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Medical and Research Library News - September 2015


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News and training opportunities
Cool websites and reports on hot topics*
Interesting journal articles

September 2015

mrl-diamondNews and training opportunities

Most Americans' Hearts Are Older Than Their Age
According to a new CDC Vital Signs report, 3 out of 4 U.S. adults have a predicted heart age that is older than their actual age. This means they are at higher risk for heart attacks and stroke. http://www.cdc.gov/media/releases/2015/p0901-heart-age.html

The Next Chapter for Google Flu Trends
Instead of maintaining their own website, Google Flu Trends will provide Flu and Dengue signal data directly to partners including Columbia University's Mailman School of Public Health, Boston Children's Hospital/Harvard, and Centers for Disease Control and Prevention (CDC) Influenza Division. http://googleresearch.blogspot.com/2015/08/the-next-chapter-for-flu-trends.html?m=1

Overweight / Obesity Prevention, Treatment, and Maintenance from Childhood to Adulthood: Discussing Review-Level Evidence
October 14, 2015, 1:00-2:30 PM EDT. Webinar on a series of five recent reviews examining overweight and obesity prevention, treatment, and weight maintenance strategies among children, youth, and adult populations. https://health-evidence.webex.com/mw0401lsp13/mywebex/default.do?nomenu=true&siteurl=health-evidence&service=6&rnd=0.8939662696810111&main_url=https%3A%2F%2Fhealth-evidence.webex.com%2Fec0701lsp13%2Feventcenter%2Fevent%2FeventAction.do%3FtheAction%

Principles of Prevention
This free online course introduces users to the fundamental aspects of violence and violence prevention. It explains the key concepts of primary prevention, the CDC's role and public health approach, and the use of the social ecological model for violence prevention. http://vetoviolence.cdc.gov/index.php/principles-of-prevention

Public Health 101 Series
The Public Health 101 Series is a set of courses that provides an introduction to public health and covers the sciences essential to public health practice including epidemiology, public health informatics and surveillance, health economics, public health laboratory science, and related fields. http://www.cdc.gov/publichealth101/index.html

Public Health, Prevention to Play Role in Precision Medicine: Interventions Aimed at Individual Risks
Precision medicine is the practice of developing targeted interventions or medical treatments based on a person's environment, genetics and lifestyle. Researchers are looking at the benefits it can have on prevention and public health. http://thenationshealth.aphapublications.org/content/45/7/1.3.full

SOPHE Center for Online Resources & Education (CORE) Webinars
Archived webinars for health education professionals. A fee is required for access to the recorded webinars. http://sophe.bizvision.com/category/webinars

Toolkits Now Available on Plan4Health Website
APHA and the American Planning Association have built a library of resources. The new toolkits, available online, include a variety of materials and cover the following topics: Comprehensive Plans and Health; Healthy Community Design; Safe Routes to Parks; Transportation and Health; Health Equity; and Health in All Policies. http://www.plan4health.us/tools-and-resources/toolkits/

mrl-diamondCool websites and reports on hot topics*

Cool websites and reports on hot topics*

CDC Launches New Healthy Youth Website
CDC's Healthy Youth website is in a responsive web design and has been reorganized to make it easier to find information. http://nnlm.gov/bhic/2015/09/02/cdc-launches-new-healthy-youth-website/

Free Get Ready Preparedness Infographics from APHA
Help prepare for disasters with free Get Ready preparedness infographics. http://www.getreadyforflu.org/getreadyinfographics.htm

The Go2HIV app provides easy access to HIV information from the National Library of Medicine's HIV/AIDS-related websites. http://go2nlm.org/

mrl-diamondInteresting journal articles

Diener HC, Charles A, Goadsby PJ, Holle D. New therapeutic approaches for the prevention and treatment of migraine. Lancet Neurol. 2015;14(10):1010-22. doi: 10.1016/S1474-4422(15)00198-2.
The management of patients with migraine is often unsatisfactory because available acute and preventive therapies are either ineffective or poorly tolerated. The acute treatment of migraine attacks has been limited to the use of analgesics, combinations of analgesics with caffeine, ergotamines, and the triptans. Successful new approaches for the treatment of acute migraine target calcitonin gene-related peptide (CGRP) and serotonin (5-hydroxytryptamine, 5-HT1F) receptors. Other approaches targeting the transient receptor potential vanilloid (TRPV1) receptor, glutamate, GABAA receptors, or a combination of 5-HT1B/1D receptors and neuronal nitric oxide synthesis have been investigated but have not been successful in clinical trials thus far. In migraine prevention, the most promising new approaches are humanised antibodies against CGRP or the CGRP receptor. Non-invasive and invasive neuromodulation approaches also show promise as both acute and preventive therapies, although further studies are needed to define appropriate candidates for these therapies and optimum protocols for their use.

Howard DP, Banerjee A, Fairhead JF, et al. Population-based study of incidence of acute abdominal aortic aneurysms with projected impact of screening strategy. J Am Heart Assoc. 2015 Aug 19;4(8). pii: e001926. doi: 10.1161/JAHA.115.001926.
BACKGROUND: Current abdominal aortic aneurysm (AAA) screening in men age 65 might have limited impact on overall AAA death rates if incidence is moving to older ages. Up-to-date population-based studies of age-specific incidence, risk factors, and outcome of acute AAA are needed to inform screening policy. METHODS AND RESULTS: In a prospective, population-based study (Oxfordshire, UK, 2002-2014), the incidence and outcome of acute AAA events were determined. Based on population projections and current incidence trends, the impact of screening strategies in the UK was estimated. Over the 12-year period, 103 incident acute AAA events occurred in the study population of 92 728. Incidence/100 000/year was 55 in men ages 65 to 74 years, but increased to 112 at 75 to 85 and 298 at ≥85, with 66.0% of all events occurring at age ≥75 years. Incidence at ages 65 to 74 was highest in male smokers (274), with 96.4% of events in men <75 years occurring in ever-smokers. Extrapolating rates to the UK population, using trial evidence of screening efficacy, the current UK screening program would prevent 5.6% of aneurysm-related deaths (315 200 scans/year: 1426/death prevented, 121/year-of-life saved). Screening only male smokers age 65 and then all men at age 75 would prevent 21.1% of deaths (247 900 scans/year; 297/death prevented, 34/year-of-life saved). By 2030, 91.0% of deaths will occur at age ≥75, 61.6% at ≥85, and 28.6% in women. CONCLUSIONS: Given that two thirds of acute AAA occurred at ≥75 years of age, screening older age groups should be considered. Screening nonsmokers at age 65 is likely to have very little impact on AAA event rates.

Kwon JH, Bommarito KM, Reske KA, et al. Randomized controlled trial to determine the impact of probiotic administration on colonization with multidrug-resistant organisms in critically ill patients [published online ahead of print August 27, 2015]. Infect Control Hosp Epidemiol. 2015:1-4.
This was a randomized controlled pilot study of Lactobacillus rhamnosus GG versus standard of care to prevent gastrointestinal multidrug-resistant organism colonization in intensive care unit patients. Among 70 subjects, there were no significant differences in acquisition or loss of any multidrug-resistant organisms (P>.05) and no probiotic-associated adverse events.
Langer A, Meleis A, Knaul FM, et al. Women and health: the key for sustainable development [published online ahead of print June 4, 2015]. Lancet.
Girls' and women's health is in transition and, although some aspects of it have improved substantially in the past few decades, there are still important unmet needs. Population ageing and transformations in the social determinants of health have increased the coexistence of disease burdens related to reproductive health, nutrition, and infections, and the emerging epidemic of chronic and non-communicable diseases (NCDs). Simultaneously, worldwide priorities in women's health have themselves been changing from a narrow focus on maternal and child health to the broader framework of sexual and reproductive health and to the encompassing concept of women's health, which is founded on a life-course approach. This expanded vision incorporates health challenges that affect women beyond their reproductive years and those that they share with men, but with manifestations and results that affect women disproportionally owing to biological, gender, and other social determinants.

Layton NA, Steel EJ. "An environment built to include rather than exclude me": creating inclusive environments for human well-being. Int J Environ Res Public Health. 2015;12(9):11146-62.
Contemporary discourses which challenge the notion of health as the "absence of disease" are prompting changes in health policy and practice. People with disability have been influential in progressing our understanding of the impact of contextual factors in individual and population health, highlighting the impact of environmental factors on functioning and inclusion. The World Health Organization's (WHO) more holistic definition of health as "wellbeing" is now applied in frameworks and legislation, and has long been understood in occupational therapy theory. In practice, however, occupational therapists and other professionals often address only local and individual environmental factors to promote wellbeing, within systems and societies that limit equity in population health and restrict inclusion in communities. This paper presents an in-depth analysis of the supports and accommodations identified by a cohort of individuals (n-100) living with disability. A range of environmental facilitators and barriers were identified in peoples' experience of "inclusive community environs" and found to influence inclusion and wellbeing. The roles and responsibilities of individuals, professionals, and society to enact change in environments are discussed in light of these findings. Recommendations include a focus on the subjective experience of environments, and application of theory from human rights and inclusive economics to address the multiple dimensions and levels of environments in working towards inclusion and wellbeing.

Porter DL, Hwang WT, Frey NV, et al. Chimeric antigen receptor T cells persist and induce sustained remissions in relapsed refractory chronic lymphocytic leukemia. Sci Transl Med. 2015;7(303):303ra139.
Patients with multiply relapsed or refractory chronic lymphocytic leukemia (CLL) have a poor prognosis. Chimeric antigen receptor (CAR)-modified T cells targeting CD19 have the potential to improve on the low complete response rates with conventional therapies by inducing sustained remissions in patients with refractory B cell malignancies. We previously reported preliminary results on three patients with refractory CLL. We report the mature results from our initial trial using CAR-modified T cells to treat 14 patients with relapsed and refractory CLL. Autologous T cells transduced with a CD19-directed CAR (CTL019) lentiviral vector were infused into patients with relapsed/refractory CLL at doses of 0.14 × 10(8) to 11 × 10(8) CTL019 cells (median, 1.6 × 10(8) cells). Patients were monitored for toxicity, response, expansion, and persistence of circulating CTL019 T cells. The overall response rate in these heavily pretreated CLL patients was 8 of 14 (57%), with 4 complete remissions (CR) and 4 partial remissions (PR). The in vivo expansion of the CAR T cells correlated with clinical responses, and the CAR T cells persisted and remained functional beyond 4 years in the first two patients achieving CR. No patient in CR has relapsed. All responding patients developed B cell aplasia and experienced cytokine release syndrome, coincident with T cell proliferation. Minimal residual disease was not detectable in patients who achieved CR, suggesting that disease eradication may be possible in some patients with advanced CLL.

Siddiqi K, Shah S, Abbas SM, et al. Global burden of disease due to smokeless tobacco consumption in adults: analysis of data from 113 countries. BMC Med. 2015;13:194.
BACKGROUND: Smokeless tobacco is consumed in most countries in the world. In view of its widespread use and increasing awareness of the associated risks, there is a need for a detailed assessment of its impact on health. We present the first global estimates of the burden of disease due to consumption of smokeless tobacco by adults. METHODS: The burden attributable to smokeless tobacco use in adults was estimated as a proportion of the disability-adjusted life-years (DALYs) lost and deaths reported in the 2010 Global Burden of Disease study. We used the comparative risk assessment method, which evaluates changes in population health that result from modifying a population's exposure to a risk factor. Population exposure was extrapolated from country-specific prevalence of smokeless tobacco consumption, and changes in population health were estimated using disease-specific risk estimates (relative risks/odds ratios) associated with it. Country-specific prevalence estimates were obtained through systematically searching for all relevant studies. Disease-specific risks were estimated by conducting systematic reviews and meta-analyses based on epidemiological studies. RESULTS: We found adult smokeless tobacco consumption figures for 115 countries and estimated burden of disease figures for 113 of these countries. Our estimates indicate that in 2010, smokeless tobacco use led to 1.7 million DALYs lost and 62,283 deaths due to cancers of mouth, pharynx and oesophagus and, based on data from the benchmark 52 country INTERHEART study, 4.7 million DALYs lost and 204,309 deaths from ischaemic heart disease. Over 85 % of this burden was in South-East Asia. CONCLUSIONS: Smokeless tobacco results in considerable, potentially preventable, global morbidity and mortality from cancer; estimates in relation to ischaemic heart disease need to be interpreted with more caution, but nonetheless suggest that the likely burden of disease is also substantial. The World Health Organization needs to consider incorporating regulation of smokeless tobacco into its Framework Convention forTobacco Control.



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Last updated February 02, 2016