A5088411006- Long-Term Effects of COVID-19
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Intensive Care Unit Cognitive Disorders
- COVID-19 Clinical Research Studies
- COVID-19 and Mental Health
- Respiratory Support and Mechanisms
- Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis
- COVID-19 and healthcare impacts
- Neuroinflammation and Neurodegeneration Mechanisms
- Cardiac, Anesthesia and Surgical Outcomes
- Chronic Disease Management Strategies
- Lung Cancer Diagnosis and Treatment
- Healthcare professionals’ stress and burnout
- Sleep and related disorders
- Frailty in Older Adults
- Nursing Diagnosis and Documentation
- Patient Satisfaction in Healthcare
- Metabolism and Genetic Disorders
- Obstructive Sleep Apnea Research
- Dermatological and COVID-19 studies
- Nausea and vomiting management
- Infectious Encephalopathies and Encephalitis
- Healthcare Systems and Technology
- Healthcare Operations and Scheduling Optimization
- Asthma and respiratory diseases
University College London
2022-2025
Guy's and St Thomas' NHS Foundation Trust
2015-2024
University College London Hospitals NHS Foundation Trust
2022
University College Hospital
2022
St Thomas' Hospital
2020-2021
Guy's Hospital
2021
University of British Columbia
2003
Southampton General Hospital
1977
Rationale: The natural history of recovery from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains unknown. Because fibrosis with persistent physiological deficit is a previously described feature patients recovering similar coronaviruses, treatment represents an early opportunity to modify the disease course, potentially preventing irreversible impairment.Objectives: Determine incidence and describe progression inflammatory interstitial lung (ILD) following SARS-CoV-2 when...
Objectives This study reports preliminary findings on the prevalence of, and factors associated with, mental health well-being outcomes of healthcare workers during early months (April–June) COVID-19 pandemic in UK. Methods Preliminary cross-sectional data were analysed from a cohort (n=4378). Clinical non-clinical staff three London-based NHS Trusts, including acute took part an online baseline survey. The primary outcome measure used is presence probable common disorders (CMDs), measured...
SARS-CoV-2 infection is a multisystem disease with post-discharge sequelae. We report early follow-up data from one UK hospital of the initial 200 inpatients slow recovery condition. At 4 weeks post-discharge, 321/957 survivors (34%) had persistent symptoms. A structured outpatient clinical assessment protocol was designed, and outcomes first patients seen 4-6 are presented here. In 80/200 (40%), we identified at cardiorespiratory cause breathlessness, including parenchymal abnormality (64...
BACKGROUND: This study investigates the role of metabolic flexibility in determining perioperative outcomes. Metabolic flexibility, a key feature health, is ability to efficiently switch between different fuel sources (predominantly carbohydrates and fats) depending on energy demands availability. Given rapidly changing physiological conditions period, we hypothesized that good adaptability could mitigate postoperative complications. METHODS: We conducted retrospective observational...
Abstract Objectives This study reports preliminary findings on the prevalence of, and factors associated with, mental health wellbeing outcomes of healthcare workers during early months (April-June) COVID-19 pandemic in UK. Methods Preliminary cross-sectional data were analysed from a cohort (n=4,378). Clinical non-clinical staff three London-based NHS Trusts (UK), including acute Trusts, took part an online baseline survey. The primary outcome measure used is presence probable common...
Abstract Background The National Health Service in England aims to implement tobacco dependency treatment services all hospitals by 2024. We aimed assess the uptake of a new service, adapted from Ottawa Model Smoking Cessation, and its impact on 6-month quit rates readmission or death at 1-year follow-up. Methods conducted pragmatic service evaluation implemented among 2067 patients who smoked were admitted 2 acute London, England, over 12-month period July 2020. intervention consisted...
<b>Physiological phenotyping using daily home-based assessments reveals early improvement in load–capacity–drive imbalance following #AECOPD and feasibility of home parasternal electromyography measurement, which tracks symptoms, health status spirometry</b>https://bit.ly/3o6I0Ty
Summary Infusions of fructose or sorbitol are used commonly in parenteral nutrition and may cause lactic acidosis. A case is reported whom blood lactate concentration was monitored frequently over a 5-day period during intravenous feeding with sorbitol-ethanol-amino acid mixture. During the first five infusions rose only moderately, but final infusion to 11-1 mmol/l patient had severe metabolic In retrospect shown deterioration renal hepatic function tests preceding 24 hr. On terminating...
Assessment of cardiorespiratory fitness is routinely carried out in the pre-operative period. Cardiopulmonary exercise testing (CPET) gold standard for assessing functional capacity [1], but centres where CPET not performed, alternative methods are recommended such as Duke Activity Status Index (DASI). This self-reported questionnaire equates physical activity scores with an associated metabolic equivalent task (MET) and, thus, oxygen consumption (VO2), and was developed heart failure...
Completion of pulmonary rehabilitation is recognised in chronic obstructive disease (COPD) guidelines as a key opportunity to consider systematically whether respiratory review assess potential suitability for lung volume reduction (LVR) procedure might be appropriate. We describe the development simple decision-support tool (the LVR-PR tool) aid clinicians working rehabilitation, operationalise this process.We took an iterative mixed methods approach, which was partnership-based and...
Following hospital admission with a COPD exacerbation, early follow up can reduce exacerbation-related readmissions<sup>1</sup> and lower mortality<sup>2</sup>. A London teaching offers "HOT" clinic appointments (HCA) to address this, but the did not attend (DNA) rate was 31.4% (60/191 HCAs) in year prior 30/11/19. This service review aims assess whether targeted phone calls from pharmacist (CP) HCA reduces DNA rates. 2 weeks before HCA, CP contacted patients confirm date, time purpose,...
Home nasal high flow (hNHF) may improve outcomes in hypoxaemic COPD patients. Those recovering from acute exacerbations (AECOPD) are at risk of readmission or re-exacerbation. We conducted a mixed-methods randomised controlled trial to determine the feasibility phase III evaluating effect hNHF on 30-day following severe AECOPD. Hospitalised patients were receive usual care additional (ISRCTN15949009) discharge. Feasibility was assessed by recruitment, protocol adherence and acceptability....
<h3>Background/introduction</h3> Current BTS guidelines suggest that when endobronchial tumour is seen optimal diagnostic sensitivity achieved at least five mucosal biopsies are supplemented with bronchial washings and brushings. We review our bronchoscopy practice annually in line current guidance, strive to make continuous improvements. have previously noted brushings improve the for lung cancer an seen, but washing samples do not. <h3>Aims</h3> To confirm not increase where flexible...
<b>Introduction:</b> Optimisation of evidence-based pharmacological & non-pharmacological treatments is essential to improve the outcomes people with COPD. Patients admitted hospital because an acute exacerbation their COPD routinely receive specialist input, but what happens when someone COPD, not it - this a missed opportunity? <b>Aim:</b> To assess appropriateness inhaled therapy in inpatients for non-COPD reasons <b>Methods:</b> Between June August 2021, patients South East London...
<h3>Introduction</h3> Respiratory conditions are very common amongst the older population with asthma and chronic obstructive pulmonary disease (COPD) potentially co-existing in more than 50% of elderly patients.<sup>1</sup> With inhaled therapy as primary pharmacological management both conditions, we aimed to evaluate inhaler competence inpatients identify impact devices, cognitive function, inspiratory flow specific comorbidities on technique, whilst also investigating patients'...
<h3>Introduction and Objectives</h3> Local data shows that only around 60% of PR assessment clinic appointments are attended. Missed delay treatments, increase the cost care, reduce efficiency negatively impact relationships between patients health care professionals.<sup>1</sup> Referrals to our university teaching hospital service received from clinicians in primary, secondary or tertiary care. referrals they vetted against clinical criteria (MRC ≥2 decreased exercise tolerance no...
<h3>Introduction and objectives</h3> FeNO is a quantitative, non-invasive biomarker of type 2 airway inflammation an established tool in the assessment patients with asthma.<sup>1</sup> However, role COPD care remains unclear, despite up to 30% having evidence eosinophilic airways inflammation.<sup>2</sup> We investigated whether measurement feasible acute exacerbation (AECOPD) it was elevated any low blood eosinophil count. <h3>Methods</h3> testing performed on who presented hospital...
<h3>Introduction and objectives</h3> The Integrated Respiratory Team aims to provide holistic individualised care for patients with COPD. Patients who are housebound, frail, or assessed as needing intensive 1:1 support self-management, receive domiciliary visits, the of improving patient preventing admission hospital. <h3>Methods</h3> (n=20) were PHQ9, GAD7 EQ5D5L questionnaires during visit, followed by a structured telephone interview within one week. excluded if they unable complete...
Summary: The natural history of recovery from Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Cov2) has not yet been well documented. Outcomes 1272 patients who were diagnosed between February and May 2020 are reported here. Methods: Patients telephoned four weeks after discharge hospital to assess if they had returned their functional baseline. Those with ongoing symptoms clinical asssessment at six weeks. Findings: Telephone assessment was completed for 696 patients. 321 (50·1%)...
<b>Introduction:</b> Ambulatory oxygen (AO) increases walking distance, reduces exertional breathlessness and has been shown to improve quality of life in patients with desaturation. Patients ILD often have a high burden hospital appointments. In response patient feedback we trialed co-locating AO assessment alongside the specialist clinic rather than at separate assessments. <b>Method:</b> Patient experience service data was collected prospectively for all referred over 6 month period. All...