University Medical Center HCMC

To evaluate the appropriateness of antimicrobial therapy in treating healthcare-associated infections and identify factors associated with patient outcomes at a national hospital in Vietnam. A cross-sectional study was conducted on 122 medical records of patients who were diagnosed with healthcare-associated infection at Thong Nhat Hospital from January 2023 to December 2023, using data from the Infection Control Department. Appropriateness of antimicrobial therapy was defined as physician adherence to Thong Nhat Hospital guidelines for antibiotic use. The factors associated with the treatment outcome were identified using multiple logistic regression analysis. The median age of the patients was 75.5 (65-85). Hospital-acquired pneumonia was identified in 51.6% of patients. The most prevalent pathogens were Klebsiella pneumoniae and Escherichia coli. The overall appropriate rate of empiric antimicrobial therapy was 76.2%. The successful treatment outcome rate was 71.3%. Lower respiratory tract infection, sepsis/sepsis shock, cancer, and comatose state were factors associated with treatment failure. Active management and treatment are essential for patients with lower respiratory infection, sepsis or septic shock, cancer, and comatose states to improve treatment outcomes.

Metabolic syndrome (MtS) is a growing global health concern, with genetic factors playing a significant role in its development. This study aimed to examine the association between ADIPOQ polymorphisms and MtS, as well as their relationships with adiponectin levels in the Vietnamese population. Metabolic parameters and genotyping data were collected from 160 individuals diagnosed with MtS according to the 2005 International Diabetes Federation criteria, and 160 control subjects. The results reveal a significant association between rs266729 and MtS, with a log-additive OR = 1.46 (95% CI: 1.02-2.09, p = 0.038). Carriers of the G allele also exhibit lower median adiponectin levels: 6.69 (3.84-10.52) µg/mL for C/C, 6.55 (3.32-9.52) µg/mL for G/C, and 4.28 (3.14-6.38) µg/mL for G/G, p for trend = 0.036. In contrast, the associations of rs2241766 and rs1501299 with MtS did not reach statistical significance in this cohort. However, adiponectin levels also show a trend of progressively decreasing with increasing numbers of minor alleles in the genotypes, particularly in the control group, p for trend = 0.02 and 0.044, respectively. These findings underscore the importance of genetic variations in regulating adiponectin, especially during the early stages of metabolic disturbances, and call for further research to assess their clinical significance.

Background: Fenestration is a well-established modification of the Fontan procedure intended to reduce systemic venous pressure and limit early postoperative complications. However, the optimal fenestration diameter that balances clinical benefits with systemic oxygenation remains uncertain. This study aimed to evaluate the association between fenestration size and early outcomes following extracardiac Fontan surgery. Methods: We retrospectively analyzed pediatric patients who underwent fenestrated extracardiac Fontan surgery at Cho Ray Hospital between January 2020 and March 2025. Fenestration diameters ranged from 4 to 8 mm. Postoperative complications were categorized as pulmonary, cardiovascular, infectious, renal, or mortality events. Continuous outcomes included postoperative pleural drainage duration, intensive care unit stay, hospital stay, and perioperative change in peripheral arterial oxygen saturation (SpO2). Correlation analyses were employed to assess the associations between fenestration size and outcomes. Results: Twenty patients (median age: 5 years; 70% male) were included. Pulmonary complications were most common (85%), with pneumonia and pleural effusion observed in 65% of cases. Fenestration size was not associated with overall complication incidence; however, cardiovascular complications differed between groups (p = 0.045), without a linear trend (p for trend = 0.271). Oxygenation improved significantly perioperatively (median SpO2 increased from 76% to 86%, mean change: 10.6%; p = 0.001). Fenestration size correlated inversely with perioperative SpO2 change (ρ = –0.75; p < 0.001), while larger fenestrations correlated with shorter pleural drainage (ρ = –0.71; p = 0.001) and reduced hospital stay (ρ = –0.59, p = 0.012). Conclusion: Fenestration significantly impacts early outcomes after a Fontan operation. Larger fenestrations promoted faster recovery, with shorter pleural drainage and hospital stays, but conferred a smaller oxygenation benefit. Individualized fenestration sizing may help optimize early outcomes in pediatric Fontan patients.

Abstract Obstructive Sleep Apnea (OSA) is a prevalent sleep disorder associated with serious cardiovascular and metabolic risks, yet the gold-standard diagnostic method, polysomnography (PSG), is costly and impractical for large-scale screening. This study presents a preliminary evaluation of a low-cost, Arduino-based system designed for home-based OSA detection. The system integrates three key biosignals: electrocardiogram (ECG) for heart rate variability (HRV) analysis, peripheral oxygen saturation (SpO 2 ) for desaturation detection, and chest–abdominal accelerometer signals for respiratory monitoring. An overnight experiment was conducted on four volunteers (two males, two females), including two habitual snorers and two normal controls. Results indicated that normal subjects maintained stable HRV (SDNN, RMSSD), higher mean SpO 2 (≥96%), and no apnea events, whereas the snoring male subject showed reduced HRV, lower oxygen nadir (87%), multiple desaturation events (ODI3 = 4, ODI4 = 2), and an estimated AHI of 5 events/hour, suggesting borderline mild OSA. The system demonstrated stable signal acquisition and meaningful physiological differentiation between normal and snoring subjects. Although limited by the small cohort and single-night monitoring, these findings support the feasibility of using Arduino-based wearable devices as accessible, low-cost tools for early OSA screening and continuous home monitoring.

Dysphagia is a prevalent and debilitating sequela in patients with oral cavity and oropharyngeal cancers undergoing surgery, often complicated by adjuvant radiotherapy or chemoradiotherapy. This prospective cohort study aimed to describe the longitudinal changes in swallowing and oral intake and assess the influence of adjuvant treatment modalities. We included 89 patients with oral cavity or oropharyngeal squamous cell carcinoma. Swallowing was assessed at 1, 3, and 6 months post-surgery using Eating Assessment Tool-10 (EAT-10), Swallowing Ability and Safety Scale (SASS), Functional Oral Intake Scale (FOIS), and Fiberoptic Endoscopic Evaluation of Swallowing (FEES). Patients were stratified by adjuvant treatment: none, radiotherapy, or chemoradiotherapy. Swallowing recovery was dynamic. EAT-10 scores increased from 8.8 at 1 month to peak at 13.5 at 3 months (p < 0.001), before decreasing to 8.3 at 6 months (p < 0.001). Penetration/aspiration for thin liquids significantly increased from 32.6% at 1 month to 44.9% at 3 months (p = 0.034), then decreased to 31.5% at 6 months (p = 0.014). FOIS and SASS scores showed overall improvement from 1 to 6 months (p < 0.001 for both), despite a transient dip in FOIS and a rise in poor SASS scores at 3 months. Patients receiving chemoradiotherapy demonstrated greater perceived dysphagia, lower functional oral intake, and higher rates of thin liquid penetration/aspiration compared to other groups across all time points. In conclusion, chemoradiotherapy is associated with more severe and prolonged dysphagia. These findings underscore the critical need for targeted rehabilitation and comprehensive multidisciplinary care.

Obstructive sleep apnea (OSA) is increasingly recognized as a major comorbidity in chronic respiratory diseases, particularly asthma and chronic obstructive pulmonary disease (COPD). The coexistence of OSA with asthma or COPD significantly complicates the clinical course, leading to poorer disease control, more frequent exacerbations, reduced lung function, impaired sleep quality, and increased cardiovascular and overall mortality. In asthma, OSA exacerbates airway inflammation, enhances bronchial hyperresponsiveness, and decreases responsiveness to standard therapies. In COPD, the “overlap syndrome” is associated with profound nocturnal hypoxemia, chronic hypercapnia, pulmonary hypertension, and a markedly elevated risk of hospitalization and death. Underlying mechanisms include chronic airway inflammation, oxidative stress induced by intermittent hypoxia, instability of ventilatory control (high loop gain), structural upper-airway alterations, and the burden of obesity and metabolic dysfunction. These interactions highlight the urgent need for integrated and proactive management strategies. Thus, we propose an Asthma–COPD–OSA Outpatient Unit (ACOSOU)—a care-delivery model, not a disease entity—designed to integrate systematic screening, diagnosis, treatment initiation, and long-term follow-up of OSA in patients with asthma and COPD. Optimal care requires systematic screening in respiratory outpatient settings, appropriate diagnostic pathways using polysomnography or home sleep apnea testing, and individualized treatment approaches. Continuous positive airway pressure (CPAP) remains the cornerstone therapy for OSA–asthma and OSA–COPD overlap, improving gas exchange, reducing exacerbations, and enhancing disease control. Comprehensive management also includes optimization of inhaled therapies, pulmonary rehabilitation, weight reduction, sleep hygiene, and multidisciplinary collaboration. This review proposes an integrated ACOSOU model to streamline screening, diagnosis, CPAP titration, and long-term follow-up. However, implementation in low- and middle-income countries faces challenges including limited trained sleep-medicine personnel, unequal access to diagnostic tools, and high CPAP costs without insurance coverage. Strengthening infrastructure, training, and policy support will be essential to improve outcomes for patients with chronic respiratory diseases and OSA comorbidity.

Viet Nam faces a significant burden of viral hepatitis-associated liver disease, but the contribution of HDV, the most severe form of viral hepatitis, remains underinvestigated. HDV is substantial in the Northern and Central regions, but has not been documented in the South of Viet Nam. To investigate HDV prevalence and its association with severe liver disease in Southern Viet Nam, we used the standardized assay (LIAISON XL Anti-HDV) to detect HDV antibodies (anti-HDV) in 721 HBsAg positive individuals with hepatitis flare (n = 158), liver cirrhosis (LC) (181), hepatocellular carcinoma (HCC) (207), chronic hepatitis B (CHB) (175). Unexpectedly, anti-HDV was rare and only detected in 11/721 participants (1.5%), and not significantly different among groups: 2/158 (1.3%) in flare, 4/181 (2.2%) in LC, and 5/207 (2.4%) in HCC, and 0/175 (0%) in CHB. This suggests that HDV is not one of the major contributors to the high burden of liver disease in Southern Viet Nam. The discrepancy of HDV prevalence between Northern-Central and Southern regions suggests location-specific distribution of HDV, which in turn reflects differences in HDV transmission routes, study populations, and/or study methodologies. Our study underscores the need for tailored, regional screening strategies rather than a single national guideline for HDV infection.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-33268-0.

[This corrects the article DOI: 10.3389/bjbs.2025.15455.].