Publications
700 results found
Cemente A, Atkinson S, Tyson LD, et al., 2020, EARLY ALCOHOL RELAPSE AFTER AN EPISODE OF ALCOHOL-INDUCED HEPATITIS (AH): PREVALENCE, IMPACT ON LIVER FUNCTION, GENETIC AND NON -GENETIC FACTORS AND IDENTIFICATION OF DISTINCT RISK PROFILES., Liver Meeting of the American-Association-for-the-Study-of-Liver-Diseases (AASLD), Publisher: WILEY, Pages: 158A-159A, ISSN: 0270-9139
Arraez DM, Cots MV, Altamirano J, et al., 2020, A LARGE WORLDWIDE STUDY SHOWS THAT MELD IS THE BEST SCORING SYSTEM TO PREDICT MORTALITY IN ALCOHOL-ASSOCIATED HEPATITIS, Liver Meeting of the American-Association-for-the-Study-of-Liver-Diseases (AASLD), Publisher: WILEY, Pages: 148A-149A, ISSN: 0270-9139
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- Citations: 1
Atkinson SR, Grove JI, Liebig S, et al., 2020, In severe alcoholic hepatitis, serum keratin-18 fragments are diagnostic, prognostic, and theragnostic biomarkers., American Journal of Gastroenterology, Vol: 115, Pages: 1857-1868, ISSN: 0002-9270
INTRODUCTION: Up to 40% of patients with severe alcoholic hepatitis (AH) die within 6 months of presentation, making prompt diagnosis and appropriate treatment essential. We determined the associations between serum keratin-18 (K18) and histological features, prognosis, and differential response to prednisolone in patients with severe AH. METHODS: Total (K18-M65) and caspase-cleaved K18 (K18-M30) were quantified in pretreatment sera from 824 patients enrolled in the Steroids or Pentoxifylline for Alcoholic Hepatitis trial (87 with suitable histological samples) and disease controls. RESULTS: K18 fragments were markedly elevated in severe AH and strongly predicted steatohepatitis (alcoholic steatohepatitis) on biopsy (area under receiver operating characteristics: 0.787 and 0.807). Application of published thresholds to predict alcoholic steatohepatitis would have rendered biopsy unnecessary in 84% of all AH cases. K18-M30 and M65 were associated with 90-day mortality, independent of age and Model for End-stage Liver Disease score in untreated patients. The association for K18-M65 was independent of both age and Model for End-stage Liver Disease in prednisolone-treated patients. Modelling of the effect of prednisolone on 90-day mortality as a function of pretreatment serum K18 levels indicated benefit in those with high serum levels of K18-M30. At low pretreatment serum K18 levels, prednisolone was potentially harmful. A threshold of K18-M30 5 kIU/L predicted therapeutic benefit from prednisolone above this level (odds ratio: 0.433, 95% confidence interval: 0.19-0.95, P = 0.0398), but not below (odds ratio: 1.271, 95% confidence interval: 0.88-1.84, P = 0.199). Restricting prednisolone usage to the former group would have reduced exposure by 87%. DISCUSSION: In a large cohort of patients with severe AH, serum K18 strongly correlated with histological severity, independently associated with 90-day mortality, and predicted response to prednisolone therapy. Quantificati
Skinner C, Thompson AJ, Thursz MR, et al., 2020, Intestinal permeability and bacterial translocation in patients with liver disease, focusing on alcoholic aetiology: methods of assessment and therapeutic intervention, Therapeutic Advances in Gastroenterology, Vol: 13, Pages: 1-16, ISSN: 1756-2848
Increased bacterial translocation (BT) across the gut barrier due to greater intestinal permeability (IP) is seen across a range of conditions, including alcohol-related liver disease (ArLD). The phenomenon of BT may contribute to both the pathogenesis and the development of complications in ArLD. There are a number of methods available to assess IP and in this review we look at their various advantages and limitations. The knowledge around BT and IP in ArLD is also reviewed, as well as the therapeutic strategies currently in use and in development.
Forlano R, Mullish BH, Mukherjee SK, et al., 2020, In-hospital mortality is associated with inflammatory response in NAFLD patients admitted for COVID-19, PLoS One, Vol: 15, ISSN: 1932-6203
Background & aimsAlthough metabolic risk factors are associated with more severe COVID-19, there is little evidence on outcomes in patients with non-alcoholic fatty liver disease (NAFLD). We here describe the clinical characteristics and outcomes of NAFLD patients in a cohort hospitalised for COVID-19.MethodsThis study included all consecutive patients admitted for COVID-19 between February and April 2020 at Imperial College Healthcare NHS Trust, with either imaging of the liver available dated within one year from the admission or a known diagnosis of NAFLD. Clinical data and early weaning score (EWS) were recorded. NAFLD diagnosis was based on imaging or past medical history and patients were stratified for Fibrosis-4 (FIB-4) index. Clinical endpoints were admission to intensive care unit (ICU)and in-hospital mortality.Results561 patients were admitted. Overall, 193 patients were included in the study. Fifty nine patients (30%) died, 9 (5%) were still in hospital, and 125 (65%) were discharged. The NAFLD cohort (n = 61) was significantly younger (60 vs 70.5 years, p = 0.046) at presentation compared to the non-NAFLD (n = 132). NAFLD diagnosis was not associated with adverse outcomes. However, the NAFLD group had higher C reactive protein (CRP) (107 vs 91.2 mg/L, p = 0.05) compared to non-NAFLD(n = 132). Among NAFLD patients, male gender (p = 0.01), ferritin (p = 0.003) and EWS (p = 0.047) were associated with in-hospital mortality, while the presence of intermediate/high risk FIB-4 or liver cirrhosis was not.ConclusionThe presence of NAFLD per se was not associated with worse outcomes in patients hospitalised for COVID-19. Though NAFLD patients were younger on admission, disease stage was not associated with clinical outcomes. Yet, mortality was associated with gender and a pronounced inflammatory response in the NAFLD group.
Daunt A, Perez-Guzman PN, Liew F, et al., 2020, Validity of the UK early access to medicines scheme criteria for Remdesivir use in patients with COVID-19 disease, Journal of Infection, Vol: 81, Pages: 666-668, ISSN: 0163-4453
Forlano R, Mullish B, Mukherjee S, et al., 2020, 450 - In-hospital mortality is associated with inflammatory response in NAFLD patients admitted for COVID-19, Hepatology, Vol: 72, Pages: 282A-283A, ISSN: 0270-9139
Kim JU, Majid A, Judge R, et al., 2020, Effect of COVID-19 lockdown on alcohol consumption in patients with pre-existing alcohol use disorder, LANCET GASTROENTEROLOGY & HEPATOLOGY, Vol: 5, Pages: 886-+
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- Citations: 124
Pedrana A, Howell J, Scott N, et al., 2020, Global hepatitis C elimination: an investment framework, LANCET GASTROENTEROLOGY & HEPATOLOGY, Vol: 5, Pages: 927-939
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- Citations: 19
Hanley B, Naresh KN, Roufosse C, et al., 2020, Histopathological findings and viral tropism in UK patients with severe fatal COVID-19: a post-mortem study, The Lancet Microbe, Vol: 1, Pages: e245-e253, ISSN: 2666-5247
BackgroundSevere COVID-19 has a high mortality rate. Comprehensive pathological descriptions of COVID-19 are scarce and limited in scope. We aimed to describe the histopathological findings and viral tropism in patients who died of severe COVID-19.MethodsIn this case series, patients were considered eligible if they were older than 18 years, with premortem diagnosis of severe acute respiratory syndrome coronavirus 2 infection and COVID-19 listed clinically as the direct cause of death. Between March 1 and April 30, 2020, full post-mortem examinations were done on nine patients with confirmed COVID-19, including sampling of all major organs. A limited autopsy was done on one additional patient. Histochemical and immunohistochemical analyses were done, and histopathological findings were reported by subspecialist pathologists. Viral quantitative RT-PCR analysis was done on tissue samples from a subset of patients.FindingsThe median age at death of our cohort of ten patients was 73 years (IQR 52–79). Thrombotic features were observed in at least one major organ in all full autopsies, predominantly in the lung (eight [89%] of nine patients), heart (five [56%]), and kidney (four [44%]). Diffuse alveolar damage was the most consistent lung finding (all ten patients); however, organisation was noted in patients with a longer clinical course. We documented lymphocyte depletion (particularly CD8-positive T cells) in haematological organs and haemophagocytosis. Evidence of acute tubular injury was noted in all nine patients examined. Major unexpected findings were acute pancreatitis (two [22%] of nine patients), adrenal micro-infarction (three [33%]), pericarditis (two [22%]), disseminated mucormycosis (one [10%] of ten patients), aortic dissection (one [11%] of nine patients), and marantic endocarditis (one [11%]). Viral genomes were detected outside of the respiratory tract in four of five patients. The presence of subgenomic viral RNA transcripts provided evidence of
Maurice J, Lett A, Skinner C, et al., 2020, Transcutaneous fluorescence spectroscopy as a tool for non-invasive monitoring of gut function: first clinical experiences, Scientific Reports, Vol: 10, ISSN: 2045-2322
Gastro-intestinal function plays a vital role in conditions ranging from inflammatory bowel disease and HIV through to sepsis and malnutrition. However, the techniques that are currently used to assess gut function are either highly invasive or unreliable. Here we present an alternative, non-invasive sensing modality for assessment of gut function based on fluorescence spectroscopy. In this approach, patients receive an oral dose of a fluorescent contrast agent and a fibre-optic probe is used to make fluorescence measurements through the skin. This provides a readout of the degree to which fluorescent dyes have permeated from the gut into the blood stream. We present preliminary results from our first measurements in human volunteers demonstrating the potential of the technique for non-invasive monitoring of multiple aspects of gastro-intestinal health.
Martinez-Gili L, McDonald JAK, Liu Z, et al., 2020, Understanding the mechanisms of efficacy of fecal microbiota transplant in treating recurrent Clostridioides difficile infection and beyond: the contribution of gut microbial derived metabolites, Gut Microbes, Vol: 12, ISSN: 1949-0976
Fecal microbiota transplant (FMT) is a highly-effective therapy for recurrent Clostridioides difficile infection (rCDI), and shows promise for certain non-CDI indications. However, at present, its mechanisms of efficacy have remained poorly understood. Recent studies by our laboratory have noted the particular key importance of restoration of gut microbe-metabolite interactions in the ability of FMT to treat rCDI, including the impact of FMT upon short chain fatty acid (SCFAs) and bile acid metabolism. This includes a significant impact of these metabolites upon the life cycle of C. difficile directly, along with potential postulated additional benefits, including effects upon host immune response. In this Addendum, we first present an overview of these recent advancements in this field, and then describe additional novel data from our laboratory on the impact of FMT for rCDI upon several gut microbial-derived metabolites which had not previously been implicated as being of relevance.
Lazarus JV, Picchio CA, Nayagam S, et al., 2020, Strengthening vaccine confidence during the COVID-19 pandemic: A new opportunity for global hepatitis B virus elimination, JOURNAL OF HEPATOLOGY, Vol: 73, Pages: 490-492, ISSN: 0168-8278
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- Citations: 4
Bernsmeier C, Cavazza A, Fatourou EM, et al., 2020, Leucocyte ratios are biomarkers of mortality in patients with acute decompensation of cirrhosis and acute-on-chronic liver failure, ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Vol: 52, Pages: 855-865, ISSN: 0269-2813
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- Citations: 25
Kaura A, Sterne J, Trickey A, et al., 2020, Invasive versus non-invasive management of elderly patients with non-ST elevation myocardial infarction: cohort study based on routine clinical data, The Lancet, Vol: 396, Pages: 623-634, ISSN: 0140-6736
BackgroundPrevious trials suggest lower long-term mortality after invasive rather than non-invasive management among patients with non-ST elevation myocardial infarction (NSTEMI), but these excluded very elderly patients.MethodsWe estimated the effect of invasive versus non-invasive management within 3 days of peak troponin on survival in NSTEMI patients aged ≥80 years, using routine clinical data collected during 2010–2017 (NIHR Health Informatics Collaborative). Propensity scores based on pre-treatment variables were derived using logistic regression; patients with high probabilities of non-invasive or invasive management were excluded. Patients who died within 3 days without receiving invasive management were assigned to the invasive or non-invasive management groups based on their propensity scores, to mitigate immortal time bias. We estimated mortality hazard ratios comparing invasive with non-invasive management, and also compared rates of hospital admission for heart failure.FindingsOf 1976 patients with NSTEMI, 101 died within 3 days of their peak troponin, whilst 375 were excluded because of extreme propensity scores. The remaining 1500 patients (56% non-invasive management) had a median age 86 (IQR 82-89) years. During median follow-up of 3.0 (IQR 1.2-4.8) years, there were 613 (41%) deaths. Using inverse probability weighting, adjusted cumulative 5-year mortality was 36% and 55% in the invasive and non-invasive management groups, respectively. The mortality hazard ratio comparing invasive with non-invasive management was 0.64 (95% CI 0.52-0.79) after multivariable adjustment for clinical characteristics and propensity score and inclusion of patients who died within three days. Invasive management was associated with lower incidence of hospital admissions for heart failure (adjusted rate ratio compared with non-invasive management 0.67, 95% CI 0.48–0.93).
Perez Guzman PN, Daunt A, Mukherjee S, et al., 2020, Clinical characteristics and predictors of outcomes of hospitalized patients with COVID-19 in a multi-ethnic London NHS Trust: a retrospective cohort study, Clinical Infectious Diseases, Vol: 2020, Pages: 1-11, ISSN: 1058-4838
Background: Emerging evidence suggests ethnic minorities are disproportionatelyaffected by COVID-19. Detailed clinical analyses of multi-cultural hospitalized patientcohorts remain largely undescribed.Methods: We performed regression, survival andcumulative competing risk analyses to evaluate factors associated with mortality inpatients admitted for COVID-19 in three large London hospitals between February 25and April 5, censored as of May 1, 2020.Results: Of 614 patients (median age 69years, (IQR 25) and 62% male), 381 (62%) had been discharged alive, 178 (29%)died and 55 (9%) remained hospitalized at censoring. Severe hypoxemia (aOR 4.25,95%CI 2.36-7.64), leukocytosis (aOR 2.35, 95%CI 1.35-4.11), thrombocytopenia (aOR1.01, 95%CI 1.00-1.01, increase per 10x9decrease), severe renal impairment (aOR5.14, 95%CI 2.65-9.97), and low albumin (aOR 1.06, 95%CI 1.02-1.09, increase per gdecrease) were associated with death. Forty percent (244) were from black, Asian andother minority ethnic (BAME) groups, 38% (235) white and for 22% (135) ethnicity wasunknown. BAME patients were younger and had fewer comorbidities. Whilst theunadjusted odds of death did not differ by ethnicity, when adjusting for age, sex andcomorbidities, black patients were at higher odds of death compared to whites (aOR1.69, 95%CI 1.00-2.86). This association was stronger when further adjusting foradmission severity (aOR 1.85 95% CI 1.06-3.24). Conclusions: BAME patients were over-represented in our cohort and, whenaccounting for demographic and clinical profile of admission, black patients were atincreased odds of death. Further research is needed into biologic drivers of differencesin COVID-19 outcomes by ethnicity.
Mohamed Z, Scott N, Al-Kurdi D, et al., 2020, Cost-effectiveness of strategies to improve HCV screening, linkage-to-care and treatment in remand prison settings in England., Liver International, Vol: 40, Pages: 2950-2960, ISSN: 1478-3223
BACKGROUND: A simplified cascade-of-care may improve screening and treatment uptake among incarcerated individuals. We assessed the cost-effectiveness of traditional and simplified screening and treatment in a London remand prison. METHODS: Using empirical data from Her Majesty's Prison (HMP) Wormwood Scrubs, London, we designed a decision tree and Markov transition state model using national average data for HCV screening and treatment for the base-case scenario. This was compared two alternative strategies; (1) general prison population screening and treatment and (2) prioritising screening and treatment among people who inject drugs (PWID) combined with general prison population screening and treatment. Strategies varied the rates of screening (47-90%), linkage-to-care (60-86%) and treatment (21-85%). Cost, utility and disease transition rates were obtained from existing literature. Outcome measures were; screening, treatment and disease-related costs per admitted individual, quality-adjusted life years (QALYs). Incremental cost-effectiveness ratios (ICERs) were calculated for each intervention. All costs and utilities were discounted at a rate of 3.5% per annum. Both univariate and probabilistic sensitivity analyses have been conducted. RESULTS: In our cohort of 5,239 incarcerated individuals with an estimated chronic HCV prevalence of 2.6%, all strategy ICER values (£3,565-10,300) fell below the national willingness to pay threshold (£30,000). Increased successful treatment (7-54%) was observed by an optimising cascade-of-care. A robust sensitivity analysis identified treatment cost of, QALY for mild liver disease and probability of completing treatment as important factors that impact the ICER value. CONCLUSION: In our remand setting, optimising adherence to the cascade-of-care is cost-effective. Where universal screening is not practical, a stratified approach focused on intensive screening and treatment of PWID also results in increased treatment
Forlano R, Mullish BH, Giannakeas N, et al., 2020, High-throughput, machine learning-based quantification of steatosis, inflammation, ballooning, and fibrosis in biopsies from patients with nonalcoholic fatty liver disease, Clinical Gastroenterology and Hepatology, Vol: 18, Pages: 2081-2090.e9, ISSN: 1542-3565
Background & AimsLiver biopsy is the reference standard for staging and grading non-alcoholic fatty liver disease (NAFLD), but histologic scoring systems are semi-quantitative with marked inter- and intra-observer variation. We used machine learning to develop fully automated software for quantification of steatosis, inflammation, ballooning, and fibrosis in biopsies from patients with NAFLD and validated the technology in a separate group of patients.MethodsWe collected data from 246 consecutive patients with biopsy-proven NAFLD and followed in London, the United Kingdom, from January 2010 through December 2016. Biopsies from the first 100 patients were used to derive the algorithm and biopsies from the following 146 were used to validate it. Biopsies were independently scored by pathologists using the nonalcoholic steatohepatitis clinical research network criteria and digitalized. Areas of steatosis, inflammation, ballooning, and fibrosis were annotated on biopsies by 2 hepatobiliary histopathologists to facilitate machine learning. Images of biopsies from the derivation and validation sets were then analyzed by the algorithm to compute percentages of fat, inflammation, ballooning, and fibrosis, as well as collagen proportionate area (CPA), and compared with findings from pathologists’ manual annotations and conventional scoring systems.ResultsIn the derivation group, results from manual annotation and the software had an inter-class correlation coefficient (ICC) of 0.97 for steatosis (95%CI, 0.95–0.99; P<.001); ICC, 0.96 for inflammation (95%CI, 0.9–0.98; P<.001); ICC, 0.94 for ballooning (95%CI, 0.87–0.98; P<.001); and ICC, 0.92 for fibrosis (95%CI, 0.88–0.96; P=.001). Percentages of fat, inflammation, ballooning, and CPA from the derivation group were confirmed in the validation cohort. The software identified histological features of NAFLD with levels of inter- and intra-observer agreement ranging from 0.95 to 0.99; t
Dhanda A, Atkinson S, Vergis N, et al., 2020, Trace element deficiency is highly prevalent and associated with infection and mortality in patients with alcoholic hepatitis, ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Vol: 52, Pages: 537-544, ISSN: 0269-2813
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- Citations: 14
Guldiken N, Argemi J, Gurbuz B, et al., 2020, Serum transferrin levels reflect hepatocyte nuclear factor 4 alpha activity in the liver, Publisher: ELSEVIER, Pages: S246-S246, ISSN: 0168-8278
Atkinson S, Buckley T, Strnad P, et al., 2020, Genetic variation in HSD17B3 reduces the risk for developing severe alcoholic hepatitis, Publisher: ELSEVIER, Pages: S61-S62, ISSN: 0168-8278
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- Citations: 4
Atkinson S, Grove J, Liebig S, et al., 2020, In alcoholic hepatitis, cytokeratin 18 serum fragments reflect its severity and predict responsiveness to prednisolone, Publisher: ELSEVIER, Pages: S179-S179, ISSN: 0168-8278
Angelis A, Thursz M, Ratziu V, et al., 2020, Early Health Technology Assessment during Nonalcoholic Steatohepatitis Drug Development: A Two-Round, Cross-Country, Multicriteria Decision Analysis, MEDICAL DECISION MAKING, Vol: 40, Pages: 830-845, ISSN: 0272-989X
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- Citations: 6
Cohen D, Ghosh S, Shimakawa Y, et al., 2020, Hepatitis B virus preS2 Delta 38-55 variants: A newly identified risk factor for hepatocellular carcinoma, JHEP Reports, Vol: 2, ISSN: 2589-5559
Background & AimsAlthough HBV is a major cause of death in Africa, its genetic variability has been poorly documented. This study aimed to address whether HBV genotype and surface gene variants are associated with HBV-related liver disease in The Gambia.MethodsWe conducted a case-control study nested in the Prevention of Liver Fibrosis and Cancer in Africa programme. Consecutive treatment-naive patients with chronic HBV infection and detectable viral load were recruited: 211 controls with no significant liver disease and 91 cases (56 cirrhosis and 35 HCC cases). HBV genotypes and surface gene variants were determined by Sanger sequencing or next-generation sequencing (NGS) in serum DNA. Aflatoxin B1 (AFB1)-specific codon 249 TP53 mutation was determined by NGS in circulating cell-free plasma DNA.ResultsIn phylogenetic analysis, 85% of individuals carried HBV genotype E, 14% genotype A, and 1% A/E recombinant viruses. Surface gene variants were more frequently observed in cases (43% and 57% in cirrhosis and HCC cases, respectively) than controls (25%; p <0.001), with preS2 deletions between nucleotides 38–55 (preS2Δ38–55) being the main genetic variant detected. In multivariable analysis, HBeAg seropositivity, low HBsAg levels, and HDV seropositivity were significantly associated with cirrhosis and HCC, whilst older age, higher viral load, genotype A, preS2Δ38–55, and AFB1 exposure were only associated with HCC. There was a multiplicative joint effect of preS2Δ38–55 variants with HBeAg seropositivity (odds ratio [OR] 43.1 [10.4–177.7]), high viral load >2,000 IU/ml (OR 22.7 [8.0–64.9]), HBsAg levels <10,000 IU/ml (OR 19.0 [5.5–65.3]), and AFB1 exposure (OR 29.3 [3.7–230.4]) on HCC risk.ConclusionsThis study identified a hotspot for HBV preS2 deletions as a strong independent factor for HCC in The Gambia, with HBV genotypes and AFB1 exposure contributing to the high liver cancer risk.
Atkinson SR, Thursz MR, Strnad P, 2020, Response to Sainath et al., Am J Gastroenterol, Vol: 115, Pages: 1136-1137
Atkinson SR, Thursz MR, Strnad P, 2020, Serum Transferrin Is an Independent Predictor of Mortality in Severe Alcoholic Hepatitis: Upping the Game or Just Upping the Ante? Response, AMERICAN JOURNAL OF GASTROENTEROLOGY, Vol: 115, Pages: 1136-1137, ISSN: 0002-9270
Atkinson SR, Thursz MR, Strnad P, 2020, Is Serum Transferrin an Independent Predictor of Mortality in Severe Alcoholic Hepatitis? Response, AMERICAN JOURNAL OF GASTROENTEROLOGY, Vol: 115, Pages: 958-958, ISSN: 0002-9270
Zhou H, Sealock JM, Sanchez-Roige S, et al., 2020, Genome-wide meta-analysis of problematic alcohol use in 435,563 individuals yields insights into biology and relationships with other traits, Nature Neuroscience, Vol: 23, Pages: 809-818, ISSN: 1097-6256
Problematic alcohol use (PAU) is a leading cause of death and disability worldwide. Although genome-wide association studies have identified PAU risk genes, the genetic architecture of this trait is not fully understood. We conducted a proxy-phenotype meta-analysis of PAU, combining alcohol use disorder and problematic drinking, in 435,563 European-ancestry individuals. We identified 29 independent risk variants, 19 of them novel. PAU was genetically correlated with 138 phenotypes, including substance use and psychiatric traits. Phenome-wide polygenic risk score analysis in an independent biobank sample (BioVU, n = 67,589) confirmed the genetic correlations between PAU and substance use and psychiatric disorders. Genetic heritability of PAU was enriched in brain and in conserved and regulatory genomic regions. Mendelian randomization suggested causal effects on liability to PAU of substance use, psychiatric status, risk-taking behavior and cognitive performance. In summary, this large PAU meta-analysis identified novel risk loci and revealed genetic relationships with numerous other traits.
Martinez-Gili L, McDonald JA, Liu Z, et al., 2020, 644 identification of novel changes in microbially-derived metabolites after fecal microbiota transplant for recurrent clostridioides difficile infection, Publisher: Elsevier BV, Pages: S-138-S-139, ISSN: 0016-5085
Ghani R, Mullish BH, McDonald JA, et al., 2020, 1144 FECAL MICROBIOTA TRANSPLANT FOR MULTI-DRUG RESISTANT ORGANISMS: IMPROVED CLINICAL OUTCOMES BEYOND INTESTINAL DECOLONISATION, Publisher: Elsevier BV, ISSN: 0016-5085
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