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The latest in leading-edge developments at Sunnybrook


Medical movies... on demand

Uninspired by the photos traditionally published in medical journals, Dr. Shelly Dev, critical care physician, had a better idea: create 'how-to' videos of commonly performed medical procedures, such as inserting IVs and breathing tubes.

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She pitched her multimedia vision to the editors of the highly respected New England Journal of Medicine three years ago, and they've never looked back. Now, the Journal and Dr. Dev's videos have become a whole new virtual world of learning for hundreds of thousands of medical students and practitioners, all at the click of a mouse. To learn more, click here.

Responding to H1N1

When the threat of the influenza A (H1N1) pandemic gripped the community last year, Dr. Andrew Simor, chief of Microbiology and Infectious Diseases, together with Dr. Henry Wong and Lisa Louie, had to respond quickly to increase the hospital's ability to detect the virus.

The team increased diagnostic capacity by testing for influenza A and B simultaneously in a single test using newer methods. This combined test doubled capacity and provided results in a matter of hours rather than days. They also used late-breaking genetic information on the H1N1 virus to enhance the U.S. Centers for Disease Control and Prevention's H1 subtyping test, making it able to detect much lower concentrations of the virus in patients' specimens. These efforts led to quick and more accurate results to support patient care in the event of increased infection. "To minimize the impact of infectious diseases on the health care system," says Dr. Simor, "we continue to provide accurate and rapid diagnosis and to lead in infection surveillance."

Targeted treatments for liver cancer

Patients are benefiting from the Odette Cancer Centre's innovative surgical and radiotherapy treatments. Lyn Burnett, who needed laparoscopic surgery to remove cancer on the liver, had previously had an ileostomy to treat rectal cancer and was worried about this latest procedure. "It wasn't super easy but Dr. Calvin Law worked skillfully around the ileostomy," he says. "I spent three days in the hospital. I was up and walking four kilometres after a week and a half."

Dr. Hans Chung and his team provide another specialized treatment: stereotactic body radiotherapy for less-operable lesions. The high-precision radiation is guided by 3-D imaging to target it on the tumour and spare healthy tissue. "Treatment didn't stop me from my everyday living. The side effects weren't terrible, and Dr. Chung and the team were very good and meticulous," says patient Barbara Jacques. E-health boon for patients

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E-health boon for patients

Sunnybrook patients can now access their personal health information anywhere, anytime via a new web-based service in partnership with TELUS.

Building on the success of Sunnybrook's MyChart application, which provides the hospital's patients with secure access to their electronic health record through a secure section of the website, this new venture provides the same technology through the TELUS Health Space website.

Sunnybrook first launched MyChart in March 2006 as one of Canada's only online, secure web portals for patients to access their personal health information and share it with their family doctor, pharmacist or any professional they choose. Since then, the technology has been adopted by a number of different health care institutions and government agencies.

Search and destroy

Imagine having a tumour lodged so deep in your brain that surgery and radiation are too risky. Now imagine the relief on being told there was a way of getting rid of it without cutting into your skull.

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Dr. Kullervo Hynynen, director of Imaging at Sunnybrook Research Institute, is working to make this a reality, not only for patients with brain tumours but with breast cancer and uterine fibroids. He has pioneered a method of using directed ultrasound to precisely pinpoint growths and destroy them.

Dr. Hynynen, who came to Sunnybrook from Harvard Medical School, has developed a process that uses ultrasound as a kind of "thermal scalpel" and magnetic resonance imaging technologies to guide the ultrasound energy to the unhealthy tissue. The idea is that several separate ultrasound beams that don't on their own damage tissue come to a single focus, producing enough heat to destroy tumours.

Dr. Hynynen's lab invented a helmet that fits over the head and has an array of devices that can produce ultrasound beams. Since each skull has a different shape and thickness, it takes precise mathematical calculations to focus the separate beams for each patient so that they pass through bone and converge on the growth. A physicist who became interested in medical physics at Finland's University of Kuopio, Dr. Hynynen says it was an area where he thought he could be of most benefit others.

Holland Centre honoured for new patient-care model

A more efficient system for treating patients with hip and knee arthritis has won Holland Orthopaedic & Arthritic Centre the prestigious 3M Health Care Quality Team Award.

The goal of the new model has been to improve access and quality of care for patients with these chronic conditions. Patients report high rates of satisfaction with the comprehensive assessments, enhanced education and improved coordination and delivery of services. The model of care, introduced in response to the Ontario Wait Time Strategy, uses a centralized referral intake and an electronic tracking system to monitor wait times and the status of referrals throughout the program.

Promise in new brain-cancer chemo

More than 2,000 Canadians are diagnosed with brain cancer each year. The most common and aggressive type, glioblastoma, is notoriously difficult to control with traditional chemotherapy. But a recent study pioneered by Sunnybrook's Dr. James Perry shows promise. By taking a low daily dose of a chemotherapy medication called temozolomide (TMZ) orally, patients experienced better control of their condition, with milderside-effects.

Daily use of TMZ has been shown to damage cancer DNA, blocking cells' ability to divide and reproduce. The medication can also overcome a particular cancer-cell protein that creates resistance to traditional chemotherapy - a huge benefit for patients. TMZ may also play a key role in the prevention of blood vessel growths that form around tumours and supply them with nourishment. Although not yet a cure for the disease, it's a step in the right direction.

Getting back into rhythm

Schulich Heart Centre has opened Toronto's first robotic arrhythmia invasive suite, where patients with irregular heartbeats can receive a state-ofthe- art, minimally-invasive treatment to restore normal cardiac function. The lab uses computerized, magnet-guided technology to enhance precision and safety, targeting the precise area in the heart where the malfunction is occurring, and treating the damaged tissue to restore a regular heart rhythm. Patients treated in the new lab are exposed to much less radiation than those who receive treatment in a traditional arrhythmia invasive lab. It is one of only three such suites in Canada.

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