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Cancer, Patient Care, Stanford News, Transplants, Videos

Immunosuppression brings higher risk for skin cancer – and need for specialized care

Immunosuppression brings higher risk for skin cancer – and need for specialized care

An estimated 50 million Americans must take immunosuppressants to treat more than 80 autoimmune disorders, according to the National Institutes of Health. These medications are particularly vital to the survival of people who have undergone organ transplants to prevent their bodies from rejecting their donor organ.

While immunosuppressants can be life-saving, their very action of reducing the body’s innate defense systems can have negative side-effects. One particularly dangerous concern is an increased risk for skin cancer, particularly for those individuals with fair skin or an inherited tendency to develop skin cancers. (My colleague Tracie White told the story of one transplant patient’s struggle here earlier this summer.)

To address the specialized needs of patients taking immunosuppressants or with compromised immune function, Stanford dermatologists recently launched the High-Risk Skin Cancer Clinic.

In this Stanford Health Care video, the clinic’s Carolyn Lee, MD, PhD, explains the particular vulnerabilities of transplant patients to aggressive skin cancer and the importance of a dedicated clinic to meet their needs. “What we hate to see — and it’s easily preventable — is someone who’s been waiting for a transplant to finally get it, only to be felled by skin cancer,” she says.

 

Previously: Rebuilding Cassie’s smile: A lung transplant patient’s struggle with skin cancer and This summer’s Stanford Medicine magazine shows some skin

Medical Education, Microbiology, NIH, Public Health, Research, Videos

Investigating the human microbiome: “We’re only just beginning and there is so much more to explore”

Investigating the human microbiome: "We’re only just beginning and there is so much more to explore"

The more scientists learn about the body’s community of bacteria, the more they believe that the human microbiome plays an important role in our overall health. For example, research published earlier this week suggests that a specific pattern of high bacterial diversity in the vagina during pregnancy increases a woman’s risk of giving birth prematurely.

Despite these and other insightful findings, researchers have a long way to go to understand the composition of our internal microbial ecosystems. As Keisha Findley, a postdoctoral fellow at the National Human Genome Research Institute says in the above video, “We’re only just beginning and there is so much more to explore.”

Findley and colleagues are working to survey all of the fungi and bacteria living on healthy human skin and develop a baseline to determine how these microbial communities may influence skin conditions such as acne, athlete’s foot, skin ulcers and eczema. Watch the LabTV video above to learn more about her work.

Previously: Drugs for bugs: Industry seeks small molecules to target, tweak and tune up our gut microbes, A look at our disappearing microbes, Exploring the microbes that inhabit our bodies and Diverse microbes discovered in healthy lungs shed new light on cystic fibrosis
Via NIH Director’s Blog

Big data, BigDataMed15, Precision health, Public Health, Research, Videos

How the FDA is promoting data sharing and transparency to support innovations in public health

How the FDA is promoting data sharing and transparency to support innovations in public health

Keynote talks and presentations from the 2015 Big Data in Biomedicine conference at Stanford are now available on the Stanford YouTube channel. To continue the discussion of how big data can be harnessed to improve the practice of medicine and enhance human health, we’re featuring a selection of the videos on Scope.

At the 2014 Big Data in Biomedicine conference, Taha Kass-Hout, MD, chief health informatics officer for the U.S. Food and Drug Administration, announced that the federal agency was launching OpenFDA, a scalable search and big-data analytics platform. In May, he returned to the Big Data in Biomedicine stage to offer an update on the initiative and discuss how the FDA is continuing to foster access and transparency of big data in government.

During his talk, Kass-Hout shared some eye-popping statistics about the information available through OpenFDA. The platform houses close to 70,000 product labels for pharmaceuticals; nearly four million reports on adverse events or malfunctions of medical devices; 41,000 records on recalls of foods, pharmaceuticals or devices and over four and a half million reports of adverse events or side-effects of drugs.

He outlined future plans to build a similar public, cloud-based platform to compliment the Obama Administration’s Precision Medicine Initiative. Watch the full talk to learn more about these exciting efforts to unlock the rapidly growing reservoir of biomedical data and spur innovation in public health.

Previously: A look at the MyHeart Counts app and the potential of mobile technologies to improve human health, Discussing patient participation in medical research: “We had to take this into our own hands,” A look at aging and longevity in this “unprecedented” time in history, Mining Twitter to identify cases of foodborne illness and Discussing access and transparency of big data in government

Infectious Disease, Medical Education, Medicine and Society, Public Health, Stanford News, Videos

Online curriculum helps students and public learn about influenza

Online curriculum helps students and public learn about influenza

Stanford’s Flu Crew, which administers flu vaccines in and around the Stanford community, has had many successes over the last few years, which we’ll highlight in a post later this week. One achievement I thought deserved special attention is an innovative curriculum on influenza created by former medical student Kelsey Hills-Evans, MD, now an internal medicine resident at Harvard. Her online videos, such as the one above (which is the first in the series), are accessible not only to Flu Crew’s student participants but the public at large.

The videos were produced via a partnership with Khan Academy and built on the flipped classroom model championed by Charles Prober, MD, senior associate dean of medical education. They also received the Shenson Bedside Innovation Award in 2013. Rishi Desai, MD, a Stanford pediatric infectious disease physician and medical fellow at Khan Academy, supervised Hills-Evans’ efforts and told me in an email that Hills-Evans and the Flu Crew “put together some really amazing videos explaining everything from the basics of influenza to common misconceptions and fears that people have about the flu vaccine. They deserve all of the credit for the idea and execution of the project.”

Hills-Evans tried to keep each video under five minutes: “I wanted it to be a quick, high-yield snapshot of information that people could watch in one sitting and not easily forget.” She shared more details with me over email:

What did you aim to convey in these training videos? How did you imagine your audience? 

I wanted our student volunteers to come away from the training with enough general knowledge about influenza to answer nearly any question that patients might have. We equipped them with knowledge about its history, how it genetically changes over time, the clinical symptoms, the vaccine’s risks and benefits, specific patient populations, and even a section on flu shot myths. Our last video was meant for students to become public-health advocates equipped with facts and counter-arguments to some of the most common excuses people have for not protecting themselves with the flu vaccine.

For these general info videos, I was really aiming to be accessible to the general public. The topics are all applicable to the lay person, so I tried my best to stay away from clinical jargon. I wanted people to come away from the training with a better understanding of how dangerous influenza can be – many people shrug at the flu as a bit worse than a winter cold, but it kills tens of thousands of people every year. In addition, there are so many myths generated by popular media and the public about the illness itself (i.e., “I got a stomach flu” which is never actually an influenza virus) and especially about vaccines. It was important to me that we make these videos public so more individuals could be informed.

For the sections meant only for clinical personnel, our priority was to train the members of the Stanford Flu Crew, but I also wanted this component to be exportable to other medical programs. It was meant to teach students to deliver the best intramuscular (IM) injections possible. We’ve been told countless times that our method for IM injections yields extremely high patient satisfaction and nearly pain-free injections (some say “the best flu shot they’ve received”).

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Big data, BigDataMed15, Cardiovascular Medicine, Medical Apps, Stanford News, Videos

A look at the MyHeart Counts app and the potential of mobile technologies to improve human health

A look at the MyHeart Counts app and the potential of mobile technologies to improve human health

Keynote talks and presentations from the 2015 Big Data in Biomedicine conference at Stanford are now available on the Stanford YouTube channel. To continue the discussion of how big data can be harnessed to improve the practice of medicine and enhance human health, we’re featuring a selection of the videos on Scope.

At last count, the number of iPhone owners who have downloaded the MyHeart Counts app and consented to participate in a large-scale, human heart study had reached 40,000. The first-of-its-kind mobile app was designed by Stanford Medicine cardiologists as a way for users to learn about their heart health while simultaneously helping advance the field of cardiovascular medicine.

Built on Apple’s ResearchKit framework, the app leverages the iPhone’s built-in motion sensors to collect data on physical activity and other cardiac risk factors for a research study. The MyHeart Counts study also draws on the strength of Stanford Medicine’s Biomedical Data Science Initiative.

At the 2015 Big Data in Biomedicine conference, Euan Ashley, MD, a cardiologist at Stanford and co-investigator for the MyHeart Counts study, shared some preliminary findings with the audience. Check out the full talk to learn more about how the app is helping researchers better understand Americans’ health habits and what states have the happiest, most physically active and well-rested residents.

Previously: On the move: Big Data in Biomedicine goes mobile with discussion on mHealth, MyHeart Counts shows that smartphones are catching on as new research tool, Lights, camera, action: Stanford cardiologist discusses MyHeart Counts on ABC’s Nightline, MyHeart Counts app debuts with a splash and Stanford launches iPhone app to study heart health.

Big data, BigDataMed15, Chronic Disease, Videos

Discussing patient participation in medical research: “We had to take this into our own hands”

Discussing patient participation in medical research: "We had to take this into our own hands"

Keynote talks and presentations from the 2015 Big Data in Biomedicine conference at Stanford are now available on the Stanford YouTube channel. To continue the discussion of how big data can be harnessed to improve the practice of medicine and enhance human health, we’re featuring a selection of the videos on Scope.

Two days before Christmas in 1994, Sharon Terry’s two young children were diagnosed with pseudoxanthoma elasticum (PXE), a rare condition that causes calcium and other minerals to be deposited in the body’s tissue. As Terry told the audience at the 2015 Big Data in Biomedicine conference, “[My husband and I] quickly learned that we, in fact, had to take this into our own hands, like many parents have done before us and many parents have done after us.” Despite not having a science background, Terry co-discovered the gene associated with PXE and created a diagnostic test for the disease; over the years, she has conducted clinical trials and authored 140 peer-reviewed papers, of which 30 are PXE clinical studies.

In the above video, Terry recounts the inspiring journey of how she and her husband worked for two decades with scientists worldwide to advance research on PXE in hopes of developing therapeutic treatments. She also explains her current work as president and CEO of Genetic Alliance to help individuals, families and communities participate in scientific research and promote the sharing of health data to improve health.

Previously: A look at aging and longevity in this “unprecedented” time in history, Parents turn to data after son is diagnosed with ultra-rare disease, Nobel Laureate Michael Levitt explains why “biology is information rich” at Big Data in Biomedicine, At Big Data in Biomedicine, Stanford’s Lloyd Minor focuses on precision health and  Experts at Big Data in Biomedicine: Bigger, better datasets and technology will benefit patients

Neuroscience, Stanford News, Videos

Are decisions driven by subconscious desires or shaped by conscious goals?

Are decisions driven by subconscious desires or shaped by conscious goals?

Throughout our lives, we often encounter perplexing situations involving other individuals or read in the news about someone’s seemingly irrational decision and say to ourselves: What were they thinking? In this Stanford+Connects video, Bill Newsome, PhD, director of the Stanford Neurosciences Institute, and his wife Brie Linkenhoker, PhD, a neuroscientists-turned-strategist who directs Worldview Stanford, examine the process of decision making and the role of impulses and self-control. Watch the full talk to learn more about the mechanisms driving us to make decisions.

Previously: Exploring the science of decision making and Exploring the intelligence-gathering and decision-making processes of infants

Big data, Stanford News, Videos

What is big data?

What is big data?

We’ve written a lot about “big data” and the field of data science here on Scope. But for those readers who are still fuzzy on what exactly big data is, or how it’s being used to improve human health, Lloyd Minor, MD, dean of the medical school, and researchers with Stanford’s Biomedical Data Science Initiative (BDSI) are here to help. In the video above they offer their own definitions of big data, discuss how Stanford is leading the way in advancing the field, and share examples of how this so-called “digitization of life” will come to benefit all patients.

Previously: At Big Data in Biomedicine, Stanford’s Lloyd Minor focuses on precision healthExperts at Big Data in Biomedicine: Bigger, better datasets and technology will benefit patientsExamining the potential of big data to transform health careRising to the challenge of harnessing big data to benefit patients and A call to use the “tsunami of biomedical data” to preserve life and enhance health

Chronic Disease, Research, Stanford News, Videos

“This is probably one of the last major diseases we know nothing about”: A look at CFS

“This is probably one of the last major diseases we know nothing about": A look at CFS

Chronic fatigue syndrome affects between 836,000 to 2.5 million people in the United States, and 25 percent of them are confined to their bed. Earlier this year, the Institute of Medicine released a report acknowledging that chronic fatigue syndrome is a real and serious disease and renaming the disorder “systemic exertion intolerance disease” to better reflect its key symptoms.

The current issue of Palo Alto Weekly focuses on the disease and tells the story of local resident Whitney Dafoe, a promising 31-year-old photographer whose career was cut short when he began experiencing crushing fatigue, dizziness, gastrointestinal problems and dramatic weight loss:

Dafoe’s disease has progressed to the point that he cannot talk, read or use the Internet. His joint pain became so severe some time ago that he could no longer walk and needed to use a wheel chair. Now he rarely gets out of bed. On a good day, he’ll show his gratitude by pointing to his heart, his mother said.

His parents have stuck a few brief messages he’s scrawled on notes to the door frame outside his room. The yellow squares of paper are the only way he can communicate these days.

“I don’t know what to say. I just feel pretty hopeless about all this. I never get a break from bad things,” he wrote on one note.

“It’s so hard not being able to take care of my stuff. The feeling of helplessness it gives me is so stressful,” another states.

Dafoe, who is also featured in the above video, is the son of Ronald Davis, PhD, a genetics researcher who was instrumental in the Human Genome Project and directs Stanford’s Chronic Fatigue Syndrome Research Center. A second article details how Davis and colleagues are working to better understand the debilitating disease and develop diagnostic tests and treatments:

Davis and his team plan to use technologies developed for the Human Genome Project to sequence the entire genome of chronic fatigue patients, including 1,600 mitochondrial genes, more than 20,000 other genes and control regions that regulate genes. They hope to identify proteins that are found in immune cells, blood and spinal fluid; search for infectious agents in blood, bone marrow, spinal fluid and saliva and changes to gastrointestinal tract flora; and find evidence of autoimmune responses. The research could reveal DNA sequences that are altered in chronic fatigue patients.

The detailed approach is more comprehensive than that of other research, which has only looked at a fraction of the genes, according to the center’s website.

Davis is working with numerous collaborators across many fields, hoping the collaborative effort will attract the best minds in their fields.

“This is probably one of the last major diseases we know nothing about. This is your last chance to be a pioneer,” he said.

Previously: ME/CFS/SEID: It goes by many aliases, but its blood-chemistry signature is a giveawayChronic fatigue syndrome gets more respect (and a new name), Studies on ME/chronic fatigue syndrome continue to grab headlines, spur conversation, Unbroken: A chronic fatigue syndrome patient’s long road to recovery and Deciphering the puzzle of chronic fatigue syndrome

Immunology, Nutrition, Stanford News, Videos

A Stanford dietician talks food sensitivities

A Stanford dietician talks food sensitivities

Ever wondered what the difference between a food allergy and a food sensitivity is? Neha Shah, MPH, RD, CNSC, a registered dietician at the Stanford Digestive Health Center, sheds some light in a new video.

In people with food allergies, she explains, the immune system responds to the presence of the food, which isn’t the case for food sensitivities. People with food allergies have to avoid the culprit foods entirely, whereas people with food sensitivities can sometimes have small amounts of the food – though they must figure out what their threshold is. (Too much and the offending food might set off other symptoms like gas, bloating or diarrhea.) Shah uses lactose intolerance as an example of a very common food sensitivity and describes how people can understand their threshold.

Previously: Peanut products and babies: Now okay?, Stanford dietitian explains how – not just what – you eat matters, Taking a bite out of food allergies: Stanford doctors exploring new way to help sufferers, Eating nuts during pregnancy may protect baby from nut allergies and Ask Stanford Med: Pediatric immunologist answers your questions about food allergy research

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