A5063770183- Liver Disease Diagnosis and Treatment
- Hepatitis C virus research
- Hepatitis B Virus Studies
- HIV/AIDS Research and Interventions
- HIV Research and Treatment
- HIV/AIDS drug development and treatment
- Retinopathy of Prematurity Studies
- Neonatal Respiratory Health Research
- Preterm Birth and Chorioamnionitis
- Mental Health and Patient Involvement
- Nausea and vomiting management
- Congenital Diaphragmatic Hernia Studies
- Infant Nutrition and Health
- Retinal Diseases and Treatments
- Gestational Diabetes Research and Management
- HIV-related health complications and treatments
- Neonatal and fetal brain pathology
- Pain Management and Opioid Use
- Health Policy Implementation Science
- Patient-Provider Communication in Healthcare
- Non-Invasive Vital Sign Monitoring
- Anesthesia and Pain Management
- Respiratory Support and Mechanisms
- Ethics in Clinical Research
- Retinal Imaging and Analysis
University College London
2015-2025
MRC Clinical Trials Unit at UCL
2016-2025
Medical Research Council
2015-2022
University of California, San Francisco
2021
Columbia University
2007-2008
In Brief BACKGROUND: Although pregabalin shows efficacy against neuropathic pain, very limited evidence supports postoperative analgesic efficacy. Our study objective was to investigate in an ambulatory day surgical population experiencing acute visceral pain. The null hypothesis that there no significant difference pain relief between and placebo. METHODS: A randomized, double-blind, parallel-group, placebo-controlled trial performed 90 women having minor gynecological surgery involving the...
<h3>Objective</h3> To evaluate the cost-effectiveness of telemedicine and standard ophthalmoscopy for retinopathy prematurity (ROP) management. <h3>Methods</h3> Models were developed to represent ROP examination treatment using ophthalmoscopy. Cost-utility analysis was performed decision analysis, evidence-based outcome data from published literature, present value modeling. Visual converted patient preference–based time trade-off utility values based on literature. Costs disease management...
BackgroundStandard-of-care antiretroviral therapy (ART) uses a combination of drugs deemed essential to minimise treatment failure and drug resistance. Protease inhibitors are potent, with high genetic barrier resistance, have potential use as monotherapy after viral load suppression is achieved treatment. We aimed assess clinical risks benefits protease inhibitor in long-term use: particular, the effect on resistance future options.MethodsIn this pragmatic, parallel-group, randomised,...
Patient and public involvement (PPI) in studies carried out by the UK Medical Research Council Clinical Trials Unit (MRC CTU) at University College London varies research type setting. We developed a series of case PPI to document share good practice.We used purposive sampling identify representing scope MRC CTU different approaches PPI. semi-structured interviews with staff patient representatives. Interview notes were analysed descriptively categorise main aims motivations for involvement;...
Abstract Background It is widely accepted that the risk of hepatitis C virus (HCV) vertical transmission (VT) 5%–6% in monoinfected women, and 25%–40% HCV infection clears spontaneously within 5 years. However, there no consensus on how VT rates should be estimated, a lack information “net” clearance. Methods We reanalyzed data 1749 children 3 prospective cohorts to obtain coherent estimates overall rate net clearance at different ages. Clearance were used impute proportion uninfected who...
Abstract Background Dolutegravir (DTG) is a preferred anchor antiretroviral therapy (ART) for children and adolescents living with HIV (CALHIV). Methods We assessed the effectiveness safety of DTG in CALHIV aged 0-18 years at start routine care Europe Thailand, including viral suppression (viral load (VL)&lt;50copies/mL), cumulative incidence failure (VF) (confirmed VL≥400copies/mL) associated factors, adverse events (AEs) discontinuation. VF on was compared to protease inhibitor...
Abstract Background Current guidelines recommend that infants born to women with hepatitis C virus (HCV) viremia be screened for HCV antibody at age 18 months and, if positive, referred RNA testing 3 years confirm chronic infection. This policy is based, in part, on analyses suggest 25%–40% of vertically acquired infections clear spontaneously within 4–5 years. Methods Data 179 and/or anti-HCV evidence infection prospective European cohorts were investigated. Ages clearance estimated taking...
BackgroundIntegrase inhibitor (INSTI) with boosted darunavir (DRV/r), a regimen high-resistance barrier, avoiding NRTI toxicities, might be switching option in children living HIV (CLWHIV).MethodsSMILE is randomised non-inferiority trial evaluating safety and antiviral efficacy of once-daily INSTI + DRV/r vs. continuing on current standard-of-care (SOC) triple ART (2NRTI PI/NNRTI) virologically-suppressed CLWHIV aged 6–18 years. The primary outcome the proportion confirmed HIV-RNA ≥50...
Chronic hepatitis C (HCV) in women of childbearing age is a major public health concern with ∼15 million aged 15-49 years living HCV globally 2019. Evidence suggests pregnancy associated adverse and infant outcomes. This includes ∼6% risk infants acquiring vertically, this the leading cause children globally. However, few countries offer routine universal antenatal screening, direct-acting antivirals (DAAs) are not approved for pregnant or breastfeeding although small clinical trials...
Background Weekends off antiretroviral therapy (ART) may help engage HIV-1-infected young people facing lifelong treatment. BREATHER showed short cycle (SCT; 5 days on, 2 ART) was non-inferior to continuous (CT) over 48 weeks. Planned follow-up extended 144 weeks, maintaining original randomisation. Methods an open-label, non-inferiority trial. Participants aged 8-24yrs with virological suppression on efavirenz-based first-line ART were randomised 1:1, stratified by age and...
For human immunodeficiency virus (HIV)-infected adolescents facing lifelong antiretroviral therapy (ART), short-cycle (SCT) with long-acting agents offers the potential for drug-free weekends, less toxicity, better adherence and cost savings. To determine whether or not efavirenz (EFV)-based ART in short cycles of 5 days on 2 off is as efficacious (in maintaining virological suppression) continuous EFV-based (continuous therapy; CT). Secondary objectives included occurrence new clinical HIV...
Abstract Objective To examine the use of vitamin D supplements during infancy among participants in an international infant feeding trial. Design Longitudinal study. Setting Information about supplementation was collected through a validated FFQ at age 2 weeks and monthly between ages 1 month 6 months. Subjects Infants ( n 2159) with biological family member affected by type diabetes increased human leucocyte antigen-conferred susceptibility to from twelve European countries, USA, Canada...
HCV test and treat campaigns currently exclude pregnant women. Pregnancy offers a unique opportunity for screening to potentially initiate direct-acting antiviral treatment. We explored treatment strategies in two lower middle-income countries with high prevalence, Egypt Ukraine.
Pregnant women and children are not included in Egypt's hepatitis C virus (HCV) elimination programmes. This study assesses the cost-effectiveness of several screening treatment strategies for pregnant infants Egypt. A Markov model was developed to simulate cascade care HCV disease progression among their according different strategies, which included: targeted versus universal antenatal screening; pregnancy or deferred till after breast feeding; infected at 3 years vs 12 years. Current...
Abstract The risk of vertical transmission hepatitis C virus (HCV) is ≈6%, and there growing evidence that maternal HCV adversely affects pregnancy infant outcomes. However, antenatal screening not routinely provided in most settings, direct acting antivirals (DAA) are approved for pregnant/ breastfeeding women. We conducted a cross-sectional survey pregnant/post-partum women Egypt, Pakistan Ukraine to assess the acceptability universal DAA treatment scenario DAAs being use pregnancy. Among...
Abstract Background Current guidelines recommend that infants born to women with hepatitis C (HCV) viremia are screened for HCV antibody at age 18 months, and if positive, referred RNA testing 3 years confirm chronic infection. This policy is based in part on analyses suggesting 25%-40% of vertically acquired infections clear spontaneously within 4-5 years. Methods Data 179 and/or anti-HCV evidence viraemia (single PCR+) or confirmed infection (2 PCR+ beyond months) three prospective...