Hue Central Hospital (HCH), established in 1894, has been the first Western hospital in Vietnam. The hospitals, providing 3939 beds and occupying 190,000 square meters (included Base 2), is one of three biggest in the country along with Bach Mai Hospital in Hanoi and Chợ Rẫy Hospital in Ho Chi Minh City, and is managed by the Ministry of Health. HCH, positioned as is a top referral hospital, is a central medical institution for the 25 million Central and high land of Vietnam population. It is also the primary training facility for the Hue University of Medical And Pharmacy. .
PURPOSE:Early integration of palliative care (PC) for children with cancer is vital to improved patient outcomes. Despite this, access to PC services for children in Asia Pacific (AP) is sparce. We aimed to explore potential barriers to PC provision in childhood cancer care across AP. METHODS:The Assessing Doctors' Attitudes on Palliative Treatment survey was revised for cultural context, translated into six languages, and distributed electronically to physicians who care for children with cancer. Descriptive statistics were used to summarize data. Secondary analyses used the Pearson chi-square test or Fisher exact test to examine associations between prior PC training and physician subspecialty with reported barriers. The McNemar test was applied to evaluate differences between actual versus ideal timing of PC consultations. Analysis of variance was conducted to compare mean values for perceived barriers across country income levels. RESULTS:Six hundred twenty-one physicians from 18 countries participated, with an overall response rate of 27% (621/2,305) and a median country response rate of 30% (range, 11%-85%). Most respondents (n = 366; 59%) believed PC should be consulted at diagnosis, but only 18% (n = 117) stated that this occurred in their clinical setting (P < .001). The most highly ranked barriers to PC provision included limited physician knowledge (n = 511; 82%), lack of national health policy/advocacy (n = 494; 79%), lack of PC-trained clinicians (n = 492; 79%), lack of home-based services (n = 487; 78%), and physician discomfort in discussing PC (n = 483; 78%). Physicians practicing in lower-middle-income countries rated these barriers more significantly. CONCLUSION:Physicians report a discrepancy between ideal and actual timing of PC integration and identify several barriers to PC provision. Study findings will inform capacity building, education, and advocacy initiatives to improve the timing and quality of PC delivery in the region.
The standard first-line treatment for patients with hormone receptor-positive (HR +) human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer is cyclin-dependent kinase 4/6 (CDK4/6) inhibitors combined with endocrine therapy (ET). Optimal therapy after CDK4/6 inhibitors remains to be determined. We aimed to define the appropriate second-line treatment after CDK4/6 inhibitors in a real-life population. Patients who had received CDK4/6 inhibitors with aromatase inhibitors (AIs) for HR + /HER2- metastatic breast cancer were included from March 2017 to May 2021 at five French cancer centers.The primary objective was to describe second-line treatment after primary treatment with CDK4/6 inhibitors plus AIs. We included 381 patients who received CDK4/6 inhibitors combined with AIs as first-line therapy. Patients with progressive disease (N = 165) benefited from a second-line of treatment: 69 (41.8
High-energy open tibial fractures with segmental bone loss and extensive soft-tissue necrosis remain limb-threatening, especially when only one recipient artery is patent. We report a 37-year-old man with a Gustilo-Anderson type IIIB open distal tibial fracture, posterior tibial artery injury, a 7-cm tibial defect and a 14 x 25 cm soft-tissue defect after serial debridement. After emergency external fixation and revascularization, the wound was optimized with repeated debridement and circumferential negative-pressure wound therapy. Definitive reconstruction used a vascularized pedicled fibular graft from the injured leg to bridge the tibial defect, combined with a latissimus dorsi free flap for coverage; the thoracodorsal artery was anastomosed end-to-side to the posterior tibial artery under 3D magnification. The flap survived without infection or secondary necrosis, allowing early rehabilitation with stable coverage and maintained alignment.
Mục tiêu: Khảo sát đặc điểm và kết quả sàng lọc ở người tham gia hiến máu tình nguyện. Đối tượng, phương pháp: Nghiên cứu mô tả cắt ngang kết hợp hồi cứu thực hiện trên các lượt hiến máu tại các điểm hiến máu lưu động và tại trung tâm Huyết học Truyền máu Bệnh viện Trung ương Huế từ 01/10/2025 đến 01/04/2026. Kết quả: Nghiên cứu trên 18.832 lượt hiến máu tình nguyện, chủ yếu là nữ giới (53,4%), nhóm tuổi 18-29(49,3%), nghề nghiệp làm cán bộ viên chức chiếm đại đa số (36,8%) và hơn nửa nguồn máu là người hiến nhắc lại (56,6%). Tổng tỷ lệ dương tính sàng lọc các tác nhân lây truyền qua đường máu bằng huyết thanh học là 0,70% (134/18832), trong đó HBV cao nhất (0,31%), tiếp theo HCV (0,25%), HIV (0,08%) và giang mai (0,06%). Sàng lọc bổ sung bằng NAT phát hiện thêm 16 trường hợp HBV DNA dương tính (0,09%). Tỷ lệ dương tính sàng lọc tăng theo tuổi, cao nhất ở nhóm 45-60 tuổi (1,39%), chủ yếu liên quan đến HBV(p < 0,001). Không ghi nhận sự khác biệt có ý nghĩa thống kê theo giới tính, nghề nghiệp, số lần hiến máu (p > 0,05).
