Gaps in patient care, brain insights presented at Inaugural Professorial Lectures

(Edmonton) Canadians could receive higher quality medical care if doctors implemented the results of current medical research, says a professor in the Faculty of Medicine & Dentistry at the University of Alberta.

Sumit Majumdar, a clinical researcher at the U of A and a general internist at the University of Alberta Hospital, talked about his research findings Jan. 24 at the Inaugural Professorial Lectures. His research shows there is a gap between what physicians know and what they actually do, so his goal is to increase the use of proven and underused treatments that could benefit patients.

For example, each year Canadian women suffer 146,000 fractures as a result of osteoporosis. That makes broken bones more common than heart attacks, stroke, pneumonia and breast cancer altogether, costing the national health-care system as much as $1 billion a year. One in four older women die within a month of a hip fracture, and if they survive, there is a 25 per cent chance they will end up in a nursing home.

Studies show people over 50 who break a wrist have a 70 per cent chance of having osteoporosis, but only 10 per cent are tested or treated within a year of the fracture. If a timely intervention, including education and bone density tests, were done, researchers estimate that for every 100 patients, three further osteoporotic fractures could be avoided.

Christian Beaulieu, a neuroscientist in the Department of Biomedical Engineering, was the second speaker to address a crowd of 200 colleagues. Both speakers were promoted to full professors last year.

Beaulieu's research focuses on the imaging and measurement of brain connectivity. These "white matter" tracks act like pathways to connect the main parts of the brain.

His premise is that these pathways need to work well, and if they do not, they may help to signal certain kinds of disorders or diseases such as epilepsy, reading ability issues, aging and fetal alcohol syndrome. All of these can be examined through brain pathways, he says, noting his lab's MRI equipment has shown distinctive white matter abnormalities that correlate to the conditions.

"This brain wiring evolves over time," said Beaulieu, as he showed images of how the volume of grey versus white matter changes with age. White-matter volume signals the development of these important pathways and connections, increasing until a certain age while grey matter decreases.

"A person's white matter connections peak between 26 and 34 years, but what goes up must come down, and by the age of 60 these connections are less than those of a five-year-old."

Further research is merited because it is not clear whether the prevalence of more white matter means some people can read better than others or whether one's reading ability affects the white matter, says Beaulieu.

The next Inaugural Professorial Lectures will be April 11, 2011, at 5 p.m. in the Allard Family Lecture Theatre at the Katz Group Centre for Pharmacy and Health Research.

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