The analysis of factors increasing the odds for type 2 diabetes mellitus remission following re-do bariatric surgery after laparoscopic sleeve gastrectomy- cohort study.

INTRODUCTION: Metabolic/bariatric surgery is the only proven treatment for type 2 diabetes mellitus (T2D) with curative intent. However, in a number of patients, the surgery is not effective or they may experience a relapse. Those patients can be offered re-do bariatric surgery (RBS). PURPOSE: The study aimed to determine factors increasing the odds for T2D remission one year after RBS following primary laparoscopic sleeve gastrectomy. METHODS: A multicenter retrospective cohort study was conducted between January 2010 and January 2020, which included 12 bariatric centers in Poland. The study population was divided into groups: Group 1- patients with T2D remission after RBS (n = 28) and Group 2- patients without T2D remission after RBS (n = 49). T2D remission was defined as HBA1c < 6.0% without glucose-lowering pharmacotherapy and glycemia within normal range at time of follow-up that was completed 12 months after RBS. RESULTS: Fifty seven females and 20 males were included in the study. Patients who achieved BMI < 33 kg/m2 after RBS and those with %EBMIL > 60.7% had an increased chance of T2D remission (OR = 3.39, 95%CI = 1.28-8.95, p = 0.014 and OR = 12.48, 95%CI 2.67-58.42, p = 0.001, respectively). Time interval between primary LSG and RBS was significantly shorter in Group 1 than in Group 2 [1 (1-4) vs. 3 (2-4) years, p = 0.023]. CONCLUSIONS: Shorter time interval between LSG and RBS may ease remission of T2D in case of lack of remission after primary procedure. Significant excess weight loss seems to be the most crucial factor for T2D remission.

Assessment of stress load and its causes among dental students. / Pomiar poziomu stresu i czynników go wywolujacych wsród studentów kierunku lekarsko-dentystycznego.

OBJECTIVES: The aim of this study was thus to assess the stress level among dental students, characterizing the factors that induce it and describing which students are most susceptible. METHODS: Two international, independent and validated to polish language and environment stress questionnaires were used: the Perceived Stress Scale (PSS-10) and the Perceived Medical School Stress Instrument (PMSS). The present study received approval from the Jagiellonian University Bioethical Committee (no. 1072.6120.290.2020). RESULTS: A total of 272 students from all five years of the dental undergraduate degree at Jagiellonian University Medical College were enrolled to the study, including 197 female and 75 male respondents. The overall response rate was 85%. The PSS-10 score for all dental students was 22.14±6.65. A total of 182 (66.91%) respondents had high levels of stress. Female students had significantly higher stress levels than male students, accordingly 22,9±6,51 and 20,12±6,69. Moreover, first and fifth year students had the highest stress level. In the case of PMSS the total score for all dental students was 36.84±8.65. CONCLUSIONS: Perceived stress among Polish dental students is generally high. These findings suggest that support services should be made widely available to all dental students. Such services should be targeted to the specific needs of male and female students as well as to those in specific years of study.

Surgical Interventions in Patients Hospitalised with COVID-19. A Review of Seven Months of Experience Working in a COVID-19 Dedicated Centre.

The Coronavirus Disease 2019 (COVID-19) pandemic has made changes to the traditional way of performing surgical consultations. The aim of the present study was to assess the need for surgical care performed by various surgical specialties among patients infected with COVID-19 hospitalized in a COVID-19 dedicated hospital. All surgical consultations performed for patients infected with COVID-19 in a COVID dedicated hospital in a seven month period were evaluated. Data on demographics, surgical specialty, consult reason, procedure performed, and whether it was a standard face to face or teleconsultation were gathered. Out of 2359 COVID-19 patients admitted to the hospital in the seven month period, 229 (9.7%) required surgical care. Out of those 108 consultations that did not lead to surgery, 71% were managed by telemedicine. A total of 36 patients were operated on while suffering from COVID-19. Out of them, only three patients admitted primarily for COVID-19 pneumonia underwent emergency surgery. The overall mortality among those operated on was 16.7%. Conclusions: Patients hospitalised with COVID-19 may require surgical care from various surgical specialties, especially during peaks of the pandemic. However, they rarely require a surgical procedure and only occasionally require major surgery. A significant portion of potentially surgical problems could be managed by teleconsultations.