scholarly journals Life-threatening visceral complications after intragastric balloon insertion: Is the device, the patient or the doctor to blame?

2019 ◽  
Vol 07 (02) ◽  
pp. E122-E129 ◽  
Author(s):  
George Stavrou ◽  
Georgia Tsaousi ◽  
Katerina Kotzampassi
Keyword(s):  
Weight Loss ◽  
Bowel Obstruction ◽  
Esophageal Perforation ◽  
Intragastric Balloon ◽  
Gastric Perforation ◽  
Low Cost ◽  
Invasive Procedure ◽  
Safe Procedure ◽  
Bariatric Endoscopy ◽  
Mandatory Education

Abstract Background and aim Intragastric balloon placement is established as a safe, relatively low-cost and well-tolerated minimally invasive procedure for weight loss, giving encouraging results under the strict prerequisite that the obese patient will enroll in a medically supervised weight loss program. This retrospective study reviews already published cases of severe visceral complications for the purpose of assigning responsibility to the device, the patient, or the doctor. Methods We reviewed PubMed and Scopus archived publications describing intragastric balloon (BIB/Orbera)-related severe visceral complications, i. e. perforations and obstructions. Results Twenty-two cases of gastric perforation, two cases of esophageal perforation and 10 cases of bowel obstruction were found. For the gastric perforation the endoscopist was responsible in nine cases, the patient in four, and the balloon itself in nine. For the two cases of esophageal perforation, the endoscopists were responsible, while for the 12 cases of bowel obstruction, the patient was responsible for seven and the device for the other five cases. Conclusion BIB/Orbera balloon insertion remains a safe procedure, with a minimum of complications related to hollow viscera. Mandatory education and accreditation of physicians dealing with bariatric endoscopy and strict supervision of the obese individuals, while living with the balloon, will eliminate such complications.

scholarly journals ASSESSMENT OF WEIGHT LOSS AFTER NON-ADJUSTABLE AND ADJUSTABLE INTRAGASTRIC BALLOON USE

2020 ◽  
Vol 57 (1) ◽  
pp. 13-18
Author(s):  
Maíra L SCHWAAB ◽  
Eduardo N USUY JR ◽  
Maurício M de ALBUQUERQUE ◽  
Daniel Medeiros MOREIRA ◽  
Victor O DEROSSI ◽  
...  
Keyword(s):  
Weight Loss ◽  
Intragastric Balloon ◽  
Excess Weight Loss ◽  
Positive Impact ◽  
Body Weight Loss ◽  
Invasive Procedure ◽  
Total Body Weight ◽  
Excess Weight ◽  
Obese Patients ◽  
Cross Sectional

ABSTRACT BACKGROUND: Intragastric balloon (IGB) use is indicated for patients whose BMI precludes the option of bariatric surgery or who need to lose weight prior to undergoing surgery. It is a minimally invasive procedure and currently there are two main models of IGBs in use, the non-adjustable intragastric balloon (NIB), implanted for six months, and the adjustable intragastric balloon (AIB), implanted for up to 12 months. OBJECTIVE: Analyze clinical characteristics between patients receiving non-adjustable gastric balloon and the adjustable (prolonged implantation) intragastric balloon. METHODS: This was a cross-sectional study of 470 patients diagnosed as obese or overweight who had balloon implantation from October 2011 to July 2018. The associations between percentage excess weight loss versus clinical and demographic variables were calculated using the chi-squared test. Independent samples were submitted to the Student’s t test to determine the quantitative variables, with a confidence interval of 95%. Calculation of excess weight was based on an estimated ideal weight that would correspond to a BMI of 24.99 kg/m2. RESULTS: A total of 414 patients completed the treatment achieving an average total body weight loss (%TBWL) of 15.4±7 with the NIB and 15.5±9.6 with the AIB. Overweight patients achieved higher excess weight loss (%EWL) values using AIBs (157.2±82.5) and obese patients did so with NIB use (56±29.7). Women achieved higher %EWL values (65.6±62.2) than men (48±27.1). Individuals who attended >4 consultations with a nutritionist (60.8%) achieved TBWL >18%. All of those P-values were <0.001. CONCLUSION: Obese individuals and women registered the greatest weight losses. Overweight patients achieved greater losses using AIB and obese patients did so using NIBs. NIB use was associated with higher EWL percentages. Nutritional accompaniment had a positive impact on the %TBWL.

Chronic ectopic pregnancy mimicking pelvic malignancy

2021 ◽  
Vol 14 (3) ◽  
pp. e233534
Author(s):  
Edwin Omih ◽  
Argyrios Makris ◽  
Cheng Choy ◽  
Nikhil Bhuskute
Keyword(s):  
Weight Loss ◽  
Ectopic Pregnancy ◽  
Bowel Obstruction ◽  
Early Pregnancy ◽  
Pelvic Mass ◽  
Common Complication ◽  
Pelvic Malignancy ◽  
Atypical Case ◽  
Ectopic Gestation ◽  
Negative Pregnancy Test

Ectopic pregnancy is a common complication of early pregnancy. We present a very atypical case of an ectopic gestation in a woman who presented with a negative pregnancy test, a large pelvic mass, weight loss and bowel obstruction.

Corrosion resistant metal-ceramic composite coatings for tribological applications

2021 ◽  
pp. 1-34
Author(s):  
Peter Renner ◽  
Swarn Jha ◽  
Yan Chen ◽  
Tariq Chagouri ◽  
Serge Kazadi ◽  
...  
Keyword(s):  
Ceramic Composite ◽  
Low Cost ◽  
Composite Coatings ◽  
Salt Spray ◽  
Extreme Environments ◽  
Safe Procedure ◽  
Corrosion Resistant ◽  
Wide Range ◽  
Metal Ceramic ◽  
Corrosion Resistant Coatings

Abstract Effective design of corrosion-resistant coatings is critical for the protection of metals and alloys. Many state-of-the-art corrosion-resistant coatings are unable to satisfy the challenges in extreme environments for tribological applications, such as elevated or cryogenic temperatures, high mechanical loads and impacts, severe wear, chemical attack, or a combination of these. The nature of challenging conditions demands that coatings have high corrosion and wear resistance, sustained friction control, and maintain surface integrity. In this research, multi-performance metal-ceramic composite coatings were developed for applications in harsh environments. These coatings were developed with an easy to fabricate, low-cost, and safe procedure. The coating consisted of boron nitride, graphite, silicon carbide, and transition metals such as chromium or nickel using epoxy as vehicle and bonding agent. Salt spray corrosion tests showed that 1010 carbon steel (1/4 hard temper) substrates lost 20-100× more mass than the coatings. The potentiodynamic polarization study showed better performance of the coatings by seven orders of magnitude in terms of corrosion relative to the substrate. Additionally, the corrosion rates of the coatings with Ni as an additive were five orders of magnitude lower than reported. The coefficient of friction of coatings was as low as 0.1, five to six times lower than that of epoxy and lower than a wide range of epoxy resin-based coatings found in literature. Coatings developed here exhibited potential in applications in challenging environments for tribological applications.

Silver diamine fluoride for managing carious lesions: A literature review

2021 ◽  
Vol 11 (2) ◽  
pp. 118-122
Author(s):  
Dishika Iswar ◽  
Arun Kumar Sajjanar ◽  
Milind Wasnik ◽  
Niharika Gawod ◽  
Partima Kolekar ◽  
...  
Keyword(s):  
Dental Caries ◽  
Dental Health ◽  
Low Cost ◽  
Invasive Procedure ◽  
Antimicrobial Effect ◽  
Permanent Teeth ◽  
Silver Diamine Fluoride ◽  
The Us ◽  
Socioeconomical Status ◽  
Silver Compounds

Though the prevalence and the severity of dental caries is decreased in past few years, still children from low socioeconomical status in many industrialized or developing countries are still suffering from ill-effects of dental caries. The antimicrobial effect of silver compounds has been proven by the 100-year-old application of silver compounds. Silver diamine fluoride (SDF) has been used to arrest dental caries during 1970s in Japan, but it was not exposed much to other parts of the world. Today in many countries a 38% (44,800 ppm fluoride) SDF solution is commonly used to arrest caries and also to reduce hypersensitivity in primary and permanent teeth. Application of SDF to arrest dental caries is non-invasive procedure and is quick and simple to use. Reports of available studies showed that there is no severe pulpal damage after SDF application. However, it has some drawbacks like black discoloration of the carious teeth and an unpleasant metallic taste. But, low cost of SDF and its simplicity in application suggest that it is an appropriate agent for use in community dental health programme. Thus, SDF appears to meet the criteria of both the WHO Millennium Goals and the US Institute of Medicine’s criteria for 21st century medical care, that is, it is a safe, effective, efficient, and equitable caries preventive agent.

Pleuroscopy early experience in the exudative pleural effusion of unknown etiology

2021 ◽  
Vol 17 ◽  
Author(s):  
Atefeh Fakharian ◽  
Hamidreza Jabbardarjani ◽  
Mohamad Reza Masjedi ◽  
Masoud Shamaei
Keyword(s):  
Pleural Effusion ◽  
Previous History ◽  
Invasive Procedure ◽  
Therapeutic Interventions ◽  
Unknown Etiology ◽  
Safe Procedure ◽  
Pathologic Diagnosis ◽  
Medical Thoracoscopy ◽  
History Of ◽  
Exudative Pleural Effusion

Background: Pleuroscopy (medical thoracoscopy) is a minimally invasive procedure to inspect and perform a biopsy of the pleural space as well as to perform therapeutic interventions; pleural fluid drainage and pleurodesis. Material and Methods: In a retrospective study in Kasra Hospital, Tehran-Iran, the patients with exudative pleural effusion of unknown etiology who underwent pleuroscopy, were evaluated. These patients had negative smear and culture for infective agents. Also, the cytological review was negative for malignancy. Results: 62 patients had undergone pleuroscopy, of which 29 (46.7) were men. After the final evaluation, 47 patients (75.8%) had a definite pathologic diagnosis, of which 39 (82.9%) were cancer. Through these 39 cases, 18 cases (46.1%) had a history of the previously confirmed cancer, in which pleural pathology was consistent with the initial diagnosis. In 21 cases (53.9%), metastatic cancers were detected without a previous history. From a total of 47 cases with definite pathologic diagnosis, 8 cases (17%) had histopathologic evidence of granulomatous lesions consistent with tuberculosis and 15 patients (24%) showed non-specific inflammatory lesions. There was no morbidity and mortality among these patients. Discussion: Considering that pleuroscopy is a safe procedure with high diagnostic accuracy, malignancy is the most finding in the exudative pleural effusion of unknown etiology. This increases the importance of this procedure in these cases to prevent wasting the time and smear-negative anti-TB treatment.

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