259 results found
Harper S, Grodzicki L, Mealing S, et al., 2023, Cost-effectiveness of a novel, non-active implantable device as a treatment for refractory gastro-esophageal reflux disease, JOURNAL OF MEDICAL ECONOMICS, Vol: 26, Pages: 603-613, ISSN: 1369-6998
McGlone ER, Carey IM, Currie A, et al., 2023, Bariatric surgery provision in response to the COVID-19 pandemic: retrospective cohort study of a national registry, Surgery for Obesity and Related Diseases, Vol: 19, Pages: 1281-1287, ISSN: 1550-7289
BackgroundWhen surgery resumed following outbreak of the COVID-19 pandemic, guidelines recommended the prioritization of patients with greater obesity-related comorbidity and/or higher Body Mass Index (BMI).ObjectivesThe aim of this study was to record the effect of the pandemic on total number, patient demographic and peri-operative outcomes of elective bariatric surgery in the United Kingdom.Setting and MethodThe United Kingdom National Bariatric Surgical Registry was used to identify patients that underwent elective bariatric surgery during the pandemic (one year from 1st April 2020). Characteristics of this group were compared with a pre-pandemic cohort. Primary outcomes were case volume, case-mix and provider. National Health Service (NHS) cases were analyzed for baseline health status and peri-operative outcomes. Chi-square, Fisher’s exact or Student’s t-test were used as appropriate.ResultsTotal number of cases reduced to one third of pre-pandemic volume (8615 to 2930). Operating volume reduction varied, with thirty-six (45%) hospitals experiencing a 75-100% reduction. Cases performed in the NHS fell from 74% to 53% (p<0.0001). There was no change in baseline BMI (45.2 kg/m2 ± 8.3 from 45.5 kg/m2 ± 8.3; p=0.228) or prevalence of Type 2 Diabetes Mellitus (26% from 26%; p=0.999. Length of stay (median 2 days) and surgical complication rate (1.4% from 2.0%; RR 0.71 (95% CI 0.45 – 1.12); p=0.133) were unchanged.ConclusionsIn the context of a dramatic reduction in elective bariatric surgery due to the COVID-19 pandemic, patients with more severe comorbidity were not prioritized for surgery. These findings should inform preparation for future crises.
Patel P, Thomas R, Hamady M, et al., 2023, EMBIO trial study protocol: left gastric artery embolisation for weight loss in patients living with obesity with a BMI 35-50 kg/m², BMJ Open, Vol: 13, ISSN: 2044-6055
Introduction Left gastric artery embolisation (LGAE) is a well-established treatment for major upper gastrointestinal (GI) bleeding when control is not established via upper GI endoscopy and recently has shown promising results for weight loss in small single arm studies. LGAE could be a treatment option in between our current tier-3 and tier-4 services for obesity. EMBIO is a National Institute for Health Research funded trial, a multicentre double-blinded randomised controlled trial between Imperial College National Health Service Trust and University College London Hospital, comparing LGAE versus Placebo procedure. The key aims of the trial is to evaluate LGAE efficacy on weight loss, its mechanism of action, safety profile and obesity-related comorbidities.Methods and analysis 76 participants will be recruited from the existing tier-3 database after providing informed consent. Key inclusion criteria include adults aged 18–70 with a body mass index 35–50 kg/m2 and appropriate anatomy of the left gastric artery and coeliac plexus on CT Angiogram. Key exclusion criteria included previous major abdominal and bariatric surgery, weight >150 kg, type 2 diabetes on any medications other than metformin and the use of weight modifying medications. Participants will undergo mechanistic visits 1 week prior to the intervention and 3, 6 and 12 months postintervention. Informed consent will be received from each participant and they will be randomised in a 1:1 ratio to left gastric artery embolisation and placebo treatment. Blinding strategies include the use of moderate doses of sedation, visual and auditory isolation. All participants will enter a tier-3 weight management programme postintervention. The primary analysis will estimate the difference between the groups in the mean per cent weight loss at 12 months.Ethics and dissemination This trial shall be conducted in full conformity with the 1964 Declaration of Helsinki and
Kowalka AM, Alexiadou K, Cuenco J, et al., 2023, The postprandial secretion of peptide YY<sub>1-36</sub> and <sub>3-36</sub> in obesity is differentially increased after gastric bypass versus sleeve gastrectomy, CLINICAL ENDOCRINOLOGY, Vol: 99, Pages: 272-284, ISSN: 0300-0664
Assaf N, Scholtz S, Ahmed A, et al., 2023, THE ACCEPTABILITY AND FEASIBILITY OF 3D RECONSTRUCTION AND VIRTUAL REALITY IN ADDRESSING BODY IMAGE IN BARIATRIC SURGERY, 26th International-Federation-for-the-Surgery-of-Obesity-and-Metabolic-Disorders World Congress (IFSO), Publisher: SPRINGER, Pages: 312-312, ISSN: 0960-8923
Ghanem A, Ahmed A, 2023, NOVEL TECHNIQUE FOR PREVENTION OF INTERNAL HERNIA AFTER LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS, 26th International-Federation-for-the-Surgery-of-Obesity-and-Metabolic-Disorders World Congress (IFSO), Publisher: SPRINGER, Pages: 208-208, ISSN: 0960-8923
Bansi D, O'Neill F, Ahmed A, 2023, ENDOSCOPIC VERSUS SURGICAL GASTROJEJUNAL REVISION FOR WEIGHT REGAIN IN ROUX-EN-Y GASTRIC BYPASS PATIENTS: A 30 DAY UK COST-CONSEQUENCE MODEL, 26th International-Federation-for-the-Surgery-of-Obesity-and-Metabolic-Disorders World Congress (IFSO), Publisher: SPRINGER, Pages: 109-109, ISSN: 0960-8923
Ghanem A, Ahmed A, 2023, SOS STEPS FOR REVERSAL OF RETRO-COLIC RETRO-GASTRIC ROUX-EN-Y GASTRIC BYPASS, 26th International-Federation-for-the-Surgery-of-Obesity-and-Metabolic-Disorders World Congress (IFSO), Publisher: SPRINGER, Pages: 492-492, ISSN: 0960-8923
Ortega PM, Sahloul M, Hakky S, et al., 2023, REFRACTORY PAIN POST ROUX-EN Y GASTRIC BYPASS: DEFINING A MANAGEMENT STRATEGY, 26th International-Federation-for-the-Surgery-of-Obesity-and-Metabolic-Disorders World Congress (IFSO), Publisher: SPRINGER, Pages: 258-258, ISSN: 0960-8923
Younus H, Williamson A, Patel P, et al., 2023, SYSTEMATIC REVIEW AND META ANALYSIS TO STUDY THE EFFECTS OF LEFT GASTRIC ARTERY EMBOLISATION ON WEIGHT LOSS: A NEW GATEWAY!, 26th International-Federation-for-the-Surgery-of-Obesity-and-Metabolic-Disorders World Congress (IFSO), Publisher: SPRINGER, Pages: 910-910, ISSN: 0960-8923
Khan N, Patel P, Ahmed AR, 2023, A REVIEW OF 5:2 INTERMITTENT FASTING, ALTERNATE DAY FASTING, AND TIME RESTRICTED FASTING FOR THE MANAGEMENT OF OBESITY, 26th International-Federation-for-the-Surgery-of-Obesity-and-Metabolic-Disorders World Congress (IFSO), Publisher: SPRINGER, Pages: 30-30, ISSN: 0960-8923
Khan N, Patel P, Ahmed A, 2023, A review of 5:2 intermittent fasting, alternate day fasting, and time restricted fasting for the management of obesity., Publisher: SPRINGER, Pages: S63-S63, ISSN: 0960-8923
Sahloul M, Hamady M, Ahmed A, 2023, Laparoscopic Sleeve Gastrectomy and Splenectomy, Publisher: SPRINGER, Pages: S143-S143, ISSN: 0960-8923
Younus H, Williams A, Patel P, et al., 2023, Systematic Review and Meta analysis to study the effects of Left Gastric Artery Embolisation on weight loss: A NEW GATEWAY!, Publisher: SPRINGER, Pages: S58-S58, ISSN: 0960-8923
Sahloul M, Ahmed A, 2023, Conversion of one anastmosis gastric bypass to Roux-en-Y gatsric bypass due to persistent leak, Publisher: SPRINGER, Pages: S138-S138, ISSN: 0960-8923
Ortega PM, Sahloul M, Tsironis C, et al., 2023, Refractory Pain Post Roux-en Y Gastric Bypass: defining a management strategy, Publisher: SPRINGER, Pages: S135-S135, ISSN: 0960-8923
O'Byrne K, Ramesh P, Purkayastha S, et al., 2023, Tier 3 weight management; Is it really needed?, Publisher: SPRINGER, Pages: S24-S24, ISSN: 0960-8923
Ghanem A, Ahmed A, 2023, Laparoscopic reversal of retrocolic-retrogastric RYGB, what to expect?, Publisher: SPRINGER, Pages: S144-S144, ISSN: 0960-8923
Limaye N, Mostafa A, Tsironis C, et al., 2023, The risk factors and patient characteristics predicting length of stay in Bariatric patients; The Imperial Weight Centre experience, Publisher: SPRINGER, Pages: S25-S25, ISSN: 0960-8923
Bansi D, O'neill F, Ahmed A, 2023, Endoscopic versus surgical gastrojejunal revision for weight regain in Roux-en-Y gastric bypass patients: A 30 day UK Cost-consequence model., Publisher: SPRINGER, Pages: S69-S69, ISSN: 0960-8923
Bolckmans R, Askari A, Currie A, et al., 2023, Clinical characteristics of patients undergoing primary bariatric surgery in the United Kingdom based on the National Bariatric Surgery Registry, Clinical Obesity, Vol: 13, ISSN: 1758-8103
Baseline demographic characteristics and operations undertaken for patients having bariatric surgery in the United Kingdom are largely unknown. This study aimed to describe the profile of patients having primary bariatric surgery in the National Health Service (NHS) or by self-pay, and associated operations performed for both pathways. The National Bariatric Surgery Registry dataset for 5 years between January 2015 and December 2019 was used. 34 580 patients underwent primary bariatric surgery, of which 75.9% were NHS patients. Mean patient age and initial body mass index were significantly higher for NHS compared to self-pay patients (mean age 45.8 ± 11.3 [SD] vs. 43.0 ± 12.0 years and initial body mass index 48.0 ± 7.9 vs. 42.9 ± 7.3 kg/m2, p < .001). NHS patients were more likely to have obesity-related complications compared to self-pay patients: prevalence of Type 2 diabetes mellitus 27.7% versus 8.3%, hypertension 37.1% versus 20.1%, obstructive sleep apnoea 27.4% versus 8.9%, severely impaired functional status 19.3% versus 13.9%, musculoskeletal pain 32.5% versus 20.1% and being on medication for depression 31.0% versus 25.9%, respectively (all p < .001). Gastric bypass was the most commonly performed primary NHS bariatric operation 57.2%, but sleeve gastrectomy predominated in self-pay patients 48.7% (both p < .001). In contrast to self-pay patients, NHS patients are receiving bariatric surgery only once they are older and at a much more advanced stage of obesity-related disease complications.
Currie A, Bolckmans R, Askari A, et al., 2023, Bariatric-metabolic surgery for NHS patients with type 2 diabetes in the United Kingdom National Bariatric Surgery Registry, Diabetic Medicine, Vol: 40, ISSN: 0742-3071
AimBariatric-metabolic surgery is approved by the National Institute of Health and Care Excellence (NICE) for people with severe obesity and type 2 diabetes (T2DM) (including class 1 obesity after 2014). This study analysed baseline characteristics, disease severity and operations undertaken in people with obesity and T2DM undergoing bariatric-metabolic surgery in the UK National Health Service (NHS) compared to those without T2DM.MethodsBaseline characteristics, trends over time and operations undertaken were analysed for people undergoing primary bariatric-metabolic surgery in the NHS using the National Bariatric Surgical Registry (NBSR) for 11 years from 2009 to 2019. Clinical practice before and after the publication of the NICE guidance (2014) was examined. Multivariate logistic regression was used to determine associations with T2DM status and the procedure undertaken.Results14,948/51,715 (28.9%) participants had T2DM, with 10,626 (71.1%) on oral hypoglycaemics, 4322 (28.9%) on insulin/other injectables, and with T2DM diagnosed 10+ years before surgery in 3876 (25.9%). Participants with T2DM, compared to those without T2DM, were associated with older age (p < 0.001), male sex (p < 0.001), poorer functional status (p < 0.001), dyslipidaemia (OR: 3.58 (CI: 3.39–3.79); p < 0.001), hypertension (OR: 2.32 (2.19–2.45); p < 0.001) and liver disease (OR: 1.73 (1.58–1.90); p < 0.001), but no difference in body mass index was noted. Fewer people receiving bariatric-metabolic surgery after 2015 had T2DM (p < 0.001), although a very small percentage increase of those with class I obesity and T2DM was noted. Gastric bypass was the commonest operation overall. T2DM status was associated with selection for gastric bypass compared to sleeve gastrectomy (p < 0.001).ConclusionNHS bariatric-metabolic surgery is used for
Behary P, Alessimii H, Miras AD, et al., 2023, Tripeptide gut hormone infusion does not alter food preferences or sweet taste function in volunteers with obesity and prediabetes/diabetes but promotes restraint eating: a secondary analysis of a randomized single-blind placebo-controlled study, Diabetes, Obesity and Metabolism: a journal of pharmacology and therapeutics, Vol: 25, Pages: 1731-1739, ISSN: 1462-8902
AimsTo investigate whether the elevation in postprandial concentrations of the gut hormones glucagon-like peptide-1 (GLP-1), oxyntomodulin (OXM) and peptide YY (PYY) accounts for the beneficial changes in food preferences, sweet taste function and eating behaviour after Roux-en-Y gastric bypass (RYGB).Materials and methodsThis was a secondary analysis of a randomized single-blind study in which we infused GLP-1, OXM, PYY (GOP) or 0.9% saline subcutaneously for 4 weeks in 24 subjects with obesity and prediabetes/diabetes, to replicate their peak postprandial concentrations, as measured at 1 month in a matched RYGB cohort (ClinicalTrials.gov NCT01945840). A 4-day food diary and validated eating behaviour questionnaires were completed. Sweet taste detection was measured using the method of constant stimuli. Correct sucrose identification (corrected hit rates) was recorded, and sweet taste detection thresholds (EC50s: half maximum effective concencration values) were derived from concentration curves. The intensity and consummatory reward value of sweet taste were assessed using the generalized Labelled Magnitude Scale.ResultsMean daily energy intake was reduced by 27% with GOP but no significant changes in food preferences were observed, whereas a reduction in fat and increase in protein intake were seen post-RYGB. There was no change in corrected hit rates or detection thresholds for sucrose detection following GOP infusion. Additionally, GOP did not alter the intensity or consummatory reward value of sweet taste. A significant reduction in restraint eating, comparable to the RYGB group was observed with GOP.ConclusionThe elevation in plasma GOP concentrations after RYGB is unlikely to mediate changes in food preferences and sweet taste function after surgery but may promote restraint eating.
Kyriazidis IP, Jakob DA, Vargas JAH, et al., 2023, Accuracy of diagnostic tests in cardiac injury after blunt chest trauma: a systematic review and meta-analysis, WORLD JOURNAL OF EMERGENCY SURGERY, Vol: 18, ISSN: 1749-7922
Ahmed AR, 2023, Innovating in the field of weight loss, BRITISH JOURNAL OF SURGERY, Vol: 110, Pages: 536-537, ISSN: 0007-1323
Ahmad SJS, Degiannis K, Borucki J, et al., 2023, The most influential COVID-19 articles: A systematic review, NEW MICROBES AND NEW INFECTIONS, Vol: 52
Schutzer-Weissmann J, Wojcikiewicz T, Karmali A, et al., 2023, Apnoeic oxygenation in morbid obesity: a randomised controlled trial comparing facemask and high-flow nasal oxygen delivery, British Journal of Anaesthesia, Vol: 130, Pages: 103-110, ISSN: 0007-0912
BackgroundObesity is a risk factor for airway-related incidents during anaesthesia. High flow nasal oxygen has been advocated to improve safety in high-risk groups but its effectiveness in the obese population is uncertain. This study compared the effect of high flow nasal oxygen and low flow facemask oxygen delivery on duration of apnoea in morbidly-obese patients.MethodsPatients undergoing bariatric surgery were randomly allocated to receive either high flow nasal (70 L min-1) or facemask (15 L min-1) oxygen. Following induction of anaesthesia, morbidly-obese patients were apnoeic for 18 minutes or until oxygen saturation dropped to 92%.ResultsEighty patients were studied (41 high flow nasal oxygen, 39 facemask). Median apnoea duration was 18 minutes in both the high flow nasal oxygen (IQR 18-18 minutes) and the facemask (IQR 4.1-18 minutes) groups. Five patients in the high flow nasal oxygen group and 14 patients in the facemask group desaturated to 92% within 18 minutes. The risk of desaturation was lower in the high flow nasal oxygen group (Hazard Ratio 0.27, 95% CI 0.11-0.65, p=0.007). ConclusionsIn experienced hands, apnoeic oxygenation is possible in the morbidly-obese and was tolerated for 18 minutes by the majority of patients, whether oxygen delivery was high flow nasal or low flow facemask. High flow nasal oxygen reduced desaturation risk compared to facemask oxygen. Desaturation risk is a more clinically relevant outcome than duration of apnoea. Individual physiological factors are likely to be the primary determinant of risk rather than method of oxygen delivery.
Ghanem A, Ahmed A, 2022, Day case explantation of a magnetic lower oesophagal sphincter augmentation device due to dysphagia, AUGIS Annual Scientific Meeting, Publisher: OXFORD UNIV PRESS, ISSN: 0007-1323
Patel P, Thomas R, Hamady M, et al., 2022, O102 We know about left gastric artery embolisation and will embio provide the next solution to treat obesity?, Annual Scientific Meeting of the Surgical-Research-Society, Publisher: OXFORD UNIV PRESS, ISSN: 0007-1323
Fehervari M, Ortega P, Muir C, et al., 2022, Single Anastomosis Gastric Bypass as a revision of failed Gastric Band, Publisher: SPRINGER, Pages: 19-19, ISSN: 0960-8923
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