Research

Melanin overproduction can lead to hyperpigmentation issues such as freckles and melasma, impacting aesthetics and health. This study investigates the inhibitory effects of C-Phycocyanin (C-PC) extracted from Spirulina on melanin synthesis using a zebrafish (Danio rerio) model. C-PC demonstrated significant tyrosinase inhibition and reduced melanin content in zebrafish embryos in a dosedependent manner. The IC50 value of C PC for tyrosinase inhibition was determined to be 38.36 ± 19 µg/mL. At the highest tested concentration (10 µg/mL), C-PC reduced melanin content in zebrafish embryos by approximately 48.57%, compared to 71.08% inhibition observed with kojic acid. Importantly, C-PC exhibited low toxicity, with treated embryos maintaining normal morphology and viability. The findings suggest the potential application of C-PC as a natural depigmenting agent in cosmetic formulations.

To evaluate the clinical features, paraclinical findings, and treatment outcomes of giant cell tumor (GCT) of bone. Fifteen patients aged 20 to 40 years with bone lesions underwent surgery and histopathological examination and were diagnosed with “giant cell tumor of bone” between January 2011 and December 2024. There were 6 males and 9 females. The most common tumor location was the tibia (53.3%). The most frequent histological pattern was fibrosis, present in 11 cases (73.3%). The average follow-up duration was 55 months. Local recurrence occurred in 3 out of 15 cases, with no cases of metastasis. The GCT cases in our study shared pathological characteristics with classic GCT populations. No specific histological feature was associated with adverse outcomes. Curettage combined with bone cement filling proved to be an effective treatment option.

Non-variceal upper gastrointestinal bleeding (NVUGIB) is a common medical emergency requiring early risk stratification to improve prognosis. This study aimed to evaluate the value of the Glasgow-Blatchford Score (GBS) in prognosticating patients with NVUGIB. This prospective, descriptive study included patients diagnosed with NVUGIB admitted to the Emergency Department of Thong Nhat Hospital from January 2020 to July 2020. Among 122 patients (73.0% male, mean age 63 years), 45.9% required medical intervention (MI), 5.7% experienced re-bleeding, and 2.5% died. The mean GBS was 9. The GBS (AUC=0.828) showed better prognostic value for MI than the clinical Rockall score (AUC=0.650). With a cut-off score of ≥10, the GBS had a sensitivity of 0.68 and a specificity of 0.88 in predicting the need for MI. Most patients with NVUGIB were elderly. The GBS is a valuable tool for prognosticating the need for medical intervention in this patient group.

Early diagnosis and in-time treatment for the patients with deep venous thrombosis (DVT) is very important because they make mortality rate and post thrombosis outcome decreased. Screening DVT in risk patients is very necessary. From 06/2015 to 06/2016, 184 elderly inpatients (≥60 age), in Thong Nhat hospital, with high – average deep venous thrombosis risk in Wells score, are quantified D-Dimer. If D-Dimer concentration > 500 ng/ml, Dopller ultrasound lower limbs, CT scan, MRI were performed to determine deep venous thrombosis. If thrombosis wasn’t found, ultrasound was done once again after the first time 7-10 days. Average age is 74 ± 10,14. Most of patients in this study had severe medical illness, in the intensive care unit and in immobility stage > 3 days, occupied the highest ratio 57,6%; then patients with active cancer and paralysis stroke patient held the ratio in turn 20,7% and 18,5%; post operation patients gained the lowest ratio 3,3%. The patients with average risk occupied the ratio 96,2%, the patients with high ratio got 3,8%. The average D-Dimer concentration in the patients with average – high deep venous thrombosis risk in Wells score in our study is 1828,99 ± 1426 ng/ml. The ratio of the patients perfomed ultrasound at the first time is 25,2%, at the second time is 8.0%, both of them are 30.4%. Average D-dimer concentration in the patients without deep venous thrombosis is 1466,27 ng/ml, in the patients with deep venous thrombosis is 2864,93 ng/ml; average D-dimer concentration in the patients without deep venous thrombosis and with thrombosis are different satistically (p <0.001). The sensitivity and specificity of D-Dimer to two times ultrasound is 80.4% and 40.8%. The positive predictive value is 23.3%. The negative predictive value is 94.4%. D-Dimer concentrations are different in levels in Wells score (p=0.001). The negative D-Dimer test helps us eliminate the deep venous thrombosis diagnosis in the elderly patients (≥ 60 years) with average – high deep venous thrombosis risk in Wells score.

We conducted this study to investigate the etiology and histopathological characteristics of kidney diseases in elderly patients undergoing kidney biopsy at Thong Nhat Hospital. This cross-sectional, retrospective study included all patients who underwent kidney biopsy at Thong Nhat Hospital from the period between May 2012 and May 2022, excluding cases with (1) inadequate samples for pathological analysis, (2) repeated biopsies and (3) incomplete medical records. The results showed that steroid-resistant nephrotic syndrome was the leading indication for kidney biopsy in the elderly (64%). Primary glomerular diseases were the leading cause of kidney diseases, with focal segmental glomerulosclerosis and membranous nephropathy being the commonest types, accounting for 32,5% and 19,4%, respectively. In contrast, minimal change disease and IgA nephropathy were less common than in younger patients. Additionally, diabetic nephropathy and tubulointerstitial lesions appeared more frequently in the elderly group. Our study revealed that the histopathological features of kidney diseases in elderly patients differ significantly from those in younger patients, with a higher prevalence of focal segmental glomerulosclerosis and membranous nephropathy. Therefore, early and accurate recognition of these features is crucial for precise diagnosis, prognosis, and appropriate treatment of kidney diseases in the elderly.

Diabetes mellitus remains a major risk for lower extremity artery disease. The ankle-brachial index (ABI) is a noninvasive technique for assessing the lower extremity artery disease. To estimate the ABI in older patients with diabetes mellitus. This case series study was conducted on the older patients with diabetes mellitus from 01/12/2021 to 31/05/2022 at Department of Cardiology in Thong Nhat Hospital. This study included 100 patients aged ≥ 60 years (mean age 72.5 ± 8,1years; male 54.0%). 71.0% of patients had diabetes mellitus with duration of diagnosis more than 5 years and 21,0% of patients has been being treated with insulin. The rates of comorbidities: hypertension (94,0%), dyslipidemia (62,0%), coronary artery disease (21,0%), history of ischemic stroke (3,0%), and heart failure (18,0%). There was 22 patients having claudication. The rates of ABI: ≤ 0.9: 27.0% and 1-1.4: 73.0%. No patient in our study had ABI higher than 1.4. In our study, 27.0% of diabetic patients had ABI of  ≤ 0.9 and 22.0% of patients had claudication.

To evaluate the effectiveness of the medical waste management
intervention program at the Department of Traumatology - Orthopedics and the Department of Urology, Thong Nhat Hospital in 2024. Intervention study, conducted on 31 nurses in two departments. The intervention program includes: knowledge training, distribution of medical waste classification instruction cards, improvement of classification means, and increased monitoring. The effectiveness is assessed through changes in knowledge, attitudes, practices, and costs of medical waste treatment before and after the intervention. After the intervention, the proportion of nurses with high knowledge increased from 0% to 96.8%, and satisfactory practice from 41.9% to 83.9% (p < 0.01). Waste treatment costs decreased by 30.8% thanks to correct classification. However, attitudes did not change significantly (p = 0.54). The factor of seniority is related to knowledge and practice (p < 0.01). The intervention program has significantly improved nurses’ knowledge and practice in classifying medical waste, contributing to a reduction in the cost of waste treatment in hospitals. This program needs to be expanded and maintained regularly.

Bowel obstruction due to colorectal cancer is a common emergency complication, especially in elderly patients with multiple comorbidities, requiring optimal surgical treatment decisions to improve clinical outcomes.To evaluate the effectiveness of one-stage right hemicolectomy with primary anastomosis in the management of bowel obstruction due to colon cancer at Thong Nhat Hospital. A retrospective and prospective descriptive case series study was conducted on 48 patients with bowel obstruction due to right-sided colon cancer who underwent one-stage right hemicolectomy with primary anastomosis at Thong Nhat Hospital from January 2019 to December 2024. Evaluation parameters included clinical characteristics, surgical methods, complications, and early treatment outcomes. The mean age of patients was 62.3 ± 13.2 years, with males accounting for 58.7%. Laparoscopic surgery was performed in 17 cases (35.4%) and open surgery in 31 cases (64.6%). The overall early complication rate was 16.7%, with the laparoscopic group showing a lower rate than the open surgery group (5.9% vs 22.6%). Mean hospital stay in the laparoscopic group was significantly shorter than the open surgery group (7.8 ± 2.4 vs 10.2 ± 3.5 days). The anastomotic leak rate was 2.1% and mortality rate was 2.1%. One-stage right hemicolectomy with primary anastomosis is a safe and effective method for treating bowel obstruction due to colon cancer. Laparoscopic surgery showed better outcomes regarding recovery time and reduced complications compared to open surgery.

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.

Osteoporosis is a skeletal disorder characterized by compromised bone strength and increased fracture risk. In Vietnam, the disease affects ~30% in postmenopausal women and ~10% in men over 50, highlighting a growing public health challenge as the population ages. Bisphosphonates remain the standard firstline treatment. Recent advances in bone biology highlight the critical role of the RANK/RANKL/OPG pathway in bone remodeling. Osteoporosis arises when the RANKL/OPG ratio becomes imbalanced. Denosumab, a monoclonal antibody that targets RANKL, replicates OPG’s ability to suppress osteoclast activity, increasing bone mineral density and reducing fracture risk by 20–68% across various skeletal sites. Unlike bisphosphonates, Denosumab is reversible, metabolized by the reticuloendothelial system, and appropriate for patients with advanced kidney disease, though it necessitates monitoring for hypocalcemia. This advancement offers clinicians a valuable tool for managing osteoporosis in Vietnam.

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.

Surgical treatment has been the standard of care in selected cases with solid tumors or uterine benign diseases. However, a majority of patients are unable to undergo surgical resection because of the tumor locations, advanced stages, or poor general condition. For patients who are not suitable for surgery or unwilling to undergo surgical treatment, high-intensity focused ultrasound (HIFU) ablation surgery is a new option. HIFU is a novel non-invasive technique that can generate coagulative necrosis at a precise focal point within the body, without damaging to the surrounding structures of the target lesions, even within the path of the beam. Ultrasound guided HIFU (USgHIFU) was first used in the treatment of bone tumors in the 1990s. Over the last two decades, this technology has made significant progress and is now widely used in the treatment of various solid tumors and benign diseases of certain organs. Currently, both magnetic resonance imaging guidance focused ultrasound surgery (MRgFUS) and USgHIFU are commercially available. Each of these two types of HIFU systems has its own advantages in guidance. USgHIFU has higher treatment efficiency, with shorter treatment time, and can treat a wider range of diseases than that of MRgFUS. Recently, HIFU has been proven to be beneficial as an adjunct in the treatment of cardiovascular diseases. In addition, MRgFUS allows for non-invasive treatment of intracranial lesions is another significant advancement in the field of therapeutic ultrasound. Histotripsy was recently approved by the U.S. Food and Drug Administration (FDA) for hepatic targets. Last year, the Focused Ultrasound Foundation announced that focused ultrasound has been used for the treatment of over 170 diseases. As advances in engineering technology, including guidance techniques for the fusion of ultrasound and MRI, as well as optimization of transducer, are making HIFU treatments easier, safer, and more efficacious. This technique may play a key role in future clinical practice.

As Vietnam’s population ages rapidly, the health system faces increasing demands for long-term, integrated, and person-centered care for older adults. To meet these challenges, the “Treatment Triangle” model has been proposed, comprising three interconnected pillars: (1) home and community-based care, (2) hospitalbased specialized treatment, and (3) rehabilitative and nursing care at dedicated centers. Together, these pillars form a continuum of care that emphasizes prevention, early detection, comprehensive management of chronic diseases, and recovery of physical and psychological function. This paper describes the structure, roles, and interconnections of each component and discusses how this model could serve as a sustainable and humane framework for geriatric care in Vietnam.

Evaluate the clinical efficacy of silver-containing antimicrobial dressings on superficial burn wounds. A prospective study involving 32 patients treated for thermal burns at the Trauma and Orthopedic Surgery Department of Thong Nhat Hospital. The patients were dressed with silver-containing antimicrobial bandages, and clinical efficacy was assessed based on the local wound progression. The dressing adhered well to the wound, was easy to change, and caused minimal pain and bleeding during dressing changes. The average treatment duration was 11.2 ± 5.8 days. Only 9.4% of patients experienced wound infection. Silver-containing antimicrobial dressings are effective in the clinical management of superficial thermal burn wounds.

Colorectal cancer is one of the most common malignancies with high incidence and mortality rates. KRAS and BRAF mutations play a crucial role in its pathogenesis and prognosis, but their association with clinical characteristics in Vietnam requires further investigation. To investigate the prevalence of KRAS and BRAF mutations in colorectal cancer patients and analyze their relationship with clinical, epidemiological, and disease-stage features. A retrospective descriptive study was conducted on 92 colorectal cancer patients diagnosed and treated at Thong Nhat Hospital from February 2020 to December 2024. Data included demographic characteristics, clinical symptoms, tumor location, disease stage, and genetic mutation test results. The median age of patients was 66, with a male/female ratio of 2.1. Common symptoms included abdominal pain (71.7%) and bloody stools (38%). The mutation rates were 35.9% for KRAS (predominantly G12D and G12V), 6.5% for BRAF, and no NRAS mutations were detected. KRAS and BRAF mutations showed no significant association with age, gender, clinical symptoms, or disease stage (p>0.05), but were linked to peripheral lymphadenopathy (p=0.035). KRAS and BRAF mutations are relatively common in colorectal cancer patients but are not strongly associated with clinical features or disease stage. Genetic testing remains essential for personalized diagnosis and treatment.

Appendiceal peritonitis is a common surgical emergency, particularly dangerous in the elderly due to atypical symptoms and high risk of complications. However, studies on the clinical and paraclinical characteristics of this condition in this age group in Vietnam remain limited. To describe the clinical and paraclinical features of appendiceal peritonitis in elderly patients at Thong Nhat Hospital, while analyzing risk factors associated with complications and hospital stay duration. A retrospective cross-sectional descriptive study was conducted on 39 patients aged ≥60 diagnosed with appendiceal peritonitis and undergoing surgery at Thong Nhat Hospital from October 2023 to October 2024. The mean age of patients was 71.9, with a nearly equal male/female ratio (48.7%/51.3%). Right lower quadrant pain was the most common symptom (48.7%), but only 20.5% of patients had mild fever. Leukocytosis (≥10 G/L) was observed in 74.4% of cases, and CRP ≥10 mg/L in 41%. CT scans detected infiltration in 76.9% of patients. Comorbidities such as hypertension (38.5%) and diabetes (20.5%) increased the risk of complications and prolonged hospital stays. The age group ≥70 had a higher rate of appendiceal necrosis (66.7%) compared to the 60–69 age group (38.1%). Appendiceal peritonitis in the elderly presents with atypical clinical features, often leading to delayed diagnosis. Comorbidities and advanced age are significant risk factors for severe complications. Imaging plays a crucial role in early detection and disease severity assessment.

This study aimed to: (1) describe the clinical and paraclinical characteristics of patients with CAP; and (2) assess the prognostic value of the CURB-65 score in determining disease severity and predicting the need for hospitalization. A retrospective descriptive study was conducted on 250 adult patients diagnosed with CAP at Thong Nhat Hospital (Vietnam) between April 2023 and April 2025. Clinical symptoms, laboratory findings, chest radiography, and CURB-65 scores were collected and analyzed using SPSS 20.0. The correlation between CURB-65 and hospitalization was assessed using chi-square tests. The most common clinical symptoms were productive cough (74%), fever (67.6%), and dyspnea (54%). Radiographic abnormalities predominantly involved the right lung (43.6%). Elevated CRP (>5 mg/dL) and leukocytosis (>10,000 cells/mm³) were observed in 89.2% and 61.6% of patients, respectively. Among hospitalized patients, the majority had CURB- 65 scores ≥2 (p < 0.001). All patients with scores ≥4 were admitted to the ICU. CURB-65 is a simple and effective tool for initial risk stratification in patients with CAP. Its predictive value for hospitalization and intensive care admission supports its routine use in clinical practice, particularly in resource-limited settings.

The global demand for organ transplantation is steadily increasing; however, the availability of donor organs remains limited. Optimal management of potential organ donors from the time of brain death diagnosis until the completion of organ procurement is crucial to maximize graft function. This research presents a case series describing three successful cases of brain-dead organ donation conducted at Thong Nhat Hospital. The donated organs included liver, kidneys, heart, and corneas, which were subsequently transplanted at various medical centers. To ensure graft survival, all donated organs must be maintained in a physiologically stable condition until procurement. Providing intensive care and protecting the organs of the donor is the first step toward ensuring a successful transplant in the future.

To evaluate arterial blood gas test results in patients with acute exacerbation chronic obstructive pulmonary disease (AECOPD). Cross-sectional descriptive study, evaluating blood gas results on 150 patients diagnosed with AECOPD, inpatient treatment at the Respiratory Department in Thong Nhat Hospital from January 2023 - March 2024.  The majority of patients (80%) have decreased PaO2 and 60% of patients have increased PaCO2. The average value of some blood gas indicators: pH 7.37 ± 0.08, PaO2 61.2 ± 10.5, PaCO2 48.3 ± 8.2, HCO3- 27.1 ± 3.4. There were 126 patients with COPD exacerbated hospitalization (84%) with respiratory failure manifested in arterial blood gas Respiratory failure characteristics according to arterial blood test in the study were mainly increased PaCO2 accounting for 30%, in patients with mixed respiratory failure had 26% and reduced respiratory depression PaO2 had 32%.  Arterial blood gas is a significant test for diagnosis the respiratory failure and discovered acid- base disorders.

Abdominal wall aggressive fibromatosis (Desmoid tumor) is a rare, locally invasive tumor with a high recurrence rate. This study reports a case of surgical resection of a large tumor and multi-material abdominal wall reconstruction, evaluating functional and aesthetic outcomes. A 29-year-old male presented with a 10x15cm abdominal wall mass, diagnosed as Desmoid tumor via biopsy. The patient underwent complete tumor resection, resulting in a significant abdominal defect. Reconstruction was performed using a combination of intraperitoneal onlay mesh (IPOM), rectus abdominis muscle flap, and fascia flap. Pathology confirmed R0 resection. The patient was discharged on day 7 without major complications. At 1-year follow-up, results showed excellent aesthetic and functional recovery with no recurrence. Surgical resection of Desmoid tumors combined with multi-material abdominal wall reconstruction is a feasible approach, ensuring long-term functional and aesthetic success. This case highlights the importance of selecting appropriate reconstruction techniques for large post-resection defects.

Retroperitoneal liposarcoma is a rare condition, accounting for approximately 15% of adult soft tissue tumors and has a high recurrence rate. We report a case of recurrent retroperitoneal tumor to evaluate and review treatment approaches. We report a case of a 45-year-old female with a history of surgical resection of a large pelvic retroperitoneal liposarcoma (23x12cm) in 2020, which was well-differentiated (Grade I) but had tumor cells in an ovarian cyst (Stage IIIB). After 3 years of follow-up, the patient was found to have a tumor recurrence at the lower pole of the right kidney measuring 37x38mm on CT scan. The patient underwent complete surgical resection of the recurrent tumor with negative margins (R0), and pathology confirmed well-differentiated liposarcoma (Grade I). After 9 months of followup, no recurrence has been detected. This case emphasizes the importance of regular postoperative follow-up, which helps detect early recurrence when tumors are still small, increases the possibility of complete treatment, and improves patient prognosis.

This study was conducted to evaluate the therapeutic efficacy and safety of electro-auricular acupuncture in the treatment of functional gastrointestinal disorders, as classified by Traditional Medicine. Thirty patients with digestive disorders were enrolled and received daily electro-auricular acupuncture for 14 consecutive days. Symptom severity was assessed at baseline D0, D7, and D14 using a standardized questionnaire. In the excess pattern group, a statistically significant improvement was observed in certain symptoms by day 7 (abdominal pain, p=0,04; borborygmus/bloating, p=0,008), with most symptoms showing marked reduction by day 14 (p<0,05). For the deficiency pattern group, most symptoms demonstrated significant improvement primarily at D14 (p<0,05); however, specific symptoms such as “sallow complexion/cold limbs” and “fatigue/poor appetite” showed improvement only at this later time point. The treatment was well-tolerated, and no serious adverse events were reported. Minor, self-limited side effects included pain at insertion (10%), mild bleeding (6,7%), and needle faint (3,3%). The findings suggest that electro-auricular acupuncture is an effective intervention for improving the symptoms of digestive disorders in both excess and deficiency patterns and possesses a favorable safety profile.

To evaluate the quality of life and associated factors among elderly patients with COPD attending the Respiratory Outpatient Clinic, Thong Nhat Hospital. A cross-sectional study was conducted on 240 patients aged ≥60 years with confirmed COPD according to GOLD 2025 criteria. Clinical data were collected, and QoL was assessed using the validated Vietnamese version of the St. George’s Respiratory Questionnaire for COPD patients (SGRQ-C). Statistical analysis included descriptive statistics, bivariate tests, and multivariate logistic regression to identify independent factors associated with poor QoL. The mean age was 72 ± 8 years; 41.3% were 60–69 years, 41.3% were 70–79 years, and 40.8% were ≥80 years. Males accounted for 86.2%; 75.4% had a history of smoking, and 71.7% had at least one comorbidity. The mean total SGRQ-C score was 50.2 ± 19.6, with the symptoms domain being the most impaired (58.5 ± 19.5). Overall, 47.9% of patients had low or very low QoL. Multivariate analysis showed that age ≥70 (OR=1.7), female gender (OR=3.1), history of hospitalization, need for caregiver support (OR=1.2), GOLD group E (OR=1.2), and acute exacerbations requiring hospitalization (OR=1.3) were independently associated with poor QoL (p<0.05). Elderly patients with COPD at Thong Nhat Hospital had significantly impaired QoL, particularly in physical activity. Advanced age, female gender, severe airflow limitation, frequent exacerbations, comorbidities, and smoking were key determinants of poor QoL. Routine QoL assessment and comprehensive interventions—including smoking cessation, pulmonary rehabilitation, comorbidity management, and psychosocial support—are essential to improve outcomes in this vulnerable population.

Employee job satisfaction and organizational commitment are key factors that determine the effectiveness, stability, and professional development of hospitals in general and public hospitals in particular. This study aims to explore and measure the factors affecting job satisfaction and employee engagement in the healthcare sector from the perspective of organizational culture. Research data was collected from 499 healthcare workers currently employed at Thong Nhat Hospital. Among them, 324 were female (64.9%) and 175 were male (35.1%). The VIF analysis results show that the observed variables had a maximum value of 8.010 and a minimum of 0.713. The test for multicollinearity violations revealed 12 direct impact relationships indicating employee job satisfaction. Of the 11 established factors, only 5 relationships corresponding to 5 factors showed statistical significance at the 5% level: reward and recognition (β = 0.217, p < 0.0001), teamwork (β = 0.200, p < 0.0001), fair compensation (β = 0.157, p < 0.0001), integrity promotion (β = 0.165, p = 0.002), and training and advancement (β = 0.137, p = 0.004). Bootstrapping results showed that 3 moderating variables were not statistically significant, as their p-values were greater than 0.05. There are five factors that positively influence job satisfaction and employee commitment in healthcare, ranked from highest to lowest impact: reward and recognition, teamwork, fair compensation, integrity promotion, and training and advancement.

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.