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  1. Article: Respiratory problems associated with liver disease in children.

    Ellis, Jordache / Grammatikopoulos, Tassos / Cook, James / Deep, Akash

    Breathe (Sheffield, England)

    2024  Volume 20, Issue 1, Page(s) 230150

    Abstract: Respiratory manifestations of chronic liver disease have a profound impact on patient clinical outcomes. Certain conditions within paediatric liver disease have an associated respiratory pathology. This overlap between liver and respiratory ... ...

    Abstract Respiratory manifestations of chronic liver disease have a profound impact on patient clinical outcomes. Certain conditions within paediatric liver disease have an associated respiratory pathology. This overlap between liver and respiratory manifestations can result in complex challenges when managing patients and requires clinicians to be able to recognise when referral to specialists is required. While liver transplantation is at the centre of treatment, it opens up further potential for respiratory complications. It is established that these complications place patients at risk of longer stays in hospital and reduced survival. Additionally, late post-transplant complications can occur, including post-transplant lymphoproliferative disease and immunosuppression-induced interstitial lung disease. Although rare, it is important for clinicians to recognise these conditions to allow for prompt management. Finally, as liver disease progresses in children, respiratory complications can occur. Hepatopulmonary syndrome can occur in the context of portal hypertension, resulting in increased mortality and poorer quality of life for patients. Another consequence is portopulmonary hypertension, which can be associated with poor survival. Failure to recognise these complications in children may result in poorer outcomes and therefore it is vital that clinicians can establish when referral to a paediatric respiratory medicine specialist is required.
    Language English
    Publishing date 2024-04-09
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2562899-9
    ISSN 2073-4735 ; 1810-6838
    ISSN (online) 2073-4735
    ISSN 1810-6838
    DOI 10.1183/20734735.0150-2023
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Optimal timing of endoscopy in pediatric variceal hemorrhage - How urgent is urgent?

    Slowik, Voytek / Grammatikopoulos, Tassos

    Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver

    2021  Volume 54, Issue 1, Page(s) 1–2

    MeSH term(s) Child ; Endoscopy ; Endoscopy, Gastrointestinal ; Esophageal and Gastric Varices ; Gastrointestinal Hemorrhage/etiology ; Humans ; Varicose Veins
    Language English
    Publishing date 2021-11-12
    Publishing country Netherlands
    Document type Editorial ; Comment
    ZDB-ID 1459373-7
    ISSN 1878-3562 ; 1125-8055
    ISSN (online) 1878-3562
    ISSN 1125-8055
    DOI 10.1016/j.dld.2021.10.009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Outbreak of hepatitis in children: clinical course of children with acute liver failure admitted to the intensive care unit.

    Deep, Akash / Grammatikopoulos, Tassos / Heaton, Nigel / Verma, Anita / Dhawan, Anil

    Intensive care medicine

    2022  Volume 48, Issue 7, Page(s) 958–962

    MeSH term(s) Child ; Disease Outbreaks ; Hepatitis ; Hospitalization ; Humans ; Intensive Care Units ; Liver Failure, Acute/epidemiology ; Liver Failure, Acute/etiology ; Liver Failure, Acute/therapy ; Retrospective Studies
    Language English
    Publishing date 2022-06-10
    Publishing country United States
    Document type Letter
    ZDB-ID 80387-x
    ISSN 1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
    ISSN (online) 1432-1238
    ISSN 0340-0964 ; 0342-4642 ; 0935-1701
    DOI 10.1007/s00134-022-06765-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Use and safety of prophylactic endoscopy from a single center serving urban and rural children with portal hypertension.

    Slowik, Voytek / Bernardez, Anissa / Wasserkrug, Heather / Fischer, Ryan T / Daniel, James F / Grammatikopoulos, Tassos

    Scientific reports

    2022  Volume 12, Issue 1, Page(s) 25

    Abstract: Prophylactic endoscopy is routine in adults with portal hypertension (PHTN), but there is limited data in pediatrics. We sought to describe our experience with prophylactic endoscopy in pediatric PHTN. This is a retrospective study of 87 children who ... ...

    Abstract Prophylactic endoscopy is routine in adults with portal hypertension (PHTN), but there is limited data in pediatrics. We sought to describe our experience with prophylactic endoscopy in pediatric PHTN. This is a retrospective study of 87 children who began surveillance endoscopy prior to gastrointestinal bleeding (primary prophylaxis) and 52 who began after an episode of bleeding (secondary prophylaxis) from 01/01/1994 to 07/01/2019. Patients who underwent primary prophylaxis had a lower mean number of endoscopies (3.897 vs 6.269, p = 0.001). The primary prophylaxis group was less likely to require a portosystemic shunt (6% vs 15%, p < 0.001) with no difference in immediate complications (1% vs 2%, p = 0.173) or 2-week complications (1% vs 2%, p = 0.097). No deaths were related to variceal bleeding or endoscopy. Kaplan-Meier Survival Curve suggests improved transplant and shunt free survival in the primary prophylaxis group (log-rank p < 0.001). Primary and secondary endoscopic prophylaxis should be considered safe for the prevention of variceal hemorrhage in pediatric portal hypertension. There are differences in outcomes in primary and secondary prophylaxis, but unclear if this is due to patient characteristics versus treatment strategy. Further study is needed to compare safety and efficacy to watchful waiting.
    MeSH term(s) Adolescent ; Child ; Endoscopy, Gastrointestinal/methods ; Female ; Gastrointestinal Hemorrhage/diagnostic imaging ; Gastrointestinal Hemorrhage/mortality ; Humans ; Hypertension, Portal/complications ; Hypertension, Portal/diagnostic imaging ; Hypertension, Portal/mortality ; Male ; Retrospective Studies ; Rural Population/statistics & numerical data ; Secondary Prevention ; Urban Population/statistics & numerical data
    Language English
    Publishing date 2022-01-07
    Publishing country England
    Document type Journal Article
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-021-03759-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Transient elastography and von Willebrand factor as predictors of portal hypertension and decompensation in children.

    Goel, Akshat / Hegarty, Robert / Dixit, Shweta / Tucker, Bethany / Douiri, Abdel / Kyrana, Eirini / Jain, Vandana / Dhawan, Anil / Grammatikopoulos, Tassos

    JHEP reports : innovation in hepatology

    2023  Volume 5, Issue 12, Page(s) 100935

    Abstract: Background & aims: Von Willebrand factor antigen (vWFAg), a protein measured to test the level of vWF released from the vascular endothelium has gained much attention as a marker for portal hypertension (PHT) severity. The objectives of this study were ... ...

    Abstract Background & aims: Von Willebrand factor antigen (vWFAg), a protein measured to test the level of vWF released from the vascular endothelium has gained much attention as a marker for portal hypertension (PHT) severity. The objectives of this study were to investigate the use of vWFAg as a biomarker along with liver and spleen stiffness measurements by transient elastography as potential predictors of clinically significant varices (CSV), variceal bleeding (VB) and decompensation in children with PHT.
    Methods: This observational prospective cohort study included 117 children (median age 10 [IQR 6-14] years) who underwent oesophagogastroduodenoscopy between January'2012 to November'2021 and a validation group of 33 children who underwent the same procedure between December'2021 to March'2023. Measurements of vWFAg and glycoprotein Ib binding activity of VWF (GPIbR) were available in 97 patients in the study group and in all patients in the validation group.
    Conclusions: This study suggests the predictive value of vWF for CSV and VB increases when combined with spleen stiffness, with AUROCs of 0.88 and 0.82, respectively. Hence, a combination of biomarkers could assist clinicians in diagnosing CSV, preventing unnecessary invasive procedures.
    Impacts and implications: Surveillance endoscopies in children with portal hypertension (PHT) have their own risks and non-invasive markers, such as von Willebrand factor antigen, glycoprotein Ib binding activity of VWF (GPIbR), and transient elastography could be used to predict clinically significant varices, variceal bleeding and disease compensation in children with PHT. Such non-invasive markers for PHT and varices are lacking in the paediatric population. The results show that von Willebrand factor and GPIbR along with transient elastography can be used to formulate a scoring system which can be used as a clinical tool by paediatric hepatologists to monitor the progression of PHT and risk of bleeding, and hence to stratify the performance of invasive endoscopic procedures under general anaesthesia. However, there is a need to validate the scoring system in children with portal vein thrombosis and for hepatic decompensation in a multi-centre registry in the future.
    Language English
    Publishing date 2023-10-12
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2589-5559
    ISSN (online) 2589-5559
    DOI 10.1016/j.jhepr.2023.100935
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Noble metal catalyst detection in rocks using machine-learning: The future to low-cost, green energy materials?

    Ifandi, Elena / Lai, Daphne Teck Ching / Kalaitzidis, Stavros / Abu Bakar, Muhammad Saifullah / Grammatikopoulos, Tassos / Lai, Chun-Kit / Tsikouras, Basilios

    Scientific reports

    2023  Volume 13, Issue 1, Page(s) 3765

    Abstract: Carbon capture and catalytic conversion to methane is promising for carbon-neutral energy production. Precious metals catalysts are highly efficient; yet they have several significant drawbacks including high cost, scarcity, environmental impact from the ...

    Abstract Carbon capture and catalytic conversion to methane is promising for carbon-neutral energy production. Precious metals catalysts are highly efficient; yet they have several significant drawbacks including high cost, scarcity, environmental impact from the mining and intense processing requirements. Previous experimental studies and the current analytical work show that refractory grade chromitites (chromium rich rocks with Al
    Language English
    Publishing date 2023-03-07
    Publishing country England
    Document type Journal Article
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-023-30822-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: The top 10 research priorities for pancreatitis: findings from a James Lind Alliance priority setting partnership.

    Mitra, Vikramjit / Munnelly, Stacey / Grammatikopoulos, Tassos / Mole, Damian / Hopper, Andrew / Ryan, Barbara / Phillips, Mary / Tarpey, Maryrose / Leeds, John

    The lancet. Gastroenterology & hepatology

    2023  Volume 8, Issue 9, Page(s) 780–782

    MeSH term(s) Humans ; Biomedical Research ; Pancreatitis/therapy
    Language English
    Publishing date 2023-06-22
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2468-1253
    ISSN (online) 2468-1253
    DOI 10.1016/S2468-1253(23)00151-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Reply to: "Doublecortin domain containing protein 2 (DCDC2) genetic variants in primary sclerosing cholangitis".

    Grammatikopoulos, Tassos / Thompson, Richard J

    Journal of hepatology

    2017  Volume 67, Issue 3, Page(s) 652–653

    MeSH term(s) Cholangitis, Sclerosing ; Genetic Variation ; Humans ; Microtubule-Associated Proteins/genetics ; Neuropeptides
    Chemical Substances DCDC2 protein, human ; Microtubule-Associated Proteins ; Neuropeptides ; doublecortin protein
    Language English
    Publishing date 2017-04-29
    Publishing country Netherlands
    Document type Letter ; Comment
    ZDB-ID 605953-3
    ISSN 1600-0641 ; 0168-8278
    ISSN (online) 1600-0641
    ISSN 0168-8278
    DOI 10.1016/j.jhep.2017.04.012
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Non-invasive assessment of intrapulmonary shunt and ventilation to perfusion ratio in children with hepatopulmonary syndrome before and after liver transplantation.

    Russell-Jones, Emma / Grammatikopoulos, Tassos / Greenough, Anne / Dhawan, Anil / Dassios, Theodore

    Respiratory medicine

    2021  Volume 180, Page(s) 106372

    Abstract: Objectives: To use the oxyhaemoglobin dissociation curve (ODC) to non-invasively measure the ventilation perfusion ratio (V: Methods: A retrospective cohort study at King's College Hospital NHS Foundation Trust, London, UK was performed between 1998 ... ...

    Abstract Objectives: To use the oxyhaemoglobin dissociation curve (ODC) to non-invasively measure the ventilation perfusion ratio (V
    Methods: A retrospective cohort study at King's College Hospital NHS Foundation Trust, London, UK was performed between 1998 and 2016. The V
    Results: Fifteen children with HPS were studied with a median (IQR) age at LT of 8.8 (6.6-12.9) years. The median (IQR) pre-LT V
    Conclusions: Ventilation/perfusion impairment reverses but not completely resolves after liver transplantation in children with hepatopulmonary syndrome. The non-invasive method for estimating intrapulmonary shunting could be used as an alternative to the macroaggregated albumin scan in this population.
    MeSH term(s) Adolescent ; Albumins ; Child ; Child, Preschool ; Cohort Studies ; Female ; Hepatopulmonary Syndrome/diagnosis ; Hepatopulmonary Syndrome/physiopathology ; Hepatopulmonary Syndrome/surgery ; Humans ; Infant ; Liver Transplantation ; Male ; Retrospective Studies ; Ventilation-Perfusion Ratio ; Ventilation-Perfusion Scan/methods
    Chemical Substances Albumins ; macro aggregates of albumin (70536-17-3)
    Language English
    Publishing date 2021-03-23
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1003348-8
    ISSN 1532-3064 ; 0954-6111
    ISSN (online) 1532-3064
    ISSN 0954-6111
    DOI 10.1016/j.rmed.2021.106372
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Non-invasive Markers of Portal Hypertension: Appraisal of Adult Experience and Potential Utilisation in Children.

    Sutton, Harry / Dhawan, Anil / Grammatikopoulos, Tassos

    Journal of pediatric gastroenterology and nutrition

    2018  Volume 66, Issue 4, Page(s) 559–569

    Abstract: Portal hypertension (PHT) is a significant cause of morbidity and mortality in children with chronic liver disease and portal vein obstruction. Increased portal pressure results in variceal formation along the gastrointestinal (GI) tract resulting in ... ...

    Abstract Portal hypertension (PHT) is a significant cause of morbidity and mortality in children with chronic liver disease and portal vein obstruction. Increased portal pressure results in variceal formation along the gastrointestinal (GI) tract resulting in major bleeding. Identifying children with significant PHT who are more likely to suffer GI bleeding has been challenging and the role of surveillance upper GI endoscopy has been debated. This review analyses research done on serum biomarkers and imaging techniques as possible predictors of significant PHT. We evaluated the research performed on adult population, as well as the limited work done on children, to identify promising areas for future research. A literature search was conducted on "PubMed." Several search terms were used including "portal hypertension," "paediatric portal hypertension," "non-invasive markers of portal hypertension," "spleen stiffness," "liver stiffness," "elastography," and "endothelial damage." The articles included were selected based on their relevance to the purpose of our review. The research suggests a combination of several biomarkers, in addition to an imaging technique such as transient elastography or magnetic resonance elastography, would allow for the best prediction of significant varices. The most promising indicators would be those that are applicable in both intra- and extra-hepatic causes of PHT. Further research on these predictors in children with PHT is required to determine their potential role as selection criteria for PHT and stratification of surveillance GI endoscopies.
    MeSH term(s) Adult ; Biomarkers/blood ; Child ; Elasticity Imaging Techniques/methods ; Humans ; Hypertension, Portal/blood ; Hypertension, Portal/diagnosis ; Liver/diagnostic imaging ; Liver/pathology ; Magnetic Resonance Imaging/methods ; Spleen/diagnostic imaging ; Spleen/pathology ; Ultrasonography/methods
    Chemical Substances Biomarkers
    Language English
    Publishing date 2018-01-11
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 603201-1
    ISSN 1536-4801 ; 0277-2116
    ISSN (online) 1536-4801
    ISSN 0277-2116
    DOI 10.1097/MPG.0000000000001882
    Database MEDical Literature Analysis and Retrieval System OnLINE

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