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London, Ontario – For a non-descript box it wields a mighty name and even more impressive possibilities for people with heart disease. Called the AngioDefender, the machine – no bigger than a shoebox - holds much promise in the ability to personalize cardiac care, say researchers at Lawson Health Research Institute, the research arm of St. Joseph’s Health Care London.

St. Joseph’s Hospital in London is the only Canadian cardiac rehabilitation centre testing the AngioDefender, a non-invasive tool that can assess the health of blood vessels by using a simple blood pressure cuff. At the recent Canadian Cardiovascular Congress in Toronto, Lawson researchers presented findings of their study, which assessed the feasibility and reliability of the AngioDefender in patients undergoing cardiac rehabilitation.  

“Right now everyone basically gets similar treatment in terms of maximizing therapy based on risk factor profiles,” says Dr. Neville Suskin, Lawson scientist and medical director of St. Joseph’s Cardiac Rehabilitation and Secondary Prevention Program. “With this machine, if it does what we hope it will do, it gives us insight into a person’s vascular health so that we can know if the treatment is working and adjust and individualize their care.”

Also key, says Dr. Suskin, is the machine can be used by any medical professional in any doctor’s office.

The AngioDefender system, manufactured by Everist Health, measures the health of the endothelium — the interior lining of blood vessels. Using a blood pressure cuff, the device runs through a series of inflations and deflations to analyze the endothelium’s response to changes in blood flow. When the blood pressure cuff is inflated, blood flow decreases and stops. When the blood pressure cuff deflates, blood flow increases and the main artery in the arm responds by getting bigger (dilating). How well it dilates is a sign of endothelial (vascular) health. 

Using a specially designed data analysis algorithm, the AngioDefender system produces each patient’s “flow-mediated dilation” score. When the information is combined with the patient’s other risk factors, it calculates the patient’s vascular age. The whole process takes 15 to 20 minutes.

“The ability for a health professional to obtain a measure of vascular health in such a straightforward manner is very novel” says Dr. Suskin, whose team has found that the machine is feasible to use in a busy cardiac rehabilitation practice setting. “It doesn’t take long, patients tolerate it, and they are also very keen to know their vascular health as determined by this machine.”

If successful, the device may become part of the standard screening to assess early-stage cardiovascular disease and atherosclerosis, and an innovative way to monitor the effectiveness of treatment.

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LONDON, ON – A research team from Lawson Health Research Institute has announced promising results from a one-of-a-kind demonstration study that evaluated the use of smart technologies in the home for people with severe mental illness.   

“Our Smart Homes solution is for people who are having difficulty managing their everyday life and need a high level of care to maintain community living,” says Dr. Cheryl Forchuk, Assistant Scientific Director at Lawson and project lead for Smart Home Community Model Phase. “We have strong initial evidence showing that technology and applications embedded in the lived environment are safe, secure and appropriate for use in health care.” 

After prototyping this approach within a hospital setting through St. Joseph’s Health Care London, the research team outfitted affordable housing units at Canadian Mental Health Association (CMHA) Elgin-Middlesex and London and Middlesex Community Housing (LMCH) with smart home technology.  

There were 13 participants as part of this project phase who had different living situations such as individual apartments, group homes or family homes. Anxiety, mood and psychotic disorders were the most common mental health diagnoses, with many also suffering from chronic pain that make the activities of daily life difficult.  

“More and more, smart technologies like phone applications or virtual care are being used for mental health care. A smart home solution like the one we have tested could be considered a higher dose of technology, offered to clients with higher needs. The right dose for one may not work for another – the technological solutions used should vary depending on the individual,” explains Dr. Forchuk.  

Each study participant selected from a wide range of tools that would best meet their individual needs, with all but one participant selecting more than one tool. Devices such as smartphones and touch-screen monitors connect with applications to provide video-conferencing, questionnaires, and prompts and reminders based on the person’s care plan. They also had access to automated medication dispensers and smart health monitoring devices for tracking heart rate, activity and sleep. 

“All of the data is viewable by both the client and health care provider, allowing for more seamless care and identification of issues earlier on,” adds Dr. Forchuk.  

The study found that visits to a health or social service provider and the emergency department decreased, as did home visits from a provider. Telephone appointments increased and communication between the client and provider were enhanced. Almost 80 per cent of the participants felt that the technologies improved their health care overall.  

Higher levels of community integration and a greater sense of independence were also reported, including a better ability to remain connected with friends and family during the pandemic. When medication dispensers were used, no medication doses were missed. Participants felt they were better able to track their own health and more motivated to lead healthier lives. 

“The compliment of smart technology in our Supportive Independent Living Program has proven to improve the quality of life of participants by reducing use of emergency services and fostering learning opportunities for independent living skills to create a good quality of life,” says Nedrita Shemshedini, Manager of Supportive Independent Living at CMHA Elgin-Middlesex. “In a large-scale rollout, this model could improve wellbeing and empower persons to better manage their care.”  

The research team hopes this work will help inform the integration of smart technology more fully into mental health care delivery. Laura Pearson, Executive Director at Ontario Peer Development Initiative, urges that “there is a need for key policies to be addressed and changed in order to support funding and access for technology at a system level for the purpose of mental health care.”  

The community model phase of the Smart Homes project was generously funded by the Canada Mortgage and Housing Corporation (CMHC). 

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LONDON, ON – In a new preclinical study published in the journal Gastroenterology, researchers at Lawson Health Research Institute and Western University have found that a specific type of inflammation may be associated with an increased risk of colorectal cancer.

Colorectal cancer is the second most common cancer in Canada and one of the leading causes of cancer death. One of the major risk factors is inflammation caused by illnesses like colitis, Crohn’s disease or other forms of inflammatory bowel disease (IBD).

Previous studies have shown that the degree of inflammation caused by colitis is an important indicator of the risk of a patient developing colorectal cancer. In this study, researchers from Lawson and Western’s Schulich School of Medicine & Dentistry studied six different types of colitis – which result in different forms of inflammation – to assess whether certain types were associated with a higher risk of cancer.

“We found it wasn't necessarily the severity and duration of the inflammation that was most important, but rather the type of inflammation,” says Dr. Samuel Asfaha, a Lawson Scientist, Gastroenterologist at London Health Sciences Centre (LHSC) and Associate Professor at Schulich.

The team found that only one type of colitis led to cancer in preclinical models. They identified a new subset of immune cells called macrophages that were critical to the development of cancer. They also found that if they blocked these specific immune cells, they could prevent colitis-associated cancer.

“To our knowledge this is the first published study that extensively compares the different models of colitis or inflammation in the colon,” says Dr. Alice Shin, lead author on the study, which she worked on as PhD student at Schulich. “We are also the first to show that this specialized subset of macrophages that we identified are important for the initiation phase of inflammation-associated cancer.”

The next steps are to understand what the macrophages are doing to initiate cancer and whether a biomarker could be found that would identify which patients with chronic inflammation are at higher risk of developing cancer. 

“Patients who have chronic inflammation often must undergo annual cancer surveillance,” Dr. Asfaha says. “By being able to differentiate those who are most at risk for developing cancer versus those who are who are at lower risk, we can focus our attention on those who are at increased risk.”

There is hope that further study could also lead to an understanding of whether certain treatments are more effective for colitis-associated cancer as opposed to other non-hereditary (sporadic) colorectal cancers.

London, Ontario – In a Canadian first, St. Joseph’s Health Care London (St. Joseph’s) and Lawson Health Research Institute (Lawson), in partnership with GE HealthCare, will become a centre of excellence in personalized treatment of cancer and other diseases by advancing the powerful blend of precision diagnostic imaging and targeted therapy.

This rapidly emerging field of medicine is called molecular imaging and theranostics (MIT). Molecular imaging provides detailed imaging at the molecular level and theranostics is a term that combines the words therapeutics and diagnostics. Together, MIT is a two-pronged approach to diagnosing and treating cancers and other diseases that merges imaging with the use of radiotracers that can not only identify the location and extent of diseased tissues but also selectively destroy the abnormal cells while leaving surrounding healthy cells undamaged. 

“The centre will confirm St. Joseph’s and the wider London medical and scientific community as national and international leaders in advancing MIT in the diagnosis of disease, for instance in the identification of cancer and its sub-types, to allow more treatment options for patients,” says Dr. Narinder Paul, Lawson Scientist, Chief, Medical Imaging at St. Joseph’s and Physician Executive, Medical Imaging at London Health Sciences Centre (LHSC). “It will also allow for an expansion of scientific collaborations, increased numbers of scientific and medical learners, and access to the latest software to acquire and integrate imaging science with other patient information.”

The partnership with GE HealthCare will see St. Joseph’s become the first hospital in Canada to install the latest generation, state-of-the-art PET-CT from GE, which will be delivered to St. Joseph’s Hospital by September 2023. The new PET-CT will mean faster exams, better patient experience, more detailed images and increased accuracy in diagnosing disease at a lower dose of radiation for patients. It will also expand clinical care at St. Joseph’s by significantly enhancing research through the Imaging Research Group at Lawson, working together with researchers at LHSC, the London Regional Cancer Program, and Western University.

“We will leverage the combined scientific expertise and innovation of scientists from GE HealthCare and Lawson to maximize the future opportunities of molecular imaging theranostics made possible through PET- CT imaging and be leaders in Canada in this area of medical science,” says Dr. David Hill (D.Phil), Lawson’s Scientific Director. 

As a dedicated MIT centre of excellence, St. Joseph’s will…

•    Advance innovation and expand the science in precision imaging of disease through Lawson, and broaden the potential of PET-CT imaging
•    Develop new treatment options for patients with cancer and other diseases
•    Examine how to maximize the opportunities of digital health technologies to improve access for patients across Canada and optimize their treatment journeys 
•    Create a knowledge dissemination hub for Canada to educate and train others in the use of advanced imaging technologies, including how to organize hospital services to maximize access to patients and improve the health care system for all Canadians.

“St. Joseph’s is proud to be in partnership with GE HealthCare on this exciting opportunity to transform the care journey and outcomes for patients with cancer and other diseases, not only locally and regionally, but also nationally,” says Roy Butler (PhD), President and CEO of St. Joseph’s.  

For patients seen in London, the benefits will include expanded use of PET-CT, the ability to extract more information from their diagnostic images more rapidly and with less radiation exposure compared to current procedures, greater diagnostic and treatment accuracy, and new options for treatment, particularly for cancers that are more difficult to treat.  

“A personalized approach to medical care requires a very detailed understanding of the localization of disease and potential response to different treatment options,” says Dr. Paul who is also the Chair of Medical Imaging at Schulich School of Medicine & Dentistry at Western University. “We will be able to offer patients across our region access to the latest therapeutic options based on a deeper understanding of the nature of their individual disease conditions gained through next generation medical imaging.”

At its core, theranostics is about treating each patient as an individual, “recognizing that the same treatment plan doesn’t work for everyone – with the goal of providing more efficient and effective medical care,”  adds says Mike Hamilton, President, GE HealthCare Canada. “This collaboration aims to advance this practice for the benefit of clinicians and patients around the world.”

The new PET-CT at St. Joseph’s will replace an aging machine and has been made possible in part through the generosity of donors to St. Joseph’s Health Care Foundation, which is contributing $1 million to state-of-the-art machine. 

Additional details on this exciting partnership are available on St. Joseph’s website
 

LONDON, ON – St. Joseph’s Health Care London and Lawson Health Research Institute have announced plans to move forward with clinical trials testing a drug that could potentially be used to prevent and treat COVID-19. St. Joseph’s Health Care Foundation will accelerate the creation of the studies by providing seed funding to get the research started through donor support. Based on the immediate need, The St. Joseph’s Health Crisis Fund has been created by St. Joseph’s Health Care Foundation to enable these and other research studies currently in development through Lawson, the research arm of St. Joseph’s. 

While supporting urgent COVID-19 clinical trials will be an immediate focus, The St. Joseph’s Health Crisis Fund will also support critical patient care equipment and care and comfort items for healthcare staff and volunteers working on the frontlines of the pandemic across St. Joseph’s.

The initial clinical trials aim to study the use of hydroxychloroquine as a preventative medication and treatment for COVID-19. Led locally by Dr. Michael Silverman, Medical Director of St. Joseph’s Infectious Diseases Care Program, one trial will assess the safety and efficacy of using the drug to prevent COVID-19 in health care workers recently exposed to the virus. This trial will also assess the drug as a treatment for non-hospitalized patients with mild cases of the illness. St. Joseph’s will be one of many participating sites in the trial, which is being led by the Research Institute of the McGill University Health Centre.

“There is much debate surrounding the drug hydroxychloroquine. We do not yet know whether it’s safe or effective, and it should not be routinely recommended until we do,” says Dr. Silverman, also a Lawson Associate Scientist and city-wide Chair/Chief of Infectious Diseases. “We plan to carefully study the drug through a randomized controlled trial and assess whether it can help combat COVID-19.” 

Dr. Silverman is also partnering with Dr. Michael Borrie, Geriatrician at St. Joseph’s and Lawson Scientist, on a prevention trial to test the safety and efficacy of the drug for patients and residents at Parkwood Institute who have been exposed to COVID-19. They are at a higher risk of infection, as well as serious complications and potential admission to acute care. 

“Lawson researchers like Drs. Silverman and Borrie excel in rapid response research,” says Dr. David Hill, Lawson Scientific Director. “Hospital-based research is uniquely positioned to handle these types of studies, as close proximity to patients and sample collection is essential.”

St. Joseph’s Infectious Diseases Program is the only program of its kind in the region. Dr. Silverman, head of St. Joseph’s Infectious Disease program, has worked with communities in crisis in Zambia, Zimbabwe, Uganda and the rainforests of Guyana. He is working closely with other health care partners in the London and surrounding area to coordinate the region’s response to the COVID-19 pandemic. 

“The Sisters of St. Joseph, who founded our organization, faced contagious diseases and other pandemics at different times in our 150+ year history,” says Michelle Campbell. “Today, it’s a different time, and a new disease. Now, more than ever, we ask our community to help us address the crisis facing us all.” 

Those interested in donating to St. Joseph’s Health Crisis Fund are asked to visit St. Joseph’s Health Care Foundation’s website to learn more at sjhcfoundation.org. Donations can be made online, through direct mail submissions or by calling the Foundation directly at 519-646-6085.

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