Research

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.

To evaluate the nutritional status of cancer patients undergoing treatment at the Oncology Department, Tay Nguyen Regional General Hospital in 2025. A cross-sectional descriptive study was conducted on 80 inpatient cancer patients from August to October 2025. Nutritional status was assessed using the Body Mass Index (BMI) and the Patient-Generated Subjective Global Assessment (PG-SGA) tool. The rate of malnutrition according to BMI was 58.8%. According to PG-SGA, 66.3% of patients were at risk of malnutrition or were malnourished, severe malnutrition accounting for 16.2%. The most common symptoms were fatigue (70.0%), anorexia (65.0%), and nausea (58.0%). The rate of malnutrition and the risk of malnutrition among cancer patients are very high. It is necessary to strengthen nutritional screening, early nutritional assessment, and timely nutritional intervention during the treatment process.

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.

Melasma is a chronic hyperpigmentation disorder with multifactorial pathogenesis, involving melanocyte hyperactivity, low-grade inflammation, oxidative stress, and vascular alterations. Current treatment modalities remain limited by suboptimal long-term efficacy and high recurrence rates. Intradermal microinjection has emerged as a promising approach to deliver active agents directly into the dermis and target multiple pathogenic pathways. Materials and methods: A narrative review was conducted by systematically searching biomedical databases for studies investigating the mechanisms, efficacy, and clinical applications of microinjection therapy in melasma. Results: Available evidence suggests that microinjection, particularly with tranexamic acid, significantly improves pigmentation by inhibiting melanogenesis, reducing inflammation, and modulating vascular factors. Compared to topical therapies, it provides faster clinical improvement, and compared to energy-based devices, it demonstrates a more favorable safety profile in darker skin types. However, sustained outcomes depend on combination strategies and strict control of triggering factors. Conclusion: Intradermal microinjection is a biologically plausible and clinically effective modality in melasma management. Optimization of technique and integration into multimodal treatment strategies are essential for achieving durable outcomes.

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.

Left ventricular noncompaction cardiomyopathy (LVNC) can lead to ventricular arrhythmias and may be misdiagnosed as arrhythmia-induced cardiomyopathy (AiCM). While LVNC is associated with genetic abnormalities, AiCM is triggered by arrhythmias and is typically reversible once the arrhythmia is eliminated. We report the case of a 59-year-old woman with LVNC carrying three TTN gene variants: c.100804A>T (p.Met33602Leu, exon 358), c.59200C>G (p.Pro19734Ala, exon 300), and c.52052T>C (p.Val17351Ala, exon 273). The patient was initially diagnosed with AiCM but showed no recovery of left ventricular function after successful catheter ablation of ventricular arrhythmias. Echocardiography and cardiac magnetic resonance imaging confirmed the LVNC phenotype. This case highlights the importance of distinguishing between these two entities in clinical practice.

 Laparoscopic restoration of intestinal continuity after Hartmann’s procedure offers significant benefits but remains a considerable challenge for gastrointestinal surgeons. To evaluate the feasibility, safety, and efficacy of laparoscopic colostomy closure after Hartmann’s procedure at Thong Nhat Hospital. A retrospective descriptive analysis was conducted on 35 cases from February 2017 to May 2025. Patients who had undergone Hartmann’s procedure with an end colostomy and received laparoscopic intestinal continuity restoration were included. The laparoscopic success rate was 85.71%. Major complications included surgical site infection (30%), anastomotic leakage, and intestinal obstruction (3% each). The average operative time was 162 minutes, and the mean hospital stay was 9.3 days. There were no mortality cases. Laparoscopic reversal of Hartmann’s procedure is a feasible, safe, and effective method with a high success rate and low complication rate.

Postpartum contraception is vital for maternal and child health, yet counseling remains insufficient to meet actual needs. This study aims to determine the prevalence of correct knowledge and its associated factors among postpartum women at Tay Nguyen University Hospital in 2025. A cross-sectional study was conducted on 153 postpartum women with healthy infants at the Obstetrics Department of Tay Nguyen University Hospital from March to June 2025. The survey revealed that 13.7% of postpartum women possessed correct knowledge regarding contraception. Univariate logistic regression analysis identified several independent factors significantly associated with adequate knowledge levels, including age, residence, occupation, and parity (p < 0.05). Postpartum contraceptive knowledge among mothers remains low, with statistically significant differences observed across age groups, residency, occupations, and parity (p < 0.05).

Human Papillomavirus (HPV) is the primary causative agent of cervical cancer and genital warts, particularly prevalent in developing countries. Therefore, equipping medical and pharmaceutical students with in-depth knowledge of vaccine prevention is an urgent requirement to optimize the effectiveness of health counseling and community care. This study aimed to determine the rate of adequate knowledge regarding HPV and cervical cancer among students at the Faculty of Medicine and Pharmacy, Tay Nguyen University, in 2025. A cross-sectional descriptive study was conducted on 210 medical and pharmaceutical students at Tay Nguyen University from March 2025 to June 2025. The proportion of students with adequate knowledge of HPV was high, accounting for 93.3%. However, knowledge regarding cervical cancer pathology remained limited, with only 38.6% of participants achieving an adequate level. While the majority of students demonstrated good knowledge of HPV and its vaccine, there is a significant need to improve specialized knowledge concerning cervical cancer and post-vaccination screening measures.

To assess patients’ average level of knowledge regarding coronary artery disease and its associated factors at Tra Vinh Provincial General Hospital in the year 2024. A descriptive cross-sectional study was conducted on 128 patients diagnosed with coronary artery disease who came for examination and surgical treatment at the Cardiology Clinic at Tra Vinh Provincial General Hospital from May 2024 to July 2024 using the CADE-Q SV questionnaire. Our research results showed that 76.6% of patients had average knowledge and 23.7% of patients had poor knowledge; no patients had good knowledge; the rate of patients answering correctly for all questions was 45.04%; there was no correlation found between the knowledge of patients with coronary artery disease at Tra Vinh General Hospital and the factors surveyed at the time of the survey. Our research results showed that the knowledge of patients with coronary artery disease at Tra Vinh General Hospital in this study was still low, and there was no factors related to the rate of patients’ knowledge about coronary artery disease have been found.

The treatment of community-acquired pneumonia (CAP) has become increasingly challenging due to the growing antimicrobial resistance among bacterial pathogens. Rational antibiotic use is a key determinant of treatment effectiveness in patients with CAP. To investigate antimicrobial resistance patterns and antibiotic utilization in the treatment of communityacquired pneumonia at Hoc Mon Regional General Hospital. A descriptive cross-sectional study was conducted using 270 medical records of hospitalized patients diagnosed with communityacquired pneumonia at Hoc Mon Regional General Hospital from July 2024 to September 2024. The median age of patients was 69 years (interquartile range, 59–77), with 65.2% aged over 65 years. Gram-negative bacteria accounted for 93.2% of isolated pathogens, predominantly Klebsiella pneumoniae (24.1%) and Pseudomonas aeruginosa (15.5%). Klebsiella pneumoniae demonstrated susceptibility rates ranging from 70% to 100% to beta-lactam/beta-lactamase inhibitor combinations. Pseudomonas aeruginosa showed high susceptibility rates (89–100%). The most commonly prescribed empirical antibiotics were ceftriaxone (51.9%) and levofloxacin (40.4%). Overall appropriateness of empirical antibiotic therapy was 41.5%. Older patients, higher Charlson score, higher CURB-65 score, and ICU admission were factors associated with treatment failure. The antibiotics recommended for the treatment of community-acquired pneumonia remain largely effective against common causative pathogens at the hospital. However, adherence to treatment guidelines for empirical antibiotic selection was suboptimal, underscoring the need for targeted interventions to promote rational antibiotic use and improve the quality of infection management.

Chronic Obstructive Pulmonary Disease (COPD) is one of the leading causes of mortality and disability worldwide. Among elderly patients, COPD not only reduces quality of life but also places a significant burden on healthcare systems. Chronic inflammation plays a key role in the pathogenesis of COPD. In recent years, peripheral blood inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR) have gained attention as useful tools for assessing inflammation and predicting disease prognosis. However, in Vietnam, especially among elderly patients- research on the role of NLR in monitoring and managing COPD remains limited. Therefore, we conducted the study titled: “Investigation of Neutrophil-to-Lymphocyte Ratio in Elderly Patients with Chronic Obstructive Pulmonary Disease at Thong Nhat Hospital”. To determine the NLR levels in elderly patients with COPD and evaluate the relationship between NLR and disease severity. Additionally, to compare NLR values across different patient subgroups based on factors such as age, gender, BMI, medication usage, comorbidities, and to investigate the correlation between NLR and the inflammatory marker               CRP. Sectional descriptive study conducted on elderly COPD patients visiting the respiratory outpatient clinic at Thong Nhat Hospital. From January 2025 to May 2025, we collected data from 221 elderly COPD patients. The mean age was 71 (65-77) years, Males accounted for a higher proportion than females. The mean NLR was 3,3 (2,2 – 6,2), CRP (mg/L)  4,3 (2,6 - 9,5), NLR showed a weak but statistically significant negative correlation with FEV1 (r = -0.147, p < 0,029) and a statistically significant positive correlation with CRP (r = 0,5012, p < 0,0001). Our study demonstrates that NLR is weakly but significantly inversely correlated with pulmonary function (FEV1), and positively correlated with CRP levels, indicating its potential role in assessing disease severity and inflammatory status.

Cardiac surgery patients with elevated serum procalcitonin (PCT) levels are associated with postoperative complications. The use of extracorporeal circulation is linked to an increase in PCT levels within the first 24 hours after cardiac surgery. We conducted this study with the aim of investigating serum procalcitonin levels in patients after cardiac surgery. A cross-sectional, 52 cardiac surgery patients meeting the inclusion criteria for the study. The median serum PCT level was 3.2 pg/ml. The highest value was 175 pg/ml, and the lowest was 0.03 pg/ml. Serum procalcitonin levels between the group of cardiac surgery patients with and without the use of extracorporeal circulation were 20.7 (95% CI: 9.5-31.8) and 2.8 (0.03-5.7), respectively, p=0.15. The area under the ROC curve (AUC) of 0.42 indicates poor significance when relying on serum PCT to diagnose infection. Serum procalcitonin levels are elevated in patients after cardiac surgery. An elevated PCT value alone is not sufficient evidence to diagnose infection for clinical decision-making.

The COVID-19 pandemic had a widespread impact on all aspects of human life globally, and specifically on Phu Yen Province (now part of eastern Dak Lak Province) in Vietnam. Numerous studies reported significant declines in outpatient visits, hospital admissions, and healthcare service utilization during this period. Evaluating the changes in disease patterns and healthcare service delivery at Phu Yen Traditional Medicine Hospital from 2020 to 2023 is essential for guiding service quality improvements and strengthening preparedness for future public health emergencies. To assess the variation in inpatient disease patterns and describe healthcare service activities at Phu Yen Traditional Medicine Hospital between 2020 and 2023. Study subjects included all inpatient medical records with primary ICD-10 diagnosis codes at Phu Yen Traditional Medicine Hospital from January 1, 2020 to December 31, 2023. Research design: retrospective cross-sectional descriptive study. From 2020 to 2023, musculoskeletal and neurological diseases were the most common. In 2021, COVID-19 cases appeared, with a notable rise in infectious diseases among patients under 15 (94.6%). Clinical staffing remained stable; bed numbers increased from 2022. During the pandemic, patient visits declined but clearly recovered by 2023. Bed occupancy was lowest in 2021 (69.7%) and peaked in 2023 (113.8%). The inpatient disease pattern and hospital service activity at Phu Yen Traditional Medicine Hospital were notably affected by COVID-19, with a sharp decline in 2021 followed by recovery starting in 2022.

This study aim to investigate and characterize the imaging features of knee osteoarthritis (OA) using high-field 3.0 Tesla Magnetic Resonance Imaging (MRI) in a cohort of patients at Thong Nhat Hospital. A cross-sectional descriptive study was conducted on 156 patients with radiographically confirmed knee OA who underwent 3.0T MRI between November 2024 and May 2025. Pathologies of the menisci, cruciate ligaments, collateral ligaments, subchondral bone and joint space were systematically evaluated. Univariable and multivariable logistic regression analysis was employed to identify imaging features associated with OA. The study included 156 patients (mean age 55.8±10.6 years; 73 males). The majority of patients were classified radiographically as Kellgren-Lawrence (KL) grade I (n=99, 63.46%). Despite the prevalence of early-stage radiographic disease, 3.0T MRI revealed a high burden of soft-tissue pathology. The most common ligamentous injury was a partial tear of the anterior cruciate ligament (ACL) in 42 patients (27%), while medial meniscal tears were identified in 56 patients (35.9%). Mild joint effusion was a frequent finding, present in 107 patients (68.6%). In the multivariable model, age (Odds Ratio 1.03, 95% Confidence Interval [CI] 1.02–1.04), ACL injury (OR 1.14, 95% CI 1.02–1.28), posterior cruciate ligament (PCL) injury (OR 1.24, 95% CI 1.02–1.50), collateral ligament injury (OR 1.23, 95% CI 1.02–1.49) and lateral meniscal injury (OR 1.14, 95% CI 1.00–1.29) were identified as significant independent predictors of OA. High-field 3.0T MRI is a pivotal tool for the comprehensive assessment of knee OA, detecting a wide spectrum of radiographically occult soft tissue and bone marrow pathologies. These findings, particularly those related to ligamentous and meniscal integrity, are critical to understanding the disease's biomechanical underpinnings and may be present despite minimal radiographic changes.

Hospital-acquired infections (HAIs) are a major challenge, especially in intensive care units (ICUs), where they lead to increased morbidity, mortality, prolonged stays, and higher healthcare costs. This study aimed to determine HAI rates, identify causative microorganisms, and assess associated risk factors among inpatients at Thong Nhat Hospital's ICU in 2024. A cross-sectional analysis was conducted from January to June 2024, including all eligible ICU inpatients. Data collection utilized medical records. The prevalence of HAIs was 4.9%, with the most common types being hospital-acquired pneumonia, bloodstream infections, and urinary tract infections. The primary causative agents were Gram-negative bacteria such as Acinetobacter baumannii and Pseudomonas aeruginosa. Factors associated with HAIs included age, underlying medical conditions, duration of endotracheal intubation, tracheostomy, duration of tracheostomy, urinary catheterization, duration of urinary catheter use, duration of central venous catheter use, duration of nasogastric tube placement, and length of stay in the. The HAI rate was 4.9%. Factors associated with HAIs included age, comorbidities, invasive procedures, and length of ICU-PCU stay. Strengthening infection control measures is essential to reduce HAIs and improve patient outcomes.

Decellularized vascular grafts hold potential for small-diameter vascular reconstruction owing to the ECM integrity maintained and appropriate dimensions. However, the thrombogenicity of tissue-derived grafts represents a notable limitation for clinical application. This study focuses on assessing the effectiveness of heparin immobilization on cross-linked decellularized vascular grafts prepared from porcine carotid arteries. The Layer-by-Layer (LbL) assembly technique was applied to immobilize heparin on the graft surface to improve hemocompatibility. Following LbL treatment, the grafts were examined for heparin content and surface morphology using scanning electron microscopy (SEM). To assess their potential for vascular implantation, the biomechanical properties and hemocompatibility were further evaluated. SEM observations and heparin quantification confirmed successful heparin immobilization. Biomechanical testing was measured and found to be suitable for graft applications. In terms of hemocompatibility, in vitro anticoagulant activity assessment revealed a thromboresistant surface on the luminal surface of the grafts. In addition, hemolysis rates remained within the non-hemolytic threshold as defined by ISO 10993-4. In summary, the Layer-by-Layer heparin immobilization method effectively immobilized heparin onto reinforced decellularized vascular grafts, enhanced hemocompatibility, and represents a promising approach for the development of xenogeneic vascular graft materials.

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.

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.

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.

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.

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.