October– November 2017 Kudos

Publications and Quality

John Scott recently published in PLOS ONE on End of Life Care for Patients Dying of Stroke. It has been previously reported that nurses expressed discomfort caring for patients at the end of life or those who have suffered severe strokes. Therefore, nurses were asked to rate their comfort with treating patients at the end of life using the Stroke End-of-Life Care Comfort Scale before and after attending an education session. The session included the presentation of a checklist for suggested orders for end-of-life care. The results showed a significant improvement 3-4 weeks after the education session compared to the score before the session, therefore the combination of focused education sessions and an order checklist can significantly improve the comfort of nurses caring for patients at the end-of-life after stroke.

Mitchell Sabloff and colleagues recently published in Nature Cell Biology on providing hope for people with acute myeloid leukemia (AML). The research team discovered that fat cells play a key role in normal blood regeneration, but this is disrupted in AML. They also transplanted human AML cells into mice and treated them with small molecules that boost bone marrow fat. This supressed the cancer and stimulated healthy blood regeneration at the same time. One of the molecules they tested is already being used in clinical trials for other conditions, providing hope that human AML trials could begin relatively quickly.

Jeremy Grimshaw led a study published in Sexually Transmitted Infections, which showed that delivery of gonorrhea treatment in Ontario often lags behind changes to treatment guidelines. Using data from Ontario gonorrhea cases over eight years, researchers tracked whether patients actually received the treatment recommended by the latest guideline. The results, show that directly after a major guideline change in 2011, only 20 percent of cases received appropriate treatment. Fifty-nine percent of cases were receiving the recommended treatment by the end of the study in May 2014. The researchers concluded that treatment guideline changes need to be better communicated to sexual health, STI clinics and primary care providers.

David Grimes recently published in Neurology to assess effects of caffeine on Parkinson disease (PD). The results of the study showed that caffeine was well-tolerated with similar prevalence of side effects as the placebo. There was no improvement in motor parkinsonism (the primary outcome) with caffeine treatment compared to placebo. Similarly, on secondary outcomes, there was no change in motor signs or motor symptoms at any time point, and no difference on quality of life. The conclusion showed that caffeine did not provide clinically important improvement of motor manifestations of PD (Class I evidence).

Erin Keely published in the Journal of Rheumatology. The study objective was to describe the use and benefits of an innovative eConsult service to improve access to rheumatologists. There were 225 eConsults directed to rheumatology that were categorized by type of question and effect on face-to-face referral rates. The conclusion showed that there are clinical questions that can be answered quickly by an eConsult, improving access to rheumatologists.

Swapnil Hiremath and Brendan McCormick recently published in PLOS ONE on the effectiveness in treating hypokalemia among peritoneal dialysis patients. Hypokalemia is common in peritoneal dialysis (PD) patients and is associated with increased cardiovascular and all-cause mortality. The management at the centre routinely includes spironolactone and this study was to assess the efficacy of spironolactone for the treatment of hypokalemia in PD patients. The findings showed that spironolactone is safe and effective in treating hypokalemia in PD patients. It is also an effective antihypertensive agent and merits further study in the PD population.

Lauralyn McIntyre, Duncan Stewart, Dean Fergusson and colleagues recently published in the American Journal of Respiratory and Critical Care Medicine. This is the world’s first clinical trial of mesenchymal stem cell therapy for septic shock, a life-threatening condition that can occur when an infection spreads throughout the body. Drs McIntyre, Stewart, Fergusson and their colleagues are testing the idea that certain stem cells may also be able to help control the body’s immune system to reduce injury and promote healing, while improving its ability to fight infection. Shawn Aaron is being recognized by Asthma Canada with its annual Leadership Award in Health Research. Dr. Aaron recently received attention around the world for his research showing that a third of Canadian adults diagnosed with asthma don’t actually have the condition. Over 90 percent of these people were able to stop their asthma medications and remain safely off medication for at least one year. Dr. Aaron was also recently awarded a Foundation grant from the Canadian Institutes of Health Research to investigate the opposite problem of under-diagnosis. Some research suggests that up to 10 percent of Canadians have asthma or COPD, but are unaware and are not receiving treatment.

Phil Wells recently published in PLOS ONE on the benefit of early discharge among patients with low-risk Pulmonary Embolism (PE), a leading cause of cardiovascular morbidity and mortality. The results of this study showed that LRPE patients with a short Length Of Stay (LOS) had better clinical outcomes at lower costs than those with a long LOS. Therefore, risk stratification of PE patients is of utmost importance, and reducing the LOS among LRPE patients may substantially reduce the disease’s clinical and economic burden. Authors: Dr. Phil Wells… 

Announcements

John Bell received the Outstanding Achievements in Cancer Research Award for his “pioneering work and ground-breaking scientific discoveries, which have propelled the entire field of oncolytic virus therapy forward, and his commitment to enabling translational research.” Committed to “bench to bedside” research, Dr. Bell has worked tirelessly to build the infrastructure to make these state-of-the-art immunotherapies a reality for patients. Through his participation in various community forums, he has made oncolytic virus therapies understandable to patient populations. The award was presented during the CCRA’s Canadian Cancer Research Conference.

Antoine Hakim and Lynn Megeney recently accepted prestigious awards from St. Boniface Hospital’s Institute of Cardiovascular Science. Dr. Hakim received the Robert Beamish Leadership Award while Dr. Megeney accepted the Vincenzo Panagia Distinguished Lecture Award.

Antoine Hakim received the Canada Gairdner Wightman Award for “outstanding research into stroke and its consequences and championing stroke prevention and treatment in Canada and beyond.” He also gave his Gairdner lecture at the University of Ottawa.  

Manish Sood helped CADTH launch the results of their expert panel on home-based dialysis for people with end-stage kidney disease. “For many patients, home dialysis is a safe and preferred alternative to frequent hospital visits,” he said. “I’m hopeful that with these evidence-informed recommendations, we can kick-start a national conversation about the role of home-based treatment in Canada.” 

Claire Touchie’ s article On The Promise, Perils, Problems And Progress Of Competency-Based Medical Education was recognized in the top 15 downloaded article for 2016 for the journal Medical Education. Competency-based medical education is being adopted wholeheartedly by organizations worldwide in the hope of meeting today’s expectations for training competent doctors.

OHRI Annual Research Award Recipients– Drs. Zha and Schlossmacher: Xiaohui Zha will receive the Chrétien Researcher of the Year Award for her breakthrough in understanding why our cells make more cholesterol and fat after a big meal. This could lead to new treatments for obesity, diabetes and related diseases.

Michael Schlossmacher will receive the Grimes Research Career Achievement Award for his pioneering research on Parkinson’s disease, including its connection with the immune system, as well as his broader leadership in neuroscience.

Ottawa researchers have been awarded nearly $10 million from the Canada Foundation for Innovation for new equipment and facilities to support cutting-edge research on neuromuscular diseases and virus-based therapies. “This funding will help us build on recent breakthroughs in our understanding of neuromuscular diseases, design much-needed new therapies and evaluate them in patients,” said Dr. Rashmi Kothary, who leads the $4 million neuromuscular project together with Dr. Bernard Jasmin. The virus project, awarded $5.8 million, is led by Dr. John Bell. Other DoM researchers involved in the project: Robin Parks, Michael Rudnicki, Jodi Warman Chardon, Jeffrey Dilworth, Harold Atkins, Marjorie Brand, Lynn Megeney, Duncan Stewart, Guy Ungerechts.

TOH Post-Visit Feedback Recognizing TOH PhysiciansDr. Carl van Walraven took the time to personally call me each morning and give me an update … He left his business card by the bedside with all of his contact information. I think that this exemplifies the values of TOH, and it is an extremely personal touch that leaves patients and family members feeling that they truly are in the best care possible.” Division of General Internal Medicine.

The kindness and nurturing care provided our Mum and the family was wonderful by Dr. Chris Skinner, and helped us with the transition from life to death.” Division of Neurology.

Media

Duncan Stewart was interviewed by CBC National News about private Canadian clinics offering unproven stem cell treatments for muscle, joint and sports injuries. He emphasized that these treatments are experimental and should only be offered as part of a properly designed clinical trial.

John Bell was interviewed by CBC’s Second Opinion about a new CAR-T therapy approved to treat cancer in the U.S., and efforts to develop a made-in-Canada version.

Curtis Cooper was interviewed by Global TV about successes and challenges in fighting HIV in Canada. 

Kumanan Wilson represented The Ottawa Hospital at the annual Health Research Showcase at Queen’s Park, organized by the Council of Academic Hospitals of Ontario. He talked about mobile health and big data on Facebook Live.