Publications
573 results found
Kokotsakis J, Anagnostakou V, Kratimenos T, et al., 2011, Frozen Elephant Trunk: A technique which can be offered in complex pathology to fix the whole aorta in one setting, JOURNAL OF CARDIOTHORACIC SURGERY, Vol: 6, ISSN: 1749-8090
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- Citations: 4
Anagnostakou V, Nenekidis I, Ashrafian H, et al., 2011, Acute aortic syndrome: surgical, endovascular or medical treatment, BRITISH JOURNAL OF HOSPITAL MEDICINE, Vol: 72, Pages: 252-258, ISSN: 1750-8460
Shaygi B, Ashrafian H, Athanasiou T, et al., 2011, Comparison of the learning curves between conventional laparoscopic surgery (CL) and single-incision laparoscopic surgery (SILS), International Surgical Congress of the Association-of-Surgeons-of-Great-Britain-and-Ireland, Publisher: WILEY-BLACKWELL, Pages: 131-131, ISSN: 0007-1323
Patel VM, Warren O, Ahmed K, et al., 2011, How can we build mentorship in surgeons of the future?, ANZ J Surg
Ashrafian H, Darzi A, Athanasiou T, 2011, Bariatric surgery - can we afford to do it or deny doing it?, Frontline Gastroenterol, Vol: 2, Pages: 82-89, ISSN: 2041-4137
Ashrafian H, 2011, Limb gigantism, neurofibromatosis and royal heredity in the Ancient World 2500 years ago: Achaemenids and Parthians, JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY, Vol: 64, Pages: 557-557, ISSN: 1748-6815
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- Citations: 4
Ashrafian H, Athanasiou T, le Roux CW, 2011, Heart remodelling and obesity: the complexities and variation of cardiac geometry, HEART, Vol: 97, Pages: 171-172, ISSN: 1355-6037
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- Citations: 36
Bueter M, Ashrafian H, Fra, et al., 2011, Sodium and water handling after gastric bypass surgery in a rat model, Surg Obes Relat Dis
Ahmed K, Rowland S, Patel VM, et al., 2011, Specialist anatomy: Is the structure of teaching adequate?, Surgeon, Vol: 9, Pages: 312-317, ISSN: 1479-666X
BACKGROUND: A knowledge and understanding of specialist anatomy, which includes radiological, laparoscopic, endoscopic and endovascular anatomy is essential for interpretation of imaging and development of procedural skills. METHODS AND MATERIALS: Medical students, specialist trainees and specialists from the London (England, UK) area were surveyed to investigate individual experiences and recommendations for: (1) timing of the introduction of specialist anatomy teaching, and (2) pedagogical methods used. Opinions relating to radiological, laparoscopic, endoscopic and endovascular anatomy were collected. Non-parametric tests were used to investigate differences in recommendations between specialist trainees and specialists. RESULTS: Two hundred and twenty-eight (53%) individuals responded to the survey. Imaging was most commonly used to learn radiological anatomy (94.5%). Procedural observation was most commonly used to learn laparoscopic (89.0%), endoscopic (87.3%) and endovascular anatomy (66.2%). Imaging was the most recommended method to learn radiological anatomy (92.1%). Procedural observation was the most recommended method for learning laparoscopic (80.0%), endoscopic (81.2%) and endovascular anatomy (42.5%). Specialist trainees and specialists recommended introduction of specialist anatomy during undergraduate training. CONCLUSION: Although the methods for specialist anatomy learning are in practice, there is no consensus on timing and structure within the anatomy curriculum. Recommendations from trainees and specialists should be considered so that the existing curriculum can be refined to maximise learning outcomes.
Ashrafian H, Ahmed K, Rowland S, et al., 2011, Metabolic surgery and cancer: The protective effects of bariatric procedures., Cancer, Vol: 117, Pages: 1788-1799, ISSN: 0008-543X
The worldwide epidemic of obesity and the global incidence of cancer are both increasing. There is now epidemiological evidence to support a correlation between obesity, weight gain, and some cancers. Metabolic or bariatric surgery can provide sustained weight loss and reduced obesity-related mortality. These procedures can also improve the metabolic profile to decrease cardiovascular risk and resolve diabetes in morbidly obese patients. The operations offer several physiological steps, the so-called BRAVE effects: 1) bile flow alteration, 2) reduction of gastric size, 3) anatomical gut rearrangement and altered flow of nutrients, 4) vagal manipulation and 5) enteric gut hormone modulation. Metabolic operations are also associated with a significant reduction of cancer incidence and mortality. The cancer-protective role of metabolic surgery is strongest for female obesity-related tumors; however, the underlying mechanisms may involve both weight-dependent and weight-independent effects. These include the improvement of insulin resistance with attenuation of the metabolic syndrome as well as decreased oxidative stress and inflammation in addition to the beneficial modulation of sex steroids, gut hormones, cellular energetics, immune system, and adipokines. Elucidating the precise metabolic mechanisms of cancer prevention by metabolic surgery can increase our understanding of how obesity, diabetes, and metabolic syndrome are associated with cancer. It may also offer novel treatment strategies in the management of tumor generation and growth.
Ashrafian H, Darzi A, Athanasiou T, 2011, Evidence Synthesis: Evolving Methodologies to Optimise Patient Care and Enhance Policy Decisions, EVIDENCE SYNTHESIS IN HEALTHCARE: A PRACTICAL HANDBOOK FOR CLINICIANS, Editors: Athanasiou, Darzi, Publisher: SPRINGER-VERLAG BERLIN, Pages: 1-46, ISBN: 978-0-85729-175-2
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- Citations: 5
Rowland S, Ahmed K, Davies DC, et al., 2011, Assessment of anatomical knowledge for clinical practice: perceptions of clinicians and students, Surg Radiol Anat, Vol: 33, Pages: 263-269, ISSN: 0930-1038
PURPOSE: In anatomy education, assessment may be done by written, practical or oral methods. These are used to varying degrees in UK medical schools with no consensus on the preferred approach. The purpose of this article is to highlight changes to methods of anatomical knowledge assessment utilised in medical schools since the early 1990s and to present recommended methods of assessment according to the level of medical training. METHODS: Medical students, trainees and specialists in the London (UK) area were surveyed to: (1) identify methods experienced in anatomy education at medical school and (2) gather recommendations. Medical student, trainee and specialist responses were compared using non-parametric tests. RESULTS: Two hundred and twenty-eight individuals responded to the survey giving a response rate of 53%. Subjects who graduated before 2005 were assessed significantly more frequently by practical (94.2 vs. 33.3%) and oral (84.5 vs. 13.1%) methods than those whose graduation year was 2005 or later. Subjects whose graduation year was 2005 or later were assessed significantly more frequently by written methods, such as EMQs than those whose graduation was before 2005 (68.7 vs. 25.2%). Practical examination was identified as the most recommended method of assessment in anatomy education by medical students (59.1%), trainees (all stages combined; 54.2%) and specialists (51.7%). CONCLUSION: Practical assessment is recommended over written and oral methods for the assessment of anatomical knowledge. A formal evaluation of the relative benefits and limitations of available assessment tools is required.
Harling L, Athanasiou T, Ashrafian H, et al., 2011, Strategies in the surgical management of atrial fibrillation., Cardiol Res Pract, Vol: 2011
Atrial fibrillation (AF) is associated with substantial morbidity, mortality, and economic burden and confers a lifetime risk of up to 25%. Current medical management involves thromboembolism prevention, rate, and rhythm control. An increased understanding of AF pathophysiology has led to enhanced pharmacological and medical therapies; however this is often limited by toxicity, variable symptom control, and inability to modulate the atrial substrate. Surgical AF ablation has been available since the original description of the Cox Maze procedure, either as a standalone or concomitant intervention. Advances in novel energy delivery systems have allowed the development of less technically demanding procedures potentially eliminating the need for median sternotomy and cardiopulmonary bypass. Variations in the definition, duration, and reporting of AF have produced methodological limitations impacting on the validity of interstudy comparisons. Standardization of these parameters may, in future, allow us to further evaluate clinical endpoints and establish the efficacy of these techniques.
Athanasiou T, Ashrafian H, Rowland SP, et al., 2011, Robotic cardiac surgery: advanced minimally invasive technology hindered by barriers to adoption, Future Cardiol, Vol: 7, Pages: 511-522, ISSN: 1479-6678
Robotic cardiac surgery utilizes the most advanced surgical technology to offer patients a minimally invasive alternative to open surgery in the treatment of a broad range of cardiac pathologies. Although robotics may offer substantial benefits to physicians, patients and healthcare institutions, there are important barriers to its adoption that includes inadequate funding, competition from alternate therapies and challenges in training. There is a growing body of evidence to demonstrate the efficacy of robotic cardiac surgery. Technological innovations are improving patient safety and expanding the indications for robotic cardiac surgery beyond the treatment of mitral valve and coronary artery disease. Robotic cardiac surgery is rapidly becoming a feasible, safe and effective option for the definitive treatment of cardiac disease in the context of 21st century challenges to healthcare provision such as diabetes, obesity and an aging population.
Ashrafian H, Athanasiou T, 2010, Emergency prehospital on-scene thoracotomy: a novel method., Coll Antropol, Vol: 34, Pages: 1449-1452, ISSN: 0350-6134
The necessity for prehospital thoracotomy is rare, but can be lifesaving. Occasionally an emergency practitioner or surgeon coincidentally arrives at a trauma scene before the arrival of emergency medical teams. In such a circumstance, even when thoracotomy may be indicated, it is not usually performed in view of the lack of equipment (e.g., dissecting tools or rib retractor). We present a novel technique of "L" shape thoracotomy, or Thoraco-sterno-costochondrotomy, whereby in a prehospital setting, and with minimal equipment (such as a penknife) a thoracotomy can be performed with adequate exposure of the heart and great vessels. The similarities of this pragmatic procedure are considered within the context of ancient Aztec and Mesoamerican thoracotomies.
Ashrafian H, Athanasiou T, 2010, Emergency Prehospital On-scene Thoracotomy: A Novel Method, COLLEGIUM ANTROPOLOGICUM, Vol: 34, Pages: 1449-1452, ISSN: 0350-6134
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- Citations: 8
Ashrafian H, O'Flaherty L, Adam J, et al., 2010, Expression Profiling in Progressive Stages of Fumarate-Hydratase Deficiency: The Contribution of Metabolic Changes to Tumorigenesis, CANCER RESEARCH, Vol: 70, Pages: 9153-9165, ISSN: 0008-5472
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- Citations: 50
Ashrafian H, Darzi A, 2010, Review of the Week Surgical instruments: objects of beauty and dread, BRITISH MEDICAL JOURNAL, Vol: 341, ISSN: 0959-535X
Patel VM, Warren O, Humphris P, et al., 2010, What does leadership in surgery entail?, ANZ J Surg
Ashrafian H, 2010, Clinical diagnosis in the ancient British Epic Poem Beowulf, CLINICAL OTOLARYNGOLOGY, Vol: 35, Pages: 448-449, ISSN: 1749-4478
Ashrafian H, Athanasiou T, JV L, et al., 2010, Diabetes resolution and hyperinsulinaemia after metabolic Roux-en-Y gastric bypass, Obes Rev
Ali A, Ramoutar D, Ashrafian H, et al., 2010, What are the Predictors that Affect the Excellent Long-term Benefits of Redo Coronary Artery Bypass Grafting?, HEART LUNG AND CIRCULATION, Vol: 19, Pages: 528-534, ISSN: 1443-9506
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- Citations: 4
Khan RS, Ahmed K, Blakeway E, et al., 2010, Catastrophizing: a predictive factor for postoperative pain, Am J Surg
Arora S, Ashrafian H, Davis R, et al., 2010, Emotional intelligence in medicine: a systematic review through the context of the ACGME competencies, MEDICAL EDUCATION, Vol: 44, Pages: 749-764, ISSN: 0308-0110
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- Citations: 207
Nagpal K, Vats A, Lamb B, et al., 2010, Information Transfer and Communication in Surgery <i>A Systematic Review</i>, ANNALS OF SURGERY, Vol: 252, Pages: 225-239, ISSN: 0003-4932
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- Citations: 144
Ahmed K, Wang TT, Patel VM, et al., 2010, The role of single-incision laparoscopic surgery in abdominal and pelvic surgery: a systematic review, Surg Endosc
Philippidis P, Athanasiou T, Nadra I, et al., 2010, Anti-inflammatory haemoglobin scavenging monocytes are induced following coronary artery bypass surgery, EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, Vol: 37, Pages: 1360-1366, ISSN: 1010-7940
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- Citations: 12
Ahmed K, Dasgupta R, Vats A, et al., 2010, Urethral diverticular carcinoma: an overview of current trends in diagnosis and management, INTERNATIONAL UROLOGY AND NEPHROLOGY, Vol: 42, Pages: 331-341, ISSN: 0301-1623
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- Citations: 24
Bueter M, Loewenstein C, Ashrafian H, et al., 2010, Vagal Sparing Surgical Technique but Not Stoma Size Affects Body Weight Loss in Rodent Model of Gastric Bypass, OBESITY SURGERY, Vol: 20, Pages: 616-622, ISSN: 0960-8923
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- Citations: 64
Jones CM, Ashrafian H, Skapinakis P, et al., 2010, Diagnostic accuracy meta-analysis: A review of the basic principles of interpretation and application, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 140, Pages: 138-144, ISSN: 0167-5273
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- Citations: 22
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