Category: National Heart and Lung Institute

COVID and lung health: patient experience and what comes next?

The pandemic has been a huge challenge for people with lung disease – Dr Nick Hopkinson outlines what needs to change to provide them with the required support.

The COVID-19 pandemic has had a double impact on people with lung disease – both the impact of the condition itself as well as measures to avoid it on individuals and the impact on access to healthcare. COVID-19 is a respiratory infection, with people with COPD and severe asthma among those who are the most vulnerable. Many people with these conditions have spent a year shielding to avoid it.

Data from patient surveys by the Asthma UK and British Lung Foundation Partnership early in the pandemic found high levels of anxiety, with four key themes emerging from survey responses:

  • Individuals’ vulnerability to COVID-19,
  • Worrying what the experience of contracting COVID-19 would be like,
  • Uncertainty about the future,
  • The inadequacy of government response.

Many patients reported that their care had been disrupted, with reduced support available and face to face appointments replaced by remote options. (more…)

A week in the life of a Clinical Research Fellow

Dr Francesca Conway takes us through a typical week as a clinical research fellow and how her previous time at Imperial contributed to her developing an interest in a career in clinical academia.

Monday

6am. I’m awakened by the horrifically jolly alarm tone on my phone. It’s still dark, it’s still raining, and it’s still cold. Hedgehogs have the right idea hibernating over winter, I think, as I haul myself out of bed.  Must consider this hibernation proposition in my next supervisor meeting. 1 shower, 1 yoghurt and 3 smoothies later and I’m in the hospital.

Today I have a patient coming to see if she is eligible to be recruited to the clinical trial which forms part of my PhD. Mrs X has travelled from 300 miles away. She greets me with a smile and tells me how pleased she is to be here. I immediately remember why I love my job, and scrap the idea of hibernation. I offer her a coffee, she gratefully accepts and whispers, could I have an extra shot in that? I assume she means coffee. I wonder what time she woke up, but am pretty sure it was before 6am.

I am researching a potential new treatment for Chronic Cbstructive Pulmonary Disease (COPD) for my PhD. Mrs X suffers with COPD, a disease affecting the lungs most commonly caused by smoking. More than 3 million people die from it each year. Targeted Lung Denervation or “TLD”, is a non-surgical procedure where we deliver energy to the airways using a system made by Nuvaira, a US-based company. The idea is that the energy disrupts the nerve supply to the lungs, so the airways relax and open. With initial data looking promising, we hope that this will lead to improvements in health for patients like Mrs X. More information on the Airflow website. (more…)

PhDs are Terminal, but learning will be lifelong

Image credit: Lubo Minar

As Lauren Headley-Morris nears the end of her PhD, she reflects on the experience gained and why learning won’t stop after she’s completed her terminal degree.

Terminal is a weird word. Usually heard on TV associated with cancer, you wouldn’t necessarily want a degree that is terminal. Some days I think my PhD is the best thing since the sequencing of the human genome; other days I think it might be the death of my love of science. But terminal is used in some less, erm, disastrous, melodramatic? scary? ways.

One of these less-morbid settings is travel. A PhD is, by nature, the end of the line of academic qualifications. It doesn’t mean you’ve now mastered your subject, sadly. There are post-doc positions and even professorships in the future perhaps.

I’m a third-year, Asthma UK funded, Clinical Medical Research PhD student based at the Guy Scadding Building, Royal Brompton campus. My work is focused on transcriptional regulation in asthma. While my day to day is obsessing about microRNA and things that are too tiny to see, I think it’s important to take a second now and then to sit back and reflect on the bigger picture of where my PhD fits in with my life as a whole. Maybe it’s the effect of spending so much time in isolation or maybe, coming to the end of my formal academic training, I’m getting a little philosophical. (more…)

A breath of fresh ‘AIR’ in the study of lung repair and regeneration

NHLI researchers Róisín Mongey and Dr Sally Kim provide an insight into developing a new tool – the AIR model – for lung research and drug development.

Lung diseases represent a significant global health burden costing the NHS upwards of £1 billion annually. A hallmark of chronic and acute adult lung diseases such as Chronic Obstructive Pulmonary Disease (COPD), Idiopathic Pulmonary Fibrosis (IPF) and COVID-19, is lung damage. The lungs are usually capable of repairing damage but in some cases, this does not happen or the repair process goes awry for example going into overdrive and causing more damage. The result of this lack of repair or abnormal repair is persistent tissue damage and declining lung function.

There are almost no treatments available to repair the lung damage in these diseases. A bold, new approach to identify novel lung repair treatments for these diseases is needed. Unfortunately, there are several roadblocks to the development of curative treatments, the primary one being that we don’t fully understand how repair happens in the healthy lung under normal circumstances. The bottom line is that unless we can figure this out, it is unlikely that we will be able to develop successful new repair treatments. (more…)

Clement Price Thomas and a once-in-a-lifetime operation

Westminster Medical School – one of the schools that formed Imperial College School of Medicine – has been home to many pioneers. But few can claim a connection to royalty.

Sir Clement Price Thomas, student and surgeon at Westminster and one of the fathers of thoracic surgery, rose to fame after an operation on King George VI. Read on to learn just how challenging this procedure would have been.

The reign of George VI was a turbulent time for the monarchy. At the end of a brutal world war and the dissolution of the largest empire the world has ever seen, the King’s health took a turn for the worse.

Because of the King’s chest problems, Sir John Weir, the Royal Family’s doctor, called in a lung disease expert, Geoffrey Marshall, and chest expert, Sir Robert Arthur Young. After X-rays and a bronchoscopy revealed a malignant tumour in his left lung, the King’s physicians set to work organising a secret operation. They all agreed that Clement Price Thomas was the best surgeon for the job.

Setting up the makeshift theatre

The operation was planned for 22 September 1951 at Buckingham Palace. But the Buhl room clearly wasn’t designed for major surgery, despite the equipment brought in for the occasion. With the stakes so high, Price Thomas demanded that the palace install emergency lighting in the room. The palace agreed – and even moved the changing of the guard to St James’s Palace to make sure the surgical team were not disturbed by the noise outside.

On Sunday 23 September 1951, the room was ready and Price Thomas, his two surgical registrars and his scrub team set to work. (more…)

Why plain packaging for cigarettes does not increase illicit trade

Dr Anthony Laverty discusses new findings that quash the argument that plain cigarette packaging increases illicit tobacco trade.

Australia was the first country in the world to introduce standardised, or plain, packaging for cigarettes and tobacco. The move was the product of a long-running campaign from the public health community and meant that the packets are allowed no branding; just the product name in standard font, colour and size. Since Australia brought in these measures, the UK followed in 2017, as did Ireland and France, increasing the number of countries in the world which restrict one of the key avenues for the tobacco industry to advertise their products. (more…)

A letter to our taught students and their loved ones

This is an open letter from Mr Martin Lupton, Vice-Dean of Education to taught students in the Faculty of Medicine and their loved-ones.

Dear Students and their friends and families,

My eldest son has recently returned to University in the UK and, even though I work in both the health and education sector, I have to acknowledge that I have a certain level of anxiety about him. It is very difficult to read the news about all that has happened during this time of COVID and not to worry.

I am telling you this because I want you to understand that I have some inkling of what you may be feeling right now, particularly if you come from overseas or your daughter, son or relation, has just started their university life. The first thing I want to say is “Welcome to the Faculty of Medicine”. We are very proud of what we have achieved during this global pandemic; the Faculty of Medicine at Imperial College has been a key player contributing to the world’s understanding of the virus, the mapping of the virus, teaching people about the virus and developing a new vaccine. However, that is not all that we have been doing. (more…)

How are people with respiratory conditions impacted by measures to reduce risk of COVID-19?

Dr Keir Philip discusses how people with long term respiratory conditions have been impacted by measures to reduce the risk of COVID-19 and whether online singing groups could help.

As the global COVID-19 pandemic draws on, effects are being felt by everyone, not just those who have been infected with the virus. From schools to offices, restaurants to gyms, many aspects of ‘normal’ have been closed, stopped, or undergone major adaptations. These societal and healthcare disruptions will affect people differently, with certain groups of people, such as those with respiratory conditions, potentially more vulnerable.

Over the last few months I have been working with Dr Nicholas Hopkinson (Respiratory Consultant, NHLI Academic, and Medical Director of the British Lung Foundation(BLF)), Dr Bradley Lonergan (Internal Medicine Trainee) in collaboration with the Asthma UK-BLF partnership, to try to understand how people with long term respiratory conditions have been impacted by measures to reduce the risk of COVID-19.

Our research published today in BMJ Open explores the findings of a large UK wide survey conducted at the height of the first wave. We found that measures to reduce risk of COVID-19, such as social distancing and changes to healthcare provision, were having profound impacts on people with long term respiratory conditions. These included cancellations of appointments, investigations, and vital aspects of their care such as pulmonary rehabilitation. (more…)

Researching remote medicine from our own homes

Student group pictured on a field trip to the Brecon Beacons pre-Covid-19

Our BSc in Remote Medicine for intercalating medical students focuses on exploring medicine in remote and low-resource environments.

Normally students would have an opportunity to travel to the Nepali Himalayas to carry out a research project. With the expedition cancelled due to Covid-19, four remote medicine students discuss how they adapted their research projects.

Carmen

For my original research project, I chose to investigate sleep during an expedition to high altitude. Previous research has shown that human error is the leading cause of mountaineering accidents and at sea-level, sleep deprivation increases the risk of accidents due to human error. Therefore, my aim was to determine the contribution of the mountaineering environment to poor sleep and impaired cognitive performance on an expedition to altitude – using a reaction time application as a surrogate marker for cognitive function. Unfortunately, due to COVID-19 the planned expedition to Nepal was cancelled and so I devised a pilot study to test the reaction time application I wanted to use at altitude remotely with a small group of participants simulating a night slept at altitude in their own homes. (more…)

How we completed our BSc research projects remotely

Three medical students reflect on how they navigated and completed their intercalated BSc research projects remotely amid the pandemic.

Ioannis Panselinas, BSc Translational Respiratory Medicine

Had someone told me back at the start of 2020 what the year would have in store, I would have probably said that they had stolen ideas from an Orwellian dystopia. Yet the world is currently in the grips of one of the most terrible pandemics in living memory. And among all the global disruption were us 4th year Imperial medics having to face a transition to remote working in the middle of project period. Unsurprisingly, lab work cannot be done from the comfort of our homes. So, as COVID-19 hit the UK, we were forced to cut short our experiments and were ultimately left with a looming deadline and a project to complete.  In retrospect, I think I can sum up my experience with the 5 stages of COVID disruption:

Denial, Bargaining, Panic, Depression, Acceptance. (more…)