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.

Solar lentigines are benign pigmented lesions commonly treated with 532-nm Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers, though outcomes can be limited by post-inflammatory hyperpigmentation (PIH), especially in darker skin types. This case series evaluated a novel 532-nm nanosecond Nd:YAG vasculature salvage laser surgery (VSLS) system, designed to minimize PIH risk through two key features: cryo-photothermolysis, which induces vasoconstriction to reduce hemoglobin absorption, and AutoDerm®, which enables precise lesion targeting. Two female patients in their 60s with persistent solar lentigines, unresponsive to prior laser treatments, underwent a single VSLS session. Complete resolution of the lentigines was achieved after one treatment session, with no signs of PIH, prolonged erythema, or scarring observed throughout 3 months of follow-up. This outcome suggests the VSLS system may offer a safer and more effective alternative for treating solar lentigines, particularly in patients at a higher risk of laser-induced complications.

The Asian Society of Cardiovascular Imaging-Practical Tutorial (ASCI-PT) is an instructional initiative of the ASCI School designed to enhance educational standards. In 2021, the ASCI-PT was convened with the goal of formulating a consensus statement on the assessment of coronary stenosis and coronary plaque using coronary CT angiography (CCTA). Nineteen experts from four countries conducted thorough reviews of current guidelines and deliberated on eight key issues to refine the process and improve the clarity of reporting CCTA findings. The experts engaged in both online and on-site sessions to establish a unified agreement. This document presents a summary of the ASCI-PT 2021 deliberations and offers a comprehensive consensus statement on the evaluation of coronary stenosis and coronary plaque in CCTA.

The Asian Society of Cardiovascular Imaging-Practical Tutorial (ASCI-PT) is an instructional initiative of the ASCI School designed to enhance educational standards. In 2021, the ASCI-PT was convened with the goal of formulating a consensus statement on the assessment of coronary stenosis and coronary plaque using coronary CT angiography (CCTA). Nineteen experts from four countries conducted thorough reviews of current guidelines and deliberated on eight key issues to refine the process and improve the clarity of reporting CCTA findings. The experts engaged in both online and on-site sessions to establish a unified agreement. This document presents a summary of the ASCI-PT 2021 deliberations and offers a comprehensive consensus statement on the evaluation of coronary stenosis and coronary plaque in CCTA.

Methods: We used 1.0-mm interval computed tomographic scan images of 100 patients (50 men and 50 women) and screw trajectory simulation software. The diameter of all screws was set at 3.5 mm, considering its common usage in real surgery. The anatomical feasibility of placing both pedicle and laminar screws on the same side was evaluated. For all feasible sides, the three-dimensional distance between the screw entry points was measured. Results: In 85% of cases, both pedicle and laminar screws could be placed on both sides, allowing for the insertion of 4 screws. In 11% of cases, 2 screws could be placed on one side, while only 1 screw was feasible on the other side, resulting in the placement of 3 screws. In all 181 sides where both types of screws could be inserted, the distance between their entry points exceeded 16.1 mm, which was sufficient to prevent the collision between the screw heads. Conclusions C2 vertebra can accommodate three (11%) or four (85%) screws in 96% of cases.

Objective: This study aimed to evaluate the effect of implementing the consensus statement from the Asian Society of Cardiovascular Imaging-Practical Tutorial 2020 (ASCI-PT 2020) on the reliability of cardiac MR with late gadolinium enhancement (CMR-LGE) myocardial viability scoring between observers in the context of ischemic cardiomyopathy. Materials and Methods: A total of 17 cardiovascular imaging experts from five different countries evaluated CMR obtained in 26 patients (male:female, 23:3; median age [interquartile range], 55.5 years [50–61.8]) with ischemic cardiomyopathy. For LGE scoring, based on the 17 segments, the extent of LGE in each segment was graded using a five-point scoring system ranging from 0 to 4 before and after exposure according to the consensus statement. All scoring was performed via webbased review. Scores for slices, vascular territories, and total scores were obtained as the sum of the relevant segmental scores. Interobserver reliability for segment scores was assessed using Fleiss’ kappa, while the intraclass correlation coefficient (ICC) was used for slice score, vascular territory score, and total score. Inter-observer agreement was assessed using the limits of agreement from the mean (LoA). Results: Interobserver reliability (Fleiss’ kappa) in each segment ranged 0.242–0.662 before the consensus and increased to 0.301–0.774 after the consensus. The interobserver reliability (ICC) for each slice, each vascular territory, and total score increased after the consensus (slice, 0.728–0.805 and 0.849–0.884; vascular territory, 0.756–0.902 and 0.852–0.941; total score, 0.847 and 0.913, before and after implementing the consensus statement, respectively. Interobserver agreement in scoring also improved with the implementation of the consensus for all slices, vascular territories, and total score. The LoA for the total score narrowed from ± 10.36 points to ± 7.12 points. Conclusion The interobserver reliability and agreement for CMR-LGE scoring for ischemic cardiomyopathy improved when following guidance from the ASCI-PT 2020 consensus statement.

PURPOSE: We tried to investigate the clinical impact of Ki-67 (MIB-1) expression on the oncological and survival outcomes in patients with bladder cancer (BCa) after the radical cystectomy. MATERIALS AND METHODS: We retrospectively analyzed the data of 230 patients who were treated by radical cystectomy for BCa. Multivariate Cox-proportional hazards models and logistic regression tests were performed to evaluate the prognostic value of each variable. RESULTS: The patients with positive Ki-67 expression showed significant worse clinical characteristics and pathologic outcomes than negative Ki-67 group. Furthermore, the patients with Ki-67 expression showed significant worse recurrence (p=0.018) and cancer-specific mortality free survival (p=0.019) than negative Ki-67 group. The overall survival was also revealed to be inferior in Ki-67 positive group than Ki-67 negative group but the statistical significance was marginal (p=0.062). Subsequent multivariate Cox analyses showed that Ki-67 was independent predictor for disease recurrence after surgery (hazard ratio, 3.142; 95% CI, 1.287–7.671; p=0.012). CONCLUSIONS: In our study, high Ki-67 expression was significantly related with worse clinical outcomes after radical cystectomy in the patients with BCa. Further prospective and basic researches are needed to validate the true prognostic value of Ki-67.
Cystectomy* ; Humans ; Logistic Models ; Mortality ; Prognosis* ; Proportional Hazards Models ; Prospective Studies ; Recurrence ; Retrospective Studies ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Background:The dimension and function of kidney have close relationship. In the developing countries, the index on kidney dimension of children has rather fully studied. In Viet Nam, most of studies only conducted on adults. Objectives:This study aims to determine the ultrasound kidney dimension and the correlation of kidney length and age, weight and height of children aged from 6 to 8 years old. Subjects and method: The data was obtained from a prospective study on 180 normal children at age from 6 to 8 years. Each kidney was measured length, width , thickness, and parenchymal thickness, and the mean values were recorded. The relationship of kidney length with age, body weight, body height were also taken. Results: Kidney dimension was increased by age. The average ultrasound kidney dimension:+ Right kidney: At 6 years old: Boy: length: 72.8\xb14; width: 31.2\xb13 ; thickness: 33.9\xb12 ; Girl: length: 69.8\xb15; width: 30.4\xb12 ; thickness: 32.7\xb12. At 7 years old: Boy: length: 75.2\xb14; width: 31.9\xb12; thickness: 33.8\xb13; Girl: length: 75.8\xb15; width: 32.0\xb12; thickness: 32.9\xb14; + Left kidney: At 6 years old: Boy: length: 73.9\xb15; width: 33.7\xb13 ; thickness: 34.9\xb12 ; Girl: length: 71.1\xb14; width: 32.4\xb13 ; thickness: 32.4\xb16. At 7 years old: Boy: length: 77.7\xb13; width: 33.8\xb13 ; thickness:34.7\xb12; Girl: length: 76.9\xb17; width: 32.0\xb12; thickness: 33,9\xb15; The kidney length, kidney weight, kidney volume of boys were bigger than girls, and the difference was significant (p<0.05). Conclusion: The kidney length correlated strongly and positively with body weight, body height and age.
Kidney/ ultrasonography ; Child

Background: Research of pH and specific gravity of urine in healhty children is nessecary in order to evaluate urine in children with neurology. Objectives:This study aims to estimate pH and specific gravity in healthy children aged from 2 months to 6 years old. Subjects and method: 3724 healthy children ( boy: 52,6% and girl: 47.4%) aged from 2 months to 6 years old located in 3 districts: Kien Thuy, Thuy Nguyen, Kien An of Hai Phong were enrolled in the descriptive and cross-sectional study using urianalysis of midstream urine samples in the morning by analyzer Model 101-Teco from USA. The data was collected and analysed bysocial statistic SPSS software. Results: - pH mean in boys was 5.38\xb10.62, in girls: 5.40\xb10.61, and both sexes: 5.39\xb10.62. In general, urine pH decreased according to age groups but there were no sex differences significantly. - Specific gravity mean of healthy boys was 1.018\xb10.007, of girls: 1.018\xb10.006 and both sexes: 1.018\xb10.007. Conclusion: In general, specific gravity increased according to age groups but no sex differences may significantly be found.
Purine-Nucleoside Phosphorylase/ analysis ; Child

Background: Open heart surgery with cardiopulmonary bypass (CPB) causes haemostatic abnormalities which result in postoperative excessive bleeding. Objectives: To investigate haemostatic disorders before - after CPB and postoperative bleeding. Subjects and methods: Sixty congenital cardiac patients with and without cyanosis were recruited consecutively. Hematology and coagulation tests were done 1 day before operation, 15 minutes after protamine administration, 2 and 6 hours after the operation in the intensive care unit (lCU). Mediastinal chest tube drainage (MCTO) was measured for the first 6h in the ICU. Results: Significant differences between 2 groups could be found for red blood cells, hemoglobin, hematocrit, fibrinogen, D-dimer, fibrinogen degradation products (FOP), von Kaulla and platelet aggregation to epinephrine before operation (p < 0.05). There were not significant differences in platelets, PT, APTT, platelet aggregation to adenosine diphosphate (AOP) in the acyanotic and cyanotic patients (p > 0.05). Most hematology parameters were decreased significantly and hemostasis measurements were prolonged after operation in both groups (p < 0.05). There was also the significant difference in MCTO between 2 groups (p < 0.05). Conclusion: Coagulation, hemostasis and fibrinolysis disorders; thrombocytopenia and acquired transient platelet dysfunction may be responsible for bleeding complications after CBP \r\n', u'\r\n', u'
Heart Defects ; Congenital/ pathology ; epidemiology ; Hemostatic Disorders/ pathology ; diagnosis