorbidities are highly prevalent and significantly impact disease progression, hospitalization rates, and mortality in chronic obstructive pulmonary disease (COPD) patients. Methods: This cross-sectional study included 209 COPD outpatients aged 40 years or older, treated at Nguyen Tri Phuong Hospital’s Respiratory Clinic from February to August 2023. COPD severity is assessed using: (1) symptoms (mMRC, CAT score); (2) exacerbation frequency; and (3) GOLD classification. Comorbidities were determined based on (1) medical records and (2) the answers to the question: “What diseases or health issues have you been diagnosed with by a physician?”. Results: Results revealed a mean of 2.12 comorbidities (SD: 1.33) per patient. The number of comorbidities increased linearly with the CAT score, and patients with ≥2 comorbidities were 2.26 times more likely to exhibit dyspnea (mMRC ≥2) compared to those with <2 comorbidities. Four factors: hypertension, diabetes mellitus, GERD, and history of pulmonary tuberculosis related to more symptoms presentation according to mMRC and/or CAT scores. Additionally, diabetes and GERD significantly associated with the “frequent exacerbators” condition (ORs: 2.55 and 3.13, respectively). Conclusions: Comorbidities may contribute to the adverse influence on COPD severity. Recognizing these relationships enables clinicians to adopt a comprehensive, patient-centered approach to COPD management. DOI: 10.59715/pntjmp.5.2.7
Duc Si Tran, Kieu Han Thi Le, Thi Van Tran, Khanh Tuong Thi Tran, Vinh Nhu Nguyen
Discordance rate between cervical cytology results and HPV DNA testing and related factors among women undergoing cervical biopsy at Hung Vuong Hospital
Background: Cervical cancer screening strategies recommend HPV DNA testing as the primary screening method instead of PAP cytology test. However, PAP testing remains widely used, and public awareness of HPV infection remains low. According to global studies, CIN 2+ detection in PAP-negative, HPV 16/18-positive women ranges from 15% - 30%. This study aims to improve healthcare professionals’ screening practices in line with national guidelines. Objectives: To assess precancerous and cancerous lesions in discordant PAP-HPV cases and identify factors associated with discrepancies between PAP and HPV test results. Methods: A retrospective cross-sectional study was conducted on 905 women who underwent cervical cancer screening with PAP testing and HPV DNA testing and had abnormal cervical biopsy results at Hung Vuong Hospital. Results: The discordance rate between PAP and HPV was 52.4%, including PAP (-) HPV (+) 46.7% and PAP (+) HPV (-) 5.6%. Three factors were identified as significantly associated with PAP-HPV discordance in women with precancerous cervical lesions: Cervical evaluation, Vaginal inflammation and Histopathological severity of cervical lesions. Conclusion: HPV DNA testing should be adopted as the primary screening method per national guidelines. DOI: 10.59715/pntjmp.5.2.6
Jean Watson’s Theory of Human Caring in nursing education: A narrative review and implications for Vietnamese context
Jean Watson’s Theory of Human Caring has been increasingly applied in nursing education to foster holistic caring competence and the development of professional identity among nursing students. This article aims to provide a thematic synthesis of existing evidence on the application of Watson’s Theory in nursing education and to analyze its implications for the Vietnamese context. A narrative review was conducted using a structured search strategy across major academic databases. Nine studies met the inclusion criteria and were synthesized thematically into three categories: (1) educational interventions with outcome measurement; (2) innovations in teaching-learning methods and learning experiences; and (3) curriculum-level integration of Watson’s Theory. Findings indicate that interventions and pedagogical models informed by Watson’s Theory were associated with improvements in caring behaviors, professional ethical attitudes, and psychological well-being among nursing students. However, the current body of evidence remains limited in scope and methodological diversity, and empirical studies conducted in Vietnam are scarce. The review suggests the potential feasibility of integrating Watson’s principles into nursing curricula and pedagogical strategies in Vietnam, while highlighting the need for rigorously designed empirical studies to evaluate contextual effectiveness. DOI: 10.59715/pntjmp.5.2.5
Nipah Virus: From Biological Characteristics to Risk of Emergence in Vietnam
Nipah virus (NiV) is a high-fatality emerging pathogen that has recently continued to be recorded through clusters of encephalitis and respiratory distress in South Asia. Reports indicate that while outbreaks’ scales are typically small, the virus possesses extreme virulence and the capacity for human-to-human transmission, particularly within hospital settings. Although case fatality rates reported across outbreaks range from 40% to 75%, transmission dynamics remain limited, and sustained community spread has not been observed to date. The virus is naturally harbored by fruit bats of the genus Pteropus, with spillover events linked to contaminated food products or intermediate hosts such as pigs; Vietnam lies within the distribution range of Pteropus bats, which, combined with high livestock density and rapid urbanization, creates a significant risk interface between animals and humans. International trade connectivity further increases the potential for introduction and spread of Nipah virus before being detected. This review aims to synthesize biological mechanisms, transmission dynamics, and Vietnam-specific ecological and livestock risk factors to inform preparedness strategies and public health policy. DOI: 10.59715/pntjmp.5.2.4
Nguyen Hoang Chuong, Pham Hien Anh Thu, Hoang Thi Phuong Dung, Pham Minh Tuan, Pham Thi Thanh Van, Tang Tuan Hai
Overview of the application of technology in acupuncture education
Objective: This study aims to provide an overview of advanced technologies (VR, AR, AI) and evaluate their effectiveness in improving spatial anatomical knowledge and safe acupuncture practice skills, addressing the limitations of traditional 2D training methods. Methods: A narrative review of representative studies published between 2012 and 2025 was conducted using the Web of Science and PubMed databases. Eligible publications included original research articles, pilot technological development studies, and review papers addressing VR, AR, or AI in acupuncture education. Selected studies were analyzed qualitatively to identify technological approaches, reported educational outcomes, and limitations. Results: Immersive VR systems integrating medical imaging data enable three-dimensional visualization of internal anatomical structures and simulated needle depth. Pilot evaluations reported improved spatial anatomical understanding and enhanced procedural accuracy. Mobile AR applications such as FaceAtlasAR support real-time facial acupoint localization with stable tracking performance. AI-based tools demonstrate educational potential; however, current evidence indicates limited clinical reliability. Most studies were preliminary and focused on feasibility and short-term outcomes. Conclusion: Technology shows the potential to improve students’ knowledge of spatial anatomy and safe practice skills. In particular, VR and AR may support anatomical visualization and safety awareness in training contexts, particularly in improving anatomical visualization and safety awareness. Gradual, context-appropriate implementation combined with strengthened foundational anatomy training may provide a sustainable integration pathway. DOI: 10.59715/pntjmp.5.2.3
Pharmacogenetics of BRAF in melanoma: mechanisms of drug resistance and therapeutic optimization – a systematic review
Background: Melanoma is the most lethal form of skin cancer with the highest mortality rate. Objective: To review research directions in pharmacogenetics related to the BRAF gene in melanoma. Methods: Data were extracted from three databases (PubMed, The Cochrane Library, and Science Direct) for studies published between January 2017 and December 2024, focusing on pharmacogenetics and the role of the BRAF gene in melanoma treatment. Results: Three main research directions were identified: (1) Elucidating mechanisms of drug resistance in BRAF-mutant patients, including NRAS/MEK mutations, PTEN loss, and drug transporter gene variants; (2) Utilizing genetic biomarkers (e.g., PD-L1) and combining targeted therapy with immunotherapy to enhance treatment efficacy; (3) Applying next-generation sequencing (NGS) for mutation detection and treatment regimen personalization. Conclusion: Clarifying drug resistance mechanisms, optimizing combination therapies, and integrating genetic technologies will contribute to improved treatment outcomes for BRAF-mutant melanoma. DOI: 10.59715/pntjmp.5.2.2
Nguyen Huynh Thao Vy, Huynh Ngoc Trinh, Nguyen Ngoc Bao Nguyen, Nguyen Hoang Thong, Le Nhat Linh
The role of endovascular therapy in the management of benign prostatic hyperplasia
Benign prostatic hyperplasia is a common condition in elderly men, often associated with lower urinary tract symptoms that negatively impact quality of life. The prevalence of benign prostatic hyperplasia is approximately 8% in men aged 30–40 years, but increases to up to 90% in those over 80 years old. Although current treatment options such as pharmacotherapy and endoscopic surgery have demonstrated high efficacy, surgical interventions still carry a risk of complications, particularly in elderly patients or those with multiple comorbidities. In recent years, prostatic artery embolization has emerged as a minimally invasive treatment modality, in which embolic agents are selectively injected into the prostatic arteries to reduce prostate volume and alleviate symptoms. Initial studies have shown that this endovascular technique offers significant symptom improvement, high treatment efficacy, fewer complications, shorter recovery time, and better quality of life. This review aims to present current medical evidence regarding the efficacy, safety, indications, and potential widespread application of endovascular intervention in the treatment of benign prostatic hyperplasia. DOI: 10.59715/pntjmp.5.2.1
Bước đầu đánh giá cắt lớp vi tính hai mức năng lượng trong dự báo chuyển dạng xuất huyết sau lấy huyết khối ở bệnh nhân nhồi máu não cấp
Mục tiêu: Đánh giá giá trị dự đoán nguy cơ chuyển dạng xuất huyết sau can thiệp lấy huyết khối cơ học của cắt lớp vi tính hai mức năng lượng (DECT). Đối tượng và phương pháp: Nghiên cứu hồi cứu trên 24 bệnh nhân nhồi máu não tuần hoàn trước được can thiệp lấy huyết khối cơ học thành công (TICI 2b hoặc 3) từ tháng 07/2024 đến tháng 07/2025 tại Bệnh viện Quân Y 175. Tất cả bệnh nhân được chụp DECT trong vòng 24 giờ sau can thiệp và không ghi nhận xuất huyết não tại thời điểm đó. Các thông số liên quan đến hiện tượng thoát mạch thuốc cản quang được đo lường và phân tích khả năng dự báo chuyển dạng xuất huyết xảy ra trong vòng 07 ngày sau can thiệp. Kết quả: Trong tổng số 24 bệnh nhân, có 5 trường hợp (20,8%) chuyển dạng xuất huyết. Các yếu tố hình ảnh liên quan đến vùng thoát mạch thuốc cản quang trong nhu mô não có giá trị dự báo chuyển dạng xuất huyết bao gồm: phân bố trong nhu mô não sâu, đường viền rõ, đậm độ cao nhất được chuẩn hoá (NDR) và nồng độ iốt cao nhất được chuẩn hoá (NICR) cao. Ngưỡng cắt NDR là 98,3% cho độ nhạy 100% và độ đặc hiệu 84,6% (AUC = 0,969). Ngưỡng cắt NICR là 221,5% cho độ nhạy 100% và độ đặc hiệu 94,7% (AUC = 0,989). Kết luận: Trong quần thể nghiên cứu của chúng tôi, chỉ số NDR và NICR thu được nhờ DECT là các chỉ số hình ảnh đáng tin cậy giúp dự đoán nguy cơ chuyển dạng xuất huyết sau can thiệp lấy huyết khối cơ học. Đây có thể là công cụ hữu ích hỗ trợ cá thể hóa điều trị và tiên lượng sau tái tưới máu. Abstract Purpose: To assess whether dual-energy computed tomography (DECT) can predict the risk of hemorrhagic transformation after mechanical thrombectomy. Methods: We retrospectively analyzed patients with anterior circulation stroke who achieved successful reperfusion (TICI 2b or 3) following mechanical thrombectomy. All underwent DECT within 24 hours post-procedure and showed no hemorrhagic transformation at that time. Quantitative iodine-extravasation-related metrics were extracted from DECT, and patients were followed up for HT occurrence within 07 days. Associations between the above parameters and hemorrhagic outcomes were evaluated. Results: Among 24 patients, 5 (20.8%) developed hemorrhagic transformation. Predictive imaging features of iodine contrast extravasation included deep brain parenchymal distribution pattern, well-defined margins, an elevated normalized density ratio (NDR) value and normalized iodine concentration ratio (NICR) value. A NDR threshold of 98.3% predicted hemorrhage with 100% sensitivity and 84.6% specificity (AUC = 0.969). A NICR threshold of 221.5% predicted ICH with 100% sensitivity and 94.7% specificity (AUC = 0.989). Conclusion: NDR and NICR derived from DECT is a highly accurate predictor of post-thrombectomy HT in ischemic stroke patients. It may serve as a valuable imaging biomarker to stratify hemorrhagic risk and optimize post-procedural care. DOI: 10.59715/pntjmp.5.1.13
Đặng Thanh Tú Anh, Trương Minh Thương, Nguyễn Đức Khang, Đàm Chí Cường
Nhân một trường hợp điều trị sa tạng chậu đa khoang (sa bàng quang – tử cung và sa trực tràng) bằng cách kết hợp phẫu thuật nội soi cố định âm đạo vào dây chằng chậu - lược (pectopexy) và phẫu thuật Altemeier
Đặt vấn đề: Sa tạng chậu đa khoang là một thử thách phẫu thuật đòi hỏi chiến lược điều trị phối hợp đa chuyên khoa. Chúng tôi báo cáo một ca sa tạng chậu đa khoang toàn phần bao gồm sa bàng quang, sa tử cung độ IV, và sa trực tràng toàn thành độ IV được điều trị bằng phương pháp phẫu thuật phối hợp nội soi ổ bụng và đường sinh môn. Trình bày ca bệnh: Bệnh nhân nữ 69 tuổi, sinh con 2 lần (PARA 2002) đến viện với khối sa âm đạo và trực tràng lớn kèm cảm giác tức nặng vùng chậu, táo bón và tiểu khó. Bệnh nhân được phẫu thuật đồng thời phẫu thuật nội soi cố định cổ tử cung và thành trước âm đạo vào dây chằng chậu – lược (phẫu thuật pectopexy) kết hợp với phẫu thuật cắt trực tràng – đại tràng sigma đường tầng sinh môn (phẫu thuật Altemeier). Thời gian nằm viện 5 ngày không có biến chứng liên quan đến phẫu thuật nặng như chảy máu, tổn thương ruột hoặc rò miệng nối trực tràng. Theo dõi sau mổ cho đến 6 tháng, chúng tôi ghi nhận bệnh nhân đã khôi phục vị trí giải phẫu các tạng sa cũng như hết tình trạng rối loạn tiểu và đại tiện. Kết luận: Ca bệnh này cho thấy phối hợp phẫu thuật nội soi pectopexy và phẫu thuật Altemeier là phương pháp điều trị an toàn và hiệu quả để điều trị sa tạng chậu đa khoang toàn phần. Kết quả thành công nhấn mạnh tầm quan trọng của hợp tác đa chuyên khoa và cá nhân hóa phương pháp điều trị. Abstract Background: Multicompartment pelvic organ prolapse presents a significant surgical challenge, requiring a multidisciplinary approach for optimal management. We report a case of complete multicompartment pelvic organ prolapse – including cystocele, stage IV uterine prolapse, and stage IV full-thickness rectal prolapse – treated with a combination of laparoscopic and perineal surgical techniques. Case Presentation: A 69-year-old female, para 2, presented with large vaginal and rectal prolapse accompanied by a sense of pelvic heaviness, constipation, and urinary difficulty. The patient underwent simultaneous laparoscopic pectopexy (fixation of the cervix and anterior vaginal wall to the iliopectineal ligament) and perineal proctosigmoidectomy (Altemeier procedure) for rectal prolapse. The hospital stay was 5 days, with no severe complications such as hemorrhage, bowel injury, or anastomotic leakage. Follow-up after surgery up to 6 months, we observed that the patient had restored the anatomical positions of the prolapsed organs and resolution of urinary and defecation symptoms. Conclusion: This case demonstrates that combined laparoscopic pectopexy and the Altemeier procedure is a safe and effective modality for the management of complete multicompartment pelvic organ prolapse. Our successful outcome highlights the importance of multidisciplinary cooperation and individualized surgical planning. DOI: 10.59715/pntjmp.5.1.29
Nguyễn Văn Ân, Lê Châu Hoàng Quốc Chương, Đoàn Vương Kiệt
Thoát vị Petersen báo cáo ca lâm sàng hiếm gặp và tổng quan y văn
Thoát vị nội là tình trạng hiếm gặp, chiếm tỉ lệ rất thấp từ dưới 1% đến 5,8% trong số những nguyên nhân gây tắc ruột non. Thoát vị Petersen là một dạng thoát vị nội hiếm gặp, chỉ chiếm tỷ lệ 7,5% các trường hợp thoát vị nội và thường xảy ra sau phẫu thuật nối dạ dày - hỗng tràng, cả ở trước và sau mạc treo đại tràng ngang. Thoát vị Petersen xảy ra khi một phần ruột hoặc mạc treo ruột thoát vị qua khoang được giới hạn bởi mạc treo đại tràng ngang, phúc mạc thành sau và quai ruột nối. Thoát vị Petersen hiếm gặp, triệu chứng lâm sàng không điển hình và có thể dẫn đến các biến chứng nghiêm trọng, như tắc ruột, thiếu máu cục bộ, hoại tử ruột và tử vong. Vì vậy, việc phát hiện sớm là hết sức cần thiết và chụp Xquang cắt lớp vi tính (CLVT) có vai trò quan trọng, được xem là phương tiện hình ảnh học đầu tay trong chẩn đoán. Chúng tôi báo cáo một trường hợp thoát vị Petersen xảy ra ở bệnh nhân nữ 45 tuổi sau phẫu thuật Roux-en-Y cắt bán phần dạ dày để điều trị ung thư dạ dày, bệnh nhân có lâm sàng nghi ngờ tắc ruột, được chẩn đoán tắc ruột quai kín nghi do thoát vị Petersen bằng CLVT và điều trị thành công tại Bệnh viện Nhân dân Gia Định, từ đó tổng hợp các dấu hiệu hình ảnh CLVT, gợi ý chẩn đoán. Abstract Internal hernia is a rare condition, accounting for a very low incidence ranging from less than 1% to 5.8% among the causes of small bowel obstruction. Petersen's hernia is a rare type of internal hernia, representing only 7.5% of internal hernia cases and commonly occurring after gastrojejunostomy, both in antecolic and retrocolic positions. Petersen's hernia occurs when part of the intestine or mesentery herniates through the space bounded by the transverse mesocolon, the retroperitoneum and the mesentery of the gastrojejunostomy's limb. Petersen's hernia is rare, its clinical symptoms are atypical, and it can lead to serious complications such as bowel obstruction, ischemia, intestinal necrosis, and death. Therefore, early detection is crucial, and computed tomography (CT) plays an important role, considered the first-line imaging modality in diagnosis. We report a case of Petersen’s hernia in a 45-year-old female patient following Roux-en-Y subtotal gastrectomy for gastric cancer. The patient presented with clinical suspicion of bowel obstruction and was diagnosed with closed-loop obstruction, likely due to Petersen’s hernia, on CT scan. She was successfully treated at Gia Dinh People’s Hospital. Based on this case, we summarize the CT imaging findings suggestive of this diagnosis. DOI: 10.59715/pntjmp.5.1.28
Huỳnh Bảo Ngọc, Lê Anh Tú, Huỳnh Thị Thương Thương
Báo cáo ca lâm sàng: suy hô hấp cấp do thuyên tắc phổi cấp tính điều trị bằng tiêu sợi huyết thành công
Thuyên tắc phổi cấp tính là một trong những nguyên nhân gây tử vong đột ngột ở bệnh nhân tim mạch. Tiêu sợi huyết là phương pháp được lựa chọn hàng đầu với bệnh nhân suy hô hấp cấp do thuyên tắc phổi cấp tính có rối loạn huyết động. Chúng tôi trình bày báo cáo một ca lâm sàng, mô tả quá trình chẩn đoán, điều trị bệnh nhân thuyên tắc phổi cấp tính bằng thuốc tiêu sợi huyết. Diễn tiến lâm sàng cho thấy sự cải thiện huyết động dần dần sau khi được dùng thuốc tiêu sợi huyết. Sau đó, bệnh nhân được chuyển sang điều trị bằng thuốc kháng đông và tiếp tục theo dõi tại khoa Nội tim mạch sau 4 ngày điều trị tại khoa Hồi sức Tích cực Chống độc và xuất viện sau 7 ngày. Đánh giá và khởi động thuốc tiêu sợi huyết sớm cho thấy tiềm năng trong việc phục hồi huyết động nhanh chóng ở bệnh nhân suy hô hấp cấp do thuyên tắc phổi cấp tính. Abstract Pulmonary embolism is one of the leading causes of sudden death in cardiovascular patients. Thrombolysis is the preferred treatment for patients with acute respiratory failure due to pulmonary embolism and hemodynamic instability. We present a case report detailing the diagnosis process, treatment, and clinical course of a patient with acute pulmonary embolism who received fibrinolytics. The patient demonstrated gradual hemodynamic improvement after receiving fibrinolytic therapy. Subsequently, the patient was transitioned to anticoagulant therapy and continued follow-up in the Cardiology Department after 4 days in Intensive Care Unit and discharged after 7 days. Early evaluation and initiation of thrombolytic therapy may facilitate rapid hemodynamic recovery in patients with acute respiratory failure due to acute pulmonary embolism. DOI: 10.59715/pntjmp.5.1.27
Nguyễn Thị Hoàng Anh, Nguyễn Hồng Trường, Nguyễn Bích Trăm, Bành Như Thanh Trúc, Lý Thị Huỳnh Nhung
Đánh giá kết quả điều trị hẹp, tắc động mạch đùi nông bằng phương pháp can thiệp nội mạch
Đặt vấn đề: Bệnh động mạch chi dưới mạn tính do xơ vữa rất thường gặp, làm tăng rõ rệt nguy cơ nhồi máu cơ tim, đột quỵ, tử vong và cắt cụt chi, trong đó tổn thương hẹp, tắc động mạch đùi nông là vị trí hay gặp. Bệnh viện 30-4 đã triển khai can thiệp nội mạch điều trị các tổn thương này từ năm 2019 nhưng chưa có nghiên cứu đánh giá kết quả một cách hệ thống. Mục tiêu nghiên cứu: Đánh giá kết quả chu phẫu, trung hạn của điều trị hẹp, tắc động mạch đùi nông bằng phương pháp can thiệp nội mạch tại Bệnh viện 30-4. Đối tượng – Phương pháp: Nghiên cứu hồi cứu mô tả hàng loạt ca, theo dõi dọc trên 51 bệnh nhân ≥18 tuổi, được chẩn đoán hẹp hoặc tắc mạn tính động mạch đùi nông do xơ vữa có triệu chứng (đau cách hồi không đáp ứng nội khoa, thiếu máu đe dọa chi) và được can thiệp nội mạch tại Bệnh viện 30-4 từ 01/2020 đến 12/2024. Loại trừ các trường hợp tổn thương không do xơ vữa, tắc cấp tính hoặc phẫu thuật bắc cầu/hybrid. Bệnh nhân được nong bóng, có hoặc không đặt giá đỡ; đánh giá thành công kỹ thuật, thành công lâm sàng (ABI, phân độ Rutherford), siêu âm Doppler mạch chi tại thời điểm ra viện, 3, 6 và 12 tháng. Số liệu được xử lý bằng SPSS 16.0, p<0,05 được xem là có ý nghĩa thống kê. Kết quả: 51 bệnh nhân (tuổi trung bình 71,3; 74,5% nam, đa số thiếu máu chi trầm trọng, TASC II C–D chiếm chủ yếu) được can thiệp với tỉ lệ thành công kỹ thuật 100%, biến chứng chu phẫu 11,7%, không tử vong. ABI tăng từ khoảng 0,6 lên 0,9 sau can thiệp, duy trì 0,9 ở 3–6 tháng và còn 0,8 sau 12 tháng; tỉ lệ còn dòng chảy tốt và cải thiện lâm sàng đạt cao trong 6 tháng đầu nhưng giảm còn khoảng 55% sau 12 tháng. Kết quả 12 tháng tốt hơn rõ ở tổn thương TASC II A–B và nhóm nong bóng kèm đặt giá đỡ so với chỉ nong bóng. Kết luận: Can thiệp nội mạch điều trị hẹp, tắc động mạch đùi nông tại Bệnh viện 30-4 đạt tỉ lệ thành công kỹ thuật rất cao, an toàn và cải thiện rõ rệt tưới máu chi, triệu chứng lâm sàng trong ngắn và trung hạn. Độ bền trung hạn phụ thuộc mức độ phức tạp tổn thương (TASC II) và chiến lược can thiệp, trong đó nong bóng kèm đặt giá đỡ cho kết quả duy trì tốt hơn. Abstract Background: Chronic lower extremity arterial disease due to atherosclerosis is common and markedly increases the risk of myocardial infarction, stroke, death, and limb amputation; among these lesions, stenosis and occlusion of the superficial femoral artery are particularly frequent. At 30-4 Hospital, endovascular intervention for these lesions has been implemented since 2019, but there has been no systematic evaluation of its outcomes. The objective of this study was to evaluate perioperative and mid-term outcomes of endovascular treatment for superficial femoral artery stenosis and occlusion at 30-4 Hospital. Objectives: To assess perioperative and mid-term outcomes of endovascular intervention in the treatment of superficial femoral artery stenosis and occlusion at 30-4 Hospital. Subjects and Methods: This was a retrospective descriptive case-series study with longitudinal follow-up of 51 patients aged ≥18 years who were diagnosed with chronic, symptomatic superficial femoral artery stenosis or occlusion due to atherosclerosis (intermittent claudication refractory to medical therapy, limb-threatening ischemia) and underwent endovascular intervention at 30-4 Hospital from January 2020 to December 2024. Patients with non-atherosclerotic lesions, acute occlusion, or prior bypass/hybrid surgery were excluded. All patients underwent balloon angioplasty with or without stent placement. Technical success, clinical success (ankle-brachial index [ABI], Rutherford classification), and duplex ultrasound of lower limb arteries were assessed at discharge and at 3, 6, and 12 months. Data were analyzed using SPSS 16.0; p<0.05 was considered statistically significant. Results: Fifty-one patients (mean age 71.3 years; 74.5% male, the majority with severe limb ischemia, predominantly TASC II C–D lesions) underwent endovascular intervention with a technical success rate of 100%, perioperative complication rate of 11.7%, and no deaths. ABI increased from approximately 0.6 to 0.9 after intervention, remained 0.9 at 3–6 months, and was 0.8 at 12 months; patency and clinical improvement were high during the first 6 months but decreased to about 55% at 12 months. Twelve-month outcomes were clearly better in TASC II A–B lesions and in the group treated with balloon angioplasty plus stent placement compared with balloon angioplasty alone. Conclusion: Endovascular intervention for superficial femoral artery stenosis and occlusion at 30-4 Hospital achieved a very high technical success rate, was safe, and provided marked improvement in limb perfusion and clinical symptoms in the short and mid-term. Mid-term durability depended on lesion complexity (TASC II) and treatment strategy, with balloon angioplasty plus stent placement yielding more sustained results than balloon angioplasty alone. DOI: 10.59715/pntjmp.5.1.26
Phan Quốc Hùng, Đoàn Văn Phụng, Phạm Mạnh Toàn
Nghiên cứu giá trị của cắt lớp vi tính trong đánh giá khả năng cắt bỏ ung thư biểu mô tuyến tụy
Mục tiêu: Nghiên cứu xác định giá trị của cắt lớp vi tính trong đánh giá khả năng cắt bỏ ung thư biểu mô tuyến tụy có đối chiếu tình trạng bờ diện cắt mô học. Đối tượng – Phương pháp nghiên cứu: Nghiên cứu hồi cứu trên 52 bệnh nhân ung thư biểu mô tuyến tụy được điều trị phẫu thuật và có kết quả tình trạng bờ diện cắt mô học, được chụp cắt lớp vi tính trước phẫu thuật tại Bệnh viện Ung Bướu Thành phố Hồ Chí Minh từ 01/2019 - 09/2025. Bệnh nhân được phân loại khả năng cắt bỏ theo tiêu chuẩn NCCN năm 2024 và đối chiếu với tình trạng bờ diện cắt mô học. Kết quả: Tỷ lệ đạt diện cắt R0 lần lượt là 72,7% (8/11) ở nhóm “Có thể cắt bỏ”, 40% (2/5) ở nhóm “Ranh giới cắt bỏ” và 2,8% (1/36) ở nhóm “Không thể cắt bỏ” (p < 0,001). Tình trạng tiếp xúc động mạch mạc treo tràng trên (p < 0,05), tĩnh mạch mạc treo tràng trên (p < 0,01) và tĩnh mạch cửa (p < 0,001) có liên quan đến khả năng cắt bỏ hoàn toàn khối u với diện cắt âm tính. Cắt lớp vi tính có độ nhạy 91%, độ đặc hiệu 85,4%, giá trị tiên đoán dương 62,5%, giá trị tiên đoán âm 97,2% và độ chính xác 86,5% trong đánh giá khả năng đạt diện cắt âm tính sau phẫu thuật cắt bỏ ung thư tụy. Kết luận: Cắt lớp vi tính áp dụng tiêu chuẩn NCCN 2024 có giá trị trong đánh giá khả năng cắt bỏ hoàn toàn khối ung thư tụy với diện cắt âm tính. Tình trạng tiếp xúc bó mạch mạc treo tràng trên và tĩnh mạch cửa có liên quan tới khả năng loại bỏ hoàn toàn khối u. Abstract Objective: This study aimed to evaluate the value of computed tomography (CT) in assessing the resectability of pancreatic adenocarcinoma, correlated with histopathologic margin status. Materials and Methods: We retrospectively reviewed 52 patients with histologically confirmed pancreatic adenocarcinoma who underwent surgery and preoperative CT at Ho Chi Minh City Oncology Hospital between January 2019 and September 2025. Resectability was classified according to the NCCN 2024 criteria into resectable, borderline resectable, and unresectable groups. CT findings were correlated with histopathologic margin status. Results: The R0 resection rates were 72.7% (8/11) for resectable, 40% (2/5) for borderline resectable, and 2.8% (1/36) for unresectable tumors (p < 0.001). Tumor abutment to the superior mesenteric artery (p < .05), superior mesenteric vein (p < 0.01), and portal vein (p < 0.001) was significantly associated with positive margins. CT demonstrated 91% sensitivity, 85.4% specificity, 62.5% positive predictive value, 97.2% negative predictive value, and 86.5% overall accuracy in predicting negative surgical margins. Conclusion: Preoperative CT assessment using NCCN 2024 criteria provides high diagnostic performance in evaluating pancreatic cancer resectability. Vascular involvement, especially of the superior mesenteric artery, superior mesenteric vein and portal vein remains a key determinant of achieving R0 resection. DOI: 10.59715/pntjmp.5.1.25