RESUMEN
INTRODUCTION: Surgical tourism is a growing phenomenon, causing a surge demand for the management of its complications. In this study, we aimed to evaluate complications that occur after cosmetic breast surgery abroad; and their costs for the public health system. MATERIAL AND METHODS: We reviewed the medical files of patients treated in our department for a complication after cosmetic breast surgery outside Switzerland and assessed all complications requiring hospitalization; and estimated the overall medical costs. RESULTS: Over a two-year period, 26 patients were treated for 39 complications. The main complication was infection (71% of cases), mainly with a multidrug-resistant organism (47%) and atypical mycobacteria. Of the 16 patients with breast prosthesis, 7 implants were removed. The effective average costs incurred for the hospital care of these cases was estimated to 14'724 Swiss Francs (â¼12'963 Euros) per patient. CONCLUSION: The high rate of multidrug-resistant and mycobacterial atypical infections are a major public health problem. It is necessary to inform patients much better about the risks of surgical tourism. Furthermore, the danger of transfer of multidrug-resistant or atypical germs from abroad should not be overlooked. Physicians should be informed about this risk and take necessary measures for treatment and diagnosis of these complications.
Asunto(s)
Costos de la Atención en Salud , Mamoplastia , Turismo Médico , Complicaciones Posoperatorias/economía , Complicaciones Posoperatorias/epidemiología , Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Adulto JovenRESUMEN
Microfabricated small-volume NMR probes consisting of electroplated planar microcoils integrated on a glass substrate with etched microfluidic channels are fabricated and tested. 1H NMR spectra are acquired at 300 MHz with three different probes having observed sample volumes of respectively 30, 120, and 470 nL. The achieved sensitivity enables acquisition of an 1H spectrum of 160 microg sucrose in D2O, corresponding to a proof-of-concept for on-chip NMR spectroscopy. Increase of mass-sensitivity with coil diameter reduction is demonstrated experimentally for planar microcoils. Models that enable quantitative prediction of the signal-to-noise ratio and of the influence of microfluidic channel geometry on spectral resolution are presented and successfully compared to the experimental data. The main factor presently limiting sensitivity for high-resolution applications is identified as being probe-induced static magnetic field distortions. Finally, based on the presented model and measured data, future performance of planar microcoil-based microfluidic NMR probes is extrapolated and discussed.