A doença pulmonar obstrutiva crônica (DPOC) e a síndrome de sobreposição asma–DPOC (ACO) compartilham manifestações clínicas e fisiopatológicas, o que dificulta o diagnóstico diferencial. O óxido nítrico exalado (FeNO) tem emergido como um biomarcador não invasivo de inflamação eosinofílica das vias aéreas, podendo auxiliar na distinção entre essas condições e no estabelecimento de decisões terapêuticas mais precisas. Este estudo teve como objetivo avaliar a aplicabilidade do teste de FeNO na diferenciação entre DPOC e ACO, em comparação com métodos diagnósticos convencionais. Foi realizada uma revisão sistemática de intervenções, conduzida de acordo com as diretrizes PRISMA e registrada no PROSPERO (CRD420251160849). As buscas foram realizadas nas bases de dados PubMed, Web of Science, Cochrane Library e Biblioteca Virtual em Saúde, utilizando os descritores “Fractional Exhaled Nitric Oxide Testing” e “Pulmonary Disease Chronic Obstructive”, resultando na inclusão de nove estudos que atenderam aos critérios de elegibilidade. O FeNO demonstrou associação significativa com inflamação eosinofílica e características asmáticas, apresentando acurácia diagnóstica moderada, com área sob a curva variando entre 0,76 e 0,78 na diferenciação entre DPOC e ACO. Ademais, seu uso permitiu a reclassificação diagnóstica em até 25% dos casos e melhor predição da resposta aos corticosteroides inalados. Dessa forma, o FeNO constitui um método seguro e reprodutível, com relevante potencial clínico para o diagnóstico diferencial e o manejo individualizado da DPOC e da ACO; contudo, a heterogeneidade metodológica entre os estudos evidencia a necessidade de ensaios multicêntricos e de longo prazo para consolidar sua aplicabilidade. Palavras-chaves: Teste da Fração de Óxido Nítrico Exalado. Biomarcadores. Diagnóstico Diferencial. Pneumopatias. Abstract Chronic obstructive pulmonary disease (COPD) and asthma–COPD overlap syndrome (ACO) share clinical and pathophysiological manifestations, which makes differential diagnosis challenging. Exhaled nitric oxide (FeNO) has emerged as a noninvasive biomarker of eosinophilic airway inflammation and may assist in distinguishing between these conditions while supporting more precise therapeutic decisions. This study aimed to evaluate the applicability of the FeNO test in differentiating COPD from ACO in comparison with conventional diagnostic methods. A systematic review of interventions was conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD420251160849). Searches were performed in the PubMed, Web of Science, Cochrane Library, and Virtual Health Library databases using the descriptors “Fractional Exhaled Nitric Oxide Testing” and “Pulmonary Disease Chronic Obstructive,” resulting in nine studies that met the eligibility criteria. FeNO demonstrated a significant association with eosinophilic inflammation and asthmatic features, showing moderate diagnostic accuracy, with an area under the curve ranging from 0.76 to 0.78 for differentiating COPD from ACO. Additionally, its use allowed diagnostic reclassification in up to 25% of cases and improved prediction of response to inhaled corticosteroids. FeNO is therefore a safe and reproducible method with considerable clinical potential for the differential diagnosis and individualized management of COPD and ACO; however, methodological heterogeneity among studies highlights the need for multicenter and long-term trials to consolidate its applicability. Keywords: Fractional Exhaled Nitric Oxide Testing. Biomarkers. Diagnosis, Differential. Doença Pulmonar.
Temporomandibular disorder (TMD) is a common musculoskeletal condition often associated with pain and functional limitation. Hyaluronic acid (HA) has been proposed as a minimally invasive therapeutic alternative for managing these dysfunctions due to its viscoelastic and anti-inflammatory properties. This integrative review aimed to compare the effectiveness of low- and high-molecular-weight sodium hyaluronate in the long-term improvement of pain symptoms in patients with TMD. A comprehensive search was performed in the PubMed, EMBASE, Cochrane, and BVS databases, without time restriction, resulting in the inclusion of seven studies that met the eligibility criteria. The findings indicated that both low- and high-molecular-weight HA effectively reduce pain and improve mandibular function. Low-molecular-weight HA showed faster regenerative effects, while high-molecular-weight HA demonstrated more prolonged anti-inflammatory action. However, most studies did not reveal statistically significant differences between formulations, suggesting comparable clinical efficacy. Despite methodological limitations and the limited number of long-term clinical trials, HA is considered a safe and effective therapeutic option for treating TMD. Further well-designed studies are needed to clarify the potential superiority between different molecular weights.
Introduction: Medical students, including dental students, are more likely to be burdened with depression, anxiety, burnout, and anorexic tendencies than their peers studying other subjects. In spite of major public health relevance, there is a large knowledge gap regarding mental health issues among Bosnian dental students. The aim of this research is to estimate the depression prevalence among dental students in Sarajevo according to age, gender, and academic year. Methods: A cross-sectional study was conducted among 1st, 3rd, 4th, and 6th year students at the Dental School, University of Sarajevo, during 2023-2024. Depression was evaluated using the self-reported patient health questionnaire-9 (PHQ-9). Statistical analysis included the Shapiro–Wilk test, with data presented as means with standard deviations (SDs), medians (Mdn) with interquartile ranges (IQRs), and frequencies. Comparisons between males and females were analyzed using the Student’s t-test or Mann–Whitney U-test and one-way analysis of variance or Kruskal–Wallis test across academic years. Results: In the total sample (n = 324), females outnumbered males, 244 versus 80. Clinically significant depression (PHQ-9 ≥10) was reported in 52.79% of students. The average PHQ-9 value was Mdn = 10.00, IQR (6.00, 16.00), M = 11.1, SD = 6.66. The highest average PHQ-9 values were observed in the 4th year and the lowest in the 6th year. Female students had significantly higher average PHQ-9 scores (p < 0.05). Conclusion: Dental students in Sarajevo exhibited high depression prevalence, but female students were more affected. These findings emphasize an urgent need for targeted mental health interventions in dental education.
A obesidade contribui significativamente para o aumento do risco de mortalidade no mundo, bem como para o uso de medicamentos para tratar comorbidades nesses pacientes. Por outro lado, o exercício físico pode ser um meio não farmacológico para prevenir e tratar diversas doenças presentes em pacientes com obesidade mórbida. Sendo assim, o objetivo deste estudo foi investigar os efeitos da cirurgia bariátrica RYGB na redução do peso corporal e da ingestão de medicamentos em pacientes com diferentes níveis de atividade física. Trata-se de um estudo longitudinal com componente retrospectivo, que acompanhou os pacientes nos períodos pré e pós-operatório. Os dados foram obtidos por meio do acesso a informações em prontuários clínicos durante o período de seis meses. No total, 319 (43,2%) pacientes foram analisados e a comparação estatística entre os períodos pré e pós-operatório de pacientes com atividade física moderada a vigorosa e baixa atividade física indicou redução significativa no número de pessoas que utilizavam medicação contínua, para ambos os níveis de atividade física. É possível concluir que o efeito da cirurgia RYGB foi eficaz na resolução do diabetes mellitus tipo 2 e da hipertensão. Mesmo nos casos em que não houve remissão total da doença, houve redução significativa no uso de medicamentos para o tratamento. Além disso, houve redução significativa no uso de medicamentos para o tratamento, sendo esta maior no grupo muito ativo. Palavras-chave: Obesidade. Cirurgia RYGB. Farmacoterapia. Exercício Físico. Abstract Obesity contributes significantly to the increased of risk of mortality in the world, as well as to the use of drugs to treat comorbidities in these patients. On the other hand, physical exercise could be a non-pharmacological means for preventing and treating various diseases that are present in patients with morbid obesity. Thus, the objective of this study was to investigate the effects of RYGB bariatric surgery on reduction in body weight and drug intake, in patients with different levels of physical activity. It is a longitudinal study with a retrospective component, which followed patients between the pre and postoperative periods. Data were obtained through access to information in clinical records over a period of 6 months. In total, 319 (43.2%) patients were analyzed and the statistical comparison between the pre and postoperative period of moderate to vigorous physical activity and low physical activity, patients indicated a significant reduction in the number of people using continuous medication, for both levels of physical activity. It is possible to conclude that the effect of RYGB surgery reduced medication use for type 2 diabetes and hypertension at six months. Also, there appears to be a reduction in the use of medication for the treatment, especially in the very active group. Keywords: Obesity. RYGB Surgery. Pharmacotherapy. Physical Exercise.
Introduction: Recent studies show that cases of infertility in couples have been increasing significantly over the years. Infertility is characterized by the couple's failure to conceive after a year of trying without using any contraceptive method. According to some studies, this condition is becoming increasingly common, with more than 2 million new cases reported annually in Brazil. Among the main known causes of infertility in couples are reproductive system pathologies, hormonal or genetic disorders, and infections in general. Objectives: To survey the main causes of infertility based on systematic reviews, seeking to determine the incidence and prevalence of clinical conditions that impair fertility. Methods: A systematic review was conducted, searching for original articles in English and Portuguese, evaluating the relationship between infertility and its current causes. Results: Most studies have shown that the most significant causes of female infertility are those caused by hormonal changes and irregularities, such as aging, endocrine disorders, and gonadal dysfunction. However, the most common disease in female infertility is endometriosis, affecting 10 to 15% of women of reproductive age, and 30 to 50% of women diagnosed with infertility also have a diagnosis of endometriosis. Preventable causes, those not caused by endogenous pathologies, include age, obesity, smoking, and sexually transmitted diseases.
Type 2 diabetes is associated with a progressive decline in patients' quality of life (QoL). Self-efficacy and adherence are critical behavioral determinants that influence disease management and outcomes. This study examines the correlation between self- efficacy and adherence to quality of life in patients with type 2 diabetes mellitus. This study used a correlational analytic research design with a cross-sectional approach. The study was conducted at Islamic Hospital Jemursari, Surabaya, from August to October 2024. The population consisted of 307 patients with diabetes, and 174 respondents were selected through purposive sampling. Data were collected using validated questionnaires: the Diabetes Management Self-Efficacy Scale (DMSES), the Adherence to Diabetes Questionnaire (ADQ), and the Diabetes Quality of Life (DQOL)questionnaire. Data analysis was the Spearman's Rank correlation test. The results showed that nearly half of the respondents reported low self-efficacy, most had low adherence, and 60.3% experienced poor QoL. Spearman analysis demonstrated a significant correlation between self-efficacy and QoL (r = 0.647; p < 0.000), and between adherence and QoL (r = 0.684; p < 0.000). In conclusion, self-efficacy and adherence are strong predictors of quality of life in patients with type 2 diabetes mellitus at Jemursari Islamic Hospital, Surabaya. Future research should investigate interventions to enhance self-efficacy and adherence, particularly among patients with a poor quality of life, to develop more effective strategies for supporting diabetes care.
Objective: to characterize teleconsultations in orthopedics carried out by the TeleNordeste project in the states of Ceará and Bahia in the Northeast region of Brazil. Method: A cross-sectional study was performed to analyze all teleconsultations carried out in the specialty of orthopedics from June 2022 to August 2023. The teleconsultation was carried out in video format, involving an orthopedic doctor, a family doctor, and a patient. Results: 173 teleconsultations were carried out with 153 patients, of whom 88.44% established the therapeutic plan in primary care itself. The main diagnosis was ICD M54.5 low back pain in 34.1% of teleconsultations. Physiotherapy was recommended in 77.46% of teleconsultations. The evaluation of this type of service resulted in positive responses in 95.45% of the completed questionnaires. Conclusion: The implementation and development of telemedicine by the TeleNordeste Project reduced orthopedic referrals to secondary care and enabled better coordination of patient care in primary care itself, increasing the resolution of the health units that are part of the project.
A composição corporal, a força muscular inspiratória (FMI) e a capacidade funcional influenciam diretamente a saúde de crianças com asma. No entanto, a relação entre esses desfechos ainda não está clara. O objetivo foi verificar a relação entre a FMI, capacidade funcional e a composição corporal de crianças com asma. O método adotado foi estudo transversal com crianças diagnosticadas com asma. As avaliações realizadas foram: função pulmonar (espirometria), FMI (KH5POWERbreathe®), capacidade funcional (Teste Sit-to-stand 1 minuto), composição corporal (bioimpedância elétrica), controle da asma (Childhood Asthma Control Test - ACT-C) e qualidade de vida (Pediatric Asthma Quality of Life Questionnaire - PAQLq). A normalidade foi verificada pelo teste de Shapiro-Wilk e as correlações pelo coeficiente de Spearman, adotando-se p<0,05. Foram avaliadas 47 crianças (42% do sexo masculino), idade 8 [7–10] anos, VEF₁ de 1,63 [1,36–1,89] L (92% do predito) e S-index de 37 [34–50] cmH₂O (63% do predito). A FMI em cmH₂O e % predito correlacionou-se com altura, peso, IMC, massa gorda, massa livre de gordura, capacitância, resistência, massa celular, água intracelular, água extracelular e água corporal total (0,34
O Salto Vertical (SV) é a principal manifestação da potência explosiva no voleibol, sendo um importante preditor de desempenho nas ações de ataque e bloqueio. Este estudo teve como objetivo quantificar e comparar o desempenho do SV em atletas de voleibol em dois momentos distintos (T1: inicial; T2: final), a fim de verificar a eficácia de um protocolo de treinamento periodizado sobre a variável potência. Adotou-se um delineamento experimental longitudinal, intra-sujeitos, com amostras pareadas (N = 18). O SV foi mensurado pela diferença entre o alcance máximo do salto e a Base de Estatura (SV = Média do Salto − BE). A análise estatística utilizou o teste t de Student para amostras pareadas e a Magnitude do Efeito (d de Cohen) para avaliar a diferença entre T1 e T2, com nível de significância de p < 0,05. A altura média do SV em T1 foi de 29,56 ± 4,88 cm, aumentando para 32,72 ± 5,25 cm em T2. O teste t revelou uma diferença média de 3,16 cm, com resultado estatisticamente altamente significativo (t₁₇ = −7,218; p < 0,001). A magnitude do efeito foi classificada como muito grande (d ≈ 1,75). O período de treinamento resultou em uma melhora significativa e substancial da potência explosiva dos membros inferiores. Esses achados validam a eficácia do protocolo de treinamento implementado na otimização do desempenho atlético específico do voleibol. Palavras-chave: Desempenho Atlético. Atividade Motora. Aptidão Física. Treinamento Resistido. Desenvolvimento Experimental. Abstract Vertical Jump (VJ) is the main manifestation of explosive power in volleyball, being a key predictor of performance in attack and block actions. This study aimed to quantify and compare VJ performance in volleyball athletes at two distinct times (T1: initial; T2: final), in order to verify the effectiveness of a periodized training protocol on the power variable. A longitudinal, intra-subject experimental design was adopted, with paired samples (N=18). VJ was measured by the difference between the maximum jump reach and the Base of Height (VJ = Average Jump - BE). Statistical analysis employed the Student's t- test for paired samples and the Effect Magnitude (Cohen's d ) to evaluate the difference between T1 and T2, with a significance level of p < 0.05. The mean height of the SV at T1 was 29.56 ± 4.88 cm, increasing to 32.72 ± 5.25 cm at T2. The t-test revealed a mean difference of 3.16 cm, with a statistically highly significant result (t17 = -7.218, p < 0.001). The magnitude of the effect was classified as very large (d ≈ 1.75). The training period resulted in a significant and substantial improvement in lower limb explosive power. These findings validate the effectiveness of the implemented training protocol in optimizing volleyball-specific athletic performance. Keywords: Athletic Performance. Motor Activity. Physical Fitness. Resistance Training. Experimental Development
A morte encefálica (ME) durante a gestação é uma condição pouco frequente e desafiadora, que exige uma abordagem multidisciplinar, incluindo o suporte nutricional. Gestantes em estado crítico e com ME apresentam características que tornam a terapia nutricional mais complexa, havendo ainda uma lacuna de conhecimento sobre o manejo nutricional nesses casos. Diante da escassez de recomendações específicas na literatura, este trabalho teve como objetivo descrever o manejo nutricional de uma gestante de 34 anos, admitida no hospital na 20ª semana de gestação e com a constatação de ME durante a 22ª semana de gestação. Trata-se de um relato de caso elaborado a partir da revisão do prontuário eletrônico e do acompanhamento nutricional realizado durante a internação. A primeira avaliação nutricional foi realizada no dia seguinte da internação, tendo como hipóteses diagnósticas um rebaixamento do nível de consciência a esclarecer, com suspeita de meningite como possível causa, hipertensão intracraniana e COVID-19. A terapia nutricional foi estabelecida por via enteral, com metas calóricas e proteicas baseadas em recomendações para pacientes críticos adultos, ajustadas para as condições clínicas e período de gestação. O acompanhamento nutricional foi mantido durante toda a internação até a confirmação do óbito fetal ao final da 24ª semana de gestação, o qual era uma possibilidade diante das condições clínicas da paciente. Este relato evidencia a ausência de diretrizes específicas para o manejo nutricional de gestantes com ME e reforça a importância da individualização da terapia nutricional, bem como da necessidade de mais estudos que subsidiem recomendações para essa população. Palavras-chave: Morte Encefálica. Gravidez. Terapia Nutricional. Cuidados Críticos. Obtenção de Tecidos e Órgãos. Abstract Brain death (BD) during pregnancy is a rare and challenging condition that requires a multidisciplinary approach, including nutritional support. Pregnant women in critical condition with BD present characteristics that make nutritional therapy more complex, and there is still a knowledge gap regarding nutritional management in these cases. Given the scarcity of specific recommendations in the literature, this study aimed to describe the nutritional management of a 34-year-old pregnant woman admitted to the hospital at 20 weeks of gestation and diagnosed with BD at the 22nd week of gestation. This is a case report based on a review of the electronic medical record and the nutritional monitoring performed during hospitalization. The first nutritional assessment was performed the day after admission, with diagnostic hypotheses of decreased level of consciousness of undetermined etiology, with suspected meningitis as a possible cause, intracranial hypertension, and COVID-19. Nutritional therapy was established via enteral feeding, with caloric and protein goals based on recommendations for critically ill adult patients, adjusted for the patient's clinical condition and gestational age. Nutritional monitoring was maintained throughout hospitalization until fetal death was confirmed at the end of the 24th week of gestation, which was a possibility given the patient's clinical condition. This report highlights the absence of specific guidelines for the nutritional management of pregnant women with BD and reinforces the importance of individualizing nutritional therapy, as well as the need for further studies to support recommendations for this population. Keywords: Brain Death. Pregnancy. Nutrition Therapy. Critical Care. Tissue and Organ Procurement.
Introduction: This study evaluated the accuracy of various cone-beam computed tomography (CBCT) reconstruction modalities, specifically the HyperSight (HS) detector, in comparison to standard computed tomography (CT) simulation for potential use in online adaptive radiotherapy. The research focused on the Hounsfield Unit (HU) to relative electron density (RED) conversion and its subsequent impact on volumetric modulated arc therapy (VMAT) dose calculations. Methods: Two tissue-equivalent phantoms, the advanced electron density and the CIRS Thorax phantom, were utilized. Imaging was performed on a SOMATOM go.Open Pro CT simulator and a Varian TrueBeam medical linear accelerator using CBCT, HS-CBCT, HS-iterative CBCT (iCBCT) and HS-iCBCT metal artifact reduction protocols. Calibration curves (HU-RED) were generated for two regions: RED <1.2 and 1.2≤ RED <1.8. VMAT plans (6 MV) were created in the Eclipse 18.1 treatment planning system (TPS), using an anisotropic analytical algorithm (AAA) and Acuros XB algorithm. Absolute dose measurements were conducted using an SNC125c ionization chamber and compared with TPS-calculated doses. Results: In the soft-tissue region (RED <1.2), all imaging modalities showed an excellent linear correlation with CT (r > 0.998), with HU deviations within ± 30 HU. In the high-density region (1.2 ≤ RED < 1.8), HS-CBCT demonstrated superior stability with the lowest root mean square error, 62.88 HU. Dosimetric results showed that 96.7% of all measurement points met the ± 3–4% agreement criteria. For the AAA algorithm, HS-iCBCT exhibited the highest precision (standard deviation = 0.59) and the lowest mean absolute error. The Friedman test confirmed a statistically significant difference between modalities (p < 0.05), with HS-iCBCT showing the most consistent performance. Conclusion: Both HS-CBCT and HS-iCBCT provide highly accurate HU-RED conversions and reliable dosimetric results for RED < 1.8.
Academic writing in English is essential for medical students as it enables access to global resources and scholarly publication (Hyland & Hyland, 2019). Yet many Vietnamese learners encounter persistent difficulties with grammar, vocabulary, and textual coherence, which restrict their academic performance. In response, Automated Writing Corrective Feedback (AWCF) systems such as Grammarly have emerged, offering immediate, technology-supported assistance. While widely adopted, their pedagogical contribution in medical education remains underexplored (Ghufron, 2019; Dizon & Gayed, 2021). This experimental study investigates Grammarly’s role in supporting academic writing among medical students at Hai Phong University of Medicine and Pharmacy. Sixty second-year students were randomly allocated to an experimental group using Grammarly Premium or a control group receiving teacher feedback. Writing assignments before and after the intervention were assessed by certified IELTS examiners, and semi-structured interviews with five instructors were thematically analyzed. Findings showed that both groups improved, Statistical analysis using paired-samples t-tests revealed significant improvements within both groups., but teacher feedback produced significantly greater gains. Teachers valued Grammarly for efficiency and learner autonomy, yet noted risks of over-reliance and limited capacity to address higher-order writing issues. The study concludes that Grammarly should supplement, not replace, teacher feedback in medical English writing instruction.
Background: The aging population in Vietnam is increasing rapidly, leading to a growing burden of chronic diseases and a rising demand for rehabilitation services among older adults. However, this demand has not been fully assessed, particularly at tertiary hospitals. Objective: To determine the prevalence and associated factors of rehabilitation needs among older adults at Thong Nhat Hospital, Ho Chi Minh City, in 2025. Subjects and Methods: A cross-sectional descriptive study was conducted on 427 older adults (≥60 years) who attended outpatient or inpatient services at Thong Nhat Hospital from September to November 2025. Results: The proportion of older adults with rehabilitation needs was 72.6%, with a mean score of 25.6 ± 3.3. The highest demand was recorded in mechanical therapy techniques, especially full-body exercise (69.4%) and assisted-device training (64.5%). Rehabilitation needs were significantly associated with female gender (OR = 1.78; p = 0.008), age group 60–69 (OR = 1; reference), and having three comorbidities (p < 0.05). Conclusion: Rehabilitation needs among older adults are common and influenced by various demographic and clinical factors. Appropriate rehabilitation programs should be implemented at tertiary hospitals to effectively meet the care needs of the aging population.
Background: Community-acquired pneumonia (CAP) remains a leading cause of morbidity and mortality worldwide, with antimicrobial resistance (AMR) posing a critical challenge in low- and middle-income countries, including Vietnam. Local data on antibiotic use, resistance, and treatment outcomes are essential to guide empirical therapy and stewardship. Methods: We conducted a retrospective study of 1,418 adult patients hospitalized with CAP at Hai Phong International Hospital, Vietnam, from 2020 to 2024. Clinical characteristics, inflammatory markers, CURB-65 severity scores, antibiotic regimens, and outcomes were extracted from medical records. Microbiological culture and susceptibility data were analyzed according to CLSI/EUCAST standards. Treatment response was assessed by clinical symptoms, biomarkers, and hospital outcomes. Results: The majority of patients were elderly (≥60 years: 76.0%) and male (53.1%). Frequent comorbidities included hypertension (53.4%) and diabetes (37.8%). At admission, 72.6% had elevated CRP and 65.7% had elevated procalcitonin. Most patients presented with cough (51.2%) and fever (43.8%). CURB-65 scores indicated low-to-moderate risk in 85.5% of cases. Fluoroquinolone monotherapy was the most common initial regimen (48.8%), followed by carbapenem monotherapy (11.6%). Combination therapy accounted for 25.1% of cases, though de-escalation was applied in only 9.4%. Clinical improvement was observed in 75.3% and cure in 20.5% of patients, with significant reductions in WBC (p<0.0001) and CRP (p<0.0001). However, high resistance rates were found in Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae. Conclusion: CAP patients in this Vietnamese cohort were predominantly elderly with multiple comorbidities and frequent use of broad-spectrum antibiotics. Despite overall favorable outcomes, inappropriate reliance on fluoroquinolones and carbapenems, coupled with high AMR rates, underscores the urgent need for hospital-based antimicrobial stewardship, adherence to evidence-based guidelines, and expansion of local resistance surveillance to optimize CAP management.
Objective: To evaluate the outcomes of thoracolumbar spinal fixation using cement-augmented pedicle screws in patients with osteoporosis‑related thoracolumbar trauma treated at Viet Tiep Hospital. Subjects and Methods: A prospective study was conducted on 21 thoracolumbar spinal injuries patients diagnosed with severe osteoporosis who underwent spinal fusion with cement-augmented pedicle screws at Viet Tiep Hospital from January 2022 to January 2025. Results: Pain significantly reduced: mean VAS score decreased from 7.6 ± 0.7 preoperatively to 1.8 ± 0.6 at 6-month postoperatively. Functional recovery was improved markedly with mean ODI decreasing from 69.9 ± 12.1% preoperatively to 24.6 ± 7.7% at 6-month postoperatively. Radiographic analysis showed a marked reduction in both the segmental kyphosis angle (Cobb angle) and the vertebral body kyphosis angle compared to pre-surgery. The most common complication observed was asymptomatic cement leakage. Conclusion: Cement-augmented pedicle screw fixation is a safe and effective surgical technique for managing thoracolumbar spine fractures in patients with severe osteoporosis, providing satisfactory pain relief, spinal stability, and functional recovery.
Anorectal melanoma (ARM) is an extremly rare case. It is an aggressive maglinancy. ARM is difficult to diagnose because of its non specific symptoms. The clincal sign is retal bleeding, tenesmus, an anorectal lump and change in bowel habits and it is like another diseases, for example hemorrhoid, anorectal polypoid and cancer…Diagnose this disease based on clinical, endoscopic and MRI examination and especially biopsy. We present a case of male 79 year-old in Viettiep hospital with perineal pain and rectal bleeding. He was admitted and diagnosed ARM by MRI and Endoscopy and postoperative histopathology. The patient was undergone surgery. The result of Histo-pathology is ARM. We emphasize the role of MRI in diagnosis and evaluation stage of disease that can help for treatment. The hypo or mixed intense on T2, hyperintense on T1, hyperintense in Diff and low in ADC, hyperenhencment after gadolinium injection are factors for positive and differential diagnose between other anorectal tumors. In conclusion, ARM is a rare lesion but it can be suggested for diagnose with MRI so we suggest that MRI should be examination for diagnostic and treatment purpose.
Objective: Assessment of Shoulder Joint Function and Quality of Life in Patients with Cardiac Implantable Electronic Devices. Background: Some common complications after cardiac implantable electronic device implantation include shoulder pain, reduced range of motion, impaired shoulder function, and decreased quality of life after device placement, which may persist thereafter. Methods: A retrospective cohort study at a hospital in Southern Vietnam from February 2023 to February 2025. Results: The study included 116 patients who underwent cardiac implantable electronic device implantation. Women accounted for 45.7%, and the mean age was 64.5 ± 14.5 years. Common comorbidities were hypertension (52.6%), diabetes mellitus (53.4%), dyslipidemia (48.3%), and chronic coronary artery disease (42.2%). The implanted devices were predominantly dual-chamber pacemakers (49.1%) and single-chamber pacemakers (40.5%), followed by ICDs (7.8%) and CRT devices (2.6%). The most frequent indications were sick sinus syndrome (44.0%) and atrioventricular block (45.7%). Shoulder pain (VAS) increased markedly immediately after implantation (0.14 ± 0.09 pre-implantation to 7.85 ± 1.06 post-implantation), then gradually decreased at 1 month (4.53 ± 0.92) and 3 months (1.55 ± 0.93), remaining significantly different from baseline at all time points (p < 0.001). Upper-limb function assessed by QuickDASH deteriorated sharply immediately after implantation (1.31 ± 1.13 pre-implantation to 79.53 ± 6.90 post-implantation), with progressive improvement at 1 month (33.33 ± 7.49) and 3 months (11.97 ± 6.99) (p < 0.001 vs baseline). Health-related quality of life (SF-36) improved after implantation and continued to increase over time: 46.01 ± 10.06 (pre-implantation), 58.54 ± 12.39 (post-implantation), 77.54 ± 12.04 (1 month), and 81.97 ± 7.92 (3 months) (p < 0.001). Conclusion: After cardiac implantable electronic device implantation, patients commonly experience shoulder pain and marked early upper-limb functional limitation, reflected by a sharp immediate increase in VAS and QuickDASH scores. These measures gradually improved over time, with substantial recovery by 3 months, while quality of life (SF-36) increased significantly. These findings suggest that shoulder symptoms should be routinely monitored and that early rehabilitation interventions may help reduce pain, restore mobility, and optimize quality of life after device implantation.
Objective: To report a rare neurological complication following percutaneous vertebroplasty through a clinical case. Case presentations: A case of vertebral compression fracture treated with percutaneous cement augmentation is described. After vertebroplasty, the patient developed spinal cord compression syndrome and subsequently underwent decompressive surgery with spinal fixation. Postoperative recovery was favorable. Conclusion: Spinal cord compression after vertebroplasty is a rare but severe complication. Careful consideration of vertebral body fracture morphology is essential when selecting patients for vertebral augmentation with bone cement in order to minimize this risk.
Gummy smile is one of the complaints of the patients, since such a situation can influence confidence and social relationships. Objective: This study aims to describe some related-factor to gummy smile of students at Viet Nam Maritime University and its related factors. Methods: A cross – sectional study was conduct on 355 students at Viet Nam Maritime University. Results and conclusions: Gummy smile which caused of vertical maxillary excess was most common. There is a strong positive correlation between gummy smile and incisor exposure in resting position and a weak positive correlation between gummy smile and upper lip mobility. Gummy smile has a positive correlation with bite plane angle and maxillary height angle at a moderate level; negatively correlated with facial convexity angle and Jarabak ratio at a moderate level; has a weak positive correlation with ANB angle.
Background: Forearm diaphyseal fractures are common injuries requiring precise anatomical restoration. This study aims to describe the clinical and radiographic characteristics and evaluate the outcomes of surgical treatment for closed forearm diaphyseal fractures in adults using locking compression plates (LCP) at Haiphong University of Medicine and Pharmacy Hospital. Materials and Methods: A retrospective and prospective cross-sectional descriptive study was conducted on 31 patients who underwent internal fixation with LCP at the Department of General Surgery, Haiphong University of Medicine and Pharmacy Hospital from January 2021 to June 2025. Results: The mean age was 44.5 ± 17.6 years, with a male-to-female ratio of 0.94. Traffic accidents were the primary cause (61.3%). The most common fracture site was the middle third (83.8%). The Thompson approach was predominantly used for the radius (83.9%), while the postero-medial approach was used for 100% of ulnar fractures. The mean operative time was 52.5 ± 6.5 minutes. Most cases utilized 6-hole locking plates (83.9% for the radius and 71.0% for the ulna). Primary wound healing was achieved in 96.7% of cases. Postoperative X-rays showed complete anatomical reduction in 90.3% of patients. At the end of the study, 96.8% of patients achieved good to excellent forearm rotation. Long-term outcomes according to Anderson’s criteria were: Excellent 90.3%, Good 6.5%, Fair 3.2%, with no poor results. No cases of pseudarthrosis or refracture after plate removal were recorded. Conclusion: Internal fixation with locking compression plates is an effective treatment for forearm diaphyseal fractures, providing excellent anatomical restoration and stable fixation that allows for early mobilization with a low complication rate.
