David S Sanders

Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England, United Kingdom

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Publications (298)1892.6 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: In view of the increasing popularity of a gluten-free diet, we sought to determine whether there has been a change in awareness of gluten-related disorders (GRD) among the general public and chefs.
    European journal of gastroenterology & hepatology. 08/2014;
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    ABSTRACT: There has been increasing interest in subclassifying irritable bowel syndrome (IBS) to make a positive diagnosis.
    European journal of gastroenterology & hepatology. 07/2014;
  • Imran Aziz, Tim Key, John G Goodwin, David S Sanders
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    ABSTRACT: Duodenal intraepithelial lymphocytosis (D-IEL) is an early marker for celiac disease (CD). However, the majority of cases are due to non-CD-related conditions.
    Journal of clinical gastroenterology. 07/2014;
  • Alimentary Pharmacology & Therapeutics 07/2014; 40(2):215. · 4.55 Impact Factor
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    ABSTRACT: A multidisciplinary panel of 18 physicians and 3 non-physicians from eight countries (Sweden, UK, Argentina, Australia, Italy, Finland, Norway and the USA) reviewed the literature on diagnosis and management of adult coeliac disease (CD). This paper presents the recommendations of the British Society of Gastroenterology. Areas of controversies were explored through phone meetings and web surveys. Nine working groups examined the following areas of CD diagnosis and management: classification of CD; genetics and immunology; diagnostics; serology and endoscopy; follow-up; gluten-free diet; refractory CD and malignancies; quality of life; novel treatments; patient support; and screening for CD.
    Gut 06/2014; · 10.73 Impact Factor
  • European journal of gastroenterology & hepatology 06/2014; 26(6):686-687. · 1.66 Impact Factor
  • Gut 05/2014; · 10.73 Impact Factor
  • American journal of epidemiology 04/2014; · 5.59 Impact Factor
  • P. D. Mooney, K. E. Evans, D. S. Sanders
    Alimentary Pharmacology & Therapeutics 04/2014; 39(8). · 4.55 Impact Factor
  • Imran Aziz, David S Sanders
    Digestive Diseases and Sciences 03/2014; · 2.26 Impact Factor
  • Journal of gastrointestinal and liver diseases: JGLD 03/2014; 23(1):103-4. · 1.86 Impact Factor
  • P D Mooney, D S Sanders
    Alimentary Pharmacology & Therapeutics 03/2014; 39(6):639-40. · 4.55 Impact Factor
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    ABSTRACT: Background Celiac disease (CD) is a common but underdiagnosed condition. A rapid point-of-care test (POCT) could reduce lead times and missed diagnoses. Objective To assess the utility of an immunoglobulin (Ig) A tissue transglutaminase (TTG) antibody POCT in an endoscopic setting. Design Prospective observational study. Setting A single UK university hospital. Patients Patients presenting with suspected CD, known CD, and routine endoscopy for upper GI symptoms. Interventions All patients were tested with POCT, serum TTG, endomysial antibody (EMA), and upper GI endoscopy with duodenal biopsies at the same visit. Main Outcome Measurements Comparison was made with histology in all cases, with villous atrophy regarded as diagnostic of CD. Results A total of 576 patients (63.5% female, mean [± standard deviation] age 49.7 years [± 17.6 years]) were recruited. A total of 523 patients had no prior diagnosis of CD, and 53 patients had known CD coming for reassessment. A total of 117 patients were newly diagnosed with CD, and 82 were positively identified by the POCT. Sensitivity, specificity, positive predictive value, and negative predictive value were 70.1%, 96.6%, 85.4%, and 91.8%, respectively. In comparison, TTG and EMA both performed significantly better than the POCT. Sensitivity and specificity of TTG were 91.0% and 83.5%, respectively, and EMA were 83.8% and 97.5%, respectively. Of patients with known CD coming for reassessment, 26 had villous atrophy, and POCT results were positive in 16 (61.5%). There was poor agreement between POCT and standard serology. Limitations High pre-test probability of CD. Conclusion The performance of this POCT was disappointing compared with standard serology and cannot at present be recommended within the context of an endoscopy unit.
    Gastrointestinal endoscopy 01/2014; · 6.71 Impact Factor
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    ABSTRACT: The term gluten-related disorders (GRD) encompasses a spectrum of systemic autoimmune diseases with diverse manifestations. GRD are characterized by abnormal immunological responsiveness to ingested gluten in genetically susceptible individuals. Celiac disease (CD) or gluten-sensitive enteropathy is only one of a number of GRD. Extraintestinal manifestations include dermatitis herpetiformis (DH) and neurologic dysfunction. Furthermore it is only recently that the concept of extraintestinal manifestations without enteropathy has become accepted. In this chapter we review the spectrum of neurologic manifestations in GRD, discuss recent advances in their diagnosis, and look at their possible pathophysiologic mechanisms.
    Handbook of Clinical Neurology 01/2014; 120:607-19.
  • I. Aziz, M. Hadjivassiliou, D. S. Sanders
    Alimentary Pharmacology & Therapeutics 01/2014; 40(1). · 4.55 Impact Factor
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    ABSTRACT: Introduction The pinnacle for SPRs who undertake research is to initially present in abstract form at national and international meetings and ultimately publish in peer-reviewed journals. We have previously shown that full publication rate from the BSG has ranged from 20.4–55.9%, furthermore the trend over a 15 year period suggests a reduction in full publication rates. There has been no study which assesses the publication rate or utility of regional research meetings in the UK. Our study prospectively presents 10 years of abstract publications rates and qualitative data from the South Yorkshire Regional Gastroenterology meeting (the Bardhan Fellowship).Methods 112 abstracts were presented at the meeting between 2003 and 2012. Abstracts were ranked at each meeting by peer review and the winner awarded a monetary prize. Subsequent full publication rates were determined using Medline searches of peer-reviewed journals. Searches were made firstly by the author’s name, subsidiary authors’, keywords from the abstract titles and personal communication with presenters.Qualitative data collected at each meeting in the form of an evaluation form was also available to provide subjective feedback from attendees on the relevance of the event.Results Overall, 37 (33%) abstracts went on to be published in peer-reviewed journals. Of the 112 abstracts presented, 32 were ranked in the top 3 of their respective meetings, of whom 24 went on to be published in peer-reviewed journals (75%), compared with 13 of the 80 not ranked (16.25%) (p < 0.0001).Ranking within the top 3 resulted in a higher impact factor (median 4.06) publication, compared with those ranked outside the top 3 (2.87) (p < 0.05), and to more rapid publication (12.8 vs. 19.3 months).Qualitative feedback indicated that >95% attendees felt the meeting was educationally beneficial, relevant to their professional development and had encouraged them to participate in research for themselves.Conclusion This is the first study to assess the value of regional SPR meetings. In terms of overall abstract publication rate, the data shows that the Bardhan fellowship is comparable with the BSG. Peer review appears to reliably predict subsequent publication success. Trainees ranked ‘top three’ at the meeting are significantly more likely to publish their work in peer-reviewed journals. Regional meetings can promote research and are a ‘friendly’ environment in which SPR’s can improve their presentation skills and may stimulate them to consider a formal period of research. We would encourage Deanery support for such initiatives.Disclosure of Interest None Declared.
    Gut 01/2014; 63(Suppl 1):A41. · 10.73 Impact Factor
  • PD Mooney, S Wong, A Johnston, DS Sanders
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    ABSTRACT: Introduction Coeliac disease (CD) remains underdiagnosed. Previous studies have shown that up to 13% of patients with CD have undergone a previous gastroscopy where the opportunity to take duodenal biopsies and make a diagnosis had been missed. Clinicians may rely on the presence of endoscopic markers of CD to guide biopsy however these have been shown to lack the required sensitivity. A routine duodenal biopsy approach may solve this problem but this is time consuming and expensive. Methods to improve the macroscopic detection of CD at endoscopy to guide biopsy would seem advantageous. A single trial on I-Scan, a commercially available digital enhancement technique, has shown promising results in identifying markers of villous atrophy. However this was an uncontrolled, unblinded trial in high prevalence population (35% CD). We aimed to assess the utility of I-Scan in a lower prevalence population in a randomised controlled trial.Methods Patients on a single coeliac enriched endoscopy list were randomised into 2 groups. Group 1 standard HD white light endoscopy (WLE) and group 2 WLE plus I-Scan. The presence of endoscopic markers of CD, scalloping, mosaic pattern, nodularity, loss of duodenal folds or increased vascularity was noted throughout the duodenum. All patients received 4 biopsies from the second part of the duodenum and at least 1 biopsy from the bulb. Coeliac serology was taken at the time of endoscopy. Macroscopic markers of CD are compared to the presence of villous atrophy on histology as the gold standard. 3, 10-point likert scales for pain, discomfort and distress were used to assess tolerability.Results 116 patients (66 female, mean age 54.9 SD 17.5) have been recruited to date (55 into group 1 and 61 in group 2). In total 14 (12.1%) new diagnoses of CD have been made. I-Scan appears to enhance the appearance of markers for CD and in a single patient in group 2 CD markers that were not noted to be seen on WLE became apparent. Preliminary results show that endoscopic markers of CD across both groups currently have a sensitivity of 78.6% (48.8 – 94.3), specificity 82.4% (73.3 – 88.9), positive and negative predictive values of 37.9% (21.3 – 57.6) and 96.6 (89.5 – 99.1). Median tolerability scores were good in both groups but better in the I-Scan group than WLE alone (4/30 vs. 8/30 p 0.005).Conclusion The addition of I-Scan to standard endoscopy to aid the diagnosis of CD is well tolerated and is feasible. I-Scan appears to enhance the markings of coeliac disease, however a larger study is required to truly evaluate the effectiveness of I-Scan as an adjunct to standard endoscopy to increase CD diagnosis.Disclosure of Interest None Declared.
    Gut 01/2014; 63(Suppl 1):A263-A264. · 10.73 Impact Factor
  • BMJ (online) 01/2014; 348:g1561. · 17.22 Impact Factor
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    ABSTRACT: Background Prevalence of neurological dysfunction in a prospective cohort of patients newly diagnosed with coeliac disease is yet to be determined. The spectrum of neurological deficit in patients with this disease remains unclear. We aimed to establish the prevalence of neurological deficit in patients newly diagnosed with coeliac disease and to compare the clinicoradiological features of this group with patients presenting with neurological changes that eventually led to diagnosis of the disorder. Methods Patients with newly diagnosed coeliac disease recruited from a tertiary referral gastrointestinal clinic at the Sheffield Teaching Hospitals NHS Foundation Trust were prospectively reviewed by a neurologist and underwent MRI of the brain. Clinicoradiological features of patients who presented with neurological dysfunction to a tertiary referral neurological clinic and who were subsequently diagnosed with coeliac disease were retrospectively reviewed. MRI biomarkers—cerebellar volume (percentage ratio of cerebellar volume to total intracranial volume [%CV:TIV]); N-acetylaspartate to creatine ratio (NAA/Cr), a marker of neuronal health, measured with cerebellar proton MR spectroscopy; and voxel-based morphometry (VBM)—were analysed. Data were also compared with those of healthy volunteers who underwent the same MRI protocol and who were recruited from the local area. Regional ethics committee approved the study and all participants gave informed consent. Findings 30 patients (mean age 47 years, SD 16, range 23–77; 12 men) with newly diagnosed coeliac disease were recruited. 20 patients (61 years, 10, 42–74, nine men) diagnosed with coeliac disease after initially presenting with neurological dysfunction (neurological dysfunction group) were reviewed. MRI data were obtained from a register of 55 healthy volunteers (41 years, 15, 20–77; 32 men). 11 patients (37%) with newly diagnosed coeliac disease had neurological deficits on clinical examination, ten with mild gait ataxia and one with peripheral neuropathy. 16 patients (80%) in the neurological dysfunction group had gait ataxia (nine mild, six moderate, one severe); four patients had peripheral sensory neuropathy. %CV:TIV and NAA/Cr were significantly reduced in the neurological dysfunction group compared with patients with newly diagnosed disease (mean %CV:TIV 7·5 [SD 1·5] vs 8·5 [0·8], 95% CI 0·24–1·76; p=0·01 and NAA/Cr 0·85 [0·13] vs 0·95 [0·07], 0·04–0·17; p=0·004). %CV:TIV and NAA/Cr were also significantly lower in the neurological dysfunction group than in healthy volunteers (mean %CV:TIV 7·5 [SD 1·5] vs 8·4 [1·2], 95% CI 0·05–1·83; p=0·039 and NAA/Cr 0·85 [0·13] vs 0·98 [0·09], 0·05–0·20; p=0·001). There was no significant difference in %CV:TIV or NAA/Cr between patients newly diagnosed with coeliac disease and healthy volunteers. Patients in the neurological dysfunction group showed multiple regions of reduced grey matter density, especially of the cerebellum but also involving supratentorial regions (p<0·05) compared with healthy volunteers. Patients newly diagnosed with coeliac disaese showed only modest reduction in grey matter in the cingulate gyrus (p<0·05). Interpretation Our results might not be generalisable because data were obtained from a tertiary referral centre. Moreover, analysis of the neurological dysfunction subgroup was retrospective. Nonetheless, to our knowledge this is the first study to attempt to provide a prevalence of neurological dysfunction prospectively in patients with coeliac disease while also examining MRI biomarkers of brain dysfunction. This study seems to show that a significant proportion of patients presenting with gastrointestinal symptoms who are diagnosed with coeliac disease already have some neurological dysfunction. The group of patients that present with neurological dysfunction are more severely affected. Serological testing for the disease should be incorporated into the investigation of patients with unexplained neurological symptoms. Increased awareness of the spectrum of neurological dysfunction in coeliac disease and close collaboration between neurologists and gastroenterologists might increase detection and prevent unnecessary delay to dietary treatment, which could lead to permanent neurological disability. Funding Coeliac UK, Bardhan Research & Education Trust.
    01/2014; 383:S39.
  • Gastroenterology 01/2014; 146(5):S-472. · 12.82 Impact Factor

Publication Stats

4k Citations
1,892.60 Total Impact Points

Institutions

  • 2003–2014
    • Sheffield Teaching Hospitals NHS Foundation Trust
      Sheffield, England, United Kingdom
    • The University of Sheffield
      • • Academic Urology Unit
      • • Department of Biomedical Science
      Sheffield, England, United Kingdom
  • 2012
    • University of Leeds
      Leeds, England, United Kingdom
    • Karolinska Institutet
      • Institutionen för medicin, Huddinge
      Solna, Stockholm, Sweden
  • 2011
    • East Coast Community Healthcare CIC
      Beccles, England, United Kingdom
    • The British Society for Gastroenterology
      Londinium, England, United Kingdom
  • 2010
    • Chesterfield Royal Hospital NHS Foundation Trust
      Chesterfield, England, United Kingdom
    • Imperial College Healthcare NHS Trust
      Londinium, England, United Kingdom