A5032021654- Orthopedic Surgery and Rehabilitation
- Shoulder Injury and Treatment
- Health Systems, Economic Evaluations, Quality of Life
- Hip and Femur Fractures
- Total Knee Arthroplasty Outcomes
- Knee injuries and reconstruction techniques
- Bone health and osteoporosis research
- Sports injuries and prevention
- Pharmaceutical Practices and Patient Outcomes
- Tendon Structure and Treatment
- Hip disorders and treatments
- Osteoarthritis Treatment and Mechanisms
- Lower Extremity Biomechanics and Pathologies
- Child and Adolescent Psychosocial and Emotional Development
- Musculoskeletal pain and rehabilitation
- Peripheral Nerve Disorders
- Dementia and Cognitive Impairment Research
- Autism Spectrum Disorder Research
- Health Policy Implementation Science
- Chronic Disease Management Strategies
- Stroke Rehabilitation and Recovery
- Asthma and respiratory diseases
- Dupuytren's Contracture and Treatments
- Diabetes Management and Research
- Diabetic Foot Ulcer Assessment and Management
University of East Anglia
2016-2025
University of Exeter
2025
Norfolk and Norwich University Hospitals NHS Foundation Trust
2024
Norwich Research Park
2015-2023
Norwich University
2005-2022
Parul University
2022
Cardiff and Vale University Health Board
2021
North East London NHS Foundation Trust
2021
Hertfordshire Partnership University NHS Foundation Trust
2017-2021
King's College London
2021
To profile the expression of all known members matrix metalloproteinase (MMP), ADAMTS, and tissue inhibitor metalloproteinases (TIMP) gene families in normal cartilage from patients with osteoarthritis (OA).Human was obtained femoral heads at joint replacement for OA or following fracture to neck. Total RNA purified, assayed using quantitative real-time polymerase chain reaction.Several above were regulated OA. Genes that showed increased MMP13, MMP28, ADAMTS16 (all P < 0.001), MMP9, MMP16,...
Most randomized trials of treatment for asthma study highly selected patients under idealized conditions.We conducted two parallel, multicenter, pragmatic to evaluate the real-world effectiveness a leukotriene-receptor antagonist (LTRA) as compared with either an inhaled glucocorticoid first-line asthma-controller therapy or long-acting beta(2)-agonist (LABA) add-on in already receiving therapy. Eligible primary care 12 80 years age had impaired asthma-related quality life (Mini Asthma...
Background/aim Shoulder pain is a major musculoskeletal problem. We aimed to identify which baseline patient and clinical characteristics are associated with better outcome, 6 weeks months after starting course of physiotherapy for shoulder pain. Methods 1030 patients aged ≥18 years referred the management were recruited provided data. 840 (82%) outcome data at 811 (79%) months. 71 putative prognostic factors collected baseline. Outcomes Pain Disability Index (SPADI) Quick Arm, Hand...
Hybrid closed-loop insulin therapy has shown promise for management of type 1 diabetes during pregnancy; however, its efficacy is unclear. Download a PDF the Research Summary. In this multicenter, controlled trial, we randomly assigned pregnant women with and glycated hemoglobin level at least 6.5% nine sites in United Kingdom to receive standard or hybrid therapy, both groups using continuous glucose monitoring. The primary outcome was percentage time pregnancy-specific target range (63 140...
<h3>Abstract</h3> <b>Objective</b> To determine whether home based medication review by pharmacists affects hospital readmission rates among older people. <b>Design</b> Randomised controlled trial. <b>Setting</b> Home after discharge from acute or community hospitals in Norfolk and Suffolk. <b>Participants</b> 872 patients aged over 80 recruited during an emergency admission (any cause) if returning to own warden accommodation taking two more drugs daily on discharge. <b>Intervention</b> Two...
The radiographs of 206 knees from 174 consecutive patients were reported blinded regarding joint space narrowing. Minimum was measured using a millimeter ruler on weightbearing posteroanterior and skyline patellofemoral radiographs. Lateral solely in terms presence or absence arthritis. results showed objective narrowing to less than 3 mm the compartment 32.7% men 36.1% women older 60 years. This high prevalence disease has not been documented before. Arthritic changes occurred isolation...
Wegener's granulomatosis (WG), Churg Strauss syndrome (CSS) and microscopic polyangiitis (MPA) are primary systemic vasculitides (PSV), the clinical features of which have been described from tertiary centres.To provide first description MPA a general hospital compare with WG CSS.Retrospective analysis patient records.Records 99 PSV patients attending single hospital, 1988 to 2000, were reviewed for: features, date/age at diagnosis, sex, duration illness, anti-neutrophil cytoplasmic...
The value of serum cartilage oligomeric matrix protein (COMP) as a marker disease progression was investigated in 81 hospital out-patients with clinical knee osteoarthritis (OA). Progressing patients were defined by decrease ≥2 mm joint space on X-ray or requiring surgery during the 5 yr follow-up. Of 57 for whom full data available, 20 progressed and 37 did not progress. Serum COMP levels increased first year those who (mean 6.42 μg/ml) (S.D. 6.64) compared to progress [mean 0.07 μg/ml...
We performed two independent, randomised, controlled trials in order to assess the potential benefits of immediate weight-bearing mobilisation after rupture tendo Achillis. The first trial, on operatively-treated patients showed an improved functional outcome for mobilised fully surgical repair. Two cases re-rupture treatment group suggested that careful patient selection is required as need follow a structured rehabilitation regimen. second conservatively-treated patients, provided no...
<b>Objective</b> To test whether a drug review and symptom self management lifestyle advice intervention by community pharmacists could reduce hospital admissions or mortality in heart failure patients. <b>Design</b> Randomised controlled trial. <b>Setting</b> Home based <b>Participants</b> 293 patients diagnosed with were included (149 intervention, 144 control) after an emergency admission. <b>Intervention</b> Two home visits one of 17 within two eight weeks discharge. Pharmacists reviewed...
Older people increasingly constitute a large proportion of the acute coronary syndrome (ACS) population. We examined relationship age with receipt more intensive management and secondary prevention medicine. Then, comparative association (reperfusion/angiography) over conservative strategy on time to death was investigated by age. Using data from 155 818 patients in national registry for ACS England Wales [the Myocardial Ischaemia National Audit Project (MINAP)], we found that older were...
Water-loss dehydration in older people is associated with increased mortality and disability. We aimed to assess the prevalence of living UK long-term care cognitive, functional, health characteristics. The Dehydration Recognition In our Elders (DRIE) cohort study included aged 65 or without heart renal failure. a cross-sectional baseline analysis, we assessed serum osmolality, previously suggested risk factors, general health, markers continence, cognitive functional nutrition status,...
Objectives To (i) identify predictors of outcome for the physiotherapy management shoulder pain and (ii) enable clinicians to subgroup people into risk groups persistent disability. Methods 1030 aged ≥18 years, referred musculoskeletal were recruited. 810 provided data at 6 months 4 outcomes: Shoulder Pain Disability Index (SPADI) (total score, subscale, disability subscale) Quick Arm, Hand (QuickDASH). 34 potential prognostic factors used in this analysis. Results Four classification trees...
<h3>OBJECTIVE</h3> To test the hypothesis that enthesophyte formation and osteophyte growth are positively associated to look for associations between bone at different sites on skeleton so a simple measure of could be derived. <h3>METHODS</h3> Visual examination 337 adult skeletons. All common either or were inspected by single observer who graded these 0-3 scale. The total score each feature was divided number examined derive an score. Cronbach's α principal components analysis used...
Abstract Objective . To investigate the prognostic value of serum hyaluronic acid (HA) and keratan sulfate (KS) levels in relation to tibiofemoral osteoarthritis (OA) knee. Methods Clinical demographic data were collected on 94 patients. Radiographs obtained at study entry 5‐year followup. Disease progression was defined as 2 mm joint space narrowing any compartment, and/or knee surgery during period. Serum HA KS measured correlated with disease progression. Results At entry, significantly...
Shock wave therapy has been used for treatment of several soft tissue disorders that are characterized by chronic pain. We sought to determine if shock reduces Achilles tendon Forty-nine patients were enrolled in a double-blind randomized placebo-controlled trial. Each patient was treated once month 3 months. The primary outcome measure reduction pain during walking. At the end trial, we found no difference relief between group and control group. There two (62 years 65 years) with ruptures...
Anterior knee pain due to dysplasia of the extensor mechanism is common. We have studied 137 knees (103 patients) in order identify a rapid and reproducible radiological feature which would indicate need for further analysis. Overall, 67 (49%) had at least one abnormality; 70 (51%) were considered normal. There five cases Dejour type-3 femoral trochlea, nine type-2 12 type-1. 49 patella alta infera. Four an abnormal lateral patellofemoral angle (patellar tilt), 15 there was more than...
Proponents of endoscopic carpal tunnel release have been advocating the technique for more than 10 years but there is still debate about its efficacy, safety and cost-effectiveness. We performed a randomized, prospective, blind trial to compare early outcome after single portal or open surgery assess cost-effectiveness procedures. There were no significant differences in symptom functional activity scores, grip strength anterior pain first 3 months. For those employment, we found...
Dupuytren's disease is a progressive fibroproliferative disorder which can result in fixed flexion contractures of digits and impaired hand function. Standard treatment involves surgical release or excision followed by post-operative therapy splinting, however the evidence supporting night splinting low quality equivocal. A multi-centre, pragmatic, open, randomised controlled trial was conducted to evaluate effect on self-reported function, finger extension satisfaction patients undergoing...