Research

Curious how close scientists are to being able to decode a person’s dreams? Then you might find this BBC.com article – the first in science writer Ed Yong’s Will They Ever series – enlightening. (Spoiler alert: They’re not very.)

And for more on dream research, there’s this article I wrote for Stanford Medicine a few years back.

Previous studies have shown that stress can contribute to a range of health conditions, from the common cold to heart disease. Now new research from UC San Francisco suggests that the mere anticipation of a stressful situation may increase a person’s risk for age-related diseases.

In the study, researchers examined how major forms of stress in individuals’ lives can influence how they respond to more minor forms of stress and how this psychological response impacts neurobiology and cellular health. To do so, they informed 50 women, about half of which were caregivers for a relative with dementia (and who, presumably, deal with daily stress), that they would be asked to perform public speaking or math tasks. The researchers then assessed participants’ cellular age by measuring the women’s telomeres, the protective caps on the ends of chromosomes. Short telomeres index older cellular age and are associated with increased risk for a various chronic diseases of aging such as cancer, heart disease and stroke.

According to a university release:

…The psychologists found that those most threatened by the anticipation of stressful tasks in the laboratory and through public speaking and solving math problems, looked older at the cellular level.

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The researchers also found evidence that caregivers anticipated more threat than non-caregivers when told that they would be asked to perform the same public speaking and math tasks. This tendency to anticipate more threat put them at increased risk for short telomeres. Based on that, the researchers propose that higher levels of anticipated threat in daily life may promote cellular aging in chronically stressed individuals.

Although the findings are preliminary, researchers say the study results are a significant step forward in their goal of understanding how psychological stress promotes biological aging and developing interventions to reduce the risk for disease in chronically stressed individuals.

The research is slated to appear in the May issue of Brain, Behavior and Immunity.

Previously: Workplace stress and how it influences health, 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
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When Stanford neurosurgeon Gary Steinberg, MD, PhD, injected human stem cells this fall into the damaged spinal cord tissue of specially-selected patients, it was considered a major step forward in moving research discoveries toward clinical application. In November, however, the Menlo Park-based Geron Corp. announced it was ending the trial and its research into stem cells to concentrate on cancer drugs. Steinberg was disappointed, as many were. But, as he explained in a new Q&A on the Stanford Hospital & Clinics website:

We should remember that five of the anticipated eight total patients were successfully transplanted with no adverse effects noted to date. Since this was designed as a safety study, the outcomes are very encouraging. These patients will be followed for 15 years to assess continued safety as well as any signs of neurologic improvement. I don’t believe the early termination of enrollment in this study will significantly set back the stem cell therapy field.

And when asked about his personal motivation to pursue and study embryonic stem cell treatment, he told me:

I was inspired by what I see every day: Patients devastated by neurological disorders and psychiatric disease with no hope or little hope for recovery of function. And it’s been like that for hundreds of years for many neurological diseases or injuries, including stroke, degenerative disorders like Parkinson’s, brain tumors, Alzheimer’s. These patients are disabled and we have no treatment once the injury has occurred to restore or regenerate function. Stem cell therapy offers great hope to change that status for a large number of patients.

Previously: First California patient treated in Geron’s human embryonic stem cell trial and Stanford joins first human embryonic stem cell trial

Using a computer model of hepatitis C, Stanford researchers have determined that two new virus-targeting drugs called protease inhibitors are a cost-effective way to treat patients with advanced disease. As my colleague explains in a press release:

The drugs, which came out in the summer of 2011, were designed to be taken in conjunction with the standard treatment, which itself is a combination of two drugs, an interferon and an antiviral called ribavirin. While the new triple therapies increase the chances of kicking the virus, they have more severe side effects — such as full body rash and rectal bleeding — and boost costs. Boceprevir adds $1,100 per week to the cost of treatment, and telaprevir adds $4,100 per week.

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[The researchers] wanted to know when or if doctors should prescribe the new treatments. Should doctors prescribe them to all hepatitis C patients? Or, should only patients with advanced disease be treated with the new drugs? With such high costs, the answers could have sweeping impacts on health-care budgets, particularly for public health systems such as the Department of Veterans Affairs hospitals where many hepatitis C patients receive care.

As described further down the release, intense statistical and simulation analysis led to the researcher’s conclusion:

Despite the large price tag and side effects, the new treatments help [patients with advanced disease] avoid costly cancers and liver transplants — as well as allowing them to live longer, higher-quality lives.

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The closer the threat of severe disease, the more justified treatment costs and risks become, said [lead researcher Jeremy Goldhaber-Fiebert, PhD]. “That would be the bottom line.”

The study appears in the current issue of Annals of Internal Medicine, which also features research showing that more people in the U.S. die from hepatitis C than HIV.

Previously: Drugs offer new hope for hepatitis C, Program examines hepatitis C, the “silent epidemic” and Hepatitis C virus’s Achilles heel

There’s a fascinating profile of Larry Smarr, PhD, a physicist turned quantified-self pioneer in Technology Review today. Over the years, Smarr has scrupulously measured and tracked his own biological data using laboratory analysis services and devices that monitor his sleep, fitness and eating habits. The information not only improved his health but lead to a surprising diagnosis. Jon Cohen writes:

Smarr, who directs the California Institute for Telecommunications and Information Technology in La Jolla, dropped from 205 to 184 pounds and is now a fit 63-year-old. But his transformation transcends his regular exercise program and carefully managed diet: he has become a poster man for the medical strategy of the future. Over the past decade, he has gathered as much data as he can about his body and then used that information to improve his health. And he has accomplished something that few people at the forefront of the “quantified self” movement have had the opportunity to do: he helped diagnose the emergence of a chronic disease in his body.

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On top of his pioneering computer science work—he advocated for the adoption of ARPAnet, an early version of the Internet, and students at his University of Illinois center developed Mosaic, the first widely used browser—Smarr spent 25 years as an astrophysicist focused on relativity theory. That gave him the expertise to chart several of his biomarkers over time and then overlay the longitudinal graphs to monitor everything from the immune status of his gut and blood to the function of his heart and the thickness of his arteries. His meticulously collected and organized data helped doctors discover that he has Crohn’s, an inflammatory bowel disease.

As the story goes on to explain, Smarr plans to go public with his personal health data and is working to convince others to do the same in hopes that crowdsourcing the information will generate new insights about the links between DNA sequences, biomarkers and disease. The article is well worth a read and both illustrates and foreshadows the ongoing digital transformation of medicine

Previously: How the C3N project is working to rewrite the medical script and empower patients and ePatient discusses how web-savvy patients are changing the practice of medicine.
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We’ve written before about autoimmune disease and pregnancy, and the fact that having children seems to be safe - and even beneficial – for women with one such disorder. Now comes research showing that having lupus or rheumatoid arthritis may affect how many children a woman has: In a survey of 578 patients, more than half said they wound up with fewer children than what they had hoped for.

As The Checkup reports:

According to [the study] it appears that some women diagnosed with RA or lupus during their childbearing years consciously choose not to have children after they’ve been diagnosed. Those choices may be based on concerns that they may pass their disease on to a child, that the medication they take to manage their condition may harm a child, or that their condition might render them unable to properly care for a child.

Beyond those understandable concerns, the study found that women with RA who had had fewer children than they had once planned had experienced higher rates of infertility and those with lupus who’d had fewer children than planned had higher rates of miscarriage than women who had the number of children they had originally planned.

In a WebMD article, first author Megan Clowse, MD, MPH, from Duke University Medical Center, noted that potential fertility problems among RA patients haven’t been studied – and need to be. And:

She adds that women with rheumatoid arthritis who wish to have children need to know that their ability to conceive may be compromised.

“This needs to be part of the conversation,” she says. “Women with rheumatoid arthritis who want to have children may be better off trying to conceive sooner rather than later if their family circumstances support this.”

The study is being published in Arthritis Care & Research.

Previously: Multiple sclerosis doesn’t appear to pose pregnancy-related risks, Childbirth may be beneficial for MS patients and Encouraging news for pregnant women with MS or epilepsy

Past research has down that exercise during pregnancy benefits mom as well as baby by, among other things, helping the fetal cardiac system grow stronger and healthier. Now findings published online in PLoS One suggest that owning a dog can be a powerful motivator to get pregnant women moving.

In the first-of-its-kind study, researchers from the United States and England examined the relationship between pet ownership and physical activity levels among pregnant women. The team drew on the Avon Longitudinal Study of Parents and Children to gather data on more than 11,000 pregnant women in the United Kingdom, and they found:

Dog ownership was associated with an increased (1.5 times) likelihood of undertaking at least 3 hours per week of activity ‘enough to work up a sweat’. Dog owners showed increased levels of brisk walking, but not other types of activity, thus the specificity of the finding makes it more likely that the association is causal. In addition, the trend of increasing likelihood of dog ownership with higher levels of activity and more hours of brisk walking per week also suggests a real effect of owning a dog.

The study showed that, overall, mothers-to-be who owned dogs were approximately 50 percent more likely to stay physically active during their pregnancy. Funding for the research was provided by a grant from WALTHAM Centre for Pet Nutrition, a subsidiary of Mars Petcare.

Previously: Extreme pregnancy: A look at exercise and expectant moms, Study: Exercise may not stave off gestational diabetes, How safe is rigorous exercise during pregnancy?, Could exercise before and during early pregnancy lower risk of pre-eclampsia? and Pregnant and on the move: The importance of exercise for moms-to-be
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For treating prolonged seizures outside a hospital setting, a quick intramuscular shot of anti-convulsant medication with an auto-injector, a kind of spring-loaded syringe, is as effective — if not more effective — than starting an intravenous line to administer the medicine directly to the bloodstream.

That’s according to findings from a first-of-its-kind study by researchers at Stanford and 16 other universities and hospitals nationwide. Their work appears in the New England Journal of Medicine.

The finding is important because giving a shot into the muscle of someone who is convulsing is generally safer and less time-consuming than starting an IV, said James Quinn, MD, a professor of emergency medicine here and a study investigator.

The intravenous route has always been considered the gold standard for treating status epilepticus in the field. But, as Quinn pointed out, “If patients are having a grand mal seizure, it can be tough to find a vein and get the medicine started, and it may increase the chance of a needle-stick injury either to the patient or medic.”

The aim of this study was to gather and compare data on the safety and efficacy of the shot, which administers midazolam, a sedative, versus the IV drip, which administers lorazepam, a similar sedative. As described in a National Institutes of Health release:

The study found that 73 percent of patients in the group receiving midazolam were seizure-free upon arrival at the hospital, compared to 63 percent of patients who received IV treatment with lorazepam.  Patients treated with midazolam were also less likely to require hospitalization than those receiving IV lorazepam.

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[The study] involved more than 79 hospitals, 33 emergency medical services agencies, more than 4,000 paramedics and 893 patients ranging in age from several months old to 103.

An interesting, behind-the-scenes aspect aspect of the research: Because they were the first responders, roughly 250 firefighter-paramedics in Santa Clara and San Mateo Counties had to be trained on how to conduct the clinical trial. “It required tremendous coordination,” Quinn told me. “For most of the firefighters, it was the first time they had done research. They did a great job, and I am proud of the job they and our research team did in this unique endeavor.”

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Here’s something to reflect on this Valentine’s Day. A recent study shows that Americans’ deep-seated regrets most often involve personal relationship mishaps, not missed career opportunities.

In the study (subscription required), researchers surveyed 500 U.S. adults about their biggest disappointments in life and then analyzed their remorse to identify what parts of their lives were most directly impacted. Healthland reports:

Study participants were asked to describe regrets that they considered both strong and weak, along with the situation that surrounded the regret. Analysis revealed that regrets involving love — think ending a relationship or cheating — rankle more than those related to less intimate choices such as dropping out of college or quitting a job. The study, published online last week in the journal Social Psychological and Personality Science, reported that love regrets outnumbered work regrets by more than 2 to 1 — 56% to 20% — in some of the comparisons. The more intense a regret, the more likely it was to be connected to personal relationships.

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What that means in general is that being bad at keeping in touch with old friends or forgetting to buy Valentine’s chocolates for your sweetie has the potential to make you feel worse — much worse — than making a mistake at work. “As you are thinking about how to feel good about your life, the thing you will feel most strongly about is protecting and strengthening your personal relationships,” says [Neal Roese, PhD, a marketing professor at the Kellogg School of Management at Northwestern University].

Previously: How social ties can influence our health, happiness
Photo by Chris Sloan

In the most recent issue of Stanford Medicine, my colleague tells the story of Minnie Narth, a young woman who learned she had an aggressive form of lymphoma while she was pregnant. As detailed in the piece, there was surprise when Narth and her husband were presented with treatment options:

“Our concern was – give chemo while she’s pregnant?” says [her husband] Paul. The response he remembers from Stanford lymphoma specialist Ranjana Advani, MD, was, “Of course we can!”

The surprise is understandable, says Richard Theriault, MD, a breast oncologist at MD Anderson Cancer Center in Houston who has studied cancer and pregnancy for 20 years… “We basically tell [expectant mothers], don’t breathe, don’t do any of these things — but we’re going to give you chemo,” Theriault says. “It does sound really crazy, doesn’t it?”

The article goes on to describe the treatment decisions Narth and her doctors made, and the existing research on cancer and pregnancy – and I thought of it when I came across results of a new study on chemotherapy during pregnancy today. In a paper in The Lancet, researchers showed that children exposed to chemotherapy in the womb appear to develop normally. As WebMD reports:

Children in the study whose mothers had an average of three to four cycles of chemotherapy during [the second or third trimester of] pregnancy were subjected to a battery of tests to assess their general health, intelligence, and behavioral development.

The tests suggested that fetal exposure to chemotherapy after the first trimester is not associated with developmental and health issues.

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“The clinical message is threefold,” [Frederic Amant, MD, PhD, of Belgium's Leuven Cancer Institute] says. “First, fear of chemotherapy is generally no reason to terminate a pregnancy. Second, fear of chemotherapy is generally no reason to delay treatment when pregnant. And third, delivery should not be rushed to avoid exposing the fetus to chemotherapy.”

Previously: A family’s grace in crisis

Stanford psychology researchers are using imaging techniques to learn more about what happens in the brains of young girls at risk of depression and, as recently described here, they’re exploring a novel way to train brains away from negative situations. Ian Gotlib, PhD, discusses the work, which represents a “critical step in learning how to prevent the onset of a depressive episode,” in a Stanford Report article and the video above.

And for more on the topic, my colleague recently reported on adolescent depression and efforts to prevent it in Stanford Medicine.

Previously: Using brain-training games to stave off depression in adolescents

Yesterday, Nikon Instruments announced the winners of its inaugural Small World in Motion Photomicrography Competition. From a selection of more than 200 submissions, judges deemed 13 stunning videos to be the most visually outstanding as well as high-caliber depictions of the intersection of science and art.

This time-lapse movie showing the movement of mitochondria in sensory neurons in the tail of a zebra fish larva took second place. MSNBC reports:

Mitochondria are the energy-producing powerhouses of the cell, and play a vital role in sparking neural activity. This movie was created in the course of [postdoctoral fellow Dominik Paquet's] research into the molecular and cellular pathologies associated with dementia and Alzheimer’s disease.

Paquet and his team at the German Center for Neurodegenerative Disease in Munich were studying how problems with the transport of cellular components can affect nerve cells. Paquet says this video may represent the first-ever example of live imaging of mitochondrial transport in the nerve cells of an intact, unmodified vertebrate.

Paquet discusses additional details about the video in this brief Q&A. Additional winning videos can be viewed here.

Previously: Wired Science picks 16 interesting science visualizations and Video: “Seven Wonders of the Microbe World”

I’m a few days late to this, but a new study (one of particular significance to those of us in the communications field) is demonstrating the important role that press releases can play in getting high-quality, accurate medical information delivered to the public.

In a BMJ paper, Dartmouth researchers identified media coverage of studies appearing in five major medical journals and then analyzed 68 associated journal press releases. They found that high-quality releases - ones that included such information as study limitations - seemed to “make the quality of associated newspaper stories better.”

Gary Schwitzer recently wrote on HealthNewsReview.org:

This is an important contribution to our understanding of the food chain of the dissemination of research news to the American public: medical journals feed journalists who feed the American public what they get out of journals – sometimes driven largely by what’s in journal news releases. If the information at the source is complete and high quality, the flow of information from journalists to the public is more likely to be complete and high quality as well. But this analysis also suggests that “low quality press releases might make (associated newspaper stories) worse.”

Previously: The problem with “science by press conference”
Via Covering Health
Photo by NS Newsflash

Stanford Medicine X, a new conference exploring how emerging technologies will advance the practice of medicine, improve health and empower patients, will be held at the School of Medicine Sept. 28-30. Organizers recently issued a call for papers and will be accepting abstracts from Jan. 15 to April 15. From the conference website:

Scientific research studies and scholarly practice-based work in the area of emerging information and social technologies and their effects on the field of medicine will be the primary scientific focus of the Medicine X conference. We seek submissions in a broad area of topics including:

• The role of Web 2.0 and Internet-based technologies and their effects on patients, health care professionals;
• Social/mobile technologies and their use in the areas of science, health and medicine;
• Health information and content on the internet;
• Collaboration using the Internet and the use of these technologies to change health care delivery and practice.

Papers will be eligible for publication in the conference’s partner journals, PLoS ONE and the Journal of Visualized Experiments (JoVE). All accepted abstracts and presentations will be published in an electronic publication entitled Stanford Medicine X Proceedings.

Previously: How the C3N project is working to rewrite the medical script and empower patients, How Regina Holliday uses art to advance the discussion about patients rights,Founder of Diabetes Mine discusses the power of patient communities, ePatient discusses how web-savvy patients are changing the practice of medicine and Stanford Medicine X advisory board announced

Eight years ago I wrote an article about particles. More precisely, I wrote about how, when it comes to lipoprotein particles like the notorious LDL and the vaunted HDL, the bigger and fluffier the better from a health standpoint. In the course of researching the article I telephoned Nir Barzilai, MD, of Yeshiva University’s Albert Einstein College of Medicine.

Barzilai has assembled a collection of over 500 Ashkenazi Jews 95 years old or older, leveraging this relatively homogeneous group to tease out gene variants that distinguish long-lived from shorter-lived but otherwise similar people. Among the interesting longevity-associated gene variants he’s fished out is one whose presence renders HDL and LDL particles larger and more bouyant. (Think of this as the biochemical equivalent of dotting I’s with big round circles, which connotes an optimistic outlook.)

I finally got to meet Barzilai in person at a symposium (read about it here) hosted by the Glenn Laboratories for the Biology of Aging. Directed by Tom Rando, MD, PhD, this Stanford-based center focuses on how changes in stem cells in various tissues that occur as we get older contribute to the development of age-related disorders.

The Jan. 30 event was the kickoff for an ongoing series of Monday-afternoon seminars that will highlight advances in our understanding, at a fundamental level, of the aging process.

A key point that Barzilai, Rando and other symposium speakers broadly agreed on: Like tots engaged in parallel play in a sandbox, investigators have tended to focus narrowly on one or another of numerous aging-related diseases from cancer to arthritis to Alzheimer’s, without necessarily talking to one another very much. But slowing the aging process, the speakers emphasized, will delay or prevent all those diseases.

Sign me up for that plan.