Clinical

By 2040, 25% of Canadians will have osteoarthritis (OA), a disabling joint disease. This number will be as high as 50% for those who hurt their knee playing youth sport. Currently, the treatment of youth sport knee injuries focuses on return to sport. Few seek care beyond their injury, and little effort is made to prevent OA. Stop OsteoARthritis (SOAR) is a new physiotherapy program to reduce the risk of OA after a youth sport knee injury.

Acutely ill patients often require life-saving measures including breathing tubes and breathing machines (mechanical ventilation; MV).  As our population ages and more people have chronic, complex health conditions, MV is becoming a more common, necessary practice.

Two out of every five individuals will develop cancer during their lifetime. My research program focuses on cancer prevention and diagnosis, using skin cancer as an initial platform. Skin cancer accounts for two thirds of all cancer cases and is an easily accessible organ to study using optical devices. Biopsies are typically used to detect skin cancers. Disadvantages of skin biopsies include possible disfigurement and complications, lengthy processing time, and occasionally inaccurate or inconclusive results.

Aggressive B-cell lymphomas are the most common form of lymphoma and ~50% of patients are cured with modern treatments. However, the outcomes for patients whose disease is not cured are dismal with ~10% of those patients alive at 5 years. This shows that these lymphomas, although grouped together on the basis of what they look like down the microscope, represent clusters of different lymphoma groups. A better understanding of the 'molecular wiring'of these lymphomas is critical to identify patients at high risk of resistant lymphoma and providing better treatments.

Spontaneous coronary artery dissection (SCAD) occurs when there is a tear in the inner layers of a blood vessel in the heart, causing blockage and reducing blood flow and oxygen to the heart. It is an emergency condition that can result in heart attack and even death. Unfortunately, the causes of SCAD are poorly understood, and it is often misdiagnosed and mistreated.

Interstitial lung disease (ILD) is a progressive lung disorder with no effective treatment. Oxygen is often used to relieve symptoms at the end of life, but the evidence supporting oxygen use in these patients is based on limited data from other diseases. The lack of data on the benefits of oxygen in patients with ILD has resulted in uncertain criteria for its use and limited access to this potentially important medication.

Acute kidney injury (AKI) complicating critical illness is an important problem, contributing to roughly 1.7 million deaths worldwide per year. Treatment is limited to dialysis, which is costly and frequently unavailable. Preventing AKI is a critical step to reduce deaths. Acetaminophen (Tylenol) has the potential to reduce AKI caused by oxidative damage from hemoglobin (released from red blood cells) and myoglobin (released from muscle cells).

Deaths due to opioid overdoses have reached epidemic proportions in Canada, with nearly 8,000 Canadians losing their lives in the last two years. Knowledge of how rescuers can best respond to cardiac arrests due to opioid overdose is urgently needed.  

Many patients with depression struggle to return to their full level of functioning in work and other areas of life. These poor functional outcomes in depression may be related to cognitive difficulties, as patients demonstrate problems with memory, attention, and problem solving. We however lack treatments for these difficulties. Cognitive training, consisting of tasks to target cognitive deficits, has been tested but shows inconsistent results in depression.      

Over 2.5 million Canadians have chronic obstructive pulmonary disease (COPD), which is a progressive lung condition that blocks the airways and makes it difficult to breathe. These patients experience worsening shortness of breath, increasing exercise limitation, and reduced quality of life. Patients must work harder to breathe, and the lungs can over-inflate, which can squeeze the heart and affect how it functions. Further, more than 1-in-4 patients also have high blood pressure, which might amplify the negative effects of lung over-inflation on the heart.

Falls cause up to 80% of traumatic brain injuries (TBI) in older adults. Any fall from standing may cause TBI if head impact occurs. Humans use movement strategies to avoid head impact during falls, such as 'arresting' the fall with the arms. Through video capture of real-life falls, we found that these strategies persist but become less effective for older adults in long-term care, with over 1/3 of falls resulting in head impact in this setting.

Over 400,000 Canadians live with long-term disability from stroke. Stroke survivors say regaining walking ability is a top priority; but, poor cognition, or thinking abilities, can limit walking in the community. How much walking recovery someone achieves likely stems from the brain's ability to dual-task (DT), like walking while talking. In fact, almost 80% of stroke survivors struggle with some aspect of cognition limiting full walking recovery after stroke.

Stroke is the leading cause of disability in Canada with more than 400,000 Canadians living with long-term disorders due to stroke. Hence, whilst challenging, it is critical to restore mobility to these individuals such as independent walking; the most frequently stated goal of individuals post-stroke. However, achieving this goal is hindered by motor impairments, including muscle weakness and spasticity, yet we still do not understand how these impairments influence walking post-stroke.

Breathing discomfort is common in patients with interstitial lung disease (ILD) and often results in an inability to perform physical activity, leading to a poor quality of life. Exercise training can reduce breathing discomfort and enable ILD patients to perform physical activity. However, severe breathing discomfort makes it challenging for these patients to withstand the amount of training they need to get the most benefit.

Sepsis is a severe disorder that occurs when human defense cells fight off an infection in an uncontrolled manner that can cause organ damage and death. Unfortunately, there is no specific treatment for sepsis, and there is a limited understanding of the mechanisms driving this deadly disorder.