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Niagara thrombosis clinic launches research studies

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After eight years of preparation, Niagara Health’s thrombosis service clinic can now offer cutting-edge treatments to thousands of patients in the region suffering from the potentially deadly disease.

For the first time since the hospital system’s Niagara Thrombosis Service began in 2015, the clinic’s director, Dr. Blair Leonard, said his team and patients are participating in four clinical research studies, offering cutting-edge medications and treatments they would have previously had to leave the region to access.

“For thrombosis, which is my area, this is obviously a first,” said Leonard, Niagara Health’s regional physician lead for benign hematology and thrombosis.

Although he said the clinic has been involved in smaller clinical trials in conjunction with Hamilton Health Sciences while other hospital programs have been involved in clinical trials for several years, this is the first time the local clinic is doing so on its own.

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And it’s starting out with four clinical trials running concurrently, with funding from Ottawa Hospital Research Institute.

The research includes two studies called ANTHOS trials, investigating promising “and very new” blood thinner medications that are not yet available “to anyone” other than patients participating in the trial.

“The fact that we have those trials here means our patients will have access to those medications,” Leonard said.

The clinic is also participating in the SAVER trial, to determine if cholesterol-lowering medications called statins can help prevent the development of potential deadly blood clots in veins, and a study called the TRIM-line trial looking at the viability of strategies to prevent blood clots in patients using peripherally inserted central catheters.

 

While those studies will be conducted concurrently in the next up to three years, he said a fifth study is expected to begin in the fall looking at treatments for patients with post-thrombotic syndrome — the ongoing symptoms of blood clots.

“We’ll have more trials that will come in the interim,” he said. “As new trial group, we are very interested in bringing whatever cutting edge research we can to Niagara.”

He said as many as about 15 people will be recruited for each of the studies from among patients who are being treated at the clinic, in addition to thousands of other patients participating at other clinics across the country.

Although typically half the patients in clinical trials are given a placebo, Leonard said that can change depending on early results of the study.

He said researchers “periodically review the data as it comes in, and if it’s quite clear that this (the medication) is a game-changer, they basically stop the trial” and provide the medication to all participants.

“We’ve tried to refine the way we do trials to be as ethical as possible, so periodically they’ll review the data as it comes in and if it’s clear that something is far superior then it’s not ethically right to take the trial to the end and deny people potentially life-saving or life-altering medication.”

Leonard said the Niagara Thrombosis Service clinic was launched primarily to allow Niagara residents to receive the care they needed within the region, while offering “the level of expertise you could get at any top institution.”

“The whole idea of creating the service was so these people wouldn’t have to leave the region for that level of specialty care, and we can take care of our own as best as possible,” he said. “We brought our standard up to the leading edge, at least cross Canada if not the world.”

However, being involved in research programs “was all part of the grand plan, since we launched many years ago,” Leonard added.

By recruiting additional specialists and increasing capacity at the clinic that currently has about 5,000 patients, he said it also made the clinic a viable location for research studies.

“Once you build that capacity, the research starts coming because people realize that there are a lot of patients here, and experts here that have an interest in research,” he said.

“That wouldn’t have happened if we didn’t build the service to allow us to see all those patients to begin with.”

Leonard said he reached contacted research institutions in Hamilton and Ottawa, offering to participate in any upcoming research projects “to offer our patients the newest potential therapeutics.”

“They were quite happy to have us involved, since we have so many patients,” he said.

 

Leonard said about 50,000 people each year experience a blood clot, while Statistics Canada listed cerebrovascular diseases that includes thrombosis as the sixth leading cause of death in the country, with 13,695 deaths reported in Canada in 2020 from the condition.

 

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Indian man is world’s first person to contract plant fungus infection – WION

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A 61-year-old Indian man from eastern Kolkata city became the first in the world to catch an infection from a plant fungus.

Doctors claimed that this is the first case of human infection by the microorganism, saying that it demonstrates the crossover of plant pathogen into humans when working in close contact with plant fungi.

The man, who worked as a plant mycologist and whose identity has not been revealed, had gone to Apollo Multispeciality Hospitals after complaining of hoarse voice, cough, fatigue, and difficulty in swallowing and anorexia for three months, according to journal Medical Mycology Case Reports.

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While undergoing medical check-up, the CT-scan of his neck revealed that the man had a paratracheal abscess.

His pus samples were then sent for testing to the WHO Collaborating Centre for Reference & Research on Fungi of Medical Importance.

It was later found that he had been infected with Chondrostereum purpureum – the same fungus that causes silver leaf disease in plants.

“Chondrostereum purpureum is a plant fungus that causes silver leaf disease in plants, particularly those in the rose family. This is the first instance of a plant fungus causing disease in a human. Conventional techniques (microscopy and culture) failed to identify the fungus,” the report added.

“Only through sequencing could the identity of this unusual pathogen be revealed. This case highlights the potential of environmental plant fungi to cause disease in humans and stresses the importance of molecular techniques to identify the causative fungal species,” it said.

The infection has alarmed health experts as it defied their understanding of the possibility of plant fungus infecting human beings. 

Notably, the case resembles the events occurring in the hit show ‘The Last of Us’ – which is itself inspired by a real-life bacteria that turns ants into ‘zombies’ and can wipe out entire colonies.

In this case, it is said that the 61-year-old made a full recovery after receiving two antifungal medications for two months.

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Heads up – wood ticks are out and about in the Thompson-Okanagan – Vernon News – Castanet.net

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Tick season is back in the Okanagan.

Colin Kennedy came across one of the blood-suckers while taking a walk with his dog.

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Kennedy was on the Test of Humanity Trail in Summerland last week and came home with an unwanted passenger – a wood tick.

“I just thought it would be good to report it so people start checking their dogs for ticks now that the weather is getting better,” Kennedy says.

Kennedy also reported the tick to eTick.

Anyone who has lived in the B.C. Interior for any length of time has likely had an encounter with a tick or knows someone who has.

They can be found year round, but are most likely to bite from March to June.

Ticks will lie in wait on a branch or tall grass, waiting for an unsuspecting person or animal to brush by. They then latch onto their victim and bury their heads under the skin.

Staying out of the woods is no guarantee you won’t encounter ticks.

Rob Higgins, an entomologist with the department of biological sciences at Thompson Rivers University in Kamloops, says the most common area to find ticks is on grasslands, but they can be found in urban environments as well.

“You can definitely pick them up in town, even when you think you’re walking in urban areas, because you’re brushing up against grasses on the side of the sidewalks,” he said.

If a tick has bitten you, Higgins says the best way to remove it is to take a pair of forceps or tweezers, slide them under the tick and pull backwards firmly – but not abruptly.

It will often take about 30 seconds of firm pressure to pull the tick out.

The variety most often found in B.C. is the Rocky Mountain wood tick.

Western black legged ticks, a species which Higgins said exists in low numbers in B.C., can carry Lyme disease. Each year, there are around a dozen Lyme cases discovered in the province, but about half those originate from outside the region.

Ticks can also carry other diseases, such as tick paralysis. According to Higgins, this disease mostly affects animals and he said vets and ranchers see cases each year.

Overall, it’s important to be careful, but most ticks in B.C. aren’t harmful.

“People don’t like ticks, fortunately here we don’t need to worry about them a great deal,” he said.

“You definitely want to remove them, you want to keep your eyes on your pets for symptoms of paralysis, but otherwise, we can consider the vast majority of them to be harmless.”

Have you had a close encounter of the insect kind? Email us a picture and we may feature it as Castanet’s Bug of the Week.

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'Pandora's Box': Doctors Warn of Rising Plant Fungus Infections in People After 'First of Its Kind' Case – VICE

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A man in India is the first human known to be infected by a fungus called Chondrostereum purpureum, a pathogen that is most well-known for causing a disease called silver leaf in plants, reports a new study. 

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The patient, who was 61 at the time of the diagnosis, made a full recovery and has not experienced any recurrence of the infection after two years of follow-up observations. However, this “first of its kind” case study exemplifies the risks that fungal pathogens pose for humans, especially now that climate change and other human activities like rampant urbanization, have opened a “Pandora’s Box for newer fungal diseases” by contributing to their spread, according to the study. 

Fungal pathogens are having a pop culture moment because they are the source of a fictional disease depicted in apocalyptic game The Last of Us, which was recently adapted into the acclaimed HBO series of the same name. But these microbes are also a real-life scourge that infect about 150 million people every year, resulting in about 1.7 million deaths. 

Though millions of fungal species exist, only a very small fraction of them are able to infect animals, including humans, because our bodies present challenges to these invaders such as high temperatures and sophisticated immune systems. 

Soma Dutta and Ujjwayini Ray, doctors at Apollo Multispecialty Hospitals in Kolkata, India, have now added one more fungus to that small list of human invaders with their unprecedented report of a C. purpureum infection. The patient, a plant mycologist, had suffered from cough, fatigue, anorexia, and a throat abscess for months before his hospital visit, and was probably exposed to the fungus as a result of his profession. 

When conventional techniques failed to diagnose the disease, the pathogen was sent to a World Health Organization center based in India where it was finally identified using DNA sequencing. The case “highlights the potential of environmental plant fungi to cause disease in humans and stresses the importance of molecular techniques to identify the causative fungal species,” according to their recent study in the journal Medical Mycology Case Reports

“This is a first of its kind of a case wherein this plant fungus caused disease in a human,” Dutta and Ray said in the study. “This case report demonstrates the crossover of plant pathogens into humans when working in close contact with plant fungi. The cross-kingdom pathogenicity demands much work to be done in order to explore insights of the mechanisms involved, thus leading to possible recommendations to control and contain these infections.”

C. purpureum can infect a variety of different plants with silver leaf disease, an often fatal condition that is named after the color that the pathogen induces on the leaves on the hosts. It is the latest in a growing number of fungal pathogens that have infected humans, which are buoyed on in part by human activities, such as urbanization, travel, and commerce. 

Human-driven climate change is also accelerating the spread of infectious diseases, including fungal pathogens, by allowing microbes to adapt to higher temperatures (like those in mammal bodies), expand their range, and interact with new hosts in the aftermath of extreme weather events. And though fungal diseases have maintained a lower profile in epidemiology compared to other pathogens, they may be more dangerous than viruses or bacteria in some contexts.

“While viral and bacterial diseases receive most attention as the potential cause of plagues and pandemics, fungi can arguably pose equal or even greater threats,” according to a 2021 study in PLoS Pathogens. “There are no vaccines available yet for fungal pathogens, the arsenal of antifungal agents is extremely limited, and fungi can live saprotrophically, producing large quantities of infectious spores and do not require host-to-host contact to establish infection. Indeed, fungi seem to be uniquely capable of causing complete host extinction.”

In addition to avoiding the spread of new fungal pathogens that can directly infect humans, researchers also point to the damage these diseases can deal to crops and ecosystems that people depend on. For this reason, Dutta and Ray recommend more research into the nature of these infections and strategies to mitigate their spread.

“Cross-kingdom human pathogens, and their potential plant reservoirs, have important implications for the emergence of infectious diseases,” Dutta and Ray said. “Fungi are also responsible for various infections in plants that cause destruction of millions of plants and crops” and “produce toxins that contaminate food and cause acute toxicity.”

“Over the past several decades multiple new pathogenic fungi have emerged,” they concluded. “A notable emergence of the multidrug resistant fungus Candida auris has spread all over the world and has become a significant threat. The worsening of global warming and other civilization activities opens Pandora’s Box for newer fungal diseases.”

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