Improving patient care through research.
A fundamental aspect of VCH Research is its focus on translational health research - improving patient care by uniting multidisciplinary teams that move research discoveries from the laboratory bench to the patients' bedside. The Mentored and Clinician Scientist Awards are one avenue to achieve this goal.
This annual funding program is supported by the VGH & UBC Hospital Foundation. Awards are granted to individuals who are up-and-coming in clinical practice, who also demonstrate promise in related areas of translational health research at VGH, UBC Hospital or GF Strong Rehabilitation Centre. Support through these awards provides clinicians with protected time, allowing them to focus on advancing their research careers. This year's grant recipients are as follows:
Traumatic brain injury (TBI) is a major cause of death and disability worldwide and is one of the leading causes of death in young Canadians. Each year in Canada, nearly 17,000 patients are hospitalized after suffering a TBI. In patients with severe TBI, a third will die and a third will suffer long-term disability. In the first few days following TBI, swelling from fluid accumulation within the brain is common. This swelling can put pressure on the surrounding brain leading to further brain injury. Increased pressure within the brain has consistently been associated with poor outcomes in patients with TBI. The purpose of my research program is to examine how to minimize brain swelling following TBI.
One possible treatment to reduce the swelling is to give a high concentration of salt water into the circulatory system. This high concentration of salt water is called hypertonic saline (HTS). HTS will stay in the blood vessels as it flows through the brain. Studies have shown that HTS will draw water from the brain tissue itself into the blood vessels, thereby decreasing the pressure in the brain. Most of the studies have only looked at HTS given as a single dose. However, brain swelling usually lasts for 5 – 7 days. As such, there may be a benefit to providing HTS continuously for this period of time.
We will perform a study that looks at HTS in patients with severe TBI. We believe that HTS will decrease the pressure within the brain and improve the blood flow to the brain compared to patients who do not receive HTS. If we demonstrate that HTS is reduces brain pressure, we can then go forward with a larger trial to see if HTS improves neurologic function at 6 months after injury.
Heart disease is the most common cause of non-cancer death in women with breast cancer. In fact, women older than 65 years old who are diagnosed with new breast cancer are more likely to die from heart disease than from cancer. By measuring the risk of heart disease, finding new risk factors for it, and learning about the best ways to treat it, I hope to reduce the burden of heart disease in women who have been diagnosed with breast cancer. My main goal is to reduce the risk of death and disability from heart disease in this rapidly growing population.
The specific goals of my study are to compare the risks of heart disease in women diagnosed with breast cancer to the risks in other women in BC, and to determine what factors increase this risk. I also plan to study whether women diagnosed with breast cancer use more health care services related to heart disease than other women in BC, and if they have heart problems, whether they receive the same quality of health care as other women. Finally, I hope to determine whether women who have been diagnosed with breast cancer have similar outcomes to other women after they undergo heart procedures such as angioplasty or surgery.
The ability to link de-identified population health data in BC provides a unique method for assembling enough patients to study rare types of heart disease and for following patients closely for long periods of time. This will be the first project to study the way that health care related to heart disease is provided to women who have had breast cancer. It will be the first study of the associations between the use of these heath care services and heart disease outcomes. It will also be the largest study ever done of outcomes after cardiac procedures in breast cancer patients. Our results will provide important new information about which treatments provide the most benefit to women who have had breast cancer.
Answering these questions will help to identify breast cancer patients who are at high risk of heart disease and allow them to avoid cancer treatments that could damage their hearts. The results of our project will also help ensure that women who develop heart disease after treatment for breast cancer get the best possible care, allowing them to live long and healthy lives.
Dr. Field is supported by the TD Grants in Medical Excellence.
Cerebral small vessel disease (CSVD) is a common brain disease that affects the small blood vessels in the brain, causing 20% of strokes and contributing to 45% of dementia. More than 300000 Canadians are affected by CSVD, and many more may have silent, early changes in the brain that are difficult to detect.
Our goals are to (1)evaluate the effectiveness of therapies (aggressive blood pressure treatment and exercise) started very early in the disease to prevent dementia, stroke and functional decline, and (2)detect patients with CVSD in the earliest stages of their disease.
ConSerVo will allow us to better identify patients in the earliest stages of CSVD when treatment has the greatest impact. This study, the first to examine the role of exercise in CSVD, will allow us to assess the efficacy of simple, achievable interventions that may be widely implemented to reduce stroke, dementia and cognitive impairment.
Dr. Field is the recipient of a grant from TD Bank Group, facilitated by VGH & UBC Hospital Foundation. TD is committed to investing in the future by promoting excellence and building health research capacity through peer reviewed salary support for early career clinician scientists located at VGH, UBC Hospital and GF Strong Rehabilitation Centre. As a result, TD has established the TD Grants in Medical Excellence, which will fund research time and reduce clinical commitments for individuals early in their career who are clinically practicing and conducting research.