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Game-changing technique could boost organ transplants in Canada. Here’s how

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A medical team in London, Ont., has achieved a Canadian first: a groundbreaking technique that boosts the viability of donor organs.

This breakthrough offers new hope for transplant patients by significantly increasing the pool of available organs, potentially saving countless lives.

The technique, called abdominal normothermic regional perfusion (A-NRP), works by pumping blood to abdominal organs after circulatory death (when the heart stops beating). This allows organs to be re-oxygenated and warmed to normal body temperature — minimizing damage and enhancing their chances of survival after transplantation.

The team at Lawson Health Research Institute, led by Dr. Anton Skaro, is pioneering the use of A-NRP in Canada. They believe this technique has the potential to increase organ transplants in Canada.


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Organ donations and transplants in Canada rebounding to pre-pandemic levels

 


“The biggest challenge that transplant physicians and surgeons face is organ shortage. There are just not enough organs to go around. And patients die every year on the wait-list in the hundreds to thousands range in Canada,” said Skaro, director of livery transplant surgery at the London Health Sciences Centre.

“There are many donors and donor families with wonderful intentions to donate this beautiful gift of life. Unfortunately, through the dying process, many of those organs are just too damaged to be safely transplanted.”

In 2023, more than 3,400 organ transplants were performed in Canada; 83 per cent of transplants used deceased donor organs and 17 per cent used living donor organs, according to the Canadian Institute for Health Information (CIHI).

Of the 952 deceased donors in 2023, 67 per cent donated following neurological determination of death, often known as brain death, and 27 per cent donated following death determination by circulatory criteria, often known as cardiac death.

 

Circulatory death and organ donation

Organ donation after circulatory death is historically been less reliable compared with brain death donations, Skaro said. This is because there is a higher risk of organ damage after circulatory death since oxygen and blood flow stop.

Once a patient’s heart stops beating, blood pressure drops and the circulation of oxygen and nutrients to the organs is compromised. This leads to a condition called warm ischemia, which irreparably damages the metabolic machinery of the organs, Skaro explained.


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“Unfortunately, through the dying process, the organs are very seriously damaged and many of them are not rendered suitable for transplantation … and that’s a heartbreaking situation,” he said.

However, the use of A-NRP has the potential to protect organs after circulatory death and could significantly increase the likelihood of successful transplants.


Click to play video: 'High school basketball star highlights importance of organ donation'
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High school basketball star highlights importance of organ donation

 


 

How it works

A-NRP works by using a specialized pump to restore blood flow to the abdominal organs of a donor after circulatory death, Skaro explained.

“After death declaration, there’s a mandatory five-minute period of time that we call a hands-off period. And that’s to reduce the likelihood that the patient can auto-resuscitate spontaneously,” he said.

“Once that’s done, the patient is brought to the operating room. And at that point, we exclude the abdomen from the rest of the body and then insert cannulas (flexible tubes) into the artery and vein and then start circulating blood to the abdominal organs.”

This allows the organs to receive a fresh supply of oxygen and blood, aiding in their recovery after the damage incurred during the dying process.


An image of the machine using the A-NRP technique.


London Health Sciences Centre

“We’re able to get rid of many of the toxic agents that are circulating within the organs that compromise their function,” Skaro said. “And so, essentially, what we’re doing is preconditioning that organ, so that it’s able to replenish its energy, replenish its molecules that are capable of counteracting this injury. And so they behave and perform far better during the transplantation.”

He said using this method is a great opportunity to not only “vastly increase the organ supply” but also provide better quality organs.

While the procedure is a first in Canada, it has been used in other nations, including in Europe, he explained.

The technology required for this has been available for a long time in Canada — Skaro described it as a portable heart and lung machine typically used to transport patients who have experienced cardiac arrest. However, his team has adapted this pump and integrated it into the organ donation process as well.

“We’re using these amazing techniques, thinking outside the box to try and solve our organ shortage problem,” he said.

 

First in Canada

On April 10, the medical team at the London Health Sciences Centre successfully implemented A-NRP for the first time in Canada. This procedure optimized organs from two donors, allowing for the transplantation of two kidneys and two livers to four patients.

“The liver is here in London, as well as one kidney. And we actually were able to send one of the kidneys to Hamilton. And our colleagues in Hamilton were able to transplant that kidney successfully as well,” Skaro said.

“This is a huge team effort that we’re looking to scale, not just throughout the province, but eventually nationally to all jurisdictions in the country, hoping that we can do everything in our power to increase the number of available organs and stop anyone from dying on the wait-list without one.”


Click to play video: 'Revolutionary technology for transplants made in B.C.'
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Revolutionary technology for transplants made in B.C.

 


Currently, the technique has been limited to abdominal organs. The next step is to scale up this method to include thoracic organs, such as the heart and lungs.

“We have interested parties both on the side of the heart transplant and the lung transplant realms. And this is going to potentially move into their domain where heart transplants will be feasible from these kinds of donors, which is astounding,” Skaro said.

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What Is Sloth Fever, and Can You Catch It in Canada?

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An emerging virus, colloquially dubbed “sloth fever,” has recently caused alarm after the European Centre for Disease Prevention and Control (ECDC) reported 19 imported cases of the disease in the European Union for the first time. Officially known as the Oropouche virus (OROV), this RNA arbovirus was first detected in the village of Oropouche in Trinidad and Tobago in 1955.

Sloth fever, or Oropouche fever, is a zoonotic disease primarily transmitted to humans through the bite of infected biting midges and mosquitoes. The virus has a reservoir in animals such as pale-throated sloths, non-human primates, and birds, which has led to its nickname. However, the name “sloth fever” can be misleading, as the virus is spread by insect bites, not by direct contact with sloths.

The Pan American Health Organization (PAHO) issued an epidemiological alert in July due to a rise in reported cases across Brazil, Bolivia, Peru, Cuba, and Colombia.

Several factors are driving the recent spread of the Oropouche virus. Enhanced surveillance, climate change, and potential changes to the virus itself have contributed to the outbreak. As with other vector-borne diseases like dengue, rising temperatures and changes in precipitation patterns can increase the proliferation of the midges and mosquitoes that transmit the virus.

Can You Catch Sloth Fever in Canada?

As of now, there is no evidence that the Oropouche virus has been transmitted in Canada. The biting midges that carry the virus are not currently established in Europe or North America. All cases diagnosed in Europe have been linked to travel to affected areas in Central and South America.

Who Is Most at Risk?

While much remains unknown about the Oropouche virus, one of the primary concerns is its potential impact on unborn fetuses. Some limited studies suggest that antibodies against the virus have been found in children born with microcephaly, and there may be a link between infection and pregnancy complications, such as miscarriage and fetal deaths, although more research is needed.

What Are the Symptoms?

Common symptoms of Oropouche fever include fever, rash, headache, muscle or joint pain, and weakness. Some individuals may also experience gastrointestinal symptoms and sensitivity to light. In rare cases, the virus can lead to severe complications, including neurological symptoms similar to meningitis.

Is There a Treatment?

Currently, there is no specific antiviral treatment or vaccine available for Oropouche virus. Treatment primarily focuses on managing symptoms, such as fever and pain relief. In severe cases, hospitalization may be necessary for supportive care.

What Should You Do If You’re Planning to Travel to an Affected Area?

If you are planning to travel to an area where Oropouche fever has been reported, it is essential to take precautions to prevent insect bites. Use insect repellent, cover exposed skin, and sleep under treated bed nets. If you are pregnant or have other health concerns, consult with a healthcare professional before traveling and visit the TravelHealthPro website for the latest health information and advice.

While the virus has not yet spread to Canada, travellers to affected regions should remain vigilant and take necessary precautions to protect themselves from this emerging disease.

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Sloth Virus Spreads to Europe: Oropouche Fever Emerges as Global Health Threat

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An insect-transmitted virus that can infect sloths, primates, and birds is spreading at an “unprecedented” rate, according to global health officials. Oropouche fever, a potentially fatal zoonotic disease, is now emerging in parts of the world where it has never been detected before, including Europe. The World Health Organization (WHO) has reported that the virus, transmitted by tiny flies called midges and mosquitoes, is spreading beyond its traditional stronghold in Central and South America.

Oropouche fever, which is part of the same family of diseases as Zika and dengue fever, has traditionally circulated in Central and South America. However, recent research published on August 8 in The Lancet indicates that the virus has also been detected in new locations, including Cuba, Italy, and Spain.

The research paper noted that “Arboviral infections have hit South America heavily in the past decade…. In addition, the region is now facing the re-emergence of another little-known arbovirus, Oropouche virus, on an unprecedented scale.” As of August 1, 2024, there have been 8,078 confirmed cases in Bolivia, Brazil, Colombia, and Peru, compared to just 832 cases reported in 2023. The first deaths linked to Oropouche fever were reported in late July, involving two young women in Brazil with no underlying medical conditions.

In response to the virus’s spread, both the Pan American Health Organization (PAHO) and the European Centre for Disease Prevention and Control (ECDC) have issued warnings. In June and July, Europe reported its first 19 cases of Oropouche virus disease, with Spain (12 cases), Italy (five cases), and Germany (two cases) being affected. The majority of these cases were linked to travel to Cuba, with one case connected to Brazil.

Dr. Isaac Bogoch, a Toronto-based infectious diseases specialist, expressed concern over the virus’s potential spread to Canada, especially given the rise in cases in popular travel destinations like Cuba. “There’s a giant knowledge gap,” Bogoch said, highlighting that many healthcare professionals and the general public may be unaware of the virus, which could lead to underreporting.

Oropouche fever is a zoonotic disease first identified among forest workers in Trinidad in 1955, and later in a sloth in Brazil in 1960. Since then, more than 500,000 cases have been reported in the Americas, though the true extent of the virus’s spread may be underestimated. The virus is primarily transmitted to humans through the bite of an infected midge or mosquito, with no direct human-to-human transmission documented so far.

Symptoms of Oropouche fever can resemble those of dengue fever and Zika virus, including fever, chills, nausea, vomiting, headache, joint pain, muscle pain, sensitivity to light, and pain behind the eyes. In rare cases, the virus can lead to severe complications such as aseptic meningitis, which involves inflammation of the membranes surrounding the brain.

The spread of Oropouche fever has been linked to climate change, urbanization, and deforestation. A study from 2017 examined an outbreak in Peru and found a significant connection to deforestation, which may displace the virus’s animal hosts and increase the likelihood of midges feeding on humans. Extreme weather conditions such as heavy rainfall and flooding, which create ideal breeding conditions for midges, have also been identified as contributing factors.

Currently, there is no vaccine or specific treatment for Oropouche fever. Prevention is the best defense, with the Centers for Disease Control and Prevention (CDC) recommending the use of insect repellent, window and door screens, and fans to keep midges and mosquitoes at bay. Since midges are smaller than mosquitoes, traditional mosquito nets may not be effective.

“Good insect repellent works extraordinarily well,” Bogoch advised, recommending repellents containing 30% DEET or 20% picaridin for the best protection.

The Canadian government has also issued travel precautions, advising those traveling to regions with Oropouche fever outbreaks to take extra care, particularly pregnant women, due to the potential risk of transmission from mother to fetus.

As the virus continues to spread, health officials urge travelers and healthcare providers to remain vigilant and report any symptoms that could be related to Oropouche fever. The situation highlights the growing threat of infectious diseases in a rapidly changing global climate.

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Achieving Your Fitness Goals: A Comprehensive Guide to Nutritional Support

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Starting a fitness regimen calls for proper nutrition. Fitness calls for a healthy, well-planned diet tailored to your needs, not only exercise. The major nutrition elements that can improve your fitness potential will be covered in this all-inclusive book.

Understand your nutritional needs.

Maximizing results depends on knowing your body’s dietary requirements. Age, gender, weight, degree of exercise, and fitness goals all affect one’s needs. A balanced diet should also call for carbohydrates, proteins, fats, vitamins, and minerals. While dietitians and nutritionists can offer advice, basic concepts can get you going.

Do you need supplements?

Although they can be a great addition to a good diet, supplements shouldn’t be taken as replacements. Nutritional deficits can be filled in part with multivitamins, protein powders, omega-3 fatty acids, and vitamin D pills. Before adding any premium vitamins to your regimen, though, you should see a medical practitioner. This stage guarantees that you are making wise judgments catered to your requirements and health condition, giving you confidence in your choices.

Some exercise supplements are supposed to improve performance and recovery. Products for muscular development and endurance exist from numerous reputable sources, like flexpharma.is. Researching and choosing supplements that meet your goals and degree of fitness is essential to make sure they will offer the expected results.

Macronutrients’ role

Macronutrients and diet components help in many ways in supporting fitness goals. Your regular workouts and activities depend on carbohydrates for energy. For nutrients and energy, choose complex carbohydrates including fruits, vegetables, and whole grains.

Proteins are needed for muscle development and repair Among the lean proteins that help muscle development and recovery are chicken, fish, tofu, and lentils. Moreover, proteins satisfy you, reducing the need for continuous unhealthy dietary intake.

Though perspectives vary, fats are vital for controlling  hormones and general health. Moderately ingested good fats can have benefits. Avocado, almonds, seeds, and olive oil give long-lasting energy and support cellular activity vital for fitness.

Hydration and micronutrients

Although macronutrients are vital, vitamins and minerals are just as critical. These components support immune response, bone health, and energy generation. To satisfy your micronutrient requirements, load many vibrantly coloured fruits and vegetables.

Nutritional support calls for hydration as well. Every cellular function—body warmth, joint lubrication, nutrient transfer—depends on water. Eight glasses of water a day—more if you exercise vigorously. Liquids high in electrolytes can help with mineral replacement following demanding workouts.

Sustainable eating plan

One diet you can stick to without feeling hungry or anxious is sustainable. Set realistic diet goals and gradually change. Reduce sugary processed foods and increase nutrient-dense foods. Food preparation and planning will help you eat well all week.

Listen to your body, too. Consider how diet affects energy and performance. Everyone reacts differently, so what works for one may not work for another. A diet should reflect your growth and experiences.

Conclusion

Fitness requires nutrition. Know your nutritional needs, balance macronutrients, get appropriate micronutrients, and keep hydrated to perform well. A good diet and the utilization of supplements will determine your success. Consistency and diet are key to fitness. Start now and let diet affect your workouts.

 

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