Safeguarding Our Health | NIH News in Health

Vaccines Protect Us All

We share more than food and culture within our homes and communities. We can also spread disease. Luckily, we live in a time when vaccines can protect us from many of the most serious illnesses. Staying current on your shots helps you—and your neighbors—avoid getting and spreading disease.

Vaccines have led to large reductions in illness and death for both kids and adults, says Dr. David M. Koelle, a vaccine expert at the University of Washington in Seattle. One study estimated that, among U.S. children born from 1994 to 2013, vaccines will prevent about 322 million illnesses, 21 million hospitalizations, and 732,000 deaths.

Vaccines harness your immune systemA collection of specialized cells and organs that protect the body against infectious diseases.’s natural ability to detect and destroy disease-causing germs and then “remember” the best way to fight these germs in the future. Vaccination, or immunization, has completely eliminated naturally occurring smallpox worldwide—to the point that we no longer need to get shots against this fast-spreading, deadly disease. Polio has been eliminated in the U.S. and most other nations as well, thanks to immunizations. Poliovirus can affect the brain and spinal cord, leaving people unable to move their arms or legs, or sometimes unable to breathe.

“These childhood diseases used to be dreaded problems that would kill or paralyze children,” says Koelle. “In the 1950s, it was a common occurrence for kids to be fine in the spring, get polio over the summer, and then have to go back to school in the fall no longer able to walk.”

Experts recommend that healthy children and teens get shots against 16 diseases (see Wise Choices box). With these shots, many disabling or life-threatening illnesses have significantly declined in the U.S., including measles, rubella, and whooping cough. But, unlike smallpox, these disease-causing germs, or pathogens, are still causing infections around the world.

“These days, the risks of not being vaccinated in a developed country, like the United States, may seem superficially safe because of low rates of infection due to vaccination and other advances in public health,” Koelle says. “But we live in an era of international travel where we can be exposed to mobile pathogens.” So even if you don’t travel, a neighbor or classmate could go overseas and bring the disease back to your area.

“When the rates of vaccination drop, there can be a resurgence of the disease,” explains Dr. Saad Omer, a global health researcher at Emory University in Atlanta. For instance, measles was completely eliminated in the U.S. in 2000. But since then, thousands of cases have occurred, mostly related to travel.

Omer and colleagues examined U.S. reports on measles outbreaks since 2000. “We found that measles cases have occurred mostly in those who are not vaccinated and in communities that have lower rates of vaccination. And that’s true for many vaccine-preventable diseases,” he says. Most of the unvaccinated cases were those who chose not to be vaccinated or not have their children vaccinated for non-medical reasons.

When enough people are vaccinated, the entire community gains protection from the disease. This is called community immunity. It helps to stop the spread of disease and protects the most vulnerable: newborns, the elderly, and people fighting serious illnesses like cancer. During these times, your immune system is often too weak to fend off disease and may not be strong enough for vaccinations. Avoiding exposure becomes key.

“There’s a huge benefit to all of us getting the recommended vaccines,” explains Dr. Martha Alexander-Miller, an immune system expert at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina. “Number one, vaccines protect you. But they also limit the presence of disease-causing entities that are circulating in the community. So, you’re helping to protect individuals who may not be capable of protecting themselves, for example because they are too young to get vaccinated.”

When expectant moms are vaccinated, immune protection can pass through the placenta to the fetus. “Early on, the baby’s immune system is immature. So there’s a period of vulnerability where disease and death can occur,” Omer explains. “But the mother’s own antibodies—proteins formed by her immune system—can protect the baby.”

Doctors recommend that moms-to-be get both flu and Tdap (tetanus, diphtheria, and whooping cough) shots. A mother’s antibodies can help protect the newborn until they can receive their own vaccinations.

Some vaccines must be given before pregnancy. Rubella, for instance, can cause life-altering birth defects or miscarriage if contracted during pregnancy. There’s no treatment, but the measles, mumps, and rubella (MMR) vaccine offers prevention. Vaccines for many other common diseases that put newborns at risk are being studied.

“We’ve made amazing progress in the development of effective vaccines,” says Alexander-Miller. “Our ability to have such breakthroughs is the end result of very basic research that went on for years and years.” NIH-funded scientists continue to search for new ways to stimulate protection against various diseases.

Koelle studies how our bodies fight herpes viruses. There are eight related herpes viruses, but the body responds differently to each one. So far, we only have vaccines for one: varicella-zoster virus, which causes chickenpox and shingles.

Koelle’s team is comparing how our immune system responds to chickenpox and the herpes simplex viruses, which cause mouth and genital sores. “We’re hoping to harness the success that has been possible with the chickenpox vaccine and see if we can create a vaccine that would work for both chickenpox and shingles and also herpes simplex,” he says.

Researchers are also working to improve existing vaccines. Some vaccines require a series of shots to trigger a strong immune response. The protection of other vaccines can fade over time, so booster shots may be needed. Some, like the flu vaccine, require a shot each year because the virus changes so that the vaccine no longer protects against new strains. So keeping up with the latest flu vaccines is important.

Ask your doctor’s office whether your vaccinations are current. You may also find records of vaccinations at your state health department or schools. If you can’t find your records, ask your doctor if it’s okay to get a vaccine you might have received before.

Most side effects of vaccines are mild, such as a sore arm, headache, or low-grade fever.

“It can be easy to take vaccines for granted, because you’ll never know all the times you would’ve gotten really sick had you not been vaccinated,” says Alexander-Miller.

Help your community keep diseases at bay: Stay up-to-date with vaccines.

Source link

The NIH HEAL Initiative | National Institute on Drug Abuse (NIDA)

 

Request for Information on The HEALing Communities Study

NIDA, in partnership with SAMHSA, has released a Request for Information (RFI) for the HEALing Communities Study, part of NIH’s Helping to End Addiction Long-term (HEAL) Initiative. The HEALing Communities Study will test the implementation of an integrated set of addiction prevention and treatment approaches in an array of settings in up to three communities affected by the opioid crisis. Through this study, NIDA and SAMHSA aim to define effective strategies to reduce opioid overdose and overdose death, while increasing the number of individuals receiving medication-assisted treatment and the number retained in treatment and receiving needed recovery support services.  The RFI seeks input on the design, study outcomes, and necessary partnerships and infrastructure for this multi-site research effort.

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 and 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, and naloxone is available in both injectable and 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, longer-lasting naloxone formulations to more effectively reverse overdose from powerful synthetic opioids such as fentanyl. Research will also focus on compounds that target different receptor systems or immunotherapies to treat symptoms of withdrawal and craving in addition to the progression of opioid use disorders.

HEALing Communities Study

Goal: To determine if an integrated set of evidence-based interventions within healthcare, behavioral health, justice systems, and community organizations can work to decrease opioid overdoses and to prevent and treat opioid use disorders.

A great tragedy of the opioid crisis is that so many effective tools already exist but are not being deployed effectively in communities that need them. Only a fraction of people with opioid use disorders receive any treatment, and of those, less than half receive the medications that are universally acknowledged to be the standard of care, or they receive treatment for too short a duration. NIDA will work with the Substance Abuse and Mental Health Services Administration to launch a multisite implementation research study to identify the ideal sequence and duration of treatment within communities. Called the HEALing Communities Study, it will look at the effectiveness of a coordinated continuum of care in up to three targeted states. The studies will test the integration of prevention, overdose treatment, and medically assisted treatment in a coordinated array of settings–primary care; emergency departments; specialty care, including prenatal care, infectious disease, and behavioral health; the criminal justice system; and other community settings.

The Clinical Trials Network OUD Research Enhancement Project

Goal: Expand NIDA’s existing Clinical Trials Network to reach more communities in areas of the country hard hit by the opioids crisis.

The National Drug Abuse Treatment Clinical Trials Network (CTN) facilitates collaboration between NIDA, research scientists at universities, and treatment providers in the community with the aim of developing, testing, and implementing new addiction treatments. The network has contributed to broad reaching changes in medical practice, including the development of the opioid treatment medication buprenorphine. The CTN Opioid Research Enhancement Project will greatly expand the CTN’s capacity to conduct trials by adding new sites and new investigators. The funds will enable the expansion of existing studies and facilitate developing and implementing new studies to improve access to high-quality addiction treatment, for example, by facilitating delivery of OUD treatment in general medical settings. It will also create new opportunities for clinical and research training.

The Justice Community Opioid Innovation Network

Goal: Improve access to high-quality, evidence-based addiction treatment in justice settings.

Much research already points to the benefits of increasing access to treatment for opioid use disorders for justice-involved populations; however, it is unknown how many effective programs exist in different jurisdictions around the country, and which specific strategies are most effective. This project will create a network of researchers who can rapidly conduct studies aimed at exploring the effectiveness and adoption of medications, interventions, and technologies in those settings; and finding ways to use existing data sources as well as developing new research methods to ensure that interventions have the maximum impact. It will include implementing a national survey of addiction treatment delivery services in local and state justice systems.

Other NIH Institutes and Centers will also be involved in the NIH Heal Initiative. For example, the National Institute on Neurological Disorders and Stroke (NINDS) (see NINDS Director’s Message on the HEAL Initiative) will be funding projects to develop improved pain medications, compounds with the strength of opioids but without the risk of addiction. To see the NIH news release on the HEAL Initiative, and the full scientific research plan, go to NIH HEAL Initiative.

To see a related blog by Dr. Nora Volkow, go to An Ambitious Research Plan to Help Solve the Opioid Crisis.

To see the JAMA Viewpoint article, go to Helping to End Addiction Over the Long-term: The Research Plan for the NIH HEAL Initiative.


Planning Meeting

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

Source link

Preparing for Menopause | NIH News in Health

A Woman’s Midlife Change

During midlife, a woman’s menstrual periods grow further and further apart. At some point, they stop completely, and she can no longer get pregnant.

This is because the ovaries aren’t releasing eggs and making hormonesSubstances sent through the bloodstream to signal another part of the body to grow or react a certain way. like estrogen anymore. After 12 months without a period, a woman can say she’s gone through menopause.

In the years before menopause, women may experience skipped and unpredictable menstrual periods. This phase is called the midlife transition, perimenopause, or the change of life. Some women go through the transition faster than others. It lasts between 1 and 10 years.

Midlife Transition

Typically, menopause occurs between ages 45 and 55. This means women can expect less frequent periods and other symptoms at some point during their 40s. But it’s different for every woman. There’s no lab test to predict when in life it will start or how easy it will be.

Along with unpredictable periods, a woman may have other symptoms—both physical and emotional. Hot flashes, poor sleep, and mood changes are common. Some women have vaginal dryness, weight gain, and thinning hair. Bone density may also start to decrease.

“Most people don’t have severe symptoms. Most people have mild or less frequent symptoms,” says Dr. Hadine Joffe, an NIH-supported menopause researcher and psychiatrist at Brigham and Women’s Hospital.

NIH is funding studies looking into how to relieve menopause symptoms. There are medicines and lifestyle changes that can help.

“No two people are going to go through menopause in exactly the same way,” explains Dr. Chhanda Dutta, who oversees clinical aging research at NIH. “Different women go through menopause with different kinds of symptoms, and we’re trying to give them options for how they can manage them.”

Waves of Heat

Hot flashes are a common symptom during the midlife transition. Many women have these for several years after menopause. Some experience hot flashes for 10 or more years.

A mild hot flash feels like being embarrassed, Joffe says. “There’s a wave of heat sensation that rises to your head and chest, and sometimes you look red, feel hot, and then it’s gone.”

A not-so-mild hot flash can make your skin appear very red. Your head, neck, and chest may become hot and sweaty.

“It’s particularly disruptive at night,” Joffe says. “People are waking up, feeling very hot and sweaty, and they have weird, disrupted sleep.”

NIH-supported studies have found some medicines that reduce hot flashes. The most effective FDA-approved treatment is low-dose hormone therapy. Some women are given estrogen or estrogen with another hormone, progestin. Women take hormone therapy for the shortest time that they need it.

Not every woman can take hormone therapy. Another option is an antidepressant that is FDA-approved for treating moderate to severe hot flashes.

A doctor can help determine which medicine might work best. See the Wise Choices box for other ways to outsmart hot flashes.

Restless Nights

During midlife, women may start having trouble sleeping because of changes in hormone levels. Hot flashes and night sweats can also cause women to wake up.

“In people who have hot flashes at night, their sleep is disrupted throughout the entire night. It’s like a ripple of a sleep irritation throughout the whole night,” Joffe says. A woman may feel tired the next day as a result.

The medicines that help with hot flashes may also help ease sleep issues. But other things can help, too.

If a hot flash or anything else wakes you up, avoid looking at a clock. “It’s much easier to fall back to sleep if you don’t know what time it is,” Joffe advises.

She also says to avoid tossing and turning. If you wake up, get out of bed briefly to read and then get back into bed to go back to sleep.

Exercise can also help women sleep better at night. It’s best to avoid caffeine and alcohol for several hours before bedtime, too. Both can disrupt sleep.

For women who have a hard time falling asleep, relaxation breathing can help. Slowly breathe in through your nose. With a hand below your ribs, feel your stomach push your hand out. Slowly exhale through your mouth. You can do this for several minutes to relax.

Rollercoaster Moods

During perimenopause, many women become irritable or feel moody. Some may feel sad and anxious and unable to enjoy things as much as they used to.

If a woman has these symptoms day after day for at least 2 weeks, she may be dealing with a clinical depression. “There is a two- to three-fold risk of depression during perimenopause,” says NIH psychiatrist and researcher Dr. Peter J. Schmidt.

Although most women don’t have a problem with depression during this transition, he explains, changes in hormones can bring a negative mood for some women. Researchers are studying how to counteract the effects of shifting hormone levels.

Schmidt and his colleagues found that women who were at risk of depression and taking estrogen therapy were less likely to become depressed during perimenopause. The medicine prevented dips in estrogen and seemed to prevent mood plunges as well.

“If you think you’re at a higher risk of depression, you should proactively touch base with your doctor, says Schmidt. “Talk about what kind of symptoms you should be looking for and be concerned about as you age.”

He advises that you set up a plan for how to look for symptoms of depression. That way, you can enter midlife prepared to act. Schmidt encourages anyone who has a depressed mood to seek help from a primary care doctor or mental health professional.

Midlife Well-Being

The midlife transition is a phase of life that brings gradual changes. Many women don’t have problems during this transition.

You can make midlife your time for optimizing well-being by eating well, exercising, and getting quality sleep. The healthier you are at midlife, the more successful you’ll be combating age-related changes and diseases.

“We see it almost like a window of opportunity where people want to be entering midlife as healthy as possible,” Joffe says. “It’s really important for people to do the right thing now. And protect their health over time.”

Source link

Acne Breakouts | NIH News in Health

 

July 2018

Controlling Problem Pimples

Zits. Pimples. Spots. Whatever you call it, acne can cause discomfort and embarrassment. This skin condition affects most people at some point during their lives. About 4 out of every 5 people experience acne outbreaks between the ages of 11 and 30.

Acne starts in the skin’s oil glands. The hair on our bodies comes out through canals from these glands called follicles. Oil glands make oils that emerge to the skin’s surface through the follicles’ openings, or pores, along with the hairs.

Sometimes hair, oil, and dead skin cells come together to plug a follicle. The plugged pore provides the right conditions for bacteria that normally live on the skin to thrive. When the body’s immune systemThe system that protects your body from invading viruses, bacteria, and other microscopic threats. attacks the bacteria, pain and swelling can result. That’s how a pimple forms.

Doctors don’t know why only some people get acne. They do know what raises the risk for acne. Increases in certain hormonesSubstances sent through the bloodstream to signal another part of the body to grow or react a certain way. can cause oil glands to get bigger and make more oil. These hormone levels go up during puberty. Because of this, acne is most common in adolescents and young adults. Hormone changes caused by pregnancy or by starting or stopping birth control pills can also trigger acne.

But people of all ages can get acne. For most, acne goes away by the time they reach their 30s. However, some people in their 30s, 40s, and 50s still get acne. Although acne is usually not a serious health threat, it can be upsetting, and severe acne can lead to permanent scarring.

There are things you can do to prevent acne, explains Dr. Edward Cowen, a skin specialist at NIH. He recommends that people with acne avoid skin products that contain petrolatum, a type of oil. Instead, he says, look for creams and lotions labeled “noncomedogenic.” These are less likely to clog pores. A lot of people think certain foods can cause acne breakouts. However, Cowen explains, research has not been able to confirm this in most cases. See the Wise Choices box for other tips.

While there are plenty of home remedies for acne, Cowen says, it’s better to start with proven over-the-counter treatments for mild acne. These products can contain benzoyl peroxide, resorcinol, salicylic acid, or sulfur.

People with severe acne should discuss prescription drug options with a doctor, he adds. These include antibiotics to kill bacteria or drugs called retinoids, which can be given as a topical to apply to the skin or as an oral medication.

NIH-funded scientists are conducting research to better understand why acne develops and to find better ways to treat the condition.

Source link