Browsing by Person "Cetnarskyj, Roseanne"

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Cirrhosis Screening with a Portable Fibroscan Device in a Community Alcohol Support Service: Feasibility Study
(BMJ Publishing Group Ltd, 2016-06) Matthews, Karen; MacGilchrist, Andrew; Smith, Margaret Coulter; Cetnarskyj, Roseanne
Alcohol misuse is the major cause of the increase in deaths from liver disease in the UK,1 particularly in Scotland2 and particularly in areas of social deprivation. Liver disease usually presents late, with advanced liver disease and cirrhosis often asymptomatic.3 Patients with alcohol misuse in areas of social deprivation are a hard to reach- population. This study assessed the feasibility of using a portable Fibroscan to measure transient elastography (TE), a non-invasive method of assessing hepatic fibrosis, as a screening tool within a community alcohol support service.
A nurse‐led FibroScan® outreach clinic encourages socially deprived heavy drinkers to engage with liver services
(Wiley, 2018-09-05) Matthews, Karen; MacGilchrist, Alastair; Smith, Margaret Coulter; Jones, Jacklyn; Cetnarskyj, Roseanne
Aims and objectives To determine whether a portable FibroScan® device can be an acceptable screening tool for chronic liver disease in a community alcohol support service, through recording uptake, determining apparent prevalence of undiagnosed fibrosis/cirrhosis in participants and report engagement following referral to specialist liver services of those individuals referred because of a FibroScan® reading ≥ 7.1 kilopascals (kPa). Background Alcohol‐related liver disease, including cirrhosis, is a major cause of death in the UK. Liver disease is silent and usually presents late. Socially deprived patients with alcohol‐related liver disease are a “hard to engage” population and at higher risk of death than less deprived. A FibroScan® device is a non‐invasive tool for measuring liver stiffness. A result of ≥7.1 kPa can indicate possible chronic liver disease. Design Prospective observational study. Method Individuals who self‐identified as harmful drinkers were recruited. Consented individuals attended for a liver FibroScan®. Those with a reading ≥7.1 kPa were referred to a nurse‐led liver clinic for further investigations, results of which determined referral to a liver specialist in secondary care. Participants referred were monitored for compliance over a 6‐month period. Results Seventy‐nine consented individuals participated, an uptake of 67% of those informed of the study. Of the 79 scans performed, three were unreliable leaving 76 participants. After scanning, 20/76 (26%) had a FibroScan® ≥7.1 kPa requiring referral on to the nurse‐led clinic. All 20 (100%) engaged in further assessment. Of those, 12 required onward referral to specialist services. Subsequent compliance with specialist services in this sample (n = 12) was ≥90%. Conclusion A nurse‐led FibroScan® outreach clinic encourages socially deprived drinkers to engage with liver services. Relevance to clinical practice A 67% uptake suggests a nurse‐led FibroScan® service in a community alcohol service is acceptable. High engagement gives potential for early intervention and improved health outcomes. What does this paper contribute to the wider global clinical community? Findings from this study should instil confidence in centres planning to deliver early intervention through nurse‐led screening for chronic liver disease with a portable FibroScan® device in community settings. These findings should inform future research in this area.
Referrals of patients to colorectal cancer genetics services in south-east Scotland
(Springer, 2005) Holloway, Susan; Porteous, Mary; Cetnarskyj, Roseanne; Rush, Robert; Appleton, Sally; Gorman, Dermot; Campbell, Harry
The discovery that genetic factors are involved in the aetiology of colorectal cancer, has prompted many relatives of affected individuals to seek genetic counselling and screening. This paper describes the demand for genetic services by families with colorectal cancer in south-east Scotland, their expectations and views of the service offered. The annual referral rate over the 21-month study period, for patients with a family history of colorectal cancer, was 0.11 per 1000 patients on general practitioner lists. This is one third of the rate for patients with a family history of breast cancer and in comparison with the breast cancer group, relatives of colorectal cancer patients were significantly older and less socially deprived. Approximately one third were referred via a hospital specialist unit. One hundred patients were included in the study. Mean (± standard deviation) age was 43 (± 10.7 years), 75 were female and 31 were self referrals. Before the consultation, almost half the patients had an inflated perception of their risk and there was little change at follow-up. There was an improvement in objective understanding after counselling which was sustained up to 6 months but only two thirds remembered their objective risk accurately. Most patients were satisfied with the consultation. Our findings suggest the need to educate individuals, in particular men, younger people and the more socially deprived, about the relevance of a family history of colorectal cancer and to facilitate patients’ comprehension of their risk status.