Research

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.

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.

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.

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.

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.

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.

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.

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.

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.

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).

 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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

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

Finger contractures, resulting from burns, trauma, or congenital anomalies, often lead to significant functional impairment. Z-plasty is a versatile reconstructive technique used to release scar contractures while preserving local tissue characteristics. This study aimed to evaluate the functional outcomes of different Z-plasty techniques in the surgical release of contracted fingers. We conducted a prospective descriptive case series involving 31 patients (38 fingers) undergoing Z-plasty for digital contractures. Depending on the location and severity of the contracture, three Z-plasty techniques were used: five-flap, double-opposing, and single 60° Z-plasty. Patients were followed for a mean of 5.6 months. Primary outcomes included range of motion (ROM), web space angle, and DASH scores. Complications and patient satisfaction (VAS) were also assessed. All techniques demonstrated significant improvements in finger extension and flexion. Mean extension deficit improved from −35.4° to −8.1°, and flexion increased from 62.3° to 81.7° (P < .001). The five-flap Z-plasty achieved the greatest gain in web space angle (from 24.2° to 46.8°). DASH scores decreased significantly from 47.6 to 21.8 (P < .001), with patient satisfaction increasing from 4.2 to 8.1 on VAS. Minor complications occurred in 5 patients (16.1%), with no cases of flap necrosis or wound infection. Z-plasty is an effective and low-risk technique for releasing digital contractures and restoring hand function. Five-flap and doubleopposing Z-plasty provide greater functional improvement in web space contractures, while single Z-plasty remains effective for linear joint contractures. These techniques offer reliable outcomes without the need for skin grafting, supporting their continued use in reconstructive hand surgery.

Heart failure with reduced ejection fraction (HFrEF) presents significant anesthetic risks during limb amputation, especially in patients with multiple comorbidities. This report describes two cases of male patients with HFrEF (EF 27% and 45%) undergoing emergency limb amputation under ultrasound-guided peripheral nerve block (PNB). The first patient, with stage V chronic kidney disease, received a supraclavicular brachial plexus block using 20 mL of 0.35% ropivacaine. Sensory onset occurred at 5 minutes, motor onset at 25 minutes, and analgesia lasted 13 hours. The second patient received adductor canal and popliteal sciatic nerve blocks using 35 mL ropivacaine and IV dexamethasone. Sensory onset was 20 minutes, motor onset 25 minutes, and analgesia lasted 21 hours. Both patients remained awake and hemodynamically stable throughout surgery, with no complications. These cases highlight the safety and efficacy of PNB in high-risk cardiovascular patients. Adjusted dosing strategies, especially in renal impairment, allowed prolonged analgesia without toxicity. Compared to general or spinal anesthesia, PNB avoids airway manipulation and minimizes hemodynamic fluctuations.

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