UCalgary
MEDICINE FACULTY OF MEDICINE
FALL 2013
A fly’s eye view inside the lab
Friendship fuelling philanthropy
Nephrology research: changing the way we view and treat kidney disease
Vol. 5 / Issue 2
01
UCALGARY MEDICINE FALL 2013
CONTENTS
FALL 2013 ISSUE
F E AT U R E S
VOLUME 5 | ISSUE 2
UCalgary Medicine is published two times a year by the University of Calgary Faculty of Medicine, providing news and information for and about our faculty, staff, alumni, students, friends and community. For more information contact: M A N AG I N G E D I TO R
Kathryn Kazoleas T 403. 220. 2232 E kjslonio @ ucalgary.ca
RESEARCH
A fly’s eye view inside the lab
E D I TO R I A L T E A M
Jordanna Heller, Director, Communications and Media Relations Marta Cyperling, Manager, Media Relations Amy Dowd, Manager, Internal Relations Aisling Gamble, Communications Advisor, Events and Recognition Amanda Fisher, Communications Coordinator
O N T H E COV E R
U Calgary
Fruit flies in a lab.
MEDICINE FACULT Y OF MEDICINE
FALL 2013
DEAN
Dr. Jon Meddings V I C E- D E A N
Dr. Glenda MacQueen
A fly’s eye view inside the lab
10
RESEARCH
Nephrology research: changing the way we view and treat kidney disease
MESSAGE FROM THE DEAN 2
RESEARCH
3
S E N I O R A S S O C I AT E D E A N S
Dr. Gerald Zamponi, Research Dr. Jocelyn Lockyer, Education Dr. Ronald Bridges, Faculty Affairs
Friendship fuelling philanthropy
Nephrology research: changing the way we view and treat kidney disease
Vol. 5 / Issue 2
PHILANTHROPY
Friendship fuelling philanthropy 6
Radon gas explored by cancer researcher 8 What is the gut? 14 Discovery could lead to new treatment options for IBD patients 27 EDUCATION
A S S O C I AT E D E A N S
Dr. Ebba Kurz, Undergraduate Health and Science Education Dr. Bruce Wright, Undergraduate Medical Education Dr. Jennifer Hatfield, Global Health and International Partnerships Dr. Doug L. Myhre, Distributed Learning and Rural Initiatives Dr. Maureen Topps, Postgraduate Medical Education Dr. Tara Beattie, Graduate Science Education Dr. Lara Cooke, Continuing Medical Education and Professional Development Dr Ray Turner, Research Grants Dr. Michael Hill, Clinical Trials Dr. Janet de Groot, Equity and Professionalism Dr. Kamala Patel, Faculty Development Dr. Paul Schnetkamp, Research Infrastructure Dr. Samuel Wiebe, Clinical Research DESIGN
Combine Design & Communications P H OTO G R A P H Y A N D I L LU S T R AT I O N S
Todd Buchanan, Amanda Fisher, iStock photo, Trudie Lee, Don Molyneaux, Janelle Pan, Bruce Perrault
D E PA R T M E N T S
F R E E CO P Y / A L U M N I U P DAT E
To receive a free copy of UCalgary Medicine please call 403. 220. 2819 or email medcomm @ ucalgary.ca The Faculty of Medicine is committed to staying in touch with our alumni. Please update your contact information at our website alumni.ucalgary.ca
Look for this icon for more content found exclusively online at medicine.ucalgary.ca/magazine
SERVICE TO SOCIETY
WANT MORE?
(CLICK ON “ UPDATE YOUR INFO”)
FAC U LT Y O F M E D I C I N E A L U M N I F E AT U R E D I N T H I S I S S U E A R E :
Dr. Matthew James, Dr. David Campbell, Gerald Zamponi, PhD, Dr. Eric Smith, Dr. Bill Ghali, Dr. Wes Jackson, Dr. Breanne Everett, Dr. Nicola Wright, Dr. Roxanne Goldade, Dr. R. Bruce Lampard
Welcome to the pack 16 Student run clinic beneficial: study 16
Q & A with Dr. Anne M. Gillis 18 What is a geneticist? 20 Good reads 22 Prestigious role leads to SACRI changes 22 In the community 23 NEWS
PM Agreement No. 41 0 9 5 52 8 Return Undeliverable Canadian Addresses to: University of Calgary Faculty of Medicine, Communications and Media Relations 7th Floor, TRW Building 3280 Hospital Drive NW Calgary, Alberta T2N 4Z6
In the news 24 Awards and recognition 26 ALUMNI
Alumnus takes skills overseas 17 Meet Dr. Roxanne Goldade, 2013 Alumna of Distinction 28
01
UCALGARY MEDICINE FALL 2013
CONTENTS
FALL 2013 ISSUE
F E AT U R E S
VOLUME 5 | ISSUE 2
UCalgary Medicine is published two times a year by the University of Calgary Faculty of Medicine, providing news and information for and about our faculty, staff, alumni, students, friends and community. For more information contact: M A N AG I N G E D I TO R
Kathryn Kazoleas T 403. 220. 2232 E kjslonio @ ucalgary.ca
RESEARCH
A fly’s eye view inside the lab
E D I TO R I A L T E A M
Jordanna Heller, Director, Communications and Media Relations Marta Cyperling, Manager, Media Relations Amy Dowd, Manager, Internal Relations Aisling Gamble, Communications Advisor, Events and Recognition Amanda Fisher, Communications Coordinator
O N T H E COV E R
U Calgary
Fruit flies in a lab.
MEDICINE FACULT Y OF MEDICINE
FALL 2013
DEAN
Dr. Jon Meddings V I C E- D E A N
Dr. Glenda MacQueen
A fly’s eye view inside the lab
10
RESEARCH
Nephrology research: changing the way we view and treat kidney disease
MESSAGE FROM THE DEAN 2
RESEARCH
3
S E N I O R A S S O C I AT E D E A N S
Dr. Gerald Zamponi, Research Dr. Jocelyn Lockyer, Education Dr. Ronald Bridges, Faculty Affairs
Friendship fuelling philanthropy
Nephrology research: changing the way we view and treat kidney disease
Vol. 5 / Issue 2
PHILANTHROPY
Friendship fuelling philanthropy 6
Radon gas explored by cancer researcher 8 What is the gut? 14 Discovery could lead to new treatment options for IBD patients 27 EDUCATION
A S S O C I AT E D E A N S
Dr. Ebba Kurz, Undergraduate Health and Science Education Dr. Bruce Wright, Undergraduate Medical Education Dr. Jennifer Hatfield, Global Health and International Partnerships Dr. Doug L. Myhre, Distributed Learning and Rural Initiatives Dr. Maureen Topps, Postgraduate Medical Education Dr. Tara Beattie, Graduate Science Education Dr. Lara Cooke, Continuing Medical Education and Professional Development Dr Ray Turner, Research Grants Dr. Michael Hill, Clinical Trials Dr. Janet de Groot, Equity and Professionalism Dr. Kamala Patel, Faculty Development Dr. Paul Schnetkamp, Research Infrastructure Dr. Samuel Wiebe, Clinical Research DESIGN
Combine Design & Communications P H OTO G R A P H Y A N D I L LU S T R AT I O N S
Todd Buchanan, Amanda Fisher, iStock photo, Trudie Lee, Don Molyneaux, Janelle Pan, Bruce Perrault
D E PA R T M E N T S
F R E E CO P Y / A L U M N I U P DAT E
To receive a free copy of UCalgary Medicine please call 403. 220. 2819 or email medcomm @ ucalgary.ca The Faculty of Medicine is committed to staying in touch with our alumni. Please update your contact information at our website alumni.ucalgary.ca
Look for this icon for more content found exclusively online at medicine.ucalgary.ca/magazine
SERVICE TO SOCIETY
WANT MORE?
(CLICK ON “ UPDATE YOUR INFO”)
FAC U LT Y O F M E D I C I N E A L U M N I F E AT U R E D I N T H I S I S S U E A R E :
Dr. Matthew James, Dr. David Campbell, Gerald Zamponi, PhD, Dr. Eric Smith, Dr. Bill Ghali, Dr. Wes Jackson, Dr. Breanne Everett, Dr. Nicola Wright, Dr. Roxanne Goldade, Dr. R. Bruce Lampard
Welcome to the pack 16 Student run clinic beneficial: study 16
Q & A with Dr. Anne M. Gillis 18 What is a geneticist? 20 Good reads 22 Prestigious role leads to SACRI changes 22 In the community 23 NEWS
PM Agreement No. 41 0 9 5 52 8 Return Undeliverable Canadian Addresses to: University of Calgary Faculty of Medicine, Communications and Media Relations 7th Floor, TRW Building 3280 Hospital Drive NW Calgary, Alberta T2N 4Z6
In the news 24 Awards and recognition 26 ALUMNI
Alumnus takes skills overseas 17 Meet Dr. Roxanne Goldade, 2013 Alumna of Distinction 28
MESSAGE FROM THE DEAN
M E D I C I N E . U C A LG A RY.C A / M AG A ZI N E
03
UCALGARY MEDICINE FALL 2013
Message from the Dean
Another academic year is well upon us. As this summer’s devastating floods are still front of mind for so many Albertans, I was very proud to see how our university united. In the aftermath of this crisis, our faculty members, staff and students came together as volunteers and to collectively donate nearly $7,000 to the Red Cross relief effort, as well as hundreds of pounds of food to the Campus Food Bank. For those still struggling, I’m hopeful things will soon return to normal or as close to as possible. As an institution, we’re still working hard to achieve our Eyes High strategic goals. As we move closer to hitting that mark, and in support of our newly developed medicine research priorities, we are enthusiastically preparing to open an important dialogue regarding our own Faculty of Medicine strategic plan. With an anticipated launch date of June 2014, this new plan will more definitively reflect our growing investment in the bold and enterprising research, and teaching
professionals who are central to our continued development. Our success as a Faculty remains invariably tied to our community, within our walls and beyond. With tremendous gratitude, we recently received a very generous gift from Dianne and Irving Kipnes to fund lymphedema research— a condition that often results from cancer treatment. This $5-million gift will fund a state-of-the-art lymphatic imaging suite, support the recruitment of new researchers, and aid in educational development in this area. We are also looking ahead with great anticipation to spring 2014 when we plan to open the Advanced Technical Skills Simulation Lab (ATSSL). This cutting-edge facility will provide health-care professionals throughout Alberta with access to advanced training in a variety of medical procedures. This initiative wouldn’t be possible without the generous philanthropic efforts of its many donors.
The ATSSL is a priority project for the Faculty of Medicine, and while we are close to reaching our fundraising goal, we still have a ways to go. I would encourage those interested in finding out more about the project to contact our Senior Associate Dean of Education, Jocelyn Lockyer, at lockyer@ucalgary.ca. Another important date on the education front is approaching as well —the deadline for an exciting new undergraduate award offered through the Faculty. The Leaders in Health Sciences Scholarship will provide a select few incoming students to the Bachelor of Health Sciences program with $60,000 to fund their four-year degree, as well as assured admission into our medical school if they meet program criteria. The driving force behind the award is to encourage the development of the next generation of physician scientists — medical doctors who also work to advance research. We’re all eager for the first intake of these students next fall. I want to conclude this message by acknowledging an extremely important occasion that took place this September. Every two years our students and faculty pay their respects and offer their gratitude to the families of those who chose to donate their bodies to medical education through our internment ceremony. The ceremony is always very moving, and on behalf of our medical school, I once again offer my heartfelt appreciation to all of these families. In helping to train and to educate our future physicians, the immense value of this gift cannot be overstated. Thanks for reading, and I hope you enjoy this fall issue of our magazine. Jon Meddings, MD Dean, Faculty of Medicine University of Calgary
Nephrology research: changing the way we view and treat kidney disease By Kathryn Kazoleas
Nephrology [nuh-frol-uh-jee] noun the branch of medicine concerned with the kidneys. APPROXIMATELY 10 PER CENT of Canadians are affected by kidney diseases and disorders and while many of these conditions are treatable, the need for new interventions and understanding is ongoing. Kidneys play a vital role in the regulatory systems in our bodies. They regulate blood pressure and electrolytes, the excretion of toxins and absorption of nutrients. There are several diseases and disorders that can affect the kidneys, and when they do, these systems are compromised, potentially leading to
life-threatening health consequences requiring long-term dialysis or even a kidney transplant. Nephrology research at the University of Calgary’s Faculty of Medicine covers a large range of areas including pathophysiology, health economics, health services research and clinical trials. The university has also played a key role in bringing together targeted research groups such as the Interdisciplinary Chronic Disease Collaboration (ICDC) and the Alberta Kidney Disease Network (AKDN). These researchers, led by
Drs. Brenda Hemmelgarn and Braden Manns at the University of Calgary, and Dr. Marcello Tonelli at the University of Alberta, are dedicated to improving the lives of those living with, or at risk of developing, chronic diseases such as kidney disease. With multiple research projects and studies published in high impact journals such as The New England Journal of Medicine and The Lancet, the University of Calgary’s nephrology group is helping to the change the way we view and treat kidney disease.
MESSAGE FROM THE DEAN
M E D I C I N E . U C A LG A RY.C A / M AG A ZI N E
03
UCALGARY MEDICINE FALL 2013
Message from the Dean
Another academic year is well upon us. As this summer’s devastating floods are still front of mind for so many Albertans, I was very proud to see how our university united. In the aftermath of this crisis, our faculty members, staff and students came together as volunteers and to collectively donate nearly $7,000 to the Red Cross relief effort, as well as hundreds of pounds of food to the Campus Food Bank. For those still struggling, I’m hopeful things will soon return to normal or as close to as possible. As an institution, we’re still working hard to achieve our Eyes High strategic goals. As we move closer to hitting that mark, and in support of our newly developed medicine research priorities, we are enthusiastically preparing to open an important dialogue regarding our own Faculty of Medicine strategic plan. With an anticipated launch date of June 2014, this new plan will more definitively reflect our growing investment in the bold and enterprising research, and teaching
professionals who are central to our continued development. Our success as a Faculty remains invariably tied to our community, within our walls and beyond. With tremendous gratitude, we recently received a very generous gift from Dianne and Irving Kipnes to fund lymphedema research— a condition that often results from cancer treatment. This $5-million gift will fund a state-of-the-art lymphatic imaging suite, support the recruitment of new researchers, and aid in educational development in this area. We are also looking ahead with great anticipation to spring 2014 when we plan to open the Advanced Technical Skills Simulation Lab (ATSSL). This cutting-edge facility will provide health-care professionals throughout Alberta with access to advanced training in a variety of medical procedures. This initiative wouldn’t be possible without the generous philanthropic efforts of its many donors.
The ATSSL is a priority project for the Faculty of Medicine, and while we are close to reaching our fundraising goal, we still have a ways to go. I would encourage those interested in finding out more about the project to contact our Senior Associate Dean of Education, Jocelyn Lockyer, at lockyer@ucalgary.ca. Another important date on the education front is approaching as well —the deadline for an exciting new undergraduate award offered through the Faculty. The Leaders in Health Sciences Scholarship will provide a select few incoming students to the Bachelor of Health Sciences program with $60,000 to fund their four-year degree, as well as assured admission into our medical school if they meet program criteria. The driving force behind the award is to encourage the development of the next generation of physician scientists — medical doctors who also work to advance research. We’re all eager for the first intake of these students next fall. I want to conclude this message by acknowledging an extremely important occasion that took place this September. Every two years our students and faculty pay their respects and offer their gratitude to the families of those who chose to donate their bodies to medical education through our internment ceremony. The ceremony is always very moving, and on behalf of our medical school, I once again offer my heartfelt appreciation to all of these families. In helping to train and to educate our future physicians, the immense value of this gift cannot be overstated. Thanks for reading, and I hope you enjoy this fall issue of our magazine. Jon Meddings, MD Dean, Faculty of Medicine University of Calgary
Nephrology research: changing the way we view and treat kidney disease By Kathryn Kazoleas
Nephrology [nuh-frol-uh-jee] noun the branch of medicine concerned with the kidneys. APPROXIMATELY 10 PER CENT of Canadians are affected by kidney diseases and disorders and while many of these conditions are treatable, the need for new interventions and understanding is ongoing. Kidneys play a vital role in the regulatory systems in our bodies. They regulate blood pressure and electrolytes, the excretion of toxins and absorption of nutrients. There are several diseases and disorders that can affect the kidneys, and when they do, these systems are compromised, potentially leading to
life-threatening health consequences requiring long-term dialysis or even a kidney transplant. Nephrology research at the University of Calgary’s Faculty of Medicine covers a large range of areas including pathophysiology, health economics, health services research and clinical trials. The university has also played a key role in bringing together targeted research groups such as the Interdisciplinary Chronic Disease Collaboration (ICDC) and the Alberta Kidney Disease Network (AKDN). These researchers, led by
Drs. Brenda Hemmelgarn and Braden Manns at the University of Calgary, and Dr. Marcello Tonelli at the University of Alberta, are dedicated to improving the lives of those living with, or at risk of developing, chronic diseases such as kidney disease. With multiple research projects and studies published in high impact journals such as The New England Journal of Medicine and The Lancet, the University of Calgary’s nephrology group is helping to the change the way we view and treat kidney disease.
RESEARCH
Three
rising stars in nephrology research
Dr. Matthew James
T
he incidence of acute kidney injury— a condition characterized by a rapid loss of kidney function—has increased five-fold over the last two decades. While it can affect anybody, the majority of those affected develop acute kidney injury in the hospital following episodes of low blood pressure or infection, surgery, imaging procedures with contrast dyes, and drug exposure. Dr. Matthew James’ research focuses on understanding how to minimize the risks of acute kidney injury, and how to improve care for those who do develop its complications.
lthough acute kidney A injury is common, its impact can be reduced by good clinical care.
MEDICINE.UCALGARY.CA/MAGAZINE
he says. “It makes the management of many medical and surgical problems more complex and lengthens the time people spend in hospital. It is a reversible condition but it is increasingly recognized to be associated with long-term health effects.” Currently, James is using existing clinical and laboratory data to explore who is at risk of acute kidney injury, how management is changed after kidney injury is identified, and which individuals are at risk for long-term complications. Through the Alberta Kidney Disease Network, he and his research team use a unique repository of laboratory and administrative health data collected from across the province to facilitate this work. Combining clinical information with common laboratory tests allows James and his team to identify ways to predict who is at high risk of acute kidney injury and its complications, including the need for dialysis. New data linkages to electronic hospital records also allows James and his research teams to study how patients who develop acute kidney injury are cared for, such as changes in the testing and medications they receive. “Although acute kidney injury is common, its impact can be reduced by good clinical care,” says James. “Identifying individuals at risk or alerting health-care providers to the onset of acute kidney injury could allow us to act sooner to avoid its most severe consequences. Early recognition of those who will develop long-term complications of kidney injury might help us target our care to those in greatest need. However, we don`t yet know how effective these strategies would be.” Evaluating barriers and facilitators to care for people with kidney injury is a fundamental component of James` current work. In the future, this information could be used to design interventions to improve care for people with acute kidney injury. Dr. Matthew James is an assistant professor in the departments of medicine and community health sciences and a member of the university’s Institute for Public Health and Libin Cardiovascular Institute
“Unfortunately, acute kidney injury often strikes when people are at their sickest,”
of Alberta. He is supported by a KRESCENT New Investigator award and by Alberta Innovates – Health Solutions.
05
UCALGARY MEDICINE FALL 2013
that allows them to identify their strengths and weaknesses and target limited resources to the areas that require attention. We started thinking through how you could tie data collection to the process of care and to the things people are actually doing in everyday practice to help them improve. By tying data collection and reporting to process metrics, we can provide programs with actionable intelligence that facilitate a targeted approach to quality improvement rather than taking a shotgun approach to fixing complex problems.”
ome of my patients S don’t mind taking vitamin D supplements but some of them will see it as being yet another tablet to add to their medications.
Dr. Sofia Ahmed
D
r. Sofia Ahmed’s research focuses on the renin-angiotension system (RAS)—a hormone system that regulates how much salt our body holds onto. An overactive RAS causes the body to retain too much salt, which can be particularly hard on the kidneys and increase blood pressure. Although some medications used to treat kidney disease block the RAS, in some cases, the disease progresses, causing the loss of kidney function over time. Having observed this challenge among her patients, Ahmed decided to further focus her research on nontraditional risk factors that may influence the RAS to make it more active. For the past few years, she has conducted and published several studies investigating the relationship between both vitamin D and high fructose diets and measures of cardiovascular risk in people with and without kidney disease. She hopes the findings will offer physicians concrete evidence regarding how to advise and treat their nephrology patients.
to have less stiff arteries and a cardiac nervous system that was better able to withstand stress. These factors could potentially lower the risk of cardiovascular disease—a common comorbidity in patients with kidney disease. “Some of my patients don’t mind taking vitamin D supplements but some of them will see it as being yet another tablet to add to their medications, so if they don’t have to take it, they don’t want to. Knowing this will be helpful either way. We just want to know what the answer is.” Fructose: High fructose corn syrup is a sweetener found in many packaged food and drink items such as pop. Sugar intake has increased dramatically over the last 30 years, so Ahmed’s team is investigating whether a high fructose diet influences the RAS. The kidney diet is one of the most restrictive of all medical diets because in addition to restricting potassium, phosphate and protein, patients also often have other conditions, such as diabetes, that will limit their diet even further. Ahmed says some of her patients tell her they’re actually afraid to eat. “This will be helpful to know so I will be able to tell my patients, ‘yes this is harmful to your kidneys or no it’s not.’” Dr. Sofia Ahmed is an associate professor in the Department of Medicine and the Division
Vitamin D: By conducting studies amongst both healthy individuals and those affected by kidney disease, Ahmed is trying to find out if vitamin D has a direct influence on the outcomes of kidney disease. In two recent studies published in Clinical and Experimental Hypertension and Nutrients, Ahmed’s team discovered that individuals with higher vitamin D levels were more likely
of Nephrology as well as a member of the Libin Cardiovascular Institute of Alberta. She is funded by the Canadian Institutes of Health Research and Alberta Innovates – Health Solutions.
Dr. Robert Quinn
C
ost is an important consideration in the health-care paradigm, and treating kidney disease is expensive. The demand for accountability in terms of health care and finances is increasing. Interested in the outcomes of dialysis and other therapies used to treat kidney disease, Dr. Robert Quinn has been involved in a number of projects focusing on the collection of high-quality data to measure performance, as well as the identification of strategies to improve the clinical care of these patients.
I t’s not enough to just collect good data and feed it back to people. Measuring performance in health care: Quinn and his team developed the Dialysis Measurement Analysis and Reporting system (DMAR), a web-based data collection platform. Currently implemented in three provinces, the database tracks the outcomes of approximately 20 per cent of the incident dialysis population in Canada. By focusing on a relatively small population that consumes a large amount of resources, the DMAR provides a manageable and effective way to observe what is being done well, and what is not, as well as identifying opportunities to improve the efficiency of care. “It’s not enough to just collect good data and feed it back to people,” he says. “You have to provide them with information
Home dialysis therapies: A common theme throughout his research in different health systems was the interest to grow home dialysis populations, specifically peritoneal dialysis. Peritoneal dialysis uses the abdomen as a filter, as an alternative to hemodialysis which removes blood from the blood stream to filter out toxins through a machine before returning it to the body. Equivalent to hemodialysis in terms of outcomes, peritoneal dialysis can be done in the home by the patient or caregiver, thereby reducing strain on the health-care system as well as that of the patient. Approximately 75 per cent of kidney patients qualify for peritoneal dialysis. Quinn’s team is conducting a systematic review to understand what interventions are available to increase the safe and effective utilization of home therapies. Vascular access: Arterio-venous fistulas are currently the preferred form of vascular access in hemodialysis and are actively promoted by guideline committees and governments. However, there is a lack of high-quality evidence to inform decision-making in this area. Quinn recently received CIHR funding to explore it further. He and his team are planning a pilot randomized controlled trial to address this question. Dr. Robert Quinn is an assistant professor in the departments of medicine and community health sciences, and is a member of the university’s Institute for Public Health.
RESEARCH
Three
rising stars in nephrology research
Dr. Matthew James
T
he incidence of acute kidney injury— a condition characterized by a rapid loss of kidney function—has increased five-fold over the last two decades. While it can affect anybody, the majority of those affected develop acute kidney injury in the hospital following episodes of low blood pressure or infection, surgery, imaging procedures with contrast dyes, and drug exposure. Dr. Matthew James’ research focuses on understanding how to minimize the risks of acute kidney injury, and how to improve care for those who do develop its complications.
lthough acute kidney A injury is common, its impact can be reduced by good clinical care.
MEDICINE.UCALGARY.CA/MAGAZINE
he says. “It makes the management of many medical and surgical problems more complex and lengthens the time people spend in hospital. It is a reversible condition but it is increasingly recognized to be associated with long-term health effects.” Currently, James is using existing clinical and laboratory data to explore who is at risk of acute kidney injury, how management is changed after kidney injury is identified, and which individuals are at risk for long-term complications. Through the Alberta Kidney Disease Network, he and his research team use a unique repository of laboratory and administrative health data collected from across the province to facilitate this work. Combining clinical information with common laboratory tests allows James and his team to identify ways to predict who is at high risk of acute kidney injury and its complications, including the need for dialysis. New data linkages to electronic hospital records also allows James and his research teams to study how patients who develop acute kidney injury are cared for, such as changes in the testing and medications they receive. “Although acute kidney injury is common, its impact can be reduced by good clinical care,” says James. “Identifying individuals at risk or alerting health-care providers to the onset of acute kidney injury could allow us to act sooner to avoid its most severe consequences. Early recognition of those who will develop long-term complications of kidney injury might help us target our care to those in greatest need. However, we don`t yet know how effective these strategies would be.” Evaluating barriers and facilitators to care for people with kidney injury is a fundamental component of James` current work. In the future, this information could be used to design interventions to improve care for people with acute kidney injury. Dr. Matthew James is an assistant professor in the departments of medicine and community health sciences and a member of the university’s Institute for Public Health and Libin Cardiovascular Institute
“Unfortunately, acute kidney injury often strikes when people are at their sickest,”
of Alberta. He is supported by a KRESCENT New Investigator award and by Alberta Innovates – Health Solutions.
05
UCALGARY MEDICINE FALL 2013
that allows them to identify their strengths and weaknesses and target limited resources to the areas that require attention. We started thinking through how you could tie data collection to the process of care and to the things people are actually doing in everyday practice to help them improve. By tying data collection and reporting to process metrics, we can provide programs with actionable intelligence that facilitate a targeted approach to quality improvement rather than taking a shotgun approach to fixing complex problems.”
ome of my patients S don’t mind taking vitamin D supplements but some of them will see it as being yet another tablet to add to their medications.
Dr. Sofia Ahmed
D
r. Sofia Ahmed’s research focuses on the renin-angiotension system (RAS)—a hormone system that regulates how much salt our body holds onto. An overactive RAS causes the body to retain too much salt, which can be particularly hard on the kidneys and increase blood pressure. Although some medications used to treat kidney disease block the RAS, in some cases, the disease progresses, causing the loss of kidney function over time. Having observed this challenge among her patients, Ahmed decided to further focus her research on nontraditional risk factors that may influence the RAS to make it more active. For the past few years, she has conducted and published several studies investigating the relationship between both vitamin D and high fructose diets and measures of cardiovascular risk in people with and without kidney disease. She hopes the findings will offer physicians concrete evidence regarding how to advise and treat their nephrology patients.
to have less stiff arteries and a cardiac nervous system that was better able to withstand stress. These factors could potentially lower the risk of cardiovascular disease—a common comorbidity in patients with kidney disease. “Some of my patients don’t mind taking vitamin D supplements but some of them will see it as being yet another tablet to add to their medications, so if they don’t have to take it, they don’t want to. Knowing this will be helpful either way. We just want to know what the answer is.” Fructose: High fructose corn syrup is a sweetener found in many packaged food and drink items such as pop. Sugar intake has increased dramatically over the last 30 years, so Ahmed’s team is investigating whether a high fructose diet influences the RAS. The kidney diet is one of the most restrictive of all medical diets because in addition to restricting potassium, phosphate and protein, patients also often have other conditions, such as diabetes, that will limit their diet even further. Ahmed says some of her patients tell her they’re actually afraid to eat. “This will be helpful to know so I will be able to tell my patients, ‘yes this is harmful to your kidneys or no it’s not.’” Dr. Sofia Ahmed is an associate professor in the Department of Medicine and the Division
Vitamin D: By conducting studies amongst both healthy individuals and those affected by kidney disease, Ahmed is trying to find out if vitamin D has a direct influence on the outcomes of kidney disease. In two recent studies published in Clinical and Experimental Hypertension and Nutrients, Ahmed’s team discovered that individuals with higher vitamin D levels were more likely
of Nephrology as well as a member of the Libin Cardiovascular Institute of Alberta. She is funded by the Canadian Institutes of Health Research and Alberta Innovates – Health Solutions.
Dr. Robert Quinn
C
ost is an important consideration in the health-care paradigm, and treating kidney disease is expensive. The demand for accountability in terms of health care and finances is increasing. Interested in the outcomes of dialysis and other therapies used to treat kidney disease, Dr. Robert Quinn has been involved in a number of projects focusing on the collection of high-quality data to measure performance, as well as the identification of strategies to improve the clinical care of these patients.
I t’s not enough to just collect good data and feed it back to people. Measuring performance in health care: Quinn and his team developed the Dialysis Measurement Analysis and Reporting system (DMAR), a web-based data collection platform. Currently implemented in three provinces, the database tracks the outcomes of approximately 20 per cent of the incident dialysis population in Canada. By focusing on a relatively small population that consumes a large amount of resources, the DMAR provides a manageable and effective way to observe what is being done well, and what is not, as well as identifying opportunities to improve the efficiency of care. “It’s not enough to just collect good data and feed it back to people,” he says. “You have to provide them with information
Home dialysis therapies: A common theme throughout his research in different health systems was the interest to grow home dialysis populations, specifically peritoneal dialysis. Peritoneal dialysis uses the abdomen as a filter, as an alternative to hemodialysis which removes blood from the blood stream to filter out toxins through a machine before returning it to the body. Equivalent to hemodialysis in terms of outcomes, peritoneal dialysis can be done in the home by the patient or caregiver, thereby reducing strain on the health-care system as well as that of the patient. Approximately 75 per cent of kidney patients qualify for peritoneal dialysis. Quinn’s team is conducting a systematic review to understand what interventions are available to increase the safe and effective utilization of home therapies. Vascular access: Arterio-venous fistulas are currently the preferred form of vascular access in hemodialysis and are actively promoted by guideline committees and governments. However, there is a lack of high-quality evidence to inform decision-making in this area. Quinn recently received CIHR funding to explore it further. He and his team are planning a pilot randomized controlled trial to address this question. Dr. Robert Quinn is an assistant professor in the departments of medicine and community health sciences, and is a member of the university’s Institute for Public Health.
PHILANTHROPY
MEDICINE.UCALGARY.CA/MAGAZINE
07
UCALGARY MEDICINE FALL 2013
B ev and I made a commitment prior to Peggy’s death that we would make something happen. -Mavis Clark
e were very determined that W we would do something, or try to do something, to advance lung cancer research. -Bev Longstaff
Friendship fuelling philanthropy By Steve Macfarlane
Bev Longstaff (left) with Mavis Clark (right).
The friendship between Mavis Clark and Bev Longstaff began under unlikely and unpredictable circumstances, but has evolved into an effective partnership between the strong-willed Calgarians and their community.
in their lives, the two dedicated philanthropic volunteers have learned more than they ever thought possible about each other and lung cancer—the terrible disease that claimed their loved ones. More people die each year from lung cancer—the cause of 27 per cent of Canadian cancer deaths—than from breast, prostate and colorectal cancers combined. Many still believe lung cancer only affects smokers; however, while smokers have a higher risk of developing the disease, more than 15 percent of those diagnosed have never smoked, and that number is rising.
DUE TO TR AGIC EVENTS
That number includes Clark’s husband, Paul, who was diagnosed with the disease in 2007 at the age of 57. A simple cough the couple thought might be bronchitis led to the life-changing diagnosis. Joining forces with Longstaff when mutual friend Peggy Valentine was also diagnosed with lung cancer, the two determined women vowed they would do something to change the landscape of lung cancer in their community. “Bev and I made a commitment prior to Peggy’s death that we would make something happen,” says Clark. “We were very determined that we would do something, or try to do some-
thing, to advance lung cancer research,” adds Longstaff. Together they’ve helped the vision of a lung cancer research program capable of improving patient outcomes become a reality with the Lung Cancer Translational Research Initiative at the University of Calgary. While her husband was undergoing treatment at the Tom Baker Cancer Centre, Clark discovered just how modest the funding for lung cancer research was in comparison to other types of cancer. She also discovered just how leadingedge that research was in spite of that shortcoming. After Paul died in April 2010, she made fundraising for lung cancer research a priority. Along with Longstaff, Peggy’s husband Peter Valentine and clinician researchers Dr. Don Morris and Dr. Gwyn Bebb, Clark helped launch the research initiative. It strives to become a leading voice in lung cancer research, following a roadmap similar to the highly successful Calgary Stroke Program, now regarded as one of the best of its kind in the country. “It’s pretty amazing what these guys can do with so little money. They’re just so dedicated, so committed, and they work like crazy,” Longstaff says of the clinicians and researchers involved. “They’re amazing human beings. With a little help from the community, they can do anything.” Focusing on prevention, care and even policy, those involved in the initiative —from basic scientists to researchers, epidemiologists and clinician researchers
—have accomplished a great deal in a short period of time, but feel they’ve barely scratched the surface of possibilities. New equipment has been acquired in the past year, giving researchers access to cutting-edge technology. Dr. Alain Tremblay, associate professor in the Division of Respiratory Medicine, is focused on early lung cancer detection and screening, which is a key component of treatment. Only about one in six patients survive more than five years, but with early treatment, before the cancer spreads outside the air passages, the five-year survival rate climbs to more than 77 per cent. The Glans-Look Database—an extensive collection of outcome data and tissue samples of lung cancer patients—now contains 10 years of detailed lung cancer related information and is beginning to offer answers regarding how patient management affects outcomes. Bebb, an associate professor in the Department of Oncology, is researching targeted therapies, while Morris, also an associate professor, is making strides in his tumour research. He’s seeking ways to make cancer-killing viruses more effective by focusing on the microenvironment that protects tumours from being seen by the immune system. By utilizing a drug already used to treat kidney cancer, which decreases the numbers of a specific cell that hide the tumour, Morris says it’s more likely for the injected virus to successfully attack
the tumour. Approval for a clinical trial to test this strategy in lung cancer patients is the next step for his work. Funded by Mavis Clark, The Paul Clark Fellowship in Lung Cancer was awarded for the first time in 2012, allowing oncologist Dr. Allison Black to outline new strategies for treatment. Aaron Goodarzi, PhD, an assistant professor in the departments of biochemistry and molecular biology, and oncology is examining how exposure to radon—a naturally occurring radioactive air contaminant—leads to lung cancers (more on pages 8 – 9). “We need to be looking at prevention strategies,” says Morris. “Fifteen percent of patients have never smoked or are remote smokers. What’s the biology behind it?” Both Clark and Longstaff are confident that the work being done now will offer more time with loved ones for those affected by lung cancer in the future. “Paul and I had great days, we just didn’t have enough good years,” says Clark. “Hopefully other people will have many great days, and many good years ahead of them if we can unlock the mysteries behind lung cancer research. “I know that Bev feels the same way.”
Did you know? Lung cancer is the leading cause of cancer deaths in Alberta.
PHILANTHROPY
MEDICINE.UCALGARY.CA/MAGAZINE
07
UCALGARY MEDICINE FALL 2013
B ev and I made a commitment prior to Peggy’s death that we would make something happen. -Mavis Clark
e were very determined that W we would do something, or try to do something, to advance lung cancer research. -Bev Longstaff
Friendship fuelling philanthropy By Steve Macfarlane
Bev Longstaff (left) with Mavis Clark (right).
The friendship between Mavis Clark and Bev Longstaff began under unlikely and unpredictable circumstances, but has evolved into an effective partnership between the strong-willed Calgarians and their community.
in their lives, the two dedicated philanthropic volunteers have learned more than they ever thought possible about each other and lung cancer—the terrible disease that claimed their loved ones. More people die each year from lung cancer—the cause of 27 per cent of Canadian cancer deaths—than from breast, prostate and colorectal cancers combined. Many still believe lung cancer only affects smokers; however, while smokers have a higher risk of developing the disease, more than 15 percent of those diagnosed have never smoked, and that number is rising.
DUE TO TR AGIC EVENTS
That number includes Clark’s husband, Paul, who was diagnosed with the disease in 2007 at the age of 57. A simple cough the couple thought might be bronchitis led to the life-changing diagnosis. Joining forces with Longstaff when mutual friend Peggy Valentine was also diagnosed with lung cancer, the two determined women vowed they would do something to change the landscape of lung cancer in their community. “Bev and I made a commitment prior to Peggy’s death that we would make something happen,” says Clark. “We were very determined that we would do something, or try to do some-
thing, to advance lung cancer research,” adds Longstaff. Together they’ve helped the vision of a lung cancer research program capable of improving patient outcomes become a reality with the Lung Cancer Translational Research Initiative at the University of Calgary. While her husband was undergoing treatment at the Tom Baker Cancer Centre, Clark discovered just how modest the funding for lung cancer research was in comparison to other types of cancer. She also discovered just how leadingedge that research was in spite of that shortcoming. After Paul died in April 2010, she made fundraising for lung cancer research a priority. Along with Longstaff, Peggy’s husband Peter Valentine and clinician researchers Dr. Don Morris and Dr. Gwyn Bebb, Clark helped launch the research initiative. It strives to become a leading voice in lung cancer research, following a roadmap similar to the highly successful Calgary Stroke Program, now regarded as one of the best of its kind in the country. “It’s pretty amazing what these guys can do with so little money. They’re just so dedicated, so committed, and they work like crazy,” Longstaff says of the clinicians and researchers involved. “They’re amazing human beings. With a little help from the community, they can do anything.” Focusing on prevention, care and even policy, those involved in the initiative —from basic scientists to researchers, epidemiologists and clinician researchers
—have accomplished a great deal in a short period of time, but feel they’ve barely scratched the surface of possibilities. New equipment has been acquired in the past year, giving researchers access to cutting-edge technology. Dr. Alain Tremblay, associate professor in the Division of Respiratory Medicine, is focused on early lung cancer detection and screening, which is a key component of treatment. Only about one in six patients survive more than five years, but with early treatment, before the cancer spreads outside the air passages, the five-year survival rate climbs to more than 77 per cent. The Glans-Look Database—an extensive collection of outcome data and tissue samples of lung cancer patients—now contains 10 years of detailed lung cancer related information and is beginning to offer answers regarding how patient management affects outcomes. Bebb, an associate professor in the Department of Oncology, is researching targeted therapies, while Morris, also an associate professor, is making strides in his tumour research. He’s seeking ways to make cancer-killing viruses more effective by focusing on the microenvironment that protects tumours from being seen by the immune system. By utilizing a drug already used to treat kidney cancer, which decreases the numbers of a specific cell that hide the tumour, Morris says it’s more likely for the injected virus to successfully attack
the tumour. Approval for a clinical trial to test this strategy in lung cancer patients is the next step for his work. Funded by Mavis Clark, The Paul Clark Fellowship in Lung Cancer was awarded for the first time in 2012, allowing oncologist Dr. Allison Black to outline new strategies for treatment. Aaron Goodarzi, PhD, an assistant professor in the departments of biochemistry and molecular biology, and oncology is examining how exposure to radon—a naturally occurring radioactive air contaminant—leads to lung cancers (more on pages 8 – 9). “We need to be looking at prevention strategies,” says Morris. “Fifteen percent of patients have never smoked or are remote smokers. What’s the biology behind it?” Both Clark and Longstaff are confident that the work being done now will offer more time with loved ones for those affected by lung cancer in the future. “Paul and I had great days, we just didn’t have enough good years,” says Clark. “Hopefully other people will have many great days, and many good years ahead of them if we can unlock the mysteries behind lung cancer research. “I know that Bev feels the same way.”
Did you know? Lung cancer is the leading cause of cancer deaths in Alberta.
RESEARCH
MEDICINE.UCALGARY.CA/MAGAZINE
09
UCALGARY MEDICINE FALL 2013
A
Radon gas explored by cancer researcher
By Marta Cyperling
University of Calgary gets new Canada Research Chair
lthough smoking remains the primary cause of lung cancer in the country, many Canadians may be unaware that a colourless and odourless radioactive gas that is the leading cause of non-smoking related lung cancer may be lurking in their homes. Last year, 25,528 Canadians were diagnosed with costly to treat and potentially fatal lung cancer. Four to 16 per cent* of new lung cancer cases each year are estimated or known to be attributable directly to the radioactive gas radon. Naturally emerging from soil, radon gas can accumulate within the home, with the highest levels accumulating in basements. Scientists say exposure to the radiation emitted by radon gas can cause instabilities in DNA, a fundamental cause of human aging as well as a driving force of cancer development. Aaron Goodarzi, PhD, a University of Calgary and Southern Alberta Cancer Research Institute researcher is exploring several initiatives to help understand and eradicate radon-induced cancer in Alberta. In March of this year, he was named the Canada Research Chair in Genome Damage and Instability Disease. Goodarzi examines human diseases caused by radiation exposure. His laboratory is exploring genetic risk factors for radiation-induced cancer, as well as novel methods of detecting radiation exposure and sensitivity in people. Since the most frequent mode of radiation exposure for most humans occurs via inhalation of radon gas, Goodarzi is particularly interested in understanding how radon triggers lung cancer. “Many Canadians may not be aware that the breakdown and erroneous repair of their own DNA, simply as a consequence of living in a certain location, will drive them towards a greater chance of cancer or premature aging,” says Goodarzi. “Individuals living in one of the many hundreds of thousands of Canadian households with high radon gas levels, for example, will be exposed to dramatically more radiation-induced DNA damage and thus are at serious risk of lung cancer, even if they have never smoked a cigarette in their life.”
Aaron Goodarzi is an assistant professor in the departments of biochemistry and molecular biology, and oncology
Only a small number of homes in Canada test for radon, but a recent Health Canada survey showed that depending on the region, between four and 44 per cent of Canadian homes have levels well above the minimum safe guidelines. The highest levels were found within Prairie and Maritime health regions.
DID YOU KNOW?
Some Home Depot stores carry radon testing kits, or a variety of companies may be found online by searching for ‘radon testing’ on Google. When choosing a testing company ensure they are C-NRPP certified. In Calgary, a local CNRPP certified company is RadonWest (radonwest.com).
Collectively, Calgary and Edmonton have a population of over two million yet only 160 homes between those cities were tested for radon by Health Canada in a 2007-2009 survey. With his team, Goodarzi hopes to map household radon levels in these major Alberta population centres to determine communities most at risk. “Radon-induced lung cancer represents a very expensive to treat and most often lethal disease, but one that is realistically preventable,” he says.
The first line of defence for concerned homeowners is to buy a simple and inexpensive test to measure radon levels in their homes. In the event that remediation is required, this too can be simple, costing between $1,000 and $4,000—a relatively minor expensive compared to most serious home renovations or alterations. “The cost of testing and remediating a home weighed against not getting lung cancer—it’s worth it. Lung cancer is a killer,” says Goodarzi. As part of the CRC, Aaron Goodarzi will receive $500,000 over five years for his research. He holds one of 71 Canadian Research Chairs at the University of Calgary.
* Official statistics provided by the WHO, US EPA, Health Canada and the scientific community at large averaging out specific variables such as gender and regional smoking habits.
RESEARCH
MEDICINE.UCALGARY.CA/MAGAZINE
09
UCALGARY MEDICINE FALL 2013
A
Radon gas explored by cancer researcher
By Marta Cyperling
University of Calgary gets new Canada Research Chair
lthough smoking remains the primary cause of lung cancer in the country, many Canadians may be unaware that a colourless and odourless radioactive gas that is the leading cause of non-smoking related lung cancer may be lurking in their homes. Last year, 25,528 Canadians were diagnosed with costly to treat and potentially fatal lung cancer. Four to 16 per cent* of new lung cancer cases each year are estimated or known to be attributable directly to the radioactive gas radon. Naturally emerging from soil, radon gas can accumulate within the home, with the highest levels accumulating in basements. Scientists say exposure to the radiation emitted by radon gas can cause instabilities in DNA, a fundamental cause of human aging as well as a driving force of cancer development. Aaron Goodarzi, PhD, a University of Calgary and Southern Alberta Cancer Research Institute researcher is exploring several initiatives to help understand and eradicate radon-induced cancer in Alberta. In March of this year, he was named the Canada Research Chair in Genome Damage and Instability Disease. Goodarzi examines human diseases caused by radiation exposure. His laboratory is exploring genetic risk factors for radiation-induced cancer, as well as novel methods of detecting radiation exposure and sensitivity in people. Since the most frequent mode of radiation exposure for most humans occurs via inhalation of radon gas, Goodarzi is particularly interested in understanding how radon triggers lung cancer. “Many Canadians may not be aware that the breakdown and erroneous repair of their own DNA, simply as a consequence of living in a certain location, will drive them towards a greater chance of cancer or premature aging,” says Goodarzi. “Individuals living in one of the many hundreds of thousands of Canadian households with high radon gas levels, for example, will be exposed to dramatically more radiation-induced DNA damage and thus are at serious risk of lung cancer, even if they have never smoked a cigarette in their life.”
Aaron Goodarzi is an assistant professor in the departments of biochemistry and molecular biology, and oncology
Only a small number of homes in Canada test for radon, but a recent Health Canada survey showed that depending on the region, between four and 44 per cent of Canadian homes have levels well above the minimum safe guidelines. The highest levels were found within Prairie and Maritime health regions.
DID YOU KNOW?
Some Home Depot stores carry radon testing kits, or a variety of companies may be found online by searching for ‘radon testing’ on Google. When choosing a testing company ensure they are C-NRPP certified. In Calgary, a local CNRPP certified company is RadonWest (radonwest.com).
Collectively, Calgary and Edmonton have a population of over two million yet only 160 homes between those cities were tested for radon by Health Canada in a 2007-2009 survey. With his team, Goodarzi hopes to map household radon levels in these major Alberta population centres to determine communities most at risk. “Radon-induced lung cancer represents a very expensive to treat and most often lethal disease, but one that is realistically preventable,” he says.
The first line of defence for concerned homeowners is to buy a simple and inexpensive test to measure radon levels in their homes. In the event that remediation is required, this too can be simple, costing between $1,000 and $4,000—a relatively minor expensive compared to most serious home renovations or alterations. “The cost of testing and remediating a home weighed against not getting lung cancer—it’s worth it. Lung cancer is a killer,” says Goodarzi. As part of the CRC, Aaron Goodarzi will receive $500,000 over five years for his research. He holds one of 71 Canadian Research Chairs at the University of Calgary.
* Official statistics provided by the WHO, US EPA, Health Canada and the scientific community at large averaging out specific variables such as gender and regional smoking habits.
RESEARCH
M E D I C I N E . U C A LG A RY.C A / M AG A ZI N E
11
UCALGARY MEDICINE FALL 2013
A pest in your kitchen but perfectly suited for science.
A fly’s eye view inside the lab By Kathryn Kazoleas
the turn of the twentieth century when Thomas Morgan, an American embryologist and evolutionary biologist, first began using Drosophila melanogaster, more commonly known as the fruit fly, to study genetics. After approximately two years of cross-breeding experiments, Morgan observed a mutant white-eyed male fly in the species that typically bears dark red eyes. Upon breeding the male with a red-eyed female, the offspring appeared normal; however, the next generation hatched all white-eyed males, but only red-eyed females. Morgan correctly hypothesized that it was related to the genetic factor that determined sex, thus the mutation became known
IT WAS AT
as white—the first known X-linked recessive mutation. Subsequent genetic studies led Morgan to conclude that genes resided on chromosomes (a coiled piece of DNA)—a major breakthrough in genetics for which he received the Nobel Award in Physiology or Medicine in 1933. Fast forward over 100 years and fruit flies are still widely regarded in the science community as a model system for studying genetics in basic research. While genetics remains the dominant reason for studying these insects, scientists have used them to study everything from behavioural traits, limb development, aging, and diseases such as cancer and diabetes.
2.5 MM
10 DAYS
30 DAYS
60 DAYS
Size: Mature females are approximately 2.5 mm. Males are slightly smaller. Lifespan: Maturation from the time of hatching is 10 days. Their entire lifespan can be approximately 30–60 days in optimal conditions.
RESEARCH
M E D I C I N E . U C A LG A RY.C A / M AG A ZI N E
11
UCALGARY MEDICINE FALL 2013
A pest in your kitchen but perfectly suited for science.
A fly’s eye view inside the lab By Kathryn Kazoleas
the turn of the twentieth century when Thomas Morgan, an American embryologist and evolutionary biologist, first began using Drosophila melanogaster, more commonly known as the fruit fly, to study genetics. After approximately two years of cross-breeding experiments, Morgan observed a mutant white-eyed male fly in the species that typically bears dark red eyes. Upon breeding the male with a red-eyed female, the offspring appeared normal; however, the next generation hatched all white-eyed males, but only red-eyed females. Morgan correctly hypothesized that it was related to the genetic factor that determined sex, thus the mutation became known
IT WAS AT
as white—the first known X-linked recessive mutation. Subsequent genetic studies led Morgan to conclude that genes resided on chromosomes (a coiled piece of DNA)—a major breakthrough in genetics for which he received the Nobel Award in Physiology or Medicine in 1933. Fast forward over 100 years and fruit flies are still widely regarded in the science community as a model system for studying genetics in basic research. While genetics remains the dominant reason for studying these insects, scientists have used them to study everything from behavioural traits, limb development, aging, and diseases such as cancer and diabetes.
2.5 MM
10 DAYS
30 DAYS
60 DAYS
Size: Mature females are approximately 2.5 mm. Males are slightly smaller. Lifespan: Maturation from the time of hatching is 10 days. Their entire lifespan can be approximately 30–60 days in optimal conditions.
RESEARCH
M E D I C I N E . U C A LG A RY.C A / M AG A ZI N E
13
UCALGARY MEDICINE FALL 2013
Research at the University of Calgary Human relevance
William Brook, PhD
Savraj Grewal, PhD
Associate Professor, Department of Biochemistry and Molecular Biology
Assistant Professor, Department of Biochemistry and Molecular Biology
Alberta Children’s Hospital Research Institute
Alberta Children’s Hospital Research Institute Southern Alberta Cancer Research Institute
A
Fruit fly larvae.
Why fruit flies?
B
Looking at fruit fly larvae under a microscope.
ecause of their small size, their short lifespan and the relatively low cost to obtain and house, fruit flies are used in many medical and science labs around the world. Considered a simple yet powerful system in which to study and manipulate the genome, scientists often regard fruit flies as a good intermediate between the simple biology of a bacterial cell, and the complicated physiology of vertebrates. Scientists are able to turn genes on and off to essentially create flies that are purpose built to study any cellular or biological process.
pproximately 60 to 80 per cent of human genes have either an identical or a similar version in the fruit fly and many known genes that cause diseases such as cancer in humans are found in flies as well. Of equal importance is the fact that cell-signalling pathways—the ways that cells communicate with each other—are also nearly identical between humans and fruit flies. Because of their ability to manipulate and mutate the genes of fruit flies, scientists are able to observe the outcome of manipulating these cell-signalling pathways on various physiological processes. In doing so, they are able to gain a greater understanding of how these processes work in humans.
Where do they come from?
Did you know?
W
hile some fruit fly stock centers do exist in various parts of the world, the majority of fruit flies are bred by the scientists themselves. Large collections of the insects, often in the thousands, are kept in the labs. Because the fly research community is well known for sharing their resources, it’s not uncommon for the flies to be shipped to other labs around the world.
Fly fact: Both fruit flies and humans have the gene tinman (called Nkx2.5 in humans) which tells cells to develop as heart tissue. Flies lacking the tinman gene have no hearts. Defects in the human gene cause congenital heart defects in newborns.
The fruit flies used in labs are the same ones you might bring home with your fruit from the grocery store. Fruit flies are found worldwide. Where there are humans, there are fruit flies. William Brook uses fruit flies to understand how cells make decisions in limb and heart development. Using the gene Tbx20— a gene first discovered in his lab that regulates the expression of other genes— his team is researching the genetic steps it takes for cells to differentiate from one another. All embryonic cells start out exactly the same but are programmed to differentiate over time into different tissues. Brook’s lab is trying to understand how cells are instructed to become different using the fly limb and heart as models. It’s hypothesized that Tbx20 acts like a genetic switch and thereby coordinates several other genetic processes and cell signals by turning groups of genes on or off. When Tbx20 is on, cells differentiate in a completely different way than when Tbx20 is off. By using genetic approaches, his lab is modifying parts of this genetic switch and getting various outcomes, subsequently leading to an understanding of how this process works.
Savraj Grewal’s lab is interested in using the fruit fly to identify genes that control how cells grow and multiply. These fly genes are similar to human growth genes and, in particular, to genes that become mutated and deregulated in cancer. Therefore, the fly provides a simple model system to study genetic events that lead to tumour formation. Grewal is particularly interested in the insulin and insulin-like growth factor (IGF) pathway. Overactivation of this pathway can drive the growth of various tumours such as those found in the brain and breast. Flies have seven types of insulins that work much like that of human IGFs—to regulate metabolism and growth. Grewal is trying to figure out how insulins control growth and how the IGF pathway may be targeted in cancer therapy. Savraj Grewal is supported by Alberta Innovates - Health Solutions.
Fruit flies are anesthetized when scientists examine them. This is done by exposing them to carbon dioxide. After the effects wear off, they are able to carry on as normal.
RESEARCH
M E D I C I N E . U C A LG A RY.C A / M AG A ZI N E
13
UCALGARY MEDICINE FALL 2013
Research at the University of Calgary Human relevance
William Brook, PhD
Savraj Grewal, PhD
Associate Professor, Department of Biochemistry and Molecular Biology
Assistant Professor, Department of Biochemistry and Molecular Biology
Alberta Children’s Hospital Research Institute
Alberta Children’s Hospital Research Institute Southern Alberta Cancer Research Institute
A
Fruit fly larvae.
Why fruit flies?
B
Looking at fruit fly larvae under a microscope.
ecause of their small size, their short lifespan and the relatively low cost to obtain and house, fruit flies are used in many medical and science labs around the world. Considered a simple yet powerful system in which to study and manipulate the genome, scientists often regard fruit flies as a good intermediate between the simple biology of a bacterial cell, and the complicated physiology of vertebrates. Scientists are able to turn genes on and off to essentially create flies that are purpose built to study any cellular or biological process.
pproximately 60 to 80 per cent of human genes have either an identical or a similar version in the fruit fly and many known genes that cause diseases such as cancer in humans are found in flies as well. Of equal importance is the fact that cell-signalling pathways—the ways that cells communicate with each other—are also nearly identical between humans and fruit flies. Because of their ability to manipulate and mutate the genes of fruit flies, scientists are able to observe the outcome of manipulating these cell-signalling pathways on various physiological processes. In doing so, they are able to gain a greater understanding of how these processes work in humans.
Where do they come from?
Did you know?
W
hile some fruit fly stock centers do exist in various parts of the world, the majority of fruit flies are bred by the scientists themselves. Large collections of the insects, often in the thousands, are kept in the labs. Because the fly research community is well known for sharing their resources, it’s not uncommon for the flies to be shipped to other labs around the world.
Fly fact: Both fruit flies and humans have the gene tinman (called Nkx2.5 in humans) which tells cells to develop as heart tissue. Flies lacking the tinman gene have no hearts. Defects in the human gene cause congenital heart defects in newborns.
The fruit flies used in labs are the same ones you might bring home with your fruit from the grocery store. Fruit flies are found worldwide. Where there are humans, there are fruit flies. William Brook uses fruit flies to understand how cells make decisions in limb and heart development. Using the gene Tbx20— a gene first discovered in his lab that regulates the expression of other genes— his team is researching the genetic steps it takes for cells to differentiate from one another. All embryonic cells start out exactly the same but are programmed to differentiate over time into different tissues. Brook’s lab is trying to understand how cells are instructed to become different using the fly limb and heart as models. It’s hypothesized that Tbx20 acts like a genetic switch and thereby coordinates several other genetic processes and cell signals by turning groups of genes on or off. When Tbx20 is on, cells differentiate in a completely different way than when Tbx20 is off. By using genetic approaches, his lab is modifying parts of this genetic switch and getting various outcomes, subsequently leading to an understanding of how this process works.
Savraj Grewal’s lab is interested in using the fruit fly to identify genes that control how cells grow and multiply. These fly genes are similar to human growth genes and, in particular, to genes that become mutated and deregulated in cancer. Therefore, the fly provides a simple model system to study genetic events that lead to tumour formation. Grewal is particularly interested in the insulin and insulin-like growth factor (IGF) pathway. Overactivation of this pathway can drive the growth of various tumours such as those found in the brain and breast. Flies have seven types of insulins that work much like that of human IGFs—to regulate metabolism and growth. Grewal is trying to figure out how insulins control growth and how the IGF pathway may be targeted in cancer therapy. Savraj Grewal is supported by Alberta Innovates - Health Solutions.
Fruit flies are anesthetized when scientists examine them. This is done by exposing them to carbon dioxide. After the effects wear off, they are able to carry on as normal.
RESEARCH
15
UCALGARY MEDICINE FALL 2013
M E D I C I N E . U C A LG A RY.C A / M AG A ZI N E
What is the gut?
ntially The gut or gastrointestinal tract is the organ of digestion. It isto esse the anus. a tube that runs from the mouth down through the intestines, der, It is served by accessory organs, such as the liver and gall blad that perform various roles to aid in the digestion process. Did you know? What does it do?
What are some of the most common illnesses of the gut?
COLON CANCER Early stages are often asymptomatic, but when caught early, colon cancer is highly treatable. Promising approaches to treatment and screening methods are currently available.
IRRITABLE BOWEL
GASTROESOPHAGEAL REFLUX
A disorder of gut sensation and function, this condition affects approximately 10 per cent of the population.
More commonly known as acid reflux, this is acidinduced heartburn.
SYNDROME (IBS)
INFLAMMATORY
With a high prevalence in Canada (approximately 1/160 Canadians are affected), IBD includes Crohn’s disease and ulcerative colitis. This chronic condition, for which there is no cure, affects many young adults as well as those who are older. BOWEL DISEASE (IBD)
ULCER DISEASE Most commonly due to a bacterial infection with Helicobacter pylori, stomach ulcers can be largely cured with antibiotics. Severe cases in the elderly can be fatal due to blood loss.
A condition that occurs when weak pouches within the bowel wall are formed, leading to infection and inflammation.
DIVERTICULITIS
An autoimmune disorder of the gut caused by a reaction to certain grain proteins, notably from wheat.
CELIAC DISEASE
Why do you get stomach butterflies in yorvurous? when you get ne This sensation is due to nervous changes that are transmitted from the brain to the gut, altering normal movement, secretion and blood flow in the gut, because of the release of stress hormones. When you experience an altered state of mind such as anxiety, the brain adapts and some people become aware of various movements of the gut that wouldn’t normally be felt.
#1
If you do not eat, your stomach will shrink to some degree. Your stomach and the rest of the gut are muscles; so if you don’t use them, they will shrink, much like the other muscles in your body. A good example of this is hibernating animals. When an animal goes into hibernation and doesn’t eat, its gut shrinks down to save energy.
#2
Approximately 2/3 of the body’s immune system is in the gut. This is to protect the body from various pathogens that may enter the body through food sources. Additionally, food becomes dangerous as it’s digested, with the potential to release harmful antigens into the body that could cause illness. The immune system protects the body from these antigens; however, in some cases, the immune system is unable to do so, resulting in some autoimmune disorders such as celiac disease.
C
B
#3
The gut is the largest endocrine organ in the body. It releases hormones which act as signalling molecules to guide and direct many bodily functions. For instance, ghrelin is the hormone released from the stomach to inform the body when it’s hungry. Ghrelin levels will increase approximately three times a day: before breakfast, lunch and dinner.
D
#4
There are as many neurons in the gut as there are in the spinal cord. These neurons control digestion and coordinate defence. One of the most important parts of the digestive process that nerves regulate is the coordinated movement of gut contents.
E
F
—
This information was provided by Keith Sharkey, PhD, a professor in the Department of Physiology and Pharmacology as well as a member of the university’s Hotchkiss Brain Institute and Snyder Institute for Chronic Diseases. Sharkey’s research focuses on understanding how nerves and neural elements, called glial cells, regulate gut function and how they are affected in various gastrointestinal diseases. He has also conducted studies on gut signalling to the brain as well as those to understand the control of vomiting.
G
Illustration by Amanda Fisher
As the organ of digestion, the gut converts food into the nutrients and energy sources that are required for life.
A
H
I
Leg end: a Liver
f Cecum
b
g Appendix
Gall bladder c Stomach d Large intestine e Small intestine
h Rectum i Anus
RESEARCH
15
UCALGARY MEDICINE FALL 2013
M E D I C I N E . U C A LG A RY.C A / M AG A ZI N E
What is the gut?
ntially The gut or gastrointestinal tract is the organ of digestion. It isto esse the anus. a tube that runs from the mouth down through the intestines, der, It is served by accessory organs, such as the liver and gall blad that perform various roles to aid in the digestion process. Did you know? What does it do?
What are some of the most common illnesses of the gut?
COLON CANCER Early stages are often asymptomatic, but when caught early, colon cancer is highly treatable. Promising approaches to treatment and screening methods are currently available.
IRRITABLE BOWEL
GASTROESOPHAGEAL REFLUX
A disorder of gut sensation and function, this condition affects approximately 10 per cent of the population.
More commonly known as acid reflux, this is acidinduced heartburn.
SYNDROME (IBS)
INFLAMMATORY
With a high prevalence in Canada (approximately 1/160 Canadians are affected), IBD includes Crohn’s disease and ulcerative colitis. This chronic condition, for which there is no cure, affects many young adults as well as those who are older. BOWEL DISEASE (IBD)
ULCER DISEASE Most commonly due to a bacterial infection with Helicobacter pylori, stomach ulcers can be largely cured with antibiotics. Severe cases in the elderly can be fatal due to blood loss.
A condition that occurs when weak pouches within the bowel wall are formed, leading to infection and inflammation.
DIVERTICULITIS
An autoimmune disorder of the gut caused by a reaction to certain grain proteins, notably from wheat.
CELIAC DISEASE
Why do you get stomach butterflies in yorvurous? when you get ne This sensation is due to nervous changes that are transmitted from the brain to the gut, altering normal movement, secretion and blood flow in the gut, because of the release of stress hormones. When you experience an altered state of mind such as anxiety, the brain adapts and some people become aware of various movements of the gut that wouldn’t normally be felt.
#1
If you do not eat, your stomach will shrink to some degree. Your stomach and the rest of the gut are muscles; so if you don’t use them, they will shrink, much like the other muscles in your body. A good example of this is hibernating animals. When an animal goes into hibernation and doesn’t eat, its gut shrinks down to save energy.
#2
Approximately 2/3 of the body’s immune system is in the gut. This is to protect the body from various pathogens that may enter the body through food sources. Additionally, food becomes dangerous as it’s digested, with the potential to release harmful antigens into the body that could cause illness. The immune system protects the body from these antigens; however, in some cases, the immune system is unable to do so, resulting in some autoimmune disorders such as celiac disease.
C
B
#3
The gut is the largest endocrine organ in the body. It releases hormones which act as signalling molecules to guide and direct many bodily functions. For instance, ghrelin is the hormone released from the stomach to inform the body when it’s hungry. Ghrelin levels will increase approximately three times a day: before breakfast, lunch and dinner.
D
#4
There are as many neurons in the gut as there are in the spinal cord. These neurons control digestion and coordinate defence. One of the most important parts of the digestive process that nerves regulate is the coordinated movement of gut contents.
E
F
—
This information was provided by Keith Sharkey, PhD, a professor in the Department of Physiology and Pharmacology as well as a member of the university’s Hotchkiss Brain Institute and Snyder Institute for Chronic Diseases. Sharkey’s research focuses on understanding how nerves and neural elements, called glial cells, regulate gut function and how they are affected in various gastrointestinal diseases. He has also conducted studies on gut signalling to the brain as well as those to understand the control of vomiting.
G
Illustration by Amanda Fisher
As the organ of digestion, the gut converts food into the nutrients and energy sources that are required for life.
A
H
I
Leg end: a Liver
f Cecum
b
g Appendix
Gall bladder c Stomach d Large intestine e Small intestine
h Rectum i Anus
EDUCATION
16
Welcome to the Pack By Colleen Biondi
If University of Calgary undergraduate and graduate students are looking for a unique opportunity to collaborate with like-minded individuals and build a robust academic portfolio, they might want to consider joining the pack. the Wolb-Pack—an interdisciplinary research team currently composed of undergraduate and graduate students from the faculties of medicine, science, arts and kinesiology—has been meeting once a week. They utilize their collaborative research model to discuss contemporary issues, plan and execute research projects, write papers and prepare podcasts for submission to a wide variety of peer reviewed journals and conferences.
SINCE 2010,
With projects grounded in the framework of ableism and disability studies, the team’s academic work reflects the research and personal interests of the students, including topics such as bioethics, medical anthropology, models and determinants of health, climate change, sustainability, sports and therapeutic enhancement technologies such as social robots and brain-computer interfaces. Gregor Wolbring, PhD, the group’s founder and a member of the university’s Institute for Public Health, says the pack gives students a place to belong, to learn about themselves and the opportunity to make a difference within the context of others. “It is about building identity as a group,” says Wolbring. When it comes to the research, the Wolb-Pack’s emphasis is on maximizing resources. Students mentor one another,
co-author documents and employ a variety of methodologies to aid in efficient and productive research. While Wolbring locates conferences and journals for the students, they do the heavy lifting. For instance, one student presented at 39 online conferences in 2012. Many of the peer reviewed academic papers are published open access and downloaded an average of 300 times. This season, the students are also organizing the second annual INSPIRe (International Network of Student Perspectives in Research) conference and will be presenting at a symposium in the United Kingdom. “Collaboration gets them further than competition,” he says. “And that’s about so much more than academics.”
Student Run Clinic (SRC) opened in January 2010 to engage medical students in the provision of medical care for Calgary’s underserved and homeless populations. Under the supervision of a physician preceptor, first- and second-year students work at the clinic one evening per week, assessing and creating care plans for patients seeking medical care. While the opportunity has proven invaluable from an educational stand point, to date, little information has been gathered regarding the overall impact the clinic is having on the community. A recent study has shown that the SRC has the potential to meet several
needs of the city’s homeless population, and despite barriers to providing a wider spectrum of health services, it is effective and well received by patients, stakeholders and fellow health-care providers. “Individuals experiencing homelessness generally have poorer health outcomes, and poorer access to care than the general population,” says lead author, Dr. David Campbell, an internal medicine resident and PhD candidate in the Department of Community Health Sciences, as well as one of the initial medical students involved in starting up the clinic. “The complexities of providing medical care to those who are homeless in an urban setting are challenging,
17
Alumnus takes skills overseas By Leigh Hurst
Gregor Wolbring is an associate professor in the Department of Community Health Sciences and the Community Rehabilitation and Disability Studies program. More about the group can be found at medicine.ucalgary.ca/crds. Jesse Hendrikse, an adjunct professor in the Department of Community Health Sciences, is the first faculty supervisor to have joined the pack. (Above) Gregor Wolbring (front row, left), with members of the pack.
Student run clinic beneficial: study THE UNIVERSIT Y OF CALGARY’S
ALUMNI
and we wanted to know if Calgary’s SRC may be an effective tool to help meet these needs.” The study involved collecting qualitative data from students, faculty members, agency directors and clients through interviews. Overall, findings suggested that the Calgary SRC has the potential to play an important role in the primary health-care needs of Calgary’s homeless population. “Further research is needed to examine what works best in Canadian SRCs and why,” says Campbell. “This will facilitate optimal planning and maximal benefits to the communities where SRCs operate.”
SINCE 2001, Dr. R. Bruce Lampard, MD ‘94 (Peccary), has dedicated his service to Médecins Sans Frontières (MSF), also known as Doctors Without Borders. Currently, he is the president of MSFCanada and has served on their board since 2009. Established in 1971 by a small group of French physicians, MSF now employs approximately 30,000 staff situated in countries around the world. Working under their mandate to provide emergency relief in countries that have little or no medical infrastructure, their involvement and investment in a region may continue for several years once the initial, urgent need is met. MSF also provides services to areas exposed to violent conditions. “MSF is like few other organizations, in working independently at the grassroots level to meet the direct needs of people in crisis. To be a part of that, to use my time and skills to the betterment of other human beings caught in a dire situation, is truly gratifying,” Lampard says. His first field physician role with MSF was in 2001 at a 70 bed rural medicalnutritional hospital in South Sudan.
“It was clearly an eye-opening experience,” he says. “On-call seven days a week, dealing with medical problems I had never heard of, sharing my hut with an iguana—it was challenging. But the needs we were able to address and the team I was fortunate enough to work with, both international and Sudanese, made my time there incredibly positive.”
y desire to get involved M in humanitarian work certainly had its roots in Calgary, partly through inspirational visiting speakers to the medical school... Subsequent experiences with MSF have taken Lampard to Nigeria, Afghanistan, Burundi, Democratic Republic of Congo, Chad and Somalia. His roles have included establishing primary health and nutritional programs for refugees, providing medical and technical support to hospitals and providing primary health-care centre supervision. “My desire to get involved in humanitarian work certainly had its roots in Calgary,
partly through inspirational visiting speakers to the medical school but also through medical staff already involved in overseas work.” After completing his medical degree and residency in general internal medicine and emergency medicine at the University of Calgary, Lampard went on to complete a Masters of International and Public Affairs at Columbia University in New York. While his contributions to MSF often take him out of Canada to practice medicine, he is an active emergency medicine physician at Toronto’s University Health Network.
What is a peccary? A peccary is a medium sized mammal found in southwestern North America and in Central and South America. It bears a strong resemblance to a pig. The University of Calgary’s Faculty of Medicine began formally naming its MD classes after animals in 1975 when a professor became frustrated with his class and called them “a bunch of turkeys”. The name stuck and so did the tradition, with each medical class naming the class behind them.
Dr. R. Bruce Lampard’s work with Doctors Without Borders has taken him around the world.
EDUCATION
16
Welcome to the Pack By Colleen Biondi
If University of Calgary undergraduate and graduate students are looking for a unique opportunity to collaborate with like-minded individuals and build a robust academic portfolio, they might want to consider joining the pack. the Wolb-Pack—an interdisciplinary research team currently composed of undergraduate and graduate students from the faculties of medicine, science, arts and kinesiology—has been meeting once a week. They utilize their collaborative research model to discuss contemporary issues, plan and execute research projects, write papers and prepare podcasts for submission to a wide variety of peer reviewed journals and conferences.
SINCE 2010,
With projects grounded in the framework of ableism and disability studies, the team’s academic work reflects the research and personal interests of the students, including topics such as bioethics, medical anthropology, models and determinants of health, climate change, sustainability, sports and therapeutic enhancement technologies such as social robots and brain-computer interfaces. Gregor Wolbring, PhD, the group’s founder and a member of the university’s Institute for Public Health, says the pack gives students a place to belong, to learn about themselves and the opportunity to make a difference within the context of others. “It is about building identity as a group,” says Wolbring. When it comes to the research, the Wolb-Pack’s emphasis is on maximizing resources. Students mentor one another,
co-author documents and employ a variety of methodologies to aid in efficient and productive research. While Wolbring locates conferences and journals for the students, they do the heavy lifting. For instance, one student presented at 39 online conferences in 2012. Many of the peer reviewed academic papers are published open access and downloaded an average of 300 times. This season, the students are also organizing the second annual INSPIRe (International Network of Student Perspectives in Research) conference and will be presenting at a symposium in the United Kingdom. “Collaboration gets them further than competition,” he says. “And that’s about so much more than academics.”
Student Run Clinic (SRC) opened in January 2010 to engage medical students in the provision of medical care for Calgary’s underserved and homeless populations. Under the supervision of a physician preceptor, first- and second-year students work at the clinic one evening per week, assessing and creating care plans for patients seeking medical care. While the opportunity has proven invaluable from an educational stand point, to date, little information has been gathered regarding the overall impact the clinic is having on the community. A recent study has shown that the SRC has the potential to meet several
needs of the city’s homeless population, and despite barriers to providing a wider spectrum of health services, it is effective and well received by patients, stakeholders and fellow health-care providers. “Individuals experiencing homelessness generally have poorer health outcomes, and poorer access to care than the general population,” says lead author, Dr. David Campbell, an internal medicine resident and PhD candidate in the Department of Community Health Sciences, as well as one of the initial medical students involved in starting up the clinic. “The complexities of providing medical care to those who are homeless in an urban setting are challenging,
17
Alumnus takes skills overseas By Leigh Hurst
Gregor Wolbring is an associate professor in the Department of Community Health Sciences and the Community Rehabilitation and Disability Studies program. More about the group can be found at medicine.ucalgary.ca/crds. Jesse Hendrikse, an adjunct professor in the Department of Community Health Sciences, is the first faculty supervisor to have joined the pack. (Above) Gregor Wolbring (front row, left), with members of the pack.
Student run clinic beneficial: study THE UNIVERSIT Y OF CALGARY’S
ALUMNI
and we wanted to know if Calgary’s SRC may be an effective tool to help meet these needs.” The study involved collecting qualitative data from students, faculty members, agency directors and clients through interviews. Overall, findings suggested that the Calgary SRC has the potential to play an important role in the primary health-care needs of Calgary’s homeless population. “Further research is needed to examine what works best in Canadian SRCs and why,” says Campbell. “This will facilitate optimal planning and maximal benefits to the communities where SRCs operate.”
SINCE 2001, Dr. R. Bruce Lampard, MD ‘94 (Peccary), has dedicated his service to Médecins Sans Frontières (MSF), also known as Doctors Without Borders. Currently, he is the president of MSFCanada and has served on their board since 2009. Established in 1971 by a small group of French physicians, MSF now employs approximately 30,000 staff situated in countries around the world. Working under their mandate to provide emergency relief in countries that have little or no medical infrastructure, their involvement and investment in a region may continue for several years once the initial, urgent need is met. MSF also provides services to areas exposed to violent conditions. “MSF is like few other organizations, in working independently at the grassroots level to meet the direct needs of people in crisis. To be a part of that, to use my time and skills to the betterment of other human beings caught in a dire situation, is truly gratifying,” Lampard says. His first field physician role with MSF was in 2001 at a 70 bed rural medicalnutritional hospital in South Sudan.
“It was clearly an eye-opening experience,” he says. “On-call seven days a week, dealing with medical problems I had never heard of, sharing my hut with an iguana—it was challenging. But the needs we were able to address and the team I was fortunate enough to work with, both international and Sudanese, made my time there incredibly positive.”
y desire to get involved M in humanitarian work certainly had its roots in Calgary, partly through inspirational visiting speakers to the medical school... Subsequent experiences with MSF have taken Lampard to Nigeria, Afghanistan, Burundi, Democratic Republic of Congo, Chad and Somalia. His roles have included establishing primary health and nutritional programs for refugees, providing medical and technical support to hospitals and providing primary health-care centre supervision. “My desire to get involved in humanitarian work certainly had its roots in Calgary,
partly through inspirational visiting speakers to the medical school but also through medical staff already involved in overseas work.” After completing his medical degree and residency in general internal medicine and emergency medicine at the University of Calgary, Lampard went on to complete a Masters of International and Public Affairs at Columbia University in New York. While his contributions to MSF often take him out of Canada to practice medicine, he is an active emergency medicine physician at Toronto’s University Health Network.
What is a peccary? A peccary is a medium sized mammal found in southwestern North America and in Central and South America. It bears a strong resemblance to a pig. The University of Calgary’s Faculty of Medicine began formally naming its MD classes after animals in 1975 when a professor became frustrated with his class and called them “a bunch of turkeys”. The name stuck and so did the tradition, with each medical class naming the class behind them.
Dr. R. Bruce Lampard’s work with Doctors Without Borders has taken him around the world.
04
SERVICE TO SOCIETY
M E D I C I N E . U C A LG A RY.C A / M AG A ZI N E
Q&A with Dr. Anne M. Gillis
By Lynda Sea
Professor of medicine reflects on her past year as president of the Heart Rhythm Society Dr. Anne M. Gillis, a professor in the Department of Medicine and a member of the University of Calgary’s Libin Cardiovascular Institute of Alberta, is only the second non-American to be selected as president of the Heart Rhythm Society (HRS). In May, she completed her one-year term as president at the Washington-based organization. HRS is the international leader in science, education and advocacy for cardiac arrhythmia professionals and patients. It represents some 5,800 medical, health-care and science professionals from 72 countries who specialize in cardiac rhythm disorders.
19
UCALGARY MEDICINE FALL 2013
What were your main duties as president of the Heart Rhythm Society?
What were the highlights of your term as HRS President?
As president, I oversaw the activities of HRS. We have four major strategic areas: education, research, health policy, and patients and caregivers. I oversaw strategic governance and operational activities of the society to maintain a focus on our strategic priorities. The highlight of our year is our annual Scientific Sessions which was held in Denver in early May. Former president Bill Clinton was our plenary speaker—the title of his presentation was ‘Embracing our Global Humanity’. The theatre, which had capacity for close to 6,000 people, was totally filled.
One of the real achievements this year was our first publication of a truly global consensus document that we led with the European Heart Rhythm Association (EHRA) and the Asia Pacific Heart Rhythm Society (APHRS). The topic addressed the diagnoses and management of patients with inherited arrhythmia syndromes. The success of this document reflects the globalization of heart rhythm societies and their willingness to work together. This past year I invested considerable time strengthening relationships with other international societies and other organizations that have an interest in heart rhythm disorders. Our big audacious goal is to end death and suffering due to heart rhythm disorders. As an organization predominantly based in North America, we cannot achieve that goal without global partnership.
What was meeting Bill Clinton like?
How did your roles at the University of Calgary and HRS complement one another?
It was an incredible experience meeting him. James Youngblood (CEO of HRS) and I greeted him when he arrived. We had a 10-minute conversation before his presentation where he very intensely talked about health-care issues. He made a comment about an article that had been published in The New York Times that day which prompted an engaged debate in the room. He is incredibly bright and knowledgeable about health care and all the issues. In his formal presentation, he also talked about health-care reform and challenged us as physicians to be part of the solution, not part of the problem.
One of our strategic goal areas at HRS is research. Until about a year ago, believe it or not, HRS had never had a research committee. I oversaw the implementation of the research committee. My research profile and focus at the University of Calgary led me to identify this as an important priority. I have been involved with leadership at different levels here at the university and all of those experiences helped me to develop skills to be an effective leader and chair of committees.
Did anything unexpected occur during your year? No matter what, every year, there are always issues whether it’s a drug, a device or a health policy issue that raises concern. This year, there was one defibrillator
lead that had been subject to a health advisory the year before I assumed the presidency. This past year there was an update on the lead performance which generated lots of questions about patient management. In response, we conducted educational webinars to inform our members on how best to deal with the information and to appropriately manage patients in an attempt to calm people to not overreact and not over-treat.
What were your biggest challenges this year? The most challenging event that happened to me in the year occurred in the last six weeks of my presidency. This consensus document we released at HRS’ Scientific Sessions almost didn’t get approved. With the assistance of the executive committee and writing group, I exercised my leadership to expedite the approval cycles and succeeded in getting the document approved in time for presentation at our annual meeting.
Much attention has been paid to you being one of the few female presidents and only the second international president at HRS. Did this pressure you in any way? I am HRS’s fourth female president. I think that no one really knew what to expect in terms of how I would deal with health policy issues that are predominantly focused on health-care change in the U.S. I think I pleasantly surprised most people in how knowledgeable I was about health policy, how engaged I was and that I could address our members on these issues. The health-care landscape is changing around the world; these issues aren’t unique to the U.S. I was determined to demonstrate that an international president could be a very successful, effective leader of our society.
04
SERVICE TO SOCIETY
M E D I C I N E . U C A LG A RY.C A / M AG A ZI N E
Q&A with Dr. Anne M. Gillis
By Lynda Sea
Professor of medicine reflects on her past year as president of the Heart Rhythm Society Dr. Anne M. Gillis, a professor in the Department of Medicine and a member of the University of Calgary’s Libin Cardiovascular Institute of Alberta, is only the second non-American to be selected as president of the Heart Rhythm Society (HRS). In May, she completed her one-year term as president at the Washington-based organization. HRS is the international leader in science, education and advocacy for cardiac arrhythmia professionals and patients. It represents some 5,800 medical, health-care and science professionals from 72 countries who specialize in cardiac rhythm disorders.
19
UCALGARY MEDICINE FALL 2013
What were your main duties as president of the Heart Rhythm Society?
What were the highlights of your term as HRS President?
As president, I oversaw the activities of HRS. We have four major strategic areas: education, research, health policy, and patients and caregivers. I oversaw strategic governance and operational activities of the society to maintain a focus on our strategic priorities. The highlight of our year is our annual Scientific Sessions which was held in Denver in early May. Former president Bill Clinton was our plenary speaker—the title of his presentation was ‘Embracing our Global Humanity’. The theatre, which had capacity for close to 6,000 people, was totally filled.
One of the real achievements this year was our first publication of a truly global consensus document that we led with the European Heart Rhythm Association (EHRA) and the Asia Pacific Heart Rhythm Society (APHRS). The topic addressed the diagnoses and management of patients with inherited arrhythmia syndromes. The success of this document reflects the globalization of heart rhythm societies and their willingness to work together. This past year I invested considerable time strengthening relationships with other international societies and other organizations that have an interest in heart rhythm disorders. Our big audacious goal is to end death and suffering due to heart rhythm disorders. As an organization predominantly based in North America, we cannot achieve that goal without global partnership.
What was meeting Bill Clinton like?
How did your roles at the University of Calgary and HRS complement one another?
It was an incredible experience meeting him. James Youngblood (CEO of HRS) and I greeted him when he arrived. We had a 10-minute conversation before his presentation where he very intensely talked about health-care issues. He made a comment about an article that had been published in The New York Times that day which prompted an engaged debate in the room. He is incredibly bright and knowledgeable about health care and all the issues. In his formal presentation, he also talked about health-care reform and challenged us as physicians to be part of the solution, not part of the problem.
One of our strategic goal areas at HRS is research. Until about a year ago, believe it or not, HRS had never had a research committee. I oversaw the implementation of the research committee. My research profile and focus at the University of Calgary led me to identify this as an important priority. I have been involved with leadership at different levels here at the university and all of those experiences helped me to develop skills to be an effective leader and chair of committees.
Did anything unexpected occur during your year? No matter what, every year, there are always issues whether it’s a drug, a device or a health policy issue that raises concern. This year, there was one defibrillator
lead that had been subject to a health advisory the year before I assumed the presidency. This past year there was an update on the lead performance which generated lots of questions about patient management. In response, we conducted educational webinars to inform our members on how best to deal with the information and to appropriately manage patients in an attempt to calm people to not overreact and not over-treat.
What were your biggest challenges this year? The most challenging event that happened to me in the year occurred in the last six weeks of my presidency. This consensus document we released at HRS’ Scientific Sessions almost didn’t get approved. With the assistance of the executive committee and writing group, I exercised my leadership to expedite the approval cycles and succeeded in getting the document approved in time for presentation at our annual meeting.
Much attention has been paid to you being one of the few female presidents and only the second international president at HRS. Did this pressure you in any way? I am HRS’s fourth female president. I think that no one really knew what to expect in terms of how I would deal with health policy issues that are predominantly focused on health-care change in the U.S. I think I pleasantly surprised most people in how knowledgeable I was about health policy, how engaged I was and that I could address our members on these issues. The health-care landscape is changing around the world; these issues aren’t unique to the U.S. I was determined to demonstrate that an international president could be a very successful, effective leader of our society.
04
SERVICE TO SOCIETY
M E D I C I N E . U C A LG A RY.C A / M AG A ZI N E
Profiling a geneticist By Laura Herperger
r. Julie Lauzon is one of only a handful of genetic bioethicists in Alberta. She obtained her medical degree at the University of Ottawa. She moved to Calgary in 2001 to begin her medical genetics residency at the University of Calgary and then completed a Masters of Health Science in Bioethics at the Joint Centre for Bioethics at the University of Toronto. Lauzon is now a clinical assistant professor in the Department of Medical Genetics. She is also the Chair of the Education, Ethics and Public Policy Committee with the Canadian College of Medical Genetics and a member of the Conjoint Health Research Ethics Board at the Faculty of Medicine.
Entering into medical school, I was interested in paediatrics but when I was in school, I was really fascinated by genetics—the building blocks of life. I liked learning about embryology and what caused normal and abnormal development in humans and I also like interacting with patients and their families. An important role for a geneticist is to try to explain in a very sensitive way this complex information about human biology and have the information understood—often treating children who are quite ill. We know the science, but people and communities live in a cultural and spiritual environment so we have to mesh this scientific information into the daily life of people from many different backgrounds. As such, we can encounter ethical dilemmas between patients, their families and their health-care providers who each have their own understanding of genetics in the context of their own beliefs.
Dr. Julie Lauzon PROFESSION
Clinical geneticist and ethicist LO C AT I O N
Alberta Children’s Hospital, Calgary OT H E R I N T E R E S T S
Former national ice dancer and coach
D
What intrigued you about becoming a bioethicist / geneticist?
NAME
What is a typical day like for you? My schedule changes from day to day. First of all, I see a lot of patients who are seeking genetic testing. I spend many hours trying to understand their specific genetic condition by reading about the case in publications, collaborating with specialists internationally and by speaking with my colleagues. Another big part of my day comprises my academic activities. I teach several classes in medical ethics to undergraduates and post-graduate students. It is interesting to reach students at an early stage in their career and introduce the concepts of ethics into the curriculum.
How did your career develop? I became interested in bioethics midway through my residency. I was fortunate to have the support of my department to pursue this interest and integrate it into my busy clinical practice. Currently, the university’s Alberta Children’s Hospital Research Institute (ACHRI) is creating a genomics facility with advanced next generation sequencers and a team of geneticists and bioinformaticians.
All of us in genetics are learning together about how this technology can bring personalized medicine to patients. I am able to collaborate with researchers and partners across the country and around the world to identify more genes responsible for a wide spectrum of rare paediatric disorders. It is a powerful technology which needs to be treated with great responsibility. As such, I hope to bring an ethical lens to the building of clinical genomics programs.
On most days when you are in clinic, what is the greatest challenge you face? We have a powerful technology, but we don’t have the complete understanding yet of what it is providing. We don’t have all the answers—we are only at the beginning of the genomics era. The greatest challenge is telling a patient that we just don’t know yet. Above and beyond this, it can also be challenging trying to explain to people something as complex as a genome.
Where do you think genomics will be 10 years from now? Genetics is like a bitter-sweet pill. It provides some answers, but few cures. It’s the first step in finding answers but not the last. It raises ethical questions which haven’t been answered. I hope that in 10 years, Canadians will have pursued the conversation around these ethical questions, and the science will have
21
UCALGARY MEDICINE FALL 2013
advanced further to allow for many more discoveries, giving more to patients than just an understanding.
What would you say to anybody interested in pursuing a career in genetics? I did not start out in medicine thinking I would be a geneticist; now I am so grateful that I’m in this field. I have learned that everyone is touched by genetics: your grandparents, your children, your community. It will dominate the next century of medicine. There are not enough professionals in this field today to meet the demand.
What information is crucial for Albertans to have about genetic testing? It is very important for a patient to be counselled on genetics. The patient needs to know what he/she will obtain from the test and what happens after the testing. With genomic testing today, the door is open to everything in a person’s biological background. So you many find out something you don’t necessarily want to know. There’s also a possibility that we as geneticists won’t know what the information means or only what it partially means. We may not have all the answers because the technology provides more information today than we have the ability to understand. But it all must be handled in a responsible way. In the U.S., recent guidelines on reporting genetic test results for genomic tests required physicians to reveal everything they know to patients upon genetic testing, whether they want to know about all genetic conditions or not. But in other places, geneticists limit the analysis of the genomic test to certain conditions which makes it easier for the patient to absorb and understand. Patients should also learn about who is making these decisions about which results are disclosed. Is it the lab, physician, geneticist or is it the patient making the decisions.
M I S CO N CE P T I O N S A B O U T G E N O M I C S Can anyone have a genetic cancer test like Angelina Jolie? The answer is both yes and no. A referral is necessary by a family doctor based on the patient’s personal and family risk factors. If there are risk factors present, the doctor can make a request for a test looking for specific cancer gene variants. Are the commercial genetic tests you find online just as good? There are a variety of different genetic tests that you can access on the Internet, to test for specific genetic diseases such as cystic fibrosis, or for ancestry testing. Some tests look at conditions such as obesity, diabetes, asthma and dementia, and these conditions are only partially related to genetics. The results from these tests are limited because they give only a percentage chance for acquiring a condition. Many of these conditions are also influenced by environmental and other lifestyle factors.
D I D YO U K N OW ? If you unwind all the DNA in the human body, the strand would reach the moon and back 6,000 times. The cost of an entire genome test has gone from $95 million in 2001 to $6,000 today.
For exclusive online content visit us at medicine.ucalgary.ca/magazine
04
SERVICE TO SOCIETY
M E D I C I N E . U C A LG A RY.C A / M AG A ZI N E
Profiling a geneticist By Laura Herperger
r. Julie Lauzon is one of only a handful of genetic bioethicists in Alberta. She obtained her medical degree at the University of Ottawa. She moved to Calgary in 2001 to begin her medical genetics residency at the University of Calgary and then completed a Masters of Health Science in Bioethics at the Joint Centre for Bioethics at the University of Toronto. Lauzon is now a clinical assistant professor in the Department of Medical Genetics. She is also the Chair of the Education, Ethics and Public Policy Committee with the Canadian College of Medical Genetics and a member of the Conjoint Health Research Ethics Board at the Faculty of Medicine.
Entering into medical school, I was interested in paediatrics but when I was in school, I was really fascinated by genetics—the building blocks of life. I liked learning about embryology and what caused normal and abnormal development in humans and I also like interacting with patients and their families. An important role for a geneticist is to try to explain in a very sensitive way this complex information about human biology and have the information understood—often treating children who are quite ill. We know the science, but people and communities live in a cultural and spiritual environment so we have to mesh this scientific information into the daily life of people from many different backgrounds. As such, we can encounter ethical dilemmas between patients, their families and their health-care providers who each have their own understanding of genetics in the context of their own beliefs.
Dr. Julie Lauzon PROFESSION
Clinical geneticist and ethicist LO C AT I O N
Alberta Children’s Hospital, Calgary OT H E R I N T E R E S T S
Former national ice dancer and coach
D
What intrigued you about becoming a bioethicist / geneticist?
NAME
What is a typical day like for you? My schedule changes from day to day. First of all, I see a lot of patients who are seeking genetic testing. I spend many hours trying to understand their specific genetic condition by reading about the case in publications, collaborating with specialists internationally and by speaking with my colleagues. Another big part of my day comprises my academic activities. I teach several classes in medical ethics to undergraduates and post-graduate students. It is interesting to reach students at an early stage in their career and introduce the concepts of ethics into the curriculum.
How did your career develop? I became interested in bioethics midway through my residency. I was fortunate to have the support of my department to pursue this interest and integrate it into my busy clinical practice. Currently, the university’s Alberta Children’s Hospital Research Institute (ACHRI) is creating a genomics facility with advanced next generation sequencers and a team of geneticists and bioinformaticians.
All of us in genetics are learning together about how this technology can bring personalized medicine to patients. I am able to collaborate with researchers and partners across the country and around the world to identify more genes responsible for a wide spectrum of rare paediatric disorders. It is a powerful technology which needs to be treated with great responsibility. As such, I hope to bring an ethical lens to the building of clinical genomics programs.
On most days when you are in clinic, what is the greatest challenge you face? We have a powerful technology, but we don’t have the complete understanding yet of what it is providing. We don’t have all the answers—we are only at the beginning of the genomics era. The greatest challenge is telling a patient that we just don’t know yet. Above and beyond this, it can also be challenging trying to explain to people something as complex as a genome.
Where do you think genomics will be 10 years from now? Genetics is like a bitter-sweet pill. It provides some answers, but few cures. It’s the first step in finding answers but not the last. It raises ethical questions which haven’t been answered. I hope that in 10 years, Canadians will have pursued the conversation around these ethical questions, and the science will have
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UCALGARY MEDICINE FALL 2013
advanced further to allow for many more discoveries, giving more to patients than just an understanding.
What would you say to anybody interested in pursuing a career in genetics? I did not start out in medicine thinking I would be a geneticist; now I am so grateful that I’m in this field. I have learned that everyone is touched by genetics: your grandparents, your children, your community. It will dominate the next century of medicine. There are not enough professionals in this field today to meet the demand.
What information is crucial for Albertans to have about genetic testing? It is very important for a patient to be counselled on genetics. The patient needs to know what he/she will obtain from the test and what happens after the testing. With genomic testing today, the door is open to everything in a person’s biological background. So you many find out something you don’t necessarily want to know. There’s also a possibility that we as geneticists won’t know what the information means or only what it partially means. We may not have all the answers because the technology provides more information today than we have the ability to understand. But it all must be handled in a responsible way. In the U.S., recent guidelines on reporting genetic test results for genomic tests required physicians to reveal everything they know to patients upon genetic testing, whether they want to know about all genetic conditions or not. But in other places, geneticists limit the analysis of the genomic test to certain conditions which makes it easier for the patient to absorb and understand. Patients should also learn about who is making these decisions about which results are disclosed. Is it the lab, physician, geneticist or is it the patient making the decisions.
M I S CO N CE P T I O N S A B O U T G E N O M I C S Can anyone have a genetic cancer test like Angelina Jolie? The answer is both yes and no. A referral is necessary by a family doctor based on the patient’s personal and family risk factors. If there are risk factors present, the doctor can make a request for a test looking for specific cancer gene variants. Are the commercial genetic tests you find online just as good? There are a variety of different genetic tests that you can access on the Internet, to test for specific genetic diseases such as cystic fibrosis, or for ancestry testing. Some tests look at conditions such as obesity, diabetes, asthma and dementia, and these conditions are only partially related to genetics. The results from these tests are limited because they give only a percentage chance for acquiring a condition. Many of these conditions are also influenced by environmental and other lifestyle factors.
D I D YO U K N OW ? If you unwind all the DNA in the human body, the strand would reach the moon and back 6,000 times. The cost of an entire genome test has gone from $95 million in 2001 to $6,000 today.
For exclusive online content visit us at medicine.ucalgary.ca/magazine
04
SERVICE TO SOCIETY
Good reads
Healing Fatty Liver Disease
M E D I C I N E . U C A LG A RY.C A / M AG A ZI N E
Prestigious role leads to SACRI changes
NEWS
In the community
The Greatest Outdoor Show ABOVE Earth RETIRED ASTRONAUT Col. Chris Hadfield made his first public presentation since returning to Earth at the University of Calgary during Stampede week
FATT Y LIVER
affects approximately one third of the North American population. Characterized by the accumulation of fat in the cells of the liver, early detection followed by lifestyle and dietary modifications can fully reverse the condition. However, approximately five to 10 per cent of those affected will experience cirrhosis (scarring) of the liver, which is irreversible and can be fatal. University of Calgary faculty member and gastroenterologist Dr. Maitreyi Raman co-authored the book Healing Fatty Liver Disease which addresses the complexities of the disease, touching on topics such as the types of fatty liver disease, risk factors, symptoms and lifestyle modifications. The book balances its information through the presentation of facts and case histories through which readers have the opportunity to learn from the experiences of other patients. Readers will also find 100 simple recipes alongside meal plans, all designed and created by registered dieticians, intended to reverse or prevent fatty liver disease.
23
on July 6. Speaking to a crowd of over 650 children and adults, he shared his experiences aboard the International Space Station.
DISEASE
Healing Fatty Liver Disease was published in March and can be purchased online or in bookstores.
Researchers play for a cause STEPHEN ROBBINS, PHD, former director of the Southern Alberta Cancer Research Institute (SACRI), was appointed as scientific director of the Canadian Institutes of Health Research Institute of Cancer Research (CIHR-ICR) July 1. Robbins will be responsible for the promotion of innovative research across the cancer care continuum, from prevention to treatment to survivorship. “I look forward to building on the previous outstanding programs established by Drs. Phil Branton and Morag Park by working with the entire cancer stakeholder community in Canada to develop innovative research programs and platforms that have positive impacts in the lives of cancer patients and their families,” he says. During his four-year term, Robbins will remain at the Faculty of Medicine where he will divide his time equally between his position with CIHR-ICR and conducting his own research. His research involves a translational approach to the basic understanding of how cancer cells invade their surrounding microenvironment and how certain cancers metastasize to distant organs.
During his research career, Robbins’ work has contributed to new therapies for malaria, the discovery of a novel class of anti-inflammatory agents and new therapeutic targets for brain tumours. He has also utilized microarray technology to identify the molecular blueprints of various childhood cancers. Dr. Gregory Cairncross, a neurologist, professor, and former Head of the Department of Clinical Neurosciences, has been appointed director of SACRI effective October 1. “Steve will be a wonderful ambassador for cancer research across Canada,” says Cairncross. “His personal warmth and vast knowledge of science, which never ceases to amaze me, position him to be an extraordinarily effective national leader.” He leaves big shoes to fill here in Calgary, but I’m looking forward to directing SACRI at the University of Calgary. I am also looking forward to working closely with CancerControl Alberta to foster research that lessens the burden of cancer in Alberta and beyond” Stephen Robbins (left) and Dr. Gregory Cairncross (right) are both supported by Alberta Innovates – Health Solutions.
5 FACULT Y OF MEDICINE researchers put their talents to good use on Canada Day as their heavy metal band, Hellrazer, played at a local benefit concert to support Alberta flood relief efforts. While none of the band members were directly affected by the flooding, the band, which includes Simon Hirota, PhD, Stan Nakanishi, PhD, Shigeki Tsutsui, PhD, and Gerald Zamponi, PhD, wanted to give back. The benefit, which was spearheaded by Rattlehead Productions, an organization that promotes local and independent metal bands, donated all ticket sales to Red Cross flood relief efforts. Ironically, $666 and some change was raised. 1
Formed in 2004 and influenced by artists such as Iron Maiden, Metallica and some European power metal bands, Hellrazer, which writes its own music, has three albums under its belt. The band was signed to a German metal label last year, and since then has seen its latest album, Operation Overlord, distributed by Sony and Universal. Most recently Hellrazer was nominated for a Western Canadian Music Award.
1 Following his comedic presentation, where he invited children up on stage for demonstrations, and a Q and A with the audience, attendees were able to tour a series of showcases highlighting many of the university’s space science research projects. 2 Hadfield chatted with Dr. Andrew Kirkpatrick and his team about how they use technological advances in space to improve everyday health care, like effectively using limited resources in rural environments. 2
04
SERVICE TO SOCIETY
Good reads
Healing Fatty Liver Disease
M E D I C I N E . U C A LG A RY.C A / M AG A ZI N E
Prestigious role leads to SACRI changes
NEWS
In the community
The Greatest Outdoor Show ABOVE Earth RETIRED ASTRONAUT Col. Chris Hadfield made his first public presentation since returning to Earth at the University of Calgary during Stampede week
FATT Y LIVER
affects approximately one third of the North American population. Characterized by the accumulation of fat in the cells of the liver, early detection followed by lifestyle and dietary modifications can fully reverse the condition. However, approximately five to 10 per cent of those affected will experience cirrhosis (scarring) of the liver, which is irreversible and can be fatal. University of Calgary faculty member and gastroenterologist Dr. Maitreyi Raman co-authored the book Healing Fatty Liver Disease which addresses the complexities of the disease, touching on topics such as the types of fatty liver disease, risk factors, symptoms and lifestyle modifications. The book balances its information through the presentation of facts and case histories through which readers have the opportunity to learn from the experiences of other patients. Readers will also find 100 simple recipes alongside meal plans, all designed and created by registered dieticians, intended to reverse or prevent fatty liver disease.
23
on July 6. Speaking to a crowd of over 650 children and adults, he shared his experiences aboard the International Space Station.
DISEASE
Healing Fatty Liver Disease was published in March and can be purchased online or in bookstores.
Researchers play for a cause STEPHEN ROBBINS, PHD, former director of the Southern Alberta Cancer Research Institute (SACRI), was appointed as scientific director of the Canadian Institutes of Health Research Institute of Cancer Research (CIHR-ICR) July 1. Robbins will be responsible for the promotion of innovative research across the cancer care continuum, from prevention to treatment to survivorship. “I look forward to building on the previous outstanding programs established by Drs. Phil Branton and Morag Park by working with the entire cancer stakeholder community in Canada to develop innovative research programs and platforms that have positive impacts in the lives of cancer patients and their families,” he says. During his four-year term, Robbins will remain at the Faculty of Medicine where he will divide his time equally between his position with CIHR-ICR and conducting his own research. His research involves a translational approach to the basic understanding of how cancer cells invade their surrounding microenvironment and how certain cancers metastasize to distant organs.
During his research career, Robbins’ work has contributed to new therapies for malaria, the discovery of a novel class of anti-inflammatory agents and new therapeutic targets for brain tumours. He has also utilized microarray technology to identify the molecular blueprints of various childhood cancers. Dr. Gregory Cairncross, a neurologist, professor, and former Head of the Department of Clinical Neurosciences, has been appointed director of SACRI effective October 1. “Steve will be a wonderful ambassador for cancer research across Canada,” says Cairncross. “His personal warmth and vast knowledge of science, which never ceases to amaze me, position him to be an extraordinarily effective national leader.” He leaves big shoes to fill here in Calgary, but I’m looking forward to directing SACRI at the University of Calgary. I am also looking forward to working closely with CancerControl Alberta to foster research that lessens the burden of cancer in Alberta and beyond” Stephen Robbins (left) and Dr. Gregory Cairncross (right) are both supported by Alberta Innovates – Health Solutions.
5 FACULT Y OF MEDICINE researchers put their talents to good use on Canada Day as their heavy metal band, Hellrazer, played at a local benefit concert to support Alberta flood relief efforts. While none of the band members were directly affected by the flooding, the band, which includes Simon Hirota, PhD, Stan Nakanishi, PhD, Shigeki Tsutsui, PhD, and Gerald Zamponi, PhD, wanted to give back. The benefit, which was spearheaded by Rattlehead Productions, an organization that promotes local and independent metal bands, donated all ticket sales to Red Cross flood relief efforts. Ironically, $666 and some change was raised. 1
Formed in 2004 and influenced by artists such as Iron Maiden, Metallica and some European power metal bands, Hellrazer, which writes its own music, has three albums under its belt. The band was signed to a German metal label last year, and since then has seen its latest album, Operation Overlord, distributed by Sony and Universal. Most recently Hellrazer was nominated for a Western Canadian Music Award.
1 Following his comedic presentation, where he invited children up on stage for demonstrations, and a Q and A with the audience, attendees were able to tour a series of showcases highlighting many of the university’s space science research projects. 2 Hadfield chatted with Dr. Andrew Kirkpatrick and his team about how they use technological advances in space to improve everyday health care, like effectively using limited resources in rural environments. 2
NEWS
In the news
In the news
IMPORTED MALARIA CASES IN CALGARY INCREASING: STUDY
3
from the University of Calgary’s Faculty of Medicine has shown that imported malaria cases in Calgary are on the rise, suggesting that few Calgarians seek medical advice or take preventative medications against malaria when travelling to countries where the disease is endemic.
A NEW STUDY
GIFT EXPANDS GENETIC RESEARCH CAPABILITIES
25
UCALGARY MEDICINE FALL 2013
MEDICINE.UCALGARY.CA/MAGAZINE
The study was published in the journal PLOS ONE. The study found that there were 295 laboratory confirmed imported malaria cases in Calgary between the year 2000 and 2011 and found that only 23.8 per cent of those infected with malaria sought medical advice prior to travel. Additionally, it was found that only 60 per cent of those who sought medical advice took preventative treatment. In the year 2000 there were about 10 cases of malaria in the city compared to 50 detected cases in 2011. 3 Senior study author Dr. Dylan Pillai.
ANTI-SMOKING PROGRAMS DO WORK
THE UNIVERSIT Y OF CALGARY
SMOKING IN YOUNG PEOPLE
has purchased three nextgeneration genome sequencers thanks to a $5.5-million community gift from the Alberta Children’s Hospital Foundation. This technology will allow researchers at the university and Alberta Children’s Hospital Research Institute (ACHRI) to identify new genes that contribute to the development of diseases and to move genomic testing into mainstream clinical care. Among the many studies enabled by this donation is a pilot study of 10 families with diseases believed to be genetically linked. All 20,000 genes in each patient will be sequenced.
is increasing in developing countries, especially those located in parts of eastern Europe and Asia. Smoking just one cigarette can lead to a habit that is hard to quit and teenagers have the same withdrawal symptoms from cigarettes as adults do. A recent systematic review published in the Cochrane Library looked at smoking prevention programs in schools in 25 different countries and found that smoking prevention programs do work. Overall, smoking rates dropped by 12 per cent compared to the control group.
GENETIC DISCOVERY OF RARE DISEASE
4 THE UNIVERSIT Y OF CALGARY
has played a large role in a new collaborative study, published in Nature Genetics earlier this year. Researchers identified 12 different genes believed to be the key players in the development of an autoimmune liver disease known as primary sclerosing cholangitis (PSC). PSC affects
approximately 10 per cent of those with inflammatory bowel disease, and there is currently no cure. The study’s discovery could lead to a stronger understanding of the disease as well as more effective personalized treatment options. With sites across North America and Europe, the study was one of the largest ever done on PSC. Twelve genes were found to be correlated with the illness. The next step is to determine if the genes act alone to give a patient PSC, or if there is an environmental factor that triggers those who are genetically susceptible to it. 4 Canadian study lead Dr. Bertus Eksteen.
RESEARCHERS SHINE LIGHT ON HOW STRESS CIRCUITS LEARN AT YOUNG AGE
5
University of Calgary’s Hotchkiss Brain Institute have discovered that stress circuits in the brain undergo profound learning early in life. Using a number of cuttingedge approaches, including optogenetics, Jaideep Bains, PhD, and colleagues have shown stress circuits are capable of self-tuning following a single stress. These findings demonstrate that the brain uses stress experience during
RESEARCHERS AT THE
early life to prepare and optimize for subsequent challenges. The team was able to show the existence of unique time windows following brief stress challenges during which learning is either increased or decreased. By manipulating specific cellular pathways, they uncovered the key players responsible for learning in stress circuits in an animal model. These discoveries culminated in the publication of two back-to-back studies in Nature Neuroscience, one of the world’s top neuroscience journals. 5 Study authors (left) Jaideep Bains, PhD, and (right) Waturu Inoue. Jaideep Bains is supported by Alberta Innovates – Health Solutions.
STUDY SUGGESTS OVERUSE OF MRI SCANNING
6
AFTER INVESTIGATING THE
appropriateness of lower back and head MRIs, researchers have concluded that many requests for these scans are not needed. In a joint study led by the University of Calgary and the University of Alberta, using methodology developed at the RAND Corporation, 2,000 MRI requisitions placed
in Edmonton and Ottawa were examined to determine if they were appropriate. Data published in JAMA Internal Medicine found evidence that when it comes to lower back scans, 56 per cent were either inappropriate or of uncertain value. In contrast, most MRI scans of the head for headache (83 per cent) were appropriate. 6 Neurologist Dr. Tom Feasby.
STUDY ADVANCES CONSISTENT TERMINOLOGY FOR VASCULAR DEMENTIA RESEARCH
7 INCONSISTENCIES IN terminology and definitions of lesions on the brain have hindered progress in the field of vascular dementia research. But a new multi-national study involving researchers from the University of Calgary’s Faculty of Medicine hopes to change that by introducing a new set of standards. The study was published online in the
journal Lancet Neurology this year. The study is the culmination of two conferences in 2012 at which 30 internationally recognized researchers developed standard terminology to define the manifestations of vascular disease on MRI. The standards offer advice on MRI protocol for the disease, such as how to describe and measure lesions as well as how to report them in scientific journals. By introducing these standards, researchers hope radiologists who interpret the scans will be able to universally communicate their findings, thereby leading to more accurate diagnoses and more efficient clinical care. 7 Canadian study lead Dr. Eric Smith. Dr. Eric Smith is supported by Alberta Innovates – Health Solutions.
IMMUNITY MECHANISM DISCOVERED SCIENTISTS AT THE University of Calgary’s Faculty of Medicine have discovered a mechanism that is used to protect the body from harmful bacteria such as methicillin-resistant Staphylococcus aureus (MRSA). Platelets, a component of blood typically associated with clotting, were discovered to actively search for specific bacteria and upon detection, seal it off from the rest of the body. The findings, which were published in Nature Immunology, provide the science community with a greater understanding of immunity.
“The science community has known that platelets do participate in immunity, but now it has been demonstrated that they have a way of actively searching for bacteria,” says Craig Jenne, PhD, one of the authors of the study. “We now have a completely different angle of how the immune system deals with specific types of bacteria,” says study author Paul Kubes, PhD. “Going forth we can begin to look at how we can help our own defences deal with these types of bacteria.” Paul Kubes is supported by Alberta Innovates – Health Solutions.
STUDY SUGGESTS LINK BETWEEN LOW VITAMIN D AND ADVERSE PREGNANCY OUTCOMES
8 A NEW STUDY from the University of Calgary’s Faculty of Medicine has shown there is a significant link between vitamin D insufficiency and adverse health outcomes in mothersto-be and newborns. The study, which was a systematic review and meta-analysis, was published in the British Medical Journal. Results showed that pregnant women with insufficient vitamin D were at a 49 per cent increased chance of developing gestational diabetes, a 79 per cent increased chance of developing
preeclampsia, a 187 per cent increased chance of developing bacterial vaginosis and an 85 per cent increased chance of giving birth to a baby small for gestational age. No significant differences were found in birth length and head circumference. “There remains a need for large, well-designed randomized controlled trials to determine whether strategies to optimize vitamin D concentration are effective in improving pregnancy and neonatal outcomes,” says the study’s lead author Dr. Doreen Rabi, an endocrinologist and member of the University of Calgary’s Institute for Public Health and the Libin Cardiovascular Institute of Alberta. 8 Dr. Fariba Aghajafari, first author on the study.
NEWS
In the news
In the news
IMPORTED MALARIA CASES IN CALGARY INCREASING: STUDY
3
from the University of Calgary’s Faculty of Medicine has shown that imported malaria cases in Calgary are on the rise, suggesting that few Calgarians seek medical advice or take preventative medications against malaria when travelling to countries where the disease is endemic.
A NEW STUDY
GIFT EXPANDS GENETIC RESEARCH CAPABILITIES
25
UCALGARY MEDICINE FALL 2013
MEDICINE.UCALGARY.CA/MAGAZINE
The study was published in the journal PLOS ONE. The study found that there were 295 laboratory confirmed imported malaria cases in Calgary between the year 2000 and 2011 and found that only 23.8 per cent of those infected with malaria sought medical advice prior to travel. Additionally, it was found that only 60 per cent of those who sought medical advice took preventative treatment. In the year 2000 there were about 10 cases of malaria in the city compared to 50 detected cases in 2011. 3 Senior study author Dr. Dylan Pillai.
ANTI-SMOKING PROGRAMS DO WORK
THE UNIVERSIT Y OF CALGARY
SMOKING IN YOUNG PEOPLE
has purchased three nextgeneration genome sequencers thanks to a $5.5-million community gift from the Alberta Children’s Hospital Foundation. This technology will allow researchers at the university and Alberta Children’s Hospital Research Institute (ACHRI) to identify new genes that contribute to the development of diseases and to move genomic testing into mainstream clinical care. Among the many studies enabled by this donation is a pilot study of 10 families with diseases believed to be genetically linked. All 20,000 genes in each patient will be sequenced.
is increasing in developing countries, especially those located in parts of eastern Europe and Asia. Smoking just one cigarette can lead to a habit that is hard to quit and teenagers have the same withdrawal symptoms from cigarettes as adults do. A recent systematic review published in the Cochrane Library looked at smoking prevention programs in schools in 25 different countries and found that smoking prevention programs do work. Overall, smoking rates dropped by 12 per cent compared to the control group.
GENETIC DISCOVERY OF RARE DISEASE
4 THE UNIVERSIT Y OF CALGARY
has played a large role in a new collaborative study, published in Nature Genetics earlier this year. Researchers identified 12 different genes believed to be the key players in the development of an autoimmune liver disease known as primary sclerosing cholangitis (PSC). PSC affects
approximately 10 per cent of those with inflammatory bowel disease, and there is currently no cure. The study’s discovery could lead to a stronger understanding of the disease as well as more effective personalized treatment options. With sites across North America and Europe, the study was one of the largest ever done on PSC. Twelve genes were found to be correlated with the illness. The next step is to determine if the genes act alone to give a patient PSC, or if there is an environmental factor that triggers those who are genetically susceptible to it. 4 Canadian study lead Dr. Bertus Eksteen.
RESEARCHERS SHINE LIGHT ON HOW STRESS CIRCUITS LEARN AT YOUNG AGE
5
University of Calgary’s Hotchkiss Brain Institute have discovered that stress circuits in the brain undergo profound learning early in life. Using a number of cuttingedge approaches, including optogenetics, Jaideep Bains, PhD, and colleagues have shown stress circuits are capable of self-tuning following a single stress. These findings demonstrate that the brain uses stress experience during
RESEARCHERS AT THE
early life to prepare and optimize for subsequent challenges. The team was able to show the existence of unique time windows following brief stress challenges during which learning is either increased or decreased. By manipulating specific cellular pathways, they uncovered the key players responsible for learning in stress circuits in an animal model. These discoveries culminated in the publication of two back-to-back studies in Nature Neuroscience, one of the world’s top neuroscience journals. 5 Study authors (left) Jaideep Bains, PhD, and (right) Waturu Inoue. Jaideep Bains is supported by Alberta Innovates – Health Solutions.
STUDY SUGGESTS OVERUSE OF MRI SCANNING
6
AFTER INVESTIGATING THE
appropriateness of lower back and head MRIs, researchers have concluded that many requests for these scans are not needed. In a joint study led by the University of Calgary and the University of Alberta, using methodology developed at the RAND Corporation, 2,000 MRI requisitions placed
in Edmonton and Ottawa were examined to determine if they were appropriate. Data published in JAMA Internal Medicine found evidence that when it comes to lower back scans, 56 per cent were either inappropriate or of uncertain value. In contrast, most MRI scans of the head for headache (83 per cent) were appropriate. 6 Neurologist Dr. Tom Feasby.
STUDY ADVANCES CONSISTENT TERMINOLOGY FOR VASCULAR DEMENTIA RESEARCH
7 INCONSISTENCIES IN terminology and definitions of lesions on the brain have hindered progress in the field of vascular dementia research. But a new multi-national study involving researchers from the University of Calgary’s Faculty of Medicine hopes to change that by introducing a new set of standards. The study was published online in the
journal Lancet Neurology this year. The study is the culmination of two conferences in 2012 at which 30 internationally recognized researchers developed standard terminology to define the manifestations of vascular disease on MRI. The standards offer advice on MRI protocol for the disease, such as how to describe and measure lesions as well as how to report them in scientific journals. By introducing these standards, researchers hope radiologists who interpret the scans will be able to universally communicate their findings, thereby leading to more accurate diagnoses and more efficient clinical care. 7 Canadian study lead Dr. Eric Smith. Dr. Eric Smith is supported by Alberta Innovates – Health Solutions.
IMMUNITY MECHANISM DISCOVERED SCIENTISTS AT THE University of Calgary’s Faculty of Medicine have discovered a mechanism that is used to protect the body from harmful bacteria such as methicillin-resistant Staphylococcus aureus (MRSA). Platelets, a component of blood typically associated with clotting, were discovered to actively search for specific bacteria and upon detection, seal it off from the rest of the body. The findings, which were published in Nature Immunology, provide the science community with a greater understanding of immunity.
“The science community has known that platelets do participate in immunity, but now it has been demonstrated that they have a way of actively searching for bacteria,” says Craig Jenne, PhD, one of the authors of the study. “We now have a completely different angle of how the immune system deals with specific types of bacteria,” says study author Paul Kubes, PhD. “Going forth we can begin to look at how we can help our own defences deal with these types of bacteria.” Paul Kubes is supported by Alberta Innovates – Health Solutions.
STUDY SUGGESTS LINK BETWEEN LOW VITAMIN D AND ADVERSE PREGNANCY OUTCOMES
8 A NEW STUDY from the University of Calgary’s Faculty of Medicine has shown there is a significant link between vitamin D insufficiency and adverse health outcomes in mothersto-be and newborns. The study, which was a systematic review and meta-analysis, was published in the British Medical Journal. Results showed that pregnant women with insufficient vitamin D were at a 49 per cent increased chance of developing gestational diabetes, a 79 per cent increased chance of developing
preeclampsia, a 187 per cent increased chance of developing bacterial vaginosis and an 85 per cent increased chance of giving birth to a baby small for gestational age. No significant differences were found in birth length and head circumference. “There remains a need for large, well-designed randomized controlled trials to determine whether strategies to optimize vitamin D concentration are effective in improving pregnancy and neonatal outcomes,” says the study’s lead author Dr. Doreen Rabi, an endocrinologist and member of the University of Calgary’s Institute for Public Health and the Libin Cardiovascular Institute of Alberta. 8 Dr. Fariba Aghajafari, first author on the study.
NEWS
M E D I C I N E . U C A LG A RY.C A / M AG A ZI N E
Dr. Cyril Frank received the Order of the University of Calgary at the convocation ceremony in May 2013. An orthopedic surgeon, Frank has been a faculty member at the University of Calgary for almost 30 years, achieving national and international stature as a clinician-scientist.
Drs. Irene Ma, Wes Jackson and Guido Van Marle, PhD, three of the Faculty of Medicine’s top educators have been awarded Canadian Association of Medical Education Certificates of Merit. The award recognizes valuable contributions to medical education including teaching, evaluation, educational leadership and course coordination.
Avenue Magazine’s Top 40 Under 40 is an annual selection of Calgary’s brightest and most active leaders under the age of 40. The Faculty of Medicine extends congratulations to: Christophe Altier, PhD, Dr. Shelagh Coutts, Dr. Breanne Everett, Deborah Kurrasch, PhD, Minh Dang Nguyen, PhD, and Dr. Nicola Wright. Dr. Ian Mitchell is one of two recipients of the 2013 Dr. William Marsden Award in Medical Ethics. This award recognizes Canadian Medical Association (CMA) members who have demonstrated exemplary leadership, commitment and dedication to the cause of advancing and promoting excellence in the field of medical ethics in Canada.
Dr. Eldon Smith was honored at the City of Calgary’s annual outstanding civic achievement awards ceremony, the Calgary Awards. Dr. Smith, emeritus professor, Faculty of Medicine, received the Grant MacEwan Lifetime Achievement Award for his esteemed medical and academic career spanning more than 30 years. This
27
Faculty updates
Awards and recognition
Dr. Bill Ghali, Susan Lees-Miller, PhD, and Keith Sharkey, PhD have been awarded the prestigious Killam Annual Professorship. The Professorship term began July 1, 2013 for one year. Killam Annual Professors will each receive a $10,000 prize from the Killam Trusts. They can choose to take the prize as a pay supplement or as a research allowance.
RESEARCH
award honours an individual who has made significant contributions and brought recognition to the community, and has improved the quality of life for citizens.
Doug Mahoney, PhD, is the first Canadian to receive the Young Investigator Award from the Alliance for Cancer Gene Therapy. The U.S. nonprofit foundation supports research in cell- and genebased therapies for the treatment of cancer. Mahoney studies oncolytic viruses for the treatment of childhood cancers.
Walter Herzog, PhD, and Dr. Peter Stys have been named Fellows of the Royal Society of Canada, the highest honour achievable by scholars, artists and scientists in Canada. The focus of Stys’ work is on the nerve fiber connections within the brain and spinal cord. Herzog’s research is focused on the neuro-biomechanics of the musculoskeletal system, and his primary impact has been in the area of the molecular mechanisms of muscle contraction.
Dr. Janet de Groot, Associate Dean, Office of Equity and Professionalism (reappointed) EFFECTIVE AUGUST 1
Ebba Kurz, PhD, Associate Dean, Undergraduate Health and Science Education and Director, O’Brien Centre for the Bachelor of Health Sciences
Discovery could lead to new treatment options for IBD patients
EFFECTIVE AUGUST 1
John Reynolds, PhD, Associate Vice-President (Research) University of Calgary EFFECTIVE AUGUST 15
Paul Schnetkamp, PhD, Associate Dean (Research Infrastructure) EFFECTIVE AUGUST 15
Ray Turner, PhD, Associate Dean (Research Grants) EFFECTIVE AUGUST 15
Tara Beattie, PhD, Associate Dean, Graduate Science Education EFFECTIVE SEPTEMBER 1
Dr. Charles Le Duc, Head, Department of Family Medicine EFFECTIVE OCTOBER 1
Dr. Gregory Cairncross, Director, Southern Alberta Cancer Research Institute EFFECTIVE OCTOBER 1
Dr. Christopher Mody, Head, Department of Microbiolgy, Immunology and Infectious Diseases EFFECTIVE NOVEMBER 1
By Caitlyn MacDonald
Over the past two decades, the prevalence of inflammatory bowel disease (IBD) has escalated quickly. Alberta has the highest rate per capita of IBD in the world, affecting tens of thousands of people.
“THERE ARE STILL a lot of problems with current therapeutics that are used to treat IBD”, says Rithwik Ramachandran, PhD, research assistant professor in the Department of Physiology and Pharmacology, and a member of the Snyder Institute for Chronic Diseases. “There are immune suppressing drugs which essentially leave the patient susceptible to other infections and there are a lot of drugs that patients just don’t respond to.”
I f human studies are able to reproduce our findings... we could potentially have something that could change lives. Ramachandran and a team of researchers at the University of Calgary have discovered that a protein called TRPM8 may be a therapeutic target in the treatment of colitis as well as other inflammatory diseases. Researchers have known that TRPM8 is a sensor of cold temperatures, and the novel idea of activating this protein to treat inflammation was explored and published in the journal PNAS earlier this year. “The first thing you do when you hit your head or sprain your ankle is put on an ice pack,” he says. “We then thought to ourselves, ‘how exactly does this make
the inflammation go away? Is cooling down the site of inflammation by activating TRPM8 reducing inflammation? And is this something that we could apply more generally to dampen other inflammatory diseases?’” Researchers introduced a condition similar to human IBD in animal models and tested whether a compound that activates TRPM8 could treat the disease. Analysis of the clinical symptoms showed the treated group had much lower disease compared to the control group. “If human studies are able to reproduce our findings in animals, we could potentially change lives,” he says. “This could give IBD patients another option to manage and hopefully treat their condition.” Additionally, Ramachandran says compounds that can activate TRPM8, such as menthol, are widely used in everyday products, so it may be possible to quickly move forward with human studies. Currently, the researchers are working on obtaining a grant with the hopes of conducting a limited patient trial.
NEWS
M E D I C I N E . U C A LG A RY.C A / M AG A ZI N E
Dr. Cyril Frank received the Order of the University of Calgary at the convocation ceremony in May 2013. An orthopedic surgeon, Frank has been a faculty member at the University of Calgary for almost 30 years, achieving national and international stature as a clinician-scientist.
Drs. Irene Ma, Wes Jackson and Guido Van Marle, PhD, three of the Faculty of Medicine’s top educators have been awarded Canadian Association of Medical Education Certificates of Merit. The award recognizes valuable contributions to medical education including teaching, evaluation, educational leadership and course coordination.
Avenue Magazine’s Top 40 Under 40 is an annual selection of Calgary’s brightest and most active leaders under the age of 40. The Faculty of Medicine extends congratulations to: Christophe Altier, PhD, Dr. Shelagh Coutts, Dr. Breanne Everett, Deborah Kurrasch, PhD, Minh Dang Nguyen, PhD, and Dr. Nicola Wright. Dr. Ian Mitchell is one of two recipients of the 2013 Dr. William Marsden Award in Medical Ethics. This award recognizes Canadian Medical Association (CMA) members who have demonstrated exemplary leadership, commitment and dedication to the cause of advancing and promoting excellence in the field of medical ethics in Canada.
Dr. Eldon Smith was honored at the City of Calgary’s annual outstanding civic achievement awards ceremony, the Calgary Awards. Dr. Smith, emeritus professor, Faculty of Medicine, received the Grant MacEwan Lifetime Achievement Award for his esteemed medical and academic career spanning more than 30 years. This
27
Faculty updates
Awards and recognition
Dr. Bill Ghali, Susan Lees-Miller, PhD, and Keith Sharkey, PhD have been awarded the prestigious Killam Annual Professorship. The Professorship term began July 1, 2013 for one year. Killam Annual Professors will each receive a $10,000 prize from the Killam Trusts. They can choose to take the prize as a pay supplement or as a research allowance.
RESEARCH
award honours an individual who has made significant contributions and brought recognition to the community, and has improved the quality of life for citizens.
Doug Mahoney, PhD, is the first Canadian to receive the Young Investigator Award from the Alliance for Cancer Gene Therapy. The U.S. nonprofit foundation supports research in cell- and genebased therapies for the treatment of cancer. Mahoney studies oncolytic viruses for the treatment of childhood cancers.
Walter Herzog, PhD, and Dr. Peter Stys have been named Fellows of the Royal Society of Canada, the highest honour achievable by scholars, artists and scientists in Canada. The focus of Stys’ work is on the nerve fiber connections within the brain and spinal cord. Herzog’s research is focused on the neuro-biomechanics of the musculoskeletal system, and his primary impact has been in the area of the molecular mechanisms of muscle contraction.
Dr. Janet de Groot, Associate Dean, Office of Equity and Professionalism (reappointed) EFFECTIVE AUGUST 1
Ebba Kurz, PhD, Associate Dean, Undergraduate Health and Science Education and Director, O’Brien Centre for the Bachelor of Health Sciences
Discovery could lead to new treatment options for IBD patients
EFFECTIVE AUGUST 1
John Reynolds, PhD, Associate Vice-President (Research) University of Calgary EFFECTIVE AUGUST 15
Paul Schnetkamp, PhD, Associate Dean (Research Infrastructure) EFFECTIVE AUGUST 15
Ray Turner, PhD, Associate Dean (Research Grants) EFFECTIVE AUGUST 15
Tara Beattie, PhD, Associate Dean, Graduate Science Education EFFECTIVE SEPTEMBER 1
Dr. Charles Le Duc, Head, Department of Family Medicine EFFECTIVE OCTOBER 1
Dr. Gregory Cairncross, Director, Southern Alberta Cancer Research Institute EFFECTIVE OCTOBER 1
Dr. Christopher Mody, Head, Department of Microbiolgy, Immunology and Infectious Diseases EFFECTIVE NOVEMBER 1
By Caitlyn MacDonald
Over the past two decades, the prevalence of inflammatory bowel disease (IBD) has escalated quickly. Alberta has the highest rate per capita of IBD in the world, affecting tens of thousands of people.
“THERE ARE STILL a lot of problems with current therapeutics that are used to treat IBD”, says Rithwik Ramachandran, PhD, research assistant professor in the Department of Physiology and Pharmacology, and a member of the Snyder Institute for Chronic Diseases. “There are immune suppressing drugs which essentially leave the patient susceptible to other infections and there are a lot of drugs that patients just don’t respond to.”
I f human studies are able to reproduce our findings... we could potentially have something that could change lives. Ramachandran and a team of researchers at the University of Calgary have discovered that a protein called TRPM8 may be a therapeutic target in the treatment of colitis as well as other inflammatory diseases. Researchers have known that TRPM8 is a sensor of cold temperatures, and the novel idea of activating this protein to treat inflammation was explored and published in the journal PNAS earlier this year. “The first thing you do when you hit your head or sprain your ankle is put on an ice pack,” he says. “We then thought to ourselves, ‘how exactly does this make
the inflammation go away? Is cooling down the site of inflammation by activating TRPM8 reducing inflammation? And is this something that we could apply more generally to dampen other inflammatory diseases?’” Researchers introduced a condition similar to human IBD in animal models and tested whether a compound that activates TRPM8 could treat the disease. Analysis of the clinical symptoms showed the treated group had much lower disease compared to the control group. “If human studies are able to reproduce our findings in animals, we could potentially change lives,” he says. “This could give IBD patients another option to manage and hopefully treat their condition.” Additionally, Ramachandran says compounds that can activate TRPM8, such as menthol, are widely used in everyday products, so it may be possible to quickly move forward with human studies. Currently, the researchers are working on obtaining a grant with the hopes of conducting a limited patient trial.
ALUMNI
29
UCALGARY MEDICINE FALL 2013
M E D I C I N E . U C A LG A RY.C A / M AG A ZI N E
Meet Dr. Roxanne Goldade, 2013 Alumna of Distinction By Leigh Hurst
11 1 What prompted you to start Paediatric Kids in Care (P-KIC)?
It actually wasn’t me who started P-KIC per se. About seven years ago, Child and Family Services Authority (CFSA) and the Department of Paediatrics agreed that the old system of serving children in care was not working as well as it should. The processes need to work differently to better serve one of our most vulnerable populations and I was asked to lead the project with Chris Tortorelli from CFSA. Chris and I then worked very closely to develop the program. We led an extensive change that involved everything from building intersectoral relationships, developing new forms and trying to rewrite legislation.
You won the Alumnus of Distinction Award for Collaboration. Do you think that collaboration was key to P-KICs success? 2
10
Dr. Roxanne Goldade, MD ’90 (Panda), has been practicing Community Paediatrics in Calgary since 1995. She is also the Physician Lead for Pediatrics for Kids in Care (P-KIC) and the new Social Paediatrics Unit.
Absolutely. I’ve found that if you have the right people working together everything else follows. We were successful because we found the right players. While preparing for paediatric grand rounds on P-KIC back in February 2012, I had an epiphany. As doctors, we are good at the medical side of care but we often find the social context too difficult and complicated to manage. We often don’t know where to turn or where to generate social referrals. I proposed a novel system to remedy this problem and it was endorsed by my department head, Dr. Jim Kellner. We have been able to develop and grow the Social Paediatrics Unit with little funding and have also established one of the first social paediatrics rotations in Canada for our paediatric residents that is set to begin next month.
Both of these initiatives will take into account the social context of any child that presents to our care. Advocacy is another important tenet of the Social Paediatrics Unit. We want to have a better foot in the political door in order to help form policy and advocate the social paediatric agenda. I also want to foster greater discussion with the judiciary system and social workers to ensure we’re going in the right direction.
5 What advice would you give to the new MD Class?
1. Persevere. Clearly, there will be ups and downs so just hang in and truly enjoy the ride. 2. Don’t lose your personality. I never gave up music because it’s a big part of who I am. Some people discouraged my continued participation in music but I’m grateful that I kept my other life. It has made me a more well-rounded physician.
4 How did the University of Calgary MD program prepare you for the collaborative nature of your role in community paediatrics?
I guess I’m a bit of an extrovert. Perhaps it’s because of my musical background. I had a couple of leadership roles in medical school and was seriously involved in the MedShow—the annual medical student talent show. I didn’t mind being out front and medical school didn’t discourage that. Also, I’m from Calgary and, while some people would see this as a disadvantage, I am glad I stayed close to home. Because I know the city so well, I know where every school is and I know the teachers. I’m glad I didn’t go away – knowing this city has made me a better community paediatrican. The University of Calgary medical school fosters a sense of collaboration. As students, we understood the power of working together in a group. I felt a sense of community here and appreciated it. It’s much the same in the community of paediatrics. Everyone in the group is an equal. We all bring our own strengths to the team as doctors, social workers, teachers, judges, lawyers, dieticians, dentists, nurses, etc.
What is a panda? A panda is a giant bear with black and white patches, native to China. The University of Calgary’s Faculty of Medicine began formally naming its MD classes after animals in 1975 when a professor became frustrated with his class and called them “a bunch of turkeys”. The name stuck and so did the tradition, with each medical class naming the class behind them.
10 Dr. Roxanne Goldade 11 From left to right: Logan Christie, Chris Tortorelli, Dr. Roxanne Goldade. 12 Dr. Roxanne Goldade with a copy of one of her records.
FUN FACT! Roxanne Goldade has been singing since two years of age and recorded two records throughout her teen years. In 1978 and 1979, she was nominated for two Juno Awards for Most Promising Female Vocalist and then for Best New Female Vocalist. 12
ALUMNI
29
UCALGARY MEDICINE FALL 2013
M E D I C I N E . U C A LG A RY.C A / M AG A ZI N E
Meet Dr. Roxanne Goldade, 2013 Alumna of Distinction By Leigh Hurst
11 1 What prompted you to start Paediatric Kids in Care (P-KIC)?
It actually wasn’t me who started P-KIC per se. About seven years ago, Child and Family Services Authority (CFSA) and the Department of Paediatrics agreed that the old system of serving children in care was not working as well as it should. The processes need to work differently to better serve one of our most vulnerable populations and I was asked to lead the project with Chris Tortorelli from CFSA. Chris and I then worked very closely to develop the program. We led an extensive change that involved everything from building intersectoral relationships, developing new forms and trying to rewrite legislation.
You won the Alumnus of Distinction Award for Collaboration. Do you think that collaboration was key to P-KICs success? 2
10
Dr. Roxanne Goldade, MD ’90 (Panda), has been practicing Community Paediatrics in Calgary since 1995. She is also the Physician Lead for Pediatrics for Kids in Care (P-KIC) and the new Social Paediatrics Unit.
Absolutely. I’ve found that if you have the right people working together everything else follows. We were successful because we found the right players. While preparing for paediatric grand rounds on P-KIC back in February 2012, I had an epiphany. As doctors, we are good at the medical side of care but we often find the social context too difficult and complicated to manage. We often don’t know where to turn or where to generate social referrals. I proposed a novel system to remedy this problem and it was endorsed by my department head, Dr. Jim Kellner. We have been able to develop and grow the Social Paediatrics Unit with little funding and have also established one of the first social paediatrics rotations in Canada for our paediatric residents that is set to begin next month.
Both of these initiatives will take into account the social context of any child that presents to our care. Advocacy is another important tenet of the Social Paediatrics Unit. We want to have a better foot in the political door in order to help form policy and advocate the social paediatric agenda. I also want to foster greater discussion with the judiciary system and social workers to ensure we’re going in the right direction.
5 What advice would you give to the new MD Class?
1. Persevere. Clearly, there will be ups and downs so just hang in and truly enjoy the ride. 2. Don’t lose your personality. I never gave up music because it’s a big part of who I am. Some people discouraged my continued participation in music but I’m grateful that I kept my other life. It has made me a more well-rounded physician.
4 How did the University of Calgary MD program prepare you for the collaborative nature of your role in community paediatrics?
I guess I’m a bit of an extrovert. Perhaps it’s because of my musical background. I had a couple of leadership roles in medical school and was seriously involved in the MedShow—the annual medical student talent show. I didn’t mind being out front and medical school didn’t discourage that. Also, I’m from Calgary and, while some people would see this as a disadvantage, I am glad I stayed close to home. Because I know the city so well, I know where every school is and I know the teachers. I’m glad I didn’t go away – knowing this city has made me a better community paediatrican. The University of Calgary medical school fosters a sense of collaboration. As students, we understood the power of working together in a group. I felt a sense of community here and appreciated it. It’s much the same in the community of paediatrics. Everyone in the group is an equal. We all bring our own strengths to the team as doctors, social workers, teachers, judges, lawyers, dieticians, dentists, nurses, etc.
What is a panda? A panda is a giant bear with black and white patches, native to China. The University of Calgary’s Faculty of Medicine began formally naming its MD classes after animals in 1975 when a professor became frustrated with his class and called them “a bunch of turkeys”. The name stuck and so did the tradition, with each medical class naming the class behind them.
10 Dr. Roxanne Goldade 11 From left to right: Logan Christie, Chris Tortorelli, Dr. Roxanne Goldade. 12 Dr. Roxanne Goldade with a copy of one of her records.
FUN FACT! Roxanne Goldade has been singing since two years of age and recorded two records throughout her teen years. In 1978 and 1979, she was nominated for two Juno Awards for Most Promising Female Vocalist and then for Best New Female Vocalist. 12
On the road to top five. 2013 Community Report ucalgary.ca/report
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