The CDC analyzed 2006 Behavioral Risk Factor Surveillance System (BRFSS) data from four states, Delaware, Hawaii, New York and Rhode Island. The study, one of the first to present state-level information on any sleep-related measure, found that the prevalence of insufficient sleep was greater in young adults. Of those ages 18 — 34, 13.3% reported insufficient rest or sleep every day over the past month. Of those aged of 35 — 54, only 10% reported insufficient rest or sleep every day over the past month. The percentage was smallest (7.3%) for those aged ≥ 55 years. Similar trends were observed for shorter periods of time. Interestingly however, for people reporting only 1 — 6 days of insufficient rest or sleep during the preceding 30 days, young adults had the lowest percentage (27.8%), while adults aged 35 — 44 had the highest percentage (38.2%), followed by adults aged 45 — 54 (36%) and people aged ≥ 55 years (31.7%).

Persons unable to work were significantly more likely to report insufficient rest or sleep everyday than people employed, students or homemakers, people unemployed or people retired. With increasing education, respondents were less likely to report no days of insufficient rest or sleep.

The study is subject to a number of limitations. Chief among them is that it uses the results of a survey. The principle limitations of a survey are the validity and reliability of responses. Poor recall, intentional deception and misunderstanding can all contribute to inaccuracies in the data. The survey method is also descriptive and cannot offer insights into cause-and-effect relationships. Lastly, the data only reflects sleep trends in four states and may not be representative of the entire United States. Nevertheless, it is consistent with another CDC study using data from the National Health Interview Study, which found that the percentage of adults at all ages reporting six hours or less of sleep per night increased from 1985 to 2006 [3].

According to the National Sleep Foundation, most healthy adults require 7 to 9 hours of sleep each night [4]. Children and adolescents need even more sleep than adults. Children aged 3 — 5 years require 11 to 13 hours of sleep each night, children aged 5 — 12 require 9 to 11 hours and adolescents require 8.5 to 9.5 hours [4].

Here’s some tips to get a good night’s sleep:

• Keep your room quiet and dark
• Make sure your bed is comfortable
• Avoid or limit caffeine and alcohol consumption
• Don’t smoke
• Eat dinner at least 2 — 3 hours before bedtime
• Relax prior to bedtime
• Don’t exercise right before bedtime
• Establish regular bedtime and waketime schedule

Additional information on sleep and sleep disorders can be found at The National Sleep Foundation, Sleep Education.com and The Insomnia blog.

The results of this study should come as no surprise, especially to many of you who are undoubtedly reading this late in the evening. How about you? Do you get enough sleep every night?

References

1. Institute of Medicine. Sleep disorders and sleep deprivation: an unmet public health problem. By the Committee on Sleep Medicine and Research. Edited by Harvey R. Colten and Bruce M. Altevogt. 404 pp. Washington, DC, National Academies Press, 2006.
2. Centers for Disease Control and Prevention (CDC). Perceived insufficient rest or sleep–four states, 2006. MMWR Morb Mortal Wkly Rep. 2008 Feb 29;57(8):200-3.
   View abstract
3. QuickStats: Percentage of Adults Aged >18 Years Who Reported an Average of <6 Hours of Sleep per 24-Hour Period, by Sex and Age Group — National Health Interview Survey, United States, 1985 and 2006. MMWR Morb Mortal Wkly Rep. 2008 Feb 29;57(8):209.
4. How Much Sleep is Enough? National Sleep Foundation. Accessed 2008 May 6.

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FreeMD.com combines text and a video doctor to ask questions about your symptoms and past medical history, and then generates a record in the form of a personal web page. The personal web page contains important information about your condition, your answers to the interview questions, and links to specific health information. Consumers can print out a copy or email the record to their doctor for review. It’s as easy as clicking “E-Mail” or “Print” in the toolbar at the top right of the page.

According to Dr. Stephen Schueler, M.D., CEO of DSHI Systems [1]:

Consumers are on their own when making the decision to see a doctor. Do they go to the emergency room, urgent care center, doctor’s office, or the nurse retail clinic? How does the average person know what to do? We have created a life-like experience that provides personalized recommendations.

FreeMD provides answers to important questions, such as: what might be causing my symptoms; do I need to see a doctor; how do I care for myself; where should I go for care? The website enables consumer-driven healthcare by empowering consumers and enabling them to avoid dangerous delays in care. The system also suggests where to go for care, reducing dependance on the emergency room.

FreeMD Breakthrough Technology

• Uses video to conduct the interview (also uses text and photos)
• Analyzes thousands of symptoms and injuries
• Generates a personal web page that contains care instructions and a detailed health record

FreeMD Evidence-Based Medicine

• 100% physician-written and maintained
• Proven accuracy through millions of interactions
• Reviewed by doctors and nurses for more than 10 years

For the last eight years, the Veterans Health Administration (VHA) has used DSHI Systems’ Veterans Health Gateway, a sophisticated software system used by nurses to provide health advice via the telephone [2]. A similar system, 24/7 WebMed, has been used by University of Central Florida (UCF) students since 2004 to look up information on specific illnesses and allow the site to guide them through a series of questions about symptoms to determine the illness [3]. UCF now uses FreeMD, which replaces the older 24/7 WebMed system.

According to the website, freeMD doesn’t make a diagnosis, but instead determines your risk for one or more condition(s) that could explain your symptoms. Nevertheless, I tried freeMD a couple of times tonight while writing this article and was impressed with its recommendations. Give it a try and let me know your thoughts.

References

1. DSHI Systems Debuts FreeMD the Web’s First Virtual Doctor. DSHI Systems Press Release. 2008 Apr 21.
2. Veterans Health Gateway (VHG). Document Storage Systems, Inc. Services & Solutions. Accessed 2008 Apr 30.
3. UCF Students Can Access Health Information, Advice on 24/7 WebMed Site. University of Central Florida News & Information. 2004 Nov 21.

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Want to reduce your stress level, spend less money at the pump and do your part to help save the planet? Here’s one of the most simple yet effective tips that will accomplish all three: Slow Down.

Improve Your Financial Health: Use Less Gas

At highway speeds, wind resistance increases exponentially and fuel economy is reduced by approximately 4 miles per gallon for every 10 mile per hour increase [1]. Thus, the faster you drive, the more it will cost you. Consider this [1].

In a typical family sedan, every 10 miles per hour you drive over 60 is like the price of gasoline going up about 54 cents a gallon. That figure will be even higher for less fuel-efficient vehicles that go fewer miles on a gallon to start with.

That’s based on a $3.25 price per gallon, which is less than the current price of gas. So we’re talking more than 54 cents a gallon.

Additionally, if you do the math, speeding doesn’t save you anywhere near the time you might think it does. An average 30 mile commute traveling at 65 miles/hour takes 28 minutes, while that same trip at 80 miles/hour takes 23 minutes. You save a whole 5 minutes by driving 15 MPH faster.

How much money is that 5 minutes worth?

Reduce Stress and Stay Safe

Moderate levels of stress from a variety of sources, including other motorists, traffic congestion and roadway conditions, are common in everyday driving. However, driver stress has been shown to also be influenced by a combination of situational and personal factors, including factors external to the driving context [2].

Not surprisingly, studies have found that life stress is associated with higher rates of accidents and disease [3]. It’s been estimated that drivers who have experienced a recent stressful event are five times more likely to cause fatal accidents than unstressed drivers [4].

If you’re running late, remember that no matter how fast you drive, you’re still going to be late. If you’re under a great deal of personal stress, it’s probably best to avoid driving altogether.

Statistically, people who drive too fast cause or contribute to almost one-third of all fatal crashes. In 2006,13,543 lives were lost in speeding-related crashes [5]. Excessive speed does a number of things:

• it increases the distance a vehicle travels when a driver reacts to a dangerous situation
• it reduces a driver’s ability to steer safely around objects in the road
• it extends the distance necessary to stop

Want to reduce your stress level, spend less money on gas and do your part to help save the planet?

      Just Slow Down!

David over at The Good Human has some additional tips on saving money, saving fuel and saving the environment.

References

1. Slow down a little, save a lot of gas. Issue #1: America’s Money. CNN Money. 2008 Mar 27.
2. Hennessy et al. The Influence of Traffic Congestion, Daily Hassles, and Trait Stress Susceptibility on State Driver Stress: An Interactive Perspective. Journal of Applied Biobehavioral Research 5(2);162–179
   doi: 10.1111/j.1751-9861.2000.tb00072.x
3. Stuart and Brown. The relationship of stress and coping ability to incidence of diseases and accidents. Journal of Psychosomatic Research, 25(4), 255-260. 1981.
   View abstract
4. Brenner and Selzer. Risk of causing a fatal accident associated with alcoholism, psychopathology, and stress: further analysis of previous data. Behav Sci. 1969 Nov;14(6):490-5.
   View abstract
5. Traffic Safety Facts 2006 Data. National Highway Traffic Safety Administration National Center for Statistics and Analysis. 2006.

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John Kanzius was diagnosed with terminal leukemia six years ago. Watching children endure difficult chemo treatments while he was undergoing his own chemotherapy motivated him to come up with an alternative. At the start of his interview with 60 Minutes correspondent Lesley Stahl, he said [1]:

I have no business being in the cancer business. It’s not something that a layman like me should in, it should be left to doctors and research people.
[Lesley Stahl: But sometimes it takes an outsider.]
Sometimes it just — maybe you get lucky.

And lucky he has been. Kanzius is a retired radio technician and station owner. As an alternative to chemotherapy, his idea was to build a radio-wave machine that focused radio waves to destroy cancer cells. Kanzius knew that strong radio waves could heat metal and wondered if metal injected in a tumor would heat up when placed in a radio-wave field, thereby killing the cells. Following initial experiments with a garage-built prototype, he spent about $200,000 to have an advanced version of his radio-wave machine built. Using hotdogs injected with copper sulfate (an aqueous metal solution), Kanzius found that he could heat up small regions injected with the metal by placing them in a radio-wave field, leaving surrounding areas unharmed.

Dr. Steven Curley and colleagues at the MD Anderson Cancer Center have begun testing Kanzius’ radio-wave technology on animals. Instead of copper sulfate, the researchers are using single-walled carbon nanotubes — molecular-scale tubes of graphitic carbon that, among other unique properties, are efficient conductors of heat. The nanoparticles are so small, thousands of them can fit inside a single cell. In a paper published in the December 2007 issue of the journal Cancer, the researchers demonstrated that, when exposed to a non-invasive radiofrequency (RF) field, an aqueous suspension of carbon nanotubes injected in malignant liver cancer tumors in rabbits produced lethal thermal injury to cancer cells [2]. The controls, tumors exposed only to the RF field or only to the nanotubes, were undamaged. However, some healthy liver tissue surrounding the cancerous tissue sustained heat damage due to nanotube leakage from the tumor.

Thus far, the technique has only been used on solid, localized tumors in animals by injection. The next step is to evaluate methods for targeting the nanotubes so they attach to and are taken up by cancer cells and not normal cells. According to Curley, the targeting of nanotubes to cancer cells and not to normal cells is a major challenge in advancing the therapy [3]. Researchers are looking to bind the nanotubes to antibodies, peptides or other agents that would target molecules expressed exclusively on cancer cells.

Gold nanoparticles have also been shown recently to enhance non-invasive RF thermal destruction of human gastrointestinal cancer cells in vitro [4].

Dr. Curley estimates that human clinical trials are at least three to four years away [3]. Using physics-based concepts, the Kanzius Machine is a potential new cancer treatment that may one day replace chemotherapy and surgery. That said, remember that many cancer therapies that have been promising in vitro and in animal models didn’t work in humans. There is zero evidence this will work in humans and targeting is a major issue that has to be overcome first.

References

1. The Kanzius Machine: A Cancer Cure? 60 Minutes. 2008 Apr 13.
2. Gannon et al. Carbon nanotube-enhanced thermal destruction of cancer cells in a noninvasive radiofrequency field. Cancer. 2007 Dec 15;110(12):2654-65.
   View abstract
3. Radio Waves Fire Up Nanotubes Embedded in Tumors, Destroying Liver Cancer. M.D. Anderson News Release. 2007 Nov 1.
4. Gannon et al. Intracellular gold nanoparticles enhance non-invasive radiofrequency thermal destruction of human gastrointestinal cancer cells. J Nanobiotechnology. 2008 Jan 30;6:2.
   View abstract

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Pausch’s lecture has since made its way to the web and has been viewed by millions of people. Hyperion published a book this week, The Last Lecture, based on his talk.

Pausch writes frequently on his battle with pancreatic cancer. In an interview with Diane Sawyer on Good Morning America, Pausch said [1]:

I’ve never understood pity and self-pity as an emotion. We have a finite amount of time. Whether short or long, it doesn’t matter. Life is to be lived.
You know, life is a gift. Again, it sounds trite, but if you wait long enough, other people will show you their good side. If there’s anything I’ve [learned] that is absolutely true. Sometimes it takes a lot longer than you might like. But the onus is on you to keep the hope and keep waiting.

His talk is inspiring, heartbreaking and filled with the wisdom and clarity that perhaps only a dying man can share.

There is no method for early detection of pancreatic cancer. The disease is asymptomatic and only 7% of cases are diagnosed early [2]. Symptoms may include weight loss, abdominal discomfort, occasional glucose intolerance and, as in the case of Pausch, jaundice (caused by tumors that develop near the common bile duct and cause blockage). Pancreatic cancer is an aggressive disease, and the 1- and 5- year survival rates are quite low at 24% and 5%, respectively [2].

More information on “Pancreatic cancer” can be found at iMedix and Organized Wisdom. Additionally, the Pancreatic Cancer Action Network (PanCAN), the first national patient advocacy organization for the pancreatic cancer community, provides public and professional education embracing the urgent need for more research, effective treatments, prevention programs and early detection methods. PanCAN also provides patient services and funds grants for pancreatic cancer research.

References

1. Dying Professor’s Lecture of a Lifetime. ABC News, Good Morning America. 2008 Mar 21.
2. Cancer Facts & Figures 2008. American Cancer Society. Atlanta, Ga. 2008.

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There are three types of NF tumors that result from mutation or loss of different tumor suppressor genes:

• Neurofibromatosis type 1 (NF1) is the most frequent inherited cause of brain and nerve tumors. One in every 3,000 children is born with NF1, making it also one of the most common inherited human diseases worldwide. Enlargement and deformation of bones may also occur. Approximately 50% of people with NF1 also have learning disabilities. NF1 is caused by a mutation or loss of the tumor suppressor gene NF1.

• Neurofibromatosis type 2 (NF2) is much rarer, occurring in one in 25,000 births. NF2 is characterized by the development of multiple tumors on the cranial and spinal nerves. The hallmark of NF2 is the formation of tumors that affect auditory nerves. Hearing loss beginning in the teens or early twenties is typically the first symptom of NF2. NF2 is caused by a mutation or loss of the tumor suppressor gene NF2.

• Schwannomatosis is even rarer than NF2, affecting one in 40,000 individuals. SImilar to NF1 and NF2, Schwannomatosis tumors can develop on cranial, spinal and/or peripheral nerves. Although patients with Schwannomatosis do not have learning disabilities, they experience chronic pain and occasionally numbness, tingling and weakness. The candidate Schwannomatosis tumor suppressor gene is named INI1.

The National Institutes of Health (NIH) is the primary source of federal funding for biomedical research. However, other agencies also support research initiatives. In 1996, Congress added Neurofibromatosis to the Congressionally Directed Medical Research Program (CDMRP-NFRP). This program has been responsible for many advances in NF research, including NF mouse models, learning disabilities and nerve signaling pathways. In 2005, the Neurofibromatosis Research Program (NFRP) established the NF Clinical Trials Consortium, which is comprised of 10 major hospitals nationwide. The Consortium was established, not for drug discovery, but as a pipeline to test drugs repurposed to treat NF, including rapamycin (a relatively new immunosuppressant drug) and lovastatin (a statin used for lowering cholesterol). The Consortium will initially focus on NF1 for proof of concept. Once established, it will have the option of expanding to encompass NF2 and Schwannomatosis studies.

NF research program funding in jeopardy

The U.S. House and Senate included an $8 million appropriation for the CDMRP-NFRP in the FY2008 Defense Bill. This is a decrease of $2 million from 2007 and is over a 66% decrease from the high-water mark of $25 million in FY2005. Recently, I wrote about Flat Funding of Biomedical Research and The Threat to America’s Health. Separate from the NIH, the CDMRP is another funding source that supports research initiatives. The drastic funding cuts in the CDMRP-NFRP, specific to NF studies, endanger the research investment made to date, particularly with the NF Clinical Trials Consortium described above.

The Children’s Tumor Foundation (CTF), a non-profit medical foundation dedicated to improving the health and well being of individuals and families affected by the neurofibromatoses, is the largest non-government funder of NF research in the world. In 1991, the CTF began a formal advocacy and lobbying program for federal funding of NF research. Recently, the CTF announced an advocacy campaign to increase federal funding of the CDMRP-NFRP [1]:

We are all aware of the budget pressures our country faces, and understand that the $25 million funded in 2005 is not realistic in the current environement. However, this small program has accomplished so much, and as we enter what we believe will be a period of rapidly increasing clinical trials, this is a particularly important time for continued support of this funding. We are asking all of you to contact your Congressman and Senators to seek their support. There is much discussion of earmark reform in Washington. It is important to note that this funding is not an earmark. It is not directed to any one institution, state or district. It is a long standing program that makes grants solely on a peer review basis. Further, this is not a partisan issue - this funding has benefited over the years from strong support from both Democrats and Republicans. The accomplishments and return on investment from the CDMRP are a shining example of what the federal government can achieve when legislators work with the scientific community and non-profit organizations.

Indeed, the CDMRP-NFRP is a small program. Congressional appropriations for NF from 1996 to 2008 totaled just $190.3 million. By comparison, CDMRP funding for breast cancer totaled $2222.7 million, for prostate cancer, $890 million [2]. Nevertheless, CDMRP funding for NF research in 2008 is critically important to address the needs of translational research (meaning to connect basic research to patient care), complications of NF with high morbidity and mortality, and refinement and standardization of imaging techniques and biomarkers for use in future clinical trials.

You can read more on the Children’s Tumor Foundation and Neurofibromatosis here at Highlight HEALTH. Additional non-profit organization resources are listed in the Highlight HEALTH Web Directory.

I’m actively involved in neuro-oncology, specifically NF research, and can attest to the importance of CDMRP-NFRP funding. I encourage you to take a moment and email your Senator and Representative and urge them to support increased Neurofibromatosis research funding through the CDMRP. You can find your legislators contact information by visiting the House and Senate websites. For the House website, simply enter your zip code in the box in the upper left corner; for the Senate website, select your state from the pulldown menu in the upper right corner. Use the contact information provided to email, fax or mail your request for support.

UPDATE: April 1st, 2008

Sample letters are now available (in MS Word format) for download, making it that much easier to email, fax or mail your Senator and Representative.

References

1. The Children’s Tumor Foundation: Advocacy. Accessed 2008 Mar 30.
2. Congressionally Directed Medical Research Programs: Funding History. Accessed 2008 Mar 30.

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It’s all about being brief and succinct.

In today’s fast-paced, hectic world, everyone is busy, especially doctors. With patient visits, paperwork and meetings, doctors have little time to learn from each other and the healthcare community. The Doctor’s Channel, an internet TV site for doctors, is a time-saving tool that offers doctors an informative media snack, enabling them to learn about the latest news, ideas and information quickly.

The site offers 1 — 2 minute streaming videos offering rich, concise content delivered by doctors, as well as opinions and editorials. Doctors can film and post short videos pertaining to anything they think would be of interest to their peers, such as therapy approaches, surgical procedures, new drugs, etc. Further, users can register on the site and, like other social networks, join groups related to their interests. The site covers a total of 42 therapeutic specialties.

The Doctor’s Channel President David Best, MD, MBA, said [1]:

We started The Doctor’s Channel because it’s apparent that the traditional system of medical education isn’t working as well as it could. Watching a talking head for 15 minutes on a computer screen is a crushing bore. The world is media snacking, getting their information in short bursts from cell phones, podcasts and RSS feeds. We decided that the physician, who really does have precious few minutes a day, is the perfect audience for short, succinct educational streaming videos. Our goal is to provide an engaging, interesting way for doctors to learn that quickly gets to the point.

The Doctor’s Channel is just one of several websites that offer reputable video content that can be viewed by health consumers. Additional websites include:

• icyou, a healthcare video community with hundreds health-oriented videos from certified medical and health professionals (as well as regular people)
• Empowered Doctor, a health and medical news website that offers the latest news with short video stories.

These are excellent alternatives to using YouTube as a source of health misinformation.

Do you know of other reputable medical video content websites? Let me know!

Additional health and medical video resources are listed in the Highlight HEALTH Web Directory.

Reference

1. The Doctor’s Channel Launches First Medical Site with Short Streaming Videos That Allow Doctors to Learn From Each Other and the Healthcare Community. PR Newswire. 2007 Aug 22.

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