Vol. 1 No. 4 (2025): Healthcare in the Digital Age

Published: 2025-10-10

Review

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.


UPDATED GUIDELINE-BASED MANAGEMENT OF HEART FAILURE WITH REDUCED EJECTION FRACTION IN ELDERLY PATIENTS WITH LOW BLOOD PRESSURE

Trương Minh Khánh, Âu Dương Trung Hào, Ninh Hoàng Phong, Nguyễn Ngọc Phương Dung, Đào Duy Lượng, Nguyễn Văn Tân

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DOI: 10.63947/bvtn.v1i4.2

Heart failure with reduced ejection fraction (HFrEF) represents a major global health burden, characterized by high rates of morbidity, hospitalization, and mortality, particularly among elderly patients. Low blood pressure is a common condition in this population, associated with worse prognosis and challenges in optimizing guideline-directed medical therapy (GDMT). Evidence from randomized controlled trials and real-world studies demonstrates that the benefits of GDMT persist even in patients with low blood pressure. Among the foundational therapies, sodium–glucose cotransporter-2 inhibitors (SGLT2i) and mineralocorticoid receptor antagonists (MRA) have minimal hemodynamic effects and can be initiated early, whereas angiotensin receptor–neprilysin inhibitors (ARNi), angiotensin-converting enzyme inhibitors (ACEi), and beta-blockers (BB) should be started at low doses and carefully up-titrated. In Vietnam, prescription rates of GDMT remain limited; however, current evidence highlights the importance of maintaining GDMT to the maximum tolerated extent, alongside evaluating secondary causes of hypotension and tailoring therapy to individual patients. This review summarizes updated evidence, discusses pharmacodynamic considerations, and proposes clinical strategies for managing elderly patients with HFrEF and low blood pressure, emphasizing the role of comprehensive geriatric assessment in achieving safe and effective therapy


ANALYZING THE POSITIVE AND NEGATIVE ASPECTS OF APPLYING ARTIFICIAL INTELLIGENCE IN PUBLIC HEALTH MANAGEMENT: A FRAMEWORK FOR VIETNAM

Quan Quốc Đăng, Phan Văn Hùng, Nguyễn Thị Thảo Sương

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DOI: 10.63947/bvtn.v1i4.3

Artificial intelligence (AI) is emerging as a disruptive technology with the potential to revolutionize the field of public health management. This study, based on a situational analysis and systematic review, indicates that AI offers significant benefits in disease outbreak forecasting, resource optimization, and supporting human clinical decision-making. However, barriers related to input data quality, algorithmic bias, infrastructure costs, and inadequately regulated legal and ethical issues are persistent challenges for Vietnam. A proposed reference framework for Vietnam, grounded in a review of global research, includes for main pillars for the application of AI in public health management: (1) Data Foundation, (2) Technology and Infrastructure, (3) Human Resources, (4) Legal and Ethical Framework. This framework is expected to be a valuable reference for policymakers, health managers, and technology developers in Vietnam in the field of public health management and community health.


MAY-THURNER SYNDROME: WHAT RADIOLOGISTS NEED TO EVALUATE ON COMPUTED TOMOGRAPHY IMAGING?

Bùi Thị Thanh Tâm, Đỗ Võ Công Nguyên, Trần Thanh Phong, Huỳnh Nguyên Thuận

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DOI: 10.63947/bvtn.v1i4.4

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.

Original Paper

EFFECTIVENESS OF THE MEDICAL WASTE MANAGEMENT INTERVENTION PROGRAM AT THONG NHAT HOSPITAL IN 2024

Nguyễn Thị Tiến, Đoàn Xuân Quảng, Đoàn Thị Ngần, Lê Thị Hà Trang, Nguyễn Thị Thắm, Vương Thị Hoa, Võ Thành Toàn

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DOI: 10.63947/bvtn.v1i4.5

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.


ASSESSING THE IMPACT OF ORGANIZATIONAL CULTURE ON EMPLOYEE JOB SATISFACTION AND ENGAGEMENT AT THONG NHAT HOSPITAL

Cao Thị Hoài, Võ Thành Toàn, Cảnh Chí Hoàng, Đinh Kiệm, Nguyễn Thị Thanh Quang, Lê Thị Kim Cương, Nguyễn Văn Tài, Lê Đình Thanh

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DOI: 10.63947/bvtn.v1i4.6

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


OROPHARYNX PAIN, DISCOMFORT, AND ECONOMIC IMPACT OF TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN PATIENTS WITH ATRIAL FIBRILLATION

Nguyễn Văn Bé Hai, Lê Quốc Hưng, Nguyễn Thanh Huân, Nguyễn Thị Hường, Phạm Thị Thu Hiền

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DOI: 10.63947/bvtn.v1i4.7

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.

 

TREATMENT OUTCOMES OF URETERAL STONES IN ELDERLY PATIENTS USING URETEROSCOPIC LITHOTRIPSYAT THONG NHAT HOSPITAL, HO CHI MINH CITY

Lý Văn Quảng, Hạ Kỳ Văn, Nguyễn Đỗ Huy Hoàng

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DOI: 10.63947/bvtn.v1i4.8

Evaluation of the treatment outcomes of ureteral stones in super-elderly patients using retrograde ureteroscopic lithotripsy (URSL) at Thong Nhat Hospital, Ho Chi Minh City. A retrospective descriptive study was conducted on 68 patients aged 80 years and older who underwent URSL from January 2022 to January 2025. Data on patient characteristics, stone size and location, stone-free rates, operative time, hospital stay, complications, and factors affecting treatment outcomes were collected and analyzed. The mean age of patients was 83.7 ± 3.1 years, with 57.3% being male. The average stone size was 12.3 ± 3.8 mm; 36.8% of patients had stones larger than 1.5 cm, and 30.9% had stones located in the upper third of the ureter. The stone-free rate after the first ureteroscopic lithotripsy was 84.7%, which increased to 93.8% after the second session. However, 7.4% of patients still had residual stones, mainly due to difficult anatomical locations or ureteral edema. The mean operative time was 29.4 ± 9.7 minutes (range 19–48 minutes). Complications occurred in 12.1% of cases, most commonly urinary tract infection (5.8%), mild bleeding (2.9%), and minor ureteral injury (3.4%). The mean hospital stay was 7.2 ± 1.9 days. Retrograde ureteroscopic lithotripsy represents an effective and safe treatment modality in the super-elderly population, demonstrating high stone-free rates with an acceptable complication profile. However, individualized treatment planning is essential, particularly in cases involving large calculi, proximal ureteral stones, or significant underlying comorbidities.


To evaluate the treatment outcomes of lumbar spinal stenosis with instability in osteoporotic patients at Thong Nhat Hospital. A retrospective descriptive case series study on all cases of lumbar spinal stenosis with instability accompanied by osteoporosis (T-score < -2.5 SD) who underwent posterior lumbar interbody fusion (PLIF) combined with pedicle screw fixation using cement augmented cannulated screws at the Neurosurgery Department of Thong Nhat Hospital, Ho Chi Minh City, from June 2015 to June 2021. Among 59 patients meeting the inclusion criteria, all showed postoperative recovery. Nearly 50% had excellent outcomes, with significant reductions in back pain and a mean motor recovery time of 23 days post-surgery. According to the Japanese Orthopaedic Association (JOA) score: 49.1% had excellent improvement, 39% good, 11.9% moderate, and no poor outcomes were observed. Preoperative vs. discharge clinical symptoms showed significant improvement: VAS score for back pain decreased from 7.1 to 3.4 (p < 0.05), radicular leg pain from 6.44 to 3.76 (p < 0.05), and neurogenic claudication reduced from 68.12% to 7.2% (p < 0.05). According to Lee’s fusion assessment criteria: 72.9% achieved definite fusion (Grade A), 25.4% probable fusion (Grade B), and only one case showed pseudoarthrosis. Complications were rare and included cement leakage, surgical site infection, and dural tear. JOA score improvements were more pronounced in patients with 1 or 2 fusion levels and significantly higher in those with 3-level fusions. Posterior lumbar interbody fusion using cement-augmented cannulated screws is an effective surgical treatment for lumbar spinal stenosis with instability in osteoporotic patients, offering good recovery outcomes.


THE RESULTS OF ACL RECONSTRUCTION WITH REPAIR OF POSTERIOR HORN OF THE MENISCUS

Nguyễn Minh Dương, Võ Thành Toàn, Ngô Hoàng Viễn, Đỗ Duy

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DOI: 10.63947/bvtn.v1i4.10

To evaluate the results of ACL reconstruction with repair of posterior horn of the meniscus. prospective study of 34 patients with ACL rupture with posterior horn of the meniscus tear underwent elective knee arthroscopy at Thong Nhat hospital from March 2020 to March 2023. There are 17 males and 17 females.  Mean age was 36 years (from 18 to 50 years). Body mass index (BMI): average 24 (range 18 to 32). Mechanism of injury: 42.3% sports accidents, 32.7% traffic accidents, 25% daily life accidents. The mean time before surgery was 44 days (4-180 days). Posterior horn medial meniscus tear accounts for 38.2% of patients and lateral horn medial meniscus tear accounts for 61.8% of patients. Chondral lesions according to Outerbrigde: 70% grade 2, 17% grade 1 and 13% grade 3. After 1 year, the mean IKDC score was 78.28 points (from 68 to 83 points), the mean Lysholm score was 88.28 points (from 70 to 94 points). Patients with knee joint stability after 1 year of follow-up have a rate of over 88.2%, patients with good symptoms of a meniscus tear after 1 year of follow-up have a rate of over 73.5%. All patients were satisfied. 83% of patients with grade I and 17% of patients with grade II according to K-L system for classification of osteoarthritis on X-ray of the knee joint after 1 year. No complications of infection, delay healing, nerve or vascular injuries, pulmonary embolism, deep vein thrombosis; 21.2% of patients had synovitis. ACL reconstruction with repair of posterior horn of the meniscus gave satisfactory results


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


OUTCOMES OF CARPAL TUNNEL SYNDROME TREATMENT WITH TRANSVERSE CARPAL LIGAMENT RECONSTRUCTION

Nguyễn Bảo Lục, Võ Thành Toàn, Nguyễn Minh Dương

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DOI: 10.63947/bvtn.v1i4.12

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.


TRANSLATION AND CROSS-CULTURAL ADAPTATION OF THE SHORT SEXUAL WELL-BEING SCALE SSWBS INTO VIETNAMESE

Nguyễn Thanh Huân, Lâm Thành Vĩ, Trần Nguyên Thảo Nhi, Ngô Long Vân, Nguyễn Lê Huy Hoàng, Huỳnh Khôi Nguyên, Nguyễn Hoàng Mai Duyên, Phạm Hòa Bình

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DOI: 10.63947/bvtn.v1i4.13

According to the World Health Organization, sexual health constitutes an essential component of overall health. Nevertheless, culturally adapted instruments for assessing sexual health in Vietnamese remain scarce. Therefore, the development of an additional tool that is concise, user-friendly, and applicable in Vietnamese is warranted. This study aimed to translate and culturally adapt the Short Sexual Well-Being Scale (SSWBS) into Vietnamese. The translation process adhered to international guidelines and involved five steps. Two independent translators performed forward translation, followed by synthesis. The back-translated version demonstrated high equivalence with the original questionnaire, with all discrepancies being synonymous. During pilot testing with 40 healthcare professionals, 34 (85%) reported that the questionnaire was clear, comprehensible, and free of ambiguity, while six (15%) raised concerns regarding the wording of item 5. After further semantic clarification, these participants also confirmed the questionnaire’s clarity and comprehensibility. Overall, the translation and cultural adaptation of the SSWBS were conducted using a standardized methodology and were evaluated as simple, clear, and easy to understand.

 

OUTCOMES OF LAPAROSCOPIC SURGERY FOR COLORECTAL CANCER WITH TOTALLY INTRACORPOREAL ANASTOMOSIS TECHNIQUE IN ELDERLY PATIENTS

Hoàng Anh Bắc, Lê Tiến Dũng, Đỗ Duy Đạt, Nguyễn Phan Thanh Tiến

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DOI: 10.63947/bvtn.v1i4.14

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.


EVALUATION OF THE EFFECTIVENESS OF RADIOFREQUENCY ABLATION FOR THE TREATMENT OF CHRONIC LUMBAR FACET JOINT PAIN

Trần Trung Kiên, Lưu Vĩnh Tiến, Nguyễn Trần Đăng Linh

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DOI: 10.63947/bvtn.v1i4.15

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.


CLINICAL AND LABORATORY CHARACTERISTICS AND EVALUATION OF CURB-65 IN RISK STRATIFICATION OF COMMUNITY ACQUIRED PNEUMONIA AT THONG NHAT HOSPITAL

Hoàng Thái Dương, Hoàng Văn Quang, Ngô Thế Hoàng, Nguyễn Duy Cường, Nguyễn Thị Phương Thanh

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DOI: 10.63947/bvtn.v1i4.16

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


ASSESSMENT OF QUALITY OF LIFE AND RELATED FACTORS IN ELDERLY PEOPLE WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AT THE RESPIRATORY CLINIC, THONG NHAT HOSPITAL

Lê Thị Điệp, Hoàng Văn Quang, Ngô Thế Hoàng, Nguyễn Duy Cường, Huỳnh Thị Thanh Ngân

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DOI: 10.63947/bvtn.v1i4.17

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


Heart failure after acute myocardial infarction (MI) is a common complication and increases mortality. The factors influencing heart failure and the treatment outcomes of acute heart failure following acute MI remain unclear. This study aim to determining the prevalence, associated factors, and treatment outcomes of acute heart failure in patients with ST-elevation MI. A case series descriptive study was conducted on 110 patients with ST-elevation MI undergoing percutaneous coronary intervention at Long Khanh Regional General Hospital from June 2023 to June 2024. Results showed the prevalance of acute heart failure is 35%. Factors associated with acute heart failure after MI included: late hospital admission >12 hours (OR = 13.6; 95% CI: 1.8–100.8); double-vessel coronary artery disease (OR = 8.87; 95% CI: 1.0002–78.65), triple-vessel coronary artery disease (OR = 10.06; 95% CI: 1.11–90.77), and left main coronary artery disease (OR = 37.4; 95% CI: 1.8–763.2). Treatment outcomes included average hospital stay of 7.9 ± 5.2 days; the most frequently intervened coronary branch was the RCA; pre-intervention coronary flow was mostly TIMI 0, and post-intervention normal coronary flow was achieved in 86% of cases. Common complications were access-site hematoma, fever, and infection; in-hospital mortality rate was 7%; procedural success rate was 83.6%. These findings emphasize the importance of early identification of prognostic factors that can easily lead to acute heart failure after myocardial infarction, in order to improve approaches and patient outcomes


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.

Case Report

CHARACTERISTICS OF BRAIN-DEAD ORGAN DONORS AT THONG NHAT HOPITAL

Trương Vân Anh, Đào Ngô Quyền, Nguyễn Anh Tùng, Nguyễn Thị Thanh Thuỷ

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DOI: 10.63947/bvtn.v1i4.20

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


ST-ELEVATION MYOCARDIAL INFARCTION TRIGGERED BY ANAPHYLACTIC SHOCK IN AN ELDERLY PATIENT: ACASE REPORT AND LITERATURE REVIEW

Âu Dương Trung Hào, Ninh Hoàng Phong, Trương Minh Khánh, Lương Đức Khải, Nguyễn Duy Linh, Đào Duy Lượng, Nguyễn Văn Tân

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Downloads: 38 Views: 91

DOI: 10.63947/bvtn.v1i4.21

Acute myocardial infarction is a leading cause of mortality in the elderly; however, it may present with atypical clinical contexts that require early recognition for timely intervention. We report a unique case of a 77-year-old male with a history of chronic coronary artery disease (previous stenting) and type 2 diabetes mellitus, who developed grade III anaphylaxis following intravenous administration of cefuroxime. The patient was initially managed according to the anaphylactic shock protocol and subsequently transferred to a tertiary hospital in a hemodynamically stable condition, although persistent cutaneous allergic manifestations and dull chest pain were still present. This case illustrates a typical clinical presentation of Kounis syndrome type II (an allergic acute coronary syndrome in a patient with preexisting coronary artery disease), triggered by drug-induced anaphylaxis, and characterized by a biphasic course. In older adults, the diagnosis of Kounis syndrome is particularly challenging due to the high prevalence of underlying coronary artery disease, age-related immune alterations, and polypharmacy—factors that can themselves act as allergens. Furthermore, the elderly often exhibit atypical symptoms, complicating early recognition. Biphasic anaphylaxis, although rare, is a potentially life-threatening phenomenon, especially when superimposed on preexisting cardiovascular disease, as it may exacerbate myocardial ischemia or cause actual infarction.  Vigilant monitoring during the first 24 to 72 hours following the initial anaphylactic episode is essential to enable timely detection and management of potentially life-threatening cardiovascular complications.


THE ROLE OF TRANSESOPHAGEAL OVERDRIVE PACING IN TERMINATING PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA

Trương Quốc Cường, Trương Quang Khanh, Nguyễn Thị Hồng Nhung, Ngô Nguyễn Quan Huy, Huỳnh Duy Mẫn

Page 135-142

Downloads: 10 Views: 26

DOI: 10.63947/bvtn.v1i4.22

Transesophageal overdrive pacing is an accepted method for the diagnosis and treatment of paroxysmal supraventricular tachycardias, although is not used frequently in clinical practice. We describe four complex cases of paroxysmal supraventricular arrhythmia to review the role of transesophageal overdrive pacing in the interruption of paroxysmal supraventricular tachycardia. In these cases depend on clinical features such as pregnancy, resistance to antiarrhythmic drugs, and comorbid bradycardia that make it difficult to treat. These cases were successfully converted by transesophageal overdrive atrial pacing. Transesophageal overdrive atrial pacing is a low-cost, simple and safe procedure that can be performed at the bedside and can do many times, especially in patients, whose condition makes difficult the usage of medicines.