A5043695505- Liver Disease Diagnosis and Treatment
- Liver Disease and Transplantation
- Hepatitis C virus research
- Liver Diseases and Immunity
- Alcohol Consumption and Health Effects
- Pharmaceutical Practices and Patient Outcomes
- Liver physiology and pathology
- Diet, Metabolism, and Disease
- Medication Adherence and Compliance
- Pancreatitis Pathology and Treatment
- Healthcare Policy and Management
- Global Health Care Issues
- Primary Care and Health Outcomes
- Drug-Induced Hepatotoxicity and Protection
- Hepatitis B Virus Studies
- Pharmaceutical Economics and Policy
- Diabetes, Cardiovascular Risks, and Lipoproteins
- Peroxisome Proliferator-Activated Receptors
- Clostridium difficile and Clostridium perfringens research
- Health Literacy and Information Accessibility
- Diet and metabolism studies
- Organ Transplantation Techniques and Outcomes
- Inflammatory Bowel Disease
- Nursing Diagnosis and Documentation
- Pharmacy and Medical Practices
The University of Queensland
2013-2022
Princess Alexandra Hospital
2012-2021
Translational Research Institute
2013-2021
Princess Alexandra Hospital
2009-2020
National Health and Medical Research Council
2017
University Hospitals Bristol NHS Foundation Trust
2013
University of Bristol
2013
Although nonalcoholic fatty liver disease (NAFLD) is conventionally assessed histologically for lobular features of inflammation, development portal fibrosis appears to be associated with progression. We investigated the composition inflammatory infiltrate and its relationship ductular reaction (DR), a second phenomenon implicated in fibrogenesis. The may contribute directly fibrogenesis as well influence fate DR hepatic progenitor cells (HPCs), regulating balance between repair fibrosis....
Abstract Background Non‐alcoholic fatty liver disease (NAFLD) is a common cause of incidental test abnormalities. General practitioners (GP) have key role in identifying people with NAFLD at risk significant disease. Recent specialist guidelines emphasise the use fibrosis algorithms or serum biomarkers rather than routine tests, to assess advanced fibrosis. Aim To evaluate primary care clinicians’ current approach diagnosis, management and referral NAFLD. Methods A cross‐sectional survey...
Noninvasive serum biomarkers (nonalcoholic fatty liver disease fibrosis score [NFS], 4 [FIB-4], or enhanced [ELF] test) are recommended as first-line tools to determine the risk of advanced in nonalcoholic disease. We aimed assess utility a pragmatic approach screening for clinically significant primary care and diabetes clinics. recruited 252 patients from an endocrine clinic facility. Anthropometric measurements, ELF test, ultrasound, stiffness measurements (LSMs) were performed....
Subjects with metabolic risk factors for non-alcoholic fatty liver disease (NAFLD) are commonly seen by hospital specialists other than gastroenterologists/hepatologists. The aim of this study was to assess the awareness NAFLD and opinions regarding management among non-hepatologists at two major tertiary hospitals in Brisbane.A face-to-face questionnaire assessing current beliefs practices administered specialists-in-training across six specialties (internal medicine, cardiology/cardiac...
Abstract Background & Aims There is increasing need to identify individuals with advanced liver fibrosis, who are at risk of complications such as hepatocellular carcinoma. The commercially available enhanced fibrosis ( ELF ) test provides a non‐invasive assessment severity. This study was designed determine the diagnostic accuracy manufacturer's cut‐off value (≥9.8) in identifying fibrosis. Methods relationship between score and examined using serum collected time biopsy for...
Ascites, the most frequent complication of cirrhosis, is associated with poor prognosis and reduced quality life. Recurrent hospital admissions are common often unplanned, resulting in increased use services.To examine services by patients cirrhosis ascites requiring paracentesis, to investigate factors early unplanned readmission.A retrospective review medical chart clinical databases was performed for who underwent paracentesis between October 2011 2012. Clinical parameters at index...
Objective The utility of International Classification Diseases (ICD) codes relies on the accuracy clinical reporting and administrative coding, which may be influenced by country-specific coding rules. This study explores limitations Australian Modification 10th revision ICD (ICD-10-AM) to detect presence cirrhosis a subset key complications for purpose future large-scale epidemiological research healthcare studies. Design/method ICD-10-AM in random sample 540 admitted patient encounters at...
Objective The prevalence of non-alcoholic fatty liver disease (NAFLD) and steatohepatitis (NASH) cirrhosis is often underestimated in healthcare administrative databases that define burden using International Classification Diseases (ICD) codes. This retrospective audit was conducted to explore the accuracy limitations ICD, Tenth Revision, Australian Modification (ICD-10-AM) detect NAFLD, metabolic risk factors (obesity diabetes) other aetiologies chronic disease. Design/Method ICD-10-AM...
Abstract Non-alcoholic fatty liver disease (NAFLD) affects 25% of the adult population globally. Since fibrosis is most important predictor liver-related complications in patients with NAFLD, identification advanced among at-risk individuals an issue clinical practice. Transient elastography best evaluated non-invasive method used referral centres to assess fibrosis, however serum-based tests, such as Enhanced Liver Fibrosis (ELF) score, have a practical advantage first-line tests due their...
Liver macrophages are a heterogeneous cell population that produces factors involved in fibrogenesis and matrix turnover, including metalloproteinase (MMP) -9. During liver injury, their close proximity to hepatic progenitor cells the ductular reaction may enable them regulate repair fibrosis.To enumerate characterise patients with chronic hepatitis C, determine whether distinct of is associated portal fibrosis.Immunostaining for macrophage markers (CD68, CD163, CCR2), (keratin-7) MMP-9 was...
An observational study describing the number and type of chronic conditions medications taken by diabetic patients with NAFLD identifying characteristics that may impact liver disease severity or clinical management. Adults 2 diabetes have a high prevalence nonalcoholic fatty (NAFLD) increased risk developing advanced disease. Appropriate management should consider population, as comorbid increase complexity treatment strategies. Diabetic at clinically significant (as assessed FIB-4 fibrosis...
Carbohydrate deficient transferrin (CDT) is the most specific serum biomarker of heavy alcohol consumption, defined as ≥ 350–420 g alcohol/week. Despite introduction a standardized reference measurement technique, widespread use CDT remains limited due to low sensitivity. The aim this study was determine factors that affect diagnostic sensitivity in patients with sustained intake. Patients self-reported history consumption were recruited from hepatology outpatient department or medical...
Liver and systemic inflammatory factors influence monocyte phenotype function, which has implications for hepatic recruitment subsequent fibrogenic responses, as well host defence.Peripheral blood surface marker (CD14, CD16, CD163, CSF1R, CCR2, CCR4, CCR5, CXCR3, CXCR4, CX3CR1, HLA-DR, CD62L, SIGLEC-1) expression capacity phagocytosis, oxidative burst LPS-stimulated TNF production were assessed in patients with hepatitis C (HCV) (n = 39) or non-alcoholic fatty liver disease (NAFLD) 34)...
People with decompensated cirrhosis are often prescribed a complex regimen of therapeutic and prophylactic medications. In other chronic diseases, polypharmacy increases the risk medication misadventure medication-related problems (MRPs), associated increased morbidity, mortality, health care costs. This study examined MRPs in cohort ambulatory patients history who were enrolled randomized controlled trial pharmacist-led, patient-oriented education intervention assessed association between...
Chronic liver disease (CLD) is associated with tissue-destructive fibrosis. Considering that common mechanisms drive fibrosis across etiologies, and steatosis an important cofactor for pathology, we performed RNA sequencing on biopsies of patients different stages, resulting from infection hepatitis C virus (HCV) (with or without steatosis) fatty disease. In combination enhanced score correlation analysis, reveal a set genes advanced fibrosis, as exemplified by those encoding the...
It remains unclear whether screening for advanced fibrosis in the community can identify subgroup of people with nonalcoholic fatty liver disease (NAFLD) at higher risk development liver‐related complications. We aimed to determine prognostic value baseline noninvasive tests predicting outcomes and mortality patients NAFLD from type 2 diabetes (T2D) clinics or primary care. Patients (n = 243) who were screened by using score (NFS), 4 (FIB‐4), enhanced (ELF) test, stiffness measurements...
To investigate the impact of medication beliefs, illness perceptions and quality life on adherence in people with decompensated cirrhosis.One hundred adults cirrhosis completed a structured questionnaire when they attended for routine outpatient hepatology review. Measures self-reported (Morisky Medication Adherence Scale), beliefs surrounding medications (Beliefs about Medicines Questionnaire), medicines (Brief Illness Perception (Chronic Liver Disease Questionnaire) were examined. Clinical...
Non-invasive markers of liver fibrosis are urgently required, especially for use in non-specialist settings. The aim this study was to identify novel serum biomarkers advanced fibrosis.We performed an unbiased screen 120 analytes including cytokines, chemokines and proteases 70 patients (35 without fibrosis, 35 with cirrhosis on biopsy), selected a panel 44 candidate biomarkers, which were subsequently measured mixed-etiology cohort 432 known HA, PIIINP TIMP1 (which comprise the validated...
AIM:To investigate the influence of macrophages on hepatocyte phenotype and function. METHODS:Macrophages were differentiated from THP-1 monocytes via phorbol myristate acetate stimulation effects monocyte or macrophageconditioned medium HepG2 mRNA protein expression determined.The in vivo relevance these findings was confirmed using liver biopsies 147 patients with hepatitis C virus (HCV) infection. RESULTS:Conditioned media macrophages, but not monocytes, induced a transient morphological...
Abstract Many patients with chronic disease do not possess the knowledge and skills required to access interpret appropriate health information. A pilot study in people liver cirrhosis ( n = 50) identified that only 54% of could recall being given written information by a clinician 64% had self‐sought information, most commonly using Internet. reported difficulties understanding material majority wanted more accessible educational booklet was well received participants 85% reporting it...
Cirrhosis patients are prescribed multiple medications for their liver disease and comorbidities. Discrepancies between medicines consumed by those documented in the medical record may contribute to patient harm impair management. The aim of present study was assess magnitude types discrepancies among patient-reported record-documented with cirrhosis, examine factors associated such discrepancies.Fifty who attended a hospital hepatology outpatient clinic were interviewed using questionnaire...
Many patients with cirrhosis follow complex medication and dietary regimens, those decompensated suffer debilitating complications. These factors impact activities of daily living quality life.To explore the concerns challenges people their use support services to also describe health professionals' (HP) perspectives patients' concerns.This is a cross-sectional study at tertiary liver clinic involving 50 54 HP. Data were collected using structured questionnaires. The includes report...
Background: We report the development and psychometric testing of a Supportive Needs Assessment tool for Cirrhosis (SNAC). Methods: The 50-item SNAC was administered to patients (n=465) diagnosed with cirrhosis recruited from five metropolitan hospitals in Queensland, Australia. Items were assessed ceiling floor effects, exploratory factor analysis used assess structure. Identified factors internal consistency convergent validity validated psychosocial tools. Results: Exploratory identified...