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Background: The COVID-19 pandemic saw an acceleration in virtual-visits (VV) for healthcare delivery. However, the impact of virtual care in metabolic/bariatric surgery (MBS) programs is not well described., Methods: Appointment data from three time-points: pre-pandemic (1/1/19-3/15/20, n = 19,290), pandemic (3/16/20-10/31/21, n = 29,459) and current-state (11/1/21-12/31/2022, n = 24,270) was retrieved in our multi-hospital ambulatory MBS program. Appointments were grouped by health care provider (HCP) (MD, dietician, and psychologist) and type (VV and in-person). Surveys assessing patient satisfaction were distributed electronically. All pre-op and post-op appointment data was analyzed for the time-points above. Appointment completion rates and patient reported preferences were described., Results: Our data showed an increase in scheduled VV from 0.5% for all HCP visits to 81% during the pandemic and a current VV visit of 77%. The number of completed VV increased for all HCPs, most prominently for dieticians. Parallel to this, the percentage of no-show visits also improved for all HCP, with MDs having the lowest no-show rate currently. Survey data revealed 89% of patients experience added benefits with VV and > 90% reported their VV experience as very good. VV were preferred over in-person visits for psychologists and dietitians (> 61%), but the majority preferred to see MDs in-person (70%)., Conclusions: Our findings reveal significant changes in healthcare utilization trends since the transition to virtual care. While overall satisfaction with virtual care is high, most patients prefer in-person visits with MDs. Thus, multi-disciplinary MBS care can be performed effectively using a hybrid model to ensure efficient distribution of resources., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The objective of this study was to investigate the expression of the catalytic subunit of telomerase, telomerase reverse transcriptase (TRT), and the possible relationship between the TRT expression and poor healing or cancer transformation in radiation-induced chronic human skin ulcer. Rabbit antibody to human TRT and SP immunohistochemical method were used to detect TRT expression in 24 cases of formalin-fixed, paraffin-embedded chronic human skin ulcer tissues induced by radiation, 5 cases of normal skin, 2 of burned skin, and 8 of cancer. The positive rate of TRT expression in chronic radiation ulcers was 58.3% (14/24), of which it was strongly positive in 41.7% cases (10/24) and weakly positive in 16.7% (4/24). TRT expression was 0% in normal (0/5) and burned skin (0/2), and 100% in cancer cases (8/8). The strongly positive expression of TRT was observed almost always in the cytoplasm and nucleus of squamous epithelial cells of the epidermis but it was negative or only weakly positive in the smooth muscle and endothelia of small blood vessels and capillaries, and in fibroblasts. Chronic inflammatory cells, plasmacytes, and lymphocytes were weakly positive for TRT. TRT expression could be involved in the poor healing caused by sclerosis of small blood vessels and lack of granulation tissue and in the cancer transformation of chronic radiation ulcer.