There’s a drug problem in Canada. Part of it involves the recreational misuse of drugs, but another large aspect stems from drugs that doctors prescribe as treatment. Utilizing drugs for their unintended purposes cause deaths and health consequences throughout the country. Termed “off-label” prescriptions, a study from McGill released last April found that 11 per cent of prescriptions are used to treat illnesses for which they haven’t been approved by Health Canada.

The McGill study used the Medical Office of the XXI Century (MOXXI) electronic health records in Quebec to document and link treatment indication to the prescribed drug. The McGill researchers found the underlying causes for off-label prescription to likely be doctors’ lack of knowledge about drugs, and a scarcity of approved or effective medication. It was also found that anticonvulsants (66 per cent), antipsychotics (44 per cent), and antidepressants (33 per cent) are the most commonly used drugs for unregulated purposes. For example, anxiety medication may be prescribed to treat someone with insomnia.

Dr. Robyn Tamblyn, scientific director of the Canadian Institutes of Health Research (CIHR), and a researcher here at McGill, recognizes that off-label prescriptions are a reality in the health care system, but thinks that there is insufficient research on the topic. Further inquiry is important, she says, because of the drugs’ potentially lethal side effects. The drug tiagabine, for instance, is an anti-convulsive medication, meant to treat seizures; but when used as a treatment for pain, it has the side effect of causing seizures.  Another example is a treatment for acne, which has been linked to nine deaths in Canada since 2000 when used as birth control.

At the Senate committee on Social Affairs, Science and Technology earlier this month, Tamblyn proposed the idea of a monitoring system for regulating drug prescriptions. Despite previous rejection for regulation by Health Canada, Tamblyn will propose the idea to the body again later this month. A major impediment to creating a monitoring system is that, in most provinces, save for Quebec, doctors are not required to indicate what a prescription is for. A monitoring system in the works would require doctors and pharmacists to make note of whether a drug is off-label, and the reason for prescribing it. Provinces already keep administrative data of which drugs are dispensed to the population. However, some sort of overarching national-level cooperation is crucial to developing this monitoring system. Allowing the provincial databases to share information would help researchers track the effects of drugs, such as if they have negative side effects, or could potentially treat a different condition.

From a financial perspective, creating a database may be beneficial for the provinces. Sharing information on the side effects of drugs will allow doctors to avoid causing unintended harm through drug prescription, and allow them to make better use of the resources already at their disposal.

“It will give us a very novel way of looking at the safety and effectiveness of drugs,” said a contributing McGill researcher, Dr. Tewodros Equale, in an interview for AlumniOnlineCommunity.

Regulation of off-label prescriptions could lead to the next big medical breakthrough; but the bottom line is that regulating off label prescriptions will help protect the health of Canadians.

In honour of “Women’s Month,” the Tribune is profiling different female researchers at McGill, and the story behind their work. 

Imagine walking into a classroom filled entirely with people of the opposite gender. McGill Physics Professor Dr. Victoria Kaspi remembers her shock at the overwhelmingly male cohort during her undergraduate studies at McGill. While a part of the minority, her gender was never an issue until she started graduate school. During her university orientation, she attended a “Women in Physics” luncheon. At the time, Kaspi was surprised by the need for such an event, but in retrospect, she sees it as a hint of the challenges she would later face in her career.

As a faculty member, Kaspi is more aware of these issues than she was as a student, and she is not alone. The need to address gender inequality in the physics department is also felt by her colleagues. The department started a “Women in Physics” program that aims to mentor and foster the community of women in the field. Through organizing various speaker events, including breakfasts featuring host speakers from other universities, students can learn more about the challenges faced by, and opportunities available to women in physics. What’s more, these events provide students with the chance to hear about the career paths of other female physicists, building a stronger sense of community amongst the women enrolled in the physical sciences at McGill, and their professors.

At the faculty level, the proportion of female professors in the physics department at McGill is higher than average. While the department is always interested in more female applicants, Kaspi stressed that there’s no compromising on quality.

“Ultimately, it comes down to research excellence, and teaching ability,” Kaspi said.

With over 200 publications and numerous scientific awards, Dr. Kaspi embodies both of these qualities. Along with her role as a physics professor, she holds the positions of the Lorne Trottier Chair in Astrophysics and Cosmology, Canada Research Chair in Observational Astrophysics, and is a Fellow of the Royal Society, a group of scientists, engineers and technologists from the UK and the Commonwealth, all of whom are elected for life on the basis of excellence in science.

Kaspi’s research focuses on neutron stars—highly dense stars that are the close cousins of black holes.

“It’s a way to study something in an extreme environment, and [with] extreme properties: extremely high density, such that it’s higher than the atomic nucleus; extremely high gravity, so that regular gravity as described by Newton doesn’t work—you need Einstein’s theory of relativity, and extreme magnetic fields, highest in the universe and stars,” Kaspi explained. “You get to study a lot of extreme physics, but [neutron stars] are observable, so it’s not like a black hole, which is hard to observe.”

One subject of Kaspi’s research is pulsars, a type of neutron star characterized by the light they emit at precise time intervals. Based on Kaspi’s research, these stars could potentially act as beacons to guide spaceship navigation in the future.

“They rotate really fast and with a beam of light, almost like a lighthouse,” said Kaspi.

On top of her impressive research accomplishments, Kaspi is also the mother of three young children. She commented that while she has now struck a great work-life balance, juggling her children with her career was one of the hardest challenges in her life that she has faced—and one she never anticipated.

While Kaspi points out the challenges of being a female in the field of physics, she does not mean it as a deterrent. Her career has allowed her to travel all over the world, and engage in amazing opportunities.

“[I’ve been to] mountain peaks in Chile, and spent months in the outback of Australia,” Kaspi recalled, noting that she has also met amazing colleagues through her work. “I feel totally blessed doing it, and I wouldn’t trade it for the world.”

Researchers have hotly debated the topic of viral classification for the past several decades. While scientists are still undecided as to whether or not viruses should be considered “living,” it is clear that these organisms do not meet the classical definition of life—maintenance of homeostasis, cellular organization, metabolism, growth, adaptation, response to stimuli, and reproduction. Viruses are complicated assemblies of molecules, including proteins, nucleic acids, and lipids; however, they lack some of the defining characteristics of life, such as the ability to replicate without the assistance of a host cell.

Recently, researchers have encountered convincing evidence that demonstrates that viruses may possess more complex immune systems than previously explored. This discovery adds to the ambiguity surrounding the nature of viruses, and presents the possibility that viruses may be gradually evolving into living organisms.

In an interview with Discovery News, Andrew Camilli, a molecular biology and microbiology professor at the Tufts University School of Medicine, noted that his recent research with cholera bacteria might possibly add to the argument that viruses exist as living entities. Camilli’s research focused on the feasibility of this bacteria’s role as a viral predator. However, while analyzing DNA sequences of phages taken from stool samples of  Bangladeshi cholera patients in the lab, postdoctoral fellow Kimberley Seed was presented with persuasive evidence that could potentially accelerate the virus’s classification as a  living species.

Seed discovered genes in these phages, usually present only in a fully operative immune system of different types of bacteria. In search for further evidence, Seed and her fellow team conducted experiments with viruses that did and did not contain immune related genes to infect another new strain of cholera bacteria. The results demonstrated that only the phages with a fully functional immune system were able to successfully kill the cholera bacteria.

The team also conducted research demonstrating that viruses have the capacity to acquire the immune systems of bacteria during their primary stage of infection. Essentially, the virus acts like a thief that invades the home of another living organism, stealing its efficient immune system, and transforming it, so that it is capable of providing an immunologic function for the virus itself.

In NBC’s interview with Gustavo Caetano-Anollés, a researcher at the University of Illinois, further evidence was presented in favour of the virus as a life form. In Caetano-Anollés’ lab, researchers conducted a census of protein folds, present in over 1,000 organisms. They sampled from the three conventional branches of life: bacteria, eukaryotes, and microbes. Different types of large viruses were also present in the study, in order to compare their genomes with genomes of the different life forms sampled.

The proteins and enzymes found in the viruses rivaled some of those of bacteria. For example, a virus called Crov, which originates in the ocean contains genes that repair themselves. Moreover, the virus may produce sugars that aid in the repair of its genome, and this allows it to gain more control over the equipment in host cells that allow the virus to replicate itself.

The research team also looked at the different characteristic features of life forms, and compared them to the structure of a virus. They found several ancient protein folds—present in different living organisms, also in the viruses examined—which exhibited more proof that a virus contains the origins of life.

While the ongoing debate has caused many scientists to ponder over whether viruses are more than simple genetic material, recent advancements are proof enough that viruses may be gradually, but efficiently moving towards being classified as a form of life. On one hand, they are considered parasites because they require the bodies of host cells to survive. However, viruses meet all of the requirements of life when living within the host cells, so some researchers have gone as far to classify them as the simplest living organisms. As for now, in the midst of controversy, viruses seem to exist in a purgatory between living and non-living, containing characteristics from both classifications.