Michael Seth Silverman is a Canadian specialist in HIV/AIDS and infectious disease and Chief of Infectious Diseases at Saint Joseph’s Health Centre and London Health Sciences Centre, at the University of Western Ontario, in London, Ontario, Canada.[1]
Work in Guyana
editBetween 1994 and 2012, Silverman travelled to Guyana to lead medical teams offering free medical treatment to the country's residents when their health system was not able to serve those in remote communities.[2] For the first few years Silverman's work was accomplished through Ve'ahavta, a Jewish humanitarian organization based out of Toronto. He was the original director of medical operations with the organization. A team of doctors, a pharmacist, nurses, and administrators from Canada and the US travelled for two weeks to the remote area of southern Guyana. They provided medical care to impoverished villagers and taught basic healthcare skills.[3]
Silverman demonstrated that the high prevalence of malaria in some regions of Guyana was leading to widespread use of antimalarial drugs, which then caused bacteria to become resistant to important antibiotics (the quinolones). Malarial control using bednets and other non-antibiotic means could then help prevent the loss of utility of these antibiotics.[4][5]
Through his work in Guyana, Silverman was among the team that discovered the relationship between Yaws in the New World and the outbreak of syphilis in Europe after the discovery of America by Christopher Columbus. According to the study, Columbus and his men would have carried the nonvenereal tropical bacteria home, where the organisms may have mutated into a more deadly form in the different conditions of Europe.[6][7][8][9]
Work in Africa
editSilverman’s research in Africa into the use of a HAART regimen during pregnancy and breastfeeding showed that it appeared to significantly prevent the transmission of HIV from mothers to infants.[10][11] Similarly, Silverman undertook his humanitarian work in Zimbabwe, through Ve'ahavta.
Silverman worked in Africa to treat mothers during pregnancy and their newborn babies noting that treatment for H.I.V., syphilis, malaria and high blood pressure, can make enormous differences in whether mother and baby survive the birth. Many African women relied on traditional healers during pregnancy and only went to clinics during labor. In order to entice them to visit doctors during pregnancy, he instituted a program of ultrasounds with the promise that the women could see their unborn baby. This was a tremendous incentive and caused a jump in antenatal clinic visits by pregnant women.[12] in 1997, Ve'ahavta's founder, Avrum Rosensweig, arranged for $12,000 in donated medicine and pharmaceuticals from Apotex and Novopharm and arranged for emergency supplied once Silverman and is team encountered malaria and typhoid in children.[13]
Silverman also led a study linking the rise of tuberculosis with food shortages in Zimbabwe following the economic collapse. Locals were particularly susceptible to infectious diseases including HIV.[14]
The economic collapse also led to a decrease in HIV infections. Silverman pointed to the fact that sex workers could not ply their trade if people had no money to employ them.[15]
Treatment of C. difficile with fecal transplantation
editSilverman was one of the first North American physicians to use fecal transplantation in the treatment of recurrent C. difficile infection.[16] He demonstrated that the procedure could be both efficacious and made simple enough for patients to do on their own at home.[17] He also studies ways to try to reduce the overuse of antibiotics in the community. This may help reduce the incidence of C. difficile.
Fecal microbiota transplantation plus anti-PD-1 immunotherapy in advanced melanoma: a phase I trial
editIn a world-first clinical trial published in the journal Nature Medicine,[18] a multi-centre study from Lawson Health Research Institute, the Centre hospitalier de l'Université de Montréal (CHUM) and the Jewish General Hospital (JGH) has found fecal microbiota transplants (FMT) from healthy donors are safe and show promise in improving response to immunotherapy in patients with advanced melanoma.[19]
Treatment of metabolic disease and weight gain with fecal transplantation
editIn a Canadian study where Silverman served as principal investigator, the effects of fecal transplants on liver fat in people with fatty liver disease showed changes in the recipients’ guts, making the gut membrane less permeable, or “leaky.”
"This is important because one hypothesis for how an abnormal microbiome could contribute to metabolic disease and weight gain is by damaging the gut barrier that keeps toxins and pathogens from crossing into the bloodstream. When this occurs, it can set off a cascade of inflammation, contributing to insulin resistance, cardiovascular disease and autoimmune conditions, said Dr. Michael Silverman, the lead author of the study and the chairman of infectious diseases at Western University in Ontario”, the New York Times reported.[20]
Work to protect injection drug Users from infection
editSilverman is involved in trying to reduce the incidence of life-threatening infections such as HIV, hepatitis and endocarditis (a heart valve infection) in people who inject drugs.[21]
He demonstrated that the sharing of equipment used to inject drugs could help to spread HIV and Hepatitis C. The reuse of the equipment could also help to lead to bacterial contamination and then endocarditis, an infection with a high mortality. He demonstrated that this was especially problematic when long acting opiates were used.[22] He initiated a novel community program to “cook your wash” and thus partially sterilize the fluid which would be injected using a cigarette lighter. This program helped to end an HIV outbreak in London, Ontario[23][21]
Silverman also showed that starting addiction counselling while in hospital (as opposed to after their release) for persons who inject drugs with heart valve infections, was associated with a reduced risk of death, possibly because patients were more receptive to change when they realized the lethal potential of this highly fatal complication.[24]
Awards
editFor his contributions to the fight against the global AIDS epidemic, Silverman was honoured by Ve'ahavta with the Tikkun olam award for medicine in 2010.[25][26]
References
edit- ^ "Michael S. Silverman". Schulich Medicine and Dentistry.
- ^ "Toronto Jews take to streets and the Guyana rainforests to serve those in need". The Jewish News of Northern California. 20 April 2001.
- ^ "Lending a hand to Guyana's poor [Medical - ProQuest". www.proquest.com. Retrieved 2024-11-14.
- ^ "Malaria drug may hit antibiotics". BBC.
- ^ Juncosa, Barbara (21 July 2008). "Antibiotic Resistance: Blame It on Lifesaving Malaria Drug?". Scientific American.
- ^ Harper, Kristin N.; Ocampo, Paolo S.; Steiner, Bret M.; George, Robert W.; Silverman, Michael S.; Bolotin, Shelly; Pillay, Allan; Saunders, Nigel J.; Armelagos, George J. (15 January 2008). "On the Origin of the Treponematoses: A Phylogenetic Approach". PLOS Neglected Tropical Diseases. 2 (1): e148. doi:10.1371/journal.pntd.0000148. PMC 2217670. PMID 18235852.
- ^ Zimmer, Carl (2008). "Isolated Tribe Gives Clues To The Origins Of Syphilis". carlzimmer.com.
- ^ Abraham, Carolyn (15 January 2008). "Columbus brought syphilis to Europe, study shows". The Globe and Mail.
- ^ Wilford, John Noble (15 January 2008). "Genetic Study Bolsters Columbus Link to Syphilis". New York Times.
- ^ Thistle, Paul; Bolotin, Shelly; Lam, Eugene; Schwarz, Dan; Pilon, Richard; Ndawana, Billy; E Simor, Andrew; Silverman, Michael (2011). "Highly active anti-retroviral therapy in the prevention of mother-to-child transmission of HIV in rural Zimbabwe during the socio-economic crisis". Medicine, Conflict and Survival (27): 1650–176.
- ^ Silverman, Michael (17 March 2010). "Clinical Study of an Aluvia-based HAART Regimen for Prevention of Mother-to-child HIV Transmission in Africa". ClinicalTrials.gov.
- ^ McNeil Jr., Donald G. "In Africa, Rural Clinics Entice Pregnant Women With 'Baby Pictures'". The New York Times. Retrieved 10 November 2017.
- ^ "Lending a hand to Guyana's poor [Medical - ProQuest". www.proquest.com. Retrieved 2024-11-14.
- ^ Damjanovic, Jelena (5 February 2014). "Food shortages in Zimbabwe sparked increase in tuberculosis, study finds". U of T News.
- ^ "Zimbabwe's HIV infection rate down". The Associated Press. 24 July 2009.
- ^ Craven, Laura J.; Parvathy, Seema Nair; Tat-Ko, Justin; Burton, Jeremy P.; Silverman, Michael S. (6 November 2017). "Extended Screening Costs Associated With Selecting Donors for Fecal Microbiota Transplantation for Treatment of Metabolic Syndrome-Associated Diseases". Open Forum Infectious Diseases. 4 (4): ofx243. doi:10.1093/ofid/ofx243. PMC 5730934. PMID 29255739.
- ^ Silverman; Davis; Pillai (October 31, 2023). "Success of Self-Administered Home Fecal Transplantation for Chronic Clostridium difficile Infection". Medscape.
- ^ "Fecal microbiota transplantation plus anti-PD-1 immunotherapy in advanced melanoma: a phase I trial". Nature Medicine.
- ^ "Fecal transplants show promise in improving melanoma treatment". Science Daily.
- ^ O’Connor, JAnahad (10 September 2008). "Seeking an Obesity Cure Researchers Turn to the Gut Microbiome". New York Times.
- ^ a b "Note to Harm Reduction Programs and Staff Regarding Recent HIV Research and 'Cook Your Wash'" (PDF). catie.ca. May 3, 2019.
- ^ Silverman, Michael; Slater; Jandoc; Garg; Weir (January 22, 2020). "Hydromorphone and the Risk of Infective Endocarditis Among People Who Inject Drugs: A Population Based Retrospective Cohort Study". Lancet Infectious Diseases. 20 (4): 487–497. doi:10.1016/S1473-3099(19)30705-4.
- ^ Dunham, Jackie (April 25, 2019). "Researchers discover another way HIV can spread among drug users". CTV News.
- ^ Long, Sacha (21 November 2018). "Surgery, counselling improve outcome for IV drug users with heart valve infection: study". CTV News London. CTV News. Retrieved 24 January 2019.
- ^ "Veahavta Tikun Olam Awards" (PDF). veahavta.org.
- ^ Rosensweig, Avrum (1 December 2011). "VE'AHAVTA HONOURS THE REPAIR PEOPLE". Canadian Jewish News.