A5013555370- Liver Disease Diagnosis and Treatment
- Liver Disease and Transplantation
- Hepatitis C virus research
- Hepatocellular Carcinoma Treatment and Prognosis
- Liver Diseases and Immunity
- Colorectal Cancer Screening and Detection
- Gallbladder and Bile Duct Disorders
- Organ Transplantation Techniques and Outcomes
- Tuberculosis Research and Epidemiology
- Hepatitis B Virus Studies
- Alcohol Consumption and Health Effects
- Pediatric Hepatobiliary Diseases and Treatments
- Gastric Cancer Management and Outcomes
- Cholangiocarcinoma and Gallbladder Cancer Studies
- Pancreatic and Hepatic Oncology Research
- Nutritional Studies and Diet
- Mycobacterium research and diagnosis
- Genetic factors in colorectal cancer
- Global Cancer Incidence and Screening
- Hepatitis Viruses Studies and Epidemiology
- Food Security and Health in Diverse Populations
- Pregnancy and preeclampsia studies
- Infectious Diseases and Tuberculosis
- Global Health Workforce Issues
- Colorectal Cancer Surgical Treatments
Queen's University
2016-2025
Kingston Health Sciences Centre
2023-2024
Institute for Clinical Evaluative Sciences
2018-2024
Queens University
2018-2024
LEK Consulting (United States)
2024
WinnMed
2022
University of California, San Francisco
2012-2020
Kingston General Hospital
2017
Pennsylvania State University
2017
Birmingham Children's Hospital
2014
We report on the long-term intention-to-treat (ITT) outcome of 118 patients with hepatocellular carcinoma (HCC) undergoing downstaging to within Milan/United Network for Organ Sharing T2 criteria before liver transplantation (LT) since 2002 and compare results 488 listed LT HCC meeting at listing in same period. The subgroups include 1 lesion >5 ≤8 cm (n = 43), 2 or 3 lesions least one >3 ≤5 total tumor diameter 61), 4-5 each ≤3 14). In group, 64 (54.2%) had received 5 (7.5%) developed...
Direct‐acting antiviral (DAA) therapy, recently approved for patients with decompensated cirrhosis (DC) secondary to hepatitis C virus (HCV), is associated improved hepatic function. We analyzed trends in liver transplant (LT) wait‐listing (WL) explore potential impact of effective medical therapy on WL registration. This a cohort study using the Scientific Registry Transplant Recipients database from 2003 2015. A total 47,591 adults wait‐listed LT HCV, B (HBV), and nonalcoholic...
BACKGROUND All patients with cirrhosis are at risk of developing hepatocellular carcinoma (HCC). This is not uniform because other patient‐related factors influence the HCC. The objective current study was to develop an HCC prediction model estimate 1‐year probability assist patient counseling. METHODS Between 2002 and 2011, a cohort 34,932 identified from national liver transplantation waitlist database United States. Cox proportional hazards regression methods were used validate for...
To evaluate screening and treatment strategies, large-scale real-world data on liver disease-related outcomes are needed. We sought to validate health administrative for identification of cirrhosis, decompensated cirrhosis hepatocellular carcinoma among patients with known disease.Primary patient were abstracted from the Toronto Center Liver Disease viral hepatitis (2006-2014), all disease Kingston Health Sciences Centre Hepatology Clinic (2013). linked clinical information tested a range...
Background and Aims Mortality secondary to cirrhosis in North America is increasing. We describe the incidence of stratified by birth cohort etiology project disease burden 2040. Approach Results This a retrospective study Ontario, Canada, using population-based administrative health care data. Individuals with incident (2000-2017) were identified, was defined as HCV, HBV, NAFLD, alcohol-associated liver (ALD), or autoimmune disease/other validated case definitions. Annual age/sex-adjusted...
Treatment outcomes for people living with autoimmune hepatitis (AIH) are limited by a lack of specific therapies, as well well-validated prognostic tools and clinical trial endpoints. We sought to identify predictors outcome AIH.
This cohort study examined the annual incidence rates of alcohol-associated end-organ disease among adolescents and young adults in Ontario, Canada, from 2003 to 2021.
BACKGROUND To the authors’ knowledge, incidence of biliary tract cancer (BTC) in Canada is unknown. In current study, authors sought to describe epidemiology BTC using a large population‐based database from Ontario, Canada. METHODS The study was cohort Ontario Cancer Registry. Patients with intrahepatic cholangiocarcinoma (IHCC), extrahepatic (EHCC), and gallbladder (GBC) diagnosed between 1994 2012 were included. Age‐standardized mortality rates compared rate ratios (IRRs). Overall survival...
Patients with primary biliary cholangitis (PBC) incomplete response to ursodeoxycholic acid are at risk of disease progression and need additional therapy. Obeticholic (OCA) was approved in Canada May 2017, but its effectiveness a real‐world setting has not been described. We sought describe our experience OCA Canadian cohort. OCA‐naive patients treated two centers were included. Clinical biochemical data collected initiation during follow‐up. Primary outcomes changes serum alkaline...
This study evaluated the association between neighborhood-level social determinants of health (SDOH) and liver transplantation (LT) among patients with cirrhosis who have universal access to care.
Mortality from cirrhosis is increasing and the highest among young adults with alcohol-associated liver disease (ALD). The aim of this study was to describe rates transplant (LT) waitlisting stratified by age, sex, etiology.Retrospective population-based 2003 2018 using Scientific Registry Transplant Recipients database. Adults newly registered on LT waitlist were included, age at listing dichotomized ±40 y. Annual standardized incidence proportions group, etiology calculated census data....
Background: Although patients with cirrhosis are at increased risk of death, the exact causes death have not been reported in contemporary era. This study aimed to describe cause-specific mortality general population. Methods: Retrospective cohort using administrative health care data from Ontario, Canada. Adult 2000–2017 were identified. Cirrhosis etiologies defined as HCV, HBV, alcohol-associated liver disease (ALD), NAFLD, or autoimmune disease/other validated algorithms. Patients...
Current guidelines recommend HCV screening by 18 months of age for those exposed to in utero; yet, occurs the minority children.
We compared the efficacy and patient tolerance of two dietary regimens used as an adjunct to standard bowel cleansing in preparation for elective colonoscopy.Our prospective, randomized, single-blind, controlled, noninferiority trial administered day before colonoscopy. Subjects received low-volume preparation. The primary outcome was colon cleansing, rated by Ottawa scale (OBPS). Patient acceptance assigned regimen assessed a secondary outcome.The mean OBPS score clear-fluid diet group...
Chronic liver disease (CLD) and cirrhosis are leading causes of death globally with the burden rising significantly over past several decades. Defining etiology is important for understanding epidemiology, healthcare planning, outcomes. The aim this study was to validate a hierarchical algorithm CLD in administrative data.Consecutive patients or attending an outpatient hepatology clinic Ontario, Canada from 05/01/2013-08/31/2013 underwent detailed chart abstraction. Gold standard determined...
Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of cirrhosis in Canada. and bariatric surgery (MBS) leads to histologic improvement patients with MASLD obesity; however, advanced fibrosis may be at risk for decompensation function following MBS. There are currently no Canadian data evaluating the association between pre-operative post-operative complications among obesity undergoing Methods: We conducted single-centre retrospective cohort study...
Abstract In the last decade, hepatitis C virus (HCV) has become a curable chronic viral infection, with excellent treatment and streamlined diagnostic testing. Canada many other countries have adopted national elimination targets; however, reaching these goals will require changes in way care is provided. Standard of HCV all-oral daily medication for 8 or 12 weeks all provinces mechanisms public coverage. Unfortunately, vertical transmission continues to be predominant reason paediatric but...