Research

Osteoarthritis is a chronic musculoskeletal disorder characterized by pain, functional impairment, and diminished quality of life, with knee, hip, and hand osteoarthritis representing the most prevalent clinical manifestations. This study aimed to analyze patient characteristics and patterns of medication utilization in the outpatient management of osteoarthritis at Thong Nhat Hospital during the period from 2016 to 2024. A retrospective cross-sectional study was conducted involving 40,916 patients diagnosed with osteoarthritis based on ICD-10 codes M16, M17, and M18. The results indicated that knee osteoarthritis accounted for most cases (97.28%). The mean age of patients was 59 years, with most patients belonging to the 30–65 and ≥65 age groups. A high prevalence of comorbid conditions was observed, particularly cardiovascular diseases and metabolic disorders. Oral NSAIDs were the most frequently prescribed medications (66.2%), followed by analgesics and topical NSAIDs. Co-prescription network analysis demonstrated that oral NSAIDs occupied a central position in most medication combination patterns, especially among patients with knee osteoarthritis, who exhibited a higher degree of polypharmacy compared with patients with osteoarthritis affecting other joint sites. These findings provide evidence to support individualized treatment strategies and to improve the effectiveness of osteoarthritis management in the Vietnamese clinical context.

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.

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.

Most epidemiological and observational clinical studies in Vietnam are conducted on hospitalized patients, frequently lacking a control group. Despite their practicality and data accessibility, these studies are often utilized to address questions that exceed the inferential capacity of their design. In this article, I analyze the methodological limitations of hospital-based epidemiological research, particularly in the absence of a control group, within the context of medical research in Vietnam. Drawing on conceptual analysis and epidemiological principles, the article discusses common sources of bias in hospital-based studies, including selection bias, collider bias, the lack of control groups, and the regression toward the mean phenomenon. Inpatients represent a highly selected population, influenced not only by disease severity but also by healthcare accessibility, referral pathways, and socio-economic factors. Conditioning the analysis on a hospitalized group can distort the association between exposure and disease, creating spurious correlations or masking true causal relationships. Without a control group, observed associations are easily misinterpreted as population-level risk factors. Furthermore, before-after studies in hospitals are susceptible to regression toward the mean, leading to inaccurate evaluations of intervention efficacy. Prognostic models developed from inpatient data may perform well in training environments but often fail to generalize to broader settings. While hospital-based research remains vital for describing severe illness, inpatient prognosis, and evaluating care processes, its inferential scope is inherently limited. Clearly identifying these methodological boundaries and anchoring interpretations to sampling conditions is essential to avoid biased conclusions and to enhance the quality of medical research in Vietnam.

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.

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.

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.

To evaluate the effectiveness of early mobilization on patients after gastrointestinal surgery. This is a cross-sectional study observed on 78 patients who underwent gastrointestinal tumor surgery at the Department of Gastrointestinal Surgery, Thong Nhat Hospital, from October 2024 to June 2025. We collected and analyzed data on age, sex, time to first flatus, Visual Analog Scale (VAS) pain scores, Timed Up and Go test performance, postoperative complications, and time to discharge. Physiotherapy was typically initiated two days postoperatively and combined respiratory with mobility training. Patients who achieved early mobilisation demonstrated earlier return of bowel function, shorter hospital stay, lower VAS pain scores, and better functional mobility as indicated by shorter Timed Up and Go test durations at postoperative days 1, 3, and 7 compared with those without early mobilization. The study demonstrated that the early mobilization group had an earlier time to first flatus, shorter length of hospital stay, lower pain levels, and better functional mobility compared with the non-early mobilization group.

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.

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.

Autologous Platelet-Rich Plasma (PRP) is an increasingly popular biological therapy in sports medicine and rehabilitation, particularly for periarticular soft tissue pathologies of the shoulder. To evaluate the clinical efficacy of autologous PRP in treating simple shoulder periarthritis over a 4-month follow-up period and to analyze factors associated with treatment outcomes. Methods: A longitudinal clinical intervention study was conducted on 30 patients diagnosed with simple shoulder periarthritis. After 4 months, the mean Visual Analogue Scale (VAS) score significantly decreased from 5.6 to 2.6, accompanied by improvements in ultrasonographic findings. Greater pain reduction was observed in younger patients. Adverse effects were primarily limited to mild, self-limiting injection-site pain resolving within 3 days. Autologous PRP is a safe and effective treatment for shoulder periarthritis, especially in younger populations.

To evaluate the safety and mid-term outcomes of laparoscopic right hemicolectomy in elderly patients (≥65 years old). A retrospective descriptive study was conducted on 52 patients aged ≥65 years who underwent laparoscopic radical right hemicolectomy with lymph node dissection at Thong Nhat Hospital from 01/2020 to 01/2025. Data analysis was performed using SPSS software version 25.0. The early complication rate was 15.4%, and the 30-day mortality rate was 1.9%. The median number of harvested lymph nodes was 13.2 (92.3% of patients had ≥12 nodes). The 36-month disease-free survival (DFS) and overall survival (OS) rates were 62.5% and 68.9%, respectively. Only 55.6% of indicated patients completed the adjuvant chemotherapy regimen. Laparoscopic right hemicolectomy is a safe, feasible, and oncologically sound procedure for elderly patients. The mid-term survival outcomes were impacted by a low adjuvant chemotherapy completion rate.

Killian’s polyp (antrochoanal polyp) accounts for approximately 4% to 6% of all nasal polyps. However, the attachment site of Killian’s polyp is located within the maxillary sinus, making it difficult to visualize and access directly. According to a study by F. Galluzzi in 2018, the recurrence rate after surgery is 15%. Therefore, identifying the attachment site of Killian’s polyp is essential. Objective: To investigate the endoscopic and CT-scan characteristics, as well as the attachment site of Killian’s polyp. Materials and Methods: A case series study using both retrospective and prospective sampling methods. Results: The male-to-female ratio was 1.85:1. Most patients presented in the late stage, with 89.2% showing partial or complete obstruction of the choana. On CT scan, opacification of sinuses on the same side as the polyp was observed in the following order: maxillary sinus (100%), anterior ethmoid (67.6%), posterior ethmoid (41.5%), frontal sinus (24.3%), and sphenoid sinus (16.2%). An accessory maxillary sinus ostium was detected on the polyp side in 49% of cases and on the contralateral side in 16.2%, with a statistically significant association (p = 0.018 < 0.05). Among 37 patients with Killian’s polyp, 6 (16.2%) had contralateral maxillary sinus cysts. All six of these had small polyps within the maxillary sinus, and the attachment site was identifiable. In 16.2% of cases with partial opacification of the maxillary sinus on CT scan, the attachment site could be determined, whereas in 83.8% with complete opacification, the site could not be identified. Killian’s polyp most commonly originated from the medial wall (13 cases, 35.1%), followed by the posterior wall (9 cases, 24.3%), inferior wall (4 cases, 10.8%), and rarely from the anterior wall (3 cases, 8.1%). No cases originated from the superior wall of the maxillary sinus. During surgery, the accessory maxillary ostium was more clearly and accurately identified than on CT scans (59.5% vs. 49%). The presence of concha bullosa was not associated with Killian’s polyp (p > 0.05). Nasal septal deviation was observed in 20 of 37 cases (54%). There was no statistically significant correlation between the polyp’s side and the side of septal deviation (p = 0.501 > 0.05). Conclusion: Most patients presented at a late stage. Maxillary and ethmoid sinus opacification are the most common imaging findings in patients with Killian’s polyp. There is a statistically significant association between the presence of an accessory maxillary ostium and the side of the Killian’s polyp. The polyp attachment site is more clearly identified during surgery than on CT scans.

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.

46 patients (patients) with proximal humerus fractures were operated on at Thong Nhat Hospital from January 2019 to April 2024. They were divided into 2 groups, group 1: 22 patients with the support of 3D printing models and group 2: 24 patients without 3D models. All patients were open reduction and internal fixation with a locking plate on the proximal humerus. The patients were evaluated for bone healing and deformity on X-ray, and shoulder function was assessed according to the Constant scale. Surgical time of group 1 (90.68 ± 13.029) was shorter than group 2 (105.25 ± 12.037). Mean blood loss of group 1 (164.55 ± 50.042) was less than group 2 (218.75 ± 28.789). Shoulder function were very good and good, accounting for a high rate of 82.6%, and there was no difference between the 2 groups. Postoperative complications had a low rate and there was no difference between the 2 groups in wound surface infection and subacromial conflict. Complications of screw perforation, osteomyelitis, and bone nonunion have not been observed.

Osteoporotic vertebral compression fractures are a major cause of back pain and reduced spinal function in elderly patients. To evaluate the pain-relieving effectiveness of vertebroplasty in patients with osteoporotic vertebral compression fractures. A prospective study was conducted on 26 patients, assessing VAS, Macnab, and ODI scores before and after cement vertebroplasty, analyzed according to the number of fractured vertebrae. VAS scores significantly decreased from 4.85 ± 0.61 to 1.81 ± 0.49 after the procedure (p < 0.001). Macnab and ODI scores also improved markedly, with pain relief observed even in patients with multiple fractured vertebrae. Vertebroplasty is a minimally invasive procedure that effectively reduces pain and improves spinal function in patients with one or multiple osteoporotic vertebral fractures.

The objective of this study was to use the fluorescent marker method to evaluate the effectiveness of an intervention aimed at improving environmental surface cleaning quality, while also investigating the correlation between cleaning staff’s awareness of protocols and the adequate provision of cleaning supplies (wipes and chemicals) at Thong Nhat Hospital. Subjects and Methods: A cross-sectional descriptive study with intervention was conducted on 446 high-touch surface locations at the Department of Internal Medicine (Service sector) and the Department of VIP (Senior Officials Treatment). Hygiene quality was assessed using the fluorescent marker method, comparing results before and after interventions that included staff retraining on knowledge and the supplementation of cleaning tools (wipes). Results: The proportion of completely cleaned surfaces increased significantly from 45.6% pre-intervention to 79.4% post-intervention. Post-intervention cleanliness rates across surface groups ranged from 63.8% to 89.2%, significantly higher than the pre-intervention range (22.8% - 62.3%). Additionally, the percentage of staff mastering the protocols rose from 68% to 82%, and the average number of wipes used per room increased from 2.42 to 3.63. Conclusion: The fluorescent marker method serves as an objective tool that reflects the actual quality of environmental hygiene more accurately than visual observation. The findings confirm the positive impact of knowledge training and the provision of adequate cleaning supplies in improving hospital surface cleaning quality.

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.

To evaluate the treatment outcomes of using radiofrequency ablation for chronic lumbar facet joint pain. This was a non randomized, interventional study conducted on patients with chronic lumbar facet joint pain who were treated with radiofrequency ablation at the Department of Neurosurgery, Thong Nhat Hospital, Ho Chi Minh City, from September 2024 to April 2025. We included 15 patients who met the study criteria. The mean VAS scores after the intervention at 1 week, 1 month, and 3 months were 3.4 ± 1.05; 1.7 ± 1.1; and 1.4 ± 0.91, respectively. The application of radiofrequency ablation for treating chronic lumbar facet joint pain is a method that initially shows effectiveness and safety.

Evaluation of the analgesic effect of low-power intravascular laser combined with electroacupuncture compared to electroacupuncture alone in patients with chronic low back pain treated at the Traditional Medicine Department of Thong Nhat Hospital. 60 patients with confirmed diagnosis of chronic back pain at the Department of Traditional Medicine, Thong Nhat Hospital. Patients were randomly divided into 2 groups. The control group (n=30) was treated with electroacupuncture; the intervention group (n=30) was treated with low-power intravascular laser combined with electroacupuncture similar to the control group. The treatment course was continuous for 10 days, once a day. Treatment effectiveness was assessed based on the VAS pain scale assessed after 5 and 10 days of treatment. After 10 days of treatment, the VAS pain score was 2,42 ± 1,67 in the control group and 1,57 ± 1,48 in the intervention group. Both groups experienced a reduction in pain to the levels of no pain (0–2 points) or mild pain (2–4 points). The intervention group demonstrated superior pain relief starting from day 5, reaching statistical significance by day 10 (p = 0.03 < 0.05). Combining electroacupuncture with intravascular low-level laser therapy  enhance effeciency in relive pain due to lumbago. No significant side effects were noted.

Open tibial shaft fractures are common injuries, accounting for the highest proportion of open long bone fractures. External fixation, particularly the FESSA frame, is highly valued for its safety, ease of application, and convenience in soft tissue wound care. To evaluate the outcomes of treating open tibial shaft fractures using the FESSA external fixation system at Thong Nhat Hospital. A retrospective cross-sectional study was conducted on 53 patients with open tibial shaft fractures treated with the FESSA frame. Bone healing was assessed using the RUST scoring system, and functional recovery was evaluated using the Karlström-Olerud criteria. The bone union rate was 92.3%, with an average healing time of 6.75 ± 3.44 months. Good and excellent functional recovery outcomes accounted for 87.5%. The FESSA external fixation system is an effective method for managing open tibial shaft fractures.

To assess the clinical effectiveness of 3D-printed models in minimally invasive plate osteosynthesis (MIPO) for ankle fractures, compared with conventional surgical planning. Methods: A quasi-experimental study was conducted at Thong Nhat Hospital from January 2024 to January 2025. Twenty-eight patients with ankle fractures were enrolled and divided equally into two groups (n = 14 each): one managed with 3D-assisted preoperative planning and the other with conventional methods. Results: The 3D-assisted group demonstrated significantly better intraoperative and postoperative outcomes. Mean operative time was shorter (55.3 ± 6.6 vs. 68.1 ± 5.3 minutes, p = 0.001), blood loss was lower (75.5 ± 10.2 vs. 110.3 ± 15.7 ml, p < 0.001), and C-arm exposure was reduced (10.8 ± 1.1 vs. 17.2 ± 1.5 shots, p = 0.003). Functional recovery was superior, with higher Rasmussen scores at 3 months (26.7 ± 1.3 vs. 23.4 ± 2.1, p = 0.002). Postoperative complications were also less frequent in the 3D group. Conclusion: Preoperative 3D printing significantly enhanced surgical accuracy and clinical outcomes in ankle fracture management. Patients treated with 3D assistance experienced shorter operations, reduced intraoperative blood loss, fewer fluoroscopic exposures, improved functional recovery, and a lower complication rate.

Exercise is a cornerstone of health promotion, yet current guidelines primarily emphasize frequency, intensity, and duration, with limited attention to the timing of exercise. Emerging evidence suggests that physiological responses to exercise are modulated by circadian rhythms, potentially influencing performance, metabolic outcomes, and sleep quality. Materials and methods: A narrative review was conducted using studies retrieved from PubMed and Scopus, covering the period from 1996 to 2026. A total of relevant studies, including experimental studies, observational studies, systematic reviews, and meta-analyses, were included. Results: Physical performance, particularly muscle strength and endurance, tends to peak in the afternoon or early evening, corresponding with higher core body temperature and optimal neuromuscular function. In contrast, morning exercise, especially in the fasted state, may enhance fat oxidation and insulin sensitivity, while evening exercise may improve postprandial glycemic control. Importantly, chronotype significantly influences these responses. Conclusion: There is no universal optimal time for exercise. Instead, aligning exercise timing with individual circadian characteristics may optimize physiological benefits. Future research should focus on long-term, stratified interventions to establish personalized exercise timing recommendations.

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.

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.