7 results on '"Oliver O'Sullivan"'
Search Results
2. 3 Cardiopulmonary, functional, cognitive and mental health outcomes post covid, across the range of severity of acute illness, in a physically active working age population: baseline findings from the MCOVID study
- Author
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Oliver O’Sullivan, David A Holdsworth, Peter Ladlow, Robert M Barker-Davies, Rebecca Chamley, Andrew Houston, Samantha May, Dominic Dewson, Daniel Mills, Kayleigh Pierce, James Mitchell, Cheng Xie, Edward Sellon, Jon Naylor, Joseph Mulae, Mark Cranley, Nick P Talbot, Oliver J Rider, Edward D Nicol, and Alexander N Bennett
- Subjects
General Medicine - Abstract
BackgroundThe medium-long impact of coronavirus disease 2019 (COVID-19) on active populations is yet to be fully understood, with potential individual and operational impact on military service personnel (SP). The M-COVID study was established to investigate cardiopulmonary, functional, cognitive, and mental health post-COVID-19 SP outcomes, across the spectrum of acute COVID-19 severity.MethodObservational four-cohort study; hospitalised, community-based illness with on-going symptoms (communitysymptomatic), community-based illness now recovered (community-recovered) and age, sex, job-role matched control. Participants underwent extensive clinical assessment involving cardiopulmonary imaging, submaximal and maximal exercise testing, pulmonary function, cognitive assessment, blood tests, electrocardiogram and questionnaires on mental health and physical function.Results113 participants (aged 39±9, 86% male) were recruited; Hospitalised (n=35), community-symptomatic (n=34), community-recovered (n=18) and control (n=26), 159±72 days following acute illness. Hospitalised and community-symptomatic groups were older (p=0.003), with a higher body mass index (pConclusionsRecovered SP who suffered mild-moderate COVID-19 do not differ from an age, sex and job-role matched controls. This is reassuring for the vast majority of individuals who have had acute COVID-19 not requiring hospital management. Individuals who were hospitalised or continue to suffer symptoms may require a specific, comprehensive clinical and occupational assessment prior to a full return to duty.
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- 2023
3. Review of neurological rehabilitation for Multiple Sclerosis in the British Military
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H Ellis, J Mitchell, L Price, L Allsopp, K Tourle, and Oliver O’Sullivan
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Adult ,medicine.medical_specialty ,Multiple Sclerosis ,media_common.quotation_subject ,Medical rehabilitation ,Neurological disorder ,Rehabilitation Centers ,03 medical and health sciences ,Presentation ,0302 clinical medicine ,Physical medicine and rehabilitation ,medicine ,Neurological rehabilitation ,Humans ,030212 general & internal medicine ,Neurorehabilitation ,media_common ,Symptom management ,business.industry ,Multiple sclerosis ,Neurological Rehabilitation ,General Medicine ,Service personnel ,medicine.disease ,Military Personnel ,business ,030217 neurology & neurosurgery - Abstract
Multiple sclerosis (MS) is a progressive neurological disorder, classically presenting in working age adults, including those in the Armed Forces. The Defence Medical Rehabilitation Centre (DMRC) Stanford Hall offers vocationally focused neurorehabilitation services for service personnel (SP) with MS, with the goal to minimise disability, maximise independence and remain able to work.This paper has two aims. First, it briefly provides a clinical update of MS, focusing on pathology, presentation, diagnosis and management. Finally, it will describe the role of DMRC and data from the last decade in the management of MS.Our findings suggest not all SP with MS are being referred to DMRC, and some of those who do have significant delays, potentially impacting on patient support, symptom management and occupational outcomes. It is hoped that this paper will improve awareness and recognition of MS for Armed Forces personnel.
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- 2021
4. Novel micropore particle technology for spinal cord injury chronic wound healing: a new paradigm?
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Oliver O'Sullivan, Rhodri Phillip, K Findlay-Cooper, and L Hayton
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Chronic wound ,medicine.medical_specialty ,Rehabilitation ,integumentary system ,business.industry ,Pressure sores ,medicine.medical_treatment ,Medical rehabilitation ,General Medicine ,medicine.disease ,Wound cleaning ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Current management ,Medicine ,030212 general & internal medicine ,medicine.symptom ,business ,Intensive care medicine ,Wound healing ,Spinal cord injury - Abstract
Current management of chronic wounds involves regular wound cleaning, antiseptic dressings and, when indicated, antimicrobials. Micropore particle technology (MPPT) is a novel concept for wound healing, aiming to bolster the action of the immune system by disrupting the wound biofilm and restoring the microbiome. Amicapsil is the first MPPT product licensed for clinical use. Patients with a spinal cord injury (SCI) are more likely to develop chronic wounds due to downregulation in their immune response increasing the risk of a minor wound, such as pressure sore, developing into large, non-healing wounds. At the Defence Medical Rehabilitation Centre (DMRC) Stanford Hall, patients with SCI often have chronic wounds causing pain, becoming infected and preventing full engagement with effective rehabilitation. We report on the first case of treatment with Amicapsil at the DMRC Stanford Hall and review MPPT as a potential new paradigm for the treatment of wound healing.
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- 2020
5. The Stanford Hall consensus statement for post-COVID-19 rehabilitation
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Philippa Turner, Mark Cranley, Alexander N. Bennett, Robert M. Barker-Davies, Rhodri Phillip, Alastair M. Nicol, Polly Baker, Daniel Sherwood, Theodora Papadopoulou, David Roscoe, Sardar Bahadur, Duncan Goodall, Oliver O'Sullivan, Kahawalage Pumi Prathima Senaratne, Michael Gough, Henrietta Ellis, Jonathan Norman, Alan Mistlin, Shreshth Dharm-Datta, Tammy Walker, and Sarah Lewis
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medicine.medical_specialty ,Sports medicine ,medicine.medical_treatment ,Pneumonia, Viral ,Physical Therapy, Sports Therapy and Rehabilitation ,virus ,recovery ,Betacoronavirus ,03 medical and health sciences ,0302 clinical medicine ,Quality of life (healthcare) ,Humans ,Medicine ,Orthopedics and Sports Medicine ,030212 general & internal medicine ,Grading (education) ,Pandemics ,Neurorehabilitation ,Rehabilitation ,biology ,SARS-CoV-2 ,business.industry ,Athletes ,Consensus Statement ,COVID-19 ,General Medicine ,Evidence-based medicine ,biology.organism_classification ,United Kingdom ,Military personnel ,consensus ,Family medicine ,Coronavirus Infections ,business ,sports and exercise medicine ,030217 neurology & neurosurgery - Abstract
The highly infectious and pathogenic novel coronavirus (CoV), severe acute respiratory syndrome (SARS)-CoV-2, has emerged causing a global pandemic. Although COVID-19 predominantly affects the respiratory system, evidence indicates a multisystem disease which is frequently severe and often results in death. Long-term sequelae of COVID-19 are unknown, but evidence from previous CoV outbreaks demonstrates impaired pulmonary and physical function, reduced quality of life and emotional distress. Many COVID-19 survivors who require critical care may develop psychological, physical and cognitive impairments. There is a clear need for guidance on the rehabilitation of COVID-19 survivors. This consensus statement was developed by an expert panel in the fields of rehabilitation, sport and exercise medicine (SEM), rheumatology, psychiatry, general practice, psychology and specialist pain, working at the Defence Medical Rehabilitation Centre, Stanford Hall, UK. Seven teams appraised evidence for the following domains relating to COVID-19 rehabilitation requirements: pulmonary, cardiac, SEM, psychological, musculoskeletal, neurorehabilitation and general medical. A chair combined recommendations generated within teams. A writing committee prepared the consensus statement in accordance with the appraisal of guidelines research and evaluation criteria, grading all recommendations with levels of evidence. Authors scored their level of agreement with each recommendation on a scale of 0–10. Substantial agreement (range 7.5–10) was reached for 36 recommendations following a chaired agreement meeting that was attended by all authors. This consensus statement provides an overarching framework assimilating evidence and likely requirements of multidisciplinary rehabilitation post COVID-19 illness, for a target population of active individuals, including military personnel and athletes.
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- 2020
6. 2 Cardiopulmonary exercise testing excludes clinically significant disease in military patients recovering from COVID-19
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Rebecca Chamley, David Holdsworth, Robert Barker-Davies, Alexander Bennett, Oliver O’Sullivan, Peter Ladlow, Andrew Houston, Samantha May, Joseph Mulae, Cheng Xie, Mark Cranley, Ed Sellon, Jon Naylor, Martin Halle, Gianfranco Parati, Constantinos Davos, and Ed Nicol
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General Medicine - Abstract
BackgroundPost-COVID-19 syndrome presents a challenge when determining the occupational grading of symptomatic military personnel, and their ability to deploy. In particular, the accurate assessment of patients with post COVID-19 syndrome is complicated by health anxiety and coincident symptomatic autonomic dysfunction. We therefore sought to determine whether either symptoms or objective cardiopulmonary exercise testing could predict clinically significant findings in the UK Armed Forces.Methods113 consecutive patients were assessed in a post COVID-19 military clinical assessment pathway. This included symptom reporting, history, examination, spirometry, echocardiography and cardiopulmonary exercise testing (CPET) in all, with chest CT, dual-energy CTPA and cardiac MRI where indicated. Symptoms, CPET findings and presence/absence of significant pathology were reviewed. Data were analysed to identify diagnostic strategies that may be used to exclude significant disease.Results7/113 (6%) patients had clinically significant disease adjudicated by cardiothoracic multi-disciplinary team. These patients had reduced fitness (&Vdot;O2 26.7(±5·1) vs. 34.6(±7·0) ml/kg/min; p = 0·002) and functional capacity (peak power 200 (±36) vs. 247 (±55) Watts; p = 0·026) compared to those without significant disease. Simple CPET criteria (&Vdot;O2 30.0 or VE/&Vdot;CO2 slope >35.0 in isolation) excluded significant disease with sensitivity and specificity of 86% and 83% respectively (AUC 0.89). The addition of capillary blood gases to estimate A-a gradient improved diagnostic performance to 100% sensitivity and 78% specificity (AUC 0.92). Symptoms and spirometry did not discriminate significant disease.ConclusionUK Armed Forces personnel with persistent symptoms post SARS-CoV-2 infection demonstrate reassuringly little organ pathology. CPET and functional capacity testing, but not reported symptoms, allow the exclusion of clinically significant disease.
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- 2022
7. HASHIMOTO'S ENCEPHALOPATHY PRESENTING AS REFRACTORY HYPOTHERMIA
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Saiju Jacob, Oliver O'Sullivan, and Aaron Sturrock
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medicine.medical_specialty ,Ataxia ,business.industry ,Limbic encephalitis ,Encephalopathy ,Hashimoto's encephalopathy ,Hypothermia ,medicine.disease ,Anti-thyroid autoantibodies ,Surgery ,Psychiatry and Mental health ,Dysarthria ,Methylprednisolone ,Anesthesia ,medicine ,Neurology (clinical) ,medicine.symptom ,business ,medicine.drug - Abstract
Hashimoto's encephalopathy (HE) is a neuropsychiatric condition characterised by elevated thyroid autoantibodies and an exquisite responsiveness to steroids. Patients may present with acute encephalopathic, chronic psychiatric, ataxia, CJD-like and limbic encephalitis symptoms. We report here, for the first time, a case of HE presenting with profound, refractory and recurrent hypothermia.A 58-year-old lady was admitted following an episode of slurred speech. At presentation GCS was 15, with a temperature of 28C and pulse of 35–45 bpm. She later developed progressive slurring dysarthria, and worsening paranoid ideation and delusions. Despite active warming with bear huggers, she remained hypothermic. 11 days after admission, her GCS dropped to 5, so was intubated and ventilated.The TPO antibody was raised at 507IU (normal 0–59IU). A diagnosis of HE was made and she responded dramatically to IV methylprednisolone. While rehabilitating on the ward one month later, her temperature fell to 33.5C and within 24 hours she was paranoid and agitated. A relapse of the HE was suspected. After a further course of IVMP, her temperature normalised, and confusion resolved within 36 hours.This case further expands the clinical phenotype of Hashimoto's encephalopathy. Furthermore it bears clinical similarities to disorders of hypothalamic dysfunction both traumatic, chronic inflammatory, and that after clonidine toxicity suggesting a possible target for future investigations.
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- 2015
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