Temerty Faculty of Medicine staff

Cannabis use during pregnancy associated with adverse birth outcomes: Study

rahul.kalvapalle — Tue, 21 Nov 2023 19:39:43 +0000

Cannabis use during pregnancy associated with adverse birth outcomes: Study

rahul.kalvapalle Tue, 11/21/2023 - 14:39

Cutline

(photo by SDI Productions/Getty Images)

Temerty Faculty of Medicine staff

Topic

Breaking Research

Temerty Faculty of Medicine

Centre for Addiction and Mental Health

Institute of Medical Science

Infants prenatally exposed to cannabis are more likely to be born preterm, have a low birth weight and require neonatal intensive care than infants without prenatal cannabis exposure, a new study by researchers at the Centre for Addiction and Mental Health (CAMH) and the University of Toronto has found.

Published in the journal Addiction, the study also found cannabis-exposed infants are not at greater risk of birth defects or death within one year, including sudden unexpected infant death.

“The global increase in cannabis use among women of reproductive age also extends to pregnant women,” says Maryam Sorkhou, a PhD student at U of T’s Temerty Faculty of Medicine’s Institute of Medical Science and lead author on the study. “We know that THC, the main psychoactive constituent in cannabis, can cross the placenta from mother to fetus and bind to receptors in the fetal brain.”

Sorkhou worked on the study with Tony George, a clinician-scientist at CAMH and a professor in the Temerty Faculty of Medicine’s department of psychiatry and Institute of Medical Science.

This study pooled the results of 57 prior studies from around the world.

Those studies occurred from 1984 to 2023, and collectively included health outcomes of more than 12 million infants, including more than 102,000 infants exposed to cannabis before birth.

For example, 20 of the studies included measured the association between intrauterine cannabis exposure and risk of preterm delivery.

In these, the combined results show that mothers using cannabis were over one and a half times more likely to have a preterm delivery compared with mothers not using cannabis during pregnancy.

Another 18 of the studies included also measured the risk of low birth weight.

In these, the combined results show that mothers using cannabis during pregnancy were more than twice as likely to have a low-birth-weight baby compared with mothers not using cannabis during pregnancy.

Ten of the studies included also measured the risk of requiring NICU admission.

In these, the combined results show that newborns with intrauterine cannabis exposure were more than twice as likely to require NICU admission than non-exposed newborns.

“Our study adds to that knowledge by showing that prenatal exposure to cannabis heightens the risk of several adverse birth outcomes,” Sorkhou says.

Unearthing the truth: Michael Pollanen on the role of forensic pathology in war zones

geoff.vendeville — Tue, 19 Apr 2022 16:18:04 +0000

Unearthing the truth: Michael Pollanen on the role of forensic pathology in war zones

geoff.vendeville Tue, 04/19/2022 - 12:18

Cutline

Michael Pollanen is a professor in the department of laboratory medicine and pathobiology in the Temerty Faculty of Medicine and Ontario's chief forensic pathologist (photo by Andrew Francis Wallace/Toronto Star via Getty Images)

Temerty Faculty of Medicine staff

Topic

Global Lens

Temerty Faculty of Medicine

Laboratory Medicine and Pathobiology

Ukraine

War

Michael Pollanen is no stranger to disaster zones.

The chief forensic pathologist of Ontario – and a professor in the department of laboratory medicine and pathobiology in the Temerty Faculty of Medicine – has participated in many missions to uncover the truth about what happened after conflicts or natural disasters, typically at the request of organizations such as the United Nations, International Criminal Court and International Committee for the Red Cross. Most recently, he was in the Central African Republic and Iraq.

“The global forensic community are truth-seekers,” Pollanen says. “In difficult circumstances of armed conflict, particularly when crimes against humanity are at issue, there are often competing narratives that are driven by various factors."

Forensic pathologists usually investigate these areas “in the early post-conflict time span,” he explained. “In addition many of these missions are for humanitarian responses after disaster rather than war. For example, I joined missions in Haiti and Thailand after natural disasters: earthquake and tsunami.”

With reports about atrocities committed in Bucha and other parts of Ukraine, international authorities are conducting on-the-ground investigations to piece together what happened – and, if war crimes were perpetrated, then who is to blame.

"The value of forensic science is that it can clarify the facts of what actually happened,” Pollanen says. “If there are questions about whether or not the mass killing of a civilian population occurred, this can be easily determined by conducting autopsies."

Often, the success of an investigation requires forensic pathologists to work in teams of experts with different specialities, Pollanen says. Forensic archeologists are trained in the exhumation of bodies, sometimes in the context of mass graves. Forensic anthropologists specialize in the examination of bones and associated identification processes. Forensic pathologists can perform a variety of roles but are mainly concerned with the interpretation of injuries, determination of the cause of death and correlation of injuries with the circumstances of how those injuries might have occurred.

Other key forensic experts may include forensic odontologists (who can identify remains by examining teeth or bite marks), forensic biologists specializing in DNA and firearms experts who study ballistic evidence.

“Our main priorities as forensic pathologists are to identify the dead and discover the truth,” Pollanen says. “The humanitarian response for the benefit of families is vital. This includes identifying human remains and helping to restore family links by providing information about what happened to missing family members. This may include repatriation of the body to the family. We also focus on obtaining evidence that may support criminal prosecution to seek justice for the dead."

Since there can be a long delay between death and an autopsy, forensic experts rely on different methods and tools to study bodies in various states of decomposition, Pollanen says. Objectivity and fact-based science are key, he notes.

“We do not approach missions and cases with preconceived notions about what we might find, but with an open mind,” says Pollanen, “In most cases, little will be known about the circumstances surrounding the death of the people who will be examined”.

Fieldwork in war zones is challenging, from both a logistical point of view and on an emotional level, he adds. “This can be very difficult work emotionally. Therefore, one of the biggest priorities on missions of this type is wellness, both personal wellness and ensuring the wellness of the people around you. The work can be very intense. Most forensic experts find meaning by understanding that their work will contribute positively to the events being investigated and provide answers for the people affected."

To beat depression, researchers hunt for perfect brain stimulation therapy 'rhythm'

Christopher.Sorensen — Wed, 26 Jan 2022 16:19:18 +0000

To beat depression, researchers hunt for perfect brain stimulation therapy 'rhythm'

Christopher.Sorensen Wed, 01/26/2022 - 11:19

Cutline

Researchers at work in the electrophysiology lab at Mount Sinai Hospital (photo by Colin Dewar/Sinai Health)

Temerty Faculty of Medicine staff

Topic

Breaking Research

Sinai Health

Temerty Faculty of Medicine

Centre for Addiction and Mental Health

Mental Health

Psychiatry

Research & Innovation

When it comes to finding a long-lasting treatment for depression, a team of Toronto researchers says it could come down to finding the perfect rhythm.

The approach, under development by scientists at Sinai Health, the Centre for Addiction and Mental Health (CAMH) and the University of Toronto, has nothing to do with music and everything to do with tweaking an existing form of brain stimulation therapy.

To improve the technology and test it in patients, four researchers have today been awarded a grant by Bell Let’s Talk and Brain Canada.

Tarek Rajii

“It is a very exciting collaboration that combines bench and bedside research in the same project,” said Tarek Rajji, principal investigator and clinical lead on the project.

Rajji is executive director of the Toronto Dementia Research Alliance (TDRA) and chief of the adult neurodevelopment and geriatric psychiatry division at the Centre for Addiction and Mental Health (CAMH), as well as a Clinician Scientist in CAMH's Campbell Family Mental Health Research Institute. He is also a professor in the Temerty Faculty of Medicine’s department of psychiatry.

The research centres around transcranial magnetic stimulation, or TMS, a form of brain stimulation therapy that’s been shown to hold enormous promise in helping patients with treatment-resistant depression. The approach uses a device to deliver pulses of magnetic stimulation to the prefrontal cortex, a part of the brain associated with mood regulation.

The basic science component of the project involves brain stimulation to determine whether changing the spacing or tempo of the pulses to the brain could ultimately deliver long-lasting relief from depression symptoms.

Graham Collingridge

“The pattern of stimulation is vital,” said Graham Collingridge, a senior investigator at Lunenfeld-Tanenbaum Research Institute (LTRI) at Sinai Health and a professor of physiology and director of the Tanz Centre for Research in Neurodegenerative Diseases at Temerty Medicine. “It has been recently discovered that instead of applying the rhythm within a short space of time, [if] you have a break for a few minutes and then repeat the stimulation, the effect on synapses in the brain is stronger and longer-lasting.”

Collingridge studies a process called long-term potentiation, in which a brief period of intense neuronal activity leads to a long-lasting increase in the strength of connections between the nerve cells.

To find the perfect pattern, Rajji and Collingridge are collaborating with Evelyn Lambe, an associate professor of physiology at Temerty Medicine, who is leading the work to optimize the stimulus parameters in the prefrontal cortex, the region targeted by TMS in patients, as part of the Bell Let’s Talk Brain Canada research grant.

Evelyn Lambe

“The goal is to optimize treatment to rebuild connections between neurons essential for mood regulation,” said Lambe.

Her lab’s work investigating the impact of social isolation on the brain has become increasingly relevant to mental health during the COVID19 pandemic. “Social isolation and other stressors wear us down by impairing brain function at the cellular level,” Lambe notes.

Rajji, meanwhile, will adapt the optimized stimulation parameters to humans using TMS and electroencephalograhy. His team will examine which pattern of stimulation leads to better brain plasticity in the frontal lobes of adults with acute depression.

Sanjeev Sockalingam

Throughout the project, Sanjeev Sockalingam, a clinician-scientist and vice-president of education at CAMH, and professor of psychiatry at Temerty Medicine, will lead the knowledge translation component of the work. This will involve mental health clinicians, people with lived/living experience and families working with researchers from the start of the project.

“The integrated approach involving clinicians and service users will help us co-create knowledge that gets to people who can use it faster and more effectively,” said Sockalingam.

With files from Sinai Health, the Centre for Addiction and Mental Health and U of T’s department of physiology.

Four new U of T medical students share what inspired them to study medicine

Christopher.Sorensen — Tue, 24 Aug 2021 14:34:27 +0000

Four new U of T medical students share what inspired them to study medicine

Christopher.Sorensen Tue, 08/24/2021 - 10:34

Cutline

Clockwise from top left: Kanza Naveed, Wafa Baqri, Amanda Mac and Siddh Sood share their thoughts on what inspired them to study medicine at the University of Toronto (photos submitted)

Temerty Faculty of Medicine staff

Topic

Our Community

Temerty Faculty of Medicine

Medical Students

U of T Scarborough

As they prepare to begin medical school at the University of Toronto, four new students describe their path to the Temerty Faculty of Medicine and what studying and practising medicine means to them.

Their reasons for choosing medicine at U of T are diverse. For one student, it was the experience of caring for an ailing relative. Another student switched career tracks, from neuroscience to medicine, after taking an interest in how physician-scientists combine research with patient advocacy.

The Temerty Faculty of Medicine recently caught up with Amanda Mac, Siddh Sood, Wafa Baqri and Kanza Naveed and asked them to share their backgrounds, interests and future aspirations.

Amanda Mac

Having family members living with chronic illness and disability, I've always been very passionate about transitional care and the importance of caring for patients as whole individuals who have personal interests, struggles, intersecting identities and lives outside of the hospital.

After my sister’s surgery, life drastically changed for her and my family as we all undertook the role of “at-home providers” to help care for her complex needs. These personal experiences led me to later volunteer with various groups in different health-care settings, including older adults in long-term care, individuals with disability, women of colour and mothers newly immigrated to Canada.

I formed close relationships with the people I met through these involvements, and I learned more about my passion for helping others feel heard and cared for.
There is immense privilege in being able to support and empower someone through some of the most vulnerable times in their life – I realized how rewarding this human connection is for me and how difficult it is for many to navigate through the inequities in our health-care system.

Medicine allows me to combine my loves for building meaningful connections, being creative and continuous learning – all while giving me the opportunity to advocate alongside marginalized groups and collaborate with others to tackle systemic issues.

I’m very excited to learn from my peers, mentors and the patients I'll cross paths with over the next few years. I’m also excited to continue exploring my interests in art and health technologies – it will be interesting to see how these areas intersect with medicine. I really appreciate the emphasis that Temerty Medicine places on pursuing interests outside of our studies, so I’m looking forward to trying new things, exploring new and existing passions and seeing how everything comes together.

Siddh Sood

I was born and raised in Windsor, Ont. and I completed my bachelor's in biological sciences at the University of Windsor. During these past few years, I have had the opportunity to explore my curiosity for the sciences through research, learn from my amazing mentors and grow as a leader by acting in service for initiatives in my community.

Above all, I was inspired to pursue medicine by the personal experiences my family and I have had with the health-care system when dealing with disease. During times of vulnerability and powerlessness, I have witnessed how physicians are not only problem-solvers, but also healers, advocates – and, when patients need it the most, just a fellow human who cares and understands.

When I went on to pursue my undergraduate degree, my experiences motivated me to make an impact, whether through cancer research to innovate for patients with limited options, or through advocacy and service roles such as with the Heart and Stroke Foundation and Obesity Canada, aiming to spearhead change in my community. I know the role of a physician combines all of these crucial tasks, and the stories of those close to me – in my family or extended community – inspire me to pursue this incredibly fulfilling career.

I am extremely grateful for the opportunity to study at the Temerty Faculty of Medicine. Alongside learning the foundations to become a physician, I am looking forward to participating in the abundant opportunities for health innovation here. Whether by improving health-care quality, researching health technology or by influencing policy that can lead to macro-level change, I am interested in seeing how I can contribute and fit into the future of medicine. In addition, with a passion for the arts and digital media, I am excited to learn more about creativity in medicine and the role of the humanities, such as in health communication and narrative medicine. Finally, I am looking forward to meeting my new classmates and learning from them, and with them, for the next four years.

Wafa Baqri

I completed my undergraduate degree in biomedical sciences at the University of Guelph. While many factors determined my choice to pursue this program, there was one element that confirmed my decision: Their human anatomy program, which allows students the ability to explore and learn human anatomy through conducting dissections. I have always been fascinated by the intricacies of the human body and its potential for scientific investigation, and knew that I wanted to pursue the biological sciences in my future, but wanted to narrow my career choices. This program, with its mixture of conceptual and hands-on experience, solidified my thoughts of pursuing medicine.

Besides my formal education, I also had the opportunity to become involved with many amazing organizations, both on campus and in the wider community, that helped me discover the real joy and fulfillment I experience in serving others.

I found a special interest in working to reduce health-care barriers and obtaining health-care equity for vulnerable and marginalized populations, such as elders and Indigenous communities, which I hope to continue to do moving forward. I spent my time before Temerty Medicine exploring my values and interests so that I could confidently say that medicine is the path for me – and now I can.

The combination of biology, human connection and care, and potential for continued learning to expand your knowledge in efforts to provide the highest quality of care, is what ultimately made me want to become a doctor. Being a physician means becoming healers, researchers, advocates and learners – all in one.

Over the next four years, I am most looking forward to the connections I will form. Temerty Medicine has a close-knit community of students and faculty, and I hope to immerse myself in that as I get to know each one of my peers and educators. As a student, I will also be able to form connections with new mentors who can provide deeper insights into my medical education and introduce me to new opportunities. However, I am most excited about the connections I will now be able to form with patients. I hope to understand the full power of the patient-physician relationship through observerships and clinical placements to form meaningful relationships with patients that centre on trust, empathy and understanding.

Kanza Naveed

Prior to joining the Temerty Faculty of Medicine, I completed my bachelor's at U of T Scarborough in the neuroscience co-op program. I had been particularly interested in behavioural neuroscience and initially envisioned myself pursuing a different career – perhaps as a neuroscientist.

However, while working with a clinical research group during my co-op placement at St. Michael’s Hospital, I had the opportunity to work in a clinical setting with some incredible physician-scientists. Seeing how they incorporated patient advocacy and care with their own research interests inspired me to explore other career opportunities, guiding me towards my pursuit of medicine. Witnessing how passionate they were about their patients, advocating for their care, while also implementing innovative research in the clinical setting, drove me to think about other career paths, such as becoming a physician.

I continued my work with that research group for several months during which I had the opportunity to meet with diverse patient groups. Learning about their challenges, especially among underrepresented and marginalized patient populations, made me realize there may be countless others who feel their concerns but their voices are not being heard. Physicians have the privilege of advocating for these individuals, for marginalized communities, and implementing equitable patient care. Therefore, that drive to bridge gaps in health care and provide patient-centered care made me want to become a doctor.

Thinking about the next four years has been daunting, to say the least, but I am perhaps the most excited to develop a tool kit of skills and knowledge that I can one day access and utilize when working with patients. Moreover, I am incredibly excited to be joining such a wonderful, interdisciplinary community at the University of Toronto, which continues to tackle various medical challenges. I look forward to working with diverse teams and experts, while also exploring new ways that we can continue to optimize patient care and foster equitable health-care practices for all patient populations.

Meet seven of U of T's newest medical school graduates

Christopher.Sorensen — Tue, 15 Jun 2021 16:17:46 +0000

Meet seven of U of T's newest medical school graduates

Christopher.Sorensen Tue, 06/15/2021 - 12:17

Cutline

Clockwise, from top left: Airiss Chan, Imaan Javeed, Asia van Buuren, Vincent Tang, Prem Nichani, Maddy Rudolph and Akshdeep Bhatia.

Temerty Faculty of Medicine staff

Topic

Our Community

Convocation 2021

Temerty Faculty of Medicine

Graduate Stories

The University of Toronto’s Temerty Faculty of Medicine celebrated its MD program graduates on Tuesday.

As they prepare to move onto the next stage of their careers, seven of the faculty’s new graduates agreed to share a few highlights of their U of T medical school experiences.

They spoke about their memories, what it was like studying medicine during a global pandemic – and what they're most looking forward to in the future.

Akshdeep Bhatia

Up next: Orthopaedic surgery at U of T

There have been several “wow” moments throughout the last four years. Some examples: seeing a cardiopulmonary machine take over a beating heart, delivering a newborn on my birthday, reducing fractures in the trauma bay and countless others.

The pandemic was a huge curveball in “the plan.” A four-month clerkship hiatus, restructuring of electives and virtual CaRMS tour were not part of how any of us expected to end medical school. It challenged us to adapt and become more resilient. These traits will serve us well in residency and will allow us to extract the most out of every learning opportunity.

In the next chapter of my medical career, I’m really looking forward to being able to teach; I’ve had many amazing residents who have taken time during clinics or while on call to teach. It is a tradition that is embedded in the foundation of medical training. I look forward to joining a resident group that takes great ownership in teaching trainees and continue to pay it forward to the next generation of medical students. Toronto has been my home from day one. I’m excited to be able to continue my medical training here and also serve the diverse patient population that makes the city unique.

Maddy Rudolph

Up next: Family medicine at U of T

The pandemic has had a massive impact on our last one-and-a-half years of medical school – we had an impromptu three months off from clinical work, and a mad dash of a fourth year to match and graduate on time. Moreover, the inequitable health outcomes we all witnessed during the pandemic emphasized to me the importance of physician advocacy and outreach to underserved populations, and I’m eager to be a part of the movement to help essential workers and racialized communities get the respect and care they deserve.

I’m excited to become a resident like the ones who guided me through the tough days of clerkship with coffee breaks, debriefs, and high-yield teaching sessions. Down the road, I’m looking forward to becoming an educator and primary care physician and who provides comprehensive and inclusive care to people from the LGBTQ2S+ community and beyond.

Vincent Tang

Up next: Psychiatry at U of T

It sounds so weird to say, but if anything, the pandemic really made me slow down and forced me to give myself the space to prioritize my own wellness. Studying, going to class, and attending clinical placements was already hard enough without the stress of the pandemic hanging over all of us, but it’s almost unbelievable how much mental exhaustion comes from doing the exact same things with the pandemic swirling around us. Giving myself the mental capacity to recognize those moments when I’m feeling overwhelmed and giving myself the space to slow down has been so important for me throughout the pandemic so far, and is a reflective practice I hope to continue moving forward.

I am very much looking forward to working with, and standing alongside, individuals and populations that have been made marginalized and vulnerable by our systems. While I am excited about continuing my training in a specialty I’m passionate about and gaining increasing independence as a resident, I also look forward to the privilege of learning with and from my patients that I will serve.

Asia van Buuren

Up next: Pediatrics at the University of British Columbia

My favourite parts of the past four years have been the hours spent with people that make me laugh until my stomach hurts. I am so lucky to have friends that see me, celebrate me, and inspire me every day. In addition, I have loved building relationships with patients and their families and have felt privileged to be with them at vulnerable times in their lives. Brené Brown says “the magic is in the mess.” In looking back on my medical training, it’s the challenging, disorienting times that have made me the clinician I am today. I’m so grateful for all of it.

The pandemic definitely brought its fair share of challenges. From a mental health perspective, I struggled with feeling disconnected from my peers and my family. I noticed I felt more burnt out, maybe because it felt like there was less separation between my medicine life and my home life. I often came home worried about patients I had seen in hospital that were facing an admission without their support networks by their side. As someone who is passionate about advocacy, I’m concerned about the inequities made visible and exacerbated by COVID-19 and how these are impacting young people in our communities. I am entering residency with an ongoing commitment to addressing these inequities in my clinical practice.

I can’t believe I have the opportunity to continue to learn and grow within an area of medicine that I am extremely passionate about. I’m so excited to learn from and with children and their families in my home province. Not going to lie ... also super excited about the joys of working in pediatrics: colouring, play time, dressing up for Halloween, and practising medicine from a place of joy and creativity.

Prem Nichani

Up next: Ophthalmology at U of T

My passion for ophthalmology stemmed from my experiences as a child in helping my mother run her busy optical practice and in witnessing the substantial impact she made on the quality of life of her patients by providing them with the advice and tools they needed to see and remain independent. This, along with my fervent curiosity in the field and future patients with symptomatic conditions who are therefore motivated partners in their care, makes me excited to continue my mother’s legacy of preserving and restoring vision within our community. Additionally, the opportunity to be surrounded by collaborative forward-thinking experts in the ophthalmology who genuinely care to help me grow as a future clinician provides fertile ground for me to pursue my research interest health policy to further enhance the provision of eye care in Canada.

Two common sayings, “Carpe diem” and “this, too, shall pass,” are more relevant than ever before. This pandemic taught me how to be resilient and that, while planning is great in theory, the unexpected cannot be controlled and so we need to savour the time we have now. I am always going to be busy with clinical and research responsibilities that will make great excuses for me to push personal commitments aside; however, I am a firm believer that time is not to be found, rather, it is to be made. I will definitely ensure that I spend the time I need to with my loved ones because a career is important, but family will always matter most.

Airiss Chan

Up next: Dermatology at the University of Alberta

Medical school has held some of the most exciting and terrifying moments in my life. When I tell stories of my times in clerkship to my family and friends, sometimes I can’t believe the things I’ve done and how much I’ve grown as a person.

I hope that moving forward in my own career, that I can motivate and inspire others who want to pursue medicine, and to encourage future medical students to push themselves to achieve their dreams and believe in themselves.

Imaan Javeed

Up next: Psychiatry at Queen’s University

While it’s felt like an inconvenience not to be able to meet with friends and family in-person as often as I once did, I think that being forced to live and work remotely has ushered in a real revolution in the way that we share knowledge and connect with others globally. While the internet has always made things publicly available (to those privileged enough to have access to it, of course), in the last year there has been a concerted effort to make things available online in unprecedented volumes. Conferences, lectures, resources… now available more than ever, and to global audiences to boot.

In terms of patient care, one thing (among many) the pandemic highlighted was the hardship we may have previously placed on patients and medical staff by not offering and appropriately remunerating remote options for patient care.

Finally, inequities and injustices around the world have been exacerbated, exposed, and broadcasted to more people than ever before, and I am hopeful this will accelerate the pace at which we can work to correct them.

I’m looking forward to meeting new colleagues and mentors, making new friends, and continuing to be in awe of patients’ stories and experiences. I hope to work with them not only to solve their individual concerns, but to work towards broader structural and societal changes to improve the lives of people and their communities both in Canada and around the world.

Temerty Faculty of Medicine staff

Cannabis use during pregnancy associated with adverse birth outcomes: Study

Read more about the study at the journal Addiction

Unearthing the truth: Michael Pollanen on the role of forensic pathology in war zones

To beat depression, researchers hunt for perfect brain stimulation therapy 'rhythm'

Four new U of T medical students share what inspired them to study medicine

Amanda Mac

Siddh Sood

Wafa Baqri

Kanza Naveed

Meet seven of U of T's newest medical school graduates

Akshdeep Bhatia

Maddy Rudolph

Vincent Tang

Asia van Buuren

Prem Nichani

Airiss Chan

Imaan Javeed

Read the original story at the Temerty Faculty of Medicine