A5047498245- Liver Disease Diagnosis and Treatment
- Hepatitis C virus research
- Liver Disease and Transplantation
- Alcohol Consumption and Health Effects
- Hepatitis B Virus Studies
- Liver Diseases and Immunity
- Coffee research and impacts
- HIV, Drug Use, Sexual Risk
- Primary Care and Health Outcomes
- Child Abuse and Trauma
- Homelessness and Social Issues
- Criminal Justice and Corrections Analysis
- Diet, Metabolism, and Disease
- Health Policy Implementation Science
- Mental Health Treatment and Access
- Liver physiology and pathology
- Pancreatitis Pathology and Treatment
- COVID-19 and Mental Health
- Drug-Induced Hepatotoxicity and Protection
- Energy and Environment Impacts
- Hepatocellular Carcinoma Treatment and Prognosis
- Cardiac Arrhythmias and Treatments
- Mental Health Research Topics
- Health Systems, Economic Evaluations, Quality of Life
- Cardiac electrophysiology and arrhythmias
Southampton General Hospital
2006-2024
University of Southampton
2015-2024
National Institute for Health Research
2024
University Hospital Southampton NHS Foundation Trust
2014-2020
University College London
2011-2019
Primary Health Care
2017-2019
Roland Hill (United Kingdom)
2019
The Royal Free Hospital
2017
Consorci Institut D'Investigacions Biomediques August Pi I Sunyer
2015
Gilead Sciences (France)
2015
The detection of fibrosis within nonalcoholic fatty liver disease (NAFLD) is important for ascertaining prognosis and the stratification patients emerging therapeutic intervention. We validated Original European Liver Fibrosis panel (OELF) a simplified algorithm not containing age, Enhanced (ELF), in an independent cohort with NAFLD. Furthermore, we explored whether addition simple markers to existing test could improve diagnostic performance. One hundred ninety-six consecutively recruited...
Summary The disease burden of hepatitis C virus ( HCV ) is expected to increase as the infected population ages. A modelling approach was used estimate total number viremic infections, diagnosed, treated and new infections in 2013. In addition, model change progression mortality 2013–2030. Finally, expert panel consensus capture current treatment practices each country. Using today's paradigm, projected decline or remain flat all countries studied. However, same time period, individuals with...
Highlights•Established blood tests can be used in primary care to stratify patients with fatty liver disease.•A 2-step pathway (FIB-4 followed by ELF™ if required) reduced unnecessary referrals 80%.•This also improved the detection of cases advanced fibrosis 5-fold and cirrhosis 3-fold.•This identify who might benefit from referral specialists.•This should reduce while at same time improving cirrhosis.Graphical abstractAbstractBackground & AimsThe development non-invasive may enable earlier...
<h3>Background</h3> Clinicians use fibrosis in a liver biopsy to predict clinical outcomes of chronic disease. The performance non-invasive tests has been evaluated against histological assessment but as the reference standard would be ideal. enhanced (ELF) test was derived and validated large cohort patients shown have high diagnostic accuracy (area under curve (AUC)=0.80 95% CI 0.76 0.85) identification significant on biopsy. <h3>Objective</h3> To evaluate ELF predicting by following up...
Abstract Primary biliary cirrhosis (PBC) is sometimes diagnosed based on a positive antimitochondrial antibody in the appropriate clinical setting without liver biopsy. Although biopsy can assess extent of fibrosis and provide prognostic information, serum markers avoid complications sampling error results as continuous variable, which may be more precise than categorical histological stages. The current study was undertaken to evaluate predictors progression large cohort PBC patients....
Summary The number of hepatitis C virus ( HCV ) infections is projected to decline while those with advanced liver disease will increase. A modeling approach was used forecast two treatment scenarios: (i) the impact increased efficacy keeping treated patients constant and (ii) increasing rate. This analysis suggests that successful diagnosis a small proportion can contribute significantly reduction burden in countries studied. largest ‐related morbidity mortality occurs when combined higher...
Assessment of liver fibrosis is important in determining prognosis and evaluating interventions. Due to limitations accuracy patient hazard biopsy, non-invasive methods have been sought provide information on fibrosis, including the European (ELF) test, shown good diagnostic for detection moderate severe fibrosis. Access independent cohorts patients has provided an opportunity explore if this test could be simplified. This paper reports simplification ELF its ability identity severity...
Abstract Background FibroTest (FT) is the most frequently used serum fibrosis marker and consists of an algorithm five markers (alfa2-macroglobulin, apolipoproteinA1, haptoglobin, GGT, bilirubin). The Enhanced Liver Fibrosis (ELF) test three (hyaluronic acid, amino-terminal propeptide-of-type-III-collagen, tissue-inhibitor matrix-metaloproteinase-1). While a systematic review has shown comparable results for both individual markers, there been no direct comparison markers. Methods In present...
Liver biopsy is the reference standard for detection of nonalcoholic steatohepatitis (NASH) within fatty liver disease (NAFLD). The aim this study was to identify a biomarker NASH in patients without significant fibrosis. In all, 172 from two centers with biopsy-proven NAFLD were included study. Eighty-four single center as derivation cohort and 88 second validation cohort. Serum samples tested candidate markers fibrosis inflammation alongside hematological biochemical markers. Among...
The identification of patients with advanced liver fibrosis secondary to non-alcoholic fatty disease (NAFLD) remains challenging. Using non-invasive tests (NILT) in primary care may permit earlier detection clinically significant for specialist review, and reduce unnecessary referral mild disease. We constructed an analytical model assess the clinical cost differentials such strategies. A probabilistic decisional simulated a cohort 1000 NAFLD over 1 year from healthcare payer perspective....
To examine the extent, nature and quality of literature on impact COVID-19 pandemic mental health imprisoned people prison staff.
Chronic kidney disease (CKD) and non-alcoholic fatty liver (NAFLD) frequently co-exist. We assess the impact of having NAFLD on adverse clinical outcomes all-cause mortality for people with CKD.A total 18,073 UK Biobank participants identified to have CKD (eGFR < 60 ml/min/1.73 m2 or albuminuria > 3 mg/mmol) were prospectively followed up by electronic linkage hospital death records. Cox-regression estimated hazard ratios (HR) associated (elevated hepatic steatosis index ICD-code) fibrosis...