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Stanford News, Women's Health

Nancy Snyderman speaks at Stanford Women’s Health Forum

NBC News Chief Medical Editor Nancy Snyderman, MD, kicked off the Women’s Health Forum at Stanford with an empowering keynote speech titled, “A Focus on Women and Medicine: Why It Matters.”

In her talk, Snyderman encouraged the mostly female audience to take charge of their well-being and become informed participants in their health-care decisions, and she stressed the importance of science in making decisions about health care. She advised that:

If you don’t have a great relationship with your physician, divorce your doctor and find one you can have a good relationship with.

Snyderman also discussed the increasing problem of health information being politicized. She cited the reaction to the controversial November 2009 recommendation by the U.S. Preventive Services Task Force that women in their 40s not get routine mammograms. The recommendation was based on studies showing the tests were not accurate enough to warrant the unnecessary procedures and worry they instigated. Snyderman said:

Within 24 hours, people came out saying that women are going to be denied mammograms tomorrow. What was lost in the message is that we are all individuals. For most women, it’s just not a particularly accurate test.

A medical correspondent for ABC News for nearly two decades, Snyderman is author of Medical Myths That Can Kill You: And the 101 Truths That Will Save, Extend, and Improve Your Life. Last December, she was a guest on the School of Medicine’s 1:2:1 podcast series, where she discussed common medical myths as well as the difficulty of communicating health-care news to a skeptical public.

Video from the presentations from the forum will be available here after the event.

Previously: Dr. Nancy

Public Health

Boston water emergency: How a hospital operates without water

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Boston is on its third day of water emergency, after two major pipe ruptures left much of the city without safe tap water. The Boston Globe has an article today describing how Massachusetts General Hospital has had to operate without tap water or ice and only a limited amount of bottled water.

Sanitizing foam, hydrogen peroxide, and bath-in-a-bag towelettes work in a pinch for cleaning hands, tools and patients, respectively. But people aren’t the only species whose safety is a concern:

Officials had to ensure the safety of animals in experiments, too, under government regulations. Tap water was an issue, even in the safe nourishment of lab mice.

Animal research is already time consuming and costly; scrapping a major experiment because of an epidemic of mouse diarrhea is enough to make a scientist go crazy. Speaking of going crazy:

In the basement, several large 60-gallon vats were boiling water, which was to be cooled and later used for food preparation, including washing salads or mixing with soups. But there was no water for coffee, much to the dismay of sleep-deprived employees.

Waterborne diarrheal disease is nothing to sneeze at, for sure. But mass caffeine deprivation has to have an effect on bedside manner.

Fortunately, the pipe disaster happened over the weekend, which left the hospital’s “Incident Command” extra time to address water issues. But something like this could easily happen again, and soon. A recent article from an award-winning New York Times investigative series describes the crumbling state of U.S. water infrastructure:

Today, a significant water line bursts on average every two minutes somewhere in the country, according to a New York Times analysis of Environmental Protection Agency data.

State and federal studies indicate that thousands of water and sewer systems may be too old to function properly.

For decades, these systems – some built around the time of the Civil War – have been ignored by politicians and residents accustomed to paying almost nothing for water delivery and sewage removal. And so each year, hundreds of thousands of ruptures damage streets and homes and cause dangerous pollutants to seep into drinking water supplies.

If the Y2K scare didn’t make you stock up on bottled water, your crumbling municipal water pipes might.

Photo by latente

Bioengineering, Stem Cells

Using discarded fat tissue as a garden to grow more

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Many Americans are trying to get rid of excess body fat; others want or need more in different places. Now researchers have come up with a fascinating way to turn one person’s extra padding into another person’s vital tissue.

In the journal Biomaterials, researchers from Queens University in Ontario, Canada describe a method to recycle liposuction leftovers into a biological scaffold that appears to turn stem cells into fat cells. Like a well-fertilized garden patch nurturing the growth of seeds into vegetables, the recycled scaffold seems to provides the right physical and chemical environment to coax the stem cells to mature into fat cells.

The researchers took human fat tissue removed during elective cosmetic surgeries and used a five-day process to gently strip the fat cells away from the supporting matrix. They seeded the matrix with stem cells harvested from human donor fat. Stem cells can develop into many different cell types and need specific chemical signals to tell them what type of cell to become.

Most isolated tissue grown from stem cells require these added chemicals as well as a supportive matrix to give it shape and strength. But the Queens University researchers’ recycled scaffold seemed to serve as both support and signal for the future fat cells. The stem cells in the scaffold started to express significant levels of two master proteins that help cement the cells’ fate as fat cells, and they did it without requiring any added chemical signals.

Photo of yellow fat tissue from histology department at Jagiellonian University Medical College via Wikimedia commons

Emergency Medicine, Technology

Windows ER?

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Being a patient in the emergency department can be a bewildering experience. Doctors, nurses and technicians drop in at seemingly random times to ask questions, examine you and take samples. You haven’t any clue what it all means, what’s going to happen, or how much it’ll hurt.

A team of Microsoft researchers is exploring ways to use electronic displays to help keep patients in the loop about their own care. They recently developed and evaluated a cut-and-paste prototype for a personalized patient information display inside patient rooms in the emergency department of a Washington, D.C.-area hospital:

We conducted a Wizard-of-Oz study in which we manually compiled information extracted from the patient medical record and constructed posters that mimicked a potential digital display (Figures 1 and 3). We placed these posters in patient rooms and updated them as frequently as appropriate. We interviewed patients and family members, as well as physicians and nurses, to garner feedback about our design.

The researchers write that they received “overwhelmingly positive” feedback on the prototype from the 18 patients and 8 visitors who volunteered for the study.

The team will present their results on April 15 at the CHI 2010 Conference in Atlanta. Theirs is one of several papers and workshops at the conference on the use of technology to manage health care.

Photo from Supplementary material for Wilcox, et al. CHI 2010

Imaging

Is that a Nile crocodile? Tell you later, Hearst curator

More crocodile mummy photographs and high-resolution CT scans have been posted in a new Stanford Medicine Flickr photo set. Two crocodile mummies from the Phoebe A. Hearst Museum of Anthropology were scanned at Stanford in February. The CT images and the mummies will be on exhibit at the museum beginning April 23.

One of the two mummies was wrapped in linens and turned out to contain a jumble of bones; it’s not clear whether they all belonged to a single crocodile or if there might be bones from more than one animal in there. The Flickr set images are of a mummy that was coated in a black, tar-like substance and had baby crocodile mummies stuck to its back. According to the Hearst Museum <http://conservationblog.hearstmuseum.dreamhosters.com/>conservation blog, the babies were falling off and had to be carefully glued back on.

The babies are invisible in some of the scans, but not in others. Paul Brown, DDS, a consulting anatomy professor who helped render 3-D images from the scans, says that’s because their skeletons haven’t totally calcified yet, so their bones aren’t opaque to x-rays like adult bones are.

Stanford’s high resolution CT scanners have peered inside at least two other mummies, including a child mummy three years ago, and an adult male priest last year. The scans are being used to construct an anatomical database. Brown wants to develop interactive educational software that allows children (and curious adults) to “fly” through and label interactive 3-D images of the mummies. Many U.S. dental students already use renderings from scans of the human mummies to study and memorize bone calcification timelines.

Forensic scientists are making use of modern CT scanning tools to solve age-old medical mysteries and extract stories from silent mummies about their ancient lives and culture. Researchers recently used data from CT scans of Tutakhamun to show that the famed Egyptian pharaoh had a cleft palate and a club foot. Brown says the 2,600 year-old mummy priest Iret-net Hor-irw showed almost no wear on his joints, which suggest that he didn’t do much manual labor while he was alive.

As for the crocodile mummies and their significance, the project has yet to recruit a herpetologist to interpret the scans. The ancient Egyptians did worship crocodiles and keep them as pets, so this crocodile mummy’s joints might betray a life as labor-free as Iret-net Hor-irw’s.

Images in the Flickr photo set compiled from renderings produced using Anatomage, by eHuman, Inc.

Previously: Ancient crocodile mummies scanned at Stanford and CT images of crocodile mummies scanned at Stanford.

Technology

A pill that spills the beans

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Take two of these pills and they’ll call your doctor in the morning.

Engineers at the University of Florida have designed a pill that tells the doctor when you’ve swallowed it. The prototype pill contains a tiny microchip and a digestible antenna that enable it to function as a (literal) inside informant. The University of Florida press release and assistant engineering professor Rizwan Bashirullah address the (huge) potential impact of the invention:

According to the American Heart Association, 10 percent of hospital admissions result from patients not following the guidelines on their prescriptions. Other studies have found that not taking medication properly results in 218,000 deaths annually.

So-called “medication compliance” is a big problem for clinical trials, Bashirullah said, because failure to take experiment drugs skews studies’ results or renders them meaningless. As a result, researchers often require visual confirmation of participants taking pills, an extremely expensive proposition if hundreds or thousands of people are participating in the trials.

“The idea is to use technology to do this in a more seamless, much less expensive way,” Bashirullah said.

Photo adapted from original by Flickr user bark.

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