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Article ; Online: Ten minutes with Anny Sykes.

Sykes, Anny

BMJ leader

2022 Volume 7, Issue 1, Page(s) 82–84

Language	English
Publishing date	2022-04-01
Publishing country	England
Document type	Editorial
ISSN	2398-631X
ISSN (online)	2398-631X
DOI	10.1136/leader-2021-000520
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Experiences, challenges and lessons learnt in medical staff redeployment during response to COVID-19.

Sykes, Anny / Pandit, Meghana

BMJ leader

2021 Volume 5, Issue 2, Page(s) 98–101

Abstract: Background: The response to the COVID-19 pandemic required redeployment of large numbers of staff to avoid acute services being overwhelmed. This unprecedented, previously unplanned redeployment occurred in a rapidly changing environment. This paper ... ...

Abstract	Background: The response to the COVID-19 pandemic required redeployment of large numbers of staff to avoid acute services being overwhelmed. This unprecedented, previously unplanned redeployment occurred in a rapidly changing environment. This paper describes the process of redeployment at a teaching hospital and assessment of this by the redeployed doctors and redeployment team. Objective: Identify key lessons from the redeployment process to inform resilience and future planning for further COVID-19 peaks. Methods: Redeployment team experiences and challenges were documented in real time and formal structured feedback obtained. All redeployed doctors were asked for quantitative and qualitative feedback regarding their experiences in two distinct acute areas with different approaches to staffing. Results: 63 redeployed staff and five members of the redeployment team completed feedback questionnaires. Most redeployed doctors (76%) were satisfied and had adequate support and training. Redeployment was associated with self-reported stress and anxiety in 95% with 59% describing this as moderate or greater. This was reduced by adequate communication, supervision and a sense of belonging to a firm with access to simple information making a significant difference. Awareness of and satisfaction with well-being support services was also high (71%).The redeployment team identified having a well-mixed team who met daily, an online portal and engagement with leads as the key factors for being successful. Conclusion: Redeployment in response to COVID-19 was associated with reported stress and anxiety in most redeployed doctors. Communication, local induction and feeling valued and being part of a team helped reduce this.
Language	English
Publishing date	2021-01-08
Publishing country	England
Document type	Journal Article
ISSN	2398-631X
ISSN (online)	2398-631X
DOI	10.1136/leader-2020-000313
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Clinical and economic impact of extracardiac lesions on coronary CT angiography.

Kelion, Andrew / Sabharwal, Nikant / Holdsworth, David / Dawkins, Sam / Peschl, Heiko / Sykes, Anny / Bashir, Yaver

Heart (British Cardiac Society)

2022 Volume 108, Issue 18, Page(s) 1461–1466

Abstract: Objective: When reporting coronary CT angiography (CCTA), extracardiac structures are routinely assessed, usually on a wide field-of-view (FOV) reconstruction. We performed a retrospective observational cross-sectional study to investigate the impact of ...

Abstract	Objective: When reporting coronary CT angiography (CCTA), extracardiac structures are routinely assessed, usually on a wide field-of-view (FOV) reconstruction. We performed a retrospective observational cross-sectional study to investigate the impact of incidental extracardiac abnormalities on resource utilisation and treatment, and cost-effectiveness. Methods: All patients undergoing CCTA at a single institution between January 2012 and March 2020 were identified. The indication for CCTA was chest pain or dyspnoea in >90%. Patients with ≥1 significant extracardiac findings were selected. Clinical follow-up, investigations and treatment were documented, and costs were calculated. Results: 4340 patients underwent CCTA; 717 extracardiac abnormalities were identified in 687 individuals (15.8%; age 62±12 years; male 336, 49%). The abnormality was already known in 162 (23.6%). Lung nodules and cysts were the most common abnormalities (296, 43.1%). Clinical and/or imaging follow-up was pursued in 292 patients (42.5%). Treatment was required by 14 patients (0.3% of the entire population), including lung resection for adenocarcinoma in six (0.1%). All but two abnormalities (both adenocarcinomas) were identifiable on the limited cardiac FOV. The cost of reporting (£20) and follow-up (£33) of extracardiac abnormalities was £53 per patient. The cost per discounted quality-adjusted life year was £23 930, increasing to £46 674 for reporting the wide FOV rather than the cardiac FOV alone. Conclusions: Extracardiac abnormalities are common on CCTA, but identification and follow-up are costly. The few requiring treatment are usually identifiable without review of the wide FOV. The way in which CCTAs are scrutinised for extracardiac abnormalities in a resource-limited healthcare system should be questioned.
MeSH term(s)	Aged ; Computed Tomography Angiography/methods ; Coronary Angiography/methods ; Coronary Artery Disease ; Cross-Sectional Studies ; Humans ; Incidental Findings ; Male ; Middle Aged ; Retrospective Studies
Language	English
Publishing date	2022-08-25
Publishing country	England
Document type	Journal Article ; Observational Study
ZDB-ID	1303417-0
ISSN	1468-201X ; 1355-6037
ISSN (online)	1468-201X
ISSN	1355-6037
DOI	10.1136/heartjnl-2021-320698
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Article ; Online: A 50-year-old man with a cough and painful chest wall mass.

Jones, Quentin / Benamore, Rachel / Fryer, Eve / Sykes, Anny

Chest

2014 Volume 145, Issue 5, Page(s) 1158–1161

MeSH term(s)	Actinomycosis/complications ; Actinomycosis/diagnosis ; Actinomycosis/therapy ; Antifungal Agents/therapeutic use ; Biopsy ; Chest Pain/diagnosis ; Chest Pain/etiology ; Chest Pain/therapy ; Cough/diagnosis ; Cough/etiology ; Cough/therapy ; Debridement ; Diagnosis, Differential ; Empyema/diagnosis ; Empyema/etiology ; Empyema/therapy ; Humans ; Lung Diseases/complications ; Lung Diseases/diagnosis ; Lung Diseases/therapy ; Male ; Middle Aged ; Radiography, Thoracic ; Thoracic Wall ; Tomography, X-Ray Computed
Chemical Substances	Antifungal Agents
Language	English
Publishing date	2014-05
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	1032552-9
ISSN	1931-3543 ; 0012-3692
ISSN (online)	1931-3543
ISSN	0012-3692
DOI	10.1378/chest.13-2039
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Article ; Online: Reexpansion pulmonary edema following local anesthetic thoracoscopy: correlation and evolution of radiographic and ultrasonographic findings.

Corcoran, John P / Psallidas, Ioannis / Barker, Graham / Sykes, Anny / Hallifax, Robert J / Gleeson, Fergus V / Rahman, Najib M

Chest

2014 Volume 146, Issue 2, Page(s) e34–e37

Abstract: Local anesthetic (medical) thoracoscopy is used with increasing frequency by pulmonologists worldwide for both diagnostic and therapeutic purposes, notably in comorbid patients who may not be physiologically robust enough for general anesthesia. ... ...

Abstract	Local anesthetic (medical) thoracoscopy is used with increasing frequency by pulmonologists worldwide for both diagnostic and therapeutic purposes, notably in comorbid patients who may not be physiologically robust enough for general anesthesia. Understanding the complications that can arise and how to manage them is crucial for any physician performing this procedure. Reexpansion pulmonary edema is a rare but recognized complication of draining pleural effusions and pneumothoraces that has not been described previously in association with physician-led thoracoscopy. This case provides an opportunity for an overview of what is known about this unusual but potentially fatal condition. Data correlating ultrasonographic, radiographic, and clinical progression are also presented to highlight the potential usefulness of ultrasonography in identifying lung parenchymal abnormalities such as extravascular lung water.
MeSH term(s)	Anesthesia, Local/adverse effects ; Anesthesia, Local/methods ; Anesthetics, Local/administration & dosage ; Diagnosis, Differential ; Drainage/methods ; Follow-Up Studies ; Humans ; Lung/diagnostic imaging ; Male ; Middle Aged ; Pleural Effusion/surgery ; Pulmonary Edema/diagnosis ; Pulmonary Edema/etiology ; Radiography, Thoracic/methods ; Recurrence ; Thoracoscopy/adverse effects ; Ultrasonography
Chemical Substances	Anesthetics, Local
Language	English
Publishing date	2014-08
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	1032552-9
ISSN	1931-3543 ; 0012-3692
ISSN (online)	1931-3543
ISSN	0012-3692
DOI	10.1378/chest.13-2989
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Article ; Online: Successful awake proning is associated with improved clinical outcomes in patients with COVID-19: single-centre high-dependency unit experience.

Hallifax, Rob J / Porter, Benedict Ml / Elder, Patrick Jd / Evans, Sarah B / Turnbull, Chris D / Hynes, Gareth / Lardner, Rachel / Archer, Kirsty / Bettinson, Henry V / Nickol, Annabel H / Flight, William G / Chapman, Stephen J / Hardinge, Maxine / Hoyles, Rachel K / Saunders, Peter / Sykes, Anny / Wrightson, John M / Moore, Alastair / Ho, Ling-Pei /

Fraser, Emily / Pavord, Ian D / Talbot, Nicholas P / Bafadhel, Mona / Petousi, Nayia / Rahman, Najib M

BMJ open respiratory research

2020 Volume 7, Issue 1

Abstract: The SARS-CoV-2 can lead to severe illness with COVID-19. Outcomes of patients requiring mechanical ventilation are poor. Awake proning in COVID-19 improves oxygenation, but on data clinical outcomes is limited. This single-centre retrospective study ... ...

Abstract	The SARS-CoV-2 can lead to severe illness with COVID-19. Outcomes of patients requiring mechanical ventilation are poor. Awake proning in COVID-19 improves oxygenation, but on data clinical outcomes is limited. This single-centre retrospective study aimed to assess whether successful awake proning of patients with COVID-19, requiring respiratory support (continuous positive airways pressure (CPAP) or high-flow nasal oxygen (HFNO)) on a respiratory high-dependency unit (HDU), is associated with improved outcomes. HDU care included awake proning by respiratory physiotherapists. Of 565 patients admitted with COVID-19, 71 (12.6%) were managed on the respiratory HDU, with 48 of these (67.6%) requiring respiratory support. Patients managed with CPAP alone 22/48 (45.8%) were significantly less likely to die than patients who required transfer onto HFNO 26/48 (54.2%): CPAP mortality 36.4%; HFNO mortality 69.2%, (p=0.023); however, multivariate analysis demonstrated that increasing age and the inability to awake prone were the only independent predictors of COVID-19 mortality. The mortality of patients with COVID-19 requiring respiratory support is considerable. Data from our cohort managed on HDU show that CPAP and awake proning are possible in a selected population of COVID-19, and may be useful. Further prospective studies are required.
MeSH term(s)	Aged ; Aged, 80 and over ; Betacoronavirus ; COVID-19 ; Continuous Positive Airway Pressure/methods ; Coronavirus Infections/mortality ; Coronavirus Infections/therapy ; Disease Progression ; Female ; Humans ; Male ; Middle Aged ; Noninvasive Ventilation/methods ; Odds Ratio ; Oxygen Inhalation Therapy/methods ; Pandemics ; Patient Positioning/methods ; Pneumonia, Viral/mortality ; Pneumonia, Viral/therapy ; Prone Position ; Retrospective Studies ; SARS-CoV-2 ; Treatment Outcome ; United Kingdom ; Wakefulness
Keywords	covid19
Language	English
Publishing date	2020-07-25
Publishing country	England
Document type	Journal Article
ZDB-ID	2736454-9
ISSN	2052-4439 ; 2052-4439
ISSN (online)	2052-4439
ISSN	2052-4439
DOI	10.1136/bmjresp-2020-000678
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Article ; Online: Improved COVID-19 outcomes in a large non-invasive respiratory support cohort despite emergence of the alpha variant

Najib M Rahman / Robert Wilson / John M Wrightson / Nayia Petousi / Ian Pavord / Mona Bafadhel / Stephen Chapman / Rachel Hoyles / William Flight / Emily Fraser / Annabel Nickol / Dinesh Addala / Radhika Banka / Robert Hallifax / Anny Sykes / John Park / Patrick Elder / Anand Sundaralingam / Maxine Hardinge /

BMJ Open Respiratory Research, Vol 8, Iss

2021 Volume 1

Keywords	Medicine ; R ; Diseases of the respiratory system ; RC705-779
Language	English
Publishing date	2021-12-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: ESX1-dependent fractalkine mediates chemotaxis and Mycobacterium tuberculosis infection in humans.

Hingley-Wilson, Suzanne M / Connell, David / Pollock, Katrina / Hsu, Tsungda / Tchilian, Elma / Sykes, Anny / Grass, Lisa / Potiphar, Lee / Bremang, Samuel / Kon, Onn Min / Jacobs, William R / Lalvani, Ajit

Tuberculosis (Edinburgh, Scotland)

2014 Volume 94, Issue 3, Page(s) 262–270

Abstract: Mycobacterium tuberculosis-induced cellular aggregation is essential for granuloma formation and may assist establishment and early spread of M. tuberculosis infection. The M. tuberculosis ESX1 mutant, which has a non-functional type VII secretion system, ...

Abstract	Mycobacterium tuberculosis-induced cellular aggregation is essential for granuloma formation and may assist establishment and early spread of M. tuberculosis infection. The M. tuberculosis ESX1 mutant, which has a non-functional type VII secretion system, induced significantly less production of the host macrophage-derived chemokine fractalkine (CX3CL1). Upon infection of human macrophages ESX1-dependent fractalkine production mediated selective recruitment of CD11b+ monocytic cells and increased infection of neighbouring cells consistent with early local spread of infection. Fractalkine levels were raised in vivo at tuberculous disease sites in humans and were significantly associated with increased CD11b+ monocytic cellular recruitment and extent of granulomatous disease. These findings suggest a novel fractalkine-dependent ESX1-mediated mechanism in early tuberculous disease pathogenesis in humans. Modulation of M. tuberculosis-mediated fractalkine induction may represent a potential treatment option in the future, perhaps allowing us to switch off a key mechanism required by the pathogen to spread between cells.
MeSH term(s)	Animals ; Bacterial Proteins/physiology ; CD11 Antigens/metabolism ; Cells, Cultured ; Chemokine CX3CL1/metabolism ; Chemokine CX3CL1/physiology ; Chemotaxis/physiology ; Humans ; Macrophages/microbiology ; Matrix Metalloproteinases/metabolism ; Mice, Inbred BALB C ; Monocytes/microbiology ; Mycobacterium tuberculosis/pathogenicity ; Tuberculosis/microbiology
Chemical Substances	Bacterial Proteins ; CD11 Antigens ; Chemokine CX3CL1 ; Matrix Metalloproteinases (EC 3.4.24.-)
Language	English
Publishing date	2014-02-03
Publishing country	Scotland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2046804-0
ISSN	1873-281X ; 1472-9792
ISSN (online)	1873-281X
ISSN	1472-9792
DOI	10.1016/j.tube.2014.01.004
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Article: Successful awake proning is associated with improved clinical outcomes in patients with COVID-19: single-centre high-dependency unit experience

Fraser, Emily / Pavord, Ian D / Talbot, Nicholas P / Bafadhel, Mona / Petousi, Nayia / Rahman, Najib M

Abstract	The SARS-CoV-2 can lead to severe illness with COVID-19. Outcomes of patients requiring mechanical ventilation are poor. Awake proning in COVID-19 improves oxygenation, but on data clinical outcomes is limited. This single-centre retrospective study aimed to assess whether successful awake proning of patients with COVID-19, requiring respiratory support (continuous positive airways pressure (CPAP) or high-flow nasal oxygen (HFNO)) on a respiratory high-dependency unit (HDU), is associated with improved outcomes. HDU care included awake proning by respiratory physiotherapists. Of 565 patients admitted with COVID-19, 71 (12.6%) were managed on the respiratory HDU, with 48 of these (67.6%) requiring respiratory support. Patients managed with CPAP alone 22/48 (45.8%) were significantly less likely to die than patients who required transfer onto HFNO 26/48 (54.2%): CPAP mortality 36.4%; HFNO mortality 69.2%, (p=0.023); however, multivariate analysis demonstrated that increasing age and the inability to awake prone were the only independent predictors of COVID-19 mortality. The mortality of patients with COVID-19 requiring respiratory support is considerable. Data from our cohort managed on HDU show that CPAP and awake proning are possible in a selected population of COVID-19, and may be useful. Further prospective studies are required.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #767949
Database	COVID19

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Article ; Online: Successful awake proning is associated with improved clinical outcomes in patients with COVID-19

Hallifax, Rob J / Porter, Benedict ML / Elder, Patrick JD / Evans, Sarah B / Turnbull, Chris D / Hynes, Gareth / Lardner, Rachel / Archer, Kirsty / Bettinson, Henry V / Nickol, Annabel H / Flight, William G / Chapman, Stephen J / Hardinge, Maxine / Hoyles, Rachel K / Saunders, Peter / Sykes, Anny / Wrightson, John M / Moore, Alastair / Ho, Ling-Pei /

Fraser, Emily / Pavord, Ian D / Talbot, Nicholas P / Bafadhel, Mona / Petousi, Nayia / Rahman, Najib M

BMJ Open Respiratory Research

single-centre high-dependency unit experience

2020 Volume 7, Issue 1, Page(s) e000678

Abstract	The SARS-CoV-2 can lead to severe illness with COVID-19. Outcomes of patients requiring mechanical ventilation are poor. Awake proning in COVID-19 improves oxygenation, but on data clinical outcomes is limited. This single-centre retrospective study aimed to assess whether successful awake proning of patients with COVID-19, requiring respiratory support (continuous positive airways pressure (CPAP) or high-flow nasal oxygen (HFNO)) on a respiratory high-dependency unit (HDU), is associated with improved outcomes. HDU care included awake proning by respiratory physiotherapists. Of 565 patients admitted with COVID-19, 71 (12.6%) were managed on the respiratory HDU, with 48 of these (67.6%) requiring respiratory support. Patients managed with CPAP alone 22/48 (45.8%) were significantly less likely to die than patients who required transfer onto HFNO 26/48 (54.2%): CPAP mortality 36.4%; HFNO mortality 69.2%, (p=0.023); however, multivariate analysis demonstrated that increasing age and the inability to awake prone were the only independent predictors of COVID-19 mortality. The mortality of patients with COVID-19 requiring respiratory support is considerable. Data from our cohort managed on HDU show that CPAP and awake proning are possible in a selected population of COVID-19, and may be useful. Further prospective studies are required.
Keywords	covid19
Language	English
Publisher	BMJ
Publishing country	uk
Document type	Article ; Online
ZDB-ID	2736454-9
ISSN	2052-4439
ISSN	2052-4439
DOI	10.1136/bmjresp-2020-000678
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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