Renovations at the centre totaling $17.4 million are now complete. iCAPTURE has renovated 20,000 square feet of additional research and educational space and purchased cutting-edge technology such as confocal, transmission electron and atomic-force microscopes.

iCAPTURE houses 250 UBC-affiliated scientists, students and staff conducting extensive laboratory-based research into the mechanisms of prevention, diagnosis and treatment of heart, blood vessel and lung diseases. As well as benefiting the health of Canadians, the centre is expected to have a profound impact on BC's knowledge-based industries by creating new opportunities for students, technologists and visiting scientists.

Technology at iCAPTURE — New iCAPTURE technology includes a confocal microscope, one of the most advanced in Canada, that produces amazing images used to investigate new treatments for heart disease.

Clinical Research at iCAPTURE — Intensive Care Unit physicians Drs. Jim Russell and Keith Walley are conducting research on vasopressin, an experimental drug that combats sepsis (blood infection), which claims the lives of thousands of Canadians each year.

The iCAPTUR4E Centre and four Providence Health Care researchers investigating lung, cardiovascular and HIV disease were among 29 recipients of the Michael Smith Foundation for Health Research 2003 Career Investigator Awards.

Dr. Keith Walley, a St. Paul's intensivist, received the award of Distinguished Scholar in the clinical research area. This award is the most senior career award offered by MSFHR and is given to investigators who are established, internationally recognized scientific leaders in their fields of study.

Dr. Walley is associate director of the iCAPTUR4E Centre/McDonald Research Laboratory and assistant head of basic research in the St. Paul's Department of Medicine.

The iCAPTUR4E Centre/McDonald Research Laboratories was a recipient in a new category of awards for research units. The centre brings together a multidisciplinary group of researchers dedicated to developing effective strategies to prevent, detect and treat heart, lung and blood vessel diseases.

Scholar awards were presented to three other PHC researchers. These awards are given to investigators who have recently completed their postdoctoral research training and demonstrate an ability to initiate and conduct independent and collaborative research, as well as an ability and interest to train future investigators.

Dr. Hélèn Côté, a molecular biologist Research Associate at the BC Centre for Excellence for HIV/AIDS research laboratory, received a Scholar award in the clinical category.

For his research on cardiovascular disease, Dr. David Granville received a Scholar award in the biomedical category. Dr. Granville began his appointment at iCAPTUR4E as Assistant Professor/Canada Research Chair on May 1, 2003.

Dr. Andrew Sandford also received his Scholar award in the biomedical category for his work on genetic modifiers of pulmonary disease severity in cystic fibrosis.

The Michael Smith Foundation for Health Research was formed in 2001 to support provincial scientists and help establish BC's competitiveness for federal research funding.

Vancouver, October 24, 2003 — The B.C. Centre for Excellence in HIV/AIDS today released new therapeutic guidelines for treating HIV-positive patients with T-20, a new drug to be made available Oct. 28 that may benefit those for whom standard anti-HIV medications are no longer effective.

The Centre's revised guidelines will make T-20 available to selected patients who are in an advanced stage of HIV disease and have documented HIV-resistance to currently available drugs. T-20 eligibility will be reviewed by the Centre's Extended Therapies Committee.

T-20, also known as Fuzeon, is one of a new class of drugs that aims to stop HIV from fusing with cells.

People with HIV are typically prescribed combinations of three drugs - commonly referred to as triple drug therapy — to suppress the disease. However, HIV therapy sometimes results in drug-resistant strains of the disease, says Dr. Julio Montaner, Director of Clinical Activities, B.C. Centre for Excellence in HIV/AIDS.

"Approximately 25 per cent of patients fail to respond to their first course of triple drug therapy. Unfortunately, due to progressive build up of HIV resistance to available drugs, rates of treatment failure tend to increase as we move down to second- and third-line regimens," says Montaner. "However, in clinical trials we have shown that T-20 is associated with positive results for advanced patients who require salvage therapy."

While most anti-HIV medication is taken orally, T-20 is injected twice daily. T-20 therapy will be closely supervised by Centre staff at the Immunodeficiency Clinic at St. Paul's Hospital. An efficacy assessment will be done at least monthly to determine the need for continued therapy.

T-20 is taken in combination with other anti-HIV medications. Conventional drug therapies for an HIV-patient cost approximately $10,000 to $15,000 a year. It's estimated T-20 will cost approximately $30,000 per patient, annually.

The Centre for Excellence's Drug Treatment Program is one of the first to use the CD4 count to predict disease progression and the initiation of triple drug therapy. CD4 count measures levels of white blood cells, called CD4 T-cells, to determine the strength of a patient's immune system. The CD4 count has enabled physicians to delay triple drug therapy and avoid subjecting patients to the side effects that often accompany such treatments. The Centre's practice has also enabled the health-care system to defer the expenditure of millions of drug-treatment dollars.

Founded in 1992 by St. Paul's Hospital and the provincial Ministry of Health, the B.C. Centre for Excellence in HIV/AIDS seeks to improve the health of people with HIV through the development, ongoing monitoring and dissemination of comprehensive investigative and treatment programs for HIV and related diseases. St. Paul's Hospital is one of seven health care facilities operated by Providence Health Care, Canada's largest faith-based health care organization.

St. Paul's Hospital, Vancouver — It's a dilemma. You're too sick for the life-saving surgery you need. Your heart's own valve is giving out and you need a new one soon. In your weakened condition the operation could kill you.

Doctors at St. Paul's Hospital's leading-edge Heart Centre see a solution on the horizon, a way to replace dying valves without surgery. They've taken their cue from an old seaman's hobby - ships in a bottle.

In the old days, intricate models of ships were made to be folded small enough to slip through the neck of a bottle, then unfurl inside the flask to their full glory.

The new medical twist is a foldable heart valve that can be threaded into a tiny incision, up through a blood vessel to the heart then unfolded and installed remotely, without major surgery.

The savings in patient discomfort are immense, but so are the dollar savings. No large operating room and no long hospital stay means saving thousands of dollars per patient. It also means saving the lives of those too weak for open-heart surgery.

The new procedure is called Percutaneous Valve Replacement. A small incision is made at the top of the leg to allow a tube the size of a pencil to be inserted. The tube is threaded along the veins up to the heart. Veins don't have a sense of touch inside them so the patient feels very little. The folded valve goes in through the tube to the heart. It's then unfurled and fixed in place exactly. When that's done, the tube is pulled back out. The leg incision is so small it only needs two or three stitches. After a rest, the patient is free to go.

Today, many people benefit from the traditional expensive and painful heart-valve surgery pioneered over 40 years ago. Hundreds of thousands of people worldwide have artificial valves. At age 85, Mrs. Eleanor Wetherly had symptoms that her own valve was failing.

"A few years ago I started getting so short of breath and so tired. When I walked to the store I had to stop and sit down so often just to catch my breath. The doctor said if I didn't have the surgery, I'd have 6 months to live."

Luckily, Mrs. Wetherly was a good candidate for traditional replacement surgery. Unfortunately many patients with failing heart valves aren't eligible for this traditional operation.

"Sometimes their hearts are just too far gone," says Heart Centre specialist, Dr. John Webb. "Sometimes they have some other condition that makes them a poor candidate for major surgery. So at first we'll just be trying this new surgery on the sickest patients, those who have no options left to them. In time, we hope to offer this more widely."

Mrs. Wetherly didn't enjoy her traditional valve replacement surgery.

"Where they broke my breast bone and ribs to get at my heart it really hurt. I was in the hospital for a long time. It was two or three months before I felt all better."

Because of the reduced risk, pain and cost, non-surgical valve replacement is the hope of the future.

"But," cautions Dr. Webb, "the new remote procedure is still highly experimental. It's not available just yet. The tube we thread it through is three feet long. The placement of these folding valves is crucial. A few hair widths out of place and the whole thing's wrong. 'Close enough' isn't good enough when you're dealing with something as intricate as the human heart. We have to get it right every time."

Although widespread use is likely some years away, Webb adds that initial limited use of the new technique on humans is expected within one or two years.

So a delicate ship in a bottle from centuries past points the way. Those with failing hearts are given new wind in their sails thanks to an old art form gone high tech. Folded valves that unfurl in the heart are set to save lives in the years to come.

This information presented by the St. Paul's Hospital Foundation, a non-profit organization dedicated to raising funds for St. Paul's Hospital to purchase medical equipment, support research and enhance patient care. For more information, contact: Communications, St. Paul's Hospital Foundation Tel: 604 806-8566
Pager: 604 667-4397

A study by researchers at the Centre for Excellence in HIV/AIDS at St. Paul's Hospital suggests that British Columbia's health care system will be challenged in coming years as injection drug users with HIV become increasingly ill.

The study, published in the Canadian Medical Association Journal, demonstrates that injection drug users on antiretroviral therapy are less likely to comply with the complex drug regimen than other HIV patients. As a result, their ability to combat the disease is severely compromised.

In British Columbia, the majority of HIV infections among injection drug users did not occur until 1996, which means that most will only be starting to require HIV treatment over the next several years. It is estimated that about 30% of British Columbia's 5,000-15,000 injection drug users have HIV infection. Yet only 359 individuals began drug therapy during the study period (1996-2000).

If left unchecked, the researchers say, this situation will have serious implications for public health and medical services as this population begins to experience higher levels of illness and death.

To help alleviate this situation, the researchers say programs known to improve access and adherence with antiretroviral therapy should be expanded. These include directly observed therapy programs, access to medical services without appointment, on-site pharmacists at medical clinics and improved access to addiction treatment.

The study was published on Sept. 30, 2003 issue of the Canadian Medical Association Journal. The full text of the study is available free of charge at www.cmaj.ca.

VANCOUVER — Providence Health Care is continuing to plan for its future by investigating options for the renewal of its aging facilities in Vancouver.

The long-term planning process, known as the Providence Legacy Project, was first announced in April 2002.

One of the options now being explored is the consolidation of Providence acute care services and research and academic space into a new facility on vacant land in the False Creek Flats area of the City of Vancouver.

The consolidation would renew the acute care services of St. Paul's and Mount Saint Joseph hospitals, and allow for the redevelopment of Providence's elder-care facilities at Holy Family and St. Vincent's, Heather hospital sites.

"Providence is working in partnership with Vancouver Coastal Health and the ministries of health planning and health services to evaluate the option and develop appropriate business cases," said Carl Roy, Providence's President and CEO.

"If this option is pursued," added Roy, "a new state-of-the-art facility would strengthen and renew Providence's role as a leading health-care provider, with a major academic and research mandate. It would enhance community-based care for the city's least fortunate and benefit the diverse communities of Vancouver's East Side."

Providence is Canada's largest faith-based health-care provider. It operates four hospitals - St. Paul's, Mount Saint Joseph, St. Vincent's Heather and Holy Family - with acute care and rehabilitation services. Another three facilities - St. Vincent's Langara, St. Vincent's Brock Fahrni and Youville - focus exclusively on residential care for the elderly.

For more information, contact:
Shaf Hussain
Communications,
Providence Health Care
Tel: 604 806-8566
Pager: 604 667-4397

The John Ruedy Immuno-Deficiency Clinic (IDC) at St. Paul's Hospital is expanding the services it provides to people with HIV.

The walk-in clinic offers medical care for people living with HIV who do not have a family doctor, or whose doctor is not able to provide the specialized care they need. Located on the 5th floor of Burrard Building, the expanded IDC will now offer primary HIV care on-site, having added family physicians to the clinic staffing. The IDC has also adopted a multi-disciplinary approach in partnership with other community clinics and institutions to give patients easier access to a full range of care and support.

Now clinic staff can connect patients with social workers, pharmacists and nutritionists, and set up consultations with specialists as needed. In addition to providing better care to people who can't get it anywhere else, the expanded operation will provide training to caregivers on the complexities of HIV treatment, and will also assist in ongoing HIV/AIDS research programs.

The clinic's hours have also been expanded. It's now open from 8 am to 5 pm, Monday through Friday (closed over the noon hour).

David Kuhl's book What Dying People Want: Practical Wisdom for the End of Life addresses ways of understanding and alleviating psychological and spiritual distress for people with terminal illness. Dr. Kuhl began his career in palliative care fifteen years ago, providing medical care for people with cancer in his practice. He was invited to develop a palliative care program for St. Paul's Hospital in Vancouver.

Staff and researchers at St. Paul's Hospital received three of eight AccolAIDS awards, presented recently by The BC People with AIDS Society (BCPWA).

The nurses of 10C were awarded for their achievement in Service Delivery; the Vanguard Project was awarded for its excellence in Science, Research and Technology and Pat White, Dr. Julio Montaner's Secretary was awarded the Above and Beyond award.

The nurses of 10C won for their compassion, patience and dedication as well as their professional skill that enables them to provide increasingly complex care that now includes acute AIDS care, palliative and supportive care and rehabilitation nursing.

"The nurses are thrilled with the award," says Pamela Miller, Program Director of HIV/AIDS at St. Paul's. "It is an honour not only because it acknowledges the special contribution made by front line nurses every day to support and care for individuals with AIDS, but because it also recognizes the teamwork it takes to provide such dedicated care."

The Vanguard Project, an on-going study run by the Centre for Excellence in HIV/AIDS, studies the HIV rates and risk factors among young gay men in the Lower Mainland, following subjects since the start of the study in 1995. The work of this project has brought invaluable information to light regarding individual health and the health of the community.

Pat White was honoured for her enduring support of, and contributions to the AIDS movement in BC over the past decade. Since 1991, Pat has been the clinical secretary for Dr. Julio Montaner at the Pacific Network Arm of the Canadian HIV Trials Network, located at St. Paul's, providing compassion, gentleness, perseverance, strength and hope for hundreds of clinic patients. She is also a volunteer member of the Board of the Hummingbird Kids Society, a participant in the BCPWA's AIDS WALK, World AIDS Day, and many more HIV/AIDS associated events and functions.

Now in its second year, the AccolAIDS honours what the BCPWA calls the heroes of the BC AIDS movement; those people, groups or organizations who have demonstrated extraordinary dedication, determination and compassion in responding to the AIDS epidemic. Congratulations to the recipients!

Congratulations to the Nurses of 10C
Meryl Aldcroft, Leslie Beech, Jane Cruz, Aileen Davidson, Rachel Davison, Michelle Derasp, Irma Edwin, Julius Elefante, Julie Foreman, Carla Frost, Stephanie Gee, Shanti Giduani, Norma Hides, Andrew Johnson, Heather Lamont, Christina Laurel, Patricia Lauridson Hoegh, Malcolm Lightfoot, Barb McKillip, Kate McNamee, Sonia Monteith, Andrew Nelson, Liz Patterson, Rosemarie Riddell, Maria Rahardja, Trudy Robertson, Tamara Shaw, Joanne Simpson, Shauna Smith, Denise Thomas, Jasmine Yong

As part of the first stage in the plan to develop a comprehensive and exemplary acute community facility, Mount Saint Joseph introduced the hospitalist program on Monday, May 5. This program will help to cultivate MSJ's clinical infrastructure by enhancing inpatient medical services.

The hospitalists will be on-site, seven days a week, aiming to improve quality of care; improve utilization; and enhance the working environment and enable change and flexibility within the hospital. Dr. Terry Chang has been named Medical Director of the Hospitalist Program, and Drs. Marlene Wickman, Eileen Wong and Helen Kwan as MSJ's first hospitalists.

When asked what a hospitalist does, Dr. Chang replies their role is to "link the different areas of the hospital together to create an efficient team." He adds that this will be accomplished in three ways, including "improved utilization of beds, improved communication within the clinical team, and facilitating greater participation in the training of medical residents and students."

SARS Clinic to Close Its Doors

Public health officials have decided to close Vancouver's SARS Clinic at 8 p.m. Monday, April 7, 2003.

The clinic was opened at the Urgent Care Centre of St.Vincent's Hospital, Heather on April 4 by Vancouver Coastal Health in cooperation with Providence Health Care.

Only four people were actually seen inside the clinic in its first three days of operation and none were suspected or probable cases of SARS. Another 54 visitors did not meet the screening criteria (fever, respiratory symptoms, travel to affected area or close contact to SARS case) and were provided with information and then sent home.

The Urgent Care Centre at St. Vincent's will re-open tomorrow at 12 noon.

Any returning travellers concerned that they may have SARS should contact their family physician.

VCH and Providence officials say that if the need again arises for a stand-alone SARS clinic, one can be opened within 24 hours at an alternative location within the region.

For up-to-date information about SARS, please call the Vancouver Coastal Health SARS information line at 604-708-5300.

For more information contact:
Clay Adams
Director, Issues Management
Phone: 604-708-5280

Viviana Zanocco
Media Relations Officer
604-708-5282 (office) or 604-612-8053 (cell)

Safer injecting facilities have the potential to provide "immediate public health and community benefits" according to results of a major study published in the Journal of Acquired Immune Deficiency Syndromes (JAIDS).

The study, conducted by health scientists at the Centre for Excellence in HIV/AIDS at St. Paul's, is based on interviews with participants in the Vancouver Injection Drug Users Study. The results demonstrate that those addicts who were at highest risk of acquiring infectious diseases, such as HIV, and those who were at highest risk of fatal overdose, were most willing to use a medically supervised safer injecting facility if were they available.

"Safer injecting facilities perform a public-health function by preventing syringe sharing and overdose, but they also provide a point of contact for this extremely marginalized and difficult-to-reach population, and can play a crucial role in getting people into drug treatment and other services," said Dr. Patricia Spittal, a medical anthropologist and co-author of the study.

The results shed light on a critical concern, which may have slowed the introduction of safer injecting facilities in Canada: whether the facilities would attract the specific group of addicts that they aim to help. Specifically, those at greatest risk of overdose and HIV transmission, and those most responsible for public order problems from the injection drug use in public places.

For a copy of the JAIDS article, go to http://www.cheos.ubc.ca/cheoswhatsnew.html

Canada is squandering hundreds of millions of dollars annually on a failed drug strategy that funds police and jails at the expense of proven and effective interventions, according to a major study by researchers at the Centre for Excellence in HIV/AIDS published Canadian Medical Association Journal (CMAJ).

The study draws on data from the Vancouver Injection Drug Users Study to examine the impact of one of Canada's largest-ever drug seizures — 100 kg of uncut heroin in Vancouver on Sept. 2, 2000 — on street drug prices, and drug use and risk behaviour. The researchers conclude that the police operation had no measurable public health benefit.

"Our data show that the market for heroin in Vancouver's Downtown Eastside was totally unaffected by the seizure," said Evan Wood, lead author of the study. "In fact, the price of heroin went down and overdoses went up slightly after the bust, suggesting that many additional heroin shipments easily compensated."

Studies have demonstrated the higher effectiveness of treatment and prevention services compared to enforcement or incarceration, which places a major burden on taxpayers, the researchers say. Not only is incarceration ineffective at dealing with the problem of drug addiction, but it makes matters worse due to disease transmission in jail. "Policy-makers continue to direct the overwhelming majority of resources into failing supply-reduction strategies despite the wealth of scientific evidence demonstrating their ineffectiveness," said Dr. Michael O'Shaughnessy, a co-author on the study and Director of the Centre for Excellence in HIV/AIDS. "Thirty percent of the 5,000 injectors in the Downtown Eastside are now HIV-positive because drug treatment and prevention services have gone under-funded."

For a copy of the CMAJ article, go to http://www.cheos.ubc.ca/cheoswhatsnew.html

Vancouver — Providence Health Care (PHC) in consultation with Health Canada has asked hospitals across Canada and in two US cities to return tissue and bone distributed by the BC Ear Bank.

The BC Ear Bank (BCEB) is a combined teaching laboratory and transplant tissue bank that is located at St. Paul's Hospital and operates under the medical direction of the Division of Otolaryngology at the University of British Columbia (UBC). The lab provides transplant tissue and bones for teaching purposes and for transplant into patients suffering hearing loss.

Due to incomplete documentation, the BCEB is not able to confirm whether proper procedures and screening of donors were conducted to prevent the transmission of HIV and Hepatitis B or C.

Eighty-seven hospitals or individual physicians in all regions except Nova Scotia, PEI and the Northwest Territories, and including two cities in the US, have received at least one specimen of tissue or bone from the BCEB. All were contacted on Feb. 18, 2003 by Providence Health Care. Physicians at these hospitals who used the transplant materials are being asked to inform their patients and provide appropriate clinical follow-up.

The move is a precautionary one. There have been no reports of disease transmission due to transplantation of these tissues.

"Patient safety is our number one concern, and we are erring on the side of caution to ensure that all of these transplant materials are returned and that all parties are notified of any potential risks," said Dr. Jeremy Etherington, Vice President of Medical Affairs for Providence Health Care.

Experts consider the risk for disease transmission by means of tissue and bone used in ear transplantation to be extremely low. In a worst case scenario, says Dr. Perry Kendall, the Chief Medical Officer for the province of British Columbia, the risk has been estimated at 1 in 10,000. It is more likely, however, that the real risk to patients is in the range of 1 in 100,000, he added.

Records from the years 1985 to 2002 show that 6,016 individual specimens of tissue and bone were distributed by the BCEB, however, the exact number of patients who underwent transplants is not known at this time. Some of this material was used for teaching or research purposes.

Patients who may have received tissue or bone from the BC Ear Bank during transplant operations and who have further questions should contact their physicians about the need for testing.

The BC Ear Bank was founded in 1974 at Vancouver General Hospital. It later moved to Shaughnessy Hospital and when that facility closed, it moved to St. Paul's Hospital site in 1995 at the request of UBC. St. Paul's Hospital is part of Providence Health Care, a Catholic health care organization based in Vancouver.

Contact: Providence Health Care Communications
Pager 604-667-4397
Tel. 604-806-8022 or (604) 806-8583

What is the BC Ear Bank?
The BC Ear Bank is a teaching laboratory and transplant tissue bank located at St. Paul's Hospital and operated under the medical direction of UBC's Division of Otolarynology. It provides tissue and bones for teaching purposes and for transplant into patients suffering hearing loss. The tissue and bone is retrieved, processed, sterilized, stored and then sent to hospitals, physicians and universities.

What kind of transplant tissue does the Ear Bank handle?
The transplant tissue may include ossicles (ear bones), tympanic membranes (ear drum), tympanic membranes with bone attached, ear bone plugs, temporal bones, costal cartilage (from the rib cage) and dura mater (outer lining of the brain).

Who is responsible for the BC Ear Bank?
The BC Ear Bank has been in existence since 1974, first located at VGH, then Shaughnessy Hospital. With the closure of Shaughnessy, PHC was asked by UBC to provide a new home for the facility, and it was moved to St. Paul's Hospital site in July 1995.

The Ear Bank's staff — a single technician who handled all day-to-day operations — is an employee of PHC. The program's medical director is UBC's head of the Division of Otolarynology.

What regulations or standards apply to transplant tissue?
Health Canada has authority under the Food and Drugs Act to regulate transplantation issues. The need for a set of standards dealing with cells, tissues and organs in Canada has been identified, and the Canadian Standards Association will be publishing a set of standards later this spring.

What is being done about this issue?
PHC administration first became aware of potential problems with issues regarding standards of practice on Sept. 16, 2002 and an investigation was initiated immediately. In the first week of October, PHC administration suspended the BC Ear Bank's operations , and no tissue or bones have been collected or shipped since then. Health Canada was informed of the documentation concerns and conducted its own review, leading to a recommendation in February 2003 that the request for return of inventory and physician notification be carried out.

Although the BCEB has been located at St. Paul's only since 1995, Providence Health Care is attempting to locate records dating back as far as possible. To err on the side of caution, PHC is asking hospitals who may have received material distributed by the BC Ear Bank as early as 1975 to thoroughly review their records, return inventory and notify physicians to follow up with their patients.

Providence Health Care has also set up a series of teams to complete the notification of hospitals and physicians, to manage the return and processing of inventory and for information dissemination and liaison with Health Canada.

What are the risks to public safety?
The risk of transmission to transplant recipients is extremely low. Dr. Perry Kendall, the Chief Medical Officer for the province of British Columbia, estimates that in a worst case scenario, the risk of transmission is 1 in 10,000. This theoretical worst-case scenario assumes that: no screening was conducted; the transplant tissue or bone was not sterilized; the donors had the same prevalence of disease as the general population; and if the donor was infected there would be a 100% rate of transmission. It is apparent that these assumptions are not accurate. PHC has clear information that sterilization did in fact occur. The problem is one of documentation. This reduces the likelihood of risk to the range of 1 in 100,000 for Hepatitis B and C, and 1 in one million for HIV There have been no reported cases of disease transmission related to the BC Ear Bank.

Why are hospitals and physicians being asked to return outstanding inventories of tissue and bone distributed by the BC Ear Bank?
Reviews of its operations show that the BC Ear Bank had incomplete documentation. The Ear Bank was not able to confirm whether proper procedures and screening were conducted to prevent the transmission of HIV or Hepatitis B or C. Although the risk for disease transmission by means of tissue and bone used in ear transplants is considered by experts to be extremely low, after discussions with Health Canada, hospital officials asked for the return of inventory, and for the notification of physicians who use the tissue and bone in surgical procedures. Physicians will be asked to follow up with their patients.

What infectious diseases could be transmitted by transplanted tissue and bone, and what steps are taken to ensure it is safe?
Tissue and bone distributed for ear transplantation is first screened for HIV, Hepatitis C and Hepatitis B. This is followed by processing steps that include fixation of these materials in a 10% formalin (formaldehyde) solution followed by autoclave sterilization. Some tissues are also irradiated. These steps destroy HIV as well as Hepatitis B and C viruses. Although we believe that appropriate fixation, autoclaving and irradiation have occurred as part of the BC Ear Bank's standard operating procedures, an exhaustive review of the data has revealed irregularities in completion of the appropriate documentation.

How much tissue and bone was distributed by the BCEB?
Records from the years 1985 to 2002 show that 6,016 individual specimens of tissue and bone were distributed by the BCEB to 87 hospitals, physicians and universities.

Has the delay in notification had any impact on people's health?
We do not believe that anyone has received infected tissue. No tissue or bone of any kind has been distributed since October, when the operations of the BC Ear Bank were suspended. However we are still advising patients to contact their physicians for follow-up.

How are hospitals being notified about the return of inventory and when did the notification process begin?
Hospitals and physicians' offices were contacted by faxed letter and phone call on Tuesday, Feb. 18, 2003. This was followed by a series of conference calls.

What should patients who have had an ear transplant do?
They should contact their physicians to review the risks and arrange for clinical follow up if appropriate.

What will be done with the returned tissue and bone?
A team led by Dr. Michael O'Shaughnessy, PHC Vice President of Research, will inventory this material. Eventually it will be destroyed.

A new study by researchers at St. Paul's Hospital on Aboriginal drug use and HIV is raising fears that Canada is losing the public health battle against the virus. The study, published in the January 7th issue of the Canadian Medical Association Journal (CMAJ) reports that Aboriginal injection drug users are becoming infected with HIV at twice the rate of non-Aboriginal injection drug users.

The study followed more than 900 injection drug users recruited between May 1996 and December 2000 in Vancouver's troubled Downtown Eastside. All participants were HIV negative at the outset of the study. It was found that by May, 2002, the infection rate for the Aboriginal participants was almost double the rate of infections in non-Aboriginal participants (21.1% vs. 10.7%). The higher risk was noted in both female and male Aboriginal participants.

These results are important because little is known about the extent of the HIV epidemic among Aboriginal people in North America. Research has shown, however, that the HIV virus targets those living in entrenched poverty, so there have long been warnings that HIV/AIDS will increasingly affect Aboriginals in Canada.

To read the CMAJ article, please go to http://www.cheos.ubc.ca/cheoswhatsnew.html

Mount Saint Joseph Hospital recently installed a new state-of-the-art integrated urology table and x-ray imaging system in their operating room. The equipment, purchased with a $430,000 anonymous donation to the Mount Saint Joseph Hospital Foundation, will benefit patients needing treatment for diseases and conditions of the urinary tract, including the bladder, prostate and kidneys.

The new equipment improves patient care by using digital X-ray technology, so no film is required. This provides better images and helps speed diagnosis, which means surgical procedures can be done more quickly and patients spend less time under anesthetic. The digital technology also provides a safer work environment for staff, because it eliminates the need for darkrooms and chemicals used to process film. The digital images can also be stored for later use, or viewed by other physicians from a password-protected web site.

The equipment also provides fluoroscopy (real-time x-rays), which allows surgeons to view the urinary tract as they work. This means, for example, that less invasive procedures can be used for the removal of kidney stones.

"This urologic table is a far superior tool compared to our old equipment. Its high-resolution gives surgeons a much-improved image and makes it easier to teach medical students and residents," said Dr. Ercole Leone, a clinical urologist at Providence Health Care.

Advance Notice: St. Vincent's Hospital presents
Geriatric Services: Building Resources for the Interdisciplinary Team

Friday, March 7th, 2003
Delta Vancouver Airport Hotel, Richmond, British Columbia

Audience: Physicians, Nurses and all member of Interdisciplinary Teams who provide services across the continuum in geriatric services.

To register for this program, download the pdf file of the program brochure, fill out the registration form and mail or fax it in via the information provided.

Dr. Alan Bernstein, President of the Canadian Institutes of Health Research (CIHR) and an internationally renowned molecular biologist delivered the inaugural Alan Bernstein Distinguished Lectureship for 2002 at St. Paul's Hospital on Dec. 6.

Dr. Bernstein has made key contributions to our understanding of embryonic development, hematopoiesis, cancer and formation of the cardiovascular system. His work has also been important in advancing techniques for gene therapy and the genetic analysis of mammalian development.

The Lectureship is the first of a series of lectures presented by the McDonald Research Laboratories/iCAPTUR4E Centre at St. Paul's Hospital, part of Providence Health Care. The series will provide iCAPTUR4E researchers and trainees with the opportunity to learn from recognized leading Canadian researchers.

Dr. Bernstein's presentation was entitled "Genetics and Genomic Approaches to Vascular Development and Hematopoiesis."

For Richmond residents living with kidney failure, traveling to a dialysis unit has been an added stress. That has changed, since the Vancouver Renal Region and Providence Health Care officially opened Richmond's first community dialysis unit on December 12, 2002.

In the past, Richmond dialysis patients had to travel to St. Paul's Hospital, Vancouver Hospital or the Vancouver Community Dialysis Unit for their treatments, three times every week. Offering community dialysis closer to home reduces the travel stresses these patients experience and helps them maintain their personal lives with more ease.

"I am full of praise for the new clinic. It is very convenient for me and all the other dialysis patients who live in Richmond," says Dr. Ferdinand Chen, a retired physician who has been on dialysis for over three years. Dr. Chen used to face a stressful fight with Oak Street Bridge traffic, three times a week, to drive from his Richmond home to Vancouver Hospital. "Now my treatment is just seven minutes away."

The dialysis clinic was made possible with the support of the Ministry of Health Services, the Provincial Renal Agency (an agency of the Provincial Health Services Authority) and the Vancouver Coastal Health Authority. St. Paul's Hospital, part of Providence Health Care, manages the clinic.

"Giving dialysis patients closer treatment options improves their quality of life," says Colin Hansen, Minister of Health Services. "Where there is a concentrated need, such as in Richmond, it makes sense to offer dialysis in the community. We are making it a priority for patients to have access to quality care wherever they live."

The additional resources associated with this new clinic improve Vancouver Coastal Health Authority's ability to provide dialysis to both acute and chronic renal patients. Similar clinics have been opened in North Vancouver, Powell River, Sechelt, Squamish and Vancouver.

"This increase in capacity within the region will help alleviate pressures on existing dialysis units and provide improved patient access to services closer to their homes," says Lee Clark, Director of the Renal Program for St. Paul's Hospital/Providence Health Care.

"The Provincial Renal Agency (PRA) is happy to help facilitate the regional development and implementation of 'Closer to Home' patient care," says Adeera Levin, PRA's Provincial Director. "It is through the collaboration of the Vancouver Renal Region team, working with and as part of the Provincial Renal Agency, that new community dialysis facilities are possible."

Dialysis is a required procedure for patients with kidney failure. It is performed to replace the kidneys' function of filtering waste products and excess fluid from the blood. It's a temporary treatment for some, but for those whose loss of kidney function is permanent, dialysis is needed on a regular basis. The only other treatment for kidney failure is a kidney transplant.

Patients for Richmond's stand-alone dialysis unit have been selected based on their stability on dialysis and control of their underlying medical conditions. Individuals requiring more medical support will remain in the care of their home hospital.

Located at #120 - 4671 No. 3 Road, the Richmond Community Dialysis Unit officially opened on December 12, 2002, but has been in operation since mid-November. It now serves 24 patients using six dialysis chairs, but will eventually serve 90 patients using 15 dialysis chairs.