Monthly Archives

June 2018

Dr. Alexandra Papaioannou by the YMCA swimming pool

Pre-surgery program for better post-surgery results

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Age hasn’t slowed Annette Atwood down. She’s never been one to sit around in front of the TV, even now in her 70’s, unless perhaps if Wimbledon is on.

When she started to notice a dull constant pain in her hip, she chalked it up to getting older. But when her hip started to frequently give out causing her to fall, she realized it was more than just old age. Annette was in need of a hip replacement.

Being the outgoing person that she is, Annette wasn’t going to let the wait for surgery slow her down. She still went out and about, making sure to always bring a walker or cane with her.

“It’s not just about ensuring our patients get the surgery they need, but ensuring it improves their quality of life.”

When she went for an appointment with her surgeon, he told her about a research study called Fit Joints that’s exploring whether participation in a pre-surgery program, which includes exercise, nutrition, medication review and goal setting, can help patients undergoing hip and knee replacements recover better. It’s well-known that the healthier a person is before surgery, the more likely they are to have a positive outcome. Researchers at the Geriatric Education and Research in Aging Sciences (GERAS) Centre of Hamilton Health Sciences (HHS) and McMaster University are applying that same concept through the Fit Joints study.

“Since many patients in need of hip or knee replacements are frail, surgery may not be as effective,” says Dr. Alexandra Papaioannou, geriatrician at HHS, executive director at the GERAS Centre and Fit Joints study lead. “But, there’s growing evidence showing that frailty can be treated through proper diet and exercise. This means our study could not only better prepare our patients for surgery, but also improve their frailty and reduce their chance of falling. The goal is to help patients get back to the life that they enjoy.”

Swimming instructor teaching Annette Attwood's aquatics class

Study participants are given an exercise plan, a food intake log and vitamin D and protein supplementation. With help from the Les Chater YMCA, participants can attend aquatic classes and receive coaching in the gym. They’re also given gentle exercises to complete at home. Since it’s a fairly big change for people who don’t exercise regularly, study coordinators provide ongoing guidance with monthly home visits. The program continues as long as patients have to wait for their surgery.

“As healthcare providers, it’s not just about ensuring our patients get the surgery they need, but ensuring it improves their quality of life,” says Dr. Papaioannou. “Regardless of the complexity, surgery can be hard on the body. So, we’re hoping this program can help patients’ recover well and enjoy the benefits of their new hip or knee.”

If the study is successful, the team at the GERAS Centre hopes the program can become a routine part of care for all joint replacement patients across Ontario.

Annette Attwood in the swimming pool at the YMCA

As for Annette, one year post hip replacement, she’s still swimming at the YMCA twice each week.

“I loved the program as soon as I started it before my surgery,” she says. “But now, it’s not just exercise, it’s a social outing.”

Annette Attwood speaking to study coordinator Ahmed Negm

Explorer Dr. Alexandra Papaioannou

Research at Hamilton Health Sciences is conducted in partnership with McMaster University.

This story was featured in our community report. Click to read the full report.

An HHS geriatrician meeting with a patient

Helping people age better

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We’re living longer than ever before, and that’s a good thing. But, are we aging well? Our researchers are exploring ways to help people live better, longer by tackling aging early on.

Getting a grip on frailty and aging

Can the strength of your grip reveal how well you’ll age? According to Dr. Darryl Leong and his colleagues at the Hamilton Health Sciences and McMaster University Population Health Research Institute, it can. They’re using data from 200,000 people in 25 countries around the world to better understand what factors affect longevity, but also how frailty can be avoided through early intervention. Hamilton is also home to the Canadian Longitudinal Study on Aging (CLSA) at McMaster University, where Parminder Raina and his team have established a robust data platform to better understand the biological, clinical, social, psychological, economic and environmental aspects of aging. The CLSA will follow over 50,000 Canadians between the ages of 45 and 85 for the next 20 years to gain insight in to why some people age well, and some others don’t.

By identifying how a young person’s eating and exercise habits, as well as their genes, affects their muscle strength and physical functioning down the line, we can learn how to delay, and even prevent, disease and frailty before they take hold.

Patient-driven aging research: A living lab

Despite their best efforts, frailty will remain a reality for some people as they grow older. In their “living laboratory”, Dr. Alexandra Papaioannou and her colleagues at the Geriatric Education and Research in Aging Sciences (GERAS) Centre at Hamilton Health Sciences’ St. Peter’s Hospital combine patient care with research to create innovative healthcare solutions based on the needs and lived experiences of their patients. Current projects include a new mobile app that will allow clinicians to quickly identify patients at risk for frailty; a wireless bed that uses artificial intelligence will anticipate patients’ needs; and a dance program for seniors to promote mobility and mental ability.

 

This article is featured in the latest Explorers publication.

Researcher and lab technician removing study samples from a nitrogen tank in the biobank

Preventing disease, everywhere

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One third of all global deaths are caused by heart attacks and strokes, and most of them in lower income countries. We’re finding solutions to prevent these deadly diseases – solutions that are available to people in every corner of the globe.

Discovery without boundaries

Cardiovascular disease knows no bounds. Despite common belief, heart attacks and strokes aren’t issues specific to the Western world. In fact, they claim the most lives from low and middle income countries. Our teams are focused on finding solutions to heart attack and stroke that can benefit people everywhere — people who are rich or are poor, people of different ethnic backgrounds and cultures, and people in all parts of the world.

Our research over the last two decades has included over one million people in 101 countries. By studying how diets, activity, genetics, social and environmental factors interact with each other to influence the development of cardiovascular disease, diabetes, and other chronic diseases, we’ve identified new ways to prevent heart attacks and strokes. Trials of innovative treatments have also discovered new ways to prevent deaths, recurrent heart attacks, or strokes once people have cardiovascular disease. Our discoveries have improved the way people with heart disease and stroke are cared for worldwide. The health of people in Canada matters, but so does the health of people around the globe. Disease knows no bounds, and neither does our research.

Canada’s largest biobank

Hamilton Health Sciences is home to Canada’s largest research biobank, a literal vault of human DNA housing more than three million samples collected from patients around the globe. The facility provides an information-rich, cellular and molecular database that supports our researchers in solving some of the world’s greatest health challenges, including heart disease and stroke.

With more than 100 international studies being led by Hamilton Health Sciences and McMaster University researchers at any given time, the biobank – developed over 20 years – has become an invaluable knowledge repository. It can provide our researchers with key information on half a million patients, at their fingertips. These samples are used for analysis of genetic biomarkers that predict the development of various diseases and provide new insight in to the causes of heart attacks, strokes, heart failure, cancer, diabetes and dementia. Samples are stored in liquid nitrogen so that they can be used for decades to come.

 

This article is featured in the latest Explorers publication.

Surgeon performing open heart surgery

Making surgery safer

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The last one hundred years have seen life-saving advancements in surgery. Still, it’s not without its risks. Our researchers are leading a new wave of exploration aimed at making surgery safer for people around the globe.

As simple as a blood test

Surgery is stressful on our body. The heart is susceptible to strain from surgery and can suffer damage as a result. This damage can give way to bigger problems like stroke, heart attack, blood clots, and even death. Dr. P.J. Devereaux and his team at Hamilton Health Sciences’ and McMaster University’s Population Health Research Institute (PHRI) have found that many of these complications are symptomless and go undetected by patients and doctors alike. But, they can surface down the line as serious health issues.

In a groundbreaking study, the team discovered that a simple, quick and inexpensive blood test can detect damage to the heart caused by surgery, triggering doctors to take action to prevent bigger problems. They were also the first to find that a blood thinner can help to prevent some of these problems, a discovery that could benefit millions of people each year.

Bridging the gap between hospital and home

Can technology help patients recover better after surgery? Dr. Mike McGillion and his team at PHRI and the McMaster University School of Nursing are testing a novel technology by Phillips Healthcare that wirelessly monitors a patient’s vital signs after an operation, and for one month after they leave hospital. If an abnormality is detected, the hospital team is alerted to check in on the patient. It’s a leading-edge example of a not so far-off future where technology bridges the gap between the hospital and home.

Treating hip fractures like heart attacks

What do broken hips and heart attacks have in common? Like a heart attack, a hip fracture is a medical emergency but has not been considered as one until now. A hip fracture puts a lot of stress on the body, creating the potential for a number of life-threatening issues. Yet, these patients aren’t treated with the same level of urgency as other emergencies and often have to wait several days for surgery.

Dr. Mohit Bhandari and his team at PHRI are testing the theory that hip fracture patients who receive surgery quickly – within 24 hours of their fracture – have a better recovery and experience fewer issues. It also means patients spend less time in hospital, reducing health care costs and making room for more patients to receive the care they need, sooner.

 

This article is featured in the latest Explorers publication.