Journal of Health & Aging is the official journal of Thong Nhat Hospital, aimed at introducing and updating knowledge about the care and protection of elderly people's health. It is published 12 issues per year. The journal publishes research papers and review articles in the fields of basic medicine, clinical medicine, preventive medicine, public health and medical sociology, with the goal of improving knowledge and practice in medical specialties. Journal information Publishing license: 17/GP-BVHTTDL p-ISSN: 3093-3102; e-ISSN: 3093-3110 Publication frequency: issues/year DOI prefix: 10.63947 Plagiarism detection tool applied: Ithenticate. Articles with a plagiarism rate greater than 25% will not be considered for evaluation. Journal homepage: https://tcsuckhoelaohoa.vn Hospital homepage: https://bvtn.org.vn Peer review process Manuscripts within the scope of publication that meet the requirements of the manuscript preparation guidelines will be sent to the editorial board members in charge. The manuscripts will then undergo a double-blind peer review process by at least 2 independent experts in the corresponding field. The editorial board member in charge will make a decision before being approved by the Editor-in-Chief. Confidentiality commitment Journal of Health & Aging is committed to implementing and complying with legal regulations and related guidelines on the confidentiality of personal information. The information users enter into the forms on the Journal's Online Publishing Management System is only used for purposes within the journal's scope of publication and will not be provided to any other third parties, or used for any other purposes. Research ethics: Research directly reflects the quality of the authors' work and the supporting institutions. To be published, articles are peer-reviewed and evaluated according to the rigorous and scientific process set out by Journal of Health & Aging - Thong Nhat Hospital. Therefore, it is important to standardize and ensure ethical standards for all parties involved in publishing activities: authors, journal editors, reviewers, publishers and the community of journals owned or funded by society.
THE CONTROL OF SOME HORMONES RELATING TO CUTANEOUS AGING: MECHANISMS, MANIFESTATIONS, AND MANAGEMENT
To summarize current evidence on the interaction between endocrine factors and skin aging, with a focus on the role of hormones and endocrine pathways. This review was conducted through a literature search in PubMed using the keywords “hormone,” “skin aging,” and “cutaneous aging.” Studies addressing the role of hormones in age-related changes of skin physiology were reviewed and synthesized. Skin aging is closely associated with hormonal changes. In women, the sharp decline in estrogen during menopause is a central factor driving aging, leading to reduced collagen and elastin synthesis, dermal thinning, loss of hydration, and increased sensitivity to environmental stressors. In men, the gradual decrease in testosterone also contributes to skin aging, though typically less prominently. Overall, the evidence highlights hormones as key regulators of skin health and resilience. The changes of some hormones play an important role in the process of skin aging. These findings underscore the potential of future skin rejuvenation strategies targeting endocrine pathways.
Copyright (c) 2026 The Author(s). Published by Journal of Health and Aging.
AESTHETIC SKIN CARE IN GERIATRICS: OPPORTUNITIES AND CHALLENGES IN ENHANCING QUALITY OF LIFE IN OLDER ADULTS
The rapidly aging population creates new demands for comprehensive healthcare, including aesthetic dermatology. Physical appearance directly influences psychological well-being, self-confidence, and quality of life in older adults. This review aims to analyze the role of aesthetic skin care in geriatrics, identify the boundaries between appropriate needs and excessive interventions, and highlight the risks of complications as well as physicians’ responsibilities in ensuring safety. We systematically synthesized and analyzed medical literature published between 2015 and 2025 related to skin aesthetics, geriatrics, and elderly healthcare. PubMed, Scopus, and Google Scholar were searched using the following keywords: “geriatrics dermatology”, “skin aesthetics”, “aesthetic skin care”, “elderly dermatology”, “cosmetic dermatology,” “aesthetic interventions complications elderly”, “quality of life”, “skin care elderly”, “complications”, “physician counseling”. Evidence indicates that aesthetic skin care significantly improves psychological health, quality of life, and social connectedness in older adults. However, complication risks are heightened due to multimorbidity, long-term medication use, and age-related physiological changes of the skin. Ethical considerations and the distinction between appropriate and excessive interventions must be carefully addressed in clinical practice. Aesthetic skin care in geriatrics represents an inevitable trend but requires cautious implementation. Physicians play a pivotal role in counseling, preventing complications, and selecting appropriate interventions to optimize both medical benefits and humanistic values in the comprehensive care of older adults.
PERIPHERAL NERVE BLOCK ANESTHESIA FOR LIMB AMPUTATION IN PATIENTS WITH HEARTH FAILURE AND REDUCED EJECTION FRACTION
Heart failure with reduced ejection fraction (HFrEF) presents significant anesthetic risks during limb amputation, especially in patients with multiple comorbidities. This report describes two cases of male patients with HFrEF (EF 27% and 45%) undergoing emergency limb amputation under ultrasound-guided peripheral nerve block (PNB). The first patient, with stage V chronic kidney disease, received a supraclavicular brachial plexus block using 20 mL of 0.35% ropivacaine. Sensory onset occurred at 5 minutes, motor onset at 25 minutes, and analgesia lasted 13 hours. The second patient received adductor canal and popliteal sciatic nerve blocks using 35 mL ropivacaine and IV dexamethasone. Sensory onset was 20 minutes, motor onset 25 minutes, and analgesia lasted 21 hours. Both patients remained awake and hemodynamically stable throughout surgery, with no complications. These cases highlight the safety and efficacy of PNB in high-risk cardiovascular patients. Adjusted dosing strategies, especially in renal impairment, allowed prolonged analgesia without toxicity. Compared to general or spinal anesthesia, PNB avoids airway manipulation and minimizes hemodynamic fluctuations.
FACTORS ASSOCIATED WITH PALLIATIVE CARENEEDS AMONG CANCER INPATIENTS AT TAY NGUYENREGIONAL GENERAL HOSPITAL
Cancer is an increasing health burden, particularly among older adults [14]. Palliative care (PC) plays a crucial role in improving patients’ quality of life. This study aimed to identify palliative care needs and associated factors among cancer patients at the Central Highlands Regional General Hospital in 2024. Subjects and Methods: A cross-sectional descriptive study was conducted among 434 cancer patients aged ≥18 years hospitalized from January to September 2024. Data were collected through face-to-face interviews using a structured questionnaire. Statistical analysis was performed using SPSS 20.0 with multivariate logistic regression. Results: 88.2% of patients had palliative care needs. The highest needs included communication & social relationships (83.9%), physical support (81.8%), and psychological support (73.5%). Factors associated with higher needs included female gender (OR=3.21; p=0.001), rural residence (OR=2.61; p=0.004), unemployment/retirement (OR=3.07; p=0.001), metastatic cancer (OR=2.87; p=0.004), and presence of complications (OR=2.45; p=0.012). Conclusion: Most cancer patients, particularly older adults, have diverse palliative care needs. Integrating geriatric considerations into palliative care is essential to address physical, psychological, and social needs comprehensively, thereby improving quality of life and reducing healthcare burden.
ANESTHESIA AND PERIOPERATIVE MANAGEMENT FOLLOWING ERAS PROTOCOL IN KIDNEY TRANSPLANTATION FROM BRAIN-DEAD DONORS AT THONG NHAT HOSPITAL: A CASE SERIES OF SIX PATIENTS
Kidney transplantation is one of the most effective treatment options for patients with end-stage renal disease. However, a considerable number of patients die while waiting for transplantation. We conducted a descriptive case series of six kidney transplantations from brain-dead donors in Thong Nhat hospital. All six procedures were completed successfully following a standardized Enhanced Recovery After Surgery (ERAS) anaesthetic protocol. No patients experienced postoperative nausea or delayed graft function, and early urine output exceeded 2 mL.kg⁻¹.h⁻¹ in all recipients. The prevalence of end-stage renal disease is steadily increasing, while the disparity between available organ supply and transplantation demand continues to widen. Organs from brain-dead donors represent an effective strategy to address this shortage. Kidney transplantation is a highly complex surgical procedure that necessitates meticulous anesthetic planning to ensure patient safety and optimize graft function. ERAS‑based protocols offer safe and effective perioperative management, resulting in reduced complications, shorter hospital stays and improved patient satisfaction.
HEPARIN IMMOBILIZATION OF THE VASCULAR GRAFTS BY LAYER-BY-LAYER (LBL) ASSEMBLY TECHNIQUE TO IMPROVE THROMBOGENICITY
Decellularized vascular grafts hold potential for small-diameter vascular reconstruction owing to the ECM integrity maintained and appropriate dimensions. However, the thrombogenicity of tissue-derived grafts represents a notable limitation for clinical application. This study focuses on assessing the effectiveness of heparin immobilization on cross-linked decellularized vascular grafts prepared from porcine carotid arteries. The Layer-by-Layer (LbL) assembly technique was applied to immobilize heparin on the graft surface to improve hemocompatibility. Following LbL treatment, the grafts were examined for heparin content and surface morphology using scanning electron microscopy (SEM). To assess their potential for vascular implantation, the biomechanical properties and hemocompatibility were further evaluated. SEM observations and heparin quantification confirmed successful heparin immobilization. Biomechanical testing was measured and found to be suitable for graft applications. In terms of hemocompatibility, in vitro anticoagulant activity assessment revealed a thromboresistant surface on the luminal surface of the grafts. In addition, hemolysis rates remained within the non-hemolytic threshold as defined by ISO 10993-4. In summary, the Layer-by-Layer heparin immobilization method effectively immobilized heparin onto reinforced decellularized vascular grafts, enhanced hemocompatibility, and represents a promising approach for the development of xenogeneic vascular graft materials.
POSTOPERATIVE ANXIETY IN PATIENTS UNDERGOING RETROGRADE URETEROSCOPIC LASER LITHOTRIPSY: A CROSS-SECTIONAL STUDY AT THONG NHAT HOSPITAL
Ureteral calculi account for approximately 20–40% of urinary tract stone diseases, second only to renal calculi. Retrograde ureteroscopic laser lithotripsy is a widely used minimally invasive procedure, offering rapid recovery and low complication rates. However, postoperative anxiety remains a clinical concern. A descriptive cross-sectional study was conducted on 165 patients undergoing retrograde ureteroscopic laser lithotripsy at Thong Nhat Hospital between March and September 2023. The prevalence and severity of postoperative anxiety were assessed using standardized measures. Postoperative anxiety was identified in 95.15% of patients, predominantly at a mild level. Mild and moderate anxiety were observed in 83.64% and 11.51% of cases, respectively, with a mean score of 4.53 ± 2.58. The most common concerns included fear of complications (84.8%), postoperative pain (66.1%), and indwelling JJ stent placement (43.6%). Postoperative anxiety was highly prevalent among patients undergoing retrograde ureteroscopic laser lithotripsy, although generally mild in severity. These findings underscore the importance of comprehensive perioperative counseling and psychological support to reduce patient anxiety and enhance recovery outcomes.
NUTRITIONAL ASSESMENT IN ONCOLOGY OUTPATIENTS: A REVIEW OF SCREENING AND ASSESSMENT TOOLS
Malnutrition and the associated phenotype of sarcopenia significantly compromise treatment tolerance, increase toxicity risk, and worsen overall survival in cancer patients. Given that the majority of oncological care occurs in the ambulatory setting, systematic nutritional assessment is a critical, mandated component of supportive care. This review synthesizes current evidence to evaluate the optimal screening and assessment tools suitable for routine use in outpatient oncology practice. A comprehensive narrative review was conducted, focusing on recent clinical guidelines and peer-reviewed literature concerning the validation and clinical utility of nutritional assessment instruments. Tools were analyzed across two tiers: Tier 1 (Screening) for feasibility and sensitivity; and Tier 2 (Comprehensive Assessment) for diagnostic accuracy regarding muscle loss and inflammation. The Malnutrition Screening Tool (MST) and Mini Nutritional Assessment Short Form (MNA-SF) emerged as the most practical and sensitive Tier 1 tools for general and geriatric oncology, respectively. For Tier 2, the Patient-Generated Subjective Global Assessment (PG-SGA) remains the gold standard. Crucially, the integration of objective measures—specifically Handgrip Strength and AI-assisted analysis of CT-derived Skeletal Muscle Index (SMI)—is essential for accurately diagnosing sarcopenia. Furthermore, the C-Reactive Protein/Albumin Ratio (CAR) is a powerful biomarker confirming the inflammatory drive of cachexia. Effective nutritional assessment mandates a structured, tiered approach. The reliance on advanced tools for objective body composition analysis is paramount for personalized care. Future efforts must focus on digitalizing this pathway, utilizing AI for automated sarcopenia detection, and ensuring robust resource allocation to oncology dietitians.
DETECTION OF PULMONARY TUBERCULOSIS IN SUSPECTED CASES USING THE GENEXPERT ASSAY AT INTERNAL MEDICINE DEPARTMENT
The early diagnosis of pulmonary tuberculosis remains a critical priority in clinical practice. Although the GeneXpert MTB/RIF assay has been recommended for tuberculosis diagnosis, its implementation has not been widely adopted in many regions of Vietnam. This study aimed to evaluate the diagnostic value of the GeneXpert MTB/RIF assay on sputum samples for detecting pulmonary tuberculosis and to compare its results with those from direct sputum smear microscopy (AFB). A cross-sectional descriptive study was conducted on 270 patients with suspected pulmonary tuberculosis who were examined and treated at the Internal Medicine Department, Thong Nhat Hospital, between January 2024 and July 2025. Among the participants, 72.2% were male and 27.8% were female. The mean age was 79.5 ± 15.1 years, and the mean body mass index (BMI) was 21.1 ± 3.4 kg/m². The detection rate of tuberculosis was 14.1% using the GeneXpert MTB/RIF assay, compared to 4.8% by AFB smear microscopy.Compared to AFB smear microscopy, the GeneXpert MTB/RIF assay demonstrated a sensitivity of 84.6%, a specificity of 89.5%, a positive predictive value (PPV) of 28.9%, and a negative predictive value (NPV) of 99.1%. The rate of rifampicin resistance among detected cases was 7.9%. Patients with suspected pulmonary tuberculosis presented with diverse clinical manifestations and comorbidities. The GeneXpert MTB/RIF assay on sputum samples showed high sensitivity and specificity for diagnosing pulmonary tuberculosis, with a rifampicin resistance rate of 7.9%.
ADVANCES IN FLEXIBLE BRONCHOSCOPY FOR EARLY DIAGNOSIS OF LUNG CANCER
Lung cancer remains the leading cause of cancer-related death. In central airway lesions, flexible bronchoscopy (FB) is the diagnostic backbone, as it allows direct visualization, lesion localization, and sampling, while integrating new technologies such as autofluorescence bronchoscopy (AFB), narrow-band imaging (NBI), endobronchial ultrasound (EBUS), optical coherence tomography (OCT), electromagnetic/CBCT-guided navigation bronchoscopy (ENB, CBCT), robotic bronchoscopy, and “real-time pathology” techniques such as confocal laser endomicroscopy (CLE). Over the past 5–7 years, evidence shows these technologies significantly enhance sensitivity/early detection, increase diagnostic yield for small peripheral nodules, reduce complications compared with transthoracic biopsy, and open the era of artificial intelligence (AI) for lesion recognition and procedural training. This article summarizes key advances, clinical impact, limitations, and implementation prospects in Vietnam.
ASSESSMENT OF HEART FAILURE KNOWLEDGE IN OUTPATIENTS WITH CHRONIC HEART FAILURE AT THONG NHAT HOSPITAL
Chronic heart failure is one of the leading causes of hospitalizations, impaired quality of life, and increased socioeconomic burden. Adequate disease awareness and effective self-care are key factors in improving prognosis and reducing hospital readmissions. A crosssectional descriptive study was conducted from January 1 to May 31, 2025, involving 200 patients. The tools used included the Dutch Heart Failure Knowledge Scale (DHFKS), a qualityof-life questionnaire, and a self-care assessment. Results: 66% of patients were aged ≥60 years, 94.5% had health insurance, and 78.5% resided in urban areas. Heart failure with reduced ejection fraction (HFrEF) accounted for 73.5%, significantly higher among patients aged ≥60 years (78.8%, p = 0.026). Hypertension (91%) and dyslipidemia (77%) were the most common comorbidities. A total of 78% of patients demonstrated good knowledge of heart failure. Regarding self-care behaviors, most adhered to a low-salt diet and regular weight monitoring, though physical activity remained suboptimal. Dyspnea and lower limb edema significantly impacted quality of life. When symptoms occurred, patients commonly contacted healthcare providers. Conclusions: The majority of outpatients with chronic heart failure demonstrated good disease awareness; however, improvements in self-care practices and multidimensional support are needed to enhance quality of life and reduce disease burden.
EVALUATION OF THE EFFECTIVENESS OF MOTOR FUNCTION REHABILITATION AFTER STROKE USING PHYSIOTHERAPY COMBINED WITH ELECTROACUPUNCTURE AT THONG NHAT HOSPITAL, 2025
Stroke is the leading cause of severe disability among adults worldwide. In Vietnam, the burden is rising rapidly. The increasing incidence drives higher healthcare costs, reduced work capacity, and greater social pressures. Accordingly, post-stroke motor rehabilitation is a priority to reduce mortality and complications and limit disability. At Thống Nhất Hospital, physiotherapy combined with electroacupuncture has been used for years under the guidance of the Ministry of Health, with observed functional benefits. Still, its effectiveness has not been formally evaluated. This study aimed to generate evidence to guide regimen selection and optimise patient outcomes. Materials and Methods: A clinical interventional study without a control group was conducted, employing a pre- and post-treatment comparison. Eighty-six patients newly diagnosed with stroke within the preceding three months, receiving inpatient or outpatient care at the Departments of Rehabilitation, Emergency Interventional Cardiology, Neurology, and Traditional Medicine at Thống Nhất Hospital from January to October 2025, were included. Motor function recovery was assessed through manual muscle testing and the Barthel Index after 30 days of treatment. Results: The proportion with muscle strength grades 0–2 fell from 53.49% to 17.44%, whereas grades 4–5 rose from 29.07% to 59.30%. The mean Barthel Index increased from 44.24 ± 18.16 to 69.07 ± 17.90. Post-intervention classifications were completely independent, 12.79%; partially dependent, 76.74%; entirely dependent, 10.47%. Conclusion: Physiotherapy plus electroacupuncture appears safe and effective for post-stroke rehabilitation, improving muscle strength and independence in activities of daily living. Benefits extend beyond statistical significance to practical gains in quality of life and community reintegration.
ASSESSING ANTIMICROBIAL THERAPY IN TREATING HEALTHCARE-ASSOCIATED INFECTIONS AT A VIETNAMESE NATIONAL HOSPITAL
To evaluate the appropriateness of antimicrobial therapy in treating healthcare-associated infections and identify factors associated with patient outcomes at a national hospital in Vietnam. A cross-sectional study was conducted on 122 medical records of patients who were diagnosed with healthcare-associated infection at Thong Nhat Hospital from January 2023 to December 2023, using data from the Infection Control Department. Appropriateness of antimicrobial therapy was defined as physician adherence to Thong Nhat Hospital guidelines for antibiotic use. The factors associated with the treatment outcome were identified using multiple logistic regression analysis. The median age of the patients was 75.5 (65-85). Hospital-acquired pneumonia was identified in 51.6% of patients. The most prevalent pathogens were Klebsiella pneumoniae and Escherichia coli. The overall appropriate rate of empiric antimicrobial therapy was 76.2%. The successful treatment outcome rate was 71.3%. Lower respiratory tract infection, sepsis/sepsis shock, cancer, and comatose state were factors associated with treatment failure. Active management and treatment are essential for patients with lower respiratory infection, sepsis or septic shock, cancer, and comatose states to improve treatment outcomes.
ASSESSMENT OF CLINICAL FEATURES, DIAGNOSTIC FINDINGS, AND TREATMENT OUTCOMES OF COLONIC DIVERTICULITIS AT THE DEPARTMENT OF GASTROINTESTINAL SURGERY, THONG NHAT HOSPITAL
Colonic diverticulitis is increasing in Asia, yet data on clinical patterns in Vietnam remain limited. This study aimed to evaluate the clinical, laboratory, imaging characteristics, and treatment outcomes at Thong Nhat Hospital. A retrospective descriptive study was conducted on 105 patients from January 1 to September 1, 2025. Data on demographics, clinical features, laboratory tests, CT findings, WSES classification, treatment strategies, and outcomes were collected and analyzed using SPSS 26.0, with p < 0.05 considered statistically significant. The mean age was 53.9 ± 20.0 years, with 31.4% aged ≥65. Males accounted for 67.6%. The most common symptom was right lower quadrant pain (55.2%). CT revealed diverticula mainly in the sigmoid colon (40.0%), cecum (37.1%), and right colon (19.0%). WSES stages were: 1a (57.1%), 1b (19.0%), 2a (11.4%), 2b (7.6%), 3 (3.8%), and 4 (1.0%). Medical treatment was applied in 89.5% of cases, percutaneous drainage in 1.0%, and surgery in 9.5%. The mean hospital stay was 7.6 ± 4.4 days, significantly longer in complicated cases and those requiring invasive interventions (p < 0.05). Colonic diverticulitis in Vietnam often affects middle-aged males, with location varying by age: cecum/right colon in younger patients and sigmoid colon in the elderly. CT-scan plays a crucial role in diagnosis, staging, and guiding treatment.
BISPHOSPHONATE INDUCED OSTEONECROSIS OFTHE JAWS
Bisphosphonate (BP) is a group of drugs used to treat osteoporosis, multiple myeloma, skeletal metastasis cancer. BP’s mechanism of action is to reduce bone resorption by inhibiting the osteoclasts activity. Therefore, the indication of BP is increasingly widespread and becomes the first class of drugs in the treatment of osteoporosis. At Frienship Hospital, over the past five years, we have encountered 12 cases of bisphosphonate-related osteonecrosis of the jaw (BRONJ) at various stages. The key message we wish to convey in this report is to kindly encourage close collaboration between internal medicine specialists and oral maxillofacial surgeons during bisphosphonate therapy, in order to minimize the risk of BRONJ complications for patients.
OUTCOMES OF Z-PLASTY SURGERY IN FUNCTIONAL RESTORATION OF CONTRACTED FINGERS
Finger contractures, resulting from burns, trauma, or congenital anomalies, often lead to significant functional impairment. Z-plasty is a versatile reconstructive technique used to release scar contractures while preserving local tissue characteristics. This study aimed to evaluate the functional outcomes of different Z-plasty techniques in the surgical release of contracted fingers. We conducted a prospective descriptive case series involving 31 patients (38 fingers) undergoing Z-plasty for digital contractures. Depending on the location and severity of the contracture, three Z-plasty techniques were used: five-flap, double-opposing, and single 60° Z-plasty. Patients were followed for a mean of 5.6 months. Primary outcomes included range of motion (ROM), web space angle, and DASH scores. Complications and patient satisfaction (VAS) were also assessed. All techniques demonstrated significant improvements in finger extension and flexion. Mean extension deficit improved from −35.4° to −8.1°, and flexion increased from 62.3° to 81.7° (P < .001). The five-flap Z-plasty achieved the greatest gain in web space angle (from 24.2° to 46.8°). DASH scores decreased significantly from 47.6 to 21.8 (P < .001), with patient satisfaction increasing from 4.2 to 8.1 on VAS. Minor complications occurred in 5 patients (16.1%), with no cases of flap necrosis or wound infection. Z-plasty is an effective and low-risk technique for releasing digital contractures and restoring hand function. Five-flap and doubleopposing Z-plasty provide greater functional improvement in web space contractures, while single Z-plasty remains effective for linear joint contractures. These techniques offer reliable outcomes without the need for skin grafting, supporting their continued use in reconstructive hand surgery.
PRELIMINARY OUTCOMES OF ARTHROSCOPIC REPAIR FOR TRAUMATIC TRIANGULAR FIBROCARTILAGE COMPLEX (TFCC) INJURIES
The triangular fibrocartilage complex (TFCC) plays a crucial role in stabilizing the distal radioulnar joint; TFCC injuries commonly cause ulnar-sided wrist pain and functional impairment of the hand. Arthroscopic wrist surgery is an effective and minimally invasive treatment option; however, domestic reports remain limited. Therefore, we conducted the study entitled “Preliminary outcomes of arthroscopic wrist surgery for the repair of traumatic triangular fibrocartilage complex injuries” with the aims of describing the clinical and paraclinical characteristics of TFCC injuries and evaluating treatment outcomes following arthroscopic wrist surgery. Subject and Methods: A total of 15 patients aged 18 years and older with triangular fibrocartilage complex (TFCC) injuries were included in this study. The diagnosis was confirmed through clinical examination, wrist X-ray, and MRI. Patients underwent arthroscopic TFCC repair at Thong Nhat Hospital from June 2021 to June 2024. Results:The study cohort consisted predominantly of female patients, with a mean age of 36.8 ± 9.14 years, the right wrist was the most commonly affected side, with household accidents being the primary cause of injury, palmer type IB TFCC injury was the most frequently observed type, the mean surgical time was 62 ± 15 minutes, the mean hospital stay was 4.4 ± 1.24 days, the VAS pain score significantly improved from 6.01 ± 0.88 preoperatively to 0.36 ± 0.63 at 6 months postoperatively (p<0.05), the MMWS score improved from 45.33 ± 3.52 to 91 ± 5.07 at 6 months postoperatively (p<0.05). Conclusion: arthroscopic TFCC repair is a minimally invasive, effective, and safe surgical approach that alleviates pain and restores wrist function.
SYNDACTYLY SYNDROME IN ASIAN POPULATIONS: GENETIC IDENTIFICATION AND PROGNOSTIC PERSPECTIVES
Syndactyly is among the most common congenital limb malformations and is characterized by substantial genetic and clinical heterogeneity. Although its global incidence is well recognized, accumulating evidence indicates that Asian populations exhibit distinct mutational spectra and variable prognostic profiles. This review systematically summarizes recent molecular and clinical findings from Asian cohorts, with emphasis on pathogenic variants, modifier effects, surgical outcomes, and advances in prenatal diagnostics. Literature published between 2008 and 2023 was retrieved from major biomedical databases following PRISMA-guided principles. Studies from Chinese, Mongolian, and Vietnamese families have repeatedly identified pathogenic variants in key developmental genes, including HOXD13, GLI3, GJA1, and FGFR2, highlighting the central role of convergent signaling pathways such as Hedgehog, WNT/BMP, and FGF in digit morphogenesis and interdigital apoptosis. Asian cohort data further demonstrate incomplete penetrance and intrafamilial variability, suggesting contributions from modifier gene networks and epigenetic influences. Clinically, the integration of next-generation sequencing into surgical planning and prenatal counseling has improved diagnostic precision and prognostic stratification, although molecular evidence remains uneven across Southeast Asia. Asian-specific syndactyly research provides critical insights into population-adapted genetic counseling and emerging precision medicine strategies. Future multi-center genomic studies with standardized clinical reporting will be essential to refine genotype–phenotype correlations and advance individualized management across diverse Asian populations.
TRANSTHYRETIN CARDIAC AMYLOIDOSIS REVEALED BY MULTIMODALITY IMAGING IN AN ELDERLY PATIENT WITH HFpEF
Amyloid cardiomyopathy is an infiltrative disease caused by extracellular deposition of amyloid fibrils within the myocardium, most commonly from immunoglobulin light-chain (AL) or transthyretin (ATTR) sources, leading to progressive heart failure, arrhythmias, and conduction disturbances. We present the case of an 80-year-old man with heart failure with preserved ejection fraction (HFpEF) and comorbidities who was admitted for acute onset dyspnea accompanied by profound hypotension at home. Together with a non-clonal free light-chain profile, these findings supported a diagnosis of transthyretin (ATTR) cardiac amyloidosis. This case highlights the value of integrating electrocardiogram, echocardiography, cardiac magnetic resonance, and bone-avid tracer scintigraphy to establish the diagnosis of ATTR cardiomyopathy and guide management in settings where disease-modifying therapy remains limited.Keywords: supraclavicular brachial plexus nerve block, adductor canal block, popliteal sciatic block, heart failure, limb amputation.
DRUG USE PATTERN AND IMPACT OF CLINICAL PHARMACIST INTERVENTION IN PRESCRIBING DRUGS FOR PATIENTS WITH ACUTE KIDNEY INJURY AT THONG NHAT HOSPITAL
Medication management in patients with acute kidney injury (AKI) poses numerous challenges due to the rapid fluctuations in renal function over a short period. This necessitates frequent reassessment of drug indications and dosages to ensure both treatment efficacy and patient safety. This study aimed to investigate the drug use characteristics and evaluate the effectiveness of clinical pharmacist interventions in prescribing medications for patients with AKI; A before-and-after study was conducted on inpatients diagnosed with AKI at Thong Nhat Hospital, Vietnam, during the pre-intervention period (from February 2022 to August 2022) and the intervention period (from September 2022 to March 2023). Clinical pharmacist interventions included reviewing prescriptions and providing guidance on dose adjustments for patients with AKI. Prescriptions were considered appropriate if the indications and dosages complied with drug usage guidelines and the Vietnamese National Drug Formulary. The effectiveness of the intervention was evaluated by comparing the appropriateness of prescribing between the two study periods; A total of 97 patients in the pre-intervention period and 94 patients in the intervention period were included. The proportion of patients receiving at least one drug potentially impairing kidney function in both periods was 33.5%, while 90.6% of patients were prescribed at least one drug that required dose adjustment or discontinuation in cases of renal impairment. The proportion of appropriately dosed prescriptions was higher in the intervention period compared to the pre-intervention period (94.7% vs. 84.5%, p = 0.022). However, the overall rate of appropriate prescribing did not differ significantly between the two periods (79.8% vs. 71.1%, p = 0.165); The rate of appropriate prescribing for AKI patients was relatively high. Clinical pharmacist interventions contributed to improving the appropriateness of drug dosing.
Copyright (c) 2025 The Author(s). Published by Journal of Health and Aging.
LEFT VENTRICULAR NONCOMPACTION CARDIOMYOPATHY WITH TRIPLE TTN VARIANTS MASQUERADING AS ARRHYTHMIA-INDUCED CARDIOMYOPATHY: A CASE REPORT
Left ventricular noncompaction cardiomyopathy (LVNC) can lead to ventricular arrhythmias and may be misdiagnosed as arrhythmia-induced cardiomyopathy (AiCM). While LVNC is associated with genetic abnormalities, AiCM is triggered by arrhythmias and is typically reversible once the arrhythmia is eliminated. We report the case of a 59-year-old woman with LVNC carrying three TTN gene variants: c.100804A>T (p.Met33602Leu, exon 358), c.59200C>G (p.Pro19734Ala, exon 300), and c.52052T>C (p.Val17351Ala, exon 273). The patient was initially diagnosed with AiCM but showed no recovery of left ventricular function after successful catheter ablation of ventricular arrhythmias. Echocardiography and cardiac magnetic resonance imaging confirmed the LVNC phenotype. This case highlights the importance of distinguishing between these two entities in clinical practice.
RELATIONSHIP BETWEEN AGE, GENDER, AND MULTIMORBIDITY WITH LENGTH OF HOSPITAL STAYIN ELDERLY PATIENTS
To evaluate the relationship between age, sex, and multimorbidity with hospital length of stay among elderly inpatients. A retrospective cross-sectional study was conducted on 507 medical records of patients aged ≥60 years admitted to the Senior Officer Department, 103 Military Hospital, between December 2022 and October 2024. Data were analyzed using SPSS version 26.0. One-way and two-way ANOVA were performed to examine the effects of age, sex, and comorbidity burden on hospital stay. Male patients had longer hospital stays (10.68 ± 6.24 vs. 9.40 ± 4.95 days) and a higher mean number of comorbidities (3.57 ± 1.70 vs. 3.26 ± 1.69; both p < 0.05) compared with females. Hospital stay increased with advancing age, from 9.27 ± 5.78 days in the 60–69 age group to 11.07 ± 5.54 days in the 80–89 age group (p < 0.001). Similarly, the number of comorbidities rose with age, from 2.84 ± 1.48 to 4.24 ± 1.93 (p < 0.001). Two-way ANOVA confirmed significant effects of both age (p < 0.001) and sex (p = 0.033) on comorbidity burden, whereas the interaction effect was not significant (p = 0.091). For hospital stay, comorbidity burden was the main determinant (p < 0.001), with no significant sex effect (p = 0.09). Patients with ≥6 comorbidities had markedly prolonged hospital stays, irrespective of sex. Age and multimorbidity are the principal determinants of hospital stay duration in elderly patients. While males showed a higher comorbidity burden, the effect of sex on hospital stay was largely explained by multimorbidity. These findings underscore the importance of comprehensive comorbidity management to reduce hospital stay and optimize care for older adults.
ORTHOPEDIC SURGERY IN THE AGING POPULATION: CHALLENGES AND FUTURE DIRECTIONS
The rapid aging of the global population has led to a substantial rise in the demand for orthopedic surgery among elderly patients, particularly for hip, knee, and shoulder arthroplasty. However, age-related physiological decline, comorbidities, and frailty increase the risk of complications and present unique clinical challenges. This review aims to summarize current evidence regarding indications, risks, and evolving strategies in orthopedic surgery for patients aged ≥65 years; We conducted a focused narrative review of the literature published between 2015 and 2025 using PubMed, Scopus, and Google Scholar. Search terms included “orthopedic surgery,” “geriatric patients,” “frailty,” “osteoporosis,” “arthroplasty,” “comprehensive geriatric assessment,” and “enhanced recovery after surgery (ERAS)”. Priority was given to original studies, systematic reviews, meta-analyses, and international guidelines relevant to orthogeriatric care; Evidence synthesis indicates that while elderly patients face higher rates of perioperative complications, successful orthopedic surgery can substantially improve functional recovery and quality of life. Key risk factors include osteoporosis, malnutrition, and frailty, which correlate with delayed healing and increased morbidity. Strategies such as prehabilitation, Comprehensive geriatric assessment, and ERAS protocols have demonstrated effectiveness in reducing hospital stays, lowering complication rates, and enhancing postoperative outcomes; Orthopedic surgery in the aging population offers both opportunities and challenges. Optimal outcomes require a multidisciplinary approach, preoperative optimization, and the integration of evidence-based perioperative strategies. Wider adoption of orthogeriatric care models may improve both safety and sustainability of orthopedic interventions in elderly patients.
FIBEROPTIC ENDOSCOPIC EVALUATION OF SWALLOWING: EXPERIENCE AT THE NATIONAL REHABILITATION HOSPITAL (2019 - 2025)
Dysphagia is increasingly recognized due to higher survival rates after central nervous system injuries, head and neck cancer treatment, and in some cases in healthy elderly individuals. It leads to severe consequences including prolonged hospitalization, delayed recovery, recurrent pneumonia, and even mortality. Bedside clinical tests alone are insufficient for diagnosis. Fiberoptic Endoscopic Evaluation of Swallowing (FEES) is one of the gold standards in dysphagia assessment, proven to be safe, effective, and feasible worldwide. However, FEES has not been widely adopted in Vietnam. This paper reports the implementation and clinical experience of FEES at the National Rehabilitation Hospital between 2019 and 2025. Literature review and clinical experience were combined. More than 700 FEES procedures were performed between April 2019 and July 2025. FEES allowed direct visualization of swallowing physiology, identification of penetration/aspiration, and guided compensatory strategies. No serious complications were reported, apart from mild discomfort. FEES is an effective and safe diagnostic tool for dysphagia, supporting individualized management strategies and should be expanded in Vietnam.
CURRENT SITUATION AND BARRIERS TO HPV VACCINATION AMONG FEMALE NURSING STUDENTS AT TRA VINH UNIVERSITY, VIETNAM, 2024
Cervical cancer is one of the most common cancers in women and can be prevented through HPV vaccination. However, HPV vaccination coverage in Vietnam remains low, especially among healthcare students. This study aimed to assess the status and barriers to HPV vaccination among female nursing students at Tra Vinh University. A descriptive cross-sectional study was conducted among 233 female nursing students from May to July 2024. Data were collected using a self-administered questionnaire and analyzed with SPSS 22.0, employing descriptive statistics, Chi-square tests, and logistic regression. Only 15.5% of students had received at least one dose of HPV vaccine, with 9.4% completing the full three-dose schedule. The main barriers included high cost (73.4%), concerns about side effects (28.8%), perception of unnecessary vaccination without prior sexual activity (22.3%), and lack of accurate information (21.5%). Most students had good knowledge and positive attitudes: 91.4% knew HPV vaccine prevents cervical cancer, 91.8% trusted its effectiveness, and 92.3% were willing to recommend it to peers. HPV vaccination coverage among female nursing students remains low, largely due to financial constraints and insufficient information. Strengthened health education and financial support policies are essential to improve vaccination uptake in this population.
ASPIRIN HYPERSENSITIVITY IN CORONARY ARTERY DISEASE: PRACTICAL CHALLENGES AND MANAGEMENT APPROACHES
Aspirin is a cornerstone therapy for coronary artery disease (CAD), yet hypersensitivity complicates its use in clinical practice. This narrative review synthesizes contemporary evidence from studies and guidelines to provide pragmatic, evidence–based recommendations on the epidemiology, mechanisms, classification, and management of aspirin hypersensitivity. Prevalence is estimated at 0.5–1.9% in the general population and 2.6% among patients undergoing coronary angiography. In the ADAPTED (Aspirin Desensitization in Patients with Coronary Artery Disease) registry, a rapid desensitization protocol achieved a 95.4% success rate, with 80.3% of patients remaining on aspirin at 12 months. The 2025 American College of Cardiology/American Heart Association (ACC/AHA) guidelines recommend aspirin desensitization as the preferred strategy in acute coronary syndromes (ACS). In contrast, the 2024 European Society of Cardiology (ESC) guidelines recommend clopidogrel for chronic coronary syndromes (CCS) when aspirin is not tolerated. Desensitization is contraindicated in patients with a history of severe anaphylaxis. Accordingly, desensitization should be preferred whenever feasible. When it is not possible or unsuccessful, alternatives—such as cilostazol, indobufen, or P2Y12 inhibitor–based regimens with or without oral anticoagulants—may be considered based on ischemic and bleeding risk. Robust randomized controlled trials are needed to confirm the efficacy of these strategies.
APPLICATION OF SIX SIGMA METHOD EVALUATING THE QUALITY OF PERIPHERAL BLOOD CELL TESTING AT PHUONG CHAU INTERNATIONAL HOSPITAL
The Six Sigma approach enables laboratories to objectively evaluate analytical performance, refine IQC protocols, and establish suitable IQC frequencies. This study aimed to evaluate the quality and optimize the IQC procedure for selected hematology tests on the Advia 2120i automated hematology analyzer. A cross-sectional descriptive study was conducted using internal quality control and external quality assessment data from April 2024 to December 2024 at Phuong Chau International Hospital. The results showed that WBC and PLT achieved sigma values >4 at all three IQC levels. HGB had sigma values ranging from 3 to <6, while RBC had sigma values between 2 and <4 across all three IQC levels. Most tests in this study reached “acceptable” sigma performance or higher. These findings demonstrate that the Six Sigma approach is effective in monitoring and improving test quality by enabling the selection of appropriate IQC strategies for each parameter.
ACUTE MYOCARDIAL INFARCTION TRIGGERED BY DROWNING IN AN ELDERLY PATIENT: A CASE REPORT
Drowning is a leading cause of unintentional injury-related mortality worldwide, particularly in two vulnerable populations: children and the elderly. In addition to respiratory compromise, drowning may lead to serious complications such as hypothermia, prolonged neurological injury, and cardiovascular sequelae — including myocardial damage. Myocardial infarction following drowning is rare and frequently overlooked in the acute setting, as elevated cardiac biomarkers are often attributed to resuscitation efforts. Nevertheless, in patients with pre-existing cardiovascular risk factors, systemic hypoxia combined with acute physiological stress induced by drowning may serve as a trigger for true myocardial infarction. This report describes an incidental finding of underlying coronary artery disease following a drowning event, underscoring the critical importance of comprehensive cardiovascular assessment in drowning survivors for early recognition of life-threatening cardiac events and timely, individualized management
STRESS COPING STRATEGIES OF HEALTH STUDENTS AT TAY NGUYEN UNIVERSITY
To assess the level of stress and describe the coping strategies of health students at Tay Nguyen University. A cross-sectional descriptive study was conducted on 424 students of General Medicine, Bachelor of Nursing, and Bachelor of Medical Laboratory Technology at Tay Nguyen University. The stress rate among health students at Tay Nguyen University is 84.0%. Of these, mild stress accounts for 34.9%, moderate stress for 40.1%, and severe stress for 9.0%. Stressed students often use the coping strategy of "cognitive restructuring" with an average score of 2.22 ± 0.63, and "problem-solving" with an average score of 2.37 ± 0.64. The rate of stressed students is relatively high. The majority of students use active coping strategies. However, inappropriate strategies still exist, so it is necessary to provide timely support interventions to improve students' physical and mental health.
KNOWLEDGE OF CORONARY ARTERY DISEASE AMONG CARDIOVASCULAR PATIENTS AT TRA VINH PROVINCIAL GENERAL HOSPITAL AND ASSOCIATED FACTORS IN 2024
To assess patients’ average level of knowledge regarding coronary artery disease and its associated factors at Tra Vinh Provincial General Hospital in the year 2024. A descriptive cross-sectional study was conducted on 128 patients diagnosed with coronary artery disease who came for examination and surgical treatment at the Cardiology Clinic at Tra Vinh Provincial General Hospital from May 2024 to July 2024 using the CADE-Q SV questionnaire. Our research results showed that 76.6% of patients had average knowledge and 23.7% of patients had poor knowledge; no patients had good knowledge; the rate of patients answering correctly for all questions was 45.04%; there was no correlation found between the knowledge of patients with coronary artery disease at Tra Vinh General Hospital and the factors surveyed at the time of the survey. Our research results showed that the knowledge of patients with coronary artery disease at Tra Vinh General Hospital in this study was still low, and there was no factors related to the rate of patients’ knowledge about coronary artery disease have been found.