According to a study published this week in the Journal of Adolescent Health, non-medical use of prescription medications like Vicodin and Adderall is rising among teens. Marijuana is also on the rise among adolescents, with the National Institute on Drug Abuse reporting 22 percent of 12th graders using it in the past month. Otherwise illicit drug use among teenagers has not increased in the last decade, and teen cigarette smokers have actually decreased, with fewer teens now smoking cigarettes than marijuana.

One potential explanation for the rise in prescription medication and marijuana misuse and abuse among teens, in contrast to other substances of abuse like tobacco, is the fact that prescription drugs and marijuana are viewed in contemporary medical and lay culture as having “medicinal” properties. Both Vicodin and Adderall have FDA-approved indications, the former for pain and the latter for attention deficit disorder. Although marijuana is a Schedule I drug at the federal level, meaning it has not been approved for any medical use, marijuana is readily available for chronic pain, anorexia, intractable nausea, and other ailments in many states through dispensaries.

Teens may be using… because they have embraced the idea that these substances are good for them, or at least not necessarily bad for them

Teens may be using Vicodin, Adderall, and marijuana in increasing numbers and with increasing frequency because they have embraced the idea that these substances are good for them, or at least not necessarily bad for them. For teens who have received a diagnosis of chronic pain or attention deficit disorder, they may justify ongoing abuse as necessary to “treat” their disorder, even in the face of obvious addiction. Furthermore, withdrawal from substances of abuse is almost universally characterized by anxiety, depression, insomnia, and attention problems. Adolescents as well as adults may misconstrue symptoms of withdrawal as indicative of an underlying physical or psychiatric disorder, which in turn perpetuates use.

What is needed to combat this alarming trend in illicit drug use among teens is to launch state and national campaigns alerting adolescents to the true dangers inherent in misuse and abuse of prescription medications and marijuana, as perceptions among teens of potential harmfulness correlates with decreased use. Such a campaign would also seek to re-stigmatize use of these substances, just as national anti-smoking campaigns stigmatized cigarette smoking to the point where prevalence rates decreased by 20-30 percent in just a couple of generations, and smoking cigarettes has been banned from almost all public venues.

Cultural narratives, in other words, around specific substances of abuse, are central to influencing behavior, especially among teens who may be more susceptible than adults to the stories we tell.

Previously: How to prevent prescription-drug misuse among teens, Do people really get addicted to marijuana? and NIH podcast reveals prescription drug abuse more prevalent in teenage girls than boys
Photo in featured entry box by RambergMediaImages

Anna Lembke, MD, is an assistant professor of psychiatry and behavioral sciences at Stanford.

Health-care officials may have a new weapon against bacteria lurking on surfaces around hospitals, including those deemed drug-resistant. Findings presented today at IDWeek 2012 in San Diego show a specific spectrum of ultraviolet light can nearly eliminate all bugs from door handles, bedside tables and other contaminated areas in hospital rooms.

Scientific American reports:

A team of researchers sampled five high-contact areas in hospital bedrooms and bathrooms (such as bed rails, toilets and remote controls) where patients with C. difficile, Acinetobacter or VRE infections had been staying. They then brought in a machine outfitted with eight bulbs to emit short-wave UV radiation (UV-C) for 25 to 45 minutes. Afterward, the researchers sampled the same locations for any persisting bacteria or spores.

“We were able to demonstrate that we could achieve well over 90 percent reduction in each of those three bad bugs after using the UV light,” Deverick Anderson, co-director of the Duke Infection Control Outreach Network, and study collaborator, said during a media briefing call earlier this week. Even shadowed surfaces that escaped direct UV exposure demonstrated this drastic reduction in bacteria.

Researchers caution that the approach is meant to enhance hospital cleaning procedures, not be the sole method of disinfecting rooms.

Previously: Harnessing evolutionary forces to develop more effective methods for treating superbugs
Photo by Ronald Woan

It could be the cooler temperatures, shorter days or reduced produce selection at the grocery store, but lately it’s been more challenging for me to make healthy-eating choices. My efforts, though, have been reinvigorated after coming across more evidence that good nutrition is important for cognitive function.

In a study presented (.pdf) this week at the Neuroscience 2012 conference in New Orleans, researchers used functional magnetic resonance imaging to measure brain activity in participants as they underwent a series of cognitive tests. As The Chart reports:

The overweight and obese participants’ brains showed more activity during difficult questions, suggesting they were working harder to get the same answers. [Lead study author Timothy Verstynen, PhD,] said the results imply that obese people are less efficient at making complex decisions, which could be important for controlling impulse behavior.

His team theorizes that unhealthy eating choices can lead to disrupted brain connections that lead to weakened brain performance, which can lead to making more unhealthy choices.

In other words, it’s a vicious cycle.

The piece goes on to outline other studies presented at the conference, including one focused on how fasting or dieting may affect the brain’s craving for high-calorie foods and whether this process can be blocked using medications.

Previously: Exploring the connection between food and brain function, How lack of sleep affects the brain and may increase appetite, weight gain and High-fat foods may tell the brain to splurge

Back in September, Lucile Packard Children’s Hospital broke ground on its 512,000-square-foot expansion, which will add 150 patient rooms, more treatment areas and the newest in medical technology. The current issue of Stanford Medicine Newsletter includes a story that lays out the plans for the new addition, which is scheduled to open in December 2016.

As two physicians point out, the new design of the rooms and surgical areas reflects Packard Children’s commitment to providing family-centered, streamlined care:

“The rooms are designed for quiet and rehabilitation,” said Michael Edwards, MD, chief of pediatric neurosurgery. “The goal is to help patients begin the recovery process in an environment created for healing so that they can return home sooner.”

…

“Surgery for a child is a scary thing for parents, so anything we can do to minimize the stress is a great thing,” said Anita Honkanen, MD, chief of pediatric anesthesia. “The design allows us to provide seamless care because there are so many efficiencies in how the suites are laid out. The right things are in the right place, which means we will all be able to do our jobs more efficiently and safely.”

Previously: Hospital mock-ups help refine plans before construction begins and City of Palo Alto approves rebuilding and expansion of Stanford Hospital and Lucile Packard Children’s Hospital
Photo of former patients Nicole Neal and her daughter, Audrey Harmon, on groundbreaking day; courtesy of Packard Children’s

The latest issue of The Spine Journal is devoted to casualties of war and includes some interesting insight into how the emotional stress of combat can impact soldiers’ spine injuries.

A key finding reported on in the issue is that non-battle spinal pain is a leading cause of medical evacuation for those deployed in Iraq and Afghanistan. Among other noteworthy findings, as outlined in a journal release:

• There have been 10 times as many long-term spinal-pain casualties unrelated to battle as blast injuries
• 60 percent of veterans seeking care for spine problems have serious continued psychological distress
• Less than one percent of military-aged Americans serve in the military (compared to nearly 50 percent during World War II), which means that veterans’ burdens after combat are now far less visible to the general public

In the release, Stanford orthopedic surgeon and journal editor-in-chief Eugene Carragee, MD, who wrote several pieces on spinal injuries for this issue and has done two tours of duty in Iraq himself, comments:

While some of the findings in this special issue are new and specific to these long wars—such as the devastating effects of IED blasts—it’s clear that we need to re-learn some very old lessons about war… We repeatedly send young people into combat to experience the worst psychological stressors possible, push them beyond endurance, and yet on the home front there is little to no collective understanding of the wars they fought or the experiences of deployment and combat. Veterans seeking care for spine problems at home are shown to have continued serious psychological distress, associated with exposure to combat. This is a serious public health issue that will continue for many years.

Previously: Stanford and other medical schools to increase training and research for PTSD, combat injuries, As soldiers return home, demand for psychologists with military experience grows, Helping brain-injured soldiers return – safely – to the battlefield and Are veterans with PTSD at higher risk for medical illnesses?
Photo by Staff Sgt. Stacey Haga/U.S. Air Force

I was 24 years old when I was diagnosed with immune thrombocytopenic purpura, a rare blood disorder that involves the immune system destroying the body’s platelets. It wasn’t an easy diagnosis and only came after several alarming calls from my primary care physician and hematologist, dozens of blood draws, countless cross-country conversations with my nervous parents, and a bone marrow aspiration. Before this experience I didn’t even really know what platelets were, and I certainly wasn’t prepared for the fact that a shortage of them could kill me. In other words: It was pretty scary.

In the decade-plus since my diagnosis, I’ve never met anyone else with this disease - which is why I was so interested in hearing today the (happy) story of YouTube star/ITP patient Reagan Claire Smith. The Atherton, Calif. 10-year-old learned of her ITP at a much younger age than I: She was six when the telltale signs of bruising and petechia brought her to Lucile Packard Children’s Hospital, with platelet counts so low that, as her mom describes, “if she was hit in the head, it could result in bleeding to the brain.” As further explained in a release:

Reagan’s treatment included medicines, hospitalizations and chemotherapy. Nothing fixed the problem. Even a paper cut could send her to the emergency room. “This became a more problematic case, so we decided to do something definitive to help her regain her quality of life,” said [hematologist Bert Glader, MD, PhD], also a professor at the Stanford School of Medicine.

That meant removing Reagan’s spleen, the site of platelet destruction. In 2010, minimally invasive surgery expert Sanjeev Dutta, MD, took it out through her belly button in a no-scar procedure. “Since that time, she’s been in remission and has definitely gotten her life back,” said Glader. Reagan’s platelet counts have returned to normal and her activities are no longer restricted.

Today, Smith (like me) is in good health. And the young girl, who first sang publicly when she was seven and has been in numerous singing competitions since, is taking the Internet by storm; her catchy pop tune “I Wanna Know” is a YouTube and iTunes hit.

I love how her mom puts it: “She was once famous for being sick. Now she’s famous for singing.”

Photo courtesy of the Smith family

It’s been a week since Brian Kobilka, MD, chair of molecular and cellular physiology at Stanford, was named a co-recipient of the 2012 Nobel Prize in Chemistry. But new details from the whirlwind day continue to surface.

This video, posted today on the School of Medicine’s YouTube channel, offers a behind-the-scenes look at last Wednesday’s press conference and includes Kobilka being congratulated by Philip Pizzo, MD, medical school dean, and Stanford University President John Hennessy, PhD.

Previously: Memorable moments from Brian Kobilka’s Nobel win captured on Storify, Image of the Week: Nobel Laureate Brian Kobilka celebrates with colleagues and friends, A busy morning for Nobel Laureate Brian Kobilka and Stanford’s Brian Kobilka wins 2012 Nobel Prize in Chemistry

We’ve partnered with Inspire, a company that builds and manages online support communities for patients and caregivers, to launch a patient-focused series here on Scope. Once a month, patients affected by serious and often rare diseases will share their unique stories; the latest comes from celiac-disease patient and expert Alice Bast.

The day I was diagnosed with celiac disease was the best day of my life.

People always react with surprise when I tell them that. They ask how I can consider being diagnosed with an autoimmune digestive disease such a positive milestone. And I tell them it’s because that’s the day I got my life back.

In hindsight, I believe a vacation to Mexico played a role in triggering the disease. You see, celiac is a genetic condition, so you have to have a genetic susceptibility in order to develop the disease. But there’s something else needed to trigger the onset: an environmental factor, usually some type of emotional or physical stress. There’s little known about it, but in my case, I believe a parasite that I caught on vacation was my trigger. I was treated, but after that, things were never the same.

My husband and I were starting a family, and my oldest daughter was born perfectly healthy after a normal pregnancy. My second pregnancy, though, was nothing like the first. Early on, severe fatigue set in. I was constantly weak and rarely got enough sleep, as severe diarrhea, joint pain and migraines kept me awake at night. No matter what I did, I lost weight. Two weeks before my due date, I lost my baby.

Over the years, I went on to have multiple miscarriages before finally delivering my youngest daughter, who weighed only 2 pounds. For eight years, I visited an incredible amount of doctors - 22, to be exact. No one knew what was wrong with me. At 5’9″, I had wilted to a mere 105 pounds. I thought I was dying. My mother died of pancreatic cancer, and I thought I had cancer too, somewhere - but where? When and how would I find it, and would it be caught in time?

It wasn’t until talking to a family friend, a veterinarian, that I realized that what I was eating could be the problem. She mentioned celiac disease and said that animals can have reactions to wheat. Still on my quest for answers, I visited my 23rd doctor. “Here’s my arm,” I remember saying. ”Give me the blood test.”

Sure enough, the results came back positive for celiac disease. Finally. After eight years of struggling, I had my answer. There’s no cure for celiac, but I was told that by adopting a gluten-free diet and ridding myself of anything derived from wheat, barley, or rye, my health would return and I could live a normal life. And it did. And I did.

But my story doesn’t end with my diagnosis. That’s where it starts.

Continue Reading »

An interesting article in this month’s issue of Discover spotlights the brain donation program at the Banner Sun Health Research Institute and discusses how donors have notably advanced neuroscience research.

The program has collected more than a thousand brains from residents who lived in three retirement communities around Phoenix, Ariz. Participants enroll in the program prospectively, allowing for standardized clinical assessments to be made while they are still living. Jeff Wheelwright writes:

A large base of well-
documented donors in close proximity sets the Sun City program apart from other repositories, which often have scant information about patients who may be scattered and diverse. Here, healthy, active seniors who eventually die of, say, heart disease, can be compared with others who develop neurodegenerative disorders. Because the two sets of subjects have similar backgrounds, lifestyles, and ethnic traits, changes relating to a brain disease should be easier to detect.

…

The brain bank has provided raw material to 110 investigators and several hundred studies over the past five years. Asked to name the most important use of the samples so far, [pathologist and program director Thomas Beach, MD, PhD,] thinks for a moment and then describes an ambitious gene-expression study, “the first thorough study of gene expression of individually selected nerve cells in several regions of the Alzheimer’s brain.” And, he adds, “it’s publicly available.” Another project enabled the first FDA-approved imaging agent that could be used in PET scans of Alzheimer’s patients who were still alive.

Previously: Finding hope for rare pediatric brain tumor
Photo by Heidi Cartwright, Wellcome Images

In case you didn’t see it yesterday, Nature News Blog is reporting on a possible NIH policy change involving how many times rejected grant applicants can re-submit proposals. Meredith Wadman writes:

Senior leaders at the $31 billion biomedical agency in Bethesda, Maryland will decide in the next several weeks whether to abandon a “two strikes and you’re out” policy that was instituted in January 2009 as part of an extensive overhaul of peer review at the agency. Before then, grant-seekers had been allowed a third try after a proposal twice failed to pass muster with peer reviewers.

…

The NIH’s rationale for the 2009 change was that the three-strikes-and-you’re out rule was causing peer reviewers, either consciously or sub-consciously, to favor second and third submissions over first-time proposals, creating, in effect, a queue similar to airplanes circling an airport waiting for a free runway to allow them to land. “Support for meritorious science may be delayed if initial submissions are placed at the end of the queue,” the expert group that reviewed peer review for NIH concluded in a draft report in 2008 that showed the success rates for first-time applications falling from over 60% in 1998 to 30% in 2007. (See page 33 of the report for the graph plotting these numbers.)

However, the change generated tremendous pushback from scientists, who have complained of it nearly incessantly to NIH’s Office of Extramural Research…