Bariatric tourists. Foreign bariatric patients treated in Poland – a survey based study.

2020 ◽  
Vol 92 (3) ◽  
pp. 1-5
Author(s):  
Piotr Kowalewski ◽  
Michał Janik ◽  
Andrzej Kwiatkowski ◽  
Krzysztof Paśnik ◽  
Maciej Walędziak

Introduction: Bariatric procedures are becoming more popular worldwide. We present current situation of foreign patients treated by high-volume bariatric surgeons in Poland in 2016. Material and Methods: We sent an online survey to twenty high-volume bariatric surgeons. The questionnaire regarded 2016. We asked for number and types of bariatric procedures performed or supervised, number of foreign bariatric patients, their qualification process, country of origin, types of procedure, and post-op recommendations. Results: We received 9 surveys (45%). Five surgeons performed or supervised from 100 to 300 bariatric procedures, 2 performed or supervised over 300 procedures, 2 performed or supervised from 50 to 100 procedures. All of the respondents performed laparoscopic sleeve gastrectomy (LSG) and laparoscopic gastric bypass (LRYGB), four carried out mini gastric bypass, two – gastric banding (LAGB), one – SADI-S and duodenal switch (DS). Six surgeons operated on the total of 64 foreign patients, mainly performing LSG, LRYGB and mini gastric bypass. Most of the patients were qualified based on international criteria (BMI over 40 kg/m2 or BMI over 35 kg/m2 with comorbidities). United Kingdom was the most popular country of origin, followed by Germany, USA, Ireland and Sweden. Qualification for surgery was based on personal visit. After surgery 83.3% (n=5) of the respondents gave out discharge documents in English, recommending long term bariatric follow-up in the country of origin. Every respondent maintained 3-month personal follow-up of every foreign patient. Conclusions: Foreign bariatric patients travelling to Poland are qualified for surgery according to known international standards. Most of the patients receive post-op discharge documents in English, with a 3-month follow-up performed by their surgeon. Further bariatric supervision in the country of origin is routinely recommended.

2015 ◽  
Vol 11 (2) ◽  
pp. 321-326 ◽  
Author(s):  
Matthieu Bruzzi ◽  
Cédric Rau ◽  
Thibault Voron ◽  
Martino Guenzi ◽  
Anne Berger ◽  
...  

2020 ◽  
Author(s):  
Hannes Beiglböck ◽  
Paul Fellinger ◽  
Tamara Ranzenberger-Haider ◽  
Greisa Vila ◽  
Anton Luger ◽  
...  

BJGP Open ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. bjgpopen20X101003 ◽  
Author(s):  
Marc De Meulemeester ◽  
Elsa Mateus ◽  
Hilda Wieberneit-Tolman ◽  
Neil Betteridge ◽  
Lucy Ireland ◽  
...  

BackgroundAlthough commonly diagnosed, gout often remains a poorly managed disease. This is partially due to a lack of awareness of the long-term effect of gout among patients and healthcare professionals.AimTo understand unmet needs for patients and provide insight into achieving better treatment.Design & settingA quantitative online questionnaire collected from 1100 people with gout from 14 countries within Europe.MethodPatients were recruited to complete an online survey via healthcare professional (HCP) referral, patient associations, or market research panels. Patients were included if they had been diagnosed with gout by a physician. Prior to commencement, patients were made aware that this study was sponsored by Grünenthal. The responses collected were collated and analyses were performed.ResultsPatients had an average of 2.9 gout flares within a 12-month period. Although 79% of patients were satisfied with treatment, inadequate gout control was also reported by 71% of patients. Furthermore, 84% experienced moderate-to-severe pain with their most recent flare. Of those who acknowledged treatment dissatisfaction, only 24% discussed other options with their GP. Most patients reported irregular follow-up and serum uric acid (sUA) monitoring. In addition, loss of belief that more can be done was a key barrier for patients.ConclusionPatients reported severe pain and social burden, coupled with low treatment expectation and lack of awareness of target sUA. Education around knowing and reaching sUA target is needed so that patients can receive and GPs can deliver higher quality management.


2021 ◽  
Vol 9 (2) ◽  
pp. 94-105
Author(s):  
Naifeng Kuang ◽  
Xiaoyu Wang ◽  
Yuexia Chen ◽  
Guifeng Liu ◽  
Fan’e Kong ◽  
...  

Spinal cord injury is a serious disabling condition. Transplantation of olfactory ensheathing cells (OECs) is one of the most promising treatments for spinal cord injury (SCI). Thirty-nine patients with chronic SCI received OEC transplantation and completed long-term follow-up, with a minimum follow-up of 7 years. We assessed sensorimotor function with the American Spinal Injury Association (ASIA) Impairment Scale (AIS) and autonomic nervous function by the International Standards to document remaining Autonomic Function after Spinal Cord Injury (ISAFSCI), and sympathetic skin responses (SSR). The scores of each group were significantly higher after OECs transplantation than before treatment. SSR latencies were shorter and response amplitudes increased after treatment. Long-term follow-up showed further improvement only in motor function and autonomic function compared with 3 months postoperatively. No complications occurred in any patient during long-term follow-up. The results indicate that the transplantation of OECs in spinal cord restored function without serious side effects.


2018 ◽  
Vol 12 (2) ◽  
pp. 76-79
Author(s):  
V. S. Samoylov ◽  
V. V. Novomlinskiy ◽  
N. А. Malkina

The number of post-bariatric patients is increasing from year to year; any medical specialist can see consequences and sometimes complications of these interventions. The variety of different scenarios associated with such patients is not well studied. Mini-gastric bypass (MGB-OAGB) is a major type of primary or recurrent bariatric surgery in obese patients. Biliary reflux (BR) is one of the most significant late complications of this operation. An increase in the intra-abdominal pressure during pregnancy can lead to the development of BR with its typical clinical symptoms, which may sometimes puzzle an obstetrician-gynecologist. In these cases, there are limitations in using traditional diagnostic approaches and regular medications for conservative treatment of BR. This report presents a clinical observation on a patient who underwent MGB-OAGB as a recurrent bariatric intervention for her morbid obesity. With no signs of gastroesophageal reflux before surgery, soon after it or in the I trimester of pregnancy, a typical clinical picture of BR developed in the II and III trimesters. A complete relief of the BR symptoms after the childbirth (confirmed by gastro-esophago-scopy) suggested a direct connection between the BR and the increase in intra-abdominal pressure during pregnancy.


Obesity Facts ◽  
2020 ◽  
pp. 1-10
Author(s):  
Julian Bühler ◽  
Silvan Rast ◽  
Christoph Beglinger ◽  
Ralph Peterli ◽  
Thomas Peters ◽  
...  

<b><i>Background:</i></b> Currently, the two most common bariatric procedures are laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB). Long-term data comparing the two interventions in terms of their effect on body composition and bone mass density (BMD) are scarce. <b><i>Objective:</i></b> The aim of this study was to assess body composition and BMD at least 5 years after LSG and LRYGB. <b><i>Setting:</i></b> Department of Endocrinology and Nutrition, St. Claraspital Basel and St. Clara Research Ltd., Basel, Switzerland. <b><i>Methods:</i></b>Bariatric patients at least 5 years after surgery (LSG or LRYGB) were recruited, and body composition and BMD were measured by means of dual-energy X-ray absorptiometry. Data from body composition before surgery were included in the analysis. Blood samples were taken for determination of plasma calcium, parathyroid hormone, vitamin D<sub>3</sub>, alkaline phosphatase, and C-terminal telopeptide, and the individual risk for osteoporotic fracture assessed by the Fracture Risk Assessment Tool score was calculated. After surgery, all patients received multivitamins, vitamin D<sub>3</sub>, and zinc. In addition, LRYGB patients were prescribed calcium. <b><i>Results:</i></b> A total of 142 patients were included, 72 LSG and 70 LRYGB, before surgery: median body mass index 43.1, median age 45.5 years, 62.7% females. Follow-up after a median of 6.7 years. For LRYGB, the percentage total weight loss at follow-up was 26.3% and for LSG 24.1% (<i>p</i> = 0.243). LRYGB led to a slightly lower fat percentage in body composition. At follow-up, 45% of both groups had a T score at the femoral neck below –1, indicating osteopenia. No clinically relevant difference in BMD was found between the groups. <b><i>Conclusions:</i></b>At 6.7 years after surgery, no difference in body composition and BMD between LRYGB and LSG was found. Deficiencies and bone loss remain an issue after both interventions and should be monitored.


EP Europace ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. 1097-1102
Author(s):  
Anders Fyhn Elgaard ◽  
Jens Brock Johansen ◽  
Jens Cosedis Nielsen ◽  
Christian Gerdes ◽  
Sam Riahi ◽  
...  

Abstract Aims  Commonly, a dysfunctional defibrillator lead is abandoned and a new lead is implanted. Long-term follow-up data on abandoned leads are sparse. We aimed to investigate the incidence and reasons for extraction of abandoned defibrillator leads in a nationwide cohort and to describe extraction procedure-related complications. Methods and results  All abandoned transvenous defibrillator leads were identified in the Danish Pacemaker and ICD Register from 1991 to 2019. The event-free survival of abandoned defibrillator leads was studied, and medical records of patients with interventions on abandoned defibrillator leads were audited for procedure-related data. We identified 740 abandoned defibrillator leads. Meantime from implantation to abandonment was 7.2 ± 3.8 years with mean patient age at abandonment of 66.5 ± 13.7 years. During a mean follow-up after abandonment of 4.4 ± 3.1 years, 65 (8.8%) abandoned defibrillator leads were extracted. Most frequent reason for extraction was infection (pocket and systemic) in 41 (63%) patients. Procedural outcome after lead extraction was clinical success in 63 (97%) patients. Minor complications occurred in 3 (5%) patients, and major complications in 1 (2%) patient. No patient died from complication to the procedure during 30-day follow-up after extraction. Conclusion  More than 90% of abandoned defibrillator leads do not need to be extracted during long-term follow-up. The most common indication for extraction is infection. Abandoned defibrillator leads can be extracted with high clinical success rate and low risk of major complications at high-volume centres.


1994 ◽  
Vol 61 (1_suppl) ◽  
pp. 256-259
Author(s):  
G. Sevin ◽  
H. Gezeroglu ◽  
R. Pacchiele ◽  
A. Carbone

Sigma-rectum pouch (Mainz Pouch II) operation, which is a detubularized modification of the well-known ureterosigmoidostomy is becoming a popular alternative of urinary diversion in selected patients. 12 male patients underwent this operation due to locally invasive bladder tumours or incurable urethral strictures and fistulas. The pouch was tailored using 12 cm of sigmoid colon and rectum and performing a side to side anastomosis of the detubularized bowel in an inverted U shape. The new formed pouch was fixed onto the posterior peritoneum so that traction affecting the pouch was minimized. Postoperative radiological analysis revealed no obstruction or ureteral reflux. Urodynamic studies revealed low pressure, high volume reservoirs. Only 1 patient had reservoir wall contractions of low amplitude during filling. Although early postoperative blood chemistry did not reveal any metabolic abnormality, at long-term follow-up some patients showed important electrolyte and acid-base disorders.


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