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  1. Article ; Online: The role of glucagon-like peptide 1 receptor agonists for weight control in individuals with acquired hypothalamic obesity-A systematic review.

    Ng, Victoria Wen Wei / Gerard, Gheslynn / Koh, Jonathan Jin Kai / Loke, Kah Yin / Lee, Yung Seng / Ng, Nicholas Beng Hui

    Clinical obesity

    2024  Volume 14, Issue 3, Page(s) e12642

    Abstract: Hypothalamic obesity does not respond well to conventional interventions for obesity. GLP-1 receptor agonists have mechanisms independent of the hypothalamus which may be potentially beneficial for managing hypothalamic obesity. This systematic review ... ...

    Abstract Hypothalamic obesity does not respond well to conventional interventions for obesity. GLP-1 receptor agonists have mechanisms independent of the hypothalamus which may be potentially beneficial for managing hypothalamic obesity. This systematic review summarizes the efficacy and safety of GLP-1 receptor agonists use in hypothalamic obesity. A PRISMA-compliant systematic review was performed. Data was extracted from included studies and analysed based on change in weight, body mass index, glycaemic control, satiety, and safety profile with GLP-1 receptor agonist use. Ten studies comprising 5 case reports, 4 case series and 1 randomized-controlled trial included 54 patients (24 males, 30 females) with mean age of 25.2 (range 13-71) years with hypothalamic obesity who had received GLP-1 receptor agonists (exenatide = 48, liraglutide = 5 and dulaglutide = 1) over a mean duration of treatment of 12 (range 3-51) months. Mean weight reduction of 7.4 (SD 7.92) kg was observed in patients in whom weight was reported, with 85.7% of patients experiencing weight loss. All patients on liraglutide had weight reduction post-therapy. The sole trial had reported a non-significant reduction in BMI post-exenatide. Glycaemic control had either improved/maintained in all patients in whom this was measured. The main side effects of GLP-1 receptor agonist in individuals with hypothalamic obesity were nausea and vomiting; there were no major safety concerns. Based on limited published experience, GLP-1RA may be effective and safe for weight control in hypothalamic obesity, with the added benefit of improved glycaemic control in those with concurrent diabetes mellitus.
    MeSH term(s) Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Young Adult ; Body Mass Index ; Exenatide/therapeutic use ; Glucagon-Like Peptide-1 Receptor/agonists ; Hypoglycemic Agents/therapeutic use ; Hypothalamic Diseases/drug therapy ; Immunoglobulin Fc Fragments/therapeutic use ; Liraglutide/therapeutic use ; Obesity/drug therapy ; Recombinant Fusion Proteins/therapeutic use ; Treatment Outcome ; Weight Loss/drug effects
    Chemical Substances dulaglutide (WTT295HSY5) ; Exenatide (9P1872D4OL) ; Glucagon-Like Peptide-1 Receptor ; Hypoglycemic Agents ; Immunoglobulin Fc Fragments ; Liraglutide (839I73S42A) ; Recombinant Fusion Proteins
    Language English
    Publishing date 2024-01-25
    Publishing country England
    Document type Systematic Review ; Journal Article
    ZDB-ID 2625816-X
    ISSN 1758-8111 ; 1758-8103
    ISSN (online) 1758-8111
    ISSN 1758-8103
    DOI 10.1111/cob.12642
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: A systematic review and meta-analysis comparing postoperative outcomes of laparoscopic versus open omental patch repair of perforated peptic ulcer.

    Chan, Kai Siang / Ng, Shi Tong Carissa / Tan, Chin Hong Ben / Gerard, Gheslynn / Oo, Aung Myint

    The journal of trauma and acute care surgery

    2022  Volume 94, Issue 1, Page(s) e1–e13

    Abstract: Background: The mainstay of surgical management of perforated peptic ulcer is omental patch repair. Advances in minimally invasive techniques have shown feasibility of laparoscopic omental patch repair (LOPR). Laparoscopic omental patch repair is ... ...

    Abstract Background: The mainstay of surgical management of perforated peptic ulcer is omental patch repair. Advances in minimally invasive techniques have shown feasibility of laparoscopic omental patch repair (LOPR). Laparoscopic omental patch repair is limited by learning curve (LC), but there is a lack of reporting of LC in LOPR. This study aims to compare outcomes following LOPR versus open omental patch repair (OOPR) with reporting of LC.
    Methods: PubMed, Embase, The Cochrane Library, and Scopus were systematically searched from inception till January 2022 for randomized controlled trials (RCTs) and non-RCTs comparing LOPR and OOPR in perforated peptic ulcer. Exclusion criteria were primary repair without use of omental patch repair. Primary outcomes were 30-day mortality, postoperative leak, and LC analysis.
    Results: There were a total of 29 studies including 5,311 patients (LOPR, n = 1,687; OOPR, n = 3,624), with 4 RCTs with 238 patients (LOPR, n = 118; OOPR, n = 120). Majority of ulcers were located in the duodenum (57.0%) followed by stomach (30.7%). Mean ulcer size ranged from 5 to 16.2 mm in LOPR and 4.7 to 15.8 mm in OOPR. Laparoscopic omental patch repair was associated with lower 30-day mortality (odds ratio [OR], 0.57; 95% confidence interval [CI], 0.35-0.92; p = 0.02), overall morbidity (OR, 0.31; 95% CI, 0.18-0.53; p < 0.0001), surgical site infection (OR, 0.27; 95% CI, 0.18-0.42; p < 0.00001), and length of stay (mean difference, -2.84 days; 95% CI, -3.63 to -2.06; p < 0.00001). Postoperative leakage (OR, 1.06; 95% CI, 0.43-2.61; p = 0.90) was comparable between LOPR and OOPR. Only three studies analyzed the proportion of consultants to trainees; LOPR was performed mainly by consultants (range, 82.4-91.4%), while OOPR was mainly performed by trainees (range, 52.8-96.8%). One study showed that consultants who performed open conversion had shorter operating time compared with chief residents (85 vs. 186.6 minutes, p < 0.003).
    Conclusion: Laparoscopic omental patch repair has lower mortality, overall morbidity, length of stay, intraoperative blood loss, and postoperative pain compared with OOPR. More prospective studies should be conducted to evaluate LC in LOPR.
    Level of evidence: Systematic Review and Meta-Analysis; Level IV.
    MeSH term(s) Humans ; Treatment Outcome ; Pain, Postoperative ; Peptic Ulcer Perforation/surgery ; Laparoscopy/methods ; Duodenum ; Postoperative Complications/epidemiology ; Postoperative Complications/surgery ; Length of Stay
    Language English
    Publishing date 2022-10-17
    Publishing country United States
    Document type Meta-Analysis ; Systematic Review ; Journal Article
    ZDB-ID 2651070-4
    ISSN 2163-0763 ; 2163-0755
    ISSN (online) 2163-0763
    ISSN 2163-0755
    DOI 10.1097/TA.0000000000003799
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

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    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

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