Brit J Hosp Med
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Obesity is a worldwide epidemic and official figures demonstrate a rising prevalence, both in the UK and globally. Increasingly, there is a recognised place for surgical intervention in carefully selected patients, but there is limited understanding of the pathway and process among non-specialist clinicians. This article summarises the available guidelines and literature on the surgical management of obesity for hospital physicians, surgeons and GPs. The focus is on appropriate referral criteria, key bariatric procedures, postoperative management and, most importantly, the complications of surgery and how to recognise them.
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Temporary epicardial pacing wires are used after cardiothoracic surgery to maintain a stable cardiac rhythm. They must be distinguished from the more commonly encountered transvenous temporary pacing wires, which are often used in coronary care units for the same purpose. ⋯ Serious complications may arise in managing patients with temporary epicardial pacing wires, which are well known in the cardiothoracic unit but not so well known elsewhere in the hospital. This article discusses the dangers associated with the management of temporary epicardial pacing wires in adult patients, some of which are common to temporary transvenous pacing wires and others are unique to temporary epicardial pacing wires.
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Patient and public involvement involves ascertaining the opinions of and collaborating with patients and members of the public to holistically improve the quality of research. Patient and public involvement provides patients with a platform to use and share their lived experiences. ⋯ This article provides a practical framework to increase diversity and engage hard-to-reach demographics in patient and public involvement. It highlights some common barriers to participation and methods for overcoming this, describes sampling frameworks and provides examples of how these have been adopted in practice.