Author: Jason Curtis

Mortality Related to Bariatric Surgery (MORSE Study): A Retrospective, International Collaborative Audit (2025)

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Type of publication:

Journal article

Author(s):

Balasubaramaniam, Vignesh; Wong, Geoffrey Yuet Mun; Martinino, Alessandro; *Riera, Manel; Abouelazayem, Mohamed; Pereira, Juan Pablo Scarano; Said, Amira; Graham, Yitka; *Jain, Rajesh Kumar; Imseeh, Helen; Aljaiuossi, Osama; Jayyab, Mustafa Ahmad Abu; Alyacoubi, Said N A; Mahawar, Kamal; Singhal, Rishi.

Citation:

Clinical Obesity. e70031, 2025 Jun 18.

Abstract:

Bariatric surgery is associated with low but definite early and late mortality. This study aims to further understand early (<= 90 days) and delayed (> 90 days) mortality related to bariatric surgery. This is a retrospective collaborative audit of patients who had undergone bariatric surgery and developed complications that ultimately led to death. Individuals who were 18 years or older and had undergone bariatric surgery (primary, revisional, and endoscopic procedures) and subsequently died within 90 days or after 90 days following the surgery between 1 January 2022, and 31 December 2022. A descriptive analysis was conducted. About 30 centres from 21 countries submitted data on 82 patients where patient death was deemed to be related to bariatric surgery. Mortality within 90 days post-surgery was observed in 58 individuals (70.7%), while 24 patients (29.3%) died after this period. Causes of mortality after SG include GI leak, PE, respiratory infection, and malnutrition. Causes of mortality after RYGB include GI leak, coronary heart disease, and bleeding. Reported common causes of early mortality in this study were gastrointestinal leaks, bleeding, coronary heart disease, and pulmonary embolism. Reported common causes of delayed mortality were gastrointestinal leaks and malnutrition. This study characterises patients where death was attributed to a bariatric procedure and identifies common causes of death in these patients. This could aid development of strategies for preventing and managing these complications in the future.

DOI: 10.1111/cob.70031

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Patient reported voice outcomes following multi-disciplinary approach to botulism toxin for spasmodic dysphonia (2025)

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Type of publication:

Journal article

Author(s):

Kakar, Sahil; Gupta, Keshav Kumar; *Richards, Emma; Shirley, Colin; Bradley, Paige; Sonsale, Anita.

Citation:

Acta Otorrinolaringologica Espanola. 512261, 2025 Jun 19. [epub ahead of print]

Abstract:

PURPOSE: Spasmodic dysphonia (SD) is a debilitating disorder primarily affecting voice production. Current treatment includes repeat botulinum toxin (botox) injections for symptomatic management. The aim of this study is to review the impact of botox injections on patient reported outcome measures (PROM), using a novel and unique quality of life, proforma, and side effects in patients treated at our centre.

METHODS: This retrospective case series evaluated all patients who were treated in our specialised voice clinic, at a single tertiary referral centre between May 2019 and April 2024 with botox for SD. The primary outcome measure was PROM of voice quality weekly post-injection as per a unique proforma. Variables extracted included patient demographics, treatment specifics and complications.

RESULTS: Fifty-two patients were included representing 21 (40.4%) males. Forty-two (80.8%) suffered from adductor spasmodic dysphonia with 8 (15.4%) having abductor dysphonia and 1 (1.92%) with mixed dysphonia. Patients with abductor dysphonia had a statistical improvement in voice following dose 2, (1.8-3.0, p=0.03) and dose 3 (1.4-3.2, p = <0.001). Patients with adductor dysphonia had significant improvements in voice following all doses (2.1-2.9, p=0.01), (1.9-3.0, p = <0.01) and (2.1-3.0, p = <0.01). The most common complication was a 'breathy voice', ranging from 31.4% to 51.0% but all patients reported this as transient.

CONCLUSION: Patient reported quality of voice is improved following botox injections for spasmodic dysphonia, and most patients do not suffer from long-term complications.

DOI: 10.1016/j.otoeng.2025.512261

The description, measurement with inter- and intra-observer reliability of calcaneal tunnel placement for tendon transfer in Achilles tendon reconstruction (2025)

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Type of publication:

Journal article

Author(s):

*Carmont, Michael R; Andresen, Tor Kristian; *Morgan, Fraser; Nilsson-Helander, Katarina; Husebye, Elisabeth Ellingsen.

Citation:

Journal of Experimental Orthopaedics. 12(2):e70223, 2025 Apr.

Abstract:

Purpose: A tendon transfer is a common method of treating ankle plantar flexion weakness and tendon end non-union following chronic Achilles tendon rupture and delayed representation following Achilles tendon re-rupture. Commonly, the transferred tendon is fixed into a bone tunnel on the postero-superior surface of the calcaneum close to the distal Achilles tendon insertion. To date, there is no standardised description or measurement of calcaneal tunnel position. The aim of this study is to describe the anatomic location for calcaneal tunnel placement and to determine the reliability of a method of measuring tunnel position and direction within the calcaneum.

Methods: The routine post-operative lateral ankle radiographs from 40 patients (40 ft) following Achilles tendon reconstruction using tendon transfer into the calcaneum: calcaneal tunnel zone (CTZ), calcaneal tunnel ratio (CTR) and calcaneal tunnel angle (CTA) were tested for reliability using test-retest between three observers. Additionally, CTR and CTA were compared in cases where a calcaneoplasty was performed or not.

Results: The intraclass correlation coefficient (ICC) of the CTR and CTA was found to be 0.86-0.95 (95% confidence interval [CI]: 0.75-0.98) and 0.95-0.99 (95% CI: 0.92-0.99), respectively, indicating good and excellent reliability. Patients who received a calcaneoplasty had a significantly greater CTR of 0.74 (0.1) and a lower CTA of 76.1degree (10.8) compared to those who did not have a CTR of 0.61 (0.1) and 100.9 (12.4), Diff 95% CI: 0.13 (0.08-0.18) and -25 (-32 to -17), respectively, both p < 0.001.

Conclusions: The CTR and CTA were reliable measures for the calcaneal tunnel following Achilles tendon reconstruction using tendon transfer within the limitations of the sagittal radiographic view. When a
calcaneoplasty was performed, it resulted in a significantly greater CTR. These measurements should be used to describe calcaneal tunnels rather than a description of tunnel placement to optimise predictive factors following Achilles tendon reconstruction.

Level of Evidence: Level III.

DOI: 10.1002/jeo2.70223

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Magnet ingestion in children in the United Kingdom: a national prospective observational surveillance study (2025)

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Type of publication:

Journal article

Author(s):

Neville J.J.; Lyttle M.D.; Messahel S.; Parkar S.; Mytton J.; Hall N.J.; Brooker H.; Varnam R.; Putt-Willis D.; Smith M.; Smith L.; Yusuf I.; Dean N.; Patel D.; Rahman M.; Vooght E.; Parveen R.; Shirley-Mansell L.; Cresner R.; Cromarty T.; Broomfield R.; Bayreuther J.; Bethell G.; Major C.; Barling J.; Wilson V.; Maney J.; Wilson K.; Ratnaraj D.; Divakaran D.; Hickey J.; Ranasinghe D.; Foster A.; Martin B.; Walker R.; Jones C.; Soans E.; Monk A.; Rahman A.; Tambudze K.; Hopgood D.; Downes A.; Nasreen T.; Preskey S.; Long J.; Adamson J.; Henderson R.; Andreassen H.; Chadwick H.L.; Towart G.; Abdelhafiz K.; O'Connor E.; Carlyle D.; Tubman L.; Wallace K.; Mohamed A.; Siner S.; Fissler S.; Mcleish S.; Tolhurst-Cleaver M.; Fletcher S.; Russell M.; Winrow K.; Taylor J.; Armitage A.; Geoghegan K.; Buckle R.; Wood S.; Tremarco L.; Collins V.; Egginton D.; Simpson G.; Dowsett S.; Djendow F.; Jarman H.; Edyta K.; Dotchin M.; Potter S.; Kamaraj K.; Fagelnor A.; Dadnam C.; Shafiq A.; Lewis S.; Zarifa I.; Craigie R.; Aldridge P.; Veeraragavan N.; Haslam Z.; Carney A.; Rimmer G.; Jones S.; Richardson S.; Riddick L.; McCourt E.; Azad-Karim A.; Quigley K.; Yassin S.; Merrick V.; Salter R.; Yoshida R.; Bass J.; Vincent E.; Healy C.; Jones E.; Ball E.; Azam A.; Ryan E.; Bedoya S.; Keers S.; Blaney E.; Peacock P.; Hartshorn S.; Cash V.; Snelson E.; Coles V.; Stacey A.; Zuhairy S.; Chandler L.; Pinedo J.; Bradley A.; Gate V.; *Sanlon N.; *Juttiga U.; *Marsh A.; *Okeke C.; *Ali N.; Ramlakhan S.; Subramanian T.; Haffenden V.; Obire J.; Hartin D.; Darlow N.; Beeby D.; Francis R.; Basu S.; Saxena A.; Jeropoulos R.; Hegan A.; Browning J.; Craven E.; Foster S.;

Citation:

Archives of Disease in Childhood. (no pagination), 2025. Article Number: archdischild-2024-328195. Date of Publication: 2025. [epub ahead of print]

Abstract:

Objective: Magnet ingestion in children and young people (CYP) is associated with significant harm. We aimed to describe the incidence, circumstances and outcomes of magnet ingestion in CYP in the United Kingdom (UK). Design(s): Prospective multicentre observational surveillance study. <br/>Setting(s): UK secondary and tertiary level hospitals in urban and rural settings. Patient(s): CYP <=16 years of age who ingested >=1 magnet. Intervention(s): Data were collected regarding demographics, circumstances surrounding ingestion, clinical features and management. The primary outcome was the incidence of magnet ingestion in the UK. Result(s): Between 1 May 2022 and 30 April 2023, 366 cases of magnet ingestion were recorded, of which 314 met eligibility (median age 8.7 years (IQR 5.1-12.0)). The incidence of magnet ingestion in the UK was at least 2.4/100 000 (95% CI 2.2 to 2.7) CYP per year. CYP sourced magnets from toys (38%), and magnet products were predominantly purchased by parents or caregivers (19%). Magnet-related injuries occurred in 23 (7%) cases, and surgery was undertaken in 32 (10%). Single magnet ingestions did not cause magnet-related injury. Swallowing greater numbers of magnets associated with an increased risk of injury (OR 1.1 (95% CI 1.0 to 1.2), p=0.002). CYP were asymptomatic in 75% of cases, but clinical features on presentation were associated with an increased risk of injury (OR 3.8 (95% CI 1.4 to 10.3), p=0.008). Conclusion(s): While magnet ingestion in children is uncommon, ingestion of multiple magnets can cause injuries requiring surgery. Greater public and clinician awareness of the associated risks is warranted. This study can inform public health interventions and evidence-based guidelines.

DOI: 10.1136/archdischild-2024-328195

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Iliopsoas Impingement After Total Hip Arthroplasty: A Review of Diagnosis and Management (2025)

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Type of publication:

Journal article

Author(s):

Younis, Zubair; Hamid, Muhammad A; Ravi, Balu; *Abdullah, Faliq; Al-Naseri, Ahmed; Bitar, Khaldoun.

Citation:

Cureus. 17(5):e83391, 2025 May.

Abstract:

Iliopsoas impingement is a growingly acknowledged yet frequently overlooked cause of persistent groin pain after total hip arthroplasty (THA), occurring in a small percentage of patients undergoing the
procedure. It typically results from mechanical irritation of the iliopsoas tendon by anterior acetabular component overhang, retained cement, long screws, or other prosthetic hardware. Clinically, patients
report pain that worsens with active hip flexion, stair climbing, and transitioning from sitting to standing. Diagnosis involves a combination of clinical assessment, imaging techniques such as radiographs, CT scans, or ultrasound, and confirmatory image-guided diagnostic injections. Conservative management, including physiotherapy and corticosteroid injections, may offer temporary relief but is often insufficient for long-term resolution. Surgical options, particularly iliopsoas tenotomy or acetabular component revision, are indicated in refractory cases and have demonstrated high success rates with improved functional outcomes. Early recognition and appropriate intervention are critical for optimizing
postoperative recovery and improving the quality of life in affected patients.

DOI: 10.7759/cureus.83391

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The efficacy of indocyanine green fluorescence in facilitating thoracic duct visualisation and mitigating injury in cervicothoracic surgery: a systematic review and meta-analysis (2025)

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Type of publication:

Systematic Review

Author(s):

Evans, Martin J; Bunola-Hadfield, Elena E; Sowkoor, Jeevith Shetty; Malik, Tahira Y; Master, Hussain; *Sultana, Emiko; Mohamed, Abdiqadir O; Alqaseer, Abdullah M; Ismail, Ahmed T; Mafi, Pouya; Rahman, Shafiq.

Citation:

British Journal of Oral & Maxillofacial Surgery. 63(5):349-356, 2025 Jun.

Abstract:

Chyle leak following injury to the thoracic duct (TD) is an uncommon but serious complication of cervicothoracic procedures, including neck dissection and oesophagectomy, and has significant morbidity and mortality. We aimed to investigate the efficacy of indocyanine green (ICG) fluorescence in facilitating intraoperative TD visualisation and preventing chyle leaks. A systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards for studies that assessed ICG for TD visualisation in cervicothoracic procedures. The primary outcome measure was TD visualisation using ICG. Secondary outcomes included rates of chyle leak detection, visualisation rate in white light, and time from injection to visualisation. Twelve studies enrolling 475 subjects met the inclusion criteria. The TD visualisation rate with ICG was 93.3% (SE 0.013, p < 0.001) compared with 54.3% (SE 0.065, p < 0.001) in white light. Detection rates for intraoperative chyle leak were higher using ICG compared with no ICG use: 74% (SE 0.047, p < 0.001) vs 17.5% (SE 0.086, p = 0.043), respectively. ICG reduced rates of postoperative chyle leak from 10.1% (untransformed proportion metric: 0.101 (0.045, 0.157), p < 0.001) to 3.9% (SE 0.021, p = 0.061). Mean time from ICG injection to TD visualisation was 83.94 minutes (p < 0.001). ICG offers an effective method of TD visualisation in cervicothoracic surgery. It can reduce rates of chyle leak and mitigate adverse sequelae from inadvertent duct injury. High-quality randomised controlled trials are required to improve the evidence base.

DOI: 10.1016/j.bjoms.2025.03.013

Risk of infection in patients with early inflammatory arthritis: results from a large UK prospective observational cohort study (2025)

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Type of publication:

Journal article

Author(s):

Adas, Maryam A; Bechman, Katie; Russell, Mark D; Allen, Victoria; Patel, Samir; Gibson, Mark; Karafotias, Ioasaf; Biddle, Kathryn; Zuckerman, Benjamin; Song, Kaiyang; Nagra, Deepak; Alveyn, Edward; Mahendrakar, Suma; Nursoy, Meryem; Atzeni, Fabiola; Gallagher, Sarah; Price, Elizabeth; *Garton, Mark; Rutherford, Andrew; Cope, Andrew P; Norton, Sam; Galloway, James B.

Citation:

Rheumatology. 2025 Jun 05. [epub ahead of print]

Abstract:

OBJECTIVE: To identify risk of serious infections-(SI) according to initial conventional synthetic disease modifying anti-rheumatic drugs-(csDMARD) and corticosteroids, in patients recruited to the National Early Inflammatory Arthritis Audit.

METHODS: An observational cohort study was used, including adults in England and Wales with new diagnoses of rheumatoid arthritis-(RA) between 2018-2023. Main outcome was SI-events, defined as infections requiring hospitalisation/or resulting in death. Secondary analyses evaluated SI-related mortality alone. Hazard ratios-(HR) were calculated using cox proportional hazards models. Primary predictor was initial treatment strategy, with confounder adjustments.

RESULTS: 17 472 patients were included, of whom 10 997 on methotrexate-based strategies; 4,540 on other csDMARDs; 13 680 received corticosteroids. There were 1307 SI-events, corresponding to incidence
rates per 100 person-years of 3.02 (95% CI: 2.86-3.19) and 311 SI-related mortality (IR 0.69, 95% CI: 0.61-0.77). Methotrexate-based strategies were associated with reduced risk of SI-events compared with other csDMARDs (adjusted HR 0.72, 95% CI: 0.63-0.82). In unadjusted models, corticosteroid was associated with higher risk of SI-events, but in adjusted models this association was no longer significant (adjusted HR 0.99, 95% CI: 0.87-1.12). Increasing age, being a current/or ex-smoker (relative to non-smoker), having a comorbidity, being seropositive, and having high DAS28 all associated with increased incidence of SI. One unit increase in baseline DAS28 increases the risk of SI-event by 10%.

CONCLUSION: Methotrexate-based regimens associated with a reduced risk of SI compared with other strategies. Patient-level and disease-related factors at diagnosis are important predictors of SI in individuals with new RA.

DOI: 10.1093/rheumatology/keaf312

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Comprehensive Review on Hair Loss and Restorative Techniques: Advances in Diagnostic, Artistry, and Surgical Innovation (2025)

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Type of publication:

Journal article

Author(s):

Mendoza, Luis A; Ocampo, Genaro G; Abarca-Pineda, Yozahandy A; Ahmad Khan, Mubashir; *Ahmadi, Yasmin; Brown, Najaee; Deowan, Denyse; Nazir, Zahra.

Citation:

Cureus. 17(4):e82991, 2025 Apr.

Abstract:

Hair loss, or alopecia, is a complex disorder that impacts individuals worldwide, frequently resulting in significant psychological and social consequences. This review analyzes the multifactorial etiology, recent diagnostic innovations, and emerging treatment alternatives for hair loss management. Alopecia is classified into the cicatricial (scarring) and non-cicatricial (non-scarring) forms, each having a unique underlying pathogenesis, ranging from autoimmune dysregulation, androgenetic mechanisms, and environmental factors. Recent advancements in diagnostics, such as artificial intelligence (AI)-enhanced imaging and biomarker analysis, have improved precision and individualization of treatment. Novel therapies, such as low-dose oral minoxidil (LDOM), topical 5-alpha reductase inhibitors, and Janus kinase inhibitors (JAKi), offer a range of promising options for hair loss management. Non-invasive therapies, such as low-level laser therapy (LLLT) and platelet-rich plasma (PRP) injections, have demonstrated synergistic benefits with existing treatments. Surgical advancements, especially AI-assisted robotic
follicular unit extraction (FUE), enhance precision and outcomes. Emerging trends in regenerative medicine, especially stem-cell-based therapies and AI integration, are influencing the future of customized hair restoration. This review serves as a comprehensive guide, highlighting the use of innovative technologies and therapies in enhancing the accuracy and customization of hair loss treatment.

DOI: 10.7759/cureus.82991

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Point of View: A Holistic Four-Interface Conceptual Model for Personalizing Shock Resuscitation (2025)

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Type of publication:

Journal article

Author(s):

Rola, Philippe; Kattan, Eduardo; Siuba, Matthew T; Haycock, Korbin; Crager, Sara; Spiegel, Rory; Hockstein, Max; Bhardwaj, Vimal; *Miller, Ashley; Kenny, Jon-Emile; Ospina-Tascon, Gustavo A; Hernandez, Glenn.

Citation:

Journal of Personalized Medicine. 15(5), 2025 May 20.

Abstract:

The resuscitation of a patient in shock is a highly complex endeavor that should go beyond normalizing mean arterial pressure and protocolized fluid loading. We propose a holistic, four-interface conceptual model of shock that we believe can benefit both clinicians at the bedside and researchers. The four circulatory interfaces whose uncoupling results in shock are as follows: the left ventricle to arterial, the arterial to capillary, the capillary to venular, and finally the right ventricle to pulmonary artery. We review the pathophysiology and clinical consequences behind the uncoupling of these interfaces, as well as how to assess them, and propose a strategy for approaching a patient in shock. Bedside assessment of shock may include these critical interfaces in order to avoid hemodynamic incoherence and to focus on microcirculatory restoration rather than simply mean arterial pressure. The purpose of this model is to serve as a mental model for learners as well as a framework for further resuscitation research that incorporates these concepts.

DOI: 10.3390/jpm15050207

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Fabry disease in the haemodialysis population: outcome of a UK screening study (SoFAH) (2025)

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Type of publication:

Journal article

Author(s):

Ng, K P; Sandhu, M; Banerjee, D; Burton, J O; Crowley, L; Doulton, T; Hameed, M A; Hamer, R; Menon, M; *Nicholas, J; Ramakrishna, S B; Shivakumar, K; Geberhiwot, T; Dasgupta, I.

Citation:

BMC Nephrology. 26(1):259, 2025 May 26.

Abstract:

BACKGROUND AND HYPOTHESIS: Fabry disease (FD) is an X-linked inherited disorder with an estimated prevalence among the end-stage kidney disease (ESKD) population of 0.3% in men and 0.1% in women [1]. Due to its non-specific manifestations, FD (especially the later-onset variant) is often underdiagnosed [2]. We aimed to estimate its prevalence in a large haemodialysis (HD) population in the UK.

METHODS: This is a cross-sectional, multicentre study of eight renal centres in the UK. All male participants were tested via dried blood spot alpha-galactosidase A (AG) enzyme and globotriaosylsphingosine (Lyso-Gb3) assays. If either the AG (<= 2.8 micromol/L/H) or Lyso-Gb3 (>= 3.5 ng/mL) level was abnormal, genetic testing for GLA variant was performed. All females had AG, Lyso-GB3 and genetic tests.

RESULTS: In total, 1325 consented to participate in the study. The mean age of the participants was 64 (SD 15) years, 67% were male, 64% were of white ethnicity, the duration of dialysis was 32 (IQR 56) months, and 32% underwent renal biopsy. Diabetic nephropathy (28%) was the most common cause of ESKD, whereas 21% had an unknown aetiology. A total of 1,295 had both AG and Lyso-Gb3 tests, whereas 573 had GLA genetic tests. Among the 14% (n = 186) with an AG level <= 2.8 micromol/L/H, 48 were female and 138 were male, all of whom had Lyso-Gb3 < 3.5 ng/mL. Only 3 (0.2%) had abnormal Lyso-Gb3 but all had normal AG and negative genetic tests. Two females were found to have likely benign, non-pathogenic GLA variants: heterozygous c.937G > T (p.(Asp313Tyr) and heterozygous c.1102G > A (p.(Ala368Thr)).

CONCLUSIONS: Despite the implementation of stringent screening criteria, we did not identify any new confirmed cases of Fabry disease in this large UK haemodialysis population.

DOI: 10.1186/s12882-025-04127-x

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