The role of adjuvant pharmacotherapy with liraglutide for patients with inadequate weight loss following bariatric surgery.

PURPOSE: Despite the benefits of bariatric surgery for many patients, there are a proportion of patients who do not achieve adequate weight loss. We evaluate the role of liraglutide as adjuvant pharmacotherapy in those who respond poorly to weight loss surgery. MATERIALS AND METHODS: A non-controlled, prospective, open-label cohort study in which participants are prescribed liraglutide following inadequate response to weight loss surgery. The efficacy and tolerability of liraglutide was measured through measurement of BMI and monitoring of side effect profile. RESULTS: A total of 68 partial responders to bariatric surgery were included in the study, 2 participants were lost to follow-up. Overall 89.7% lost weight on liraglutide, with 22.1% showing a good response (>10% total body weight loss). There were 41 patients who discontinued liraglutide mainly due to cost. CONCLUSION: Liraglutide is efficacious in achieving weight loss and reasonably well tolerated in patients who have inadequate weight loss post-bariatric surgery.

Following the Trend: A Comparative Analysis of Public Engagement and Funding for Annual Prostate and Breast Cancer Campaigns Using Google Trends.

BACKGROUND/AIM: Google Trends (Google Inc., USA) is a web-based service that offers data on the time and volume of Google Internet searches. We used Google Trends to identify increases in search traffic caused by cancer campaigns, which are held in October and November each year for breast cancer (BC) and prostate cancer (PC), respectively, in our region. We investigated whether this increase in search traffic coincided with increased research funding or public donations. MATERIALS AND METHODS: Google searches for PC were compared and scaled against searches for BC from January 2010 to December 2021. The month with the highest volume of search hits for either term was given a relative search volume index of 100. All other months for both search terms were scaled against this index of 100. The degree of government research spending and public donations were contrasted against search traffic. RESULTS: Search volume increased for both campaign months (49% for BC in October, 5% for PC in November). The mean relative search volume for each campaign's specific month was 72.6 for BC, 18.4 for PC; mean difference of 50.75 (95% confidence interval=42.7-58.8, p<0.001). Annual mean (±standard deviation) expenditure of Government research grants was $22.2 million (± $1.5 million) for BC and $9.7 million (± $2.9 million) for PC with a mean difference of $12.5 million (95% confidence interval=$10.5-14.6 million, p<0.001). CONCLUSION: The BC campaign resulted in a statistically significant increase in search traffic compared to that for PC and correlated with statistically significant increases in research spending. Google Trends offers a method of evaluating cancer campaign efficacy and public interest.

Peritoneal Oxygenation as a Novel Technique for Extrapulmonary Ventilation; A Review and Discussion of the Literature.

The COVID-19 crisis has highlighted the difficulties that might occur when attempting to oxygenate patients who have suffered a severe pulmonary insult, including in the development of acute respiratory distress syndrome (ARDS). Traditional mechanical ventilation (MV) is effective; however, in severe cases of hypoxia, the use of rescue therapy, such as extracorporeal membrane oxygenation (ECMO), may be required but is also associated with significant complexity and complications. In this review, we describe peritoneal oxygenation; a method of oxygenation that exploits the peritoneum's gas exchange properties in a fashion that is similar to peritoneal dialysis and has shown considerable promise in animal models. We have conducted a review of the available literature and techniques, including intraperitoneal perfluorocarbons, intraperitoneal jet ventilation, a continuous low-pressure oxygen system (PEROX) and the use of phospholipid-coated oxygen microbubbles (OMBs) through peritoneal microbubble oxygenation (PMO). We conclude that peritoneal oxygenation is a promising technique that warrants further investigation and might be used in clinical settings in the future.

Cost-effectiveness of Iterative Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for the Treatment of Peritoneal Carcinomatosis.

BACKGROUND: Iterative cytoreduction (iCRS) and hyperthermic intraperitoneal chemotherapy is a treatment for recurrence of peritoneal carcinomatosis. There are considerable upfront costs for this approach for which the cost-effectiveness has not been evaluated. PATIENTS AND METHODS: We used a prospectively maintained database of patients having undergone primary and iterative cytoreduction at St. George Hospital between January 1, 2014, and December 31, 2017, which was linked with financial data. Cost effectiveness and survival outcomes were used to compare primary cytoreduction (pCRS) and iterative cytoreduction (iCRS) in addition to comparison with other treatment modalities. RESULTS: The average cost per patient in Australian dollars was $69,295 ($14,691-$696,002) and the average cost per life-year was $15,842. There was no difference in cost-effectiveness between those who had undergone pCRS and those who had undergone iCRS. The overall survival was 52.5 months (95% confidence interval=49.7-55.2 months) with no difference in survival between pCRS and iCRS groups. The median length of hospital stay was significantly longer for patients in the pCRS treatment group (25.51 days) when compared to the iCRS treatment group (21.15 days, p=0.034). CONCLUSION: iCRS is a cost-effective treatment in the management of recurrent peritoneal carcinomatosis.