• Alcohol: is it all that bad?

      Mortimore, Gerri; University of Derby (University of Derby, 2018-02-01)
    • Cirrhosis in the over 16's: assessment and management

      Mortimore, Gerri; University of Derby (National Institute for Health and Care Excellence (NICE), 2016-07)
    • Dying from liver disease: the importance of end-of-life discussions

      Watson, Sharan; Mortimore, Gerri; University of Derby; Post-Registration Lecturer, at the College of Health and Social Care, University of Derby; Lecturer, at the College of Health and Social Care, University of Derby (2018-12-21)
      Over the past 50 years, deaths from liver disease have risen dramatically, whereas deaths from many other major diseases have fallen. Liver disease is now the third largest cause of premature death in the UK, with alcohol-related liver disease accounting for nearly 40% of these deaths. With advanced liver disease comes the associated complications of varices, hepatic encephalopathy and ascites, and death from liver disease can be sudden and catastrophic. Supportive and palliative care needs in people with liver disease often go unrecognised and unaddressed. End-of-life care and wishes can be a difficult subject to broach to patients and their loved ones, but it is one that nurses are often best placed to undertake. Therefore, when considering the overall care of patients with liver disease, it is necessary to incorporate anticipatory and concordant end-of-life plans.
    • Genetic haemochromatosis.

      Mortimore, Gerri; Woodward, Amelia; University of Derby (2018-07-10)
      Genetic Haemochromatosis (GH) is the most common inherited disorder in Caucasians affecting 1:200 in the UK. GH causes the body to absorb too much iron from the diet which over times can lead to systemic iron overload. Treatment involves weekly removal of blood termed venesection. There is little research that examines patients thoughts and feelings of being diagnosed with this life long disease which requires life long treatment in the form of venesections. Exploring the patients symptoms prior to and after venesection has not been fully studied
    • Genetic haemochromatosis: diagnosing and treating hereditary iron overload.

      Mortimore, Gerri; University of Derby (Mark Allen Group, 2017-12)
      Genetic haemochromatosis (GH) is the most common inherited genetic disorder in caucasians, affecting approximately 1 in every 200–250 people. It leads to an increased absorption and deposition of iron, and if it is untreated it can cause systemic iron overload in some patients. This iron overload can cause inflammation and tissue damage to multiple organs, with the potential to lead to heart disease, diabetes and cirrhosis of the liver. Despite being a common condition, it is thought to be under diagnosed. However, it is known that some patients with a diagnosis of GH will present with cirrhosis at a young age, while others are virtually asymptomatic. Symptoms can be generalised, and diagnosis is made on blood tests. Treatment for GH requires the removal of blood, known as venesection. Approximately 400–500mls are removed at a time, and this procedure can be undertaken weekly until ferritin levels are brought down to 50 µg/l or below.
    • Liver disease

      Mortimore, Gerri; University of Derby (National Institute for Health and Care Excellence (NICE), 2017-06)
    • Liver disease presentation and red flags in urgent, primary and community care

      Mortimore, Gerri; University of Derby (2019-03-06)
      Liver Disease Presentations & Red Flags in Urgent, Primary & Community Care- Gerri Mortimore, Advanced Practice Lecturer, ANP Specialist & Expert Advisor for NICE
    • Nutrition and malnutrition in liver disease: an overview.

      Mortimore, Gerri; University of Derby (Mark Allen Group, 2019-07-17)
      The term malnutrition is generally understood to refer to a deficiency of nutrition, and it is rarely appreciated that malnutrition can also result from excesses in nutritional status. Relatively recent clinical practice guidelines (CPG) from the European Association for the Study of the Liver (EASL) (Merli et al, 2019) acknowledged that malnutrition includes both nutritional surplus and deficiency, but stated that, for the purpose of the CPG, malnutrition would be referred to as undernutrition.
    • Patient experience of day case liver biopsy: Prospective audit

      Li, Ka Kit; Mortimore, Gerri; Jackson, Michelle; Clarke, Dominic; Freeman, Jan G.; Austin, Andrew; Royal Derby Hospital (Wiley, 2006-10-01)
      Background: Percutaneous liver biopsy remains an important toolin the diagnosis and staging of chronic liver disease. There is oftenreluctance to use wider bore needles because of potentially highercomplication rates. There are no good prospective studies of thepatient experience and morbidity associated with the procedure.Aims: To describe the patient experience and compare two differ-ent biopsy needles. Patients and Methods: Data collected prospec-tively was available for 83 ultrasound-sited percutaneous biopsiesfor chronic liver disease. Subjects were regularly offered analgesiaand asked to rate pain on a visual analogue scale (0-10). Patientswere contacted 30 days post-biopsy. Results: Indications for bi-opsy were alcoholic liver disease (21%), NAFLD (21%), HCV(14%), HBV (8%), haemachromatosis (10%), autoimmune hepatitis(8%), other (22%). Data are expressed as mean (CI) and comparedusing t-test and ANOVA. Within the first 6 hours, 28 took parac-etamol only, 8 required codeine-based analgesia, and 1 receivedpethidine. There were no episodes of bradycardia, hypotension orpyrexia and only one re-admission (for recurrent ascites). Therewere no serious adverse events in either group. Conclusions: Themajority of patients experienced only mild discomfort after liverbiopsy and 45% did not require analgesia. A small difference inpain scores was detected at one hour but did not persist to sixhours and may reflect the greater use of lignocaine by one group.
    • We may unknowingly consume dangerous levels of alcohol.

      Mortimore, Gerri; University of Derby (EMAP publishing limited, 2018-05-31)
      Alcohol is the main cause of liver disease and associated death. By raising awareness and offering brief interventions, not only to patients but also to family and friends, nurses can potentially save lives.