Indications and Coverage of Metabolic and Bariatric Surgery: A Worldwide IFSO Survey Comparing Different National Guidelines.

INTRODUCTION: Knowing how metabolic and bariatric surgery (MBS) is indicated in different countries is essential information for the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO). AIM: To analyze the indications for MBS recommended by each of the national societies that comprise the IFSO and how MBS is financed in their countries. METHODS: All IFSO societies were asked to fill out a survey asking whether they have, and which are their national guidelines, and if MBS is covered by their public health service. RESULTS: Sixty-three out of the 72 IFSO national societies answered the form (87.5%). Among them, 74.6% have some kind of guidelines regarding indications for MBS. Twenty-two percent are still based on the US National Institute of Health (NIH) 1991 recommendations, 43.5% possess guidelines midway the 1991s and ASMBS/IFSO 2022 ones, and 34% have already adopted the latest ASMBS/IFSO 2022 guidelines. MBS was financially covered in 65% of the countries. CONCLUSIONS: Most of the IFSO member societies have MBS guidelines. While more than a third of them have already shifted to the most updated ASMBS/IFSO 2022 ones, another significant number of countries are still following the NIH 1991 guidelines or even do not have any at all. Besides, there is a significant number of countries in which surgical treatment is not yet financially covered. More effort is needed to standardize indications worldwide and to influence insurers and health policymakers to increase the coverage of MBS.

Diagnostic and prognostic utility of surface electrocardiography in cats with left ventricular hypertrophy.

OBJECTIVES: To assess the ability of electrocardiography (ECG) to predict left ventricular hypertrophy (LVH) in the cat and to investigate the prognostic value of selected ECG variables in cats with LVH. ANIMALS: Fifty-seven privately owned cats: 22 clinically healthy cats and 35 cats with LVH. MATERIAL AND METHODS: This is a clinical cohort study. Echocardiographic diagnosis and surface ECG were available. Electrocardiography analysis included rhythm diagnosis and specific electrocardiographic measurements. In cats with LVH, cause of death and outcome data were recorded and analyzed using Kaplan-Meier curves. RESULTS: The presence of arrhythmia had sensitivity and specificity of 31% and 100%, respectively, for identifying LVH. Among ECG measurements, duration of QT interval (QT) and QT interval corrected for heart rate (QTc) was statistically different between healthy cats and cats with LVH (p = 0.007). Overall, the most accurate cutoffs to identify LVH were QT > 170 ms (sensitivity and specificity 48.3% and 91%, respectively) and QTc > 188 ms (sensitivity and specificity 62% and 77%, respectively). In healthy cats, the highest QT and QTc values were 180 ms and 200 ms, respectively. Mean survival time was 58 days and indeterminable for cats with QT > 180 ms and QT ≤ 180 ms, respectively (p = 0.042) and 125 days and indeterminable for cats with QTc > 200 ms and QTc ≤ 200 ms, respectively (p = 0.017). CONCLUSIONS: Arrhythmias as well as prolonged QT and QTc are useful ECG parameters in identifying LVH and predicting survival in affected cats.

[Tuberculin test: proposal for a pre-test risk assessment questionnaire and a standardized evaluation]. / Test alla tubercolina: proposta di scheda di valutazione del rischio e di interpretazione standardizzata.

Relevance of latent infection in the epidemiology of tuberculosis (TB) is expected to increase in many developed countries. Indeed, many demographic, social and public health changes could contribute to the expansion of groups or communities at significantly higher risk than the general population for infection to Mycobacterium tuberculosis or progression from latent to active disease. Tuberculin skin testing (TB), the gold standard for diagnosis of M. tuberculosis infection, is imperfect and prone to false positive and negative results, unless strictly targeted and carefully standardized for reliable performance and interpretation. This paper proposes a pre-test risk assessment questionnaire and standardized criteria for evaluation of TB test according to international guidelines.

A 3D ultrasound scanner: real time filtering and rendering algorithms.

The work described here has been carried out within a collaborative project between DIST and ESAOTE BIOMEDICA aiming to set up a new ultrasonic scanner performing 3D reconstruction. A system is being set up to process and display 3D ultrasonic data in a fast, economical and user friendly way to help the physician during diagnosis. A comparison is presented among several algorithms for digital filtering, data segmentation and rendering for real time, PC based, three-dimensional reconstruction from B-mode ultrasonic biomedical images. Several algorithms for digital filtering have been compared as relates to processing time and to final image quality. Three-dimensional data segmentation techniques and rendering has been carried out with special reference to user friendly features for foreseeable applications and reconstruction speed.

[Long-term electrical stimulation of tachycardias: control by ambulatory electrocardiographic monitoring (author's transl)]. / Trattamento elettrico a lungo termine delle aritmie ipercinetiche: controllo mediante elettrocardiografia dinamica.

The Authors suggest a new method, elaborated by their own, for long-term antiarrhythmic stimulation. They used ambulatory electrocardiography in order to evaluate the results. It consists of a radio frequency device for synchronization and stimulation, and allows the scanning stimulation of all the cycle of tachycardia, with automatic search for the zone of interruption. The stimulatory is carried by the patient, who must set it in motion at the onset of the tachycardia. Preliminary results show the efficacy of the method; Holter monitoring seems to be the best guide to the development of a satisfactory implantable automatic tachycardia-terminating pacemaker.