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Research, Sports, Stanford News

New research offers comprehensive picture of the lingering effects of sports injuries

New research offers comprehensive picture of the lingering effects of sports injuries

15403-injuries_newsIn an effort to better understand the lasting impact of sports injuries, Stanford physicians collaborated with the university’s athletic department to enroll nearly 1,700 student athletes in an electronic pre-participation evaluation (ePPE) program and track their health over a three-year period.

During the course of the study, which was published in the current issue of The American Journal of Sports Medicine, the researchers documented 3,126 injuries (1,473 for women and 1,653 for men) that caused athletes to miss an average of 31 days of competition each. Musculoskeletal injuries were the most common, but athletes also suffered from concussions, eating disorders and infectious illnesses. As reported in a Stanford news story today, the research provides new insights into the lasting impact of injuries in greater detail than ever:

Among the findings, 11 percent of the students still suffered symptoms from a previous injury at the time of their next ePPE. Head injuries accounted for 9 percent of all injuries. Although only 3 percent of women reported a diagnosed eating disorder, 15 percent of all women reported a history of stress fractures, which can be associated with low body fat, from either disordered eating or overtraining.

[Gordon Matheson, MD, PhD, who led the study,] said that although the data are eye-opening, interpreting the material and deciding what is particularly meaningful may be an even bigger effort.

“We know that student-athletes have a lot of injuries from sport participation. But unless we have pooled, aggregate data like this, it’s difficult to measure trends and spot areas of concern applied to prevention,” said Matheson.

Researchers hope to partner with other universities to expand their data set and learn more about why some players are symptomatic at the time of follow-up evaluations and, ultimately, help make sports safer.

Previously: Female high-school athletes suffer more overuse injuries than their male counterparts, Director of Stanford Runner’s Injury Clinic discusses advances in treating six common running injuries, Lingering effects of injuries sideline many former college athletes later in life and Sports medicine specialists, educators endorse checklist to reduce injuries among youth athletes
Photo by Andrey Popov/Shutterstock

Addiction, Mental Health, Pain, Public Health, Technology

Student engineers unveil tamper-proof pill bottle

Student engineers unveil tamper-proof pill bottle

Pill-dispenserThe United States has been battling a prescription painkiller epidemic for years. The statistics from the Centers for Disease Control and Prevention are chilling: The number of painkillers prescribed has quadrupled since 1999; more than two million people abused painkillers in 2013; every day, 44 people die from a prescription opioid overdose.

In response, faculty at the Center for Injury Research and Policy at the Johns Hopkins Bloomberg School of Public Health issued a challenge to seniors in the university’s mechanical engineering program: build a pill bottle that would protect against theft and tampering.

One team of students came up with a design that worked so well that their team’s mentors Andrea Gielen, ScD, and Kavi Bhalla, PhD, submitted a proposal to the National Institutes of Health for further testing.

The device is about the size of a can of spray paint, much larger than the average pill bottle. It can only be opened with a special key, which pharmacists can use to refill with a month’s supply of OxyContin. A fingerprint sensor ensures only the prescribed patient can access the pills at prescribed intervals and doses. In a story on the Johns Hopkins website earlier this month, Megan Carney, one of the student engineers described how the pill dispenser works:

The device starts to work when the patient scans in his or her fingerprint. This rotates a disc, which picks up a pill from a loaded cartridge and empties it into the exit channel. The pill falls down the channel and lands on a platform where the patient can see that the pill has been dispensed. The patient then tilts the device and catches the pill in their hand.

A short video about the pill dispenser shows it in action, too. The dispenser still has to undergo additional testing, but the team hopes to bring it to market soon — and help prevent future opioid overdoses.

Previously: Unmet expectations: Testifying before Congress on the opioid abuse epidemic, The problem of prescription opioids: “An extraordinarily timely topic”, Assessing the opioid overdose epidemic, Why doctors prescribe opioids to patients they know are abusing them and Stanford addiction expert: It’s often a “subtle journey” from prescription-drug use to abuse
Photo courtesy of Johns Hopkins University

Autoimmune Disease, Immunology, Public Health, Research, Sleep, Stanford News

Cause of 2009 swine-flu-vaccine association with narcolepsy revealed?

Cause of 2009 swine-flu-vaccine association with narcolepsy revealed?

syringesBack in 2001, in the wacko cinematic tour de farce “Rat Race,” British actor Rowan Atkinson – a.k.a. the iconic “Mr. Bean” – put a humorous face on narcolepsy, a rare, chronic, incurable and lifelong sleep disorder that can strike at any time, even in the heat of a foot race.

In 2009, narcolepsy suddenly became, for a time, not quite so rare.

The swine flu pandemic sweeping the world that year was no joke. In the United States alone, the H1N1 strain of influenza virus responsible for that pandemic resulted in 274,304 hospitalizations and 12,469 deaths, as mentioned in our news release on a just-published study in Science Translational Medicine.

There probably would have been far more hospitalizations and deaths had not several vaccines tailored to that particular influenza strain been rushed to the market. Two vaccines in particular — Focetria, manufactured by Novartis, and Pandemrix, made by GlaxoSmithKline — are credited with saving a lot of lives in Europe. But there was a dark side. As our news release notes:

Populations that had been immunized with GlaxoSmithKline’s Pandemrix vaccine showed an increase in narcolepsy, but those immunized with Novartis’ Focetria did not.

That’s not news; it’s been known for some time. But the findings in the new study, whose senior author is Stanford neuroimmunologist Larry Steinman, MD, may explain why.

Continue Reading »

Aging, Cancer, Dermatology, Genetics, Research, Stanford News

Genetic secrets of youthful skin

Genetic secrets of youthful skin

new hatEvery year, upwards of $140 billion a year gets spent on cosmetics. In the United States alone, says an authoritative report, a recent year saw upwards of 5.6 million Botox procedures, 1.1 million chemical peels, almost a half-million laser skin procedures, 196,286 eyelid surgeries and a whole bunch of face lifts.

If you’ve got the courage to compare your present-tense face with the one you were wearing 20 or even 10 years ago, you’ll see why. As I wrote in a just-published Stanford Medicine article, “Wither youth?”:

The terrain of aging skin grows all too familiar with the passing years: bags under the eyes, crow’s feet, jowls, tiny tangles of blood vessels, ever more pronounced pores and pits and pigmentation irregularities. Then there are wrinkles — long, deep “frown lines” radiating upward from the inside edges of the eyebrows and “laugh lines” that trace a furrow from our nostrils to the edges of our lips in our 40s, and finer lines that start crisscrossing our faces in our 50s. Sagging skin gets more prominent in our later years as we lose bone and fat.

“And,” I added wistfully, “it’s all right there on the very outside of us, where everyone else can see it.”

Stanford dermatologist Anne Chang, MD, who sees a whole lot of skin, got to wondering: Why does skin grow old? Armed with a sophisticated understanding of genetics, she went beyond lamenting lost youth and resolved to address the question scientifically, asking: “Can you turn back time? Can aging effects be reversed? Can you rejuvenate skin, make it young again?”

The answers she’s come up with so far – from hereditary factors to a possible underlying genetic basis for how some treatments now in common commercial cosmetic use (such as broadband light therapy) could potentially slow or even reverse the aging of skin – are described in my magazine article.

Previously: This summer’s Stanford Medicine magazine shows some skinResearchers identify genetic basis for rosacea, New study: Genes may affect skin youthfulness and Aging research comes of age
Photo by thepeachpeddler

Grand Roundup

Grand Roundup: Top posts of June

Grand Roundup: Top posts of June

It’s time to look back at this month’s five-most read stories on Scope. They were:

Eating for good blood: Tips for boosting iron levels and hemoglobin: This entry from the Stanford Blood Center discusses hemoglobin levels and offers ways to boost levels prior to blood donation.

New recommendation: Adults need at least 7 hours of sleep each night: How much sleep is needed for adults? A new set of recommendations was published in the journal SLEEP and developed by 15 sleep experts in a consensus panel assembled by the American Academy of Sleep Medicine and the Sleep Research Society.

CRISPR marches forward: Stanford scientists optimize use in human blood cells: CRISPR is a breakthrough way of editing the genome of many organisms, including humans — a kind of biological cut-and-paste function that is already transforming scientific and clinical research. New work in this area is detailed here.

To live longer, men need to embrace their femininity, new research suggests: Women live longer than men, but when faced with socio-economic adversity, that lifespan gap grows, according to new research from a team of Stanford scientists.

Stanford med student/HHMI fellow investigates bacteriophage therapy as an alternative to antibiotics: In this piece, second-year medical student Eric Trac discusses the work he’s doing for his year-long Howard Hughes Medical Institute fellowship.

Our most-shared story of the month: New recommendation: Adults need at least 7 hours of sleep each night

And still going strong – the most popular post from the past:

What are the consequences of sleep deprivation?: Brandon Peters, MD, an adjunct clinical faculty member at the Stanford Center for Sleep Sciences and Medicine, explains how lack of sleep can negatively affect a person’s well-being in this Huffington Post piece.

Behavioral Science, Health and Fitness, Mental Health, Public Health, Research, Stanford News

Exposure to nature helps quash depression – so enjoy the great outdoors!

Exposure to nature helps quash depression - so enjoy the great outdoors!


hiking_news-1

Walking is good for your health. But walking somewhere natural is even better, according to a new Stanford-led study.

Study participants who walked in a natural area for 90 minutes showed less activity in a brain region associated with depression than those who walked through a city or other urban area, a Stanford News story states. From the piece:

“These results suggest that accessible natural areas may be vital for mental health in our rapidly urbanizing world,” said co-author Gretchen Daily, the Bing Professor in Environmental Science and a senior fellow at the Stanford Woods Institute for the Environment. “Our findings can help inform the growing movement worldwide to make cities more livable, and to make nature more accessible to all who live in them.”

Even further, the research supports — but does not prove — a link between urbanization and growing rates of mental illness, said co-author James Gross, PhD, a professor of psychology.

The researchers had one group of participants walk in a grassland with oak trees and shrubs. The other group walked along a traffic-clogged four-lane road. They then measured heart and respiration rates, performed brain scans and had the participants answer a series of questions. The results showed that:

Neural activity in the subgenual prefrontal cortex, a brain region active during rumination – repetitive thought focused on negative emotions – decreased among participants who walked in nature versus those who walked in an urban environment.

Evidence that supports the knowledge you’ve had since grade school: The outdoors really can make you feel better.

Previously: To get your creative juices flowing, start movingA look at the effects of city living on mental health and Out-of-office autoreply: Reaping the benefits of nature
Photo by Linda A. Cicero/Stanford News Service

Health and Fitness, Pediatrics, Research, Sports

Female high-school athletes suffer more overuse injuries than their male counterparts

Female high-school athletes suffer more overuse injuries than their male counterparts

When I was younger, the prevailing parenting advice regarding athletics and children was to identify a sport your child would enjoy early on and have them focus on it throughout adolescent so she would have a competitive edge. Which is how I ended up playing on a boys soccer team at the age of five — there were no all-girls soccer teams in Austin, Texas in 1983. Soccer continued to be my sole sport throughout high school and college. Eventually, I had to give it up because the constant ankle injuries I endured meant I spent more time in rehab mode than training mode.

Never once did a physician or a trainer suspect that the injuries were related to overuse, despite the long hours I logged on running paths, in the weight room and on the field. So I was interested to read about recent research showing that girls are at a much higher risk than boys when it comes to overuse injuries in high-school sports.

In the study, researchers at the Ohio State University Wexner Medical Center reviewed 3,000 male and female injury cases over a seven year period across 20 high-school sports including soccer, volleyball, gymnastics and lacrosse. According to a release:

[Researchers] found the highest rate of overuse injuries occurred in girls track (3.82), followed by girls field hockey (2.93) and girls lacrosse (2.73). Overuse injuries in boys were most found in swimming and diving (1.3).

“These young people spend more time playing sports both in competition and in practice. So, there’s a correlation there between the amount of time that they’re playing and the increased incidence of injuries,” said [Thomas Best, MD, PhD,] who is also a professor and Pomerene chair in Ohio State’s department of family medicine.

The participation and intensity of high school athletics has increased over the past decade. According to Best, some high school athletes spend more than 18 hours a week participating in athletics and many participate in multiple sports concurrently.

Watch the clip above to learn more about researchers’ findings and recommendations.

Previously: Researchers call for improvements to health screenings for female college athletes and Stanford physician discusses prevalence of overuse injuries among college athletes

Big data, BigDataMed15, Chronic Disease, Genetics, Videos

Parents turn to data after son is diagnosed with ultra-rare disease

Parents turn to data after son is diagnosed with ultra-rare disease

Keynote talks and presentations from the 2015 Big Data in Biomedicine conference at Stanford are now available on the Stanford YouTube channel. To continue the discussion of how big data can be harnessed to improve the practice of medicine and enhance human health, we’re featuring a selection of the videos on Scope.

Four years ago, Matthew Might, PhD, and his wife, Christina, learned that their son Bertrand was the first person to be diagnosed with ultra-rare genetic disorder called N-Glycanase Disorder. At the 2015 Big Data in Biomedicine conference at Stanford, Might recounted the story of his son’s medical odyssey and explained how a team of Duke University researchers used whole-exome sequencing, which is a protein-focused variant of whole-genome sequencing, on himself, his wife and Bertrand to arrive at his son’s diagnosis.

Watch the video above to find out how Might and his family, who turned a deaf ear to doctors’ advice that nothing could be done for their son, harnessed the power of the Internet to identify 35 more patients with the same disorder and are now leading the charge in helping scientists better understand the disorder.

Previously: Nobel Laureate Michael Levitt explains why “biology is information rich” at Big Data in Biomedicine, At Big Data in Biomedicine, Stanford’s Lloyd Minor focuses on precision health, Experts at Big Data in Biomedicine: Bigger, better datasets and technology will benefit patients, On the move: Big Data in Biomedicine goes mobile with discussion on mHealth and Big Data in Biomedicine panelists: Genomics’ future is bright

Events, Imaging, Neuroscience, Research

Physician-monk leads Stanford doctors in meditation

Physician-monk leads Stanford doctors in meditation

Kerzin and Verghese - smallAfter he finished his recent Grand Rounds talk here at the medical school, and before he opened the room to questions, physician Barry Kerzin, MD, asked the audience of doctors, residents, and a PBS film crew, to silence their cell phones, focus on their breath, and join him for five minutes of meditation.

It made sense because Kerzin, who provides medical care to His Holiness the Dalai Lama and is also a Buddhist monk, had just spent time explaining the central ideas of mindfulness meditation and highlighting the results from various scientific studies on brain changes and the benefits that mindfulness training can bring. Kerzin’s familiarity with the work comes partly from his participation in two of these studies.

As Stanford’s Abraham Verghese, MD, said when introducing Kerzin, many people in the audience may have had their work published in journals like Nature or PNAS, but “who has had [their] brain appear in one of these publications?”

Kerzin’s brain was part of research that compared those of long-term meditators (people who had clocked more than 10,000 hours meditating) to novices’ brains. MRI brain scans revealed increases in size and activity in Kerzin’s and the other monks’ prefrontal cortex, the part of the brain involved with planning and reasoning, as well as empathy and imagination. In one of the studies, Kerzin was hooked up to an EEG machine to demonstrate that when engaged in mindfulness meditation, his brain gave out bursts of high frequency signals called gamma waves, an unusual brain pattern thought to be linked to neural synchrony.

While these studies’ findings pertained to experienced meditators, Kerzin also presented a study where beginners were given either meditation training or health education for six weeks. At the end, when given a stress test, people in the meditation group produced statistically less stress hormones.

Although the most striking differences weren’t seen in beginning meditators, Kerzin also presented a study were volunteers where given either meditation training or health education for six weeks. At the end, when given a stress test, people in the meditation group produced statistically less stress hormones.

Last year I myself participated in a meditation study similar to the ones presented by Kerzin, although the final test in my case was an observation session of the participating parents’ interactions with their toddlers, and measuring stress hormone levels in both. That study hasn’t been published yet, but the subjective view of my husband is that I’m a lot calmer these days as a result of my continued meditation.

Given my experience, I wish I could say I rocked the group meditation at the talk, but I had a hard time concentrating. By focusing on my breathing I could mostly ignore the presentation and applause coming from the room next door. What was harder was blocking out my own thoughts, thoughts of the future – and specifically of writing this blog post. But overall, it was nice to take a moment and try to live in the present.

Kerzin’s talk, called “The science behind meditation,” is available here. Kerzin is also speaking on “Compassionate living” at a Center for Compassion and Altruism Research and Education event this evening; video of that talk will be available on the CCARE website in coming weeks.

Kim Smuga-Otto is a student in UC Santa Cruz’s science communication program and a writing intern in the medical school’s Office of Communication and Public Affairs.

Previous: What the world needs now: altruism/A conversation with Buddhist monk-author Matthieu Ricard, From suffering to compassion: Meditation teacher-author Sharon Salzberg shares her storyHis Holiness the 17th Karmapa discusses the nature of compassionResearch brings meditation’s health benefits into focus and 10% happier? Count me in!
Photo of Barry Kerzin (left) and Abraham Verghese by Margarita Gallardo

Genetics, In the News, Research, Science, Stanford News, Stem Cells, Technology

CRISPR marches forward: Stanford scientists optimize use in human blood cells

CRISPR marches forward: Stanford scientists optimize use in human blood cells

The CRISPR news just keeps coming. As we’ve described here before, CRISPR is a breakthrough way of editing the genome of many organisms, including humans — a kind of biological cut-and-paste function that is already transforming scientific and clinical research. However, there are still some significant scientific hurdles that exist when attempting to use the technique in cells directly isolated from human patients (these are called primary cells) rather than human cell lines grown for long periods of time in the laboratory setting.

Now pediatric stem cell biologist Matthew Porteus, MD, PhD, and postdoctoral scholars Ayal Hendel, PhD, and Rasmus Bak, PhD, have collaborated with researchers at Santa Clara-based Agilent Research Laboratories to show that chemically modifying the guide RNAs tasked with directing the site of genome snipping significantly enhances the efficiency of editing in human primary blood cells — an advance that brings therapies for human patients closer. The research was published yesterday in Nature Biotechnology.

As Porteus, who hopes to one day use the technique to help children with genetic blood diseases like sickle cell anemia, explained to me in an email:

We have now achieved the highest rates of editing in primary human blood cells. These frequencies are now high enough to compete with the other genome editing platforms for therapeutic editing in these cell types.

Porteus and Hendel previously developed a way to identify how frequently the CRISPR system does (or does not) modify the DNA where scientists tell it. Hendel characterizes the new research as something that will allow industrial-scale manufacturing of pharmaceutical-grade CRISPR reagents. As he told me:

Our research shows that scientists can now modify the CRISPR technology to improve its activity and specificity, as well as to open new doors for its use it for imaging, biochemistry, epigenetic, and gene activation or repression studies.

Rasmus agrees, saying, “Our findings will not only benefit researchers working with primary cells, but it will also accelerate the translation of CRISPR gene editing into new therapies for patients.”

Onward!

(Those of you wanting a thorough primer on CRISPR —how it works and what could be done with it — should check out Carl Zimmer’s comprehensive article in Quanta magazine. If you prefer to learn by listening (perhaps, as I sometimes do, while on the treadmill), I found this podcast from Radiolab light, but interesting.)

Previously: Policing the editor: Stanford scientists devise way to monitor CRISPR effectiveness and “It’s not just science fiction anymore”: Childx speakers talk stem cell and gene therapy

 

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