April – June Kudos 2017

Publications and Quality

Antoine Hakim has received the Canada Gairdner Wightman Award for “outstanding research into stroke and its consequences, and championing stroke prevention and treatment in Canada and beyond.” This award is given to one Canadian each year who has demonstrated outstanding leadership in medicine and medical science. In the early 1980′s, Dr. Hakim characterized how the brain tissue surrounding a stroke’s core could “hold its breath” for a short time and potentially come back to life if blood flow was restored. Working with many partners, he also developed and championed a strategy for stroke treatment and prevention that is now used across the country and beyond, saving countless lives and billions of dollars.

Antoine Hakim recently published a book called Save Your Mind about how to prevent dementia and the loss of mental control that accompanies that brain disease. It contains an easy-to-understand explanation of how the brain works and what happens when dementia affects it. Dr. Hakim argues that individuals can build up a defensive system, a cognitive reserve, to protect their mind from damaging events such as a stroke, and that it’s even possible to reverse the early signs of dementia. Former Governor General Michaëlle Jean calls the book “an immeasurably vital resource for the understanding, prevention and care of Alzheimer’s disease and dementia.” It was a #1 best-seller on Alzheimer’s disease and Dementia on Amazon.ca, and follows the French version published last year.

Leo Renaud, Catherine Morris and Antoine Hakim honoured for their impact on neuroscience – The Neuroscience Program recently held a world-class symposium honouring three of its most distinguished, long-serving scientists. Drs Renaud, Morris and Hakim have played a key role in shaping the neuroscience community in Ottawa and have also had an impact around the world. The symposium, titled “From the Bedside to Neurons and Back”, was held at the Canadian Aviation Museum and featured a keynote address from Dr. Joseph Martin, Dean Emeritus of Harvard University. More than 100 people attended the event. Drs+ Renaud, Morris and Hakim are continuing their work as emeritus senior scientists.

Mark Clemons and other colleagues published in BMC Medicine on 13 evidence-based characteristics that researchers can use to help identify predatory journals. It is not uncommon for a researcher to receive dozens of emails from “predatory” journals each week. These emails offer to publish academic research in an open access journal, often with rapid peer-review at a discount, but in many cases, they engage in questionable editorial practices.

Phil Wells and his international research team found that the blood thinner rivaroxaban is as safe as aspirin, and more effective at preventing recurrence of life-threatening venous thromboembolism. Dr. Wells recently presented the findings at the American College of Cardiology meeting, with simultaneous publication in the New England Journal of Medicine. While current guidelines recommend long-term treatment with blood thinners to prevent further clots, some patients are taking aspirin instead because they or their physicians believe it has a lower risk of bleeding. “We know from previous studies that only about 40 percent of venous thromboembolism patients are actually on long-term blood thinners,” said Wells. “We hope that this study, which shows the blood thinner rivaroxaban is as safe as aspirin but much more effective at preventing future clots, will convince patients and their physicians to continue life-long medication that can prevent potentially dangerous blood clots.”

John Bell and his colleagues recently published in Molecular Therapy – Oncology . They have found a way for cancer fighting viruses to avoid both immune system defences. Their approach makes use of the lymphocytic choriomeningitis virus, which has a unique ability to evade antibodies. It also uses the Maraba MG1 virus, which attacks many cancer cells without harming normal cells, as well as a protein from cobra venom that blocks complement molecules.

Mark Clemons and colleagues published in The Lancet Oncology. They have played an important role in an international clinical trial that has opened the door for a new kind of drug. The trial tested a drug that targets a protein called PI3K. Patients who received the drug survived an additional two months without disease progression and a certain subset survived an additional four months without progression. Although side effects were a concern, the trial showed for the first time that PI3K could be a promising target for advanced breast cancer. The Ottawa Hospital was one of the top enrolling sites in this trial, which included more than 1,000 patients in 29 countries.

Mark Freedman led the Ottawa site trial on a common oral acne medication that could provide a new affordable treatment option for people suffering from relapsing-remitting multiple sclerosis (MS), according to the results of a Canadian clinical trial published in the New England Journal of Medicine. The academic trial showed that minocycline can slow the progress of the disease in people who have recently experienced their first symptoms. While current therapies for relapsing-remitting MS cost about $20,000 to $40,000 per year in Canada, the minocycline treatment could offer similar results at $600 per year. The trial was led by the University of Calgary and included 142 participants at 12 sites across Canada.

Theodore Perkins and his team recently received the highest award at a major international conference for developing a new mathematical approach which will give scientists an extremely powerful tool to understand cancer and develop new treatments. One of the biggest challenges is to figure out more reliable and efficient ways to analyze a whopping 2.5 petabytes (2.5×1012 bytes) of data. This new approach could create more reliable networks to show how certain microRNA molecules are expressed together in cancer cells. The research was presented at the International Society for Computational Biology’s Great Lakes Bioinformatics Conference.

Marc Rodger led a research group that developed and validated a rule that was published in BMJ and could let half of women with unexplained vein blood clots stop taking blood thinners for life. Over 1.5 million Canadians will experience a vein blood clot in their lifetime, half happen for no apparent reason and guidelines recommend that patients take blood thinners for the rest of their lives. Dr. Rodger and his team developed the HERDOO2 rule to identify people who are at low risk of having another blood clot, and can therefore be taken off blood thinners. The team estimates that if the rule was implemented across Canada, 10,000 women would be able to come off blood thinners, and $7.7 million would be saved annually in drug costs. Authors: Rodger MA, Le Gal G, Ramsay T…

Research groups from TOH, affiliated with the University of Ottawa, have been awarded nearly $11 million in the most recent project grant competition from the CIHR. “The Ottawa Hospital is one of Canada’s top research and learning hospitals, where excellent care is inspired by research and driven by compassion,” said Dr. Duncan Stewart. “These CIHR results are consistent with our strong performance over many years and reflect the top quality of our science.”

The grants awarded to the Department of Medicine Researchers focus on:

  • Blood transfusions: Is male donor blood better for recipients than female donor blood? Summary; Principal Investigators: Dean Fergusson, Alan Tinmouth; Co-Investigators: Shane English, Alan Forster, Kumanan Wilson
  • Parkinson’s disease: A new model to study triggers and visualize disease progress. Summary; Principal Investigators: Doug Gray, John Woulfe; Co-investigator: Michael Schlossmacher
  • Pancreatic cancer: Using viruses to kill cancer cells and stimulate an anti-cancer immune response. Summary; Principal Investigator: Carolina Ilkow; Co-investigator: Avijit Chatterjee
  • Home care: Using big data to develop new tools to improve service delivery and patient outcomes (administered through Bruyère Research Institute); Summary; Principal Investigators: Peter Tanuseputro, Douglas Manuel
  • Kidney disease: Could cell fragments from umbilical cord blood treat acute kidney injury? Summary; Principal Investigator: Kevin Burns; Co-Investigators: Dean Fergusson
  • Septic shock: Evaluating mesenchymal stem cell therapy. Summary; Principal Investigators: Lauralyn McIntyre, Dean Fergusson; Co-Investigators: Duncan Stewart, Shane English, Paul Hébert, Timothy Ramsay…
  • Real-world trials: Developing an ethical framework. Summary; Principal Investigators: Dean Fergusson… Co-Investigators: Jeremy Grimshaw, Lauralyn McIntyre
  • Tobacco dependence: Strategies to reduce tobacco smoking among the most at-risk inner city low income population. Summary; Principal Investigators: Smita Pakhale
  • Blood clots: Comparing new blood thinners to prevent venous thromboembolism. Summary; Principal Investigators: Lana Castellucci, Marc Rodger; Co-Investigators: Grégoire Le Gal
  • Brain bleeding: Comparing blood transfusion strategies for aneurysmal subarachnoid hemorrhage. Summary; Principal Investigator: Shane English; Co-Investigators: Michael Chasse, Dariush Dowlatshahi, Dean Fergusson, Cheemun Lum, Shawn Marshall, Lauralyn McIntyre, Alan Tinmouth

Gonzalo Alvarez – The Public Health Agency of Canada announced an investment of $197,000 to expand a TB study led by Dr. Alvarez. The study involves a new drug combination called 3HP that can eliminate latent TB in just 12 weeks with once-a-week treatment, the new funding will allow Dr. Alvarez and his colleagues to fully expand their Iqaluit study to patients at The Ottawa Hospital and CHEO. Co-investigators and staff: Mulpuru, S., Aaron, S., Cameron, B., Grimshaw

John Bell and his colleagues have been awarded $4 million from the Ontario Institute of Cancer Research to develop and test new approaches to harness the immune system to attack cancer. The funding will support 1) a clinical trial of a made-in-Ottawa viral therapy combined with an immune-stimulating drug, 2) a clinical trial of the same viral therapy combined with a patient’s own genetically-enhanced immune cells, 3) analyzing patient samples to determine why some benefit from immunotherapy and others do not and 4) laboratory research to develop a new kind of immunotherapy that involves removing a patient’s cancer cells, infecting them with a virus, and putting them back into the same patient. See full story and share on twitter. Local team members: John Bell, Rebecca Auer, Guy Ungerechts, David Stojdl.

Garth Nicholas is leading a trial in Ottawa which combines two experimental viruses (one made at The Ottawa Hospital and the other in Hamilton) with a recently-approved drug that stimulates the patient’s immune system to attack their cancer. Part of the therapy was developed by Drs John Bell, David Stojdl and Brian Lichty. “In recent years, immunotherapy has shown great promise in treating certain kinds of cancer, but we’re still at the early stages of understanding and optimizing this approach.” said Dr. Nicholas. “We hope that this new combination of immunotherapies will make a difference for people with lung cancer.” The first patient was recently treated in Hamilton. An additional 54 patients are expected to be treated in Ottawa, Hamilton and other centers.

Mark Clemons, George Dranitsaris, and their colleagues have developed a new calculator that could help prevent nausea and vomiting for patients who experience side effects from cancer chemotherapy. The calculator incorporates eight risk factors to predict the likelihood that someone will suffer from nausea and vomiting after chemotherapy. It was developed using data from nearly 1,200 patients from five studies around the world. Patients who are deemed high risk can be given more aggressive anti-nausea drugs. A previous clinical trial led by Dr. Clemons showed that this kind of mathematical approach was more effective in preventing nausea and vomiting than leaving it up to physician choice. The calculator is meant to be used by physicians, in consultation with patients.

Rashmi Kothary was awarded $300,000 from the MS Society of Canada to investigate a molecule that may be preventing repair of the damage caused by multiple sclerosis (MS). During MS, the immune system mistakenly attacks the insulation that protects the nerves in the brain and spinal cord, known as myelin. Over time the body loses its ability to repair this damage. Dr. Kothary’s team previously discovered a small RNA molecule that helps control myelin production. The molecule, called MiR-145, keeps progenitor cells from becoming myelin-producing cells. The team thinks that high levels of this molecule at sites of MS damage could be preventing myelin repair. The researchers plan to explore the pathways this molecule is involved in, and determine how it can be manipulated to increase myelin production and recovery. They hope to one day target MiR-145 as a potential therapy for MS.

Lauralyn McIntyre, Michael Rudnicki and other Ottawa researchers are bringing stem cell discoveries made in the lab closer to human trials and therapies, thanks to five new peer-reviewed research grants from the Ontario Institute for Regenerative Medicine (OIRM) worth just over $1.5 million. The projects, led by the DoM Research, focus on translational research for septic shock trials (Dr. McIntyre), designing a drug delivery strategy for Duchenne muscular dystrophy (Dr. Rudnicki).

Announcements

Roanne Segal won the coveted Medicine Ball trophy at third annual Dancing with the Docs fundraiser. Drs Mark Clemons, Lothar Huebsch, Andrea Kew, also participated from the Department of Medicine and helped raise more than $160,000 for research and care at The Ottawa Hospital.

The Renal Hypertension Clinic at TOH’s Riverside Campus has become the first Canadian clinic to achieve American Society of Hypertension Certification as a Comprehensive Hypertension Center. This recognizes the team’s ability to treat highly complex cases, while also contributing to research and training. The team includes Drs Swapnil Hiremath, Cedric Edwards, Brendan McCormick, Ann Bugeja, Peter Magner and Jan Mooney, Dawn Johnston, Manon Campbell and Melanie Pierre.

Congratulations to the Department of Medicine members who received recognition at the TOH 2017 Excellence Awards Ceremony:

Physician Leadership - Krista Wooller

Physician Clinician Recognition Award – Stephen Kravcik

Research Excellence – this award recognized a team who has made a significant contribution to the research mandate of TOH – Harry Atkins and Marc Freedman

Patient Experience – this award recognizes a team who has made a significant contribution to TOH’s patient experience goal – Medical Aid In Dying (MAID) includes many DoM members, several preferred to remain anonymous

Healthier Populations – this award recognizes a team who has made a significant contribution to TOH’s healthier populations – Shirley Huang, Frank Molnar, Lara Khoury and Ed Spilg

Accreditation Excellence Award – awarded to the team that has improved quality of clinical care or supporting process through overall Accreditation Survey preparations. The team when above and beyond that which was required to meet an Accreditation Standard or ROP. The team demonstrated exceptional team collaboration and engagement in the process in order to improve care and service- John Kim (team representative)

Media

Smita Pakhale was interviewed on CBC Radio’s Ottawa Morning show about new research showing that Canadians with cystic fibrosis live longer than Americans.

Smita Pakhale was interviewed on APTN about The Bridge, a community engagement and research center in downtown Ottawa that works towards equitable access to high quality health care for people who use drugs. A research peer and client also spoke about his efforts to support The Bridge through The Ottawa Hospital Foundation’s Run for a Reason.

Dar Dowlatshahi was interviewed by CBC Ottawa Morning about his research using mobile tablets to get speech therapy to stroke patients sooner.

Antoine Hakim was interviewed by RadioCanada Toronto about a recent study that showed volunteering can reduce the risk of dementia.

Curtis Cooper was interviewed by the Ottawa Citizen about an Ebola vaccine trial he is playing a lead role in. Two hundred people with HIV in Africa and Canada (including Ottawa) will be recruited to test the safety and immunogenicity of the vaccine.

Shawn Aaron was interviewed by WRVO Public Media radio station about his study showing that one third of adults recently diagnosed with asthma did not have it.

Deborah Zimmerman was interviewed by Our Ottawa CBC Television about the treatment and management of kidney disease and what drew her to the field of Nephrology.

Kumanan Wilson was interviewed by the National Post and TVO about using the vaccine-tracking app CANImmunize to keep track of childhood immunizations. Canada has the second lowest rate of childhood vaccination among developed countries.

Natasha Kekre was interviewed on News1310 Ottawa about her work and research as a stem cell transplant physician and plans to investigate CAR-T cell therapy for cancer.

Harold Atkins was interviewed for the Ontario Institute for Regenerative Medicine’s blog about his clinical trial of stem cell transplantation for multiple sclerosis, focusing on “understanding the layers of consent and risk in clinical trials.”

Grégoire Le Gal will speak briefly about his role in revealing the Mediator scandal before the screening of La fille de Brest at The Outaouais Film Festival. Dr. Le Gal helped lead a case control study that found the diet pill was associated with fatal heart valve damage. The drug is believed to have caused the death of at least 500 people.