Imperial College London

Dr Vassiliki Bravis

Faculty of MedicineDepartment of Metabolism, Digestion and Reproduction

Honorary Clinical Research Fellow
 
 
 
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Contact

 

+44 (0)20 3312 5944v.bravis

 
 
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Location

 

CL52FMint WingSt Mary's Campus

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Summary

 

Publications

Publication Type
Year
to

39 results found

Humphreys A, Bravis V, Kaur A, Walkey HC, Godsland IF, Misra S, Johnston DG, Oliver NSet al., 2019, Individual and diabetes presentation characteristics associated with partial remission status in children and adults evaluated up to 12 months following diagnosis of type 1 diabetes: An ADDRESS-2 (After Diagnosis Diabetes Research Support System-2) study analysis, Diabetes Research and Clinical Practice, Vol: 155, ISSN: 0168-8227

AIMS: People with recently-diagnosed type 1 diabetes mellitus (T1D) may undergo a transient period of glycaemic control with less exogenous insulin. Identification of predictors of this 'remission' could inform a better understanding of glycaemic control. METHODS: Participants in the ADDRESS-2 study were included who had 1 or 2 assessments of remission status (coincident insulin dose and HbA1c measurement, with remission defined by ≤0.4 units insulin/kg-body-weight/day with HbA1c < 53 mmol/mol). Demographic and clinical presentation characteristics were compared according to remission status and predictors of remission were explored by logistic regression analysis. RESULTS: 1470 first and 469 second assessments of remission status were recorded within 12 months of diagnosis of T1D. Step increases in the probability of remission were identified at age-at-diagnosis 20 years and 3 months after diagnosis (both p < 0.001). Among those aged < 20 years, remission was associated with male gender (p = 0.02), no ketoacidosis (p = 0.02) and fewer than 2 symptoms at presentation (p = 0.004). None of these characteristics predicted remission in those aged ≥ 20 years. In the subgroup with two assessments, transition to remission was independently associated with first remission assessment in months 1-2 post-diagnosis (p = 0.01), with age-at-diagnosis ≥ 20 years (p = 0.01) and, in those aged < 20 years, with an early HbA1c of <57 mmol/mol. Adiposity, ethnicity, autoantibody status and other autoimmune disease were unrelated to remission. CONCLUSIONS: For those diagnosed before 20 years of age, males, ketoacidosis-free, with fewer symptoms and low early HbA1c were more likely to experience remission, but remission was most likely in anyone aged ≥ 20 at diagnosis.

Journal article

Hirani D, Salem V, Bravis V, 2019, Conservative management of diabetic foot ulceration: Healing, amputation rates and deaths in non-heel and heel wounds presenting to a central London multidisciplinary diabetes foot service, Publisher: WILEY, Pages: 125-125, ISSN: 0742-3071

Conference paper

Dorman E, Salem V, Valabhji J, Bravis Vet al., 2019, Conservative management of diabetic foot ulceration complicated by underlying osteomyelitis, Publisher: WILEY, Pages: 128-128, ISSN: 0742-3071

Conference paper

Rahman S, Salem V, Sangster A, Dunbar J, Arkle T, Bloomfield L, Bravis Vet al., 2019, Do tissue cultures add useful microbial information that changes diabetic foot ulcers management and outcome?, Publisher: WILEY, Pages: 126-126, ISSN: 0742-3071

Conference paper

Normahani P, agrawal R, Bravis V, Falinska A, Bloomfield L, Mehar Z, Gaulton D, Sangster A, Arkle T, Gomm C, Aslam M, Standfield NJ, Jaffer Uet al., 2018, Effectiveness of a multicenter training programme to teach point-of-care vascular ultrasound for the detection of peripheral arterial disease in people with diabetes, Journal of Foot and Ankle Research, Vol: 11, ISSN: 1757-1146

BackgroundThe primary aim of this study was to evaluate the effectiveness of a training programme to teach a focused bedside ultrasound scan (PAD-scan; Podiatry Ankle Duplex Scan) for the detection of arterial disease in people with diabetes.MethodsFive podiatrists and one diabetologist across two hospitals were enrolled in a structured training programme consisting of a training course (1-day), supervised scanning (5-weeks), independent scanning (3-weeks) and a final evaluation of performance (1-day).Time, technical skills (Duplex Ultrasound Objective Structured Assessment of Technical Skills tool (DUOSATS); minimum score = 6, maximum score = 26) and accuracy (level of agreement with vascular scientist PAD-scan assessment) were assessed for every supervised scan and again for the final evaluation of performance.ResultsA total of 90 PAD-scans in 65 patients were performed during the supervised phase. Participants demonstrated significant improvements in median time (19 min(IQR 13.9–25.5) vs 9.3 min (IQR 7.3–10.5); p = 0.028) and DUOSATS scores (17.5 (IQR 16.8–21) vs 25 (IQR 24–25.3); p = 0.027). At the final evaluation, participants completed scans in 5.4 min (IQR 5.3–5.9), achieved full DUOSAT scores and perfect agreement with the vascular scientist.ConclusionA structured training programme, integrated into diabetic foot clinics, was effective in teaching the PAD-scan

Journal article

Walkey HC, Bravis V, Akaal K, Godsland I, Misra S, Williams AJK, Bingley PJ, Dunger DB, Dayan CM, Peakman M, Oliver N, Johnston Det al., 2018, The relationship between islet autoantibody status and the clinical characteristics of children and adults with incident type 1 diabetes in a UK cohort, BMJ Open, Vol: 8, ISSN: 2044-6055

Objectives:Todescribethecharacteristicsofchildrenandadultswithincidenttype1diabetesincontemporary,multi-ethnicUK,focusingondifferencesbetweentheisletautoantibodynegativeandpositive.Design:Observationalcohortstudy.Setting:146mainlysecondarycarecentresacrossEnglandandWales.Participants:3,312peopleaged≥5yearswererecruitedwithin6monthsofaclinicaldiagnosisoftype1diabetesviatheNationalInstituteforHealthResearchClinicalResearchNetwork.3,021wereofwhiteEuropeanethnicityand291(9%)werenon-white.Therewasasmallmalepredominance(57%).Youngpeople<17yearscomprised59%.Mainoutcomemeasures:Autoantibodystatusandcharacteristicsatpresentation.Results:Themajoritypresentedwithclassicalosmoticsymptoms,weightloss,andfatigue.Ketoacidosiswascommon(42%),especiallyinadults,andirrespectiveofethnicity.35%wereoverweightorobese.Ofthe1,778participantswhodonatedabloodsample,85%werepositiveforoneormoreautoantibodiesagainstglutamatedecarboxylase,isletantigen-2,andzinctransporter8.Presentingsymptomsweresimilarintheautoantibodypositiveandnegativeparticipants,aswasthefrequencyofketoacidosis(43%vs40%,p=0·3).Autoantibodypositivitywaslesscommonwithincreasingage(p=0·0001),inmalescomparedwithfemales(82%vs90%,p<0·0001)andinpeopleofnon-whitecomparedwithwhiteethnicity(73%vs86%,p<0·0001).Bodymassindexwashigherinautoantibodynegativethanpositiveadults(median,IQR25·5,23·1-29·2vs23·9,21·4-26·7kg/m2;p=0·0001).Autoantibodynegativeparticipants weremorelikelytohaveaparentwithdiabetes(28%vs16%,p<0·0001)andlesslikelytohaveanotherautoimmunedisease(4%vs8%,p=0.01).Conclusions:Mostpeopleassignedadiagnosisoftype1diabetespresentedwithclassicalclinicalfeaturesandisletautoantibodies.Althoughindistinguishableatanindividuallevel,autoantibodynegativeparticipantsasagroupdemonstratedfeaturesmoretypicallyassociatedwithotherdiabetessubtypes.

Journal article

Arkle T, Rosenfeld P, Valabhji J, Bloomfield LM, Sangster A, Dunbar J, Vakilgilani T, Bravis Vet al., 2018, Calcification: A sequelae of corticosteroid injection in the treatment of Morton's neuroma in a patient with diabetes, Diabetes UK, Publisher: WILEY, Pages: 103-104, ISSN: 0742-3071

Conference paper

Sangster AJ, Rosenfeld P, Valabhji J, Bloomfield L, Arkle T, Vakilgilani T, Bravis V, Dunbar Jet al., 2018, Transient migratory osteoporosis: A rare differential diagnosis to Charcot foot, Diabetes UK, Publisher: WILEY, Pages: 103-103, ISSN: 0742-3071

Conference paper

Dunbar J, Bloomfield LM, Sangster AJ, Arkle T, Valabhji J, Bravis V, Vakilgilani Tet al., 2018, Gram-negative pathogens: Does superficial wound sampling miss the culprit?, Diabetes UK, Publisher: WILEY, Pages: 103-103, ISSN: 0742-3071

Conference paper

Hirani D, Bloomfield L, Valabhji J, Salem V, Bravis Vet al., 2017, Should calcaneal ulcers be managed in a class of their own?, 53rd Annual Meeting of the European-Association-for-the-Study-of-Diabetes (EASD), Publisher: SPRINGER, Pages: S467-S468, ISSN: 0012-186X

Conference paper

Walkey HC, Kaur A, Bravis V, Godsland IF, Misra S, Williams AJK, Bingley PJ, Dunger DB, Oliver N, Johnston DGet al., 2017, Rationale and protocol for the After Diabetes Diagnosis REsearch Support System (ADDRESS): an incident and high risk type 1 diabetes UK cohort study., BMJ Open, Vol: 7, ISSN: 2044-6055

INTRODUCTION: Type 1 diabetes is heterogeneous in its presentation and progression. Variations in clinical presentation between children and adults, and with ethnic group warrant further study in the UK to improve understanding of this heterogeneity. Early interventions to limit beta cell damage in type 1 diabetes are undergoing evaluation, but recruitment is challenging. The protocol presented describes recruitment of people with clinician-assigned, new-onset type 1 diabetes to understand the variation in their manner of clinical presentation, to facilitate recruitment into intervention studies and to create an open-access resource of data and biological samples for future type 1 diabetes research. METHODS AND ANALYSIS: Using the National Institute for Health Research Clinical Research Network, patients >5 years of age diagnosed clinically with type 1 diabetes (and their siblings) are recruited within 6 months of diagnosis. Participants agree to have their clinical, laboratory and demographic data stored on a secure database, for their clinical progress to be monitored using information held by NHS Digital, and to be contacted about additional research, in particular immunotherapy and other interventions. An optional blood sample is taken for islet autoantibody measurement and storage of blood and DNA for future analyses. Data will be analysed statistically to describe the presentation of incident type 1 diabetes in a contemporary UK population. ETHICS AND DISSEMINATION: Ethical approval was obtained from the independent NHS Research Ethics Service. Results will be presented at national and international meetings and submitted for publication to peer-reviewed journals.

Journal article

Walkey HC, Kaur A, Godsland IF, Bravis V, Misra S, Williams AJK, Bingley PJ, Dunger DB, Oliver NS, Johnston DGet al., 2017, Clinical presentation and islet autoantibody status in a UK multi-ethnic cohort of children and adults with new-onset Type 1 diabetes-the after diabetes diagnosis research support system-2 (ADDRESS-2), 77th Scientific Sessions of the American-Diabetes-Association, Publisher: American Diabetes Association, Pages: A467-A468, ISSN: 0012-1797

Conference paper

Kaur A, Walkey H, Godsland IF, Bravis V, Misra S, Williams AJK, Bingley PJ, Dunger DB, Oliver NS, Johnston DGet al., 2017, Characteristics Associated with Diabetic Ketoacidosis in Children and Adults Newly Diagnosed with Type 1 Diabetes: Data from the After Diabetes Diagnosis Research Support System (ADDRESS-2) Cohort, 77th Scientific Sessions of the American-Diabetes-Association, Publisher: AMER DIABETES ASSOC, Pages: A467-A467, ISSN: 0012-1797

Conference paper

Kaur A, Walkey H, Bravis V, Misra S, Godsland IF, Oliver NS, Johnston DGet al., 2017, Predictors of glycaemia at the time of diagnosis in people with newly diagnosed Type 1 diabetes: data from the After Diabetes Diagnosis Research Support System (ADDRESS-2) cohort, Diabetes UK Professional Conference 2017, Publisher: Wiley, Pages: 73-73, ISSN: 0742-3071

Conference paper

Nogueira EF, Lim C, Samarasinghe D, Kashef E, Bloomfield L, Kawsar A, Keogh G, Batho E, Ribaroff G, Bravis Vet al., 2017, Staphylococcus aureus sepsis with multi-organ involvement frommetastatic diabetic foot osteomyelitis, DIABETIC MEDICINE, Vol: 34, Pages: 99-99, ISSN: 0742-3071

Journal article

Daunt A, Karia P, Russo E, Gable D, Bravis Vet al., 2017, Inpatient hypoglycaemia management in an inner city London hospital across general medical and surgical specialties, DIABETIC MEDICINE, Vol: 34, Pages: 149-149, ISSN: 0742-3071

Journal article

Leal SA, Bloomfield L, Reed J, Jairam C, Duncan N, Valabhji J, Bravis Vet al., 2017, Stratification of foot ulcer risk in patients with diabetes on renal dialysis therapy at Imperial College Healthcare NHS Trust, London, UK, DIABETIC MEDICINE, Vol: 34, Pages: 89-90, ISSN: 0742-3071

Journal article

Humphreys A, Bravis V, Godsland IF, Kaur A, Johnston DGet al., 2016, Influences on clinical remission after presentation with Type 1 diabetes: an ADDRESS-2 (After Diagnosis Diabetes Research Support System 2) study analysis, Publisher: Wiley, Pages: 24-24, ISSN: 0742-3071

Conference paper

Bravis V, Kaur A, Walkey H, Godsland I, Dayan C, Peakman M, Bingley P, Dunger D, Oliver N, Johnston DGet al., 2016, The effect of ethnicity on the clinical presentation of people with Type 1 diabetes and on humoral autoimmunity of the cohort within ADDRESS-2 (After Diagnosis Diabetes Research Support System 2), Publisher: Wiley, Pages: 25-25, ISSN: 0742-3071

Conference paper

Bravis V, George AB, Poulter C, Sackey A, Smith C, Jairam C, Chahal H, Yee M, Valabhji J, Gable Det al., 2016, Improvement of acute diabetes care through the introduction of a proactive inpatient diabetes service, DIABETIC MEDICINE, Vol: 33, Pages: 151-151, ISSN: 0742-3071

Journal article

George AB, Jairam C, Smith C, Irhuebor N, Poulter C, Sackey A, Oliver N, Gable D, Bravis Vet al., 2016, Prospective review of the incidence of monitoring blood glucose levels in medical and surgical inpatients receiving corticosteroid therapy, DIABETIC MEDICINE, Vol: 33, Pages: 151-152, ISSN: 0742-3071

Journal article

Bravis V, Kaur A, Walkey H, Godsland IF, Dayan C, Peakman M, Bingley PJ, Dunger D, Oliver N, Johnston DGet al., 2015, An incident and high risk Type 1 diabetes cohort, After Diagnosis Diabetes Research Support System (ADDRESS-2): initial clinical description of a multi-ethnic cohort in the UK, Publisher: WILEY-BLACKWELL, Pages: 85-85, ISSN: 0742-3071

Conference paper

Bravis V, Kaur A, Walkey H, Godsland IF, Dayan C, Peakman M, Bingley PJ, Dunger D, Oliver N, Johnston DGet al., 2015, An incident and high risk Type 1 diabetes cohort, After Diagnosis Diabetes Research Support System (ADDRESS-2): description and comparison of clinical characteristics and presentation of patients with and without evidence of humoral autoimmunity, Publisher: WILEY-BLACKWELL, Pages: 86-86, ISSN: 0742-3071

Conference paper

Bravis V, Kaur A, Walkey H, Godsland I, Dayan C, Peakman M, Bingley P, Dunger D, Oliver N, Johnston DGet al., 2015, AN INCIDENT AND HIGH RISK TYPE 1 DIABETES COHORT - ADDRESS-2: CLINICAL PRESENTATION OF A MULTI-ETHNIC COHORT IN THE UK AND EFFECTS OF HUMORAL AUTOIMMUNITY, Publisher: MARY ANN LIEBERT, INC, Pages: A156-A156, ISSN: 1520-9156

Conference paper

Pérez-Pevida B, Sancho L, Guillén Valderrama F, Escalada J, García Velloso MJ, Pascual Corrales E, Gutiérrez-Buey G, Llavero Valero M, Galofré JC, Richter J, Salvador Jet al., 2015, Optimization of metformin discontinuation in diabetic patients explored with 18F-FDG PET/CT, Pages: 1-607

Conference paper

Bravis V, Kaur A, Walkey H, Godsland I, Dayan C, Peakman M, Bingley P, Oliver N, Johnston DGet al., 2014, Ater diagnosis diabetes research support system-2 (ADDRESS-2): clinical presentation of type 1 diabetes in the beginning of the 21st century in a multi-ethnic UK cohort, European Association for the Study of Diabetes, Publisher: SPRINGER, Pages: S127-S128, ISSN: 0012-186X

Conference paper

Fikri R, Bravis V, Gedroyc WM, Rosenfeld P, Gibbs RA, Samarasinghe DG, Oliver N, Valabhji Jet al., 2014, Conservative management of neuropathic heel ulceration with calcaneal osteomyelitis and avulsion fracture in a cohort with diabetic foot disease, DIABETOLOGIA, Vol: 57, Pages: S472-S472, ISSN: 0012-186X

Journal article

Bravis V, Kaur A, Walkey H, Godsland I, Dayan C, Peakman M, Bingley P, Johnston DGet al., 2014, An Incident and High-Risk Type 1 Diabetes Cohort-After Diagnosis Diabetes Research Support System-2 (ADDRESS-2): Key Initial Findings, Publisher: AMER DIABETES ASSOC, Pages: A645-A645, ISSN: 0012-1797

Conference paper

Bravis V, Gedroyc WM, Rosenfeld P, Gibbs RGJ, Samarasinghe DG, Valabhji J, Robinson S, Fikri Ret al., 2014, Successful conservative management of calcaneal osteomyelitis with avulsion fracture in a diabetic cohort, DIABETIC MEDICINE, Vol: 31, Pages: 122-122, ISSN: 0742-3071

Journal article

Hui E, Reddy M, Bravis V, Rahman M, Darko D, Hassanein Met al., 2012, Fasting among pregnant women with diabetes during Ramadan, INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Vol: 66, Pages: 910-911, ISSN: 1368-5031

Journal article

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