Published by
Stanford Medicine

Category

Stanford News

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

Autoimmune Disease, Pregnancy, Research, Stanford News, Women's Health

The latest on the pregnancy risks for women with lupus

The latest on the pregnancy risks for women with lupus

2892182827_accf82f274_zWomen with lupus, an autoimmune disorder that can attack a variety of tissues, were once counseled to avoid pregnancy. Now, physicians tailor their advice to each patient’s case. In many instances, however, it’s difficult for physicians to gauge what types of risk their patient might be facing.

A new study designed to clarify those risks found that women with lupus during pregnancy — and even women who may soon be diagnosed with lupus — are more likely to experience preeclampsia, stroke and infection than women without lupus. Infants born to mothers with lupus or pre-lupus are also more likely to be born preterm, have infections, or be small for gestational age, according to the paper, which was published today in Arthritis Care and Research.

“We’ve confirmed previous findings while strengthening the data to show that lupus is associated with a variety of adverse pregnancy outcomes both to the mother, and to the infant,” said senior author Julia Simard, ScD, assistant professor of health research and policy at Stanford.

The research team, which included collaborators in Sweden and at several U.S. universities, examined data from population-based Swedish registers. That data set allowed the researchers to identify patients who had babies several years before being diagnosed with lupus.  From 13,598 single, first-time births, the team identified 551 women with existing lupus and 198 who presented with lupus within five years after giving birth.

For women who have not yet been diagnosed, it’s possible that autoantibodies implicated in the disease may lead to some of the adverse outcomes, but the exact mechanisms remain unknown, Simard said.

She and others are also working to clarify the clinical ramifications of the work, which may help refine physicians’ recommendations and care of pregnant women with lupus, and may lead to earlier diagnoses.

This is a descriptive study, Simard cautioned. Lupus is a challenging condition to study, because it can manifest differently in every patient. As with other chronic diseases, it’s also difficult to distinguish between conditions that could strike anyone, and conditions that might be caused by lupus, she said.

Previously: Empowered is as empowered does: Making a choice about living with lupus, Women and men’s immune system genes operate differently, Stanford study shows Lupus and rheumatoid arthritis may mean fewer children for female patients and Why some autoimmune diseases go into remission during pregnancy
Photo by J.K. Califf

Behavioral Science, Big data, Neuroscience, Research, Stanford News

What were you just looking at? Oh, wait, never mind – your brain’s signaling pattern just told me

What were you just looking at? Oh, wait, never mind - your brain's signaling pattern just told me

headI’ve blogged previously (here, here and here) about scientific developments that could be construed, to some degree, as advancing the art of mind-reading.

And now, brain scientists have devised an algorithm that spontaneously decodes human conscious thought at the speed of experience.

Well, let me qualify that a bit: In an experimental study published in PLOS Computational Biology, an algorithm assessing real-time streams of brain-activity data was able to tell with a very high rate of accuracy whether, less than half a second earlier, a person had been looking at an image of a house, an image of a face or neither.

Stanford neurosurgical resident Kai Miller, MD, PhD, along with colleagues at Stanford, the University of Washington and the Wadsworth Institute in Albany, NY, got these results by working with seven volunteer patients who had recurring epileptic seizures. These volunteers’ brain surfaces had already been temporarily (and, let us emphasize, painlessly) exposed, and electrode grids and strips had been placed over various areas of their brain surfaces. This was part of an exacting medical procedure performed so that their cerebral activity could be meticulously monitored in an effort to locate the seizures’ precise points of origin within each patient’s brain.

In the study, the volunteers were shown images (flashed on a monitor stationed near their bedside) of houses, faces or nothing at all. From all those electrodes emanated two separate streams of data – one recording synchronized brain-cell activity, and another recording statistically random brain-cell activity – which the algorithm, designed by the researchers, combined and parsed.

The result: The algorithm could predict whether the subject had been viewing a face, house, or neither at any given millisecond. Specifically, the researchers were able to ascertain whether a “house” or “face” image or no image at all had been presented to an experimental subject roughly 400 milliseconds earlier (that’s the time it takes the brain to process the image), plus or minus 20 milliseconds. The algorithm correctly nailed 96 percent of all images shown in the experiment. Moreover, it made very few lousy guesses: only one in 25 were rotten calls.

“Although this particular experiment involved only a limited set of image types, we hope the technique will someday contribute to the care of patents who’ve suffered neurological imagery,” Miller told me.

Admittedly, that kind of guesswork gets tougher as you add more viewing possibilities – for instance, “tool” or “animal” images. So this is still what scientists call an “early days” finding: We’re not exactly at the point where, come the day after tomorrow, you’re walking down the street, you randomly daydream about a fish for an eighth of a second, and suddenly a giant billboard in front of you starts flashing an ad for smoked salmon.

Not yet.

Previously: Mind-reading in real life: Study shows it can be done (but they’ll have to catch you first), A one-minute mind-reading machine? Brain-scan results distinguish mental states and From phrenology to neuroimaging: New finding bolsters theory about how brain operates
Photo by Kai Miller, Stanford University

Biomed Bites, Research, Stanford News, Videos

Study of ion channels could improve care for osteoporosis

Study of ion channels could improve care for osteoporosis

Welcome to Biomed Bites, a weekly feature that introduces readers to some of Stanford’s most innovative biomedical researchers. 

Ion channels are similar to very sophisticated dog doors. They’re specific, only allowing beloved Fido, not Rover from next door, to enter the house (cell).

And they play an integral role in the electrical signaling that underlies a variety of fundamental physiological processes. Merritt Maduke, PhD, associate professor of molecular and cellular physiology, studies these channels and in the video above, she lays out the puzzles that motivated her to study ion channels, and their kin, ion transporters. (In the dog door analogy, transporters are a door that propels Fido outdoors when he’s feeling lazy). She says:

My interest in ion channels and transporters stems from the molecules themselves. How do they reside in the greasy, thin film of the membrane while at the same time making an aqueous pore that allows ions to cross that barrier? How do they select for certain ions over others? How are they regulated? How do they harvest energy using molecular motions to pump ions?

The answers to these questions may allow researchers to improve treatments for osteoporosis, a condition caused by the weakening of bones, which is spurred, in part due to ion channel-mediated acidification, Maduke says.

Learn more about Stanford Medicine’s Biomedical Innovation Initiative and about other faculty leaders who are driving biomedical innovation here.

Previously: Stanford hearing study upends 30-year-old belief on how humans perceive sound, New genetic regions associated with osteoporosis and bone fracture and Pediatrics group issues new recommendations for building strong bones in kids

Genetics, Immunology, Microbiology, Research, Stanford News

Special delivery: Discovery of viral receptor bodes better gene therapy

Special delivery: Discovery of viral receptor bodes better gene therapy

8565673108_28e017bf50_zGene therapy, whereby a patient’s disorder is treated by inserting a new gene, replacing a defective one, or disabling a harmful one, suffered a setback in 1999, when Jesse Gelsinger, an 18-year-old with a genetic liver disease, died from immense inflammatory complications four days after receiving gene therapy for his condition during a clinical trial. It was quite a while before clinical trials in gene therapy resumed.

But what Stanford virologist Jan Carette, PhD, describes as “intense interest” in the field is once again in full bloom. Gene therapies for several inherited genetic disorders have been approved in Europe, and a gene-therapy approach for countering congenital blindness is close to approval in the United States.

That a virologist would be paying such close attention to this topic isn’t odd, as the most well-worked-out method for introducing genetic material to human cells involves the use of a domesticated virus.

If there’s one thing viruses are really good at, it’s infecting cells. Another viral trick is transferring their genes into cellular DNA — it’s part of their modus operandi: hijacking cells’ replicative machinery and diverting it to production of numerous copies of themselves. Scientists have become increasingly adept at taming viruses, tweaking them so they retain their ability to infect cells and insert genes, but no longer contain factors that wreck tissues or taunt the infected victim’s immune system into a rage destructive to virus and victim alike.

Adenovirus-associated virus — ubiquitous in people and not associated with any disease – makes a great workhorse. Properly bioengineered, it can infect all kinds of cells without replicating itself inside of them or triggering much of an immune response, instead obediently depositing medically relevant genes into the infected cells to repair a patient’s defective metabolic, enzymatic, or synthetic pathways.

Figuring out how to tailor this viral servant so it will invade cells more efficiently, or invade some kinds of cells and tissues but not others, would broaden gene therapy’s utility and appeal. In a series of experiments described in a study in Nature, Carette’s group, with collaborators from Oregon Health & Science University and the Netherlands, used a sophisticated method pioneered by Carette to bring that capability a step closer.

Continue Reading »

Medicine and Literature, Podcasts, Stanford News

When Breath Becomes Air: A conversation with Lucy Kalanithi

When Breath Becomes Air: A conversation with Lucy Kalanithi


Kalanithis - bigA few months before he died, I interviewed Paul Kalanithi, MD, for a 1:2:1 podcast about a gorgeous article he wrote for Stanford Medicine entitled “Before I Go.” I knew his days were short, yet when he came into the studio I was taken aback by his frailty. I think I was hit broadside because seeing him reminded me so much of my brother, Bill, in his last days alive. On the one hand each was still fighting cancer and yet there before you was a map illustrating how a disease overwhelms a body.

Paul spent his last months writing a book called When Breath Becomes Air. It’s a searing memoir that at times strikes you so hard, you cry. Already, it’s being heralded as a great book that is “indelible.”

One passage still stabs at my heart. It’s the rawest part of the article he wrote for Stanford Medicine, and it’s included in the book. It’s written as a note to his daughter, Cady, conceived after he was diagnosed and born while sand was slipping through his fingers:

When you come to one of the many moments in life when you must give an account of yourself, provide a ledger of what you have been and done, and meant to the world, do not, I pray, discount that you filled a dying man’s days with sated joy. A joy unknown to me in all my prior years, a joy that does not hunger for more and more, but rests, satisfied. In this time, right now, that is an enormous thing.

Now that his book has been published, it’s his widow, Lucy, a physician at Stanford, who has become his voice. As we sat down for this 1:2:1 interview I told her I had felt so unsure about the direction of my questions the day I spoke to her husband. How do you sit across from someone living and talk about their dying? The same anxiety was there before I spoke with Lucy. Were there areas of grief still bandaged over that I shouldn’t try to uncover?

In the end, the conversation with Lucy feels like a bookend. What began with Paul, a discussion about the time that remained for him, is cemented now with her words after he’s gone. (As we began, I told her that months before when Paul and I had talked he had sat in the same chair she was in. It comforted her knowing that.)

Continue Reading »

Stanford Medicine Resources: