A5021599391- Pain Mechanisms and Treatments
- Ocular Surface and Contact Lens
- Botulinum Toxin and Related Neurological Disorders
- Glaucoma and retinal disorders
- Diabetes Treatment and Management
- Retinal Diseases and Treatments
- Diabetes Management and Research
- Diet and metabolism studies
- Pharmacology and Obesity Treatment
- Heart Rate Variability and Autonomic Control
- Corneal surgery and disorders
- Liver Disease Diagnosis and Treatment
- Cardiovascular Function and Risk Factors
- Diet, Metabolism, and Disease
- Metabolism, Diabetes, and Cancer
- Advancements in Transdermal Drug Delivery
- Fibromyalgia and Chronic Fatigue Syndrome Research
- Retinal Imaging and Analysis
- Parkinson's Disease Mechanisms and Treatments
- Musculoskeletal pain and rehabilitation
- Cardiovascular Disease and Adiposity
- Atrial Fibrillation Management and Outcomes
- Advanced Glycation End Products research
- Acute Ischemic Stroke Management
- Bee Products Chemical Analysis
University of Liverpool
2017-2025
Aintree University Hospitals NHS Foundation Trust
2017-2025
Liverpool Heart and Chest Hospital
2023-2025
Liverpool John Moores University
2023-2025
University of Staffordshire
2023-2025
Khyber Medical College
2024-2025
National Institute of Cardiovascular Diseases
2020-2024
University of Manchester
2014-2024
New Mexico State University
2023-2024
New York University
2023-2024
Diabetic neuropathy is associated with increased morbidity and mortality. To date, limited data in subjects impaired glucose tolerance diabetes demonstrate nerve fiber repair after intervention. This may reflect a lack of efficacy the interventions but also difficulty tests currently deployed to adequately assess repair, particularly short-term studies. Corneal confocal microscopy (CCM) represents novel noninvasive means quantify damage repair. Fifteen type 1 diabetic patients undergoing...
Purpose.: To assess the diagnostic validity of a fully automated image analysis algorithm in vivo confocal microscopy images quantifying corneal subbasal nerves to diagnose diabetic neuropathy. Methods.: One hundred eighty-six patients with type 1 and 2 diabetes mellitus (T1/T2DM) 55 age-matched controls underwent assessment neuropathy bilateral (IVCCM). Corneal nerve fiber density (CNFD), branch (CNBD), length (CNFL) were quantified expert, manual, fully-automated analysis. The areas under...
OBJECTIVE Quantitative assessment of small fiber damage is key to the early diagnosis and progression or regression diabetic sensorimotor polyneuropathy (DSPN). Intraepidermal nerve density (IENFD) current gold standard, but corneal confocal microscopy (CCM), an in vivo ophthalmic imaging modality, has potential be a noninvasive objective image biomarker for identifying damage. The purpose this study was determine diagnostic performance CCM IENFD by using guidelines as reference standard....
Diabetic peripheral neuropathic pain (DPNP) is common and often distressing. Most guidelines recommend amitriptyline, duloxetine, pregabalin, or gabapentin as initial analgesic treatment for DPNP, but there little comparative evidence on which one best whether they should be combined. We aimed to assess the efficacy tolerability of different combinations first-line drugs DPNP.OPTION-DM was a multicentre, randomised, double-blind, crossover trial in patients with DPNP mean daily numerical...
Abstract Aims/hypothesis Insulin is the primary treatment for type 1 diabetes. However, alternative glucose-lowering therapies are used adjunctively, but importantly off-label in Little work has previously been undertaken to evaluate safety with long-term efficacy and cardio-renal benefits of such therapies. We sought investigate real-world impact sodium–glucose cotransporter 2 inhibitor (SGLT2i) glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapy individuals diabetes relation effect...
Abstract Aims/hypothesis A protective role of sodium–glucose cotransporter 2 inhibitors (SGLT2is) and glucagon-like peptide 1 receptor agonists (GLP1-ra) in the development diabetic retinopathy macular oedema has been described some recent studies, which may extend beyond glycaemic control. We aimed to review clinical impact SGLT2i GLP1-ra therapy on risk individuals with type diabetes taking insulin. Methods This is a retrospective cohort analysis approximately two million people receiving...
To compare the risk of cardiovascular disease (CVD) and common solid cancers between JAK inhibitors (JAKi) versus TNF or IL-17 inhibitors, among people with psoriatic arthritis (PsA) axial spondyloarthritis (axSpA). We used real-world electronic health records data from a predominantly North American population PsA axSpA. Initiators JAKi (tofacitinib upadacitinib) TNFi were 1:1 propensity score matched. Cox models to time CVD (acute myocardial infarction, stroke revascularization) (breast,...
OBJECTIVE To establish if corneal nerve loss, detected using in vivo confocal microscopy (IVCCM), is symmetrical between right and left eyes relates to the severity of diabetic neuropathy. RESEARCH DESIGN AND METHODS Patients (n = 111) with type 1 2 diabetes 47 age-matched healthy control subjects underwent detailed assessment stratification into no 50), mild 26), moderate 17), severe 18) IVCCM was performed both fiber density (CNFD), branch (CNBD), length (CNFL) tortuosity coefficient were...
Purpose: To establish intraobserver and interobserver repeatability, agreement, symmetry of corneal nerve fiber (NF) morphology in healthy subjects using vivo confocal microscopy. Methods: Nineteen underwent microscopy (Heidelberg Retinal Tomograph III Rostock Cornea Module) at baseline 7 days apart. Bland–Altman plots were generated to assess the intraclass correlation coefficient repeatability calculated estimate for NF density (numbers per square millimeter), branch (NBD; numbers length...
Impaired glucose tolerance (IGT) represents one of the earliest stages dysregulation and is associated with macrovascular disease, retinopathy, microalbuminuria, but whether IGT causes neuropathy unclear.Thirty-seven subjects 20 age-matched control underwent a comprehensive evaluation by assessing symptoms, neurological deficits, nerve conduction studies, quantitative sensory testing, heart rate variability deep breathing (HRVdb), skin biopsy, corneal confocal microscopy (CCM).Subjects had...
Corneal confocal microscopy (CCM) is a rapid, non-invasive, reproducible technique that quantifies small nerve fibres. We have compared the diagnostic capability of CCM against range established measures damage in patients with diabetic neuropathy.In this cross sectional study, thirty subjects Type 1 diabetes without neuropathy (T1DM), one T1DM (DSPN) and twenty seven non-diabetic healthy control underwent detailed assessment neuropathic symptoms neurologic deficits, quantitative sensory...
OBJECTIVE Impaired glucose tolerance (IGT) through to type 2 diabetes is thought confer a continuum of risk for neuropathy. Identification subjects at high developing and, hence, worsening neuropathy would allow identification and stratification more aggressive management. RESEARCH DESIGN AND METHODS Thirty with IGT 17 age-matched control underwent an oral test, assessment neuropathic symptoms deficits, quantitative sensory testing, neurophysiology, skin biopsy, corneal confocal microscopy...
Abstract Aims/hypothesis Corneal confocal microscopy is a rapid non-invasive ophthalmic imaging technique that identifies peripheral and central neurodegenerative disease. Quantification of corneal sub-basal nerve plexus morphology, however, requires either time-consuming manual annotation or less-sensitive automated image analysis approach. We aimed to develop validate an artificial intelligence-based, deep learning algorithm for the quantification fibre properties relevant diagnosis...
Objective To assess the effect of high-dose vitamin D in patients with painful diabetic neuropathy. Methods A single intramuscular dose 600 000 IU was administered, and effects on metabolic parameters neuropathic pain assessed over 20 weeks. Results 143 participants predominantly type 2 diabetes, aged 52.31±11.48 years, a Douleur Neuropathique 4 (DN4) score (3.0±1.8), total McGill (21.2±14.9), Short Form Pain Questionnaire (SFMPQ) (2.1±0.9), were enrolled. The baseline 25-hydroxyvitamin...
The study aimed to assess the impact on neuropathy of simultaneous pancreas and kidney transplantation (SPK) in individuals with type 1 diabetes. This longitudinal observational examined neuropathic symptoms, deficits, quantitative sensory testing, neurophysiology, corneal confocal microscopy skin biopsy results 32 healthy (non-diabetic) control participants, 29 diabetes severe diabetic peripheral [DPN] 36 after SPK. Following SPK, HbA1c, eGFR, triacylglycerols HDL improved significantly...