Cost estimation of a school-based intervention for improving HIV/AIDS risk perception among secondary school adolescents in Enugu State, Nigeria.

Early sexual debut is common in Nigeria and increases HIV risk among adolescents. About 152,000 adolescents are living with HIV. Lack of knowledge and appropriate sexual reproductive health services are some factors responsible. This paper estimated the cost of secondary school-based HIV/AIDS intervention for schools in Enugu State, Nigeria. The rationale for estimation is to avoid unaffordable and ineffective interventions. The cost was estimated between March to October 2019 for schools in urban and rural areas with population of 1595 students. The cost estimation was aided through UNAID proposed guideline. The estimation was done by classifying intervention into cost of training, cost of services and cost of commodities. The cost was estimated at $5954. The estimated cost in urban is lesser than that of rural. This estimated cost of intervention may inform stakeholders with the knowledge of cost implications to avoid unaffordable school-based HIV interventions in Enugu State, Nigeria.

Surgeon and nonsurgeon personalities at different career points.

BACKGROUND: Previous studies have demonstrated correlations between personality traits and job performance and satisfaction. Evidence suggests that personality differences exist between surgeons and nonsurgeons, some of which may develop during medical training. Understanding these personality differences may help optimize job performance and satisfaction among surgical trainees and be used to identify individuals at risk of burnout. This study aims to identify personality traits of surgeons and nonsurgeons at different career points. MATERIALS AND METHODS: We used The Big Five Inventory, a 44-item measure of the five factor model. Personality data and demographics were collected from responses to an electronic survey sent to all faculty and house staff in the Departments of Surgery, Medicine, and Family Medicine at The Ohio State University College of Medicine. Data were analyzed to identify differences in personality traits between surgical and nonsurgical specialties according to level of training and to compare surgeons to the general population. RESULTS: One hundred ninety-two house staff and faculty in surgery and medicine completed the survey. Surgeons scored significantly higher on conscientiousness and extraversion but lower on agreeableness compared to nonsurgeons (all P < 0.05). Surgery faculty scored lower in agreeableness compared with that of surgery house staff (P = 0.001), whereas nonsurgeon faculty scored higher on extraversion compared with that of nonsurgeon house staff (P = 0.04). CONCLUSIONS: There appears to be inherent personality differences between surgical and nonsurgical specialties. The use of personality testing may be a useful adjunct in the residency selection process for applicants deciding between surgical and nonsurgical specialties. It may also facilitate early intervention for individuals at high risk for burnout and job dissatisfaction.

Near-infrared fluorescent cholangiography facilitates identification of biliary anatomy during laparoscopic cholecystectomy.

BACKGROUND: Intraoperative cholangiography (IOC) is the current gold standard for biliary imaging during laparoscopic cholecystectomy (LC). However, utilization of IOC remains low. Near-infrared fluorescence cholangiography (NIRF-C) is a novel, noninvasive method for real-time, intraoperative biliary mapping. Our aims were to assess the safety and efficacy of NIRF-C for identification of biliary anatomy during LC. METHODS: Patients were administered indocyanine green (ICG) prior to surgery. NIRF-C was used to identify extrahepatic biliary structures before and after partial and complete dissection of Calot's triangle. Routine IOC was performed in each case. Identification of biliary structures using NIRF-C and IOC, and time required to complete each procedure were collected. RESULTS: Eighty-two patients underwent elective LC with NIRF-C and IOC. Mean age and body mass index (BMI) were 42.6 ± 13.7 years and 31.5 ± 8.2 kg/m(2), respectively. ICG was administered 73.8 ± 26.4 min prior to incision. NIRF-C was significantly faster than IOC (1.9 ± 1.7 vs. 11.8 ± 5.3 min, p < 0.001). IOC was unobtainable in 20 (24.4 %) patients while NIRF-C did not visualize biliary structures in 4 (4.9 %) patients. After complete dissection, the rates of visualization of the cystic duct, common bile duct, and common hepatic duct using NIRF-C were 95.1, 76.8, and 69.5 %, respectively, compared to 72.0, 75.6, and 74.3 % for IOC. In 20 patients where IOC could not be obtained, NIRF-C successfully identified biliary structures in 80 % of the cases. Higher BMI was not a deterrent to visualization of anatomy with NIRF-C. No adverse events were observed with NIRF-C. CONCLUSIONS: NIRF-C is a safe and effective alternative to IOC for imaging extrahepatic biliary structures during LC. This technique should be evaluated further under a variety of acute and chronic gallbladder inflammatory conditions to determine its usefulness in biliary ductal identification.

Chemosensitivity analysis of tiger nuts (Cyperus esculentus L.) using ethyl methanesulfonate (EMS) and colchicine mutagens.

Four hundred tubers of four genotypes, two brown and two black tiger nuts were subjected to Ethyl Methanesulfonate (EMS) and Colchicine treatments at concentrations of 0 %, 0.1 %, 0.25 %, 0.5 % and 1.0 % for 24 h. Each genotype had twenty tubers treated with each of the five different concentrations and were planted using Complete Randomized Design (CRD) in a greenhouse. Quantitative data was collected and LD50 and RD50 were analysed using Excell 2016 and Genstat 11.2. A general decreasing trend in percentage germination and plant height was observed with increasing concentrations of mutagens applied. An EMS treatment had LD50 and RD50 values of 0.97 % and 1.49 % for black and 0.63 % and 1.63 % for brown genotypes. Similarly, the percentage colchicine treatment had LD50 and RD50 values of 1.65 % and 19.51 % concentrations for black and 0.91 % and 1.71 % concentrations for brown genotypes.

From Option B+ to Universal "Test and Treat" in Cameroon: Identification and Evaluation of District-level Factors Associated with Retention in Care.

Background and Objective: Retaining women in Option B+ services is crucial for eliminating new pediatric HIV infections. However, there are few studies on factors influencing retention at the district level. This study evaluates the factors associated with retention in two health districts of Cameroon. Methods: From September 1, 2015, to February 29, 2016, we reviewed the records of pregnant and breastfeeding women initiating Option B+, a lifelong approach to preventing mother-to-child transmission (PMTCT) of HIV, between October 2013 and July 2014. We abstracted sociodemographic and clinical data from registers in 22 health facilities in the Bamenda urban and Kumba rural districts into spreadsheets. Cox regression age-adjusted survival curves were used to compare retention probabilities at 6 and 12 months post-antiretroviral therapy (ART) initiation. Multivariable modified Poisson regressions were run to estimate adjusted relative risk (aRR) of factors associated with retention in PMTCT care at 12 months post-ART initiation. STATA software was used for the analyses. Results: Of the 560 files reviewed, majority, 62.7% (n=351), were above 24 years of age and married, 68.9% (n=386). From the multivariable analysis, enrolling early in antenatal care (ANC) (aRR: 1.50, 95% CIL: 1.17-1.93) and knowing the male partner's HIV-negative status (aRR: 1.16, 95% CI: 1.00-1.34) were significantly associated with higher retention in care, adjusting for maternal age, marital status, and distance from the health facility. By health district, knowing the male partner's HIV-negative status (aRR: 1.30, 95% CI: 1.13-1.50) in the Bamenda urban and enrolling early in ANC (aRR: 2.03, 95% CI" 1.21-3.41) in the Kumba rural district, had significantly higher retention rates after adjusting for the same covariates. Conclusion and Global Health Implications: Overall, factors influencing retention varied by urban or rural district. Therefore, tailored district-level interventions are needed to enhance early ANC enrollment in the rural and partner HIV status disclosure in the urban districts to improve retention in PMTCT care.

Intervention for burnout and irrational beliefs in parents of couples seeking a divorce: A critical reflection of Igbo-African marital discord.

BACKGROUND: Looking at the sociocultural dimension of marriage in the sub-region of Nigeria like Igbo, parents allow their sons and daughters to marry so that they can have homes. The expectation is for them to have permanent homes. If there is anything contrary to that such as divorce, parents usually frown at it. To some extent, the psychological effects of it may be deeply rooted in parents who hear that their children are seeking a divorce. Given this reason, this study investigated the effect of rational emotive family health therapy (REFHT) on burnout and irrational beliefs in parents of couples seeking a divorce. METHODS: This is a pretest-posttest randomized control group research. Two instruments were used to measure 73 participants who were assigned to treatment and control arms. the intervention group received 12 sessions of counseling that aimed to decrease the level of burnout and irrational beliefs. At the end of the sessions and assessments, the data were analyzed using repeated measures, cross-tabulation, and univariate statistics. RESULTS: the finding indicated that REFHT was highly effective in decreasing the high parental burnout orchestrated by irrational belief. Comparing the mean scores of the participants exposed to the intervention and those in the control group after time 1 and 2 assessments, the mean reduction of burnout and irrational beliefs further showed a positive treatment outcome. There was no significant influence of gender, time, and group. CONCLUSION: This study suggests that REFHT is significant in improving the psycho-emotional wellness of parents of couples seeking a divorce. Thus, additional research is required to validate the impact of REFHT in decreasing burnout in other populations.

Effectiveness of rational emotive behavior education (REBE) on computer anxiety among school teachers enrolled in e-learning.

BACKGROUND: Reports from past studies indicated that research on anxiety disorder is not extensive and further investigation is needed using different populations. Besides, psychological intervention for computer anxiety has not been given the required empirical attention. Given this, we investigated the effectiveness of rational emotive behavior education on computer anxiety among primary school teachers enrolled in e-learning. METHODS: A pure experimental design was used, which helped to randomly assigned recruited 112 primary school teachers to 2 arms (treatment and control groups). The Computer Anxiety Scale was distributed before, immediately after, and 4 weeks after completion of intervention with 12 sessions that were given to the treatment group. RESULTS: The ANOVA results showed that rational emotive behavior education significantly decreased teachers computer anxiety. The mean computer anxiety score among instructors did not significantly differ by group or gender. Therefore, we recommended that computer educators, policymakers, and rational emotive behavior educators should organize rational and emotive-oriented conferences for schoolteachers.

Cognitive-behaviour intervention for critical thinking disposition of religion and social science students.

BACKGROUND: The dispositions of students towards critical thinking (CT) no doubt improve their clinical practice and performance. Hence, efforts to explore ways to help students become aware and conscious of the need for CT are imperative for their self-actualization, development, and improved professional practice. It is worrisome that in spite of the limited intervention addressing CT disposition challenges, scholars are yet to study the problem, especially in developing countries. METHODS: In view of that, we assessed how CT disposition can be improved among students enrolled in cognitive-behavioral reflective training programme (CBRT-P) using a group-randomized control study with three months follow-up. To achieve this, 163 students were allocated to different groups. The recruited participants were exposed to CBRT-P. RESULTS: Repeated-measures analysis performed shows that at the posttest, the mean CT disposition scores of the participants enrolled in CBRT-programme (treatment group) were significantly greater compared to the counterpart group that is the comparison group. At the third assessment, the mean score of the dependent measure consistently remained higher in favor of the experimental group. CONCLUSION: Given the results, it is concluded that the treatment programme improves the CT disposition of students over time.

Genetic Studies on the Inheritance of Storage-Induced Cooking Time in Cowpeas [Vigna unguiculata (L.) Walp].

Cowpeas provide food and income for many small-holder farmers in Africa. Cowpea grains contain substantial quantities of protein, carbohydrates, vitamins, and fiber. In areas where subsistence farming is practiced, cowpea's protein is cheaper than that obtained from other sources such as fish, meat, poultry or dairy products and combines well with cereal grains in diets. However, long-cooking times, typical of many grain legumes, is a major limitation to the utilization of cowpeas especially among the low-income and growing middle-income population of Africa. Long periods of cooking cowpeas lead to loss of nutrients, loss of useful time and increased greenhouse gas emission through increased burning of firewood. Fast-cooking cowpeas has the potential to deliver highly nutritious food to the hungry within shorter periods, encourage less use of firewood, improve gender equity, increase the consumption of cowpeas, trigger an increase in demand for cowpeas and thus incentivize cowpea production by smallholder farmers in Sub-Saharan Africa. In this study, the inheritance of storage-induced cooking time in cowpeas was investigated. Two sets of bi-parental crosses were conducted involving three cowpea genotypes: CRI-11(1)-1, C9P(B) and TVu7687. Generation means from six generations were used to determine the phenotypic and genotypic variances and coefficients of variation. Broad and narrow sense heritabilities and genetic advance percentage of mean were estimated. Generation mean analysis showed that additive, dominant, additive-additive, additive-dominant, and dominant-dominant gene actions were significant (p < 0.001). Fast-cooking trait was dominant over the long-cooking trait. Broad sense heritability for crosses C9P(B) × CRI-11(1)-1 and TVu7687 × CRI-11(1)-1 were 0.94 and 0.99 respectively while narrow sense heritabilities were 0.84 and 0.88 respectively. Genetic advances were 27.09 and 40.40 respectively. High narrow-sense heritabilities and moderate genetic advance for the fast-cooking trait indicated the presence of additive genes in the trait and the possibility of introgressing the trait into farmer-preferred varieties using conventional selection methods. However, due to significant epistatic gene effects observed, effective selection for fast-cooking trait would be appropriate at advanced generations.

AMPATH: living proof that no one has to die from HIV.

BACKGROUND AND OBJECTIVE: The HIV/AIDS epidemic in sub-Saharan Africa is decimating populations, deteriorating economies, deepening poverty, and destabilizing traditional social orders. The advent of the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) made significant supplemental resources available to sub-Saharan national programs for the prevention and treatment of HIV/AIDS, but few programs have demonstrated the capacity to use these resources to increase rapidly in size. In this context, AMPATH, a collaboration of Indiana University School of Medicine, the Moi University School of Medicine, and the Moi Teaching and Referral Hospital in Eldoret, Kenya, is a stunning exception. This report summarizes findings from an assessment of AMPATH staff perceptions of how and why this has happened. PARTICIPANTS AND APPROACH: Semistructured, in-depth, individual interviews of 26 AMPATH workers were conducted and recorded. Field notes from these interviews were generated by independent reviewers and subjected to close-reading qualitative analysis for themes. RESULTS: The themes identified were as follows: creating effectively, connecting with others, making a difference, serving those in great need, providing comprehensive care to restore healthy lives, and growing as a person and a professional. CONCLUSION: Inspired personnel are among the critical assets of an effective program. Among the reasons for success of this HIV/AIDS program are a set of work values and motivations that would be helpful in any setting, but perhaps nowhere more critical than in the grueling work of making a complex program work spectacularly well in the challenging setting of a resource-poor country. Sometimes, even in the face of long odds, the human spirit prevails.

An electronic medical record system for ambulatory care of HIV-infected patients in Kenya.

Administering and monitoring therapy is crucial to the battle against HIV/AIDS in sub-Saharan Africa. Electronic medical records (EMRs) can aid in documenting care, monitoring drug adherence and response to therapy, and providing data for quality improvement and research. Faculty at Moi University in Kenya and Indiana and University in the USA opened adult and pediatric HIV clinics in a national referral hospital, a district hospital, and six rural health centers in western Kenya using a newly developed EMR to support comprehensive outpatient HIV/AIDS care. Demographic, clinical, and HIV risk data, diagnostic test results, and treatment information are recorded on paper encounter forms and hand-entered into a central database that prints summary flowsheets and reminders for appropriate testing and treatment. There are separate modules for monitoring the Antenatal Clinic and Pharmacy. The EMR was designed with input from clinicians who understand the local community and constraints of providing care in resource poor settings. To date, the EMR contains more than 30,000 visit records for more than 4000 patients, almost half taking antiretroviral drugs. We describe the development and structure of this EMR and plans for future development that include wireless connections, tablet computers, and migration to a Web-based platform.

Engaging the Entire Care Cascade in Western Kenya: A Model to Achieve the Cardiovascular Disease Secondary Prevention Roadmap Goals.

Cardiovascular disease (CVD) is the leading cause of death in the world, with a substantial health and economic burden confronted by low- and middle-income countries. In low-income countries such as Kenya, there exists a double burden of communicable and noncommunicable diseases, and the CVD profile includes many nonatherosclerotic entities. Socio-politico-economic realities present challenges to CVD prevention in Kenya, including poverty, low national spending on health, significant out-of-pocket health expenditures, and limited outpatient health insurance. In addition, the health infrastructure is characterized by insufficient human resources for health, medication stock-outs, and lack of facilities and equipment. Within this socio-politico-economic reality, contextually appropriate programs for CVD prevention need to be developed. We describe our experience from western Kenya, where we have engaged the entire care cascade across all levels of the health system, in order to improve access to high-quality, comprehensive, coordinated, and sustainable care for CVD and CVD risk factors. We report on several initiatives: 1) population-wide screening for hypertension and diabetes; 2) engagement of community resources and governance structures; 3) geographic decentralization of care services; 4) task redistribution to more efficiently use of available human resources for health; 5) ensuring a consistent supply of essential medicines; 6) improving physical infrastructure of rural health facilities; 7) developing an integrated health record; and 8) mobile health (mHealth) initiatives to provide clinical decision support and record-keeping functions. Although several challenges remain, there currently exists a critical window of opportunity to establish systems of care and prevention that can alter the trajectory of CVD in low-resource settings.

Bioabsorbable hernia plugs in laparoscopic inguinal herniorraphy: short-term and long-term results.

PURPOSE: To report our short-term and long-term experience with laparoscopic inguinal hernia repair (LIHR) using a bioabsorbable plug. METHODS: Patients who underwent LIHR from 2009 to 2011 using a bioabsorbable plug and synthetic mesh patch were reviewed retrospectively. Short-term follow-up information was obtained within 30 days of surgery, whereas long-term follow-up was obtained in 2014. Quality of life was assessed using the Carolinas Comfort Scale. RESULTS: Forty-four patients (43 male), including 6 (13.6%) with recurrent disease, underwent 52 LIHR with a bioabsorbable plug. Mean age and body mass index were 60.9 ± 10.5 years and 27.9 ± 4.7 kg/m, respectively. Among 39 (88.6%) patients available for short-term follow-up, early postoperative complications were seen in 10 (25.6%) patients, all of which resolved spontaneously. Mean long-term follow-up duration was 41.6 ± 4.1 months, among 30 (68.2%) patients (40 hernia repairs). There were 2 (5%) hernia recurrences, with 1 requiring a reoperation 12 months after initial repair. Only 2 (6.7%) patients reported moderate or bothersome chronic pain. CONCLUSIONS: Bioabsorbable plug combined with a synthetic mesh is safe and effective for use during LIHR. The technique offers an acceptable incidence of chronic pain and recurrence.

Laparoscopic adjustable gastric banded plication: case-matched study from a single U.S. center.

BACKGROUND: Laparoscopic adjustable gastric banded plication (LAGBP) is a novel technique for weight loss surgery. This study evaluates the safety and short-term efficacy of LAGBP in a U.S. population. The setting was an academic medical center in the United States. METHODS: Patients who underwent LAGBP between 2012 and 2013 were reviewed retrospectively. Demographic characteristics, pre and perioperative details, body mass index (BMI), and percent excess weight loss (%EWL) were analyzed and compared to case-matched cohorts that had laparoscopic adjustable gastric banding (LAGB) or laparoscopic sleeve gastrectomy (LSG) during the same time period. RESULTS: Seventeen patients (14 females) underwent LAGBP during the study period and were case-matched based on age, sex, race, and preoperative BMI with patients having LAGB and LSG. Mean age and preoperative BMI for LAGBP cohort were 42.5±11.6 years and 47.7±6.5 kg/m2, respectively. Mean operative time and estimated blood loss were 72±16 minutes and 23±23 mL, respectively, compared to 49±16 minutes (P=.002) and 15±23 mL for LAGB, and 66±18 minutes and 36±22 mL for LSG. There were no perioperative deaths. Hospital length of stay was 1.1±.3 days for LAGBP, versus .7±.3 days (P=.004) for LAGB, and 2.7±1.4 days (P<.001) for LSG. At 12-month follow-up, patients in the LAGBP and LAGB groups had undergone similar number of band adjustments (4.7 versus 5.1; P=.68). The %EWL was 46.1±14.8% for the LAGBP cohort, compared to 38.9±20.6% for LAGB, and 57.7±16% for LSG. CONCLUSION: LAGBP is technically feasible and safe, and offers weight loss results positioned between LAGB and LSG at 1 year. To date, this is the largest U.S. series to compare this novel technique to more traditional weight loss procedures.

The determination of efficacy of antimicrobial rinses on turkey carcasses using response surface designs.

Chlorine, lactic acid. TSP (trisodium phosphate) and a commercial phosphate blend (Avgard) were evaluated for their potential bactericidal effects on faecally contaminated turkey carcasses. Carcasses were sprayed for 10 s with each bactericide, at various concentrations and pressure combinations, derived from a response surface central composite design. For all the bactericides, variation in pressure had no significant (P > 0.05) effect in reducing either total or coliform counts. Lactic acid at various concentrations showed a significant effect (P < 0.20) in reducing total and coliform counts. The results indicate that lactic acid at 4.25% (w/w) has the potential for reducing the total microbial load and coliforms by more than 95%. Chlorine, TSP and Avgard concentration did not significantly (P > 0.20) affect the microbial load when compared with a water spray, i.e. no bactericide. Preliminary presumptive testing indicated that lactic acid and Avgard had some effect against Salmonella spp. Chlorine and TSP, irrespective of concentration and pressure, were not effective against Salmonella spp. Overall, these findings suggest that lactic acid was the most effective bactericide for reducing microbial contamination and improving the safety of poultry meat.

The MODEL project: a scoring system to manage demand for cataract and joint replacement surgery.

Cataract surgery and joint replacement are highly cost-effective procedures; however, their availability is inequitable and doctors lack guidance on whom to refer and treat. We investigated the feasibility of using a scoring system to assess patients' suitability for operation. Wefound acceptable correlations between the scores ofgeneral practitioners and surgeons for both procedures. Scoring systems can be used in a consistent way bygeneralpractitioners and surgeons, and can make a contribution towards matching patients' needs with available treatment capacity.

Aggressive angiomyxoma.

Myxoid tumors are a heterogeneous group of lesions characterized by a marked abundance of extra cellular mucoid (myxoid) matrix.[1] The term aggressive emphasizes the often infiltrative nature of the tumor and its frequent association with recurrence.[2] A case of aggressive angiomyxoma arising from the vagina in a 55-year-old woman is reported for its rarity.

Metastatic Crohn's disease.

Crohn's disease, first described in 1922, is characterized by segmental granulomatous inflammation of the intestinal tract and frequently involves the cutaneous tissues as well. Cutaneous Crohn's disease (CCD) is synonymous with metastatic Crohn's disease (MSD). A case of CCD, without any gastrointestinal involvement is reported for its rarity.

Biomarkers as predictors of recurrence following curative resection for pancreatic ductal adenocarcinoma: a review.

Pancreatic ductal adenocarcinoma (PDA) is the fourth most common cancer causing death in the United States. Early tumor recurrence is an important contributor to the dismal prognosis. The availability of an accurate prognostic biomarker for predicting disease recurrence following curative resection will be beneficial for patient care. Most of the currently studied biomarkers remain in the investigational phase, with CA 19-9 being the only biomarker currently approved by the FDA. Herein, we review the utility of CA 19-9 and other investigational cellular, gene, and molecular tumor markers for predicting PDA recurrence following curative surgical resection.

Laparoscopic Roux-en-Y gastric bypass for treatment of symptomatic paraesophageal hernia in the morbidly obese: medium-term results.

BACKGROUND: The ideal surgical approach for treatment of symptomatic paraesophageal hernias (PEH) in obese patients remains elusive. The objective of this study was to assess the safety, feasibility, and effectiveness of combined laparoscopic PEH repair and Roux-en-Y gastric bypass (RYGB) for the management of symptomatic PEH in morbidly obese patients. METHODS: Fourteen patients with symptomatic PEH and morbid obesity (body mass index [BMI]>35 kg/m(2)) underwent laparoscopic PEH repair with RYGB between 2008 and 2011. Demographic characteristics and preoperative and perioperative details were analyzed. Patients were contacted in October 2013 for follow-up. BMI, reflux symptoms, and disease-specific quality of life (QoL) data were obtained. RESULTS: There were 11 females (79%). Median age and preoperative BMI were 48 years and 42 kg/m(2), respectively. Mean operative time was 180 minutes, with median length-of-stay of 4 days. There were no perioperative deaths, and 5 patients experienced postoperative complications including 1 gastrojejunostomy leak. Complete follow-up with a median follow-up interval of 35 months was available in 9 (64%) patients. The median % excess weight loss was 67.9%. Thirty-three percent required antisecretory medications for reflux control, compared to 89% preoperatively. Seventy-eight percent of patients reported good to excellent QoL outcomes assessed by the Gastroesophageal Reflux Disease Health-Related Quality of Life questionnaire. Overall, 89% of patients were satisfied with their operation and would undergo the procedure again. CONCLUSION: Combined laparoscopic PEH repair and RYGB is a safe, feasible, and effective treatment option for morbidly obese patients with symptomatic PEH, and offers good to excellent disease-specific quality-of-life outcomes at medium-term follow-up. To date, this is the largest series with the longest follow-up in this unique patient population.