Saturday, May 21, 2011

From frostbite to stem cells, research projects display medical students’ talents at symposium

A mountaineer in her spare time, Mackenzie Wehner has reason to fear frostbite. So the third-year medical student developed a technique that may help researchers study treatments for the condition: pinching the skin on a mouse’s back, then freezing the exposed area.
“There is no good therapy for frostbite,” Wehner explained at the 28th annual Stanford Medical Student Research Symposium, where she was presenting a poster on the technique. “Homeless people, soldiers and mountaineers often suffer from frostbite, and we don’t have anything for them.”
The pinching technique, which uses magnets to hold the skin in place, aids research because the toes of mice and rabbits tend to fall off when they’re frozen, frustrating researchers’ efforts to test treatments on frostbitten digits. “This is an easy, go-to model for researchers to use,” Wehner noted.
Wehner’s presentation was one of 52 at the symposium, held May 12 in the Li Ka Shing Center for Learning and Knowledge. It provided MD and MD/PhD students an opportunity to show off their research to the medical school community as well as gain valuable practice communicating about it. Judges, made up of faculty, staff and students who have already presented at the event, chose five winners, who received a $200 prize sponsored by the Stanford University Medical Center Alumni Association.
Laurence Baker, PhD, director of medical student scholarship and professor of health research and policy, noted that the students’ work was much more than a school assignment. “What we really love is seeing people doing things that make a difference,” he said before the awards were presented.
While some students conducted their research in a lab, among petri dishes and rodents, others went out into the community to interview patients, and still others fired up their calculators to evaluate cost-of-treatment policies. All are approaches to improving medicine, whether by providing more effective treatments, by saving limited health-care dollars or by helping patients care for themselves.
Third-year medical students Matthew and Atalie Thompson, who are married to each other, looked into the reasons so many ophthalmology patients fail to show up for appointments — even when their eyesight is at stake. Half or more of the patients suffering from progressive eye diseases in their study either failed to show for one or more appointments or canceled three or more within a year’s time.
The students, who interviewed hundreds of patients, found that lack of transportation was a critical factor, as vision problems prevented many patients from driving themselves to the appointments, and friends or family members were unreliable.
But clinicians also failed to educate the patients on the importance of keeping appointments. “A really staggering percent didn’t understand that if they don’t follow up on their appointments, they can go blind,” Matthew Thompson said. The students recommended that nurses or nurse practitioners speak with the ophthalmology patients at each visit to explain the course of the disease and the importance of receiving treatments.
Gaurav Banka took a stab at surgery policy. The fourth-year student crunched the numbers on bariatric surgery — a procedure that reduces the size of the stomach to reduce the amount a person eats — and concluded that it’s cost-effective to treat diabetics with a body mass index, known as BMI, between 30 and 35 using gastric bypasses.
“The surgery is currently not available for people with a BMI below 35, but I think this surgery is the most promising treatment for diabetes that we have today,” he said. Banka believes it should be available for diabetics who are moderately obese but not overweight enough to qualify under current guidelines. That policy may change soon, however: “There’s been a lot of discussion of lowering the BMI requirement for bariatric surgery and this research will hopefully encourage further discussion,” Banka said.
Meanwhile, Sana Hashmi is working at a microscopic level, hoping to take an important step toward skin cancer treatment. The second-year student found a way to produce antibodies to attack a protein, Laminin-322, which runs on high gear in cancerous tissue. The idea is to turn off that protein, with the hope that it will stop the cancer from spreading. “If it works, it’s very important, because then we can treat the cancer in one location, and side effects are minimized,” Hashmi said.
Third-year student Ian Corcoran-Schwartz is also putting rodents to work. He found that injecting neuronal stem cells into the spines of rats that had suffered back injuries works just as well if the cells are injected below the injury site. The discovery is significant, because while stem cell epidurals are thought to be the future of spinal cord treatment, injecting them into the site of injury is problematic. “Scarring and other damage make it hard to deliver the cells,” he said.
His research found that even when the cells are injected farther down the rats’ spines, “There’s a significant improvement in their ability to move their hind legs.” The rats’ recovery isn’t complete, he said, but it indicates that stem cells might help spine-injured people recover some use of their limbs.

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