Vol. 2 No. 8 (2026): Geriatric Medicine in the Era of Personalization, Technology, and Prevention

The global elderly population (≥60 years) is rapidly growing, projected to reach 2.1 billion by 2050. To review the latest evidence (2022–2025) on preventive care for older adults. Multicomponent interventions and the WHO ICOPE framework 2nd edition (2025) provide the foundation for standardized preventive geriatric care at primary care level.

Physical activity behavior varies substantially among individuals and cannot be fully explained by environmental factors alone. Increasing evidence suggests that genetic factors play an important role in shaping individuals’ propensity to engage in and maintain exercise. This review aims to synthesize current evidence regarding the role of genetic factors in physical activity behavior. Relevant studies were identified through systematic searches of PubMed and Scopus databases from 2000 to 2025, focusing on human studies investigating the association between genetic factors and physical activity behavior. Multiple genetic loci associated with physical activity levels and behavioral tendencies have been identified. Neural mechanisms, particularly the dopaminergic system, appear to play a central role, alongside psychological mediators and gene–environment interactions. Exercise behavior is a multifactorial trait in which genetic factors contribute significantly but are not deterministic. Personalized approaches based on biological and behavioral characteristics hold promise for improving the effectiveness of physical activity interventions.

In recent years, Artificial Intelligence (AI) has rapidly entered the scientific world and become an integral part of the research process: from formulating questions, reviewing literature, designing studies, and detecting bias, to writing data analysis code, creating charts, and drafting or editing scientific manuscripts. In other words, AI is transitioning from a “supplementary tool” to a “research assistant”. In this paper, the researcher discusses the applications of AI in scientific research from a practical perspective. The first part defines AI and Large Language Models. The subsequent sections present how to utilize AI in formulating research questions, constructing hypotheses, selecting study designs, identifying bias and confounding factors, analyzing data, and writing scientific papers.

Spectral computed tomography (Spectral CT) is an advanced technology that is increasingly being applied in oncology. Spectral CT allows for tissue characterization beyond that of conventional CT as imaging is performed using different energy spectra that can help differentiate tissues based on their specific attenuation properties at different X-ray energies. The most common post-processing applications of Spectral CT include virtual monoenergetic images (MONO-E), iodine density overlay, virtual non-contrast images (VNC), and calcium supprression image. The diverse image sets obtained from Spectral CT offer numerous advantages, such as enhanced lesion detection and characterization, accurate determination of material composition, reduced iodine contrast dose, and reduced artifacts. These versatile applications play an increasingly important role in tumor evaluation and oncologic imaging, including the diagnosis of primary tumors, local and metastatic staging, post-treatment monitoring, and management of complications. This paper provides an overview of the main applications, post-processing techniques, and demonstrate some clinical cases from Thong Nhat Hospital in Ho Chi Minh City to highlight the role of Spectral CT in the management of cancer patients.

This study aims to evaluate the role of Artificial Intelligence-enabled Quantitative Computed Tomography (AI-QCT) in enhancing diagnostic accuracy and risk stratification compared to manual assessment using the CAD-RADS 2.0 standard in patients with non-obstructive coronary artery stenosis (<50%) via Coronary Computed Tomography Angiography (CCTA). Data were extracted from PubMed, ResearchGate, and ScienceDirect over the past six years. Selection criteria focused on clinical studies involving AI-QCT, high-risk plaque (HRP) characteristics, and the CAD-RADS 2.0 system. Results indicated that AI-QCT delivers superior performance, with sensitivity in detecting high-risk plaques ranging from 85% to 94%. The Area Under the Curve (AUC) for cardiovascular risk stratification reached 0.8 to 0.93. The integration of AI-QCT into CCTA analysis and the CAD-RADS 2.0 framework holds a dual strategic value: eradicating subjective bias to optimize risk stratification, while establishing a core foundation for personalizing preventive therapies and enhancing long-term clinical outcomes.

The number of elderly patients undergoing coronary angiography and percutaneous coronary intervention is steadily increasing, creating an urgent need for effective management of vascular access complications, particularly important in geriatric patients with multiple specific risk factors. Although radial artery access is superior to femoral access in terms of bleeding and mortality, elderly patients remain at higher risk due to specific anatomical and physiological changes: arterial tortuosity, calcification, small luminal diameter, and reduced elasticity; coupled with frailty, multimorbidity, polypharmacy, impaired renal function, and coagulation disorders. This narrative review analyzes the incidence, pathophysiology, and risk reduction strategies for radial artery access complications in the elderly, including individualized approaches: geriatric risk assessment, ultrasound-guided puncture, slender sheaths, patent hemostasis techniques, distal radial access considerations, and optimized anticoagulation–antiplatelet therapy. Evidence from randomized trials, meta-analyses, and real-world data is synthesized, alongside an assessment of the current state and research gaps in Vietnam.

Botulinum toxin type A (BTX-A) is one of the key tools in non-invasive aesthetic contouring. Initially used primarily for the reduction of dynamic wrinkles, BTX-A is now widely applied in facial slimming and body contouring. However, differences in anatomical characteristics, muscle physiology, and treatment responses across anatomical regions have not yet been systematically synthesized. Materials and methods: This study was conducted as a narrative review, based on a structured search of the PubMed, Scopus, and Web of Science databases for studies related to the application of BTX-A in facial and body aesthetic contouring. Results: BTX-A demonstrates significant effectiveness in reducing muscle volume and improving contour across various anatomical regions. Factors influencing outcomes include dosage, injection technique, muscle characteristics, and individual patient factors. Notably, substantial differences between facial and body contouring highlight the need for region-specific treatment approaches. Conclusion: BTX-A is an effective and safe modality in aesthetic contouring. Optimization of treatment outcomes requires a thorough understanding of anatomy, the mechanism of action, and individualized injection strategies. Future research should focus on dose standardization and the development of personalized treatment models to enhance both efficacy and safety.

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.

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.

Gastrointestinal hemorrhage (GIH) is a common medical-surgical emergency with high morbidity and mortality rates. Rapid and accurate identification of the location and cause of bleeding is essential to guide timely intervention. Computed tomography angiography (CTA) has emerged as a modern, non-invasive imaging method capable of detecting active bleeding with high sensitivity and specificity. This study aimed to describe the CTA imaging characteristics in patients with GIH and evaluate the value of CTA in diagnosing and localizing hemorrhage. A cross-sectional study was conducted at Thong Nhat Hospital, Ho Chi Minh City, from May 2024 to May 2025, involving 31 patients ≥18 years old with suspected GIH who underwent CTA when endoscopy failed and were confirmed by endoscopy, digital subtraction angiography (DSA), or surgery. Data were analyzed using SPSS 20.0, calculating sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Among 31 patients (71% male; mean age 62.5 ± 17.1 years), the most common CTA finding was contrast extravasation in the arterial phase >90 HU (38.7%), of which 50% showed changes in density and 33.3% showed morphological changes in the venous phase. Other findings included perienteric fat stranding (32.3%) and bowel wall enhancement (6.5%). CTA had a sensitivity of 73.9%, specificity of 87.5%, PPV of 94.4%, NPV of 53.9%, and accuracy of 77.4%. The most common bleeding site was the small bowel (27.8%). The main causes were ulceration (22.2%) and GIST tumors (16.7%). CTA is a highly valuable, non-invasive method for diagnosing and localizing GIH, particularly useful when endoscopy fails, with high specificity and good applicability in clinical practice.

This study aimed to characterize the clinical, paraclinical, and therapeutic features of ischemic stroke in patients aged 60 years and older treated at Thong Nhat Hospital. A prospective descriptive design was applied to 242 patients aged ≥60 years who were admitted with acute ischemic stroke to the Department of Neurology, Thong Nhat Hospital, between February and August 2025. The median age of the cohort was 71 years (69 years in males and 76 years in females). Males accounted for 63,4% of the sample. Hypertension was the most prevalent risk factor, present in 75,6% of patients, followed by diabetes mellitus and dyslipidemia, while atrial fibrillation was rare. The mean LDL-cholesterol level was 117,9 ± 50,7 mg/dl. At admission, low NIHSS scores (0–5) were observed in 58,8% of males and 57,3% of females. Favorable recovery (low NIHSS scores) after treatment was achieved in 80,4% of males and 64% of females. Female sex is associated with poorer treatment outcomes. The rate of reperfusion therapy was 21,1%. Among identifiable etiologies, small vessel disease was the most common, accounting for 26,4%. However, 47,9% of patients had undetermined causes. Ischemic stroke patients aged ≥60 years at Thong Nhat Hospital exhibit characteristics consistent with global trends, while also presenting distinctive features regarding risk factors and etiologies.

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

To describe nutritional status and selected related factors in patients after laparoscopic gastrectomy at Thong Nhat Hospital. This retrospective descriptive study included 30 patients who underwent laparoscopic gastrectomy from January 2021 to December 2024 and had available baseline and 3-month postoperative follow-up data. Variables included clinical characteristics, type of surgery, adjuvant chemotherapy, gastrointestinal symptoms, dietary tolerance, oral nutritional supplement (ONS) use, micronutrient supplementation, anthropometric indices, and biochemical parameters. Nutritional status was classified using the Subjective Global Assessment (SGA). Dietary intake was assessed from follow-up records/nutrition notes, focusing on meal frequency, tolerance, ONS use, and clinically recorded achievement of energy–protein intake. Given the retrospective design and small sample size, comparisons were considered exploratory and intended to describe between-group differences rather than infer causality. Most patients were male, with a mean age of nearly 60 years; gastric cancer was the main diagnosis. At 3 months postoperatively, patients had an average weight loss of approximately 9–10%, decreased BMI, and lower albumin and hemoglobin levels. Approximately 40% of patients were classified as malnourished or at risk by SGA. Common gastrointestinal symptoms included anorexia, nausea/vomiting, and dumping syndrome/symptoms suggestive of dumping. Malnutrition after laparoscopic gastrectomy requires proactive monitoring. Periodic screening, assessment of dietary tolerance, standardized nutritional counseling, appropriate micronutrient supplementation, and larger prospective studies are needed to further evaluate associated factors.

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.

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).

Hookworm infection is a soil-transmitted helminthiasis that remains common
among children in rural and mountainous areas, adversely affecting health and physical
development. This study aimed to determine the prevalence of hookworm infection among
pupils at Y Jut Primary School, Lien Son Lak Commune, Lak District, Dak Lak Province, in 2025.
A cross-sectional study was conducted among 218 pupils. Stool samples were examined using direct smear and Willis flotation techniques, and demographic and household information was collected using structured questionnaires. Results showed that 28 pupils were infected with hookworm, yielding an overall prevalence of 12.84%. The infection rate was higher in males than in females (15.69% vs. 10.34%). The prevalence among pupils in grades 3, 4, and 5 was 10.94%, 11.54%, and 15.79%, respectively, with the highest rate observed in grade 5. Pupils of the Ê Đê ethnic group had the highest prevalence (44.44%). Higher infection rates were also observed among pupils whose parents were illiterate (54.55%) and among those whose parents were farmers (15.24%). These findings indicate that hookworm infection remains a public health concern in the study area, emphasizing the need for strengthened health education, improved sanitation, and regular deworming programs for primary school pupils.

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

To apply Six Sigma and Quality Goal Index (QGI) for evaluating and improving the quality of 10 routine biochemical tests (glucose, urea, creatinine, uric acid, ALT, GGT, calcium, magnesium, iron, CK) on the AU5800 analyzer at the Biochemistry Department, Thong Nhat Hospital. Subject and methods: he study utilized internal quality control (IQC) data from the AU5800 system at two control levels (Level 2 and Level 3) across two phases. Parameters such as bias, coefficient of variation (CV%), and Six Sigma metrics were calculated based on total allowable error (TEa), combined with analysis of the Quality Goal Index (QGI). Results: In Phase 1, 6/10 tests achieved a Sigma ≥4, while Urea and Creatinine had a Sigma of 2 with low QGI. In Phase 2, Sigma values for Urea and Creatinine improved to ≥ 3. Conclusion: The combination of Six Sigma and QGI enables early detection of errors, effective targeted improvement — especially for urea and creatinine — and demonstrates superior value and sustainability in the quality management of biochemical tests on the AU5800 analyzer.

Traditional upper extremity surgery relies on tourniquets and sedation/general anesthesia. WALANT utilizes a mixture of lidocaine and epinephrine to achieve hemostasis and anesthesia without a tourniquet, allowing intraoperative active movement examination. Objective is to evaluate the safety and efficacy of WALANT in upper extremity surgery at Vung Tau General Hospital. A report of 4 clinical cases treated with WALANT. All surgeries were successful with minimal blood loss and excellent visualization. Patients reported minimal pain, no tourniquet discomfort, and successfully performed intraoperative active movements to verify surgical repairs. No complications such as necrosis or toxicity occurred. WALANT is a safe, effective, and cost-efficient approach, enabling intraoperative functional assessment and facilitating early discharge