Stanford professor Rafael Pelayo, MD, was the guest on KGO’s Ronn Owens Show yesterday. During the hour-long interview, Pelayo discussed and took listeners’ questions on mobile applications that claim to help you rest easy, sleep disturbances related to aging, the dream cycle, the importance of sleep environment and the effectiveness of sleeping aids, including various medications.

On the topic of irregular sleep schedules, such as pulling an all-nighter or shift work, Pelayo explained that it could take some time to regain the sleep loss:

If you go one night with zero sleep it takes four to five days to make up that difference. For example, if you normally sleep eight hours a night then you’re not going to sleep 16 hours the next day. You might sleep 10 hours over a series of days to make up the time that you’ve lost.

Previously: Stanford expert: Quality, not quantity, of sleep is what counts
Photo by CraigGrocott

Past studies have shown that exercising can reduce anxiety, help in treating depression and boost your mental health in other ways. Now a study (subscription required) recently published in Journal of Business and Psychology shows it could also make the workplace more enjoyable — that is if it’s your boss who’s hitting the gym.

Scientific American reports:

Researchers asked 98 MBA students who were also employed full-time to rate how their supervisors treated them, by responding to statements like “[my boss] puts me down in front of others.” The researchers also had supervisors fill out a different survey, about their stress levels and weekly exercise. And, as the authors expected, the more stressed-out supervisors were, the more their employees felt belittled by them. But the employees felt better about bosses who exercised, whether it was yoga, cardio or weight lifting. And just one or two days a week did the trick.

Exercise didn’t simply melt away the stress—bosses who worked out reported feeling just as much pressure as their sedentary counterparts. Active bosses just spared subordinates the verbal attacks.

Previously: Taking time out to exercise during the workday may boost productivity, Do exercise breaks improve mental and physical fitness? and Exercise may be effective in treating depression
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Findings recently published in the journal Obesity offer new insights into the link between obesity and chronic pain.

In the study (subscription required), researchers analyzed responses from 1,010,762 men and women who answered health survey questions during a telephone interview by the Gallop Organization between 2008 and 2010. Participants’ body mass index (BMI) was calculated based on questions regarding their height and weight. Respondents also answered questions about pain, such as if they “experienced pain yesterday.” Science Daily reports:

Sixty three percent of the 1,010,762 people who responded to the survey were classified as overweight (38 percent) or obese (25 percent). Obese respondents were further classified into one of three obesity levels as defined by the World Health Organization. In comparison to individuals with low to normal weight, the overweight group reported 20 percent higher rates of pain. The percent increase of reported pain in comparison to the normal weight group grew rapidly in the obese groups: 68 percent higher for Obese 1 group, 136 percent higher for Obese 2 group, and 254 percent higher for Obese 3 group.

Researchers suggested several explanations for the close relationship between obesity and pain including: the possibility that having excess body fat triggers complex physiological processes resulting in inflammation and pain; depression, often experienced by obese individuals, influences pain; and medical conditions that cause pain, such as arthritis, might result in reduced levels of exercise leading to weight gain.

Although more study is needed, the findings are notable and add to the evidence showing that overweight patients are at greater risk for chronic pain.

Previously: More than three-quarters of Americans projected to be overweight, obese by 2020, Behavioral therapy for weight loss may also benefit family members, Study finds family members of weight-loss-surgery patients also shed pounds, Stanford researchers, clinicians and academics gather for Obesity Summit 2, Study shows U.S. obesity rates will expand over next 40 years and Experts weigh in on the most effective approach to fighting obesity
Photo by Tony Alter

The first inkling I had that statisticians could be the opposite of dull was at last spring at Stanford’s Cancer Institute retreat. I was listening to the keynote speaker and thinking: (1) A statistician for the keynote? I hope I can keep my eyes open; and (2) What he’s saying is revolutionary! The speaker was Donald Berry, PhD, from the University of Texas M.D. Anderson Cancer Center, describing how to do clinical trials that get answers far quicker than traditional trials can. The audience was charged up – popping with questions during and after the talk.

Once I started paying attention, I noticed those “boring” statisticians were doing some of the coolest research we cover here, and that they’re changing the paradigm for drug discovery – or at least creating a new one.

Now my suspicions are confirmed.

Here’s how Stanford statistics professor Rob Tibshirani, PhD, puts it, in a post in the New York Times Bits blog today:

“Most of my life I went to parties and heard a little groan when people heard what I did,” says Robert Tibshirani, a statistics professor at Stanford University. “Now they’re all excited to meet me.”

The piece continues:

It’s not because of a new after-shave. Arcane statistical analysis, the business of making sense of our growing data mountains, has become high tech’s hottest calling.

To find out about the statistics boom, including what starting salaries for statistics grads are, and how hard it has become to get into Stanford’s statistics graduate program, read the whole piece.

I was a pretty healthy kid growing up, something I’ve mostly attributed to my parents’ encouragement of my vegetable-eating, outdoor-playing tendencies. It wasn’t until today when I read this Reuters article that it even occurred to me that my health could influence – or predict – that of my parents.

A new study in the Journal of Pediatrics finds that kids’ health may be a good predictor of their parents’ cardiovascular health.

Charles J. Glueck, MD, of Jewish Hospital of Cincinnati led the study that measured weight, blood pressure, cholesterol and triglycerides of over 800 children at age 12, and then reassessed them, as well as their parents, 26 years later. The study found that nearly half of the now grown-up children – 47 percent – had a parent who had suffered a heart attack, stroke or needed a procedure to clear blocked arteries at some point during the duration of the study; 37 percent, a parent had developed diabetes.

For children in the study who were overweight, their parents’ likelihood of developing high blood pressure or diabetes had doubled. “Pediatric risk factors -  cholesterol, triglycerides, high blood pressure - identified families where parents were at increased risk,” Glueck told Reuters.

But what does this mean? For now, simply that childhood screenings – including one for cholesterol, which has only been recommended in recent years as part of ‘well-child’ checkups - may predict risks in both kids and parents. (And this is important, Glueck said, because some parents don’t go to the doctor’s themselves – but routinely take their children.)

Photo courtesy of parcelbrat

Hitting the gym or going for a jog could alleviate fatigue, depressive symptoms and other mental health issues among chronically ill patients, according to new findings (subscription required) published in Archives of Internal Medicine.

Reuters reports:

[Researchers] combed through 90 previous studies including more than 10,000 people with health problems like cancer, heart disease, chronic obstructive pulmonary disorder (COPD), fibromyalgia, chronic pain or obesity.

In each study, people had been randomly chosen to do exercises — on average, three times a week over 17 weeks — or not.

According to [study author Matthew Herring, PhD], people’s depressive symptoms, as rated on a variety of psychological scales, dropped about 22 percent with exercise overall. That’s similar to the effects on fatigue, anxiety, pain and other mental health outcomes.

More study is needed – the researchers say they haven’t determined what types of exercise are most beneficial and how long the effects last – but the findings add to the evidence on the health benefits of exercise. As one of our surgeons opined in a recent Stanford Medicine article on the topic, “There’s practically nothing that exercise isn’t good for.”

Previously: How light exercise can help prevent arthritis from getting worse,Exercise may alleviate symptoms of arthritis regardless of weight loss and Treating joint pain with physical activity, self-management programs
Photo by Sasha Wolff

A growing body of research suggests that children’s friends can provide a strong calming influence on them and that these relationships have a measurable effect on stress hormones during tense times. Echoing these findings is research published in Developmental Psychology showing the presence of friends mitigates the effects of negative experiences on children.

In the small study (subscription required), researchers assigned 5th and 6th graders enrolled in Montreal schools to keep journals on their feelings and experiences over the course of four days and submit to regular saliva tests that monitored cortisol levels. Study results showed children’s feelings of self-worth and levels of cortisol, a hormone produced naturally by the adrenal gland in direct response to stress, are largely dependent on the social context of a negative experience.

Study co-author William M. Bukowski, PhD, director of the Concordia Centre for Research in Human Development, discussed the significance of the findings in a release:

Having a best friend present during an unpleasant event has an immediate impact on a child’s body and mind. If a child is alone when he or she gets in trouble with a teacher or has an argument with a classmate, we see a measurable increase in cortisol levels and decrease in feelings of self-worth.
…

Our physiological and psychological reactions to negative experiences as children impacts us later in life. Excessive secretion of cortisol can lead to significant physiological changes, including immune suppression and decreased bone formation. Increased stress can really slow down a child’s development. What we learn about ourselves as children is how we form our adult identities. If we build up feelings of low self-worth during childhood, this will translate directly into how we see ourselves as adults.

Previously: Study offers insights into how friendships help children manage stress
Photo by D. Sharon Pruitt

Speaking of tweens, there’s an interesting (and sobering) article in The Atlantic today on how parents’ money-related depression may affect their middle-school-aged children. It highlights a 2011 study that found:

The more stressed the parents were about money, the more likely they (the parents) were to be depressed. Not a surprising finding. But parental depression also affected the strength of the relationships between the parents and their kids: Parents who experienced more depressive symptoms were less connected to their children — and this was true based on reports from both the parents and the kids.

But the most revealing connection was one between the intimacy of the parent-child relationships and the “pro-social behavior” of the kids. The children, between the ages of 10 and 14 when the study began, were polled on how they felt about reaching out to friends, family, and strangers. They ranked themselves on statements like “I help others even if it’s not easy for me,” “I volunteer in programs to help others in need,” and “I really enjoy doing small favors for my family.” Kids who had less-connected relationships with their parents were less likely to exhibit these pro-social behaviors than kids who enjoyed stronger relationships with their parents.

…

While earlier studies have looked at the effects of the economy on kids’ psyches, they have typically considered only the development of negative behaviors, like substance abuse, mental illness, aggression, and other “problem behaviors.” The idea that the economy could, through indirect means, cause a shift or decline in kids’ positive social behaviors has not been illustrated until now.

In this video, Clifford Nass, PhD, a professor of communication at Stanford, discusses research he conducted with colleagues showing girls ages 8-12 who spend endless hours multitasking with digital devices tend to be less successful in their social and emotional development. But the good news, says Nass, is these unwanted effects might be warded off with something as simple as face-to-face conversations with other people.

A Stanford Report article published today offers more details about the study and notes that, while researchers found a correlation between some media habits and diminished social and emotional skills, a definite cause-and-effect relationship has yet to be proved.

Previously: Study shows neural “bottleneck” may limit performance while multitasking and A conversation about our evolving relationship with technology and the dangers of multitasking

Today’s San Jose Mercury News included an interesting Q&A with Mark Cullen, MD, professor of medicine at Stanford, about how job stress can affect your health. In the interview, Cullen discussed the contributing factors to occupational stress, how it can impact a person physically and how stress in the workplace has changed over the past few decades.

On the topic of reducing job-related stress, he said:

There are two totally different components – individual and societal. I think the unrest in our society is not just due to unemployment, but also to the vast insecurity about work and its future. As terrible as the Great Recession was, in which 8 to 10 million people lost their jobs, 200,000 million people got nervous, real nervous. So the biggest question is, how do we return to some civil society in which people have security that there will be work, and they can be productive?

But, individually, the biggest step most people can take is to become their own advocates. To do their own job analysis and to think about what parts of their job — the demands, the control over their job and the rewards — are amenable to change. For example, people who have trouble sleeping should give some thought to ways in which they can protect their sleep, even if they can’t change some aspects of their work. Or you can decide that after 8 p.m. at night, your computer is staying off and people in your environment will learn that if they need you in an emergency, there’s always the telephone. Many of us can exercise more control and leverage over our work than we realize. If people dissect these components of their job, many people can actually make the current situation much more compatible with day-to-day good health.

The full Q&A is worth a read.

Previously: The health benefits of compassion and tips for dealing with unpleasant people, interactions, How work stress affects wellness, health-care costs, Robert Sapolsky discusses stress physiology, Can stress increase risk of neurodegenerative diseases?, No surprise here: Anger and stress are bad for your health, Robert Sapolsky on stress and your health and New year, new (less stressed) you
Photo by Mike Hoff

A surprising potential therapy for severe, hard-to-treat malformations of the lymphatic system is now being studied at Stanford and Lucile Packard Children’s Hospital.

The malformations, called lymphangiomas, are overgrowths of the one-way lymph channels that return extra fluid from our tissues to the bloodstream. Rarely, in infants and children, these channels grow abnormally large and cause deformity or death. (The overgrowth may choke off a child’s airway or interfere with other aspects of heart and lung function.) Lymphangiomas are hard to treat, since the overgrown vessels are often too tangled into vital organs to remove surgically. And the deformity tends to grow with the child, worsening over time.

But physicians at Packard Children’s discovered, essentially by accident, that a common drug – sildenafil, a.k.a. Viagra – appears to shrink the overgrown vessels. A letter published today in the New England Journal of Medicine describes the first three cases the Stanford/Packard team treated, including MRI scans and photos that show dramatic before-and-after changes in the patients’ malformations.

“There has been no medical treatment for lymphangiomas; now all of a sudden there may be one,” Al Lane, MD, a co-author on the NEJM letter and an investigator on the lymphangioma research now underway at Packard Children’s, recently told me.

The research team has a long way to go in determining if and how sildenafil should be routinely used to treat these malformations, Lane cautioned. They’re now studying a handful of children using seed money provided by an Innovations in Patient Care grant from Spectrum Child Health, funds from SPARK, as well as medication provided by Pfizer, and they’re applying to the U.S. Food and Drug Administration’s orphan conditions program for funds to run a larger trial.

“We think this may work, but we don’t know,” Lane said. “We need to do a placebo-controlled trial.”

However, the fact that the condition is so severe and hard to treat made the team feel that it was important to get the word out about the early findings, Lane added. “We felt like, if it really works, and we have data to suggest that it does, it wasn’t fair for patients who have no other options to not at least know what we’re observing,” he said.

For more information on the current Stanford/Packard trial, visit this website.

Working in media relations, I always get excited when one of our studies gets so much attention in the press. That was certainly the case this week, when oodles of reporters and bloggers wrote about a Stanford study of electronic medical records that found women reported more-intense pain than men may in virtually every disease category. (My only beef? The few headlines that implied that women “can’t handle pain.” That was not one of the findings – and if it were the case, babies would cease to be born!)

If you haven’t heard much about the study, or are interested in the topic of pain, this Forum show is one to listen to. Study co-author Martin Angst, MD, was one of the guests, and he and two other pain experts (including Stanford’s Sean Mackey, MD, PhD) discussed the findings and examined the causes and treatments for pain.

Previously: Women report feeling more pain than men, huge EMR analysis shows, A call to fight chronic-pain epidemic, No pain, no gain. Not!, Relieving Pain in America: A new report from the Institute of Medicine, Elliot Krane discusses the mystery of chronic pain, Researching ways to “heal the hurt”, Stanford’s Sean Mackey discusses recent advances in pain research and treatment and Oh what a pain

I’ve mentioned before that I rarely wear flat shoes. Even two pregnancies couldn’t get me to abandon my heels: I pulled on a pair of Skechers before heading to the hospital to deliver my daughters, but I can’t remember reaching for them before that. (I considered this a sort of badge of honor at the time; in retrospect it was probably pretty foolish.)

A few studies have shown that wearing high heels may lead to pain and knee and joint problems, but as Gretchen Reynolds writes on Well today, whether these shoes “affect the wearer’s biomechanics and injury risk has received scant scientific attention.” In her piece, she discusses a new Australian study that found wearing heels “may compromise muscle efficiency in walking” and may increase the likelihood of strain injuries. And she offers advice from Neil J. Cronin, PhD, the researcher who led the work, for readers who can’t kick (sorry, couldn’t resist) their heel habit:

So, if you do wear heels and are at all concerned about muscle and joint strains, his advice is simple. Try, if possible, to ease back a bit on the towering footwear, he says. Wear high heels maybe “once or twice a week,” he says. And if that’s not practical or desirable, “try to remove the heels whenever possible, such as when you’re sitting at your desk.” The shoes can remain alluring, even nestled beside your feet.

Previously: Do pretty shoes lead to ugly problems?, Study links high heels to osteoarthritis and joint problems and Ouch! How high heels can shrink leg muscle, cause pain
Photo by NessieNoodle

Two years ago, the U.S. Food and Drug Administration held hearings on regulating how drugs and medical devices under its oversight are promoted through social media and on the web. The agency recently released social-media marketing guidelines (.pdf) for pharmaceutical companies and is currently taking public comments on the proposal.

American Medical News reports:

The draft guidance encourages all responses to unsolicited requests for information, which could include requests from physicians for information on off-label uses for certain drugs, to be made in a nonpublic format.

The agency calls on companies to respond to public requests, such as those sent through Facebook or Twitter, by guiding the requestor to the appropriate personnel or department for private, one-on-one help. The agency said the private responses should be science-based and answer only the question or questions asked.

The guidance does not apply to information or requests received in response to a solicitation by the pharmaceutical or medical device company.

Comments are being accepted until March 26. They can be submitted to Division of Dockets Management (HFA-305), Food and Drug Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD, 20852.

Over at the Nature News blog, there’s a great summary of the ways that last night’s State of the Union address by President Obama tackled issues near to scientists’ hearts. Several of these points are particularly relevant for medical researchers. For instance, the post says:

- Obama urged lawmakers not to “gut” US investments in basic research, arguing among other things that “the discoveries taking place in our federally-financed labs and universities could lead to new treatments that kill cancer cells but leave healthy ones untouched” and create lightweight vests that protect police and soldiers from “any bullet.”

- Calling on Congress to “stop expelling responsible young people who want to staff our labs,” the president argued that a path to citizenship should be created for foreign students who come here to study subjects like business, science and engineering. “Send me a law that gives them the chance to earn their citizenship. I will sign it right away.”

The entire post – which also addresses such areas of science as green technology and high-tech manufacturing – is a worthwhile read. A video of the president’s speech is available here in case you missed it.

Previously: Obama reaffirms commitment to health reform – but does Congress care?
Photo by The White House