Thrombosis research gives patients access to ‘cutting edge’ care
Clinical trials getting underway in Niagara Health’s Thrombosis Service will give patients access to some of the newest treatments for preventing deadly blood clots.
Some of those trials include the ANTHOS trials, investigating promising novel blood thinners that aren’t yet available to patients and doctors elsewhere.
“You can go all over Canada and lots of places have never heard of these medications,” says Dr. Blair Leonard, Director of Niagara Thrombosis Service and Regional Physician Lead for Benign Hematology and Thrombosis. “That’s how cutting edge these are and this research is.”
It’s research that’s also vitally important for treating and managing a common yet serious condition that’s also preventable.
One in four people die from causes related to thrombosis, which is the formation of potentially deadly blood clots in the artery (arterial thrombosis) or the vein (venous thromboembolism or VTE). Once formed, a clot can slow or block normal blood flow. It can even break loose and travel to an organ, resulting in disability or death.
The Niagara Thrombosis Service is currently participating in four clinical trials whose findings will benefit patients around the world. The other studies include the SAVER Trial, a multi-centre investigation to determine if statins, a cholesterol-lowering medication, can help prevent VTE; and the TRIM-Line Trial, looking at strategies to prevent blood clots in patients using PICC lines.
With the groundwork being laid for a fifth study dealing with post-thrombotic syndrome (PTS), which is the ongoing symptoms of blood clots, Niagara Health has positioned itself as a leader in thrombosis research.
Proving Niagara Health’s research prowess
And it’s done so in a short time under the leadership of Dr. Leonard, who steered the launch of Niagara Health’s Thrombosis Service in 2015 to satisfy the need for focused thrombosis care in the region.
Previously, thrombosis patients were treated by generalists or had to travel outside Niagara for specialized care, and only if physicians and programs elsewhere elected to take them on. Today, Niagara Health’s Thrombosis Service has five dedicated thrombosis specialist physicians, including Dr. Leonard, who run two clinics every day at the St. Catharines Site, and provide 24/7 patient coverage across the region.
“The plan when we launched was to satisfy the tremendous clinical need, then branch into research and teaching,” Dr. Leonard says, adding the service took on its first resident last year.
Dr. Leonard began demonstrating Niagara Health’s prowess in thrombosis research in 2018 when he used retrospective data to investigate the use of warfarin, a common blood thinner, in patients with heart valves.
In 2021, he published preliminary results about VTE prophylaxis in outpatient oncology patients at the Walker Family Cancer Centre. Over the last three years, the thrombosis team participated in the COACHED clinical trial with McMaster University that looked at inpatient use of warfarin and the need for monitoring and adjusting dosing during the transfer of care back to family physicians.
That work set up Niagara Health for a significant grant from the Ottawa Hospital Research Institute (OHRI) to participate in larger, randomized patient trials, like those currently in the works, and expand the team to add Research Assistant Kailee Morrison.
“We started to get recognition as a place that had keen research interest and potential,” Dr. Leonard says. “The main thing is OHRI saw our desire to be involved in research and how innovative we were at attracting research with limited resources.”
Providing high-quality patient care
Morrison, who joined Niagara Health in January, helps with research ethics applications and works with Dr. Leonard to identify and recruit patients. She also provides training to study participants and does non-medical follow-up throughout trials. That includes regular patient check-ins, reviewing patient charts and keeping the lines of communication between participants and the research team open.
The trials vary in length from 90 days to three years, and retention can be a challenge for longer studies, she notes. The success of the trials depends on the ability to ethically recruit patients, however, with one study needing as many as 144 people.
Most participants will come from the Walker Family Cancer Centre because thrombosis is a common complication of chemotherapy, Morrison explains. But the hope is to work with departments throughout Niagara Health to recruit a wide variety of study candidates.
“For some of the trials, we won’t have patients walking into the (thrombosis) clinic,” she says. “We want them to not just send us patients but we want them to send us patients because the patient benefits from participating.
“Seeing people go through these and for the whole duration will be really rewarding.”
Ultimately, the goal is to continue expanding the breadth of thrombosis research at Niagara Health and with it, provide the highest quality, most up-to-date care to patients.
“Our research division brings cutting edge care to Niagara,” Dr. Leonard says. “When we launched the service, we expected to have a dramatic effect on improved treatment in VTE and PTS. We’ve done that and we wouldn’t have had that without the emphasis on research here from our humble beginnings.”
Respiratory Outbreak Over: Jasper Place – Thunder Bay District Health Unit
March 27, 2023 – The Thunder Bay District Health Unit (TBDHU) and The City of Thunder Bay – Jasper Place confirm that the respiratory outbreak at Jasper Place, located at 1200 Jasper Drive, has been declared over. All outbreak restrictions have been lifted.
TBDHU recommends the public refrain from visiting hospitals, long-term care facilities and other high risk settings when feeling unwell to avoid spreading infections to those most vulnerable and at higher risk of severe outcomes.
The Health Unit reminds the public that they can prevent getting and spreading infections by:
- Staying at home when sick. Wearing a well-fitted mask in indoor spaces, especially when around vulnerable people or when recovering from illness.
- Keeping up-to-date with influenza and COVID-19 vaccinations.
- Washing hands often, for at least 20 seconds with soap and warm water, or by using an alcohol-based hand sanitizer.
- Covering coughs/sneezes with the upper sleeve if no tissue is available.
- Being familiar with the Ontario screening tool, to self-assess and know what to do next.
For more information on current outbreaks, please visit the following link: https://www.tbdhu.com/outbreaks.
For more information – TBDHU Media: email@example.com
Diseases & Infections
COVID cold and flu assessment centre to close Friday
It’s the end of an era of the pandemic.
The COVID Cold and Flu Care Clinic at 400 Southgate Dr. is closing at the end of the week.
The location will take patients until the end of day Friday.
Guelph General Hospital said in a news release the closure is because of the steady few months of low volumes and stable COVID hospital admissions.
“The COVID, Cold, Flu Care Clinic played a significant role in meeting the needs of the community during the pandemic by providing community residents a much-needed alternative to the emergency department and primary care,” Guelph General Hospital president and CEO Marianne Walker said in a release.
“As care transitions back to community providers, I’d like to thank the over 100 team members from Guelph General Hospital, Guelph Family Health Team and other partner organizations for their valuable service during some very difficult times.”
The clinic opened in September 2020, after moving over from the Victoria Road Recreation Centre. The clinic also used to operate on Delhi Street.
The Southgate Drive location expanded last December to include treatment for cold and flu symptoms.
Anyone looking for COVID-19, cold and flu treatment are now asked to go to family doctors, walk-in clinics, pharmacies and clinics led by Guelph Family Health Team physicians and nurse practitioners.
Severe COVID cases should still go to the emergency department.
Wellington-Dufferin-Guelph Public Health said it will still offer COVID-19 and flu shots at its Chancellors Way building.
The hospital does caution that COVID-19 is still prevalent in the community, and to continue taking precautions if you’re not feeling well.
Whooping cough on the rise in southern Ontario
Several public health units in southwestern Ontario say they’ve seen a spike in cases of whooping cough and are urging residents to get vaccinated against the respiratory illness that can be particularly severe in young children.
Southwestern Public Health – which serves Oxford County, Elgin County and St. Thomas, Ont. – said it recorded 82 cases of whooping cough from January 2022 to the end of this February.
“This was 40 per cent of the provincial total from that time period,” Dr. Ninh Tran, medical officer of health for Southwestern Public Health, said in an interview.
“It’s a significant increase … that is certainly striking.”
Previous years have seen annual caseloads in the single digits, Tran said.
Whooping cough, or pertussis, can see a person’s cough intensify to the point where a “whooping” sound is heard when they try to catch their breath, Tran said.
Lower rates of immunization against whooping cough could be a factor in the rise in cases, he said.
“In our region, we have relatively lower rates of immunization compared to others,” Tran said.
“We’ve had a few cases that were hospitalized. That’s why we just really need folks to get up-to-date on their immunization.”
Huron Perth Public Health, which serves Stratford, Wingham, Listowel and Clinton, said it has confirmed at least 21 cases of whooping cough so far this year. In 2022, there were only three cases.
“The illness can be serious for infants younger than 12 months of age who are not vaccinated, or who have not received all doses of the pertussis vaccine,” Dr. Miriam Klassen, the medical officer of health for Huron Perth, wrote in a statement.
“Young children have the highest risk for severe complications, such as hospitalization and death, if they get sick.”
Klassen said the COVID-19 pandemic might have put residents of southern Ontario behind on routine immunizations, and urged residents to catch up on their vaccines.
The Windsor-Essex County Health Unit said there had been “a recent dramatic rise” in whooping cough cases in its region. It said last week that it counted 18 cases since November 2022.
“Cases have predominately been clustered in the Leamington and Kingsville communities, and exclusively in children who are unvaccinated or partially vaccinated,” it wrote in a statement, urging residents to get vaccinated.
The health unit noted that the cough brought on by pertussis can be so severe that it can cause vomiting. If left untreated in infants, young children and the elderly, it “can lead to complications such as pneumonia, dehydration, brain damage, hospitalization and death.”
Wellington-Dufferin-Guelph Public Health said it recorded 12 cases over the fall and winter, which is “higher than normal for the region.”
“Many individuals may be behind in their vaccinations because they were unable to get them due to COVID-19,” it wrote in a statement. “Now is the time to get fully vaccinated as we engage in more community activities.”
This report by The Canadian Press was first published March 27, 2023.
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