The Public Health Agency of Canada estimates that 315,000 Canadians were living with the effects of stroke in 2011.

Stroke can lead to physical and functional deficits including paralysis, physical pain, emotional disturbances and difficulty swallowing, speaking or thinking. Although a number of specially designed rehabilitation programs exist that help stroke survivors recover as much of their strength and function as possible, patients and their caregivers often comment that the transition home can be the most difficult.

A team of researchers led by TRI Adjunct Scientist Dr. Jill Cameron demonstrated that allowing stroke survivors to go home for the weekend (on a "weekend pass") can inform their rehabilitation program and facilitate the transition home.

To gain insight into the impact of the weekend pass, the researchers interviewed patients, caregivers and their health care providers after the first weekend pass and four weeks after returning home. Researchers found that the weekend pass helped stroke survivors identify challenges at home that could be addressed in their rehabilitation programs prior to discharge from the hospital. It also helped caregivers understand the stroke survivors' abilities and better prepare for bringing their family member home. Moreover, the study revealed ways in which the current weekend pass could be modified to better meet the needs of patients and their caregivers.

Dr. Cameron comments, "Enhancing the process for the weekend pass is one way to help patients and families manage one of the most challenging of transitions within the health care system—the transition home."

This work was supported by the Ontario Stroke Network.

Stroke survivors', caregivers', and health care professionals' perspectives on the weekend pass to facilitate transition home. Cameron JI, Bastawrous M, Marsella A, Forde S, Smale L, Friedland J, Richardson D, Naglie G. J Rehabil Med. 2014 Aug 28. [Pubmed abstract]

The highly varied symptoms of lupus (also known as systemic lupus erythematosus) include joint pain, fever, light sensitivity, fatigue, hair loss and skin conditions.

Lupus is a condition in which the body's immune system attacks multiple organs. The disease is often hard to diagnose because the exact symptoms differ in each person and vary over time. Often patients with lupus experience "flares" when their symptoms worsen. Currently, blood tests for two proteins (anti-dsDNA and C3) are used to diagnose lupus; however, they do not always provide reliable readouts of disease activity. As a result, lupus is often underdiagnosed or overdiagnosed, which can lead to serious medical complications.

Researchers are searching for other molecules (eg, biomarkers) that better predict disease state. At TWRI, Principal Investigator Dr. Carolina Landolt-Marticorena and Senior Scientist Dr. Joan Wither have helped advance this global search. Their study, published in Rheumatology, found that immune molecules in the blood, known as anti-nucleosome antibodies, out-performed traditional biomarkers. Specifically, levels of anti-nucleosome antibodies were better able to predict the severity of lupus symptoms over time in individual patients.

Dr. Landolt-Marticorena comments, "While anti-nucleosome antibodies performed as well as widely used biomarkers, their real advantage is that levels of this biomarker actually mirror changes in disease activity over time. Thus, anti-nucleosome may serve as a valuable personalized readout of disease, leading to better informed and more effective treatment decisions."

This study was supported by the Canadian Institutes of Health Research and the Alliance for Lupus Research. PR Fortin is a Tier I Canada Research Chair in Multidisciplinary Health Research.

Anti-nucleosome antibodies outperform traditional biomarkers as longitudinal indicators of disease activity in systemic lupus erythematosus. Li T, Prokopec SD, Morrison S, Lou W, Reich H, Gladman D, Urowitz M, Scholey J, Fortin PR, Boutros PC, Wither J, Landolt-Marticorena C. Rheumatology. 2014 Sep 5. [Pubmed abstract]

The small intestine (orange) is the site of digestion and nutrient absorption after a meal.

Cells that line the small intestine are efficient at absorbing fats (triglycerides) from food, as well as secreting them into the blood. While fats absorbed by the intestine travel to various tissues in the body for storage, the intestine itself also has an ability to store these lipids. A recent article by TGRI Senior Scientist Dr. Gary Lewis provides important insight into how the body controls the balance between fat storage and release.

In the article, Dr. Lewis identified a new role for a gut hormone known as GLP2. After administering GLP2 to healthy volunteers, the research team found that blood triglyceride levels were momentarily elevated. In a separate experiment, his team devised a way to track triglycerides and found that GLP2 caused the release of triglycerides that had been stored inside intestinal cells.

Currently GLP2 is used to treat people with nutrient deficiencies caused by bowel disorders. This study raises important questions about whether long term effects could include elevated blood lipid levels, which is a risk factor for heart disease.

Dr. Lewis comments, "This work reveals a new way to control blood triglycerides and may enable the design of new, more specific drugs to treat bowel disorders. Furthermore, drugs that target GLP2 may represent a new strategy help reduce high blood triglyceride associated with heart disease."

This work was supported by the Canadian Institutes of Health Research, the National Institutes of Health and the Toronto General & Western Hospital Foundation. GF Lewis is the Sun Life Financial Chair in Diabetes and the Drucker Family Chair in Diabetes Research.

Glucagon-like peptide 2 regulates release of chylomicron from the intestine. Dash S, Xiao C, Morgantini C, Connelly PW, Patterson BW, Lewis GF. Gastroenterology. 2014 Aug 27. [Pubmed abstract]