Research

This study investigates the distribution of pathogenic microorganisms and their antibiotic resistance status in bloodstream infections at Thong Nhat Hospital from April 30, 2024, to May 1, 2025. Retrospective, cross-sectional descriptive study conducted on 770 microbial isolates obtained from blood samples from April 30, 2024, to May 1, 2025, at Thong Nhat Hospital. Among the total 770 isolated strains, bacteria accounted for 97.27%, and fungi accounted for 2.73%. The common pathogens included Coagulase-negative Staphylococci (30.44%), Escherichia coli (21.23%), Staphylococcus aureus (8.54%), Klebsiella pneumoniae (7.34%), and Pseudomonas aeruginosa (2.94%). E. coli showed >80% susceptibility to amikacin and piperacillin/tazobactam and >97% susceptibility to carbapenems. K. pneumoniae demonstrated resistance rates of 30.2% to imipenem, 31,3% to meropenem, and 25.5% to ertapenem. P. aeruginosa resistance rates were 50% to imipenem and 40.9% to meropenem. S. aureus exhibited high resistance to benzylpenicillin (96.6%), erythromycin (75.9%), and clindamycin (67.2%) but remained 100% susceptible to vancomycin, linezolid, teicoplanin, and tigecycline. The MRSA rate was 62.5%. Candida spp. remained susceptible to commonly used antifungal agents. Bacteria are the primary cause of bloodstream infections. Multidrug-resistant strains such as P. aeruginosa, K. pneumoniae, and MRSA account for a significant proportion. Continuous monitoring of resistance patterns supports clinicians in selecting appropriate antibiotics, thereby reducing mortality and treatment costs.

This study aimed to describe the characteristics of common hematological disorders through immunophenotypic analysis using flow cytometry (FCM). A retrospective descriptive study was conducted on all patients aged 16 years and older who were analyzed by FCM testing at the Hematology Department, Thong Nhat Hospital from January 2023 to March 2025. Convenience sampling was applied. Data analysis was performed using Microsoft Excel 2021. A total of 104 patients were tested by flow cytometry. The median age at diagnosis was 68 years [55.8–77]. Baseline hematologic findings showed anemia (Hb 9.3 ± 2.6 g/dL) and wide variations in white blood cell (20.1 ± 42.4 K/uL) and platelet counts (197 ± 172.3 K/uL), reflecting the diversity of underlying hematologic conditions. FCM demonstrated high diagnostic value in identifying and classifying various hematologic disorders: distinguishing acute leukemia lineages (myeloid/B-lymphoid/T-lymphoid), detecting monoclonal lymphoid populations in lymphomas, and differentiating benign from malignant plasma cells in multiple myeloma. Correlation with bone marrow morphology was high, especially in diagnostically challenging cases. However, FCM could not fully replace bone marrow examination in assessing cellular morphology and tissue architecture. In conclusion, Flow cytometry is a powerful complementary tool in the diagnosis of hematologic disorders. The combination of FCM and bone marrow studies provides optimal diagnostic accuracy and supports effective patient management.

Hepatitis B virus (HBV) infection is a prevalent and serious infectious disease. Severe acute exacerbation of chronic hepatitis B occurs in 40-50% of patients with chronic hepatitis B, which can progress to acute-on-chronic liver failure (ACLF) when their liver damage worsens. Early diagnosis and treatment play an important role in the survival of patients with ACLF. To investigate risk factors associated with the progression of ACLF in severe acute exacerbation of chronic hepatitis B. A retrospective, cross-sectional study with longitudinal follow-up was conducted on 69 patients with severe acute exacerbation of chronic hepatitis B, conducted at the Department of Gastroenterology, The University of Medicine Center of Ho Chi Minh City from January 2022 to December 2023. Of the 69 patients, 30 (43.5%) progressed to ACLF. Univariate analysis identified a history of compensated cirrhosis (OR = 9.04; 95% CI: 3.0–27.2), spider angiomas (OR = 4.43; 95% CI: 1.54–12.75), palmar erythema (OR = 5.07; 95% CI: 1.75–14.64), lower serum sodium (OR = 1.18; 95% CI: 1.02–1.37), higher total bilirubin (OR = 1.06; 95% CI: 1.01–1.12), and lower serum albumin (OR = 1.29; 95% CI: 1.13–1.47) as significant risk factors for ACLF progression in severe acute exacerbation of chronic HBV. Risk factors associated with the progression of ACLF in severe acute exacerbation of chronic hepatitis B are a history of compensated cirrhosis, spider angiomas, palmar erythema, serum sodium, total bilirubin, and serum albumin. Serum albumin is an independent risk factor.

The Editorial Board of the Journal of Health and Aging hereby announces:

This article published in Volume 1, Issue 3, is being retracted from the Journal.

Reason: After a review process, we have identified that the content of this article duplicates a previously published work, with the DOI: 10.52163/yhc.v65iCD1.976.

The Editorial Board sincerely apologizes to our readers and the research community for this inconvenience. The authors have been informed of this decision.

We are committed to maintaining transparency, integrity, and the highest ethical standards in our scientific publishing activities to ensure the quality and reputation of the Journal.

Sincerely,

The Editorial Board

Journal of Health and Aging

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.

Early vascular recanalization in acute ischemic stroke is an effective therapeutic strategy for neurological recovery; however, the outcome is influenced by various patient-related and baseline factors. To evaluate the effectiveness of recanalization therapy and investigate factors associated with neurological improvement in patients with acute ischemic stroke. A retrospective descriptive study was conducted on 186 acute ischemic stroke patients treated at Thong Nhat Hospital from January 2024 to March 2025. Clinical assessments (NIHSS, mRS), degree of recanalization (TICI), and associated factors were analyzed. The proportion of patients with NIHSS improvement ≥4 points was high in the thrombectomy-only and bridging therapy groups, at 80,7% and 90,3%, respectively. The highest rate of complete recanalization (TICI 3) was observed in the bridging therapy group (64,5%). The highest proportion of favorable functional outcome at discharge (mRS 0–2) was seen in the IV thrombolysis-only group (80,6%). Factors significantly associated with neurological improvement included: baseline mRS 0–2 (p=0,016), pre-intervention blood pressure (p<0,05), initial NIHSS score (p=0,004), pre-intervention blood glucose level (p=0,003), degree of recanalization (p=0,048), and hemorrhagic transformation (p=0,001). Combined intravenous thrombolysis and mechanical thrombectomy yielded the greatest neurological improvement. Multiple baseline factors are predictive of prognosis and should be thoroughly assessed prior to intervention.

Antibiotic resistance is a major global health challenge. This study aimed to investigate the prevalence and antibiotic resistance patterns of pathogenic bacteria at Cai Nuoc General Hospital during 2023–2024. A cross-sectional descriptive study was conducted using clinical specimens identified and tested for antibiotic susceptibility according to CLSI 2023 standards. The predominant isolates were Escherichia coli 9,9%, Klebsiella pneumoniae 8.1%, Staphylococcus epidermidis 13,5% and Staphylococcus aureus 46,8%. High resistance rates were observed for beta-lactam and quinolone groups. ESBL-producing Gram-negative bacilli accounted for 21,2%, and MRSA for 89,7%. Conclusion: Antibiotic resistance at the hospital remains high, emphasizing the need for antimicrobial stewardship and regular surveillance.

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.

Laparoscopic surgery (LS) is increasingly applied in the placement and salvage of Tenckhoff catheters for peritoneal dialysis in end-stage chronic kidney disease (ESKD). This study aims to evaluate the preliminary efficacy and safety of this technique. A retrospective descriptive study was conducted on 27 patients who underwent laparoscopic Tenckhoff catheter placement or salvage at Thong Nhat Hospital from January 2022 to October 2024. There were 17 new catheter placements (60.71%) and 11 salvages (39.29%). The mean age was 56 ± 17 years, and the average operative time was 60.59 ± 17.09 minutes. In the placement group, 29.41% underwent omentectomy, 17.64% received omentopexy, and 58.82% had catheter fixation to the abdominal wall. Reported complications included poor outflow and abdominal wall hernia (11.76%), and infection (5.88%). In the salvage group, 81.82% had catheter migration due to the omentum, with 54.55% requiring omentectomy and 18.18% undergoing omentopexy; all patients had catheter fixation. Complications included poor outflow and hernia (9.09%), with no infections or catheter removals observed within 3 months. Catheter function was well maintained postoperatively. Laparoscopic surgery is a safe and effective method for Tenckhoff catheter placement and salvage, supporting longterm catheter function and reducing risks of infection and obstruction. It is a viable option for renal replacement therapy with peritoneal dialysis in ESKD patients.

Older patients (≥65 years old) with non-ST-segment elevation myocardial infarction (NSTEMI) have a high risk of in-hospital complications. This study aimed to evaluate the predictive value of the ACTION ICU score for the need for ICU admission in this patient population. This was a retrospective, descriptive, cross-sectional study of 122 patients ≥65 years old diagnosed with NSTEMI and hemodynamically stable upon admission at Nhan dan Gia Dinh Hospital from January 2022 to December 2023. The primary endpoint was a composite outcome including cardiac arrest, shock, respiratory failure requiring mechanical ventilation, high-degree atrioventricular block requiring a pacemaker, stroke, or in-hospital death. The predictive value of the ACTION ICU score was assessed using receiver operating characteristic (ROC) curve analysis. The mean ACTION ICU score in the group with complications was significantly higher than in the group without complications (11.6 ± 3.5 vs. 7.5 ± 3.3; p < 0.001). The ACTION ICU score showed good predictive ability with an area under the ROC curve (AUROC) of 0.792 (95% CI: 0.688–0.896). The optimal cutoff score was ≥11 points, with a sensitivity of 63.6%, a specificity of 82.0%, a positive predictive value of 43.8%, and a negative predictive value of 91.1%; The ACTION ICU score is a simple and clinically useful tool for risk stratification, helping to predict the need for ICU admission in older NSTEMI patients in Vietnam. The use of this score can support clinical decisions, contributing to a more effective use of ICU resources.

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.

Population aging is an inevitable global trend, driven by increased life expectancy and a prolonged decline in the total fertility rate (TFR) below replacement level. This article analyzes the current situation and underlying causes of persistently low fertility in high-income countries and in Vietnam. It points out that once the TFR drops below 2.1 for several decades, almost no country has succeeded in restoring replacement-level fertility, despite implementing numerous supportive policies at great cost. Through the analysis of demographic, economic, and social data from over 40 countries, combined with typical surveys conducted in Ho Chi Minh City and Japan, the author identifies five root causes of fertility decline. Based on these insights, a comprehensive system of solutions is proposed to shift from unsustainable to sustainable aging. Key measures include: ensuring a living wage for a family of four; reforming the social insurance system; expanding public housing and preschool education; promoting gender equality; preserving Vietnamese cultural traditions that value family life; educating citizens on knowledge and skills for building happy families; raising awareness of civic responsibility; and creating a social environment that is friendly to women and children.The article emphasizes that without decisive policy changes during the 2025–2050 period, Vietnam’s population could shrink from a peak of 107 million in 2050 to just 88 million by 2100, with further severe decline thereafter. Conversely, if strategic solutions are comprehensively implemented, Vietnam can fully achieve the goal: happy elderly, a prosperous nation, and a thriving people.

Pheochromocytoma is a rare endocrine cause of secondary hypertension. The definitive diagnosis requires a combination of biochemical testing and imaging studies. Management of pheochromocytoma-induced hypertension involves appropriate pharmacologic therapy followed by surgical resection of the adrenal tumor. In this report, we present the case of an elderly patient who was admitted with chest pain and initially diagnosed with acute coronary syndrome. However, invasive coronary angiography revealed no significant stenosis. Subsequent investigations confirmed the diagnosis of pheochromocytoma. The patient underwent successful medical stabilization and surgical removal of the tumor. This case highlights the importance of multidisciplinary collaboration in the diagnosis and treatment of pheochromocytoma at Thong Nhat Hospital.

Periprosthetic fractures around the knee are serious complications following total knee arthroplasty, commonly occurring in elderly patients with poor bone quality. The most frequent fracture site is the supracondylar region of the femur, followed by the tibia and patella. Causes may include low-energy trauma, suboptimal surgical technique, or implant loosening. Diagnosis and treatment of periprosthetic fractures around the knee are challenging due to interference from the implant and compromised bone quality. Treatment may be conservative in non-displaced fractures or surgical in cases of displacement, implant loosening, or comminuted fractures. Surgical options include locked plating, retrograde intramedullary nailing, or revision arthroplasty using long-stem components. Fracture classifications by Lewis-Rorabeck and Su are helpful in guiding management. Tibial and patellar periprosthetic fractures may also occur and require careful preoperative planning to avoid complications. Postoperative complications such as non-union, infection, or soft tissue injury are common when not properly managed. Prevention through patient screening, improved surgical technique, and close postoperative monitoring plays a critical role in reducing fracture incidence. Successful treatment requires a multidisciplinary approach involving orthopedic surgery, rehabilitation, and management of comorbidities.

Periprosthetic fractures of the hip are serious complications following total hip arthroplasty, particularly affecting elderly patients, those with osteoporosis, or individuals with a history of revision surgeries. These fractures may occur intraoperatively or postoperatively, involving the femoral shaft (classified as Vancouver A, B, or C) or the acetabulum (Paprosky classification). Acetabular fractures are less common than femoral fractures. The mechanisms of fracture involve both biological factors (such as stress risers, implant loosening, and poor bone quality) and external forces (such as falls, torsional, and bending loads). Identified risk factors include advanced age, female gender, osteoporosis, implant loosening, use of cementless femoral stems, rheumatoid arthritis, and multiple revision surgeries. Studies have reported the incidence of periprosthetic fractures after primary hip replacement ranging from 0.8% to 4.5%, with higher rates observed following revision procedures. Diagnosis relies on both clinical and paraclinical assessments, with plain radiographs and computed tomography (CT) being the primary tools to evaluate implant stability, bone loss, and to guide treatment planning. Treatment depends on the type of fracture and the stability of the prosthesis. Stable Vancouver A fractures may be managed conservatively; Vancouver B1 fractures often require internal fixation with plates and screws; B2 and B3 fractures typically necessitate revision with a long-stem prosthesis and bone grafting if needed. Nondisplaced acetabular fissure fractures may be treated conservatively, but displaced or unstable fractures require surgical reconstruction using plates, screws, bone grafts, or specialized acetabular components. Prognosis is influenced by patient age, the severity of osteoporosis, prosthesis stability, and the number of prior surgeries. The mortality rate following periprosthetic hip fractures ranges from 7% to 18% within the first year postoperatively. Prevention, thorough risk assessment, and appropriate treatment strategies play crucial roles in improving clinical outcomes.

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.

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.

Laparoscopic surgery with totally intracorporeal anastomosis has become an advanced technique for treating colon cancer, especially in elderly patients. However, studies on its feasibility and safety in Vietnam remain limited. To evaluate the outcomes of laparoscopic colectomy with intracorporeal anastomosis in elderly patients, focusing on safety, complications, and recovery time. A cross-sectional descriptive study was conducted on 49 patients aged ≥62 who underwent laparoscopic colectomy with intracorporeal anastomosis at Thong Nhat Hospital from January 2021 to February 2025. Data included demographic characteristics, operative time, postoperative complications, and oncological results. The mean age of patients was 73.15 ± 5.26, with 63.26% male. The average operative time was 231.52 ± 49.67 minutes, and the mean blood loss was 73.59 ± 14.67 ml. The postoperative complication rate was 12.24%, including pneumonia/wound infection (6.12%), anastomotic leakage (4.08%), early obstruction (2.04%), and ileus (4.08%). The mean number of harvested lymph nodes was 9.37 ± 2.25, with 69.52% showing nodal metastasis. The average hospital stay was 11.62 ± 7.2 days. Laparoscopic surgery with totally intracorporeal anastomosis is safe and feasible for elderly patients, offering quick recovery and low complication rates.

Carpal tunnel syndrome (CTS) is a common neuropathy caused by median nerve compression, leading to pain, numbness, and weakened grip strength. The conventional treatment involves releasing the transverse carpal ligament (TCL), but this may reduce grip strength and biomechanical stability. TCL reconstruction may help maintain carpal tunnel integrity and protect the median nerve. This study aims to evaluate the clinical effectiveness of TCL reconstruction following CTS surgery. A prospective study was conducted on 13 patients diagnosed with CTS and undergoing TCL reconstruction at Thong Nhat Hospital from 12/ 2023 to 12/ 2024. After 12 months of follow-up, VAS scores significantly decreased from 6.4 ± 1.2 to 1.3 ± 0.8. Grip strength increased from 19.7 ± 5.6 kg to 29.4 ± 4.8 kg (p < 0.05). Two-point discrimination improved from 6.8 ± 1.5 mm to 4.3 ± 0.9 mm. The DASH score improved from 55.2 ± 6.7 to 18.4 ± 4.1. EMG findings showed improvement in 76,9% of patients. No cases of infection or recurrence were recorded. One patient (7.7%) had a transient palmar cutaneous branch injury, which resolved within six months. Patient satisfaction was reported at 92%. TCL reconstruction in CTS surgery significantly improves symptoms, preserves grip strength, and enhances hand function while minimizing complications. This method could be considered a standard option for CTS treatment.

Osteoporosis is a common complication in elderly patients with chronic kidney disease (CKD), particularly at fracture-prone sites such as the femoral neck. However, osteoporosis screening in this population remains insufficient in routine clinical practice, especially in Vietnam. This study aimed to determine the prevalence of osteoporosis and its associated factors in patients aged ≥70 years with CKD. A cross-sectional study was conducted on 76 patients aged ≥70 years with stage 3–5 CKD (including 47 predialysis and 29 maintenance hemodialysis patients) at Thong Nhat Hospital from September 2022 to June 2024. Clinical and laboratory data were collected, and bone mineral density (BMD) was measured using DXA at three sites: lumbar spine (LS), total hip (TH), and femoral neck (FN). Logistic regression was used to identify predictors of osteoporosis, with model accuracy evaluated by AUC. The overall prevalence of osteoporosis was 43.4%, highest at the femoral neck (40.8%). Mean BMD at the femoral neck (0.559 ± 0.147 g/cm²) was significantly lower than at the total hip (0.713 ± 0.168) and lumbar spine (0.901 ± 0.209; p < 0.001). Independent protective factors included male sex (OR = 0.082; p < 0.001) and higher BMI (OR = 0.670; p = 0.004). Maintenance hemodialysis was identified as an independent risk factor (OR = 4.368; p = 0.027). The predictive model incorporating these three variables achieved good accuracy (AUC = 0.89). Patients aged ≥70 years with CKD—particularly women, those with low BMI, and those on maintenance hemodialysis—are at high risk of osteoporosis, especially at the femoral neck. Routine BMD screening should be implemented for early detection and timely intervention.

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.

Transesophageal echocardiography (TEE) plays an essential role in detecting left atrial appendage (LAA) thrombus in patients with atrial fibrillation (AF), aiding clinical decisions regarding catheter ablation. However, this procedure may induce anxiety, discomfort, and sore throat in patients. This cross-sectional study aimed to evaluate patient experiences related to TEE and its economic implications in AF management. A total of 108 patients with AF undergoing TEE at the Department of Cardiology, Thong Nhat Hospital, were enrolled. The prevalence of LAA thrombus was 13.8%. Patients with thrombus had significantly higher body mass index (BMI) and lower LAA emptying velocity (p < 0.05). Moderate-to-severe anxiety was observed in 38.9% of patients, while 41.6% reported moderate-to-severe sore throat. Factors significantly associated with anxiety included current employment status, hemodynamic control, and coexisting cardiovascular diseases. Higher educational level and cardiovascular comorbidities were associated with less severe sore throat. Discomfort in the oropharyngeal region was reported by 76.9% of patients, though no significant predictors were identified. Outpatient TEE was associated with a statistically significant reduction in hospital stay by an average of 2.8 days (p = 0.048). Although TEE is a necessary diagnostic tool, it may cause considerable discomfort for patients. Adequate hemodynamic control, patient counseling, and implementing outpatient TEE strategies may improve patient experience and healthcare efficiency.

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.

May-Thurner syndrome is a vascular compression syndrome in which the left common iliac vein is compressed between the lower lumbar spine and the right common iliac artery. This condition can cause lower extremity venous thrombosis, and profound venous thrombosis, leading to life-threatening complications. The treatment of May–Thurner syndrome differs from other causes of non-compressive lower extremity thrombosis. Therefore, radiologists must recognize this condition to help patients receive accurate and timely treatment. Among diagnostic imaging methods, computed tomography is the superior imaging method, providing useful information for the treatment of May–Thurner syndrome. This essay aims to assist radiologists in maximizing the advantages of MDCT, from protocol to image interpretation, in a comprehensive examination of a patient with suspected May-Thurner syndrome.

Formulating a clear and structured research question is a critical first step for the success of a medical study. However, many clinicians struggle with this initial phase, leading to unfocused research with little potential for significant impact on practice. In this paper, I introduce the PICOT framework, which can transform vague curiosities into precise, answerable questions suitable for practical research methodologies.However, a well-structured question is insufficient if it does not lead to outcomes that are meaningful to patients. The POEM (Patient-Oriented Evidence that Matters) principle provides a filter for evaluating research questions, ensuring that studies focus on outcomes relevant to patient health, rather than solely on biochemical markers. PICOT and POEM are two core principles of evidence-based medicine that help clinicians prioritize research that will positively change clinical practice and directly benefit patients. This ensures that time and resources are invested in research that generates evidence truly applicable at the bedside.