pulmonary diseases

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.

The World Health Organization (WHO) aims to eliminate TB by 2050, but Canada is not on target to meet that goal. To reach our national TB elimination targets, we must reduce TB rates by 10% per year but we are only reducing TB rates by 2% per year. My research program is aimed at developing evidence to improve TB screening, prevention and treatment policies in order to accelerate TB elimination in British Columbia (BC) and Canada.  

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.

Interstitial lung disease (ILD) is a group of disorders characterized by fibrosis and inflammation of the lungs. Dyspnea (i.e., breathlessness) is the most common symptom in ILD. To minimize dyspnea, ILD patients commonly avoid physical activity, leading to a progressive decline in exercise capacity, and eventually the inability to perform daily activities. Maintaining exercise capacity is important, given that ILD patients with the lowest physical activity levels have the lowest quality of life and the highest mortality.

The discovery of antibiotics was one of the greatest advances in modern medicine, enabling control of infections. However, bacteria can develop antibiotic resistance over time, and become less sensitive to antibiotics. Without effective treatments, infections by these organisms can lead to prolonged illness, and routine surgeries can become life threatening. The lack of new antibiotics to combat the rapidly growing number of multi-drug resistant (MDR) organisms has become one of the most serious global health concerns.

Patients with human immunodeficiency virus (HIV) are now living to older ages thanks to effective anti-HIV medicines. Despite these gains, many of them suffer from chronic lung disease that greatly impacts their ability to carry out their daily activities and impairs their quality of life. The type of lung disease they face is similar to what longtime smokers develop, a progressive narrowing of the airways and destruction of the lung. However, in HIV, the process appears to be accelerated and more severe.

Interstitial lung disease (ILD) encompasses a large number of entities that cause inflammation and/or fibrosis of the lungs. An estimated 10,000 Canadians have idiopathic pulmonary fibrosis and an additional 30-40,000 have other common forms of fibrotic ILD. Fibrotic ILD reduces quality of life, is often disabling, and increases healthcare costs. The susceptibility to ILD, severity of its manifestations, frequency of adverse treatment effects, and risk of comorbidities all increase with age. Frailty is a major health problem and will be even more important with an aging population.

Tuberculosis (TB) is a major health problem in developing countries, but it also remains an issue of concern in parts of Canada. British Columbia has one of the highest TB rates in Canada, with nearly 300 cases of active TB diagnosed each year. TB treatment requires long courses of potentially harmful antibiotics and, in some cases, hospital stays of several weeks to months, exacting significant economic and personal tolls. Recently the BC Ministry of Health developed the BC Strategic Plan for Tuberculosis Prevention, Treatment and Control.

Chronic respiratory diseases are a leading cause of death and disability in British Columbia and around the world. Patients with respiratory diseases commonly experience shortness of breath which makes it difficult, if not impossible, to perform simple activities of daily living such as walking up a flight of stairs. To avoid this uncomfortable sensation, patients adjust by minimizing physical activity which makes them weaker and ultimately leads to even more shortness of breath.