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Stem Cell Transplant Induces Multiple Sclerosis Remission

Multiple sclerosis (MS) is an autoimmune disease in which the immune system attacks the central nervous system. It results in damage to nerve fibers, disrupting communication between the brain and the body. The disease has a wide range of symptoms that include tingling or numbness in the limbs, movement and speech difficulties, weakness, fatigue, chronic pain, vision loss, and depression.

  
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The most common form of MS is relapsing-remitting MS (RRMS), which affects about 80% of people with the disease. It's characterized by periods of mild or no symptoms interspersed with periods of more severe symptoms, called relapses. It can change into a progressive form where symptoms worsen over time without any symptom-free periods. RRMS can be treated with drugs that suppress the immune system and reduce inflammation. However, these drugs can cause serious side effects, are costly, and patients may become resistant to them over time.

 

One promising treatment for MS is HDIT/HCT (high-dose immunosuppressive therapy with autologous hematopoietic cell transplant). The goal of this therapy is to "reset" a person's immune system so that it will stop attacking their central nervous system. The treatment involves first collecting a patient's hematopoietic stem cells (HSCs)-precursor cells that develop into blood cells. High-dose chemotherapy and other drugs are then used to deplete the immune system and remove disease-causing cells. Finally, the participant is infused with his or her own HSCs, which develop into red and white blood cells and reestablish their immune system.

 

Researchers from several sites across the country have been monitoring 24 volunteers, ages 26 to 52, who underwent HDIT/HCT treatment for RRMS. The 5-year results of the study, which was funded by NIH's National Institute of Allergy and Infectious Diseases, were published online in Neurology. The researchers found that 5 years after the procedure, 69% of the participants showed no signs of progression of disability, relapse of MS symptoms, or new brain lesions (viewed by MRI). Most importantly, participants didn't take any MS medications after receiving HDIT/HCT. Fifteen of the participants-more than half-had a decrease in an index of MS disability. Side effects included infections, which are commonly associated with the toxic nature of the HDIT/HCT procedure. Three participants had disease progression and died during the follow-up period. None of the deaths were related to the transplant procedure.

 

Have a Kidney Stone? Time for a Roller Coaster Ride

When patients told Dr. David Wartinger that a roller coaster ride helped them pass kidney stones, he did what any good researcher would do-he tested the hypothesis. He packed a 3-D kidney replica with three kidney stones into a backpack and headed for Big Thunder Mountain at Walt Disney World. Dr. Wartinger and his "kidney" took 20 trips on Big Thunder Mountain, finding a 64% pass rate if seated in the last car, compared to a 16% pass rate if seated in the first car.

  
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Interestingly, the kidney stones only passed on Big Thunder Mountain. The researcher theorizes that some rides are too fast and violent, not allowing the kidney stones to pass. What is needed is a ride that is rough and quick, with no upside down movements. The study was published in Journal of the American Osteopathic Organization.

 

Help Your Patients Cut Down on Sodium

If you've ever worked with patients to help them cut down on sodium, you probably know they need focused strategies and tools to stay on track. Fortunately, a new resource based on the Dietary Guidelines for Americans (https://health.gov/dietaryguidelines/2015/guidelines/) can help patients find ways to limit sodium in their diets. Share Cut Down on Sodium (PDF-821 KB) (https://health.gov/dietaryguidelines/2015/resources/DGA_Cut-Down-On-Sodium) with your patients to help them understand:

  
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* The relationships between sodium, blood pressure, and heart disease

 

* Recommendations for limiting sodium intake

 

* What foods are high in sodium

 

* How to find choices lower in sodium

 

 

The resource also includes five specific strategies and tools people can use to reduce their sodium intake with small changes. For example, learning how to use the Nutrition Facts label to choose foods lower in sodium or cooking more at home can go a long way toward helping people cut back. The same goes for making shifts from higher-sodium foods to healthier options -like choosing fewer processed deli meats or sausages and opting for fresh options like seafood or lean meats and poultry instead.

 

The bottom line is that strategies like these can make it easier for your patients to cut down on sodium. And we hope that healthcare professionals like you will use this resource to help your patients choose strategies that work best for them. Also be sure to check out our full Toolkit for Health Professionals (https://health.gov/dietaryguidelines/2015/resources.asp) to help you share key information from the dietary guidelines with your patient.

 

Check Out healthfinder.gov's Guidelines for Assessing Reliable Health Websites

Online health information is easy to access and abundant-but searching for health information can be overwhelming and confusing. http://healthfinder.gov has guidelines that can help consumers and patients figure out which health websites are credible and reliable. http://healthfinder.gov has been sharing reliable health information since 1997. Along the way, the healthfinder team developed criteria for sites they will link to. These guidelines are informed by a set of website quality guidelines that are a part of Healthy People 2020-and anyone can use them to evaluate the reliability and credibility of health websites. Organizations can adapt these guidelines for use on their own websites. Healthcare professionals can share this list of quality website indicators with patients.

  
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The following are good signs that the information on a given website is credible:

 

* The names of the site developers, sponsors, partners, and funding sources are clearly noted.

 

* The purpose of the site and its intended audiences are clearly stated.

 

* "Advertisement" labels clearly identify and separate ads from health information.

 

* The site includes information about the sources, editors, and expert reviewers of the content.

 

 

Finding reliable websites is only the beginning of what it takes for people to access and act on the health information they need-and using these guidelines can help make sure they start with credible information.

 

Injury and Violence

Motor vehicle crashes, homicide, domestic and school violence, child abuse and neglect, suicide, and unintentional drug overdoses are important public health concerns in the United States. In addition to their immediate health impact, the effects of injuries and violence extend well beyond the injured person or victim of violence, affecting family members, friends, coworkers, employers, and communities. Witnessing or being a victim of violence is linked to lifelong negative physical, emotional, and social consequences.

  
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Both unintentional injuries and those caused by acts of violence are among the top 15 killers of Americans of all ages. Injuries are the leading cause of death for Americans age 1 to 44, and a leading cause of disability for all ages, regardless of sex, race and ethnicity, or socioeconomic status. Each year, more than 29 million people suffer an injury severe enough that emergency department treatment is needed. More than 180,000 people each year die from these injuries, with approximately 51,000 of these deaths resulting from a violent event. Many intentional and unintentional injuries are preventable.

 

Efforts to prevent violence may focus on:

 

* Changing social norms about the acceptability of violence and the willingness to intervene

 

* Improving skills and competencies (e.g., communication, impulse control, parenting, conflict resolution, coping)

 

* Fostering safe, stable, nurturing relationships and environments for children and families

 

* Changing policies to address the social and economic conditions that often give rise to violence

 

 

For unintentional injuries, there is a need to better understand the trends, causes, and prevention strategies for:

 

* Prescription drug overdose deaths

 

* Motor vehicle crashes due to distracted driving

 

* Traumatic brain injury

 

 

In the area of violence, there is a need to better understand the trends, causes, and prevention strategies related to:

 

* Bullying, dating violence, and sexual violence among youth

 

* Elder maltreatment, particularly with respect to quantifying and understanding the problem

 

* Overlapping causes of violence and the strategies that can prevent multiple forms of violence.