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Keeping an eye on care of the future
Dr. Khaldon Abbas is using his curiosity and passion for ophthalmology to improve patient care and outcomes for people with eye diseases and disorders.
While in university, Dr. Khaldon Abbas had a deeply moving experience as a volunteer with the Canadian Centre for Victims of Torture (CCVT) that changed the trajectory of his life and career.
The community-based organization helps victims of war and torture, and Abbas, whose family immigrated to Canada from Iraq a little more than a decade before, wanted to share his skills as a translator and tutor with newcomers.
“I came to Canada when I was 12. I had limited English, we had no family or friends here, and it was really hard to acclimate,” says Abbas. “I wanted to give back to the community and to be there for immigrant families who were facing similar challenges that my family had to deal with.”
During one shift with CCVT, Abbas was paired with a family from Syria, whose nine-year old daughter was losing her eyesight. She was living with retinal dystrophy, a degenerative disorder that can progress to complete blindness.
Witnessing the impact the eye disorder had on the young girl and her family inspired Abbas to further his own education and set a goal to become an ophthalmologist.
That was eight years ago. Since then, Abbas spent several years working as a clinical research coordinator and completed four years of medical school at the University of British Columbia.
Today, he is a clinical research fellow at the Ivey Eye Institute of St. Joseph’s Health Care London (St. Joseph’s) – a position supported through St. Joseph’s Health Care Foundation thanks to the generosity of donors.
During the next year, Abbas’ research will focus on improving patient care and outcomes for people with eye diseases and disorders.
Drs. Phil Hooper, Verena Juncal and Tom Sheidow, all retinal surgeons at Ivey Eye, are the impetus behind the fellowship and now serve as Abbas’ mentors. Through the fellowship, the trio wanted to expand their clinical research program which is heavily focused on clinical trials. Their goal was to delve into quality improvement projects and explore, among other things, patient data, referral patterns and wait times – information that could guide Ivey Eye in refining care to better understand how to improve the overall flow of patient care.
As surgeons at the largest single-site eye care centre in Canada committed to innovative care, the Ivey Eye physician leaders felt a responsibility to make this work a reality.
“We started talking about this about three years ago,” says Sheidow. “We were familiar with similar roles at other academic eye care centres and we were fortunate to have some funding, so we brought the idea to the foundation and started to craft the terms of reference,” he adds.
Abbas is the second physician in this fellowship, following in the footsteps of Dr. Amy Basilious, who is now in her second year of residency at Ivey Eye.
“Amy did an exceptional job as our inaugural fellow and we were looking for someone with similar characteristics – bright, curious, motivated, a self-starter and a passion for ophthalmology,” says Sheidow. “Khaldon has all of that and more,” he adds, referring to Abbas’ interest and background in clinical trial work.
Even before arriving in London for the fellowship, Abbas began working with his new team to generate research project ideas and shape a research plan. Among the projects he will tackle is one that will assess the effectiveness and complications of lens exchange surgeries, and another in collaboration with Basilious focused on macular hole repairs.
He will also spearhead two quality improvement studies aimed at streamlining the referral process to Ivey Eye for optometrists and enhancing education and information resources for patients with eye diseases and disorders. Through his work, Abbas is excited to build his research skills, forge new professional connections and see some of his research translated into tangible improvements in patient care.
He’s grateful to Hooper, Juncal and Sheidow, along with St. Joseph’s and the Foundation, for their vision and spirit of innovation in establishing the fellowship.
“Everyone has been extremely welcoming and supportive of me, especially my mentors and fellow co-workers” he says. “There’s a real family environment at St. Joseph’s. I feel like this is my new home away from home.”
Landmark study investigates potential of Ambroxol, a cough medicine, to slow Parkinson’s-related dementia
Researchers at Lawson are studying Ambroxol - a common cough medicine in Europe - as a potential treatment for dementia linked to Parkinson’s disease.
LONDON, Ont. – Dementia poses a major health challenge with no safe, affordable treatments to slow its progression.
Researchers at Lawson Research Institute (Lawson), the research arm of St. Joseph’s Health Care London, are investigating whether Ambroxol - a cough medicine used safely for decades in Europe - can slow dementia in people with Parkinson’s disease.
Published today in the prestigious JAMA Neurology, this 12-month clinical trial involving 55 participants with Parkinson’s disease dementia (PDD) monitored memory, psychiatric symptoms and GFAP, a blood marker linked to brain damage.
Parkinson’s disease dementia causes memory loss, confusion, hallucinations and mood changes. About half of those diagnosed with Parkinson’s develop dementia within 10 years, profoundly affecting patients, families and the health care system.
Led by Cognitive Neurologist Dr. Stephen Pasternak, the study gave one group daily Ambroxol while the other group received a placebo.
“Our goal was to change the course of Parkinson’s dementia,” says Pasternak. “This early trial offers hope and provides a strong foundation for larger studies.”
Key findings from the clinical trial include:
Ambroxol was safe, well-tolerated and reached therapeutic levels in the brain.
Psychiatric symptoms worsened in the placebo group but remained stable in those taking Ambroxol.
Participants with high-risk GBA1 gene variants showed improved cognitive performance on Ambroxol.
A marker of brain cell damage (GFAP) increased in the placebo group but stayed stable with Ambroxol, suggesting potential brain protection.
Although Ambroxol is approved in Europe for treating respiratory conditions and has a long-standing safety record - including use at high doses and during pregnancy - it is not approved for any use in Canada or the U.S.
“Current therapies for Parkinson’s disease and dementia address symptoms but do not stop the underlying disease,” explains Pasternak. “These findings suggest Ambroxol may protect brain function, especially in those genetically at risk. It offers a promising new treatment avenue where few currently exist.”
An old drug with new possibilities
Ambroxol supports a key enzyme called glucocerebrosidase (GCase), which is produced by the GBA1 gene. In people with Parkinson’s disease, GCase levels are often low. When this enzyme doesn’t work properly, waste builds up in brain cells, leading to damage.
Pasternak learned about Ambroxol during a fellowship at The Hospital for Sick Children (SickKids) in Toronto, where it was identified as a treatment for Gaucher disease - a rare genetic disorder in children caused by a deficiency of GCase. He is now applying that research to explore whether boosting GCase with Ambroxol could help protect the brain in Parkinson’s related diseases.
“This research is vital because Parkinson’s dementia profoundly affects patients and families,” says Pasternak. “If a drug like Ambroxol can help, it could offer real hope and improve lives.”
Funded by the Weston Family Foundation, this study is an important step toward developing new treatments for Parkinson’s disease and other cognitive disorders, including dementia with Lewy bodies. Pasternak and his team plan to start a follow-up clinical trial focused specifically on cognition later this year.
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Dr. Stephen Pasternak is available for interviews on June 30.
To arrange, please contact:
Allison Hansen, Communication Consultant
St. Joseph’s Health Care London
Cell: 519-933-4272
About Lawson Research Institute: Lawson Research Institute, the health innovation arm of St. Joseph's Health Care London, is committed to making and sharing discoveries that improve lives locally and internationally. Every day, Lawson researchers work to transform imagination to innovation to patient impact. Lawson leads health-care research. Find us online at sjhc.london.on.ca/research and on social media @stjosephslondon
Largest trial ever done in hemodialysis care examines optimal dialysis temperature
More than 15,000 patients participated across 84 hemodialysis centres
LONDON, ON – Published in the Lancet, findings from a large clinical trial through Lawson Health Research Institute (Lawson), ICES Western and Western University suggest that lowering dialysis temperatures does not lead to improved patient outcomes, despite previous studies suggesting otherwise.
The standard temperature for dialysis treatments is approximately 36.5 degrees Celsius, which is similar to a human’s body temperature. But over the past several years, there have been small studies suggesting that cooler dialysis temperatures could reduce the risk of cardiovascular-related deaths and hospitalizations and better maintain blood pressures during hemodialysis treatments.
“There have been studies looking at whether a lower dialysis temperature would result in better outcomes,” says Dr. Amit Garg, Lawson Scientist, Site Director for ICES Western and Associate Dean of Clinical Research at Western’s Schulich School of Medicine & Dentistry. “The studies have been limited, especially in numbers, yet the practice of lowering the dialysis temperature has become a practice growing in popularity. Some institutions have even made this a centre-wide policy for all hemodialysis patients.”
Over the course of four years, the research team examined outcomes of both standard and cooler dialysis treatments in more than 15,000 patients. This was done across 84 of 97 hemodialysis centres in Ontario, and in terms of the number of patients, it the largest hemodialysis trial ever published worldwide.
Ten of the centres were those operated through London Health Sciences Centre (LHSC).
“We wanted to determine if lowering the dialysis temperature would help people live longer and healthier,” explains Dr. Garg, who is also a Nephrologist at LHSC. “We also measured symptoms and how people felt on the dialysis. We set out to collect high-quality evidence to make sure we are doing the right thing for patients.”
The research team examined linked healthcare data sets from ICES. The trial period included a total of 4.3 million hemodialysis treatments. Patients were randomized to receive dialysis with either the standard temperature or a lowered dialysis temperature of 0.5 degrees Celsius to 0.9 degrees Celsius below each patient’s measured pre-dialysis body temperature, with a lowest recommended temperature of 35.5 degrees Celsius.
“We did not see any benefits to patients who had the lowered temperature with no improvements to cardiovascular health. Some patients experienced discomfort from the lower dialysis temperature,” says Dr. Garg. “The results suggest we should not be adopting lower dialysis temperatures, as a centre-wide policy, and its utility in select patient care warrants scrutiny.”
The findings were presented by Dr. Garg at the American Society of Nephrology conference in Orlando, Florida on Friday Nov 4th @ 11:45 am EST.
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.
Western delivers an academic experience second to none. Since 1878, The Western Experience has combined academic excellence with life-long opportunities for intellectual, social and cultural growth in order to better serve our communities. Our research excellence expands knowledge and drives discovery with real-world application. Western attracts individuals with a broad worldview, seeking to study, influence and lead in the international community.
The Institute for Clinical Evaluative Sciences (ICES) is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of health care issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting health care needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. For the latest ICES news, follow us on Twitter: @ICESOntario
Senior Media Relations Consultant
Communications & Public Engagement
T: 519-685-8500 ext. 73502
Celine.zadorsky@lhsc.on.ca
Law Summaries
The HULC Clinical Research Laboratory provides a number of lay summaries every year to share the important findings of our research with public audience. The following are a list of lay summaries that anyone can access to read.
View lay summeries in the following categories:
Neck/Shoulder
- A systematic review of the cross-cultural adaptations and measurement properties of the Shoulder Pain and Disability Index.
- Evaluating the reproducibility of the short version of the Western Ontario Rotator Cuff Index (Short-WORC) prospectively
- A narrative review and content analysis of functional and quality of life measures used to evaluate the outcome after total shoulder arthroplasty (TSA): an ICF linking application.
Elbow
- The use of Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaire in patients with Tennis Elbow
Wrist/Hand
Lawson and Western researchers suggest walking and talking can be an early predictor of dementia
In a new study, researchers at Lawson Health Research Institute and Western University are demonstrating that gait, or motion testing, while simultaneously performing a cognitively demanding task can be an effective predictor of progression to dementia and eventually help with earlier diagnosis. To date, there is no definitive way for health care professionals to forecast the onset of dementia in a patient with memory complaints.
Dr. Manuel Montero-Odasso, a Lawson scientist, geriatrician at St. Joseph’s Health Care London, and associate professor in the Division of Geriatric Medicine at Western University’s Schulich School of Medicine & Dentistry, is leading the “Gait and Brain Study.” His team is assessing up to 150 seniors with mild cognitive impairment (MCI), a slight decline of memory and other mental functions which is considered a pre-dementia syndrome, in order to detect an early predictor of cognitive and mobility decline and progression to dementia.
Dr. Montero-Odasso with study participant, Roy Bratty
“Finding methods to detect dementia early is vital to our ability to slow or halt the progression of the disease,” says Dr. Montero-Odasso. The study, funded by the Canadian Institutes of Health Research, followed participants for six years and included bi-annual visits. Researchers asked participants to walk while simultaneously performing a cognitively demanding task, such as counting backwards or naming animals. Those individuals with MCI that slow down more than 20 per cent while performing a cognitively demanding task are at a higher risk of progressing to dementia.
“While walking has long been considered an automatic motor task, emerging evidence suggests cognitive function plays a key role in the control of walking, avoidance of obstacles and maintenance of navigation,” says Dr. Montero-Odasso. “We believe that gait, as a complex brain-motor task, provides a golden window of opportunity to see brain function.”
The “gait cost,” or speed at which participants completed a single task (walking) versus a dual-task, was higher in those MCI individuals with worse episodic memory and who struggle with executive functions such as attention keeping and time management.
“Our results reveal a ‘motor signature’ of cognitive impairment that can be used to predict dementia,” adds Dr. Montero-Odasso. “It is conceivable that we will be able to diagnose Alzheimer’s disease and other dementias before people even have significant memory loss. Our hope is to combine these methods with promising new medications to slow or halt the progression of MCI to dementia.”
The study, “Association of Dual-Task Gait with Incident Dementia in Mild Cognitive Impairment”, was published in the journal, JAMA NEUROLOGY.
Members of the study’s research team, from left to right: Korbin Blue, Research Assistant (Co-op Student); Yanina Sarquis-Adamson, Lab Research Assistant; Frederico Faria, Post-Doctoral Fellow; Dr. Montero Odasso, Director, Gait and Brain Lab; research participant; Alanna Black, Lab Research Coordinator; Stephanie Cullen, Research Assistant (Undergraduate Student); and, Navena Lingum, Research Assistant (Master Student).
Lawson cyclotron to produce new imaging agent that may better locate prostate cancer
Lawson Health Research Institute is the first in Canada to enter a sublicense agreement with The Centre for Probe Development and Commercialization (CPDC) to produce PSMA-1007, a new imaging agent that could help improve the detection of prostate cancer.
The radiopharmaceutical tracer can locate and bind to prostate specific membrane antigen (PSMA) – a protein on the surface of prostate cancer cells. This imaging agent makes the prostate cancer cells visible with PET/CT (positron emission tomography/computed tomography) imaging.
Dr. Glenn Bauman, a Radiation Oncologist at the London Regional Cancer Program at London Health Sciences Centre and Scientist with Lawson, has been involved in a number of research developments in PSMA PET/CT.
“Until now, a PET imaging agent called 18F-DCFPyL, was commonly used in research. More recently, we've been looking at a PET radiopharmaceutical called PSMA-1007 that may give us clearer pictures in the pelvis and the area of the prostate,” says Dr. Bauman, who is also a Professor of Oncology and Medical Biophysics at Western University’s Schulich School of Medicine and Dentistry.
Dr. Michael Kovacs, Director of the Lawson Cyclotron & PET Radiochemistry Facility at St. Joseph’s Health Care London, says the license means London will have a local supply of PSMA-1007 that is “more or less a magic bullet for prostate cancer cells.”
Radiopharmaceuticals decay quickly after production and so there is a need to produce them locally. Lawson’s cyclotron, which is housed at St. Joseph’s, is one of fewer than roughly two dozen facilities in Canada and delivers products to the GTA, Windsor and London.
“The cyclotron is a type of particle accelerator where we can accelerate particles called protons to high energy and fire them into a target that makes radioisotopes every day,” Dr. Kovacs explains. “The raw radioisotope is taken to the lab to synthesize PET radiopharmaceuticals, including PSMA imaging agents, before going through quality control.”
“Being able to produce PSMA-1007 locally is exciting, as outsourcing comes with logistical challenges if a production run fails or transportation fails,” explains says Dr. Bauman. “Having our own means of production is a real advantage to us as we conduct our research.”
CPDC, which holds the rights to produce PSMA-1007 in Canada, is already running a clinical trial in hopes of having it available in clinical settings. They expect to have study results in two to three years.
Early studies show the clearer images from PSMA-1007 may have the biggest impact in patients with a recurrence of prostate cancer who have already had treatment. The return of cancer can be very small and difficult to detect with conventional methods. In many of those cases, studies are finding a rise in PSMA levels can be an early signal of the cancer’s return, allowing for earlier diagnosis with PSMA PET.
Looking forward, PSMA-1007 has the potential to be used as a theranostic agent where by the isotope is used deliver radiation treatment directly to the cancer, but this application is likely many years away.
This is the part two of a three-part series on PSMA PET imaging research. Check out part one and three.
Lawson Impact Awards celebrates research making a difference
With nearly 300 guests in attendance, health research was celebrated at the fourth annual Lawson Impact Awards on Wednesday, April 19 at the London Convention Centre.
The Lawson Impact Awards celebrates hospital-based research that makes a difference by advancing scientific knowledge and applying it directly to patient care. With awards in seven categories, the annual event honours Lawson scientists, staff, trainees and partners who demonstrate excellence.
“The Lawson Impact Awards recognizes those who have made exceptional contributions to science and innovation. This year's winners include individuals, groups and partners who work tirelessly to improve our understanding of health and disease in Canada and around the world,” says Dr. David Hill, Scientific Director, Lawson Health Research Institute.
This year’s Lawson Impact Awards winners include:
- Dr. Peeyush Lala - Scientist Career Award
- Drs. Glenn Bauman and Aaron Ward - Innovation Award
- Dr. Gediminas Cepinskas - Dr. Joseph Gilbert Research Contribution of the Year Award
- IDB Holland bv - Industry Partner of the Year Award
- Helen and Andy Spriet - Community Partner of the Year Award
- Arthroplasty Clinical Research Team (Dr. Lyndsay Somerville, Codie Primeau and Bryn Zomar) - Staff Award of Excellence
- Charles Ishak - Leadership Award (Student & Trainee)
The recipients of Lawson’s 2017 Strategic Research Fund (SRF) were also revealed at the Lawson Impact Awards. The Lawson SRF is an annual competition that supports projects that will advance science in alignment with Lawson’s strategic research goals, as outlined in the Lawson Strategic Plan 2014-2018. For the second year in a row, the 2017 competition was focused on “inflammation”. The following two projects were awarded $50,000 over a two-year period:
- “Re-setting the breast microbiome to lower inflammation and risk of cancer” – Drs. Muriel Brackstone and Gregor Reid
- “Assessing acute cardiac inflammation after left-sided breast cancer radiotherapy with hybrid PET/MRI” – Drs. Stewart Gaede and Gerald Wisenberg
A highlight of the event was a keynote presentation from record-breaking Canadian astronaut, aquanaut and researcher, Dr. Dave Williams, titled “The Art of the Possible: Innovation Transforming Healthcare”. Dr. Williams provided an inspiring talk that used examples from his space shuttle missions and health research to illustrate how the impossible can be made possible.
In addition, this year’s event honoured Canada’s 150th year as a nation by paying tribute to Canadian scientists and the contributions they’ve made on the world stage. Acknowledging the role of Lawson scientists in continuing this legacy, attendees were also asked to provide their feedback about the future of innovation. These insightful ideas will be shared in the months to come as Lawson continues to celebrate Canada 150.
To view videos of each award winner, visit the Lawson YouTube page. To see more photos from the event, visit Lawson's Facebook page.
Lawson Impact Awards Community Partner of the Year Award: Archie Verspeeten
A London philanthropist and his family are helping advance genomic cancer research to improve patient care
After being personally touched by cancer, Archie Verspeeten and his family have dedicated their philanthropy towards supporting advancements in cancer research through the London Health Sciences Foundation (LHSF).
Through generous support, the Verspeeten’s have helped create the Archie and Irene Verspeeten Clinical Genome Centre at London Health Sciences Centre (LHSC), a first of its kind in Canada.
Senior Media Relations Consultant
Communications & Public Engagement
T: 519-685-8500 ext. 73502
Celine.zadorsky@lhsc.on.ca
Lawson Impact Awards honours research excellence and innovation
On April 11, in a full room at the London Convention Centre, almost 350 guests celebrated the sixth annual Lawson Impact Awards. The event honours research that is making a difference both locally and globally, and recognizes the remarkable accomplishments of Lawson scientists, staff, trainees and partners.
“This event gives us the opportunity to reflect on the importance of the work we do here at Lawson, and how everyone’s contributions ultimately improve patient care,” says David Hill, Scientific Director, Lawson Health Research Institute. “Throughout the organization, individuals regularly go above and beyond to drive innovative new discoveries.”
This year’s Lawson Impact Award winners are:
• Dr. Guido Filler – Scientist of the Year Award
• Dr. Don Richardson – Innovation Award
• Dr. Sarah Morrow – Dr. Joseph Gilbert Research Contribution of the Year Award
• Saagar Walia – Staff Award of Excellence
• Laura Craven – Leadership Award for Fellows and Students
• Lawrence Yip – Leadership Award for Fellows and Students
• GE Healthcare – Industry Partner of the Year
• Breast Cancer Society of Canada – Community Partner of the Year Award (LHSF)
• Legate Personal Injury Lawyers – Community Partner of the Year Award (CHF)
• 3M Canada – Community Partner of the Year Award (SJHCF)
Two Children’s Health Research Institute (CHRI) award recipients were also recognized at the event. As a program of Lawson, CHRI awards a Scientist and Trainee of the Year annually, sponsored by the Children’s Health Foundation. CHRI’s 2019 award recipients are: Dr. Craig Campbell (CHRI Scientist of the Year), and Dr. Mohamed Gatie (CHRI Deb Comuzzi Trainee of the Year).
An engaging keynote was delivered by Dr. Dorin Comaniciu, Senior Vice President for Artificial Intelligence and Digital Innovation at Siemens Healthineers, titled “Artificial Intelligence for Health Care: The Road Ahead.” Dr. Comaniciu spoke about the wide application for artificial intelligence in health care, focusing on the fields of diagnostic imaging, image-guided therapy and personalized medicine. Sharing his own digital avatar, guests were treated to a glimpse of what the future of care will look like with the advancement of this technology.
If you attended the event, you are encouraged to complete this short survey. Your feedback is important in helping make improvements for next year’s event.
Visit the Lawson YouTube channel to watch videos highlighting each of the award recipients. To see photos from the event, visit Lawson’s Facebook album.
Lawson Impact Awards Innovation Award: Dr. Dalton Wolfe
For more than 30 years, Dr. Dalton Wolfe has been conducting innovative research to improve mobility for those who are facing long-term injuries, such as spinal cord and brain injuries. He is being recognized with the 2022 Lawson Innovation Award for this work.
“We want to help people impacted by these conditions right now, developing innovations that can immediately be implemented into patient care,” says Dr. Wolfe, Lawson Scientist at St. Joseph’s Health Care London’s Parkwood Institute.
One of the most recent studies surrounds a new tool for those living with a mild traumatic brain injury (mTBI) called MyBrainPacer™ App. The app is an online tool that tracks and assigns values to everyday tasks such as driving, grocery shopping and exercising to help users pace their daily activities. The user is then given a total number of points per day that will keep their mTBI symptoms in a safe range.
Senior Media Relations Consultant
Communications & Public Engagement
T: 519-685-8500 ext. 73502
Celine.zadorsky@lhsc.on.ca