Background: While advanced age is a known risk factor for postoperative complications following hip arthroplasty, its role as an independent predictor versus a surrogate for comorbidity remains unclear, particularly in developing countries. This study aimed to investigate the independent impact of age on postoperative outcomes and explore the mediating role of key comorbidities in a resource-limited setting. Methods: We retrospectively reviewed 769 adult patients undergoing hip arthroplasty at a Vietnamese tertiary hospital (2021–2024), categorized into three groups: younger adults (18–64 years), older adults (65–79 years), and oldest old (≥80 years). The primary outcome was a composite of major postoperative complications. Multivariable logistic regression and structural equation modeling were used to identify independent predictors and assess mediation effects. Results: Among 769 patients, 363 were younger (47.2%), 241 older adults (31.3%), and 165 oldest old (21.5%). Complication rates increased significantly with age (18.7%, 36.9%, and 60.0%, respectively; p<0.001). However, multivariable adjustment showed that age was not an independent predictor. Instead, heart failure (adjusted odds ratio [aOR]=5.49, 95% confidence interval [CI] 2.19–13.74) and preoperative anemia (aOR=1.77, 95% CI 1.21– 2.59) were identified as independent risk factors. Mediation analysis revealed that the effect of age on complications was significantly mediated through preoperative anemia. Conclusion Increased postoperative risk in older adults is driven by comorbidity burden rather than chronological age. Preoperative anemia and heart failure are critical, independent predictors, with anemia acting as a key mediator for the effects of age. Individualized correction of modifiable comorbidities may be more beneficial than using age alone to assess surgical risk.

BACKGROUND : The prevalence of rs5186 (AGTR1 A1166C) in the Mekong Delta remains largely unexplored. This study aimed to determine the prevalence of rs5186 in patients with primary hypertension at Xuyen A Vinh Long hospital and to investigate its association with some risk factors for hypertension. METHODS : A case-control study was conducted including 65 hypertensive and 65 non-hypertensive patients. Genotype analysis of rs5186 was performed using tetra-primer amplification refractory mutation system-polymerase chain reaction, and glucose level and lipid profiles were measured. Associations between single-nucleotide polymorphisms, biochemical indicators, and hypertension risk were evaluated using multivariate logistic regression. A dominant genetic model (AC + CC) versus AA was applied for rs5186, and false discovery rate correction was used to account for multiple testing. RESULTS : The genotypes of rs5186 in the hypertension group were 55.4% AA, 43.1% AC, and 1.5% CC, whereas in the control group, they were 64.6% AA, 35.4% AC, and 0% CC. The differences in the genotype distribution were not statistically significant (p = 0.7). The AC + CC genotypes showed no significant association with hypertension after adjustment for confounders. Among biochemical factors, elevated blood glucose (>6.5 mmol/l) was strongly associated with hypertension, with a 6-fold increased risk compared to individuals with normal glucose levels (p<0.001). CONCLUSIONS The rs5186 was not significantly associated with hypertension in this cohort, whereas metabolic factors, particularly hyperglycemia and obesity, were strongly associated with increased hypertension risk. Larger studies are needed to confirm the role of rs5186 and to examine the consistency of effect sizes across different populations.
glucose ; hypertension ; PCR ; SNPs ; Vietnam

Strongyloidiasis, a chronic helminth infection caused by the parasitic nematode Strongyloides stercoralis, has various clinical manifestations. Although rare, duodenal obstructions and venous thromboembolism are possible complications of strongyloidiasis.This paper presents the case of a 47-year-old Vietnamese male with a history of right lower limb edema, anorexia, nausea, vomiting, diarrhea, and abdominal discomfort lasting for four months. Venous Doppler ultrasound detected a thrombus in the right femoral vein, while an abdominal CT scan revealed a mass lesion suggestive of a lower bile duct tumor. Esophageogastroduodenoscopy showed a friable duodenal cap mucosa with multiple ulcers and edematous mucosa of the second part of the duodenum that caused a partial lumen obstruction. The final histological examination of the biopsy specimen revealed chronic duodenitis with larvae consistent with Strongyloides stercoralis. The patient was treated with Ivermectin for two weeks and anticoagulation therapy for three months. After treatment and a six-month follow-up, the patient's gastrointestinal symptoms and leg swelling resolved completely. This is the first documented case of a patient in Vietnam with strongyloidiasis who presented with venous thromboembolism and duodenal obstruction. (Korean J Gastroenterol 2023;81:270-275)