Every year, Vancouver Coastal Health Research Institute (VCHRI) holds a Team Grant Awards competition to facilitate research mentorships at Vancouver Coastal Health (VCH) and encourage VCH staff and clinicians to take on applied research projects that will improve their care practice. Team Grant Awards involve VCH health care providers partnering with experienced researchers who will mentor them through the entire research process, from proposal to project completion.
The 2014 Team Grant Award winners are:
- Dr. Jess MacKenzie-Feder, Endocrinologist and Clinical Associate Professor, UBC Department of Medicine, Division of Endocrinology and Metabolism
- Dr. David Wilson, Primary Care Physician, VCH-Vancouver Community, Three Bridges and Raven Song Community Health Centre; Clinical Instructor, UBC Department of Family Medicine
- Vininder Bains, Registered Nurse, Vancouver General Hospital – Intensive Care Unit
- Dr. Alina Gerrie, Hematologist and Clinical Assistant Professor, UBC Department of Medicine, Division of Hematology
Congratulations to this year’s Team Grant Award winners and best of luck on their promising research endeavors!
Sepsis is the tenth leading cause of mortality; it is a condition in which the body’s response to infection damages its tissues and organs. It is essential that sepsis in a critically ill patient be recognized early and treated promptly before it becomes severe and leads to multi-organ system failure.
Cortisol (a corticosteroid) is a stress hormone produced by the adrenal glands that has been shown to increase during sepsis. In some cases though, adrenal gland function is impaired during sepsis. Studies on corticosteroids administered to septic patients have found conflicting results, with some suggesting that this reduces the chance of death, while others show that it may cause harm. An accurate and rapid method of measuring cortisol levels is needed along with a definitive study on the role of cortisol in sepsis.
This research proposal aims to validate novel measurement techniques of free cortisol hormone in septic patients treated in the intensive care unit (ICU).
“This study aims to validate a measurement of ‘free’ cortisol and hopefully provide a more accurate picture of the patient’s adrenal function and reserve,” says Principal Investigator, Dr. MacKenzie-Feder. “We can very feasibly validate this new method of determining free cortisol, which could eventually have broad implications for testing and treating patients in the critical care setting.”
People who identify as transgender possess a strong sense their outward-looking body does not match their inner sense of gender. For transgender/transmasculine individuals – assigned female at birth but identify along the male spectrum – there is a strong desire to achieve a more masculine appearance that fits their own unique sense of gender identity. While surgery, clothing, and hairstyling can help a person physically appear more masculine, many also wish to take testosterone to achieve this goal.
Taking testosterone usually involves injections directly into a muscle every one to two weeks for many years. These intramuscular injections can often be uncomfortable or painful and require the patient to know how to properly give themself an injection, or have someone else do it. There is a growing trend in the transmasculine community to inject themselves just below the skin or subcutaneously (similar to insulin injections) because it is more comfortable. However, we don’t know if the two methods produce similar levels of testosterone in the blood.
This project will look at a small group of transmasculine individuals who are already on intramuscular testosterone, and switch them to the same dose of subcutaneous testosterone. Their blood testosterone levels will be compared to see if the more comfortable subcutaneous injection route gives similar results to the more traditional intramuscular injection.
“We prescribe testosterone using the intramuscular technique because we've always done it that way, despite being more uncomfortable and requiring more teaching than the subcutaneous route. Some people in the trans community are quietly using the subcutaneous technique anyway and we want to find out if it’s the same or even better,” explains Principal Investigator, Dr. David Wilson.
The study may potentially change the way in which doctors prescribe testosterone and may reduce a barrier to its use. It may also have an impact on anyone who uses testosterone for any type of therapy.
Acetaminophen (also known as Tylenol) is generally considered a benign drug, and commonly given to patients without much concern. Like with most drugs, our evidence about safety and efficacy is primarily based on non-critically ill patients. However, ICU patients are especially vulnerable.
This study will examine the safety and fever-reducing efficacy of acetaminophen in the critically ill patient. Recent studies conducted in the ICU population suggest acetaminophen may not be as effective at reducing fever, or may even put critically ill patients at risk of acute hypotension (a sudden, and severe drop in blood pressure).
The study seeks to answer two questions: first, when acetaminophen is given to treat fevers in ICU patients, are they more likely to experience a drop in blood pressure? And second, how much acetaminophen will reduce fever in ICU patients? This information will help determine when and how to treat fevers in the ICU.
“At the moment we are still swimming in the details of this study, and preparing for all the tasks that lay ahead, but we have been bitten by the research bug,” says Principal Investigator, Vininder Bains. “We have received so much encouragement and support from many of our co-workers. In a way, we all are learning about conducting research and developing capacities for future projects.”
Bone marrow transplants (BMT) are used to treat life-threatening blood cancers such as leukemia and lymphoma. Recent advances have led to higher cure rates and overall survival; however, BMTs can have long-term side effects including decreased physical endurance and muscle function, bone loss and fractures, and high levels of fatigue. There are many studies demonstrating that exercise programs for cancer patients and survivors can positively influence quality of life and physical function; however, BMT patients face significant barriers to exercising, particularly immediately after transplant.
This current study is a preliminary study to assess whether or not it is possible to introduce an exercise program for BMT patients once they are discharged from hospital. The study may lead to an exercise program becoming part of the regular care of BMT patients at VCH.
“I see first-hand the difficulties patients have after a bone marrow transplant in terms of getting back to their usual state of health, particularly with respect to energy level, physical and emotional strength,” says Principal Investigator, Dr. Alina Gerrie. “Exercise can have a profound impact on physical and emotional well being, as well as quality of life, and therefore it is important that patients have the opportunity to safely incorporate exercise into their daily routine early in the post-transplant period.”
VCHRI’s internal grants and awards program, which includes the Team Grant Awards, is an important tool for fostering and developing research activity at VCH. Through such competitions, VCHRI promotes better health outcomes and develops best practices shared throughout VCH and across other health authorities. The Team Grant Awards are made possible with the generous support of the VGH & UBC Hospital Foundation.