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Patient Care, Pediatrics, Stanford News, Videos

Pediatric patients create vibrant mural with help from Hewlett-Packard and DreamWorks Animation

Pediatric patients create vibrant mural with help from Hewlett-Packard and DreamWorks Animation

Here’s a feel-good story that will lift your spirits. Over at Lucile Packard Children’s Hospital Stanford, patients are working with volunteers from Hewlett-Packard and DreamWorks Animation to construct a unique piece of artwork designed digitally or drawn by hand. As described in the above video, the DreamWorks team worked with children in the hospital’s onsite school to create imaginary creatures, and next built a background and composited the patients’ art into a large mural. Then, Hewlett-Packard printed the custom designs onto PVC-free wallpaper. The final mural now hangs in Hewlett-Packard’s Palo Alto headquarters.

Previously: Ensuring young dialysis patients make the grade

Medicine X, Stanford News, Technology, Videos

Medicine X symposium focuses on how patients, providers and entrepreneurs can ignite innovation

Medicine X symposium focuses on how patients, providers and entrepreneurs can ignite innovation

A special Medicine X event on Sept. 4 will explore how patients, providers and entrepreneurs can help ignite innovation in the health-care industry. During the daylong symposium, James Hereford, chief operating officer at Stanford Hospital & Clinics, will be presenting crucial opportunities for innovation in medicine today, and challenging physicians, patients and entrepreneurs to collaborate and build partnerships in an effort to create impact and change.

In the above Medicine X film, Hereford discusses the importance of patient-centered care, the need to treat the whole person and not just the illness and how including patients in pivotal discussions is crucial to transform health care. “I don’t think the world should be defined around us,” said Hereford. “I think the world should be defined around our patients.”

The brief conversation offers a taste of the thoughtful commentary that attendees can expect at this event. Other speakers include: Robert Pearl, MD, executive director and chief executive officer of The Permanente Medical Group; Stanford radiologist Lawrence Hoffman, MD; Mark Tomaino, senior industry executive at Welsh, Carson, Anderson & Stowe; Vivian Lee, MD, PhD, chief executive officer of University of Utah Health Care; and Alexandra Drane, co-founder of Eliza Corp. For more information or to register for the symposium visit the conference website.

More news about Stanford Medicine X is available in the Medicine X category.

Previously: Medicine X spotlights mental health, medical team of the future and the “no-smartphone” patient, Medicine X Live! to host Hangout on design thinking for patient engagement and Quite the reach: Stanford Medicine X set record for most number of tweets at a health-care conference

Cardiovascular Medicine, Patient Care, Stanford News, Technology, Videos

“Liberated from LVAD support”: One patient’s story

“Liberated from LVAD support”: One patient’s story

One of the first things I noticed about Donna Jackson — 68 years old when I met her in 2011 — was her decisive nature. She had a schedule filled with activity, and regardless of how many people (many of her children, grandchildren, great-grandchildren, in-laws and friends live very near at hand) came to visit in her modest home in Central California, she was a certain force of calm. She was also someone who did not like restrictions on what she could do.

Back then, she was just a few months out from surgery at Stanford Hospital to implant a mechanical pump, a left ventricular assist device or LVAD, on her heart. She knew it had saved her life, but she chafed at the battery, back-up battery and controller she had to wear at all times. Before the surgery, she had been a regular at a water aerobics class, and she loved to swim with her grandchildren. Even in those early months, Jackson was leaning on her Stanford doctors to find a way to get her back in the water. She asked her cardiologist, Dipanjan Banerjee, MD, to consider allowing her to swim in a wetsuit.

Banerjee did her one better. It had become apparent to him that she could be one of that small percentage of LVAD recipients whose heart recovers after the rest that the LVAD gives it and who no longer need the device. (He had been waiting, he said, to find a patient “who can be liberated from LVAD support.”) By Spring 2013, a little less than three years after her LVAD implantation, Banerjee and Jackson’s surgeon, Richard Ha, MD, put Jackson in an even smaller percentage. She became the first person to have her LVAD deactivated by catheter in the most minimally invasive approach yet.

The challenge set by Jackson for her Stanford team — and its groundbreaking procedural response — appears today in the August issue of the Annals of Thoracic Surgery. The lead author of the paper is Sanford Zeigler, MD, a cardiothoracic surgery resident.  Ha, surgical director of the hospital’s Mechanical Circulatory Support Program is the paper’s senior author, and Banerjee, medical director of Mechanical Circulatory Support Program, is a co-author. As they explain in the paper, Jackson, nearing 71,  was a high surgical risk for complete removal of the implant — that would have required them to crack open her ribs again — a procedure that’s followed typically by a long and sometimes painful recovery.  So, her doctors instead threaded a slim plastic tube through a small incision to her femoral artery in the groin and up to her aorta, allowed them to plug the flow of blood to the LVAD. Then, they cut, cleaned and capped the wiring powering the LVAD so it no longer emerged from an opening in her abdomen. (The LVAD remains inside Jackson’s chest.)

The new catheter-based deactivation of the LVAD has value beyond Jackson’s way of life, as the paper explains. She inspired the team to begin research on how to predict which LVAD patients might be like her and reach a point where they no longer need the LVAD. “If we can find out which patients are going to recover sooner, we can be more aggressive with them so they can be liberated from the LVAD,” said Banerjee, “and many of these patients will not want or be able to tolerate a complete removal of the LVAD.”

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Cancer, Health Costs, In the News, Stanford News, Videos

TV spot features a more humane approach to late-stage cancer care

Updated 8-4-14: The video is no longer posted on the Al Jazzera website, but the online story is still available.

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7-30-14: Is it possible to cut the costs of late-stage cancer care by 30 percent and provide a much better experience for patients?

That’s the question that recently brought an Al Jazzera America TV news crew out to the VA Palo Alto Health Care System, to interview patients enrolled in a new Stanford-designed pilot study on cancer care. You can watch their 9-minute video on this topic here.

The guiding principle behind this cancer-care program is this: Make sure that patients are fully informed about survival odds and treatment side effects well before they’re on the brink of death, when emotions overwhelm the decision-making skills of patients, their families and clinicians.

“Eighty percent of all cancer patients express a desire to die at home, yet only 10 percent do,” says Manali Patel, MD, the VA hospital oncologist running this study. “These end-of-life conversations, which typically take two hours in the beginning and require many follow-on conversations, are too hard, time-consuming and draining for a busy oncologist to do well.”

For these life-and-death discussions, patients are assigned personal care coaches who help them understand the big picture — treatment side effects, survival odds and pain-relief options. They also have access to a 24-hour symptom-management hotline and an option for in-home chemotherapy.

Architects of this new cancer care model, working with Arnold Milstein, MD, at Stanford’s Clinical Excellence Research Center, estimate that this program will lead to fewer unwanted treatments and expensive emergency room visits, saving the overall heath-care system money, while at the same time improving patient quality of life.

Previously: Communicating with terminally ill patients: A physician’s perspective, Identifying disparities in palliative care among cancer and non-cancer patients, Uncommon hero: A young oncologist fights for more humane cancer care, The money crunch: Stanford Medicine magazine’s new special report and New Stanford center to address inefficient health care

Cardiovascular Medicine, Research, Videos

Researchers capture detailed three-dimensional images of cardiac dynamics in zebrafish

Researchers capture detailed three-dimensional images of cardiac dynamics in zebrafish

The stunning video above depicts a reconstructed beating heart of a zebrafish embryo with the muscle layer shown in red and the endothelium highlighted in blue. Researchers at the Max Planck Institute of Molecular Cell Biology and Genetics in Germany created the video using a new three-dimensional imaging technique, which holds the promise of leading to a better “understanding of congenital heart defects as well in future experiments on cardiac function and development”. As explained in a release:

[Researchers] developed a high-speed, selective plane illumination microscope that manages to do just that. By gently illuminating the fish heart with a thin light sheet and observing the emitted fluorescence with a fast and sensitive camera the researchers have achieved fast, non-invasive imaging of labelled heart tissue. The process involves taking multiple movies, each covering individual planes of the heart (movie stacks), then using the correlations between the individual planes to generate a synchronised, dynamic 3D image of the beating heart.

“These renderings allow us to further follow characteristic structures of the heart throughout the cardiac cycle,” says Michaela Mickoleit, PhD student who performed the experiments in [Jan Huisken's] lab.

Via Medgadget
Previously: An advancement in optogenetics: Switching off cells with light now as easy as switching them on and New York Times profiles Stanford’s Karl Deisseroth and his work in optogenetics

Patient Care, Stanford News, Videos

More on the Navy pilot with mysterious symptoms – and the Stanford doctors who diagnosed him

More on the Navy pilot with mysterious symptoms - and the Stanford doctors who diagnosed him

Last week, we blogged about a Navy pilot whose mysterious symptoms were diagnosed by clinicians here. A just-published Stanford Hospital video shares more of Robert Buchanan’s compelling story.

Previously: Medical mystery solved: Stanford clinicians identify source of Navy pilot’s puzzling symptoms

Nutrition, Pediatrics, Stanford News, Videos

Where is the love? A discussion of nutrition, health and repairing our relationship with food

Where is the love? A discussion of nutrition, health and repairing our relationship with food

Maya Adam, MD, a lecturer on child health and nutrition in Stanford’s Program in Human Biology, associates food with love. “Through food, we learn about where we come from, who we are, and in many ways who we want to be,” she said in a recent TEDxStanford talk. But, as in human relationships involving love, our encounters with food may involve fighting – and even tragedy and betrayal, she noted. She pointed to an antacid commercial’s presentation of a “food fight” between foods we consume to taste but that cause us indigestion and larger health problems over time.

Early in her medical training, Adam said, she learned that “pain is a protective sensation; it helps us to avoid things that could cause damage to our bodies.” Ignoring pain or masking it with antacids, as the ad suggests, sends the message that “we should medicate that sensation away and continue consuming the foods that are hurting us.” What’s more, she said, a cultural “war on food” is depleting our time, energy and joy around eating, all in the midst of an obesity epidemic.

In her talk, Adam, who teaches a massive open online course called “Child Nutrition and Cooking,” recommends examining our modern-day relationship with food, which has grown distant. Regaining a healthy relationship involves learning where food comes from and what’s inside it, and taking care to prepare and cook real food for yourself and loved ones, she said: “May the foods you eat be worthy of you, and may they be made with love.”

Previously: A spotlight on TEDxStanford’s “awe-inspiring” and “deeply moving” talks and Free Stanford online course on child nutrition & cooking

Chronic Disease, Stanford News, Videos

Gracefully saying goodbye: Isabel Stenzel Byrnes shares lessons to help cope with losing loved ones

Gracefully saying goodbye: Isabel Stenzel Byrnes shares lessons to help cope with losing loved ones

Isabel Stenzel Byrnes and her identical twin sister Anabel were diagnosed with cystic fibrosis when they were only three days old. At the time, physicians told their parents it would be unlikely that they would survive to see their 10th birthday. Working together, the sisters completed rigorous daily respiratory and digestive treatment to maintain their health, and in their 20s, they received double lung transplants at Stanford Hospital & Clinics. The dynamic duo become forceful organ donor advocates and authored a memoir, titled The Power of Two, that inspired an award-winning documentary.

In this powerful and moving TEDxStanford talk, Byrnes shares her lifelong experience of practicing the art of saying goodbye. Over the past 30 years, she has said goodbye to 123 friends, including her sister, who died of cancer last October. To help others cope with loss, she discusses the lessons about bereavement that she’s learned along the way and outlines the choices we have in saying goodbye.

Previously: A spotlight on TEDxStanford’s “awe-inspiring” and “deeply moving” talks, Film about twin sisters’ double lung transplants and battle against cystic fibrosis available online, Meet the filmmakers behind “The Power of Two” and Living- and thriving- with cystic fibrosis

Applied Biotechnology, Stanford News, Videos

Drew Endy discusses the potential to program life and future of genetic engineering at TEDxStanford

Drew Endy discusses the potential to program life and future of genetic engineering at TEDxStanford

In 2013, Drew Endy, PhD, assistant professor of bioengineering, was honored as a Champion of Change by the White House. A leader in the field of synthetic biology, Endy founded BioBricks Foundation, which has underwritten an open technical-standards-setting process for synthetic biology and developed a legal contract for making genetic materials free to share and use. He spoke at TEDxStanford about his work with designers, social scientists and others to transcend the industrialization of nature. Watch the above video to learn more about the potential for making life programmable and the future of genetic engineering.

Previously: Programming cells for chemical production and disease detection, The “new frontier” of synthetic biology, Drew Endy discusses developing rewritable digital data storage in DNA and Researchers create rewritable digital storage in DNA

Big data, Cancer, Research, Science, Stanford News, Videos

Will hypothesis or data-driven research advance science? A Stanford biochemist weighs in

Will hypothesis or data-driven research advance science? A Stanford biochemist weighs in

The 2014 Big Data in Biomedicine conference was held here last month, and keynote speakers, panelists, moderators and attendees are now available on the Stanford Medicine YouTube channel. To continue the discussion of how big data can be harnessed to benefit human health, we’ll be featuring a selection of the videos this month on Scope.

Julia Salzman, PhD, a Stanford assistant professor of biochemistry, is concerned that significant amount of data is being thrown in the trash “because the data don’t fit our sense of what they should look like.” At Big Data in Biomedicine 2014, she explained how giving her computers a long leash led her down an unexpected path and the discovery of a new, and probably noteworthy, biological entity. My colleague Bruce Goldman highlighted her findings in a news release:

Using computational pattern-recognition software, her team discovered numerous instances in which pieces of RNA that normally are stitched together in a particular linear sequence were, instead, assembled in the “wrong” order (with what’s normally the final piece in the sequence preceding what’s normally the first piece, for example). The anomaly was resolved with the realization that what Salzman and her group were seeing were breakdown products of circular RNA — a novel conformation of the molecule.

In its circular form, she noted, an RNA molecule is much more impervious to degradation by ubiquitous RNA-snipping enzymes, so it is more likely than its linear RNA counterparts to persist in a person’s blood. Every cell in the body produces circular RNA, she said, but it seems to be produced at greater levels in many human cancer cells. While its detailed functions remain to be revealed, these features of circular RNA may position it as an excellent target for a blood test, she said.

In the above Behind the Scenes at Big Data video, Salzman discusses her work and addresses a question asked during the Single Cells to Exacycles panel: In this next era of science, will science advance mainly through hypothesis or data driven research? She comments, “I think that’s a fundamental question moving forward, whether the scientific method is dead or whether it’s still alive and kicking. I think that’s a really important question for us as to answer and deal with as scientists.” Watch the interview to find out the rest of Salzman’s thoughts on the issue.

Previously: Rising to the challenge of harnessing big data to benefit patients, Discussing access and transparency of big data in government and U.S. Chief Technology Officer kicks off Big Data in Biomedicine

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