Tracheoesophageal fistula treatment in 531 Thoracic surgery clinics worldwide

I’ve been in the er waiting room for 3 1/2 hrs now and haven’t been seen yet and when I got here there wasn’t any one else here. now it’s full of patients. I worked in an er for years so I understand the situation and process of seeing patients but just because I wasn’t bleeding and wasn’t screaming in pain I was put on the back burner.

My wife has been coming here for long time because she has a pacemaker/ defibrillator for over ten years. Couldn't tell there was anything wrong with other than that. September 7, she had an amulet placed in her heart because she couldn't take blood thinners. Week later she had lost 4 pints of blood. They had to repair the leak. While she was in surgery they did CPR on her. Not blaming anyone for that. On November 16 she was transferred to heart hospital because she built up with fluid. We were in there for 11 days and everyday I asked them what the game plan was. It was always still trying to get the fluid off. Nothing else was ever brought up to me about them trying to do anything different but giving her diuretics. NOTHING!! I'm not a doctor or nurse and I sure don't know every question to ask. They sure as hell didn't offer any information. Dr Lane was even going to send her home 9 days later. We told him no. Not until we knew what was going on. A day later her defibrillator shocked her because her heart rhythm went crazy. Never told us how bad her heart was. Two days later they still just said they had to get the fluid off. Did find out that my wife had stage 3 kidney failure. Also had to ask them to check her liver enzymes since they were doing blood work every day. Found out she had cirrhosis of liver but that's all the ultrasound showed. They never told me there were other options they could do to try and help her heart. I finally got my daughter-in-law up there that's a nurse practitioner. She got in and started going over everything asking questions about the other options that was never mentioned to me. She had more information in 15 minutes that they had given me in 11 days. That's just tells me that they don't care about all of their patients. Over at Baptist now and has gotten more done in 4 days than they did in 2 weeks. Got 30 pounds of fluid off in 4 days. Her heart is still real weak but getting a little stronger each day. These people actually seem like they care about their patients. Especially her cardiologist. She takes time to talk to us and explains what they can and can't do. I think GOD that my daughter-in-law came or my wife would have been dead. Don't need any excuses from anyone at heart hospital. Don't want to hear that you're sorry for what happened either. I already know how sorry you are.

My 1st appointment with Dr. Lo was on 06/28. I was given an EKG and after reading the results and consulting with me regarding my medical history, Dr. Lo listened to my heart and was able to get me approved for an Echocardiogram and lab work immediately 2 hours later. Getting 3 tests performed in 3 different departments in the same building on my 1st appointment was not only convenient but crucial. I received a call 24 hours later and was advised that I have a complete heart block and that Dr. Lo wanted me back immediately and scheduled me for surgery Monday 07/03. It's been 6 weeks since I received ER heart surgery and a pacemaker to save my life. Thank you Dr. Monica Lo and your team at the Arkansas heart hospital for going above and beyond for a new patient that was literally on borrowed time. I am truly blessed to have you as my cardiologist. I highly recommend Dr. Lo and her team at the AHH. Leicha Wilkerson

I moved fro Vancouver to Montreal for my job. I am shocked to see how horrible the medical care in Quebec despite the higher deduction on provincial taxes and health care that they cut from my paycheque. I hope the one year here in this shixhole pass quickly so I can go back to British Columbia!!! This Montreal is for the Canadian salves not the citizens

What’s wrong with the doctors at the Emergency? I had chest pain, went there, they seemed annoyed that I chose that hospital. When they saw that my pain was not necessarily caused by heart, they refused/couldn’t explain the plain despite being doctors. I get it, you’re a hospital that deals with the heart but the patient who’s having pain in the chest doesn’t know about what’s going on. Why would I donate money to a place that treats you like you’re an idiot for showing up. If I enter the ER, it’s cause I’m feeling extremely bad and it’s an emergency, just do your job, respect your oath and stop acting like patient is wasting your time.

Merci Beaucoup pour tout

EXCELLENT CARDIOLOGY CENTER DOCTOR. EFFICIENT BUT THE DEPARTMENT STAFF SERVANTS TO BE KICKED OUT X RUDE AND RUDE AN INDECENT THING THE ELDERLY ESPECIALLY TREATED BADLY. BUT NOBODY WHO CHECKS THE EQUALITY OF THE DISGUSTING SERVANTS. TAKE MEASURES FOR THOSE WHO CAN GO HOME UNWILLED.

They don't respect visiting hours. One piled on top of the other. First and last time I set foot in this kind of structure

Arrival at the emergency room with heart disease, pacemaker and thrombosis in progress, GREEN triage assignment and discharge (but return the following day for a vascular visit, the patient thrown here and there without hospitalization because "there are no beds"). The surgeon undertakes to anticipate access to the TAO, to date he has never responded (not even out of politeness). Hippocrates now seems like a distant memory of school studies......... It would be a pleasure to review this review in case something changes, but - given the trend - I doubt it.. Too bad!

I've been getting echocardiograms going to have to do aortic valve replacement surgery there seems good

They treated well Mui :)

Provide a helpful assistance in term of pharmaceutical advice, medical appliances, and non-expense cuisine for Covid-19 patients with modest courteousness service mind.

They saved my live and I will owe them for the rest of my life.!!

Paid children's department of the polyclinic (regular examination). Everything is as in the best traditions of the USSR. You must make an appointment no later than a month in advance. In this case, the queues are 3-4 hours long. Children are asked to eat and drink. Water can be found by going downstairs to the cooler. The dining room is only for patients and staff, in 20 minutes around the building there is no food at all (standing in the middle of the forest). And the specialists seem to be good, only new every year.!!

I am grateful to God for the existence of this hospital and the OLG department. Very talented doctors work here, doctors from God! Yes, it is not possible to do everything right the first time, it is difficult to collect all the documents, but it is worth it. There are certainly queues, but not huge ones. Here you can conduct various studies. It is possible for OMS, or for a fee. They are trying to help people here. Thanks for this!!!

I came to the cardio center in August 23 for a blocked iliac artery problem, now I feel like I've been to Lourdes. The kindness of all the medical staff is exemplary. Thank you all for your professionalism.👌👍

I brought my six year old daughter yesterday who was complaining of having heart throbs, it was the first time that I came to the cardiothoracic center of Monaco, and it is really the best hospital center that I have made of all my life, whether in terms of speed, to take care of my daughter, the staff of incredible patience and kindness, the center and impeccable cleanliness, I thank you again. Sincerely Gregory

Good morning, Operation: Double bypass August 2022. An extraordinary team at all levels, whether in terms of medical care, unparalleled professionalism, kindness, service, quality of meals, attentiveness, cleanliness, availability, respect, good manners , a good mood. A big BRAVO and THANK YOU to Doctor Armand EKER and his teams. Regards and THANK YOU from the bottom of my heart.

I went to the hospital’s emergency during the night just before Good Friday, after having a terrible food poison. The team helped me a lot! They all spoke English, were super comprehensive, and took good care of me. I really recommend the place to foreigners in case you have an emergency like mine 🍀

After my horrendous experiences in Brno's hospitals, this came as a goldmine. I was hospitalized due to gas leak in my apartment, so they gave me oxygen and there were some other procedures. The doctor spoke English well, the nurses did not speak very well but tried their best. They were very nice, smiling, helpful. I am forever thankful

I’d compromised my wrist month ago and it got worse when I fell down few days ago playing football and went to the hospital “Pod Marjankou” got served there made an X-Ray and there I’ve been told to go to the “Nemocnice Motol”, I thought the doctor said I need to go to any emergency to make a surgery. And decided to go the this “hospital” – surgery department building A8 and there I met the nurse that told that even I’ve been sent to another hospital they can paste my paste wrist back. Eventually, after 5 minutes analysing my X-Ray snapshot results they invite me in and told that finally I ned to go to another hospital. I’m okay if the explain me they policy or bureaucracy but instead, they were rudely yelling at me, that I didn’t need to go the hospital a whole month so I can tolerate another 3 days, because today they cannot fix my worrit wrist. These doctors are amoral, incompetent. They given an gippocratic oath that they didn’t fulfilled. They are just shame of Czech medicine.

Had a very pleasant experience at CVSKL. I was unsure about certain things regarding my appointment but Sharon Heng of Dr John Chan’s clinic was able to assist. And although she was on leave, she took the trouble to call me to explain further and followed up the next day. Sharon is a gem. Dr John Chan is very lucky to have someone like her working for him.

In July, my husband experienced chest pain, prompting us to rush to CVSKL Malaysia's emergency department. Right from the start, we were impressed by the care and attention we received. The ED doctor was not just professional but also incredibly attentive. They quickly conducted an ECG and echocardiogram, leading to my husband's admission. The next morning, Dr. Al-Fazir performed an angiogram for further diagnosis. In the following month, my husband underwent complex stenting, once again expertly handled by Dr. Al-Fazir. His expertise and transparency instilled great confidence in us. In my opinion, Dr. Al-Fazir is an extraordinary expert who goes above and beyond. He's straightforward and speaks the truth about complex stenting, never sugarcoating anything. We truly appreciated his honesty and transparency. Despite his busy schedule, Dr. Al-Fazir made it a point to meet with us every day, and his positivity and genuine concern for our well-being were incredibly reassuring. Nurse Nor and Nurse Sylvester were our heroes. Their dedication and compassion were incredible. They went the extra mile to ensure my husband's comfort and well-being, making a significant difference during his recovery. Despite a few minor hiccups, the entire CVSKL team, from medical professionals to administrative staff, ensured we were well taken care of. Our heartfelt thanks go to Puan Zehan and Puan Syima for their assistance in addressing our needs. Thanks to CVSKL Malaysia, my husband is now on the path to recovery, and we couldn't be happier with the care we received. Dr. Al-Fazir, along with the dedicated team at CVSKL, truly embody the spirit of expertise, honesty, and heartfelt care.

My dad had done bypass surgery at this hospital by Dr John Chan. We have great confidence in him and his abilities. Thank you so much for the great care and surgery performed on my dad. Also thanks to the nurse Sharon who helped us from booking appointments until discharged from ward. Thanks for her kindness and answered our questions enthusiastically. We also glad to have Dr Nadia as anesthetist. My dad had been treated very well by all the nurse, physiotherapist, nutritionist and staff. We appreciate that all the services from every department. Thanks a lot❤️

Check in very easy and quick but privacy not so much. You last check in before they put you in the room, the lady front desk say your phone number loud and ur emergency contacts number. Not very professional and conventional. Need a private room like the first check in has. At my work I only say the last 4 digits of someone's number. Please make this private I did not like my husband's and my phone number broad cast

I think the only good thing about the hospital are the staffs. Really friendly staff. But you can really feel that emergency I’d understaffed. The hospital was dirty. This is the dirtiest emergency I have ever been to. Timhortons cups lying around the floor with Napkins, papers. Lack of facilities. No rooms. People are everywhere. They have put beds on corridors.

I thank the staff of St. Mary's General Hospital from the bottom of my heart for saving my loved one's life with grace, kindness, expertise and excellence. Every single housekeeper, tech, nurse, doctor, surgeon and staff were absolutely amazing and God given gifts to us. We were all (patient and family alike) treated with kindness, dignity and respect throughout the duration of our entire stay while on CVICU and 3West. I am forever grateful to St. Mary's for the excellent care we received and the miracle of life through open heart surgery that my loved one received. God bless you all and continue the wonderful work. Thank you, thank you, thank you!

RIP King Kester 👑

People on whom medicine would have given up a few years ago, or even a few kilometers away, have a very reasonnable chance here. The hospital is second to none in interventionnal cardiology and some of the procedures in which they specialize can only be performed in a handful of hospitals around the world. They are the only hospital in France which can perform pulmonary endarterectomy. I know these facts first-hand, for having had relatives and close people being successfully attended there for life threatening conditions.

My best hospital experience so far - top surgeons and fantastic staff

Thank you for the good and safe treatment.

A wonderful group of people and a very helpful environment ❤⭐⭐⭐⭐⭐⭐⭐⭐⭐⭐❤

Mother's treatment was transferred here from Turku a couple of years ago (pacemaker pkl and heart pkl) The level of treatment rose to a completely different level.

Top

Was in Claraspital for air in stomach, I was given drip and inj in drip. Was told not to eat. What inj did they give me in drip that burned my insides from my mouth till my throat. If I eat or drink I'm in a lot of pain. Asked nurse why I'm not allowed to eat. Was told I'm having operation. Was there for 4 days without food or water. The doctor did not discuss it with me. The lady who went for operation day after I arrived never came back. I asked them where she is was told in another room. I think the Keller her. NO DOCTOR HAVE THE RIGHT TO DO WHAT THEY WANT WITHOUT DISCUSSING IT WITH THE PATIENTS. AND THIS WAS ONLY A DRS ASSISTANT. Dr told my friend she don't have blood, they will admit her to give blood in vein. When she went to spital she was given 2x document to sign which she refused after reading them. The document was to have stomach test from mouth and down. She was not given blood or Iron tablets yet she don't have enough blood the test results showed. When asked about it the dr told her it's ok. She can go home after staying in claraspital for 2 nights. How can anyone trust drs if they lie to people. PLEASE BE CAREFUL IM THINKING THEY ARE TAKING BODY PARTS FROM PEOPLE. After taking vaccine in Basel many people ended up in spital sick. Some cannot walk, some are bedridden. I must add that all the nurses was very nice to my friend. It's just that it's not nice for a doctor to lie just to make test on patient. 2022 I went to Claraspital for pain in my stomach. They did a scan after making me wait more than half an hour after the scan I got a big blister on my stomach. I told the Dr and was told it's nothing. I was very uneasy about it. There was something round on my skin. The dermatologist gave me 3 x cortisone injections but it never went away. Another Dr removed it by operation and there was something as long and thick as my small finger and was black in colour . What did they put in my body? I will never go there again. They only want to operate. The lady who was in the ward with me was so happy that she's going to get better after the stomach op. She was British. Unfortunately she never came back. The nurse was going through her handbag. It's a shame. What are they doing? Taking out body parts and selling them or reusing them like kidneys/ heart/ liver/ and so on. Please if you want to live do not go to Claraspital.clara hospital in Basel. In 2018 the Dr wanted to operate on me she tried to make me afraid telling me I will die if I don't have the op. They were giving me big doses of mofin till I stopped them. Today 2023 I'm alive, my stomach is ok by the Grace of God If you want to live DO NOT TO TO THE HOSPITAL. Every time I went there I was told OPERATE. NO WAYS

Great hospital, do all the truly necessary procedures, pretty good communicating staff and waiting time is ok. Running a hospital to this level is quite an achievement. Many thanks to the staff, it is reassuring to have you around.

I wasn't going to write a review (I'm so over all this), but I feel compelled to after reading a review that was extremely similar to what I experienced here for COVID-19 treatment. I tested COVID-positive on January 3rd and started Paxlovid. I saw my neighborhood doctor on January 4th. I am vaccinated (and boosted) but am at high risk with asthma. I was given steroids and breathing medicine. I was instructed to go to the hospital if I got worse. I got worse. The following evening, my oxygen dropped below 80. Scared, I called an ambulance and requested to be taken to this hospital as it was supposed to be the best. They took my oxygen in the ambulance and immediately gave me oxygen. I was on oxygen the whole time in the ambulance. I was taken off oxygen when I arrived as my saturation reached the high 90s. I requested the antiviral remdesivir. The doctor refused to give me the medicine. I explained how my condition worsened despite days on Paxlovid, steroid injections, oral steroids, bronchodilators, and rescue inhalers. He could not have cared less. I requested to leave as the doctor was not going to treat me (he charged me, though). The doctor told me there were other ID specialists. I requested to speak to one of them, and the doctor left. While waiting, someone else came in and said there were no other ID specialists there, so I paid and left. It should be noted my saturation had fallen to 92% by that time. I struggled at home with symptoms for the next few days. I continued testing positive after completing Paxlovid. My condition worsened, and I returned to the neighboring doctor about a week after leaving the hospital. Still symptomatic and COVID-positive, he examined me and found pneumonia. My labs were also abnormal, showing evidence I had developed blood clots due to COVID-19. He prescribed medicine for pneumonia and clots (which worked). All this could have been prevented. Trying to get my medical records from this hospital afterwords (for insurance) was like pulling teeth. It took forever to get my records, and when I finally did, I was shocked. The doctor noted that I said things I never did. My signature was forged on the documents. Worst hospital experience ever. Very expensive and received no treatment. The administration is a nightmare as well. Avoid it if possible.

We have been living In 3 different countries for the past 9 years, never experienced anything as bad. We have a a top insurance but they “suddenly” only excepts credit card payment. Stayed for additional 5 hours because they did not let’s leave. No one speaks English except the doctors. However, doctors are very competent and reason for not one but two stars.

Absurdly (like, for real) expensive for a very mediocre level of service. I went to the urgency center, and i found it very useless that on every stage (reception, triage, first and second doctor) they asked me the same questions. The doctor took more than half an hour to arrive. The receptionist has misinformed me and I did a very expensive (since I’m traveling abroad) call which wasn’t necessary at that moment. Also, several times there were several people coming in at a time, also unnecessary, certainly didn’t create a feeling of comfort. The room in which I was attended was small and the door was never closed.

I call and call, of the three phones, no one answers 📞 one needs to know about their relatives, visiting hours and other questions. They should improve this telephone information service

My elderly mother was hospitalized, and was very well attended and cared for, as well as her guardian being promptly informed of her condition. I am very grateful for the attention she received there, because they even made sure that due to her position she would not get more bedsores. I was really very afraid because I had two terrible experiences in other hospitals (Barros Luco, the worst, and another that is not even worth giving the name).

Super

Had a bike accident, broke my elbow and collarbone and got admitted to Thomayerova. Very satisfied with the entire treatment from arriving at the emergency until being released 10 days later, after two surgeries. I do speak some Czech but not enough for everything. Neverthless, all the nurses, doctors and other stuff were kind and friendly. We managed to get along using google translate and even have some fun while overcoming language barriers. Never felt as "they have to deal with another foreigner". I wanna thank everyone who took care of me at pavillon G3

Been there with severe lower back pain unable to even stand straight. I have been told that it will be some waiting time between 1 to 2 hours and i accepted that. After 4 hours i asked the nurses why noone from the people in waiting room have not been approached by a nurse or some explanation given to the waiting. The doctor was chatting all this time with the nurses ignoring the visible pain suffered by the waiting patients . Only after i raised my voice they decided to call me inside the cabinet for a check. This without carrying that a lady patient who was there before me was visible crying out of pain in the waiting room. The lack of empathy and respect i have never see before in a Prague Hospital. I did heard about horrible stories coming out from Thomayerova Hospital with some high profile cases on national television and i was hoping that after this some measures were taken by the ministry of health. Obviously there is business as usual. Avoid with all costs. Now i came to Neurology Clinic in Prague 2 and i feel better just by the kindness and empathy the staff have showed me here.

I got chest infection and I admitted in this hospital.i am not Czech and I don't speak Cezch at all.But almost all Doctors here speaks good English and Nurses hardly speaks English but they are kind and they know they job well,so no need to communicate much..Here Hospital food is on another level..each food design according on your diet and health conditions..thank you all the team members of this Hospital.🙏

Good day, thank God, I had to request the services of RZP 3 times already. Twice they came from a joke, but that's simply not worth commenting on!!! Deep below the level!!! Neská is 1 November 2023 at around 12 noon. And I need them again! And they came, but from Galanta! Those people from RZP are really professionals! Nice friendly and PROFESSIONAL !!! DIAGNOSIS FOR TWO COINS !!! GENTLEMEN, THANK YOU!!!

Today my father was discharged from the internal ward for a pulmonary embolism. What he experienced there with the cleaners is simply unfathomable. Rude, arrogant, humanity means nothing to them. They raised their voices at the patients, ran into the room in the morning with such a roar, with the intention of waking them up, and even when that didn't help, they shouted at my father that hey hey hey we're building. My father, who is seriously ill on the devices, should have been sober and not put up with such inappropriate behavior of the cleaning ladies. It seems that they consider themselves to be of a higher caste, because what they allow themselves to do to patients is unparalleled. Unfortunately, they spoil the good name of the hospital. Someone competent should sort things out with them and order a course in empathy and, above all, decent behavior.

I am extremely dissatisfied with the emergency room staff and especially with the approach of the nurses. My son had a coughing fit, I rang the bell about 5 times and no one answered. After 20 minutes, the nurse came out and was quite unpleasant. It would probably be possible to complete training on empathy towards patients and family members. . I don't even want to imagine what would happen if a patient came here with a bloody injury. Apparently, he could also bleed out here, since the bell is only there to be when no one responds to it.

My experiences there have consistently been the worst, primarily due to the limited English-speaking staff. I would strongly advise against recommending this hospital to anyone. It's incredibly frustrating to receive appointments scheduled months in advance at 9:30 AM, only to still be waiting for an examination at 1 PM. This is, in my opinion, the worst hospital to visit.

I participated in my daughter's labor. I say that I participated, because I was not there as a spectator, but being an active part of the labor. I didn't give birth to my daughter, I didn't feel the labor pains, my body is still intact and strong. My wife suffered and went to her physical limit to bring our little seed into this world. But I was there, in her every contraction, I was there in every sigh of pain, I was there holding her in my arms and living in our moment, taking care of my family and being the strength and support for my loved one. It was 14 hours of labor, it was exhausting and suffering, but it was also beautiful, magical, poetic, it was our moment, where our connection was strengthened even more. My heart is filled with the most beautiful emotions every time I remember that moment. St Joseph Krankenhaus, I have no words to describe this amazing hospital, I can't think of a better place for us to experience all of this. The midwives, the nurses, the doctors, the pediatricians, how much sensitivity and respect for us, for our moment. They were a fundamental part of all of this, I can only thank them. The "birth ritual" conducted by the midwives was the dance of life, the path of light for our Sementinha. And where some people see suffering, I see beauty, the beauty of giving birth to the beauty of life.

Our heartfelt gratitude to the exceptional staff at the hospital. The care and support my wife received during childbirth were beyond compare. The medical team was skilled, compassionate, and attentive, making us feel safe and at ease. The facility was clean and well-equipped, ensuring a smooth delivery. This joyous occasion was made even more memorable by the hospital's outstanding care. Thank you for an unforgettable experience! ⭐⭐⭐⭐⭐

My family is exceedingly satisfied with the professionalism and commitment to excellent nursing care received from Global Hospital. The medical services received by my mother during her stay in your hospital were exceptional. She felt at home throughout the whole recovery process. Your hard work does not go unnoticed. We are extremely pleased with the top-notch care provided by your team.... Thank you very much to the entire team of Global Hospital 🙏🏻

Dr Shirish Hastak and his team has been a big blessing for our family.. he has not just diagnosed my dad's condition correctly but also gave the right advise for his unique medical issues like low CSF syndrome, cerebellum stroke syndrome, etc and I am glad my dad is well and healthy under his guidance. He has been a true blessing every time we have approached him. Thank you Dr Shirish Hastak for always standing behind and helping us sail through the difficult times. Thanks to Global Hospital staff for helping and making our stay comfortable in this trying times. -Priyanka Deshmukh on behalf of Dr Subhash Deshmukh

Doctor Jignesh Gandhi of Global Hospital is the best surgeon. He performed my surgery very well. Also his assistant doctor Alpana cooperated very well. Nurse Archana and Nurse Siddhi at Global Hospital took great care of me. All the staff at Global Hospital cooperated well. Global Hospital is the best hospital for me. A very clean and well maintained hospital I must say. I had periodical medical examination there. The staff is very polite and friendly.

I would like to share my impressions and opinions about my stay at the National Scientific Cardiosurgical Center. I am in the second cardiology department. An operation was performed to establish the EX. Everything went at a high level. It was nice to see our young growth in the operating room, which is doing its job very well. Great guys: correct, attentive and sympathetic. Department 2 of cardiology headed by Myrzakhmetova Gulzhan Shapataevna deals directly with the healing of our hearts, both literally and figuratively. Each procedure performed meets the highest standards. You feel like you are in a foreign hospital. Comfort, professionalism of the staff, cleanliness, discipline of the staff, that's what especially pleases the soul and heart. I would like to wish the Center to remain the Center of our Kazakh hearts.

Dear compatriots. Having come here from our province, I still can’t get used to such a humane and sincere attitude. I am very grateful to the staff, to all those who warm the patients with the warmth of their souls. Low bow to you. And may the Almighty reward your service to sick people when you turn them into healthy ones. You are best!!!!!!

a place, where miracles make

And if there were even more stars I would click them, a doctor who is not only competent but of infinite humanity which combined with professionalism makes a doctor an exceptional man

My heart is working again thanks to Dr. Glauber.

I would like to thank Dr. Mattia Glauber, an extraordinary doctor and sensitive person. My partner had surgery in December (mitral valve prolapse) the surgery was decisive and the recovery was very fast. Within a month he was back to his usual life as if nothing had happened. What to say?! Thank you, Mattia Glauber! Happy Easter everyone :-)