scholarly journals An unusual case of a completely eroded gastric band and port tubing removed via endoscopy alone

2019 ◽  
Vol 101 (2) ◽  
pp. e48-e51
Author(s):  
G Kourounis ◽  
R Pearson ◽  
D McArthur ◽  
S Gibson
Keyword(s):  
Bariatric Surgery ◽  
Gastric Band ◽  
Multidisciplinary Care ◽  
Band Erosion ◽  
Endoscopic Removal ◽  
Hernia Surgery ◽  
Eligibility Criteria ◽  
First Case ◽  
Management Of Complications ◽  
The Uk

Bariatric surgery is an established intervention providing significant health benefits to patients with obesity. As a result, the National Institute for Health and Care Excellence now recommends bariatric surgery for those that fulfil the eligibility criteria, while emphasising the need for multidisciplinary care before and after surgery. The UK National Bariatric Surgery Registry shows gastric band procedures to be the second most common bariatric procedure performed in the UK. Gastric band erosion is a known potential complication treated primarily by laparoscopic removal of band and repair of stomach. To our knowledge, we present the first case of a partially eroded gastric band with separate gastric fistulation of the port tubing. The band was removed via endoscopy without the need for a cutaneous exploration as the port had previously been removed at incisional hernia surgery. Owing to the fact that the tubing and band were both evident within the lumen of the stomach, complete band erosion was inferred and therefore endoscopic removal thought to be indicated. In actual fact, there was separate erosion of the band and tubing; more specifically, the gastric band clasp had not eroded fully and while endoscopic removal was still possible, it was challenging and required the band to be divided. This case highlights the importance of careful patient selection, involvement of multidisciplinary care prior and after surgery and close follow-up to facilitate timely identification and management of complications.

Gastric Band Erosion in 63 Cases: Endoscopic Removal and Rebanding Evaluated

2011 ◽  
Vol 21 (11) ◽  
pp. 1676-1681 ◽  
Author(s):  
Jacob Chisholm ◽  
Normayah Kitan ◽  
James Toouli ◽  
Lilian Kow
Keyword(s):  
Gastric Band ◽  
Band Erosion ◽  
Endoscopic Removal

scholarly journals Using rapid cycle tests of change to develop the Carers Assistive Technology Experience Questionnaire: a cognitive interview study in the UK

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e042361
Author(s):  
Vimal Sriram ◽  
Crispin Jenkinson ◽  
Michele Peters
Keyword(s):  
Assistive Technology ◽  
Cognitive Interview ◽  
Electronic Version ◽  
Cognitive Interviews ◽  
Eligibility Criteria ◽  
Paper Version ◽  
Healthcare Settings ◽  
Technology Experience ◽  
The Uk ◽  
Experience Questionnaire

We describe the use of rapid cycle tests of change to pretest and develop a Carers Assistive Technology Experience Questionnaire for a survey of informal carers of persons with dementia. The Plan-Do-Study-Act (PDSA) cycle is a commonly used improvement process in healthcare settings. We used this method for conducting rapid cycle tests of change through cognitive interviews to pretest the questionnaire. The items for the questionnaire were developed based on an earlier systematic review and qualitative study. PDSA cycles were used incrementally with learning from each cycle used to inform subsequent changes to the questionnaire prior to testing on the next participant.DesignQualitative with use of cognitive interviews through rapid cycle tests of change.SettingUK.ResultsNine participants were recruited based on eligibility criteria and purposive sampling. Cognitive interviewing using think aloud and concurrent verbal probing was used to test the comprehension, recall, decision and response choice of participants to the questionnaire. Seven PDSA cycles involving the participants helped identify problems with the questionnaire items, instructions, layout and grouping of items. Participants used a laptop, smartphone and/or tablet computer for testing the electronic version of the questionnaire and one participant also tested the paper version. A cumulative process of presenting items in the questionnaire, anticipating problems with specific items and learning from the unanticipated responses from participants through rapid cycle tests of change allowed rich learning and reflection to progressively improve the questionnaire.ConclusionUsing rapid cycle tests of change in the pretesting questionnaire phase of research provided a structure for conducting cognitive interviews. Learning and reflections from the rapid testing and revisions made to the questionnaire helped improve the process of reaching the final version of the questionnaire, that the authors were confident would measure what was intended, rapidly and with less respondent burden.

scholarly journals National survey of feasibility of NIV trials for management of children with bronchiolitis

2020 ◽  
Vol 4 (1) ◽  
pp. e000780
Author(s):  
Anna Rosala-Hallas ◽  
Ashley P Jones ◽  
Emma Bedson ◽  
Vanessa Compton ◽  
Ricardo M Fernandes ◽  
...  
Keyword(s):  
National Survey ◽  
Controlled Trial ◽  
Management Strategies ◽  
Eligibility Criteria ◽  
Training Requirements ◽  
Non Invasive Ventilation ◽  
Respiratory Management ◽  
Randomised Controlled ◽  
The Uk ◽  
Future Work

BackgroundBronchiolitis is a major cause of admission to hospital in children. Non-invasive ventilation (NIV) support with continuous positive airway pressure (CPAP) or high-flow nasal cannula (HFNC) oxygen is routinely used for infants in the UK with bronchiolitis.ObjectiveTo establish UK paediatric practice regarding management of bronchiolitis, and to explore issues pertinent to the design of a potential future randomised controlled trial of NIV.DesignScreening logs were completed in hospitals in England capturing information on paediatric bronchiolitis admissions. An online national survey of clinical practice was disseminated to healthcare professionals (HCPs) across the UK to ascertain current management strategies.ResultsScreening logs captured data on 393 infants from 8 hospitals. Reasons for admission were most commonly respiratory distress and/or poor fluid intake. Oxygen was administered for 54% of admissions. Respiratory (CPAP and HFNC) and non-respiratory support administered varied considerably. The national survey was completed by 111 HCPs from 76 hospitals. Data were obtained on criteria used to commence and wean NIV, responsibilities for altering NIV settings, minimum training requirements for staff managing a child on NIV, and numbers of trained staff. Most centres were interested in and capable of running a trial of NIV, even out of normal office hours.ConclusionsRespiratory and non-respiratory management of bronchiolitis in UK centres varies widely. A trial of HFNC oxygen therapy in this group of patients is feasible and HCPs would be willing to randomise patients into such a trial. Future work should focus on defining trial eligibility criteria.

scholarly journals Cystic fibrosis

2019 ◽  
Vol 13 (1) ◽  
pp. 39-46
Author(s):  
Jen Standen
Keyword(s):  
Cystic Fibrosis ◽  
Genetic Testing ◽  
Neonatal Screening ◽  
Tertiary Care ◽  
Multidisciplinary Care ◽  
Shared Care ◽  
The Uk

In the UK over 10 000 people live with cystic fibrosis (CF), with 1-in-25 people being carriers of the disease. Multidisciplinary care is provided by tertiary care CF centres, with or without local secondary service shared care agreements. There are still, however, several reasons why CF sufferers or their families present to their GPs. This article aims to provide a brief overview of CF and its management. It also gives the information needed to guide patients about genetic testing and neonatal screening for the disease.

Delivering a shared library management system for Wales

2016 ◽  
Vol 37 (6/7) ◽  
pp. 385-395 ◽  
Author(s):  
Gareth Wyn Owen
Keyword(s):  
Management System ◽  
Review Of Literature ◽  
Content Type ◽  
Implementation Phase ◽  
Library Management ◽  
First Case ◽  
Library Management System ◽  
The Uk ◽  
Practical Implications

Purpose A case study of the Wales Higher Education Libraries Forum (WHELF) project to procure and implement a shared library management system (LMS) for all universities in Wales, together with the National Health Service Libraries in Wales and the National Library of Wales. In particular, the purpose of this paper is to explore the drivers to this collaboration, outline the benefits achieved and the framework to realise further benefits. Design/methodology/approach Case study review of the process, together with a review of literature on consortia and LMSs. Findings WHELF has developed into a more mature consortium through procuring and implementing a shared LMS. The process has delivered tangible benefits and is driving more work to realise further benefits. Research limitations/implications As the WHELF Shared LMS project is only nearing the end of the implementation phase, many of the anticipated operational benefits cannot be reported. Practical implications Useful case study for other consortia or potential consortia. Originality/value WHELF is in vanguard of consortia developments in the UK, and this is the first case study of the project.

Causes and Timing of Nonelective Reoperations after Bariatric Surgery: A Review of 1304 Cases at a Single Institution

2015 ◽  
Vol 81 (10) ◽  
pp. 969-973 ◽  
Author(s):  
Erin Thompson ◽  
Lisa Ferrigno ◽  
Jonathon Grotts ◽  
Jenna Knox ◽  
Samantha Sobelman ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastric Band ◽  
Biliary Disease ◽  
Single Institution ◽  
Index Procedure ◽  
Common Cause ◽  
Common Indication ◽  
Number Of Patients ◽  
Gastric Bands

As the number of patients undergoing bariatric procedures for weight loss increases, an understanding of the causes and timing of complications requiring reoperation is critical. The aim of our study was to characterize the type and timing of nonelective (NE) reoperations in these patients. Over five years, 1304 patients undergoing index procedures were identified: 769 laparoscopic Roux-en-Y gastric bypasses (LRYGB), 301 laparoscopic sleeve gastrectomies, and 234 laparoscopic adjustable gastric bands. We identified 117 NE reoperations, which were grouped by index procedure as well as whether they occurred early (≤90 days) or late (>90 days). In the laparoscopic adjustable gastric bands group, slipped gastric band was the most common indication for early (n = 2) and late (n = 2) reoperations. Biliary disease was the most common cause for early reoperations (n = 4), and the only cause for late reoperations (n = 2) after laparoscopic sleeve gastrectomies. For LRYGB, diagnoses differed between the early and late groups, with the most common early indications being bowel obstruction (n = 8) and anastomotic leak (n = 4) of the 18 early reoperations, and internal hernia (n = 36) and biliary disease (n = 17) of the 82 late reoperations. The vast majority of NE reoperations were performed laparoscopically (92%), with conversions and primarily open procedures only occurring in the LRYGB group.

Rethinking Eligibility Criteria for Bariatric Surgery

JAMA ◽  
2014 ◽  
Vol 312 (9) ◽  
pp. 953 ◽  
Author(s):  
Justin B. Dimick ◽  
Nancy J. Birkmeyer
Keyword(s):  
Bariatric Surgery ◽  
Eligibility Criteria

scholarly journals Variant Creutzfeldt-Jakob disease in a Canadian resident

2002 ◽  
Vol 6 (33) ◽  
Author(s):  
◽  
◽  
Keyword(s):  
Surveillance System ◽  
Collaborative Study ◽  
Personal Communication ◽  
National Network ◽  
Incidence Data ◽  
First Case ◽  
Collaborative Study Group ◽  
Jakob Disease ◽  
The Uk ◽  
Health Canada

Variant Creutzfeldt-Jakob disease (vCJD) has been confirmed in a resident of Saskatchewan, Canada (1). The patient, a man under the age of 50, was first notified to the Canadian national CJD surveillance system at Health Canada in April 2002 when his clinical presentation, age, and history of residence in the United Kingdom (UK) led Canadian doctors to suspect vCJD. Post-mortem examination of brain tissues by experts in Canada and the UK has now confirmed the diagnosis of vCJD. Since 1998, when the national CJD surveillance system was launched, all suspect cases of CJD are reported to Health Canada through a national network of specialist physicians. Incidence data are also shared with European and other allied countries as part of the Collaborative Study Group of CJD (EUROCJD, http://www.eurocjd.ed.ac.uk/euroindex.htm). This patient is the first case of vCJD reported in Canada, which together with 6 cases reported in France and one each in the Republic of Ireland, Italy and USA, brings the total number of cases with onset outside the UK to 10 (personal communication National CJD Surveillance Unit, Edinburgh).

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