Department of Medicine Research Expo

Research Expo Tuesday, October 30, 2012 Paetzold auditorium, Jim Pattison Pavillion, VGH Come See Department of Medicine faculty and guests from local centres talk about their research The first Department of Medicine Research Expo wwas held at the Paetzold Education Centre at VGH on Tuesday, October 30th.

 

This event was an opportunity for faculty presenters to give a talk about their research to their colleagues in the Department. We hope that this opportunity will result in new collaborations and interdisciplinary projects.

For a schedule and abstracts for the speakers, please see below.

Presenter Abstracts:

(For a downloadable document with all abstracts, click here. Please note that no abstract booklets will be available on the day of the event.)

1:10 Robin Hsiung

Assistant Professor, Neurology

Cognitive Impairment and Dementia: causes and rescue

Nearly half a million Canadians suffer from dementia. Recent advances in genetics and molecular biology holds promise for early detection, prevention, and treatments of dementia. Other risk factors such as head injuries, lower educational level, and vascular factors such as hypertension, diabetes, and hypercholesterolemia, all increase the risk of developing dementia over one’s lifetime. My research utilizes detailed data collected in our clinical cohorts to analyze the relationships between genetic and environmental risk factors that lead to Alzheimer Disease and related disorders, and study interventions that may help to preserve function and quality of life in this growing elderly population.

1:20 Neil Cashman

Professor, Neurology

Proteinopathies: the Future in Unfolding

We have found that propagated misfolding of Cu-Zn superoxide dismutase (SOD1) underlies familial and sporadic amyotrophic lateral sclerosis (ALS), providing new diagnostic and treatment targets for this disease. ALS now joins company with Alzheimer’s, Parkinson’s, and other neurodegenerative and systemic diseases as a “prion-like” disorder that transmits from cell to cell – and perhaps also between individuals.

1:30 Peter Dodek

Professor, Critical Care Medicine

Moral Distress In ICU Professionals Is Associated With Profession And Years Of Experience

Moral distress is experienced when a practitioner feels certain of an ethical course of action but is constrained from taking that action. Moral distress is associated with ‘burn-out’ and attrition. It is not known which demographic or professional factors are associated with moral distress in ICU professionals. We administered the Moral Distress Scale survey to 1390 health care providers in 13 ICUs. Nurses and other health professionals report higher moral distress than physicians. Age is associated (inversely) with moral distress, only in other health professionals, and years of experience is associated (directly) with moral distress, only in nurses. Moral distress is associated with quitting a job, past and present.

1:40 Rose Hatala

Associate Professor, General Internal Medicine

Do you hear what I hear? A systematic review and meta-analysis of simulation-based training for cardiac auscultation skills

A comprehensive, systematic search of multiple databases through May 2011 was undertaken. Included studies investigated simulation based medical education (SBME) to teach health professions learners cardiac physical examination skills using outcomes of knowledge or skill. We identified 18 articles for inclusion. Meta-analysis of the 13 no-intervention comparison studies demonstrated that simulation-based instruction in cardiac auscultation was effective, with pooled effect sizes of 1.10 (95% CI 0.49-1.72; p<.001; I2= 92.4%) for knowledge outcomes and 0.87 (95% CI 0.52-1.22; p<.001; I2 =91.5%) for skills. In sub-group analysis, hands-on practice with the simulator appeared to be an important teaching technique.

1:50 Anita Palepu

Professor, General Internal Medicine

Housing and Health in Transition: Methodological Challenges

This talk will illustrate the challenges and strategies we have used to optimize follow-up of a cohort of vulnerably housed and homeless persons in Vancouver as well as highlight the complex housing histories as well as data collection and entry issues we have encountered and our proposed solutions.

2:00 Nadia Khan

Associate Professor, General Internal Medicine

Ethnic differences in cardiovascular disease

Cardiovascular disease varies dramatically by ethnicity. We found that South Asian patients were twice as likely to develop AMI in BC as the general population and Chinese were 1/3rd as likely. We also found that Chinese and South Asian patients were more likely to present with atypical acute coronary syndrome and were more likely to arrive late for ACS. Once diagnosed, however, they were just as likely to receive coronary revascularization and secondary prevention medications as the general population. We also found however, Chinese patients and South Asian patients, to a lesser extent, were more likely to be non-adherent to secondary prevention medications. Chinese patient had a higher early mortality after AMI but South Asian patients had a much lower long term mortality after AMI. These data highlight the need for prevention interventions and enhanced chronic cardiovascular disease management.

2:10 Jerilynn C. Prior

Professor, Endocrinology and Metabolism

Progesterone and Women’s Cardiovascular Health 

Estrogen was considered cardioprotective for women until several large randomized controlled trials (RCT; HERS & WHI HT) showed it was not. However, menstruating premenopausal women are protected. Does progesterone add to estrogen for premenopausal protection? New RCT data in healthy postmenopausal women (n=108) for the first time show 15% (NS) improvement in endothelial function with oral micronized progesterone, no changes in weight, blood pressure, lipids, inflammation or coagulation except a small but significant decrease in HDL-C. Framingham General CVS profile was unchanged. Treatment of hot flushes with progesterone alone appears safe and progesterone may add CVS protection in premenopausal women.

2:20 Ken Madden

Associate Professor, Geriatric Medicine

Older Adults and Exercise

Although the benefits of aerobic exercise are well established in young adults, there has been much less work done on the effects of exercise prescriptions in older adults with multiple cardiovascular risk factors. This talk will briefly summarize some of the work the VITALiTY Research Lab has done in this area.

2:30 Craig Mitton

Associate Professor School of Population and Public Health/ Centre for Clinical Epidemiology and Evaluation

C2E2 – who are we and what do we do

In this talk the core mission and primary areas of research of the Centre for Clinical Epidemiology and Evaluation (C2E2) will be discussed. Some highlights from active research programs in health economics, health services research and biostatistics will also be presented.

2:40 Andrei Krassioukov

Professor, Physical Medicine & Rehabilitation

Autonomic assessment of Paralympic Wheelchair Athletes.

It is known that cardiovascular function and performance are intimately coupled with athletic performance following spinal cord injury. Our data from three Paralympics games (Beijing, Vancouver, London) suggests that autonomic nervous system control, and subsequent impairment of the cardiovascular system, has not been evaluated comprehensively in Paralympic athletes. A new evidence based autonomic assessment could provide needed component of athlete safety: prevention of practice of life threatening self-inducing episodes of autonomic dysreflexia or boosting. The ultimate goal of this proposal is to allow more athletes with severe autonomic instability to be involved in competitive sport and participate in Paralympic competitions.

2:50 Noah Silverberg

Clinical Assistant Professor, Physical Medicine & Rehabilitation

Improving outcomes from mild traumatic brain injury

Dr. Silverberg will outline a research program that aims to validate prognostic factors and advance rehabilitation strategies for improving outcome from concussion, or mild traumatic brain injury.

3:00 Claudia Jacova

Assistant Professor, Neurology

Cognitive Testing On Computer (C-TOC): Validity, feasibility, and acceptance

C-TOC is a tool in the format of a brief self-administered neuropsychological battery for the detection of Mild Cognitive Impairment (MCI). C-TOC has been created by a team of researchers in cognitive science, clinical neurology and computer science. The tool has undergone iterative development to meet the interface needs of cognitively impaired older users. In preliminary studies we have found high concurrent and convergent validity for all C-TOC subtests. In surveys we have found good acceptance among seniors attending a dementia clinic or recruited at a community centre, and among geriatricians providing care for those with MCI and dementia.

3:10 Vince Duronio

Professor, Respiratory Medicine

eEF2 kinase regulation of atherosclerosis

Oxidized LDL has long been known to alter macrophages by promoting their cytokine-independent survival. We have studied the signaling pathways regulated by oxidized LDL and found an important role for eEF2K.

3:20 Coffee Break

 

3:55 Marco Marra

Director, Genome Sciences Centre

4:10 Don McKenzie

Professor, Sports Medicine

Research in Sport and Exercise Medicine

‘Sports Medicine’ has evolved beyond ACL and rotator cuff injuries and now encompasses many subspecialties within Medicine. This presentation will review the scope and breadth of the research within the Division of Sports Medicine.

4:20 Ed Conway

Professor, Hematology

Uncovering new links between clotting and innate immunity

The coagulation and complement pathways simultaneously promote homeostasis in response to injury but cause tissue damage when unregulated. Mechanisms by which they cooperate are poorly under- stood. Our lab is devoted to uncovering novel interactions with a view to identifying new sites for therapeutic intervention.

4:30 Gordon Francis

Professor, Endocrinology and Metabolism

Smooth muscle cells as a major component of macrophage-like and foam cells in human atherosclerosis

Smooth muscle cells comprise a major component of human atherosclerotic plaque. Using tissues in the James Hogg Research Centre human tissue bank, we have characterized the contribution of SMCs to total foam cell and macrophage-like cells in human atherosclerosis and found that they contribute more than 50% of total foam cells and macrophage-like cells in these lesions. This represents a major shift in our understanding of atherosclerosis and potential targets for intervention.

4:40 Horacio Bach

Adjunct Professor, Infectious Diseases

Novel plastics embedded with silver nanoparticles to control catheter-associated infections

Infections associated with medical devices such as catheters, are an important cause of morbidity and mortality for patients. Antimicrobial activities of silver nanoparticles (AgNPs) in a range of 25-30 nm embedded in polyurethane plastics were evaluated. Results demonstrate that these novel synthesized plastics retain their antimicrobial activities. Also, no cytotoxic effect on macrophages was observed and no immunological response, based on the measurement of secreted cytokines, was detected. Thus, plastics embedded with AgNPs have great potential to be used in medical devices as a strategy to limit the incidence of infection attributable to microbial colonization of implanted medical devices.

4:50 David Moore

Assistant Professor, AIDS

Lack of effectiveness of antiretroviral therapy as an HIV prevention tool in serodiscordant couples in Uganda

We conducted a cohort study of HIV serodiscordant couples in rural Uganda. In one group the infected partner was receiving ART because of meeting eligibility criteria and in the second group the infected partner was not yet ART-eligible. Both groups received counseling and condoms every three months. A total of 586 couples were enrolled. 348 (59%) of the positive participants received ART during the study. We found 9 new infections among partners of ART participants and 8 infections in partners of non-ART participants, for an incidence rate of 2.09 and 2.30 infections per 100 person-years, respectively. The incidence rate ratio was 0.91 (p=0.84).

5:00 Viviane Lima

Assistant Professor, AIDS

Overview of HIV Treatment and Outcomes n British Columbia

Patient’s response distribution to HIV treatment is highly heterogeneous. While most patients derive a full treatment response, with sustained undetectable viral load and consequent CD4 cell count recovery, there is a number of patients who will have varying levels of detectable viral load while on treatment. Here, we describe the factors associated with treatment failure in a large cohort of patients receiving antiretroviral treatment in British Columbia.

5:10 Winson Cheung

Assistant Professor, Medical Oncology

Adjuvant Chemotherapy (AC) Initiation and Early Discontinuation in Elderly Patients (EPs) with Colon Cancer (CC)

Research suggests that EPs with cancer are commonly undertreated, but the precise reasons for this observation are unclear. We identified 810 patients: 51% men, 52% younger patients (YPs) and 48% EPs, and 74% received AC in the entire cohort. When compared to YPs, EPs had worse ECOG and more comorbidities (both p<0.01). EPs were less likely than YPs to receive AC (57 vs 91%, p<0.01). Frequent reasons for no treatment included age, comorbidities and perceived minimal benefit from AC. Among those treated with AC, EPs were less likely to receive FOLFOX (32 vs 74%, p<0.01) in favor of capecitabine due to patient preference, age and comorbidities. Once started on AC, EPs had similar rates of early treatment discontinuation as YPs (70 vs 62%, p=0.08). Reasons for early discontinuation were comparable between EPs and YPs. Receipt of either FOLFOX or capecitabine was correlated with improved cancer-specific survival (CSS), compared to surgery alone. Age did not modify CSS, irrespective of AC choice (interaction p for capecitabine and age=0.26; interaction p for FOLFOX and age=0.40). Our results suggest that AC should not be withheld from CC patients based on advanced age alone.

5:20 Christopher Carlsten

Associate Professor , Respiratory Medicine

Studying Health Effects of Air Pollution in Humans: APEL’s Interdisciplinary Approach to Public Health

To convincingly contribute to the knowledge base connecting air pollution to human health effects, and to leverage discoveries to public health benefits, requires an interdisciplinary approach. The Air Pollution Exposure Laboratory (APEL) strives to adopt this approach. Risks and benefits of this framework will be discussed.

5:30 Janice Eng

Professor, Physical Therapy and CIHR University Delegate

CIHR’s research agenda

5:45 Diane Finegood

President and CEO, Michael Smith Foundation for Health Research

MSFHR’s Current Activities and Future Directions

 

6:00 Networking Session