Published by
Stanford Medicine

Category

Stanford News

Cancer, Global Health, Pediatrics, Stanford News

The “little angel” who helps young Latin American children with cancer

The “little angel” who helps young Latin American children with cancer

ZambranoEduardo Zambrano’s spare office in Stanford Hospital displays some of the essentials of his pathology practice: a large microscope which dominates his desktop and a cabinet overflowing with colorful, hand-painted wooden boxes, each one representing a Latin American child with cancer.

Over the last 12 years, Zambrano, MD, has received as many as 1,000 tumor samples from pediatric oncologists in Venezuela and other Latin American countries who treat desperately poor young patients with various forms of cancer. Each sample is carried on a glass side or embedded in wax, then carefully wrapped in tissue paper and lovingly packaged in a wooden box painted by a patient’s mother or local artisan as a gesture of gratitude. The boxes are covered in suns, stars, flowers and other images of life and hope.

“To me, behind each one of these boxes is a child with cancer, and to know we’ve been able to help them is very special to me,” said Zambrano, chief of pathology at Lucile Packard Children’s Hospital Stanford. An expert in pediatric solid tumors, he volunteers his service on behalf of these youngsters.

A professor of pediatrics and of pathology who came to Stanford a year ago, he said he receives one or two of these boxes a week. He examines the samples under the microscopic and then issues a diagnosis, some involving rare cancers. Clinicians ship the samples to him because in these low-resourced countries, they don’t have the means to accurately diagnose the problem.

“Very frequently the diagnosis (from the home country) is either incomplete because they don’t have the resources to perform confirmatory tests or it’s wrong because they don’t have expertise in pediatric tumors,” he said. “It’s frequent that I have to give them a significantly different diagnosis than what they sent.”

Among the most common tumors he sees are pediatric sarcomas, which can originate in various parts of the body; neuroblastomas; lymphomas; and brain tumors.

Continue Reading »

Research, Science, Sleep, Stanford News

Flashing light at night could help beat jet lag, Stanford study says

Flashing light at night could help beat jet lag, Stanford study says

plane in sunsetThe body will eventually adjust to jet lag, it’s just that it takes time — about an hour a day to be precise. And anyone who has suffered the unpleasant side effects of jet lag – brain fog, body achiness, an overwhelming need for endless pots coffee — might have an interest in speeding the process up.

A new Stanford study suggests that exposing travelers to short bursts of flashing lights the night before a trip while asleep could help speed up the process significantly. In a press release I wrote on the study, which was published today in the Journal of Clinical Investigation, researchers explained how this works at a biological level:

The transfer of light through the eyes to the brain does more than provide sight; it also changes the biological clock. A person’s brain can be tricked into adjusting more quickly to disturbances in sleep cycles by increasing how long he or she is exposed to light prior to traveling to a new time zone.

Light therapy is designed to speed up the brain’s adjustment to time changes. By conducting light therapy at night, the brain’s biological clock gets tricked into adjusting to an awake cycle even when asleep. It’s a kind of “biological hacking” that fools the brain into thinking the day is longer while you get to sleep.

 To determine whether continuous or flashing lights would provide the fastest method of sleep cycle adjustment, researchers had 39 study participants sleep in a lab, exposing some to continuous light for an hour, and others to flashing light for an hour. They found that the flashing light —which most could sleep through just fine— elicited about a two-hour delay in the onset of sleepiness, while those exposed to continuous light, the delay was only 36 minutes.

Jamie Zeitzer, PhD, the senior author of the study, described how flashing-light therapy could be used to adapt to traveling from California to the East Coast: “If you are flying to New York tomorrow, tonight you use the light therapy. If you normally wake up at 8 a.m., you set the flashing light to go off at 5 a.m. When you get to New York, your biological system is already in the process of shifting to East Coast time.”

“This could be a new way of adjusting much more quickly to time changes than other methods in use today,” he told me.

Previously: Cheating jet lag: Stanford researchers develop methods to treat sleep disturbances, Why sleeping in on the weekends may not be beneficial to your health, How sleep acts as a cleaning system for the brain, Study shows altered circadian rhythms in the brains of depressed people, Jet-lag drug is a no go and Jet-lagged hamsters flunk IQ test
Photo by Eric Prado

Behavioral Science, Cardiovascular Medicine, Neuroscience, Research, Stanford News

Scientists zero in on brain’s sigh-control center

Scientists zero in on brain's sigh-control center

sighWhy do we sigh?

(Sigh…) How should I know? Don’t I already have enough on my mind?

As we all well know, sighing is a long, deep involuntary inhalation accompanying sensations of yearning, sadness, relief, boredom, exhaustion, or (see above) exasperation. Fewer of us know (at least I didn’t, but now I do!) that the typical person also sighs spontaneously about every five minutes or so.

If you’re a mouse, you do it much more often – as much as 40 times per hour. (Nobody said it would be easy, little mousie.)

Those spontaneously sighs (and all the other ones), it’s thought, may be helping to keep our half-billion or so alveoli – the tiny sacs through which our lungs exchange oxygen and carbon dioxide with the atmosphere that surrounds us – pumped up and operating efficiently.

That could be, at least in part, why we sigh. But Mark Krasnow, MD, PhD, Stanford biochemist and molecular biologist and Howard Hughes Medical Institute Investigator, has figured out how.

In a series of experiments described in a Nature study, Krasnow’s team, along with colleagues at Stanford and UCLA, painstakingly employed genetic, pharmacological and surgical techniques to map out a precise set of nerve circuits in the brain that are essential to the act of sighing. They showed that a sigh results when inhalation-initiating nerve impulses generated rhythmically within these circuits double up: One impulse effectively laps another and rides piggyback on top of it, producing a deeper, drawn-out inhalation.

The experiments were performed in mice. But the brain circuits involved are sufficiently ancient that our common ancestors no doubt had them, too – and therefore we (probably) do, too, or at least very similar ones.

Continue Reading »

Neuroscience, Science, Stanford News

Stanford neurobiologist Carla Shatz on learning and the value of collaboration

Stanford neurobiologist Carla Shatz on learning and the value of collaboration

As director of Stanford Bio-X, Carla Shatz, PhD, not only supports campus-wide interdisciplinary research efforts, but her own research serves as an example of how teams can work in collaboration. In this video, she talks about her work identifying the molecular basis for why kids learn so quickly and so well where adults struggle.

Look at learning a second language for example. Kids can learn languages with ease and with no accent. Not so with adults. Shatz hopes to extend that window on learning into adulthood.

Shatz has used tools developed by engineering colleagues and benefits from the expertise of colleagues in immunology and stroke clinicians, among others.

“There’s no way we could make progress on this kind of a complicated question without being able to collaborate and interact with so many other people in so many other labs and so many other disciplines,” she says. “Colleagues here, faculty and students, are really thrilled to collaborate.”

More faculty talk about the value of collaboration in their work as part of the Stanford Interdisciplinary website.

Previously: New website chronicles tales of collaborative researchBuilding for collaboration spurs innovative science, Drug helps old brains learn new tricks, and healScience is like an ongoing mystery novel, says Stanford neurobiologist Carla Shatz and Pioneers in science
Video by Worldview Stanford, in collaboration with Eric Kuziol

Health and Fitness, Stanford News

Raining? Snowing? Too cold? Tips to stay fit during winter

Raining? Snowing? Too cold? Tips to stay fit during winter

My husband still teases me about the time he spotted me completely drenched, trying to jog during a downpour when we were dating. What kind of a oddball is she, he wondered. Now, I’m a bit less daring and, as a recent BeWell@Stanford feature reminds us, you don’t have to get wet, or cold, to stay fit during the winter.

As outlined in the piece, indoor options abound, and it’s possible to modify favorite outdoor pursuits such as:

Running: You can use a hallway, garage, kitchen, living room, or local gym for alternative running exercises such as butt kickers, side-to-side shuffle, backward/forward running, jumping jacks and high knees. You can also try interval training on the treadmill to keep indoor running interesting.

Walking: Walk indoors on the treadmill, at a mall, or anywhere you feel comfortable. You can do step-ups at the bottom of a staircase, or even purchase an old school step platform for less than $100.

Strength Training: Bodyweight exercises are a great way to get a strength workout without using any equipment. An exercise band, hand weights, a Swiss ball, and/or TRX/suspension trainers can all be purchased and used at home, as well. You can also find credible workout videos (DVD/online) that are safe and evidence-based. Another option: Incorporate exercise while doing chores, such as calf raises while washing dishes or doing planks while watching TV (during commercials).

Biking: Purchasing a bike trainer is an option for people who want to ride indoors, but would rather not be in the gym. Trainers can cost anywhere between $100-400 and can be set up in your garage or inside your house. Additional equipment such as a mat, fan, towel, etc. also may be useful. Cycling classes can also be a fun and worthwhile way to stay in biking shape during the winter.

Of course, it can be tough to stay motivated – with dark days and blustery conditions making exercise daunting. The BeWell@Stanford team recommends working out with friends or co-workers, signing up for an activity, which requires a commitment, and keeping the many good reasons for exercising at the top of your mind.

And if you do venture outdoors, make sure you dress in layers (and include lights/reflectors if it’s dark) and cover up those exposed extremities.

Previously: Why I never walked to school: the impact of the built environment on health, Injured? Tips on maintaining your physical and mental fitness and “Nudges” in health: Lessons from a fitness tracker on how to motivate patients
Photo by bertvthul

Pediatrics, Sports, Stanford News

A Super Bowl surprise at Packard Children’s

A Super Bowl surprise at Packard Children’s

Just in time for the Super Bowl: A sweet story out of Lucile Packard Children’s Hospital about a special visit for 18-year old patient/football fan Alex Walter. As writer Samantha Dorman describes on the hospital’s Healthier, Happier Lives Blog:

Last week, as Super Bowl 50 excitement grew, we learned that Alex’s dream was to meet his beloved Denver Broncos, who would be practicing just down the street at Stanford University. On Monday, we posted this to our Facebook page. The goal was to catch the Broncos’ eye. Thousands of fans liked and shared the post, tagging Peyton Manning, the Broncos, local reporters, and anyone else to help spread the word.

By the next morning we made contact with Vernon Davis, former 49er and now Super Bowl-contending Broncos tight-end. The photo also caught the attention of Bay Area news outlets, including KTVU’s (Fox 2) Rob Roth and NBC Bay Area, who called the hospital wanting to talk to Alex. Staff and the hospital school devised a plan to surprise Alex, telling him that two TV stations were going to interview him about wanting to meet a Bronco. And during the interview Vernon Davis would walk in and give Alex the surprise of a lifetime!

It all worked according to plan. Check out our behind-the-scenes video of the surprise.

As outlined in the post, Walters received a heart transplant at Packard Children’s when he was 11 and is now being treated for rhabdomyosarcoma, a soft tissue cancer. The treatments leave him with little energy, but he is, according to his mom, “relentlessly positive.”

Medicine and Literature, Podcasts, Stanford News

Into the Magic Shop: Stanford neurosurgeon Jim Doty’s captivating memoir

Into the Magic Shop: Stanford neurosurgeon Jim Doty's captivating memoir

Doty and Dalai LamaWhen he was 12 years old, Stanford neurosurgeon Jim Doty, MD, met an unusual woman named Ruth in a magic shop in Lancaster, Calif., the town where he grew up. When she enters his life, she seems ethereal or perhaps even a dream. She arrives at the exact moment she’s needed, a young boy from a fractured home spinning without direction or parental love. Well before mindfulness became commonplace, Ruth taught him a series of mental exercises to ease his angst and focus on a world of possibilities not problems. Most significantly, Ruth offered hope to a somewhat hopeless life.

Doty has written an unusual memoir – Into the Magic Shop – detailing his life’s journey. In this 1:2:1 podcast I spoke with him about this most uncommon life –  one of potholes and promise, detours and dreams, redemption and revisions, and, yes, contentment and even possibly peace.

Stanford physician and noted author Abraham Verghese, MD, gave advance praise to the book:

Into the Magic Shop is pure magic! That a child from humble beginnings could become a professor of neurosurgery and the founder of a center that studies compassion and altruism at a major university, as well as an entrepreneur and philanthropist is extraordinary enough. But it is Doty’s ability to describe his journey so lyrically, and then his willingness to share his methods that make this book a gem.

Outside of the OR, Doty spends much of his time studying the neuroscience of compassion and altruism. He serves as director of the Center for Compassion and Altruism Research and Education at the School of Medicine, of which the Dalai Lama is a founding benefactor.

Into the Magic Shop may not be like anything else you read. But it will take you places where you might never have been.

Previously: What the world needs now: altruism/A conversation with Buddhist monk-author Matthieu RicardFrom suffering to compassion: Meditation teacher-author Sharon Salzberg shares her story and How being compassionate can influence your health
Photo of Doty and the Dalai Lama, from a 2010 Stanford event, by Linda Cicero

Applied Biotechnology, Ask Stanford Med, Clinical Trials, Research, Stanford News

SPARKing a global movement

SPARKing a global movement

browser-98386_1280

Many academic researchers are tenacious, spending years in the lab studying the processes that lead to human diseases in hopes of developing treatments. But they often underestimate how difficult it is to translate their successful discovery into a drug that will be used in the clinic.

That’s why Daria Mochly-Rosen, PhD, founded SPARK, a hands-on training program that helps scientists move their discoveries from bench to bedside. SPARK depends on a unique partnership between university and industry experts and executives to provide the necessary education and mentorship to researchers in academia.

In recent years, Stanford’s program has sparked identical programs throughout the world; at TEDMED 2015, Mochly-Rosen described this globalization. I recently spoke with her about the SPARK Global program, which she co-directs with Kevin Grimes, MD, MBA.

How has SPARK inspired similar programs throughout the world?

We’ve found our solution for translational research to be particularly powerful. Of the 73 completed projects at Stanford, 60 percent entered clinical trials and/or were licensed by a company. That’s a very high accumulative success rate. So I think it has showed other groups that we have a formula that really works – a true partnership with academia and industry. It’s the combination of industry people coming every week to advise us and share lessons learned and our out-of-the-box, risk-taking academic ideas that makes SPARK so successful.

We feel that what we’ve learned is applicable to others. Kevin and I also feel very strongly that universities need to take responsibility to make sure inventions are benefitting patients. So we’re trying to do our part.

How do you and Dr. Grimes help develop the global programs?

When a university asks about our program, we invite them to come visit us for a couple of days so they can talk to SPARKees (SPARK participants), meet SPARK advisors and watch our weekly meeting. Sometimes they also ask Kevin and I to come to their country to help set up a big event or assist in other ways. If they begin a translational research program at their institution, we offer for them to be affiliated with SPARK Global. Everyone is invited.

There are now SPARK programs throughout the world, including the United States, Taiwan, Japan, Singapore, South Korea, Australia, Germany and Brazil. We are also working with other countries, including Norway, Israel, Netherlands, Poland and Finland, to help them start a program.

Do researchers in other countries face the same challenges as those in the U.S. when developing new drugs?

There are many common challenges. And there are also some advantages and challenges that are different in other places. So it’s a mix, both within and outside the U.S.

There are several key components to the success of translation research. It’s important to have a good idea. It’s even more important to have good advisors from industry to help develop the idea. And it’s very important that the people involved are open-minded and not inhibited by hierarchical structures. In some places, there is a big problem with hierarchy – particularly in parts of Europe and East Asia. In some cultures, it’s also difficult to get experts to volunteer and academics can’t afford to pay multiple advisors. Also, some universities don’t have a good office of technology to help with patent licensing, which can be a major challenge.

Continue Reading »

Cardiovascular Medicine, Patient Care, Pediatrics, Pregnancy, Stanford News

World-first treatment for rare heart defect saves baby born at Packard Children’s

World-first treatment for rare heart defect saves baby born at Packard Children's

Group shot Liam and doctorsLinda Luna was five months pregnant with her first child when she got the bad news: Ultrasound scans showed a deadly defect in her baby boy’s heart. He had a 90 percent chance of dying before or just after birth. But thanks to a groundbreaking treatment at Lucile Packard Children’s Hospital Stanford, two-month-old baby Liam, who just went home to San Jose last week, is beating those odds.

He is the first baby in the world successfully treated with prenatal maternal hyper-oxygenation for his rare heart defect: congenital Ebstein’s anomaly. This week, several local news outlets report on the success of Liam’s case.

The problem at diagnosis? Due to severe leaks in two heart valves, blood flowed backward through the right half of Liam’s heart. His heart became dangerously enlarged. Too little blood reached his lungs and the rest of his body. Left untreated, the defect would cause irreparable heart and lung damage.

“Once you see type of leakage Liam had, it’s usually a progressive process,” said Theresa Tacy, MD, the fetal cardiology specialist who treated Liam in concert with his mom’s high-risk obstetrician, Katherine Bianco, MD, and a team of other specialists from across the hospital. “It just gets worse,” Tacy said. “The fetus eventually develops heart failure and dies.”

The team gave expectant mom Luna 12 hours per day of oxygen therapy for the last three weeks of her pregnancy. The idea was to relax Liam’s lung blood vessels with the extra oxygen he’d get from his mom. This would make it easier for his heart to pump blood forward into his lungs and, the doctors hoped, let him survive until birth and surgery.

Ebsteins vs normal by Tacy“We were trying to offer Liam’s parents hope but also remain realistic that their baby had a very high chance of not making it,” said cardiologist David Axelrod, MD, who cared for Liam in the cardiovascular intensive care unit after he was born. “We knew that even if he made it through pregnancy, his risk of dying during his first few days of life was very high.”

Immediately after his Nov. 22 birth, the doctors put Liam on an ECMO machine that delivered oxygen to his blood. Cardiothoracic surgeon Frank Hanley, MD, also closed a blood vessel near the heart to help Liam’s blood to flow forward. Finally, 11 days later, Liam was strong enough for a Dec. 3 surgery in which Hanley fully repaired his heart.

“It was a huge operation for a tiny baby fighting for his life,” Luna said. “The seven-hour wait during surgery was the longest wait of my life, but when they finally wheeled him out, he was a different baby. We were so thankful.”

Continue Reading »

Science, Stanford News

New website chronicles tales of collaborative research

New website chronicles tales of collaborative research

interdis_DSC_1526_Scope

One thing you notice working at Stanford is how close you are to other areas of research. A short lunchtime walk from the medical school campus can involve coffee at the School of Engineering or a sandwich at the business school.

This proximity matters for more than just lunch. Many important medical advances have come out of collaborations between faculty members from very different backgrounds. These collaborations have produced medical technologies, revealed the inner working of our brains, and generated strategies for solving international health crisis, and that’s just collaborations involving medical school faculty.

Institutes across Stanford support similarly interdisciplinary approaches to solving many of the grand challenges we face today in environmental research, security, economic policy and energy. Technology like virtual reality (above) is being applied to environmental research, questions of empathy, and athletics.

We’ve collected many of these stories and videos of boundary-crossing research on a new website that chronicles the results of venturing outside departmental silos. We’ve launched with stories about decision-making, water policy, intersections with the arts, and interdisciplinary undergraduate research, all of which span schools and departments to tackle real world problems.

Photo of virtual reality research by Linda Cicero

Stanford Medicine Resources: