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Advanced imaging will help better guide radiation treatments

MEDIA RELEASE
For Immediate Release
January 12th, 2022

 

London, Ontario- Prostate cancer is the most common cancer among Canadian men, and it is estimated that one in eight men will be diagnosed with prostate cancer within their lifetime. Researchers at both Lawson Health Research Institute and Sunnybrook Research Institute, are teaming up on a study which is pairing advanced imaging technology with high precision short course radiotherapy, that could lead to better outcomes for patients.

“We have started to look at ways to integrate advanced imaging to help better understand the amount of cancer in the prostate and the location of cancer in the prostate to help guide radiation treatments,” says Lawson Scientist, and Radiation Oncologist at London Health Sciences Centre’s (LHSC) London Regional Cancer Program (LRCP), Dr. Glenn Bauman.

Currently when radiation is done, a computer tomography scan (CT)  gives radiologists the location and boundary of the prostate, but it doesn’t give details about the location of the cancer within the prostate.

“What we are doing in the study is integrating two other forms of imaging; magnetic resonance imaging (MRI) and prostate specific membrane antigen (PSMA) PET scans, both of which can give information on the exact location of the cancer,” explains Dr. Bauman. “This will allow us to refine the radiation treatment and to target the cancer with more intensified radiation.”

Scientist at Sunnybrook Research Institute, Dr. Andrew Loblaw says using advanced imaging will also pinpoint if the cancer has moved into other areas of the pelvic region, which helps target all possibilities and lessens the chance of the cancer coming back. The type of radiation being used for this study is called stereotactic body radiotherapy (SBRT) which is more accurate, and reduces both radiation side effects to adjacent organs, while also reducing treatment visits.

“The combination of PSMA and SBRT gives us the ability to save some normal tissue and dramatically reduce treatment times,” explains Dr. Loblaw. “If we know the cancer is in one place and not another, we can spare radiation from areas not needing it which spares side effects.”

The team plans to recruit 50 men for the study that have advanced prostate cancer and need more intense treatments.  Participants will undergo the advanced PSMA PET imaging at St. Joseph’s Health Care London.  The same imaging techniques will be used to determine and track if the cancer is responding well to treatments.

“This is a smarter tool that will help us more accurately know what patients have,” says Dr. Loblaw. “We will know if they have more of a metastatic disease and who has localized disease. Cure rates are better when you know exactly what you are trying to cure.”

Study participants will be closely monitored for five years, to determine the success of the more targeted and intense radiation treatments.  Dr. Bauman says this will also help quickly identify the potential need for more advanced therapies.

“Our treatments are good, but If there is a man we haven’t cured we want to know as soon as possible.”

The study has received funding by the Ontario Institute for Cancer Research (OICR) as part of the Institute’s new initiative that supports pre-clinical research and new clinical trials that focus on early stage, and recurrent cancers.
 

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About Lawson Health Research Institute: Lawson Health Research Institute is one of Canada’s top hospital-based research institutes, tackling the most pressing challenges in health care. As the research institute of London Health Sciences Centre and St. Joseph’s Health Care London, our innovation happens where care is delivered. Lawson research teams are at the leading-edge of science with the goal of improving health and the delivery of care for patients. Working in partnership with Western University, our researchers are encouraged to pursue their curiosity, collaborate often and share their discoveries widely. Research conducted through Lawson makes a difference in the lives of patients, families and communities around the world. To learn more, visit www.lawsonresearch.ca.

About Sunnybrook Research Institute: Sunnybrook Research Institute (SRI) is the research arm of Sunnybrook Health Sciences Centre, an internationally recognized academic health sciences centre fully affiliated with the University of Toronto. SRI is one of the fastest growing hospital-based research enterprises in Canada with well-established programs in basic and applied sciences which span across three scientific platforms and ten clinical programs, developing innovations in care for the more than 1.3 million patients the hospital cares for annually. Recognized as a Centre of Excellence in focused ultrasound, SRI has one of the most comprehensive and successful focused ultrasound research programs in the world, with technical, scientific and clinical experts accelerating progress in the field.

FOR MORE INFORMATION, PLEASE CONTACT:
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www.lawsonresearch.ca/news-events

A new study from Lawson Health Research Institute and Western University published in the journal Microbiome has found changes in the microbiome in multiple locations in the body are linked to the formation of kidney stones.

The human microbiome comprises trillions of microorganisms, including healthy bacteria. In recent years, research has begun to uncover its role in health and numerous diseases.

The research team examined the gut, urinary and salivary microbiomes in 83 patients who had kidney stones and compared them to 30 healthy controls. They found changes in all three microbiomes were linked to kidney stone formation.

“Kidney stone disease has been rising in recent years, affecting roughly 10 per cent of people,” says Dr. Jeremy Burton, Lawson Scientist and Research Chair of Human Microbiome and Probiotics at St. Joseph’s Health Care London (St. Joseph’s). “While previous research has shown a connection between the gut microbiome and kidney stones in those who have taken antibiotics, we also wanted to explore the connection to other microbiomes in the hopes we can advance understanding and potential treatments.”

Study participants included people who had formed kidney stones, had not had antibiotic exposure in the last 90 days and were having the stones removed surgically at St. Joseph’s.

“Our testing – called shotgun metagenomic sequencing – allowed us to discover which bacteria were present in the gut and the genetic capabilities of those bacteria, or how it functions. We also did a simpler sequencing of the oral and urinary samples,” explains Dr. Kait Al, lead author on the study and Postdoctoral Research Fellow at Western’s Schulich School of Medicine & Dentistry.

Kidney stones are most commonly formed from calcium oxalate, which is a waste product produced by the body. Historically, it was thought people with specific gut microbes, like one bacterium called Oxalobacter formigenes that breaks down oxalate, were less likely to form kidney stones. This study suggests there are other factors.

“It’s a more complex story. The microbes form a kind of network that’s stable and beneficial in healthy people, but in those with kidney stones, that network is broken down. They’re not producing the same vitamins and useful metabolites, not just in the gut but also in the urinary tract and oral cavity,” Dr. Al explains.

There was also evidence that those with kidney stones had been exposed to more antimicrobials, as they had more antibiotic-resistant genes.

“We found not only that those who got kidney stones had an unhealthy microbiome, including a gut microbiome that was more likely to excrete toxins to the kidneys, but also that they were antibiotic resistant,” explains Dr. Burton, also an Associate Professor in the Department of Microbiology and Immunology at Schulich Medicine & Dentistry.  

The research team says that although more research is needed, these initial findings shed light on the overall importance of a person’s microbiome and keeping it as healthy as possible, with a microbiome-friendly diet and minimal antibiotic use potentially part of the solution.

The study was funded in part through the Weston Foundation and supported by the American Urological Association.

LONDON - In a study published in MDPI Journal, a team of researchers at Lawson Health Research Institute have shown that the use of technology may assist in better outcomes for those living with both mental health and physical disorders.

Dr. Cheryl Forchuk, Assistant Scientific Director at Lawson, and her team embarked on a pilot study that used smart home monitoring solutions to assist those living with both a mental health disorder and other health challenges. The purpose of this pilot study was to see if technology could improve overall lifestyle and wellbeing.
 
“We began our research by using hospital prototype apartments – apartment style care spaces within hospital settings – that were equipped with smart home technology solutions such as a screen device, activity trackers, weigh scales and medication dispensers,” says Dr. Forchuk who is also the Beryl and Richard Ivey Research Chair in Aging, Mental Health, Rehabilitation and Recovery at St. Joseph’s Health care London. “Once we tested it in a hospital setting, we wanted to find a way to take this idea out into the community in different kinds of housing and living situations to see if it would be beneficial.”

The research team partnered with the Canadian Mental Health Association (CMHA) and the London and Middlesex Community Housing (LMCH) to work together to retrofit the homes of the 13 study participants.

“We worked together with the participants and their care providers to choose what combination of  technology they felt would be best for them,” says Dr. Forchuk. “No matter their health condition each participant wanted to be more active and independent, with the goal of staying out of hospital.”

All smart devices were connected to the Lawson Integrated Database, which is a database that can securely collect data from multiple sources such as health devices. This allowed care providers to send reminders to participants, while also tracking usage and results.

“The key benefits we noted was that study participants started to live healthier lives,” says Jonathan Serrato, Lawson Research Associate. “Participants logged going for walks and exercising more often, as well as making healthier food choices. Those who used the medication dispensers did not miss a single dose. The touch screen devices also allowed participants to easily communicate with care providers and support networks, and access more resources.”

Following the pilot study, the research team also published a subsequent paper, as a ‘how-to guide’ for utilizing smart home technology interventions as a health care tool.

“This paper is a helpful resource that outlines implications and considerations when it comes to smart home technologies,” adds Serrato. “There are many areas we touch upon such as security, privacy and feasibility as well as hardware and software information for those who would like to take on their own similar type of smart home technology project.”

LONDON - Recently published in The Journal of Translational Medicine, a team at Lawson Health Research Institute has discovered unique patterns of blood plasma proteins in patients with suspected long COVID that could act as a potential drug target to improve patient outcomes.

Currently, approximately 10-20 per cent of people with a confirmed case of COVID-19 will get long COVID.

“Those patients experience a wide variety of symptoms, which may include fatigue, brain fog and difficulty breathing,” says Dr. Douglas Fraser, Lawson Scientist and Critical Care Physician at London Health Sciences Centre (LHSC). “Their quality of life can be significantly altered, so anything that we can do to learn about this disorder and identify potential treatment targets is very important.”

Called “the plasma proteome,” the proteins being studied are found in blood plasma and are released by cells that often play an important role in the body’s immune response to viruses. The research team is studying how those proteins adapt and change in long COVID.

“Trying to understand this mechanism is quite important because it provides further insight into how patients are affected,” says Dr. Michael Nicholson, Associate Scientist at Lawson and Respirologist at St. Joseph’s Health Care London (St. Joseph’s). “This paper sheds further light onto a possible mechanism which may provide insight into why some patients have certain symptoms.”

As part of the study, blood plasma samples were collected from long COVID outpatients through the Post-Acute COVID-19 Program at St. Joseph’s and analyzed in comparison to acutely ill COVID-19 inpatients at London Health Sciences Centre (LHSC), as well as compared to a group of healthy volunteers.

“We used novel technologies for this study, allowing us to analyze more than 3,000 proteins in blood plasma at the same time with multiple patients,” explains Cristiana Iosef, Research Analyst at Children’s Health Research Institute (CHRI), a program of Lawson. “We used novel bioinformatic pipelines, a form of artificial intelligence (AI), to then analyze the proteins to determine the specific changes that occur in long COVID.”

By using advanced technology the researchers were able to determine unique patterns in the blood proteins. The team discovered that people with suspected long COVID have prolonged inflammation associated with changes in their immune cells and blood vessels. These changes may lead to problems in specific organs, like the brain and the heart.

Dr. Fraser, who is also a Professor at Western University, adds that the proteins discovered could act as a potential drug target. The team is now examining potential new drug therapies with the hopes of improving outcomes for these patients.

“When we identify these signaling patterns within the blood plasma, we can then take the information and screen drug databases to better understand which drugs would be best to target the changes we identified in long COVID patients,” says Dr. Fraser. “With this understanding, the identified drugs may be used in future long COVID clinical trials.”

This research, which used multiple state-of the-art technologies, was enabled by existing expertise and infrastructure through CHRI.

LONDON, ON- The COVID-19 pandemic has taken a toll on social connections, emotional health and well-being, especially for older adults.  A new study through Lawson Health Research Institute will examine whether online/virtual ‘meaning-centered’ groups can help promote social connections and reduce risk for psychological distress.

Online meaning-centered groups are a promising approach developed by a research team led by Dr. Marnin Heisel, a Lawson Scientist, Clinical Psychologist at London Health Sciences Centre and Professor at the Schulich School of Medicine and Dentistry at Western University.

In his previous research, which began in-person and pivoted online during the pandemic, Dr. Heisel found that Meaning-Centered Groups helped men transitioning into retirement, a time when there is often a struggle with issues of identity, purpose and lost social connections.

“We found that people really enjoyed the camaraderie, they supported one another and many of them started getting involved in community activities, including outreach activities of their own and volunteering,” says Dr. Heisel.

Now, Dr. Heisel and his colleagues are looking to recruit participants from one of the populations hardest hit by the mental health impacts of the pandemic – older adults, who have become even more socially isolated.

“A lot of my research is focused on suicide prevention in older adults and I realized over time that one of the best ways of doing that is not waiting until people have to come for a psychologist or psychiatrist’s help, but rather to intervene much earlier and help people find those things that make life worth living,” notes Dr. Heisel.

The sessions will be 75 to 90 minutes and convened online once a week for eight weeks. The hope is to include approximately 10 people per group, with multiple groups underway at the same time.

“The meetings will focus on supporting one another, trying to build and enhance psychological resiliency, focusing on finding meaning in creative outlets, in relationships and other experiences,” explains Dr. Heisel. “They will also focus on attitudes towards challenges in life including adversities, the pandemic, being socially isolated, and also positive experiences.”

Dr. Heisel says he recognizes that the virtual format can be a challenge for some, but his team will help participants to both access and successfully use the technology.

Recruitment for the study is underway. Those interested in participating or who have friends or loved ones who might be interested can contact Dr. Heisel at Marnin.Heisel@lhsc.on.ca or view the study website at https://meaningfulgroups.com/groups for details.

Funding for the study is being provided by the Centre for Aging and Brain Health Innovation at the Baycrest Centre and the Canadian government.
 

LONDON, ONTARIO - Lawson Health Research Institute and the Centre of Excellence on Post-Traumatic Stress Disorder (PTSD) are partnering with a population at high risk of mental illness – Canadian Veterans and spouses of Canadian Veterans – to study how they have been impacted by the COVID-19 pandemic. Through online surveys, the project will hear directly from Veterans and their spouses to assess the pandemic’s effects on their wellbeing over time. The team hopes results can be used by health care workers and policymakers to support Veterans and their families during both the current pandemic and future public health emergencies. 

“With concerns about COVID-19 infection and drastic changes to everyday life, the pandemic is taking a toll on the health of Canadians,” explains Dr. Don Richardson, Lawson Associate Scientist and Director of the MacDonald Franklin Operational Stress Injury (OSI) Research Centre. “And it may be particularly distressing for those vulnerable to mental illness.”

Population studies show that Canadian Veterans are at double the risk of mental illness when compared to the rest of the population. They experience higher rates of depression, anxiety and loneliness. Spouses of Canadian Veterans are also at higher risk of distress, sometimes undertaking significant caregiving responsibilities that lead to less independence.  

“It’s currently unknown how the pandemic will impact Veterans and their spouses, but it could result in particularly serious outcomes,” says Dr. Anthony Nazarov, Associate Scientist at Lawson and the MacDonald Franklin OSI Research Centre. “We want to hear from all Canadian Veterans and their spouses, whether they’re doing well or not and whether they’re seeking care or not.”

The study aims to recruit 1,000 Canadian Veterans and 250 spouses of Canadian Veterans.  Participants will complete online surveys, available in both English and French, once every three months for a total of 18 months. They will be asked questions about their psychological, social, family-related and physical wellbeing, and any relevant changes to their lifestyle and health care treatment. 

“Veterans who regularly access health care services could encounter significant changes, including a move to virtual care appointments. This could lead to increased caregiving responsibilities for spouses,” says Dr. Nazarov. “Given the uncertainty surrounding the pandemic, these changes may persist well into the future, mandating a thorough assessment of patient satisfaction and treatment outcomes.”
 
The team hopes results can be used to support the wellness of Veterans and their families during public health emergencies. This includes providing health care professionals and policymakers with information to guide emergency preparedness policies and health care delivery models. They hope results can also be used to recognize early signs of distress in order to target with early interventions.

“We are seeking to understand the impact of COVID-19 on Veterans and their families to identify if this global pandemic is leading to psychological distress or triggering historical traumas,” says Dr. Patrick Smith, CEO of the Centre of Excellence on Post-Traumatic Stress Disorder. “The Centre’s primary goal is to increase Canadian expertise related to military and Veteran mental health, suicide prevention and substance use disorders. This study can help us understand if the pandemic is having debilitating and life-altering effects, and help us address a potential mental health crisis.”  

Interested Canadian Veterans and spouses of Canadian Veterans can learn more about the study at www.veteransurvey.ca.

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LONDON, ON- A recently published preclinical study by researchers at Lawson Health Research Institute and Western University’s Schulich School of Medicine & Dentistry show that vaping may negatively affect pulmonary surfactant in the lungs.

Surfactant, which is made of lipids and proteins, is a critical layer in the lungs that allows people to breathe with minimal effort by reducing surface tension. Without surfactant, it would take more effort to breathe and a person would need mechanical help to do so.

“Vaping continues to be popular but not much is known about what happens with the aerosol when it enters the lungs,” says Dr. Ruud Veldhuizen, Lawson Scientist and Professor at Schulich Medicine & Dentistry. “We realized that the first thing the vapor aerosol comes in contact with in the lungs is pulmonary surfactant, which is an area our team specializes in.”

The research team was able to study the effects by placing a film of surfactant inside a syringe and, then using a vaping device to push aerosol into the syringe. This allowed the vapor to directly interact with the surfactant. The researchers then mimicked inhaling and exhaling vapor into the syringe 30 times to resemble a standard vaping session.

“In particular we were looking at the surface tension in the surfactant,” explains Emma Graham, Master’s student at Schulich Medicine & Dentistry. “After vaping, we saw high surface tension which suggests the surfactant would not be as effective at supporting proper lung functioning.”

The team also examined different vaping devices, flavours, additives and nicotine to see if there were any difference in effects.

“Nicotine didn’t have any worse effects on surface tension of surfactant compared to other e-liquids, but some flavourings like menthol e-liquid did,” says Graham.

While his team intends to study this further, Veldhuizen says these findings could provide an indication as to why people that vape have a susceptibility to develop lung injury, including those with respiratory viruses such as COVID-19.

“We would like to get this information out there so that people know vaping may be damaging to the lungs,” says Veldhuizen. “As a next step, we hope to further investigate the effects of vaping on the lungs and how we can treat resulting injury.”

The study has been published in the PLOS ONE Journal.  These findings build on a body of research about the impacts of vaping through Lawson and Schulich Medicine & Dentistry. Our researchers were the first in the world to report on a potential new type of vaping-related injury in 2019.

London - In a national multicentre study, scientists at Lawson Health Research Institute and Western University are working to create rare isotopes that will be used as an important tool to help treat cancer.

Currently, radiation therapy is a staple in cancer treatment, with approximately 50 per cent of cancer patients receiving radiation at some point in their cancer journey. Although a very effective tool, traditional radiation therapies rely on intense beams of energy. These beams can kill cancer cells, but their use is limited to select locations, making them less suited for difficult-to-treat metastatic cancers that have spread to multiple sites.

“Cancer treatment has evolved over the years with targeted drugs that go straight to the cancer and advanced radiation therapy. However, radiation comes from an external source that can damage other areas in the body,” says Dr. Len Luyt, Lawson Scientist and Professor at Western. “We are now working to advance treatment further by combining radiation and targeted drug therapy.”

The therapies work like a homing device — using specially designed molecules to seek out and deliver radioactive isotopes directly to cancer cells, wherever they might be in the body.

The multidisciplinary research team involves researchers at Lawson, Western University, University of British Columbia, BC Cancer, TRIUMF, Simon Fraser University, Université Laval, Université de Sherbrooke, University of Toronto and University of Alberta.

“This is the holy grail of cancer treatment. These disease-targeting molecules circulate throughout the body, binding tightly to cancer cells in order to eliminate them with a highly localized blast of energy,” explains principal investigator Dr. François Bénard, Professor of Radiology and Associate Dean at UBC’s Faculty of Medicine, and Senior Executive Director of the BC Cancer Research Institute.

The London, Ontario team will focus on developing the radio pharmaceuticals at labs in the London Regional Cancer Program at LHSC, the Cyclotron located at St. Joseph’s Health Care London, and at Western. 

“The radio pharmaceuticals we are designing will be very specific to certain receptor proteins that are on cancer cells and not elsewhere on the body. This allows us to bring the isotopes to the cancer cells and clear it from the body so you have less side effects in other areas,” says Dr. Luyt. “This approach is showing promise in prostate cancer and now this team-based approach is looking at targeting any metastatic cancer.”

This collaborative research project has received $23.7 million in federal funding through the New Frontiers Research Fund (NFRF) over six years.

“We will establish Canada as a world leader in the field of nuclear medicine and ensure Canadian patients are the ones who benefit,” adds Dr. Bénard. “By developing these medicines in Canada and bringing them into local clinical trials, we will ensure Canadians have access to innovative cancer treatments sooner.”

The team hopes to bring multiple drug candidates into clinical trials in the coming years with the ultimate goal of developing an effective treatment for metastatic cancer patients. 

Scientists examining microbiome to improve cancer therapies

MEDIA RELEASE 
For Immediate Release 

LONDON, ON- Pancreatic cancer is an aggressive disease that affects up to six-thousand Canadians a year and is the third leading cause of cancer deaths. In a new study a multidisciplinary team of scientists at Lawson Health Research Institute are examining the microbiome in the gut, as a possible gateway to improving treatment outcomes.

“Pancreatic cancer is very hard to treat, partially because when it’s detected, the cancer is usually in a later stage and spreads very quickly,” explains Dr. John Lenehan, Medical Oncologist at London Health Sciences Centre’s London Regional Cancer Program (LRCP) and Associate Scientist at Lawson. “Our best chemotherapy treatments for the average patient, will give them a little less than a year to live.”

With the goal of improving treatments for these patients the research team led by Dr. Saman Maleki, Scientist at Lawson, is studying whether changing the gut microbiome can result in better response to cancer treatments. 

“We know that the microbiome plays an important role in patients’ response to various forms of systemic treatments such as immunotherapy and chemotherapy for different cancers,” says Dr. Maleki.

This unique study will happen in three stages. The first stage is an observational study to examine fecal samples of 52 patients at LRCP with advanced pancreatic cancer. The second stage will focus on using the samples from these patients in preclinical models to test new combinations of treatments. The final stage of the study will focus on intervention through human clinical trials by modifying a patient’s microbiome with something called a fecal transplant prior to treatment.

“The microbiome is involved in many aspects of cancer development and these organisms aren’t just living in the gut but also within the tumor,” says Dr. Michael Silverman, Lawson Scientist and Chair/Chief of Infectious Diseases at LHSC and St. Joseph’s Health Care London. “We believe that by giving people a fecal transplant, we can change the bacteria that live within the tumor and gut and then optimize the immune response to both the tumour and to treatment, with the goal of improving patient outcomes.”

Fecal transplants involve collecting stool from a healthy donor, preparing it in a lab and safely transplanting it to the patient, in this case with a capsule. The goal is to transplant the donor’s microbiome so that healthy bacteria will colonize in the patient’s gut.

“If you think of microbiome, each bacterium is like a little factory and all together they are a giant factory within us producing things we need,” explains Dr. Jeremy Burton, Lawson Scientist who specializes in human microbiome research. “Over time, a person’s diet, medications, and lifestyle can change the microbiome and it can have a big impact to the rest of our body.” 

The research team was recently awarded a $450,000 Catalyst 2021 grant from the Weston Family Foundation to conduct this study, which is the first in the world focusing on prospectively modifying the microbiome in pancreatic cancer patients for treatments and outcomes.

“We normally don’t see this in one study where we go through the full spectrum of learning from patients, to looking at treatments, and then moving to a final intervention stage,” explains Dr. Maleki. “This has not been tried in pancreatic cancer before, but we think leveraging the microbiome and improving the immune response can potentially move the needle in this patient population.”

The team is recruiting both pancreatic cancer patients, as well as healthy volunteers for fecal transplant samples. Those interested in helping with fecal transplant donations can contact Dr. Seema Parvathy at 519-646-6100 ext. 61726 or email seemanair@@email

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LONDON, ON- A team at Lawson Health Research Institute and St. Joseph’s Health Care London, has created a new online tool called MyBrainPacer™ App to help assist people living with a mild traumatic brain injury (mTBI).

mTBI’s, including concussions, may come with lasting effects that can alter a person’s life.  Although a person with an mTBI may appear fine on the outside, many have to pace their day-to-day activities in order to allow the time needed for the brain to properly heal. That’s where the MyBrainPacer™ App can come into play as a helpful resource.

“By documenting activity levels over time, patients and their clinicians can better understand what activities are linked to worsening symptoms, which they can therefore avoid,” explains Dr. Dalton Wolfe, Lawson Scientist.

The online application is being used as a research tool, allowing Dr. Wolfe and his team to track its efficacy. Much like point tracking used by dieters to monitor food choices, through MyBrainPacer™ App, users can assign values to tasks like driving, grocery shopping, screen use and exercise so they can plan and pace their daily activity. Individual users are given a total number of points per day that will keep their persisting symptoms in the “safe range.” As users track their symptoms through the app, the app adjusts the daily point value to what is best for the user. The app is based on St. Joseph’s Pacing and Planning Program, which has helped hundreds of concussion patients achieve their recovery goals. 

“By putting the app in the hands of patients and the clinicians who treat them, the app has the potential to give us data that traces the recovery patterns of patients and how that relates to the activities that they participate in over time,” adds Dr. Wolfe. “This will enable us to document safe levels of activity for persons with specific characteristics or symptom profiles, which could be the key to unravelling better treatment strategies.” 

After a number of concussions, study participant Cindy Vanderveen, has been using the app to manage her brain injury and has noticed a positive change. 

“In the beginning I wasn’t able to drive farther than five minutes at a time,” remembers Cindy. “My care team at St. Joseph’s recommended MyBrainPacer™ App to help me plan and pace my day. Once I began to use the app to plan and track my activities, my symptoms dramatically decreased. I still have bad days and some tasks are harder than others, but through using MyBrainPacer™ App, I am able to do more activities independently and I am 90 per cent back to who I was.”

Currently anyone with an mTBI can enroll as a study participant on the MyBrainPacer™ App by visiting mybrainpacer.ca.  The research team is hoping to enroll approximately five-thousand users.

The creation of the app has been made possible by funding provided by the Cowan Foundation and other community supporters through St. Joseph’s Health Care Foundation.

LONDON, ONTARIO - For patients with kidney stones, ureteral stents (hollow devices placed in the ureter – the tube between the kidney and bladder) can be used temporarily to relieve urinary obstruction. Despite the use of antibiotics, ureteral stents often become encrusted with minerals and coated with bacteria. This can lead to complications like infection and the need for replacement surgery. 

Published today in Cell Reports Medicine, researchers at Lawson Health Research Institute and Western University conducted a novel microbiome study to examine bacteria associated with ureteral stents. They found that nearly all the stents, whether visibly coated or not, had unique bacterial profiles that were most associated with a patient’s medical condition rather than antibiotic use. For patients with ureteral stents, they may benefit from a personalized approach to care and antibiotic treatment. 

The study included 241 patients from St. Joseph’s Health Care London. The research team collected and analyzed patient urine samples and ureteral stents following surgical removal, as well as relevant patient information such as antibiotic use and history of infections.  

“We wanted to know which bacteria were present and whether the bacteria found in urine samples corresponded to the bacteria found on a patient’s stent,” explains Dr. Kait Al, Postdoctoral Fellow at Lawson and at Western’s Schulich School of Medicine & Dentistry. “We found that there was a bacterial community present on almost all stents, even if they were not visibly affected, and that it differed from the bacterial community found in a patient’s urine.”

These findings challenge long-held beliefs that the urinary tract is a sterile environment devoid of bacteria.

The study revealed that the bacteria present were determined by an individual patient’s medical condition. They differed significantly based on comorbidities like irritable bowel syndrome, obesity and hypertension. Antibiotic use within the past 30 days did not seem to have an effect on the types of bacteria detected on the stents. 

“While more research is needed, our study suggests that antibiotic use during the placement of these stents could one day be more conservative or targeted based on each patient’s condition,” says Dr. Jeremy Burton, Lawson Scientist and Associate Professor at Schulich Medicine & Dentistry.

The team also discovered that in patients needing multiple stents, the bacterial community remained stable over time, suggesting that infections on a patient’s previous stent could direct the course of treatment for their future device placements. 

“This is the largest study of its kind, investigating bacteria both in urine and adhered to ureteral stents,” states Dr. Hassan Razvi, Urologist at St. Joseph’s, Lawson Associate Scientist and Professor at Schulich Medicine & Dentistry. “We hope this will be the first step towards personalized care, ultimately leading to fewer stent-associated infections.” 

The study was made possible through the generous support of The W. Garfield Weston Foundation and St. Joseph’s Health Care Foundation.

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Scanning electron microscopy images showing organic material, crystals, and bacteria present on the surface of the ureteral stents.

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Recovered ureteral stent encrusted with minerals and bacteria. 

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