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Fertility, Research, Women's Health

PCOS linked with higher risk of type 2 diabetes even in young women who are not overweight, study finds

PCOS linked with higher risk of type 2 diabetes even in young women who are not overweight, study finds

Women with polycystic ovarian syndrome, which is present in 5 to 10 percent of women of childbearing age and is associated with reproductive and metabolic dysfunction, may be at higher risk for type 2 diabetes. Previous research has shown this correlation in women who are also overweight; now, an Australian study has shown that even young women with PCOS who are not overweight may be at a significantly higher risk for developing diabetes.

From a release:

Over 6000 women aged between 25-28 years were monitored for nine years, including 500 with diagnosed PCOS. The incidence and prevalence of type 2 diabetes was three to five times higher in women with PCOS. Crucially, obesity, a key trigger for type 2 diabetes, was not an important trigger in women with PCOS.

The women studied were aged 25-28 in 2003 and were followed over 9 years until age 34 to 37 years in 2012.

Findings from the large-scale epidemiological study were presented at the recent joint meeting of the International Society of Endocrinology and the Endocrine Society in Chicago.

“Our research found that there is a clear link between PCOS and diabetes,” study author Helena Teede, PhD, said in the release. “However, PCOS is not a well-recognised diabetes risk factor and many young women with the condition don’t get regular diabetes screening even pre pregnancy, despite recommendations from the Australian PCOS evidence based guidelines.”

Previously: Study shows bigger breakfast may help women with PCOS manage symptoms and NIH study suggests progestin in infertility treatment for women with PCOS may be counterproductive

Neuroscience, Research

Talk from the hand: the role of gesture in verbal communication

handAnother reason to revitalize commedia dell’arte: Gestures help us decipher meaning in communication. Okay, I might have made a leap from one Italian study’s conclusions, and the research could have broader implications, but the 16th century multiform theater genre incorporating pantomime to distinguish characters and advance plot came to my mind first.

For the recent study, published in Frontiers in Psychology, scientists conducted two experiments examining how spontaneous gestures that accompany speech carry information that conveys meaning, like intonation and rhythm of oral language. The International School of Advanced Studies researchers found that the sight of gestures combined with the sound of speech created a whole-body system of communication in which movement played an important role in helping listeners understand language that was unclear either because its sounds were unintelligible or the sentence could have more than one possible meaning. Twenty Italian speakers participated.

The authors write in the study:

Our results demonstrate that the prosody that characterizes speech is not a modality specific phenomenon: it is also perceived in the spontaneous gestures that accompany speech. We draw the conclusion that spontaneous gestures and speech form a single communication system where the suprasegmental aspects of spoken language are mapped to the motor-programs responsible for the production of both speech sounds and hand gestures.

“In human communication, voice is not sufficient: even the torso and in particular hand movements are involved, as are facial expressions,” said study author Marina Nespor, PhD, in a release.

Previously: Abstract gestures help children absorb math lessons, study finds
Photo by Eddi 07 – free stock

Health and Fitness, Health Disparities, Public Health, Technology

Creating safer neighborhoods for healthier lifestyles

hoodWalking sounds like a simple path to maintaining a healthy weight if you can’t afford a gym membership. But what if your neighborhood isn’t a safe space to walk or jog, or for your kids to play? Abby King, PhD, and scientists from Stanford Prevention Research Center‘s Healthy Aging Research and Technology Solutions lab have been working with residents of North Fair Oaks, Calif., to understand which environmental factors contribute to or detract from a healthy-living environment.

Participants used a GPS-powered Stanford Healthy Neighborhood Discovery Tool to survey the streets where they lived and provide information about which areas most need improvement in order to facilitate physical activity. During 36-minute walks, the middle-school-aged and older-adult participants collectively provided 224 audio and video recordings of their environment.

The low-income community of North Fair Oaks comprises 73 percent Latino residents. An article in Salud America! Growing Healthy Change reports:

“There are a lot of issues and challenges in the area,” [Priscilla Padilla-Romero, MPH, a public health educator at the Fair Oaks Center and a study author] said. “New immigrants face substantial challenges on a daily basis such as high unemployment rates, and significant social stressors.” Additionally, [Lisa Goldman Rosas, PhD, MPH] mentioned that, “Many immigrants point out that their lifestyles were naturally more active in their countries of origin and when they move to the US they have to think about how to get more physical activity for the first time.”

Among the findings, the piece notes:

The features that were reported as being facilitators of physical activity by the greatest number of participants were:

  • Having amenities and destinations to walk to
  • The presence of good quality sidewalks
  • The presence of parks, playgrounds and crosswalks
  • The aesthetic feel of the neighborhood (for example, attractive plants and well maintained homes)

The features that were reported as being barriers to physical activity by the greatest number of participants were:

  • Poor quality sidewalks
  • Trash and illegal dumping
  • Personal safety

At a June meeting with county officials the study participants, termed “citizen scientists,” discussed which factors of their environment were the greatest barriers to physical activity, hoping to influence local policy and strengthen their community.

Previously: Moderate exercise program for older adults reduces mobility disability, study showsHelp from a virtual friend goes a long way in boosting older adults’ physical activity and What type of smartphone apps are effective for promoting healthy habits among older adults?
Photo by Jukie Bot

Grand Roundup

Grand Roundup: Top posts for the week of June 15

The five most-read stories this week on Scope were:

The reefer connection: Brain’s “internal marijuana” signaling system implicated in very early stages of Alzheimer’s pathology: A-beta, a substance suspected as a prime culprit in Alzheimer’s disease, may start impairing learning and memory long before plaques form in the brain. Daniel Madison, PhD, is the study’s senior author.

The hospital becomes a different place: pregnant in medical school: In the latest installment of SMS Unplugged, medical student Jennifer DeCoste-Lopez discusses the best and worst aspects of being pregnant while in medical school.

A new era for stem cells in cardiac medicine? A simple, effective way to generate patient-specific heart muscle cellsJoseph Wu, MD, PhD, and Paul Burridge, PhD, have devised a way to create large numbers of heart muscle cells called cardiomyocytes from stem cells without using human or animal-derived products, which can vary in composition and concentration among batches.

Stanford bioengineer develops a 50-cent paper microscopeManu Prakash, PhD, assistant professor of bioengineering, has developed an ultra-low-cost paper microscope to aid disease diagnosis in developing regions. The device is further described in a technical paper.

Stanford microscope inventor invited to first White House Maker Faire: Bioengineering professor Manu Prakash, PhD, was invited to attend the first-ever White House Maker Faire to celebrate our “Nation of Makers” and to help empower America’s students and entrepreneurs to invent the future. Prakash showed attendees how to build a 50-cent microscope and a $5 programmable microfluidic chemistry set.

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

The mystery surrounding lung-transplant survival rates: A 2012 article in the San Francisco Chronicle offered a look at the challenges facing lung transplant patients and explored why a significant number don’t live beyond the five-year mark, despite improvements in survival rates.

Bioengineering, Neuroscience, Sports, Stanford News

Mouthguard technology by Stanford bioengineers could improve concussion measurement

Mouthguard technology by Stanford bioengineers could improve concussion measurement

head impactPerhaps you’ve heard of helmet sensors to alert emergency contacts if a rider falls from a bicycle. Now, Stanford bioengineers are working with mouthguards that measure and report head impacts in football players in real time, and the research could have implications for understanding the forces of head traumas from more common accidents.

Stanford News reports:

For the past few years, David Camarillo, an assistant professor of bioengineering, and his colleagues have been supplying Stanford football players with special mouthguards equipped with accelerometers that measure the impacts players sustain during a practice or game. Previous studies have suggested a correlation between the severity of brain injuries and the biomechanics associated with skull movement from an impact.

Camarillo’s group uses a sensor-laden mouthguard because it can directly measure skull accelerations – by attaching to the top row of teeth – which is difficult to achieve with sensors attached to the skin or other tissues. So far, the researchers have recorded thousands of these impacts, and have found that players’ heads frequently sustain accelerations of 10 g forces, and, in rarer instances, as much as 100 g forces. By comparison, space shuttle astronauts experience a maximum of 3 g forces on launch and reentry.

Camarillo, PhD, and colleagues including bioengindeering doctoral student Lyndia Wu are enhancing the technology and refining the data collected, detecting head impacts in a lab test-dummy with 99 percent accuracy.  They’ve recently published a paper on their work in IEEE Transactions on Biomedical Engineering.

“Our football team has been extremely cooperative and interested in helping solve this problem,” Camarillo told writer Bjorn Carey. “What we are learning from them will help lead to technologies that will one day make bike riding and driving in your car safer too.”

Previously: Is repetitive heading in soccer a health hazard?Now that’s using your head: Bike-helmet monitor alerts emergency contacts after a crash and Stanford researchers working to combat concussions in football
Photo by Linda A. Cicero/Stanford News Service

Addiction, FDA, Health Policy, otolaryngology, Public Health

How e-cigarettes are sparking a new wave of tobacco marketing

e-cig tip - smallFollowing the FDA’s announcement earlier this spring that it would regulate the sale – but not marketing – of electronic cigarettes, debate has continued on the safety of using e-cigarettes and the ethics of advertising them.

In case you missed it, today’s New York Times delves into the issue and highlights how Big Tobacco is now rolling into the world of e-cigarettes, which writer Matt Richtel calls an “overnight sensation.” A subsidiary of Reynolds American plans to begin distributing its Vuse e-cigarette line nationwide on June 23 with a campaign that includes television ads (forbidden for cigarettes) in major markets, and other tobacco companies have similar entries in the works. Questions about the potentially far-reaching effects advertising of e-cigarettes, including promoting smoking tobacco and reaching child audiences, concern public-health advocates and other critics – and a U.S. Senate hearing is planned for Wednesday.

From the article:

Matthew L. Myers, [JD,] president of the Campaign for Tobacco-Free Kids, who is scheduled to testify at the Senate hearing, said the fact that the F.D.A. did not limit marketing allowed tobacco companies to return to the airwaves with ads that make e-cigarettes sexy, rebellious, glamorous — “exactly the same themes we saw work with kids in the U.S. for decades with cigarettes.”

In the absence of marketing regulation, “they will set the agenda,” Mr. Myers said of the tobacco companies. “They will drive the evolution of the product in a way that serves their interests and not public health, and that’s exactly what’s happening.”

Robert Jackler, MD, chair of otolaryngology at Stanford Medicine, is an expert on tobacco marketing who studies it through his center, the Stanford Research Into the Impact of Tobacco Advertising. Like Myers, he has vocalized his concerns about e-cigarettes and tobacco companies’ aggressive marketing tactics – especially those targeted toward teens – and you can hear more about his views and research in this recent podcast.

Previously: E-cigarettes and the FDA: A conversation with a tobacco-marketing researcherE-Cigarettes: The explosion of vaping is about to be regulatedStanford chair of otolaryngology discusses federal court’s ruling on graphic cigarette labels and What’s being done about the way tobacco companies market and manufacture products
Photo by Li Tsin Soon

Grand Roundup

Grand Roundup: Top posts for the week of June 8

The five most-read stories this week on Scope were:

Say Cheese: A photo shoot with Stanford Medicine’s seven Nobel laureates: A video shot earlier this spring captures Stanford Medicine’s seven Nobel Prize laureates preparing for a photo shoot at the Li Ka Shing Center for Learning and Knowledge. The group photo appears on Stanford Medicine’s new website.

Stanford bioengineer develops a 50-cent paper microscopeManu Prakash, PhD, assistant professor of bioengineering, has developed an ultra-low-cost paper microscope to aid disease diagnosis in developing regions. The device is further described in a technical paper.

Living with Ehlers-Danlos Syndrome: “Sometimes I just don’t have it in me to be inspirational”: In this Inspire column, a patient shares his thoughts about living with Ehlers-Danlos Syndrome, a rare connective tissue disorder. “Every EDS patient knows that one of the hardest parts of our day is the moment we open our eyes and waken into the reality of our bodies,” Michael Bihovsky writes.

Stanford Medicine partners with TEDMED on “first-ever gathering on the West Coast”: Stanford Medicine has been named a medical research institution partner for TEDMED. The three-day conference will be held Sept. 10-12 and consist of a live, digitally-linked event held simultaneously in San Francisco and Washington, D.C.

Study shows banning soda purchases using food stamps would reduce obesity and type-2 diabetes: In a new study published in this month’s Health Affairs, Stanford researcher Sanjay Basu, MD, PhD, and colleagues created a computer model to simulate the effects of a soda ban on the health of food stamp recipients.

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

The mystery surrounding lung-transplant survival rates: A 2012 article in the San Francisco Chronicle offered a look at the challenges facing lung transplant patients and explored why a significant number don’t live beyond the five-year mark, despite improvements in survival rates.

Patient Care, Technology

Listening to the stethoscope’s vitals

p013296.jpg“What will happen to bookshelves?”, bibliophiles lamented with the ascent of the e-book, mourning the loss of the feel of paper pages between their fingers and the smell of rich mahogany encasing their many leather-bound books. Now, physicians may be wondering the same thing about stethoscopes. As ultrasound machines become smaller, cheaper and more portable, a recent BMJ article notes, some doctors propose that point-of-care scans may replace the stethoscope as “the symbol of the profession.”

In a BMJ blog post responding to the original article, Rhy Davies, a medical student at Imperial College London, writes an “Ode to a stethoscope” summarizing the history of the instrument, its medical pros and cons and the meanings it embodies. He writes:

And can you boldly stride into the hospital canteen with an ultrasound device the way you can with a stethoscope? Slung around the neck, it declares to the world that, yes, everything will be fine now that the medical student is here. (Actually, that’s infuriating. Can we all agree to stop doing that?)

Lastly, what of one of the greatest uses of the stethoscope? In a hectic emergency room or a busy GP surgery, when the earbuds go in and the diaphragm is laid meaningfully on the chest, the stethoscope ferries the doctor or student to that quiet mental space…..what will become of that little space where the doctor or student can synthesise, diagnose, and reflect? Will the next generation of ultrasounds have an app for that?

Previously: Med school friendships from classroom to clinicsThe OMG Factor: Curbing your enthusiasm during clinical rotations and Students design special stethoscope for use in space, noisy places
Photo by PhotosNormandie

CDC, In the News, Pediatrics, Public Health

Teens these days: smoking less, but engaging in other risky behaviors

Teens these days: smoking less, but engaging in other risky behaviors

teen musicalMr. Camel, tear up those cigarettes. Statistics from the latest Youth Risk Behavior Surveillance System survey, released today by the U.S. Centers for Disease Control and Prevention, show that 2013 marked the lowest incidence (15.7 percent) of teen smoking reported since 1991.

In other news, texting while driving, drinking soda and having unprotected sex are among the behaviors the report notes are worthy of concern. From the report:

During the 30 days before the survey, 41.4% of high school students nationwide among the 64.7% who drove a car or other vehicle during the 30 days before the survey had texted or e-mailed while driving, 34.9% had drunk alcohol, and 23.4% had used marijuana. During the 12 months before the survey, 14.8% had been electronically bullied, 19.6% had been bullied on school property, and 8.0% had attempted suicide.

During the 7 days before the survey, 5.0% of high school students had not eaten fruit or drunk 100% fruit juices and 6.6% had not eaten vegetables. More than one-third (41.3%) had played video or computer games or used a computer for something that was not school work for 3 or more hours per day on an average school day.

Previously: Adolescent Health Van wins community award for aiming to “help kids turn their lives around”A reminder that texting and driving don’t mix, To reduce use, educate teens on the risks of marijuana and prescription drugs and National Cancer Institute introduces free text message cessation service for teens
Via The Checkup
Photo by Daniel Oines

Cancer, In the News, Patient Care

“You have cancer”: On being a doctor and receiving the news

"You have cancer": On being a doctor and receiving the news

Inquiring patients might want to know what their doctors would do for themselves in certain medical situations. (And, as recently discussed here, the answers might be surprising.) An article in this morning’s San Francisco Chronicle surveys oncologists and other cancer specialists who have been diagnosed with a disease they study or treat. It describes how they respond to the news “You have cancer” – and if or how they choose to share their personal experiences with patients.

From the piece:

As a pathologist, [Kimberly Allison, MD, associate professor of pathology] typically sees patients’ cells, rather than the patients themselves.

So it’s not surprising that when she had a biopsy on her breast after noticing tissue changes in 2008, her first reaction was to be excited to see her own sample under the microscope. She assumed the sample would be benign, but when her colleagues came to her with the results, looking grim, she knew it was bad.

“I knew I needed to be worried,” said Allison, who is now at Stanford but was working at the University of Washington in Seattle at the time. “I knew I was going to get aggressive treatment, but I was terrified about what that might be like. That fear was just the same as in any patient.”

The article goes on to describe how Allison found support from fellow patients and even wrote a book about her experience with the disease. Her specialized knowledge of cells proved to be a key weapon against her illness:

She could look at her cancer cells under the microscope before they were wiped out by the treatments.

“Whenever I felt like I wanted to talk smack to it, I would look at it,” she said. “I’d tell it, ‘I never want to see you again.’ “

Previously: A doctor recounts his wife’s battle with cancer: “My knowledge was too clear-eyed”, A Stanford physician’s take on cancer prognoses – including his own, Both a doctor and a patient: Stanford physician talks about his hemophilia and Red Sunshine: One doctor’s journey surviving stage 3 breast cancer

Stanford Medicine Resources: