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When patients with testicular cancer undergo lymph node removal surgery there is a risk that their fertility will be affected if proper nerve sparing techniques are not used. Up to 75 per cent of men will not be able to father children if they receive the surgery without these techniques.

Lawson’s Internal Research Fund (IRF) has awarded a grant to Dr. Nicholas Power, a researcher at Lawson and urologic oncologist at London Health Sciences Centre (LHSC), who is leading a study to identify the nerves involved in fertility that are affected in lymph node removal surgery for testicular cancer.

“Sometimes patients go through a lot to be cured of testicular cancer only to be left dealing with long-term survivorship issues such as fertility. We hope to gain new insights into how fertility can be preserved after these men receive lymph node removal surgery,” says Dr. Power, who is also an assistant professor at Western University’s Schulich School of Medicine & Dentistry.

In collaboration with Schulich assistant professors Dr. Marjorie Johnson and Dr. Brian Allman, and PhD candidate Tyler Beveridge, Dr. Power published initial results in The Journal of Urology announcing their discovery of a brand new anatomic structure, the pre-hypogastric ganglion, which needs to be spared in surgery to maintain fertility. They were also able to describe the first roadmap of retroperitoneal neuroanatomy – the anatomy of nerves in the space where surgeons locate lymph nodes most commonly affected by testicular cancer that has spread.

“There has never been a definitive anatomic study of the nerves of the retroperitoneum so it was our goal to provide the first comprehensive study of the nerves as they relate directly to patients who have testicular cancer,” explains Dr. Power. “After we published the initial results we were approached by textbook authors to use our data in upcoming editions of anatomy and surgical atlases. This will help to provide insight into nerve sparing techniques for surgeons who have not been trained at high-volume centers and ultimately improve the quality of care in testicular cancer patients overall.”

Already Dr. Power has found that using this knowledge when he performs lymph node removal surgery for testicular cancer has led to a 95 per cent success rate of preserving fertility.

The IRF will go towards their research to further investigate the actual function and physiology of the retroperitoneal neuroanatomy using a pig model.

“Lawson’s IRF provides incredible support for a field of study such as ours that is not yet at the stage of applying for a large grant. Receiving the funding gives us the independence to test out novel yet important hypotheses that will then lead us to further grants,” says Dr. Power.

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Above: Dr. Nicholas Power

The IRF is designed to provide Lawson scientists and students the opportunity to obtain start-up funds for new projects with the potential to obtain larger funding, be published in a high-impact journal, or provide a clinical benefit to patients. Funding is provided by the clinical departments of London Health Sciences Centre and St. Joseph’s Health Care London, as well as the hospital foundations (London Health Sciences Foundation and St. Joseph's Health Care Foundation).

A recent study suggests the use of probiotics to prevent respiratory tract infections in Canada could result in nearly $100 million per year in savings.

There is growing evidence that probiotics can reduce the risk of respiratory tract infections and lower their frequency, as well as reduce the duration of an infection, antibiotic use and absences from work. Replicating a research model used in France, researchers examined the potential clinical and economic impacts in Canada.

Sponsored by The Alliance for Education on Probiotics, the study included researchers from Lawson Health Research Institute (Lawson), Western University, Laval University and Utrecht University. It incorporated two separate scenarios from two meta-analyses. A meta-analysis combines data from multiple studies using a statistical approach.

Results from the study showed that regular probiotic use could eliminate between 573,000 to 2.3 million days per year of respiratory tract infections, resulting in 330,000 to 500,000 fewer sick days for Canadians and 52,000 to 84,000 fewer antibiotic prescriptions. This would translate to $1.3 to $8.9 million in health system savings. When accounting for productivity losses due to illness, it could save $61.2 to $99.7 million.

Respiratory tract infections are highly contagious infections of the sinus, throat or airways, including influenza or ‘the flu.’ Currently, 5 to 20 per cent of the Canadian population experience at least one respiratory tract infection per year. It’s estimated that respiratory tract infections represent 2.9 per cent of all health care costs in Canada.

“If we could reduce the burden of respiratory tract infections, it would benefit both patients and Canadian taxpayers,” says Dr. Gregor Reid, Director for the Canadian Centre for Human Microbiome and Probiotic Research at Lawson, and Professor at Western’s Schulich School of Medicine & Dentistry.

The research showed that children under the age of 10, individuals living in a community setting (including office work in open spaces) and those not vaccinated against influenza would benefit the most.

Respiratory tract infections are typically viral in nature. Existing treatments rely on symptom control while an estimated 26 per cent of patients are also prescribed antibiotics. These antibiotics are largely unnecessary since antibiotics are not effective against viruses. “Antibiotics are often prescribed even when an infection is likely to be viral. Antibiotics can have serious side effects like destroying many beneficial bacteria in the human body,” says Dr. Reid. 

Probiotics are defined as “live microorganisms that, when administered in adequate amounts, confer a health benefit on the host.”

“People are increasingly making probiotics a part of their daily diet or dietary supplements for their proven health benefits,” explains Dr. Reid “The fact that probiotics can also be used to prevent respiratory tract infections makes them even more important.”

Dr. Reid notes that several probiotic products can be effective in preventing respiratory tract infections, as outlined in the Clinical Guide to Probiotic Supplements. These include probiotic yogurts and oral capsules.

The study, “The Clinical and Economic Impact of Probiotics Consumption on Respiratory Tract Infections: Projections for Canada,” is published on PLoS One.

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Above: Dr. Gregor Reid (Photo credit: Schulich School of Medicine & Dentistry)