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Article ; Online: Acute Confusion Following Liver Transplantation: HE or Not HE, That Is the Question.

Than, Nwe Ni / Cataluna, Jose Guillain / Majumdar, Avik

2021 Volume 73, Issue 2, Page(s) 858–860

MeSH term(s)	Angiography ; Collateral Circulation ; Diagnosis, Differential ; Female ; Hepatic Encephalopathy/diagnosis ; Hepatic Encephalopathy/etiology ; Hepatic Encephalopathy/therapy ; Hepatitis C, Chronic/complications ; Hepatitis C, Chronic/pathology ; Hepatitis C, Chronic/surgery ; Humans ; Liver Cirrhosis/complications ; Liver Cirrhosis/pathology ; Liver Cirrhosis/surgery ; Liver Transplantation/adverse effects ; Middle Aged ; Portal System/abnormalities ; Portal System/diagnostic imaging ; Portal System/surgery ; Postoperative Complications/diagnosis ; Postoperative Complications/etiology ; Postoperative Complications/therapy ; Time-to-Treatment
Language	English
Publishing date	2021-02-06
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	604603-4
ISSN	1527-3350 ; 0270-9139
ISSN (online)	1527-3350
ISSN	0270-9139
DOI	10.1002/hep.31452
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Article ; Online: Poor correlation of 2D shear wave elastography and transient elastography in Fontan-associated liver disease: A head-to-head comparison.

Gill, Madeleine / Mudaliar, Sanjivan / Prince, David / Than, Nwe Ni / Cordina, Rachel / Majumdar, Avik

JGH open : an open access journal of gastroenterology and hepatology

2023 Volume 7, Issue 10, Page(s) 690–697

Abstract: Background and aims: Fontan-associated liver disease (FALD) is a long-term complication of the Fontan procedure. Guidelines recommend elastography, but the utility of transient elastography (TE) and two-dimensional shear wave elastography (2D SWE) is ... ...

Abstract	Background and aims: Fontan-associated liver disease (FALD) is a long-term complication of the Fontan procedure. Guidelines recommend elastography, but the utility of transient elastography (TE) and two-dimensional shear wave elastography (2D SWE) is unknown. We aimed to evaluate the relationship between TE and 2D SWE in FALD. Methods: This prospective cohort study included 25 patients managed in a specialist clinic between January 2018 and August 2021. Trained clinicians performed 2D SWE (GE Logiq-E9) and TE (FibroScan 503 Touch) on the same day under the same conditions. Laboratory, echocardiography, and imaging data were collected. The atrioventricular systolic-to-diastolic duration (AVV S/D ratio) was calculated as a measure of cardiac diastolic function. Results: We analyzed 40 paired measurements. Median age was 22 years. Median liver stiffness measurement (LSM) was 15.4 kPa (12.1-19.6) by TE and 8.0 kPa (7.0-10.3) ( Conclusions: In FALD, TE and 2D SWE are poorly correlated. LSM by either modality was not associated with known risk factors for liver fibrosis or Fontan function. Based on these data, the role of elastography in FALD is uncertain.
Language	English
Publishing date	2023-09-14
Publishing country	Australia
Document type	Journal Article
ISSN	2397-9070
ISSN (online)	2397-9070
DOI	10.1002/jgh3.12967
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Article ; Online: Steroid-refractory T-cell mediated rejection after human metapneumovirus infection in a liver transplant recipient.

Than, Nwe Ni / Chin, Simone / Kench, James G / McCaughan, Geoff / Majumdar, Avik

Pathology

2021 Volume 53, Issue 6, Page(s) 793–794

MeSH term(s)	Aged ; Anti-Inflammatory Agents/administration & dosage ; Bronchodilator Agents/administration & dosage ; Graft Rejection/virology ; Humans ; Immunosuppressive Agents/administration & dosage ; Liver Transplantation ; Male ; Metapneumovirus/physiology ; Paramyxoviridae Infections/virology ; Prednisolone/administration & dosage ; Steroids/immunology ; T-Lymphocytes/immunology ; Tacrolimus/administration & dosage
Chemical Substances	Anti-Inflammatory Agents ; Bronchodilator Agents ; Immunosuppressive Agents ; Steroids ; Prednisolone (9PHQ9Y1OLM) ; Tacrolimus (WM0HAQ4WNM)
Language	English
Publishing date	2021-03-06
Publishing country	England
Document type	Case Reports ; Letter
ZDB-ID	7085-3
ISSN	1465-3931 ; 0031-3025
ISSN (online)	1465-3931
ISSN	0031-3025
DOI	10.1016/j.pathol.2020.11.008
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Article: An Unusual Case of Hematochezia.

Payne, Anna / Than, Nwe Ni / Jalan, Rajiv / Yu, Dominic

Cureus

2020 Volume 12, Issue 7, Page(s) e8957

Abstract: Lower gastrointestinal bleeding (LGIB) is a serious and potentially life-threatening condition warranting hospital admission. The most frequent causes include diverticular disease, colitis, hemorrhoids, neoplasm, inflammatory bowel disease, and varices. ... ...

Abstract	Lower gastrointestinal bleeding (LGIB) is a serious and potentially life-threatening condition warranting hospital admission. The most frequent causes include diverticular disease, colitis, hemorrhoids, neoplasm, inflammatory bowel disease, and varices. Varices usually occur secondary to liver cirrhosis and are frequently located in the gastroesophageal region. Those occurring elsewhere are known as ectopic varices. The diagnosis and management of ectopic varices is challenging, and guidelines are not currently available. We report the case of recurrent large-volume hematochezia secondary to a cecal varix in a 60-year-old female with alcoholic liver cirrhosis. Initial investigation with CT angiography and endoscopy failed to identify the source of bleeding. A second CT angiogram identified a large varix in the cecum, and the patient was successfully managed with radiological embolization and transjugular intra-hepatic porto-systemic shunt (TIPSS).
Language	English
Publishing date	2020-07-02
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.8957
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Article: Non-alcoholic fatty liver disease: when to intervene and with what.

Than, Nwe Ni / Newsome, Philip N

Clinical medicine (London, England)

2015 Volume 15, Issue 2, Page(s) 186–190

Abstract: Non-alcoholic fatty liver disease (NAFLD) is increasingly common due to the rising prevalence of obesity in both children and adults. It is associated with metabolic risk factors such as diabetes mellitus, dyslipidaemia and hypertension, and is ... ...

Abstract	Non-alcoholic fatty liver disease (NAFLD) is increasingly common due to the rising prevalence of obesity in both children and adults. It is associated with metabolic risk factors such as diabetes mellitus, dyslipidaemia and hypertension, and is associated with increased mortality both from cardiovascular-related and liver-related deaths. Identification of those individuals with significant inflammation and fibrosis is a critical part of the patient pathway. Current treatments for NAFLD include weight loss from lifestyle modification or bariatric surgery, management of underlying metabolic risk factors and for those with end stage liver disease, liver transplantation.
MeSH term(s)	Bariatric Surgery ; Female ; Humans ; Life Style ; Male ; Non-alcoholic Fatty Liver Disease/diagnosis ; Non-alcoholic Fatty Liver Disease/therapy ; Risk Factors ; Weight Loss
Language	English
Publishing date	2015-03-31
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2048646-7
ISSN	1473-4893 ; 1470-2118
ISSN (online)	1473-4893
ISSN	1470-2118
DOI	10.7861/clinmedicine.15-2-186
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Article ; Online: A concise review of non-alcoholic fatty liver disease.

Than, Nwe Ni / Newsome, Philip N

Atherosclerosis

2015 Volume 239, Issue 1, Page(s) 192–202

Abstract: Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome and the incidence of which is rising rapidly due to the increasing epidemic of obesity in both adults and children. The initial accumulation of fat followed ... ...

Abstract	Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome and the incidence of which is rising rapidly due to the increasing epidemic of obesity in both adults and children. The initial accumulation of fat followed by subsequent inflammation is central to the development of liver damage, and is critically influenced by host factors including age, gender, presence of diabetes, genetic polymorphisms and more recently by the gut microbiome. An increasing body of data suggest that NAFLD is also an independent risk factor of cardiovascular disease, which remains the commonest cause of mortality in such patients. This review focusses on the pathogenesis of NAFLD, and the evolution of new approaches to the management and treatment of NAFLD.
MeSH term(s)	Adipose Tissue/pathology ; Adult ; Apoptosis ; Cardiovascular Diseases/blood ; Cardiovascular Diseases/complications ; Child ; Dyslipidemias/blood ; Fatty Acids, Nonesterified/blood ; Fatty Liver/physiopathology ; Female ; Fibrosis/physiopathology ; Hepatocytes/cytology ; Humans ; Insulin Resistance ; Male ; Non-alcoholic Fatty Liver Disease/complications ; Non-alcoholic Fatty Liver Disease/diagnosis ; Non-alcoholic Fatty Liver Disease/therapy ; Obesity/complications ; Polymorphism, Genetic ; Risk Factors ; Triglycerides/blood
Chemical Substances	Fatty Acids, Nonesterified ; Triglycerides
Language	English
Publishing date	2015-03
Publishing country	Ireland
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	80061-2
ISSN	1879-1484 ; 0021-9150
ISSN (online)	1879-1484
ISSN	0021-9150
DOI	10.1016/j.atherosclerosis.2015.01.001
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Article: The Fatty Liver, Cirrhosis, and Liver Cancer Study (TENDENCY): Protocol for a Multicenter Case-Control Study.

Hussain, Yaqza / Bannaga, Ayman / Fisher, Neil / Krishnamoorthy, Ashwin / Kimani, Peter / Malik, Ahmad / Truslove, Maria / Joshi, Shivam / Hitchins, Megan / Abbasi, Abdullah / Corbett, Christopher / Brookes, Matthew / Randeva, Harpal / Than, Nwe Ni / Arasaradnam, Ramesh P

JMIR research protocols

2023 Volume 12, Page(s) e44264

Abstract: Background: Hepatocellular cancer (HCC) is associated with high mortality, and early diagnosis leads to better survival. Patients with cirrhosis, especially due to nonalcoholic fatty liver disease and viral hepatitis, are at higher risk of developing ... ...

Abstract	Background: Hepatocellular cancer (HCC) is associated with high mortality, and early diagnosis leads to better survival. Patients with cirrhosis, especially due to nonalcoholic fatty liver disease and viral hepatitis, are at higher risk of developing HCC and form the main screening group. The current screening methods for HCC (6-monthly screening with serum alpha fetoprotein and ultrasound liver) have low sensitivity; hence, there is a need for better screening markers for HCC. Objective: Our study, TENDENCY, aims to validate the novel screening markers (methylated septin 9, urinary volatile organic compounds, and urinary peptides) for HCC diagnosis and study these noninvasive biomarkers in liver disease. Methods: This is a multicenter, nested case-control study, which involves comparing the plasma levels of methylated septin 9 between confirmed HCC cases and patients with cirrhosis (control group). It also includes the comparison of urine samples for the detection of HCC-specific volatile organic compounds and peptides. Based on the findings of a pilot study carried out at University Hospital Coventry & Warwickshire, we estimated our sample size to be 308 (n=88, 29% patients with HCC; n=220, 71% patients with cirrhosis). Urine and plasma samples will be collected from all participants and will be frozen at -80 °C until the end of recruitment. Gas chromatography-mass spectrometry will be used for urinary volatile organic compounds detection, and capillary electrophoresis-mass spectrometry will be used for urinary peptide identification. Real-time polymerase chain reaction will be used for the qualitative detection of plasma methylated septin 9. The study will be monitored by the Research and Development department at University Hospital Coventry & Warwickshire. Results: The recruitment stage was completed in March 2023. The TENDENCY study is currently in the analysis stage, which is expected to finish by November 2023. Conclusions: There is lack of effective screening tests for hepatocellular cancer despite higher mortality rates. The application of more sensitive plasma and urinary biomarkers for hepatocellular cancer screening in clinical practice will allow us to detect the disease at earlier stages and hence, overall, improve HCC outcomes. International registered report identifier (irrid): DERR1-10.2196/44264.
Language	English
Publishing date	2023-05-31
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2719222-2
ISSN	1929-0748
ISSN	1929-0748
DOI	10.2196/44264
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Article ; Online: Corrigendum to "Autoimmune Hepatitis: Progress from Global Immunosuppression to Personalised Regulatory T Cell Therapy".

Than, Nwe Ni / Jeffery, Hannah C / Oo, Ye H

Canadian journal of gastroenterology & hepatology

2016 Volume 2016, Page(s) 1468106

Abstract: This corrects the article DOI: 10.1155/2016/7181685.]. ...

Abstract	[This corrects the article DOI: 10.1155/2016/7181685.].
Language	English
Publishing date	2016-11-20
Publishing country	Egypt
Document type	Published Erratum
ZDB-ID	2762182-0
ISSN	2291-2797 ; 1916-7237 ; 0835-7900
ISSN (online)	2291-2797 ; 1916-7237
ISSN	0835-7900
DOI	10.1155/2016/1468106
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Article ; Online: Liver abnormalities in pregnancy.

Than, Nwe Ni / Neuberger, James

Best practice & research. Clinical gastroenterology

2013 Volume 27, Issue 4, Page(s) 565–575

Abstract: Abnormalities of liver function (notably rise in alkaline phosphatase and fall in serum albumin) are common in normal pregnancy, whereas rise in serum bilirubin and aminotransferase suggest either exacerbation of underlying pre-existing liver disease, ... ...

Abstract	Abnormalities of liver function (notably rise in alkaline phosphatase and fall in serum albumin) are common in normal pregnancy, whereas rise in serum bilirubin and aminotransferase suggest either exacerbation of underlying pre-existing liver disease, liver disease related to pregnancy or liver disease unrelated to pregnancy. Pregnant women appear to have a worse outcome when infected with Hepatitis E virus. Liver diseases associated with pregnancy include abnormalities associated hyperemesis gravidarum, acute fatty liver disease, pre-eclampsia, cholestasis of pregnancy and HELLP syndrome. Prompt investigation and diagnosis is important in ensuring a successful maternal and foetal outcome. In general, prompt delivery is the treatment of choice for acute fatty liver, pre-eclampsia and HELLP syndrome and ursodeoxycholic acid is used for cholestasis of pregnancy although it is not licenced for this indication.
MeSH term(s)	Fatty Liver/physiopathology ; Female ; HELLP Syndrome/physiopathology ; Humans ; Liver Diseases/diagnosis ; Liver Diseases/physiopathology ; Liver Diseases/therapy ; Pre-Eclampsia/physiopathology ; Pregnancy ; Pregnancy Complications/physiopathology
Language	English
Publishing date	2013-08
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2048181-0
ISSN	1532-1916 ; 1521-6918
ISSN (online)	1532-1916
ISSN	1521-6918
DOI	10.1016/j.bpg.2013.06.015
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Article ; Online: Autoimmune Hepatitis: Progress from Global Immunosuppression to Personalised Regulatory T Cell Therapy.

Than, Nwe Ni / Jeffery, Hannah C / Oo, Ye H

Canadian journal of gastroenterology & hepatology

2016 Volume 2016, Page(s) 7181685

Abstract: Autoimmune hepatitis (AIH) is an immune mediated liver injury. The precise aetiology of AIH is still unknown but current evidence suggests both genetic and environmental factors are involved. Breakdown in peripheral self-tolerance, and impaired functions ...

Abstract	Autoimmune hepatitis (AIH) is an immune mediated liver injury. The precise aetiology of AIH is still unknown but current evidence suggests both genetic and environmental factors are involved. Breakdown in peripheral self-tolerance, and impaired functions of FOXP3(+) regulatory T cell along with effector cell resistance to suppression at the tissue level seem to play an important role in AIH immunopathogenesis. AIH is predominantly a T lymphocytes driven disease but B lymphocytes are also involved in the immunopathology. Innate immune cells are crucial in the initial onset of disease and their response is followed by adaptive T (Th1, Th17, and cytotoxic T cells) and B cell responses evidenced by liver histology and peripheral blood serology. Standard treatment regimens involving steroid and immunosuppressive medications lead to global immune suppression requiring life-long therapy with many side effects. Biologic therapies have been attempted but duration of remission is short-lived. Future direction of diagnosis and treatment for AIH should be guided by "omics" and the immunology profile of the individual patient and clinicians should aim to deliver personalised medicine for their patients. Cell therapy such as infusion of autologous, antigen-specific, and liver-homing regulatory T cells to restore hepatic immune tolerance may soon be a potential future treatment for AIH patients.
MeSH term(s)	Hepatitis, Autoimmune/immunology ; Hepatitis, Autoimmune/pathology ; Hepatitis, Autoimmune/therapy ; Humans ; Immune Tolerance ; Immunosuppression Therapy/methods ; Liver/immunology ; Liver/pathology ; Precision Medicine/methods ; T-Lymphocytes, Regulatory
Language	English
Publishing date	2016-05-18
Publishing country	Egypt
Document type	Journal Article ; Review
ZDB-ID	2762182-0
ISSN	2291-2797 ; 1916-7237 ; 0835-7900
ISSN (online)	2291-2797 ; 1916-7237
ISSN	0835-7900
DOI	10.1155/2016/7181685
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