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Month: June 2018

New Website Design for the NLM Disaster Information Management Research Center

The National Library of Medicine released a new design for the Disaster Information Management Research Center website & the Disaster Lit® database.  The new design improves access to key resources on natural and man-made disasters, as well as public health emergencies such as emerging infectious diseases. 
The Disaster Lit database complements PubMed with information from hundreds of sources concerning disasters and public health emergencies. Over 14,000 reports, guidelines, training courses, websites, etc., from government agencies, non-governmental organizations, universities, & more are included in Disaster Lit.
We keep our Disaster Health Information Guides up to date by linking directly to searches of Disaster Lit & PubMed. This ensures that the latest articles and resources are always at your fingertips.
Want to keep up to date with DIMRC? Join our announcement list, or the weekly or daily Disaster Lit update digest, & follow us on Twitter: https://disasterinfo.nlm.nih.gov/stay-connectedv

Since its founding in 1836, the National Library of Medicine https://www.nlm.nih.gov has played a pivotal role in translating biomedical research into practice and is a leader in information innovation. NLM is the world’s largest medical library, & millions of scientists, health professionals and the public around the world use NLM services every day.
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Genetics Home Reference: Lyme disease

Lyme disease is an infectious disease caused by Borrelia burgdorferi bacteria. The bacteria are transferred to humans by tick bite, specifically by blacklegged ticks (commonly known as deer ticks). The condition is named for the location in which it was first described, the town of Lyme, Connecticut.
If not treated with antibiotics, Lyme disease follows three stages: early localized, early disseminated, and late disseminated infection. A small percentage of individuals have symptoms that persist months or years after treatment, which is called post-treatment Lyme disease syndrome.
A characteristic feature of Lyme disease, & the key feature of early localized infection, is a slowly expanding red rash on the skin (called erythema migrans) at the site of the tick bite; the rash is often bull’s-eye shaped. Flu-like symptoms & enlarged lymph nodes (lymphadenopathy) are also early signs of infection. Most people who are treated at this stage never develop further symptoms.
The early disseminated stage of Lyme disease occurs as the bacteria is carried throughout the body in the bloodstream. This stage occurs a few weeks after the tick bite. Signs & symptoms can include additional rashes on other parts of the body, flu-like symptoms, and lymphadenopathy. Some affected individuals develop neurologic problems (referred to as neuroborreliosis), such as paralyzed muscles in the face (facial palsy); pain, numbness, or weakness in the hands or feet; difficulty concentrating; or memory problems. Rarely, the heart is affected (Lyme carditis), causing a sensation of fluttering or pounding in the chest (palpitations) or an irregular heartbeat.
The late disseminated…

Systolic Blood Pressure Intervention Trial (SPRINT) Study

In adults age 50 & older who had high blood pressure and at least one additional cardiovascular disease risk factor, but who had no history of diabetes or stroke, SPRINT showed that treating to a target systolic blood pressure of less than 120 mm Hg reduced rates of high blood pressure complications, such as heart attack, heart failure, & stroke, by 25 percent. Compared with the standard target systolic pressure of 140 mm Hg, treating to less than 120 mm Hg also lowered the risk of death by 27 percent. In 2015, the SPRINT Research Group published its findings in the New England Journal of Medicine.
The cardiovascular benefits of the lower systolic blood pressure target were consistent in all groups of people included in SPRINT, regardless of gender, race, age, or pre-existing CKD. To achieve the target systolic blood pressure of less than 120 mm Hg, the first treatment group received three medicines on average. The second treatment group received two medicines to treat to the target systolic blood pressure of less than 140 mm Hg. Participants had high levels of satisfaction with treatment and adherence to medicines regardless of which treatment group they were in.
In the lower blood pressure group, there were expected side effects from blood pressure medicines, such as lower blood levels of potassium and sodium. Treating to the target systolic blood pressure of less than 120 mm Hg also showed an increase in complications due to low blood pressure such as fainting; however, there was not…

Golden Star Wholesale Issues Allergy Alert on Undeclared Sulfites in Dried Apricots Sour

Golden Star Wholesale of Troy, MI 48084 is recalling, AL Reef  Dried Apricots Sour, because it may contain undeclared sulfites. People who have an allergy or severe sensitivity to sulfites run the risk of serious or life-threatening allergic reactions if they consume this product.
The recalled AL Reef  Dried Apricots Sour, 12 oz clear plastic container, un-coded were sold via retail stores in MI, NY,MN,KY,WI,FL,NC,VA,OR,MA,OH,TX,MO between November 2017 & May 2018.
No illnesses have been reported to date in connection with this problem.
The recall was initiated after routine sampling of the product by New York State Dept. of Agriculture & Markets food inspectors & subsequent analysis by Department food laboratory personnel revealed the presence of undeclared sulfites in Al Reef Dried Apricot Sour package that did not declare sulfites on the label.
Consumers who have purchased AL Reef Dried Apricot Sour should return it to the place of purchase. Consumers with questions may contact the company at 248-577-5080.
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What are you reading this summer?

We asked some staff here at the National Library of Medicine what was on their summer reading list, & we were thrilled by the diversity of answers.
Every list is different.
No two readers even had the same author on their lists.
Predictably, many of the titles cover science and medicine. One staffer even recommended a novel destined to get children interested in science. But you’ll also find fiction & even a bit of poetry. They tell us in their own words what books are on their summer reading list and why.
But if you’re looking for quicker reads, we’ve included a few posts from a trio of NLM blogs: Circulating Now, Musings from the Mezzanine, & NLM in Focus.
We also give you space at the end of the article to let us know what you’re reading.
As always, we’d be delighted to hear from you.
Read on. . .
Most of my summer reading will be related to my work. I am will battle to stay current with fast-paced developments in biomedical research & even within NCBI!  As in the rest of the year, I’m will be reading the NIH Director’s Blog & Nature’s news postings. And as many scientific articles as possible!
Outside of work, my reading material will also be utilitarian: I'm will will be searching the web for gardening tips & for ideas on chasing various critters out of my backyard. Raccoons are my latest “interest.” But if they continue with their mad gardening in my plots, I will reach for something more spiritual to…

The FDA Encourages New Treatments for Sickle Cell Disease

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Sickle cell disease (SCD) is the most common inherited blood disorder in the United States. It affects about 100,000 children & adults in the United States & millions of people worldwide.
New treatments are needed to prevent and treat its serious complications. That’s why the U.S. Food and Drug Administration is working with patients and stakeholders, including academics & those from the pharmaceutical industry, to help.
What Is Sickle Cell Disease?
Sickle cell disease affects millions of people globe & is particularly common among people with ancestors from sub-Saharan Africa; Spanish-speaking regions in the Western Hemisphere (South America, the Caribbean, and Central America); Saudi Arabia; India; & Mediterranean countries such as Turkey, Greece, & Italy, according to the Centers for Disease Control & Prevention.
More than 3 million Americans, including one in 13 African Americans, carry the sickle cell trait, the gene that can potentially allow the disease to be passed on to their children. A baby born with sickle cell disease must inherit a SCD gene from each parent. Babies born in the United States are typically screened at birth for SCD.
People with the disease have “sickled” or abnormally shaped red blood cells that get stuck in small blood vessels & block the flow of blood & oxygen to major organs in the body. These blockages can cause severe pain, organ damage, or even stroke. Other complications include vulnerability to infection, fatigue, & delayed growth.
SCD is chronic and its severity varies. Most people with the disease will…

NIH HEAL Initiative

Upcoming Meeting
On June 18, 2018, the National Institutes of Health will host the HEALing Communities Study Design Workshop to solicit feedback from scientific experts, state partners, federal partners, and other key stakeholders.  This meeting will be videocast.

NIDA is playing a major role in the National Institutes of Health (NIH) HEAL initiative (Helping to End Addiction Long-term), launched in June 2018 to provide scientific solutions to the national opioid overdose crisis, including improved treatment strategies for pain as well as opioid use disorders (OUDs).   This new initiative, funded by Congress, brings new hope for people, families, and communities affected by this devastating crisis.
NIDA will be coordinating four overarching research projects around the country:
Focused OUD Medications Development Research Project
Goal: Conduct a series of high-impact studies that will ideally lead to about 15 Investigational New Drugs (INDs), which would then produce around five New Drug Applications (NDAs) submitted to the Food & Drug Administration (FDA).
This project will focus on developing new addiction treatments and overdose-reversal tools. Three medications are currently FDA-approved to treat opioid addiction, & naloxone is available in both injectable & intranasal formulations to reverse overdose. But a wider range of options is needed in both areas. These may involve new formulations of existing drugs including longer-acting depot formulations of opioid agonists as well as stronger naloxone formulations that can reverse fentanyl overdoses. Research will also focus on compounds that target different receptor systems or immunotherapies to treat symptoms of withdrawal & craving in addition to the progression of opioid use disorders.
HEALing Communities…

Mind Over Matter: Prescription Pain Medications (Opioids)

Long-term opioid use changes the way nerve cells work in the brain. This happens even to people who take opioids for a long time to treat pain, as prescribed by their doctor. The nerve cells grow used to having opioids around, so that when they are taken away suddenly, the person can have lots of unpleasant feelings & reactions. These are known as withdrawal symptoms.
Have you ever had the flu? You probably had aching, fever, sweating, shaking, or chills. These are similar to withdrawal symptoms, but withdrawal symptoms are much worse.
That is why use of opioids should be carefully watched by a doctor—so that a person knows how much to take & when, as well as how to stop taking them to lessen the chances of withdrawal symptoms. Eventually, the cells will work normally again, but that takes time.
Someone who is addicted to opioids has other problems as well. For example, they keep taking the drug even though it may be having harmful effects on their life & their health. They have strong urges to take the drug—called cravings—and they no longer feel satisfied by natural rewards (like chocolate, TV, or a walk on the beach). …

Fentanyl and Other Synthetic Opioids Drug Overdose Deaths

Figure 1: Recent Trends
In 2016, synthetic opioids (primarily illegal fentanyl) passed prescription opioids as the most common drugs involved in overdose deaths in the United States.
In 2016, synthetic opioids were involved in nearly 50% (19,413) of opioid-related deaths, up from 14% (3,007) in 2010.
*This infographic summarizes mortality data from 2010-2016. Please note, 15 to 25 percent of death certificates analyzed did not indicate the type of drug involved in the overdose. This was because drug tests were not conducted or there was a failure to record test results on death certificates. Figure 2: Synthetic Opioids Linked to Overdose Deaths with Other Substances
In 2016, 42,249 drug overdose deaths involved opioids. Of those, 45.9% involved synthetic opioids. 17,087 overdose deaths involved prescription opioids. Of those, 23.7% involved synthetic opioids. 15,469 overdose deaths heroin. Of those, 37.4% involved synthetic opioids. 10,375 overdose deaths involved cocaine. Of those, 40.3% involved synthetic opioids. 7,542 overdose deaths involved psychostimulants. Of those, 13.8% involved synthetic opioids. 10,684 overdose deaths involved benzodiazepines. Of those, 31.0% involved synthetic opioids. 4,812 overdose deaths involved antidepressants. Of those, 20.8% involved synthetic opioids. 1,877 overdose deaths involved antipsychotics & neuroleptics. Of those, 20.5% involved synthetic opioids. 409 overdose deaths involved barbiturates. Of those, 21.5% involved synthetic opioids. 543 overdose deaths involved other illicit drugs. Of those, 26.5% involved synthetic opioids.
*Deaths are not mutually exclusive. Deaths involving more than one drug or drug class are counted multiple times. Figure 3: Type of Opioid Involved in Opioid-Related Overdose Deaths
Among the 42,249 opioid-related overdose deaths…

Benzodiazepines & Opioid

More than 30 percent of overdoses involving opioids also involve benzodiazepines, a type of prescription sedative commonly prescribed for anxiety or to help with insomnia. Benzodiazepines (sometimes called “benzos”) work to calm or sedate a person, by raising the level of the inhibitory neurotransmitter GABA in the brain. Common benzodiazepines include diazepam (Valium), alprazolam (Xanax), & clonazepam (Klonopin), among others.
Every day, more than 115 Americans die after overdosing on opioids.1 However, between 1996 & 2013, the number of adults who filled a benzodiazepine prescription increased by 67%, from 8.1 million to 13.5 million.2 The quantity obtained also increased from 1.1 kg to 3.6 kg lorazepam-equivalents per 100,000 adults. Combining opioids and benzodiazepines can be unsafe because both types of drug sedate users & suppress breathing—the cause of overdose fatality—in addition to impairing cognitive functions. In 2015, 23 percent of people who died of an opioid overdose also tested positive for benzodiazepines (see graph).3 Unfortunately, many people are prescribed both drugs simultaneously. In a study of over 300,000 continuously insured patients receiving opioid prescriptions between 2001 and 2013, the percentage of persons also prescribed benzodiazepines rose to 17 percent in 2013 from nine percent in 2001.4 The study showed that people concurrently using both drugs are at higher risk of visiting the emergency Department or being admitted to a hospital for a drug-related emergency.
Previous studies have also highlighted the dangers of co-prescribing opioids & benzodiazepines. A cohort study in North Carolina found that the overdose death rate among patients receiving both…

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