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Researchers

The Department of Medicine has a long and distinguished record of basic, translational, and patient-oriented research in a wide range of fields and our members have an excellent track record of publication and peer-reviewed funding. Much of our research takes place in multidisciplinary centers affiliated with the Department and many of our research faculty are nationally distinguished leaders in their fields of study.

Wendy Cook, MD, MHSc, FRCPC
Clinical Instructor, Geriatric Medicine, UBC
Director, Fall Clinic, St. Paul's Hospital
St. Paul's Hospital Foundation Physician Scholar

Research Interests:
• Falls and functional status in older adults on dialysis.
• Fall prevention among community -dwelling seniors
• The use of performance measure to assess mobility impairment in older adults.

Peter Dodek M.D., M.H.Sc, FRCPC
Professor of Medicine, UBC
Center for Health Evaluation and Outcome Sciences

Research in Progress:
PI (Najib Ayas is co-PI)--ICU Patient Safety Team--funded by MSFHR--to develop standard measures for patient safety processes and outcomes in ICU, to study the relationship between organizational/safety culture in the ICU and patient safety outcomes, to develop measures of medication safety in the ICU, to study the relationship between worker hours and patient safety outcomes in the ICU, to participate in the B.C.Patient Safety and Learning System (incident reporting system) from the ICU perspective.

PI--Relationship between Organizational Culture and Family Satisfaction in the ICU--funded by CIHR--to examine the independent association between domains of organizational culture and survey-measured family satisfaction in the ICU (23 sites from B.C. and across Canada participating).

Co-investigator--PROTECT (a randomized clinical trial to compare unfractionated heparin and low molecular weight heparin in the prevention of venous thromboembolic disease in critically ill patients)-multicenter international study funded by CIHR

Co-investigator--NICE-SUGAR (a randomized clinical trial to compare 'tight' versus conventional glucose control in the ICU)--multicenter international study that will be the largest clinical trial ever done in critically ill patients funded by CIHR

Site investigator--REDOXS (a multicenter randomized clinical trial to examine the effects of glutamine and anti-oxidants versus placebo as part of nutrition in critically ill patients, funded by CIHR)

Site investigator--SLEAP (a multicenter randomized clinical trial to compare use of a sedation algorithm to sedation algorithm plus daily interruption of sedation in critically ill patients, funded by CIHR)

Co-investigator--AFIB (a multicenter pilot randomized clinical trial to compare rate control alone to rate control plus rhythm control for new onset, hemodynamically stable atrial fibrillation in the ICU, funded by HSFC)

Co-investigator--ABATE-VAP (a multicenter observational study to examine the effect of opinion leaders and reminders in the implementation of clinical practice guidelines for the prevention, diagnosis, and treatment of ventilator-associated pneumonia, funded by CIHR)

Site investigator--CANHELP (a multicenter observational study to examine patient and provider satisfaction with care near the end of life, funded by CIHR)

Dr. Dodek is also involved in a number of local projects including, examination of sex differences in admission rate to ICUs in B.C., seasonal variation in incidence of severe community acquired pneumonia, associations between organizational factors and outcomes for critically ill patients in B.C. (funded by MSFHR).

Gordon A. Francis MD, FRCPC
Professor of Medicine
Director, Heart and Stroke Foundation Lipid Research Laboratory
Director, Healthy Heart Program Prevention Clinic
University of British Columbia

Dr. Francis studies the mechanisms of formation of high-density lipoproteins (HDL) at the cellular and in vivo level, with the aim to develop therapies that increase HDL formation for the treatment and prevention of vascular disease.

Projects in his laboratory include:

Understanding the mechanism of enhancement of formation of HDL following treatment of cells and whole animals with HDL oxidized by tyrosyl radical (tyrosylated HDL). Short peptide fragments of HDL proteins oxidized by tyrosyl radical that increase HDL formation are being studied as potential therapies to increase HDL formation clinically.

Determining the cellular factors required for initial HDL production by arterial smooth muscle cells. Smooth muscle cells in the plaque or intimal layer of arteries fail to bind HDL proteins and generate new HDL proteins, while smooth muscle cells in the medial or muscular layer of arteries make HDL efficiently. The differences in gene and protein expression by these two cell types serve as a model to determine the requirements of cells to generate HDL.

Patients with lysosomal cholesterol storage diseases exhibit low levels of HDL. The Francis lab is using cells obtained from patients with lysosomal cholesterol storage diseases Niemann-Pick type C disease and Cholesteryl Ester Storage Disease to study the role of lysosomal cholesterol in regulating HDL production.

Dr. Francis is also involved in clinical studies of the effects of LDL apheresis on biochemical and radiologic measures of atherosclerosis and on quality of life.

The Francis lab is funded by research grants from CIHR, CFI, the Heart and Stroke Foundation of BC and Yukon.

 

Rose Hatala, MD, FRCPC
Clinical Associate Professor
Division of General Internal Medicine

Research in Progress:
Dr. Hatala is working on a number of medical education research projects with an emphasis on the assessment of students.

 

Thomas Kerr, PhD
Assistant Professor
Division of AIDS


Thomas Kerr is a Research Scientist with the BC Centre for Excellence in HIV/AIDS and an Assistant Professor in the Department of Medicine at the University of British Columbia, as well as a Michael Smith Foundation for Health Research Scholar. In his role at the BC Centre for Excellence in HIV/AIDS, Thomas is a principal investigator of several large cohort studies involving people who inject drugs and individuals living with HIV/AIDS, including the Vancouver Injection Drug Users Study (VIDUS). Thomas’ primary research interests are HIV/AIDS, injection drug use, health policy and service evaluation, and community-based research methods.

A key focus of Thomas’ work has been the scientific evaluation of Insite, North America’s first safer injecting facility, and his research in this area has contributed significantly to academic, public, and government discussion, both nationally and internationally. Thomas has published extensively in various medical and public health journals. Thomas has published 150 scientific papers in international peer-reviewed journals and has received local and national awards for his contribution to public health, including the National Knowledge Translation Award from the Canadian Institutes of Health Research for his efforts to promote scientific discussion in illicit drug policy. Thomas has also maintained a longstanding working partnership with the Vancouver Area Network of Drug Users (VANDU).

 

Phillip Lee, MD, FRCPC
Assistant Professor, Geriatric Medicine
St. Paul’s Hospital Foundation Physician Scholar

As part of the Vancouver Initiative To Add Life To Years (VITALiTY) group, I am currently working on a project that explores the role that cognitive impairment plays as a risk factor for catastrophic disability. As part of this study, we will also look at the role that inflammatory mediators play in thedevelopment of delirium during hospitalization in older adults.

Other projects include looking at different aspects of the diagnosis and treatment for Alzheimer's disease and related disorders. We are developing a new clinical measurement tool for dementia.Someprojects focus on the efficacy and safety of new treatments for the condition, while other projects assessaspects of treatmentusing currently approved medications for Alzheimer's disease.We are alsolooking at theclinicopathological effects of the presence of TDP-43 in different forms of dementia.

 

Anita Palepu, MD, MPH, FRCPC
Professor of Medicine, Division of Internal Medicine, UBC
Research Scientist, CHÉOS
Michael Smith Foundation for Health Research Senior Scholar

Research Interests:
• Urban Health
• Addiction treatment
• HIV/AIDS
• Housing and homelessness
• Quality of life

Dr. Anita Palepu is a Full Professor, Division of Internal Medicine, UBC and a conducts her research at the Centre for Health Evaluation and Outcome Sciences (CHÉOS ) and has many collaborations with her colleagues at the BC Centre for Excellence in HIV/AIDS. Her research program falls under the broad umbrella of urban health research with particular interest in vulnerable populations such as drug users, HIV-infected persons, and homeless persons. She also is part of a network of Canadian researchers examining issues pertaining to housing, homelessness and health and is the Vancouver site PI for the Health and Housing in Transition Study, which is a 2008 CIHR-funded, four-year longitudinal study of 400 homeless and vulnerably housed persons being conducted in Vancouver, Toronto and Ottawa. In 2004, she assumed co-directorship of the UBC Department of Medicine Clinical Investigator Program and was awarded a Michael Smith Foundation for Health Research Senior Scholar.

As an Internal Medicine specialist at St. Paul's Hospital, Dr. Palepu is active in teaching residents and medical students in both the inpatient and clinic setting. She has been actively involved with the launch of an independent, open access general medical journal Open Medicine and is the Co-editor. She is also the President of the International Society of Urban Health and the Organizing Chair of the 7th International Conference on Urban Health scheduled for Oct 29-31 in Vancouver, BC.

Awards, Fellowships
2006 Boston University School of Public Health Distinguished Alumni

Related websites
Faculty of Medicine, UBC
Open Medicine http://www.openmedicine.ca
International Conference of Urban Health 2008 http://www.icuh2008.com

 

James A. Russell, MD, FRCPC
Professor, Medicine
Division of Critical Care Medicine

Research Summary

The two major current themes of my research are (1) the genetics of the systemic inflammatory response syndrome (SIRS) and sepsis and (2) randomized controlled trials in the critically ill.

1. Genomics of Critical Care and Sepsis

We are doing studies in the critically ill of SNP’s and haplotypes of key coagulation, inflammatory and innate immunity genes. We focused initially on refining the clinical phenotypes of organ dysfunction in the critically ill. We are doing gene association studies of candidate genes in: (1) critically ill ICU patients who have SIRS, sepsis, and septic shock and (2) cardiovascular surgery patients.

I have been Co-investigator of a CIHR gene environment grant to study haplotypes of susceptibility genes in cardiac, pulmonary and vascular disease ($2,756,473 over 5 years). I have had peer-review grant funded studies of the association of genotype with phenotype in SIRS in the critically ill, SIRS after cardiopulmonary bypass (Co- PI of a grant from CIHR), in ARDS (grants from BC Lung Association and Providence Health Care) and in acute lung injury (funded by NIH SCCOR/University of Washington contract).

Our main findings to date are focused on key coagulation, innate immunity and inflammatory genes. We have found significant relationships of genetic markers (specific haplotypes and single nucleotide polymorphisms (SNPs)) of protein C, IL-6, IL-10 and fibrinogen with increased risk of death (protein C: peer-reviewed references # 122 & 133. IL-6: reference # 108; IL-10: reference # 112; fibrinogen reference: # 124). In contrast, genetic variants of key innate immune genes CD14, MBL, TLR-2 and TLR-1 are associated with increased risk of severe infections (sepsis) (CD14, MBL, TLR-2: reference # 110; TLR-1 reference # 135).

2. Clinical Trials in the Critically Il

I have an active clinical trials program in critical care. I have previously shown that therapies such as prostaglandin E1 increase oxygen delivery but do not decrease mortality in ARDS and that sodium bicarbonate (compared to hypertonic saline) does not improve oxygen delivery in critically ill patients who have lactic acidosis. We have led clinical trials of vasopressin in septic shock, ibuprofen in sepsis (NIH grant-funded), antioxidants in ARDS and in sepsis, interleukin-1 receptor antagonist in sepsis, endotracheal tobramycin in pneumonia, anti-tumor necrosis factor in sepsis, interleukin-10 in ARDS, tissue factor pathway inhibitor, and activated protein C in sepsis.

We have published literature reviews, retrospective, prospective and animal model studies of vasopressin for septic shock. I have been Principal Investigator of a CIHR-funded multicentre, randomized controlled trial of vasopressin vs. norepinephrine in septic shock (VASST) published in the New England Journal of Medicine (Russell JA, Walley KR, Singer J, Gordon AC, Hébert PC, Cooper DJ, Holmes CL, Mehta S, Granton JT, Storms MM, Cook DJ, Presneill JJ, Ayers D for the VASST investigators. Vasopressin versus norepinephrine infusion in patients with septic shock. N Engl J Med 2008; 358: 877 – 887). Mortality rates were similar in the vasopressin and norepinephrine groups at 28 days
(35.4% and 39.3% respectively, P=0.26), and at 90 days (43.9% and 49.6% respectively, P=0.11). Serious adverse event rates were similar in both treatment groups. In the prospectively defined stratum of less severe septic shock, mortality was lower in the vasopressin group at 28 days (26.5% vs. 35.7%, P=0.05; absolute difference 9.2%, 95% confidence interval, -0.1 to 18.5) and at 90 days (35.8% vs. 46.1%, P=0.04; absolute difference 10.4%, 95% confidence interval, 0.4 to 18.5). Our conclusions are that low dose vasopressin in addition to conventional catecholamines appears comparable in efficacy and safety to
norepinephrine in septic shock. Low dose vasopressin may be more effective than norepinephrine alone in less severe septic shock. The VASST study is cited in the 2008 international sepsis treatment guidelines.

I also have had a research contract as the only Canadian centre in the NIH/NHLBI - funded clinical network for the treatment of ARDS (ARDSnet). We participated in a clinical trial of the pulmonary artery catheter and liberal vs. conservative fluid regimens in acute lung injury (references # 120, 121).

The clinical research success in sepsis is recognized in an invited review in the New England Journal of Medicine (Russell JA. Management of sepsis. N Engl J Med 2006; 355 (16): 699 – 713.)

 

Andy Sandford, B.Sc. (Hons), PhD
Associate Professor, Respiratory Medicine

University of British Columbia


Dr. Sandford earned his B.Sc. in biological sciences from the University of Leicester, England in 1988 and a Ph.D. studying the genetic basis of allergic diseases such as asthma at the University of Oxford, England in 1993. He continues to research the genetic basis of asthma and has extended his studies to include the genetic basis to chronic obstructive pulmonary disease and the genetic basis of pulmonary disease severity in cystic fibrosis. Dr. Sandford currently holds a Tier 2 Canada Research Chair and a Michael Smith Foundation for Health Research Senior Scholar Award. The focus of Dr. Sandford’s research is investigation of the genetic basis of obstructive lung disease. He is currently studying three large cohorts of individuals. The first cohort was recruited by Drs. Moira Chan-Yeung from UBC and Allan Becker from the University of Manitoba. This cohort contains infants at high risk for developing allergic diseases and is being used to evaluate the importance of genetic risk factors for the development of these diseases. The second cohort was recruited as part of the NHLBI Lung Health Study and contains individuals whose lung function has been followed for five years. Genetic factors that affect the rate of decline of lung function are being investigated in this cohort. This work is a collaboration with Drs. John Connett from the University of Minnesota and Nicholas Anthonisen from the University of Manitoba. The third cohort consists of cystic fibrosis patients and their relatives that are being recruited in a collaborative study with investigators at Toronto’s Hospital for Sick Children. This is a multi-center study to study modifier genes in cystic fibrosis and involves investigators and physicians from around Canada.

Education / Training:
University of Leicester, England B.Sc. (Hons) Biological Sciences 1985-1988
University of Oxford, England PhD Linkage analysis of atopy 1990-1993

Recent Publications:
He J-Q, Burkett K, Connett JE, Anthonisen NR, Paré PD, Sandford AJ. Interferon gamma polymorphisms and their interaction with smoking are associated with lung function. Hum. Genet. 2006;119:365-375.
McKone EF, Shao J, Frangolias DD, Keener CL, Shephard CA, Farin FM, Pare PD, Sandford AJ, Aitken ML, Kavanagh TJ. Variants in the glutamate-cysteine-ligase gene are associated with cystic fibrosis lung disease. Am. J. Respir. Crit. Care Med. 2006; 174:415-419.
Tremblay K, Lemire M, Provost V, Pastinen T, Renaud Y, Sandford AJ, Laviolette M, Hudson TJ, Laprise C. Association study between the CX3CR1 gene and asthma. Genes Immun. 2006;7:632-639.
Zhang X, Mahmudi-Azer S, Connett JE, Anthonisen NR, He J-Q, Paré PD, Sandford AJ. Association of Hck genetic polymorphisms with gene expression and COPD. Hum. Genet. 2007;120:681-690.
He J-Q, Shumansky K, Zhang X, Connett JE, Anthonisen NR, Sandford AJ. Polymorphisms of interleukin-10 and its receptor and lung function in COPD. Eur. Respir. J. 2007;29:1120-1126.
Dorfman R, Sandford A, Taylor C, Huang B, Frangolias D, Wang Y, Sang R, Pereira L, Sun L, Berthiaume Y, Tsui L-C, Paré PD, Durie P, Corey M, Zielenski J. Complex two-gene modulation of lung disease severity in children with cystic fibrosis. J. Clin. Invest. 2008 118:1040-1049.

 

Don Sin, MD, FRCPC
Associate Professor, Respiratory Medicine
University of British Columbia
The James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research

Research:
Briefly, over the past 5 years, he has pursued two major themes in research: 1) systemic inflammation and its potential impact on the health outcomes of patients with chronic obstructive pulmonary disease (COPD) ; and 2) more recently, the growing health burden of COPD in women in Canada . His team's major findings to date are that: 1) systemic inflammation is present in COPD patients ( Thorax 2004), independently of cigarette smoking ( Chest 2005); 2) the intensity of the inflammatory process (especially serum C-reactive protein, CRP) is related to the severity of the underlying airflow obstruction (Circulation 2003) and related to the severity of the inflammation in the small airways ( Eur Resp J 2006); 3) systemic inflammation is related to future morbidity and mortality of COPD patients (Thorax 2006) and to cardiovascular complications and lung cancer (Circulation 2003; Chest 2005); 4) serum CRP is related to progression of dysplastic (precancerous) lesions in the airways ( Am J Resp Crit Care Med 2005); and systemic inflammation may be modulated by the use of inhaled corticosteroids (ICS) ( Am J Resp Crit Care Med 2004). They have also shown that ICS attenuates lung inflammation ( BMC Pulmonary 2005), reduces all-cause mortality ( Thorax 2005) and improves health status in COPD ( JAMA 2004).

Over the next five years, his research program will build upon these observations to address some major gaps in knowledge. The over-arching hypothesis of the program will be that women are more susceptible to COPD and lung cancer and that lung and systemic inflammation will be in large measure responsible for this excess risk . Additionally, He will collaborate with Drs. Paul Man, Peter Paré, Andy Sandford, Jim Hogg, Stephan Van Eeden and Harvey Coxson (all iCAPTURE and UBC Investigators) and Stephen Lam and Annette McWilliams (UBC investigators) to identify the precise components of inflammation responsible for the excess risk with the aim of developing novel therapeutic compounds to attenuate inflammation and improve health outcomes of COPD patients, especially in women.

 

Stephanus (Stephan) F. van Eeden MD, PhD, FRCPC(C)
Professor, Department of Medicine,
University of British Columbia
The James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research
St. Paul's Hospital, Burrard Building,
Room 166 - 1081 Burrard Street, Vancouver, B.C. V6Z 1Y6
Phone: (604) 806-8346 (ext 63142)
Fax: (604) 806-9274
E-mail: svaneeden@mrl.ubc.ca


Dr Stephan van Eeden is an Internist at St Paul's Hospital and Professor with the faculty of Medicine attached to the Division of Internal Medicine & Respirology. He graduated from the University of Stellenbosch, Cape Town, South Africa in 1975, and after four years as a family practitioner resumed his studies in Internal Medicine at the same University. He trained and certified in Pulmonology and Critical Care in 1985 and was promoted to Director of Critical Care, Tygerberg Hospital, University of Stellenbosch in 1989. He did his PhD in the Department of Experimental Medicine, University of British Columbia with DR James C Hogg as his supervisor. He graduated in 1995 and completed his Canadian specialist examination (FRCPC) in 1996. He is currently Director of the COPD Chronic Disease Management Program at PHC.


Research Activities:
The focus of his research efforts are the mechanisms of lung inflammation, particularly, lung inflammation caused by infection, cigarette smoking and air pollution. This research covers a broad range of clinical conditions such as pneumonia, chronic bronchitis, emphysema and acute respiratory distress syndrome. Current research addresses the response of the bone marrow during acute and chronic lung inflammation. He has shown that white cells released from the bone marrow play a crucial role in the lung inflammation elicited by cigarette smoke and particulate air pollution. This research has lead to the novel hypothesis that white cells released from the bone marrow are responsible for the increase in heart and lung disease and deaths in subjects exposed to high levels of air pollution. This research has given him international recognition as an expert on the bone marrow response during inflammation and the response of the heart and lung to air pollution. It has led to several landmark publications including in 2002 his group was the first to show that air pollution causes the development and progression of atherosclerosis, the underlying disease in vessels responsible for stroke and heart attacks. He recently (2008) showed that pro-inflammatory mediators generated in the lung are responsible for the downstream adverse cardiovascular health effects of exposure to air pollution.


Dr van Eeden spends the majority of his time (~50%) in the James Hogg Research Laboratory & iCAPTURE Center, St Paul's Hospital. His research has resulted in 93 peer-review publications, numerous abstracts and presentations at national and international meetings. He is the recipient of the Martin F Hoffman Award for Excellence in Research and the Department of Medicine Faculty Research award, St Paul's Foundation and CIHR research fellowship. He is also a Career Investigator of the American Lung Association, Senior Scholar of the Michael Smith Foundation for Health Research and the recipient of the Thurlbeck Distinguish Research Award.
His work has been strongly influenced by long-standing collaborations with many scientists including Drs. James C Hogg, Claire Doerschuk, Blair AM Walker, Scott Simon, Renaud Vincent and George Agnes and the national levels and numerous other scientist on international level as well as interactions with numerous research fellows and students.

 

Evan Wood, M.D. PhD
Clinical Associate Professor, AIDS

Evan Wood, M.D. PhD (Principal Investigator) is a Clinical Associate Professor in the Department of Medicine at the University of British Columbia and is a Research Scientist at the British Columbia Centre for Excellence in HIV/AIDS, where he is responsible for a range of nationally and internationally funded research projects related to injection drug use and HIV/AIDS. He has extensive research experience in the area of clinical epidemiology, especially in evaluating the treatment of HIV/AIDS, addiction, and epidemiologic study design, particularly among injection drug using populations. Dr. Wood has published over 170 scientific papers in international peer-reviewed journals, including over 35 studies specific to SIFs, and has given over 200 scholarly presentations. He is the Associate Editor of the International Journal of Drug Policy and serves on the Editorial Boards of a range of scientific journals. Dr. Wood has received a range of national and international recognitions for his contributions to research including being awarded the Canadian Medical Associations 2007 award for young leaders.

 

Hematology Research Group
The Hematology Research group at St. Paul’s Hospital investigates a broad range of blood conditions including both benign and malignant disorders of blood proteins and blood cells. Areas of research include: Myelodysplastic Syndromes, Acute Myeloid Leukemia, Chronic Myeloid Leukemia, Chronic Lymphocytic Leukemia, Idiopathic Thrombocytopenic Purpura, Lymphoma in HIV patients, Hemophilia and Thrombosis. The group was pioneered and founded by Dr. Linda Vickars and is currently directed by Dr. Heather Leitch. The group entails seven hematologists all acting as investigators and two research study staff. The research staff brings a wide range of experience, both local and international, to the group, which include employment in industry, as well as clinical research with other groups.