Dr Jamie Rylance

Senior Clinical Lecturer in Respiratory Medicine; Honorary Consultant in Respiratory Medicine

Areas of Interest

  • Acute respiratory infection (factors impairing mucosal immunity, and clinical care)
  • Hospital medicine in resource limited settings

Background

 

After medical school in Nottingham, Jamie Rylance completed junior posts in General Internal Medicine, Emergency Medicine and Respiratory Medicine.

For two years he has worked in  Regional Hospital, Tanzania as a Medical Officer with . This work focussed on health service development, particularly on the quality of medical care given to critically unwell patients.

His further specialty training in General Internal Medicine and Respiratory Medicine incorporated a Clinical PhD. This examined Household Air Pollution (HAP) in Malawi as it affects innate immunity and redox balance in the lung, and sought mechanistic explanations for HAP related respiratory infection.

Research in Medecine

Mucosal immunity in the respiratory tract

PhD findings: HAP exposure, even in asymptomatic and healthy adults is associated with reduced antibacterial capacity of the alveolar macrophage, and increased buffering against oxidative stress in the lung epithelial lining fluid. Extending this work, Jamie is investigating the interaction of tuberculosis with HAP particulate exposed alveolar macrophages.

As part of the Foto-Cewek collaboration, we are using human models of pathogen carriage to understand the protective effect and risks of disease posed by nasophayngeal carriage of Streptococcus pneumoniae.

Clinical care of acute respiratory disease

Identification of patients at high risk of deterioration is a priority in the UK, and in more resource limited settings. Providing timely and appropriate respiratory support, including oxygen provision, is critical. Jamie Rylance has been examining how well severity scores predict deterioration, and the use of new modes of oxygen delivery. This includes humidified oxygen in acute asthma [UK] and the appropriate technology in resource limited settings (for example high flow oxygen concentrators).

In patients with respiratory infections complicated by sepsis, there is a high mortality in all settings. We are investigating additional (adjunct) treatments which might be used to improve patients’ immunity to infection. To support this work, we are developing near-patient tests to identify which patients might benefit from a “boost” to their immunity.

Collaboration in respiratory research in resource limited settings

Jamie Rylance collaborates with the study in Zimbabwe which examines the respiratory effects of vertically acquired HIV infection. In particular, this aims to understand how clinical patterns of disease correlate with abnormalities of lung function and chest radiography.

Teaching

Academic Supervision

 

  • University of Birmingham: projects
  • Foto-Cewek: MSc projects
  • : MRes /

Guidelines

  • Contribution to expert to the most recent WHO “ District Clinician Manual”, and the guidelines on WHO “Management of the Patient in Severe Respiratory Distress”.

Research in Medecine Grants

  • 2008- 2012: Clinical PhD for “Research in Medecine priorities in the developing world” (£320,000)
  • 2015 - : Confident in Concept award for whole blood phagocytic assay as a biomarker of sepsis (£50,000)

 

Publications

  • Selected Publications

    Mwalukomo T, Rylance SJ, Webb EL, Anderson S, O'Hare B, van Oosterhout JJ, Ferrand RA, Corbett EL, Rylance J. Clinical characteristics and lung function in older children vertically infected with HIV in Malawi. Journal of the Pediatric Infectious Diseases Society. 2015; in press.

    Lagan J, Cutts L, Zaidi S, Benton I, Rylance J. Are we failing our trainees in providing opportunities to attain procedural confidence? Br J Hosp Med (Lond). 2015; 76(2): 105-8.

    Collins AM, Rylance J, Wootton DG, Wright AD, Wright AKA, Fullerton DG, Gordon SB. Bronchoalveolar Lavage (BAL) for Research in Medecine; Obtaining Adequate Sample Yield. J Vis Exp. 2014: e4345.

    Rylance J, Fullerton DG, Scriven J, Aljurayyan AN, Mzinza D, Barrett S, Wright AK, Wootton DG, Glennie SJ, Baple K, Knott A, Mortimer K, Russell DG, Heyderman RS, Gordon SB. Household Air Pollution Causes Dose-dependent Inflammation and Altered Phagocytosis in Human Macrophages. American journal of respiratory cell and molecular biology. 2014.

    Gordon SB, Bruce NG, Grigg J, Hibberd PL, Kurmi OP, Lam KB, Mortimer K, Asante KP, Balakrishnan K, Balmes J, Bar-Zeev N, Bates MN, Breysse PN, Buist S, Chen Z, Havens D, Jack D, Jindal S, Kan H, Mehta S, Moschovis P, Naeher L, Patel A, Perez-Padilla R, Pope D, Rylance J, Semple S, Martin WJ, 2nd. Respiratory risks from household air pollution in low and middle income countries. The Lancet Respiratory medicine. 2014; 2(10): 823-60.

    Rylance J, Waitt P. Pneumonia severity scores in resource poor settings. Pneumonia. 2014; 5.

    Rylance J, Gordon SB, Naeher LP, Patel A, Balmes JR, Adetona O, Rogalsky DK, Martin WJ, 2nd. Household air pollution: a call for studies into biomarkers of exposure and predictors of respiratory disease. American journal of physiology Lung cellular and molecular physiology. 2013; 304(9): L571-8.

    Wheeler I, Price C, Sitch A, Banda P, Kellett J, Nyirenda M, Rylance J. Early warning scores generated in developed healthcare settings are not sufficient at predicting early mortality in Blantyre, Malawi: a prospective cohort study. PLoS One. 2013; 8(3): e59830.

    Bangert M, Wright AK, Rylance J, Kelly MJ, Wright AD, Carlone GM, Sampson JS, Rajam G, Ades EW, Kadioglu A, Gordon SB. Immunoactivating Peptide p4 augments alveolar macrophage phagocytosis in two diverse human populations. Antimicrobial agents and chemotherapy. 2013; 57(9): 4566-9.

    Cook J, Jefferis O, Matchere P, Mbale E, Rylance J. Sickle-cell disease in Malawian children is associated with restrictive spirometry: a cross-sectional survey. The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease. 2013; 17(9): 1235-8.

    Baker T, Rylance J. Critical care where there is no ICU: Basic management of critically ill patients in a low income country. Update in Anaesthesia. 2012; 28: 27.

    Baker T, Rylance J, Konrad D. Identifying Critically Ill Patients: Triage, Early Warning Scores and Rapid Response Teams. Update in Anaesthesia. 2012; 28: 22.

    Rylance J, Fullerton DG, Semple S, Ayres JG. The global burden of air pollution on mortality: the need to include exposure to household biomass fuel-derived particulates. Environ Health Perspect. 2010; 118(10): A424; author reply A-5.

    Rylance J, Pai M, Lienhardt C, Garner P. Priorities for tuberculosis research: a systematic review. Lancet Infect Dis. 2010; 10(12): 886-92.

    Tellabati A, Fernandes VE, Teichert F, Singh R, Rylance J, Gordon S, Andrew PW, Grigg J. Acute exposure of mice to high-dose ultrafine carbon black decreases susceptibility to pneumococcal pneumonia. Part Fibre Toxicol. 2010; 7: 30.

    Gordon S, Rylance J. Where there's smoke... there's tuberculosis. Thorax. 2009; 64(8): 649-50.

    Rylance J, Baker T, Mushi E, Mashaga D. Use of an early warning score and ability to walk predicts mortality in medical patients admitted to hospitals in Tanzania. Trans R Soc Trop Med Hyg. 2009; 103(8): 790-4.

     

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