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An international study led by Sunnybrook researchers has found vaginal birth is just as safe as C-section when it comes to twins. The result could reverse birthing trends around the world.

"The perception is that C-section may be safer for the baby, but our Twin Birth Study has proved this is not true. The evidence is clear that C-section for twins is not the best plan," says Dr. Jon Barrett, chief of Sunnybrook's Maternal Fetal Medicine and the study's lead investigator. "Women expecting twins should be encouraged to plan for a vaginal birth, provided that an obstetrician, experienced in twin vaginal births, will be available at delivery."

The debate about the best method of delivering twins has been controversial, with planned C-section gaining support in recent years. However, the Twin Birth Study – after nine years of research – found no significant difference in outcome between natural birth and C-section.

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Twins have a significantly higher risk of complications around the time of labour than single babies, and the number of twin births has increased by at least 40 per cent over the last decade due to in vitro fertilization, Dr. Barrett says. "We hope the results from our study will change dramatically the way twins are delivered worldwide. It will hopefully reverse the trend and prompt the need for more training for vaginal births."


Doctors could soon be prescribing bike rides to bipolar disorder patients.

That's because early findings from a Sunnybrook study suggest aerobic exercise benefits cognitive function, which could lead to important therapy for these patients.

Dr. Benjamin Goldstein, director of Sunnybrook's Centre for Youth Bipolar Disorder, says exercise has the potential to become an important part of treatment for bipolar patients. He cites a growing body of research which demonstrates exercise helps improve mood and brain function.

Dr. Goldstein is teaming up with Dr. Brad MacIntosh, an expert in brain imaging in Sunnybrook's Heart & Stroke Foundation Centre for Stroke Recovery. So far, 15 teenagers with bipolar disorder have participated in the full-day study, which sandwiches a 30-minute bout of stationary cycling between two sessions in an MRI scanner. During the scanning sessions, participants complete a test of attention span, and MRI images are collected to determine how the brain is functioning. It appears activity in specific brain regions is reduced following exercise. Drs. Goldstein and MacIntosh believe aerobic exercise may lead to greater brain efficiency, allowing the teens to maintain their accuracy on the test with less brain effort.

"The more biological evidence we have that exercise does positive things for the brain and the body in these situations would make suggestions to exercise come across as more serious," says Dr. Goldstein.

He says a simultaneous focus on brain and body is key to better understanding bipolar disorder and identifying new treatment strategies.

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Imagine knowing what time of day you're most likely to die. It sounds creepy, but the information might actually help keep the Grim Reaper at bay.

"If we know when a person is likeliest to die, we can act to prevent this by administering medical treatments at more optimal times and better monitor vulnerable patient populations," says Dr. Andrew Lim, a Sunnybrook neurologist and lead author of a recent study that discovered a gene associated with one's likeliest time of death, as well as with the timing of one's sleep-wake cycle.

Researchers measured sleep/wake and activity rhythms in older individuals and obtained their DNA. They looked for common gene variants that might play a role in the internal biological clock. "This is exciting because it is the first gene variant shown to influence the timing of directly-recorded human sleep and activity rhythms, as well as time of death," Dr. Lim says.

The findings came from research that set out 15 years ago to investigate risk factors for Alzheimer's disease. While Dr. Lim and fellow investigators were able to identify a broader period for time of death – for instance, late morning – they were not able to predict an exact time.

This content was produced by The Globe and Mail's advertising department, in consultation with Sunnybrook. The Globe's editorial department was not involved in its creation.

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