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Trusted Health Information from the National Institutes of Health NIHMedlineSUMMER 2016 Plusthe magazine Padma Lakshmi, host and producer of the hit TV show Top Chef, endured a 23-year struggle to find relief from the pain of Confronting endometriosis. Endometriosis Zika Virus: Avoiding Drug and Alcohol Colorectal Cancer Assessing the Threat Interactions Screening A publication of the NATIONAL INSTITUTES OF HEALTH and the FRIENDS of the NATIONAL LIBRARY OF MEDICINE FRIENDS OF THE NATIONAL LIBRARY OF MEDICINE In May, the National Library of Medicine (NLM) NLM Supports Outreach Efforts hosted two events that highlight how the Library promotes National Institutes of Health (NIH) to Diverse Communities outreach efforts to diverse communities. Native Hawaiian Health The Hokule’a is an iconic double-hulled canoe from Hawaii that is on a journey of 47,000 nautical miles around the world. It will stop at 85 ports in 26 countries, including landing in Old Town Alexandria, Virginia, on May 15, 2016. During that stop, Nainoa Thompson, master navigator of the Hokule’a, keynoted a special presentation on Native Hawaiian health at the NLM. Thompson told a packed audience in the Library’s Lister Hill Auditorium about: 7 The rich history of deep sea voyaging, exploration, and oceanic way finding 7 The indigenous system of orientation and navigation at sea 7 Efforts to use these experiences to revitalize Native Hawaiian culture and health He explained the symbiotic relationships between Betsy Humphreys, acting director of the National Library of land, sea, sky, and people, and their cultural, ecological, Medicine (NLM); Donald A.B. Lindberg, MD, director emeritus of the and personal health. NLM; and Nainoa Thompson, master navigator of the Hokule’a. Follow the journey of the Hokule’a at Photo: Bill Branson, NIH Photo: Bill Branson, www.hokulea.com. Science Pathfinders Day NIH was the site of the Third Annual Science Pathfinders Day. The event, sponsored by the NLM, the Friends of the NLM, and Mentoring in Medicine (MIM), seeks to promote diversity in the biomedical workforce. It brings hundreds of middle and high school students from the Washington, D.C., metropolitan area to the NIH campus to hear NIH scientists and researchers tell about the work they do and the scientific process. MIM is a national nonprofit organization that has reached more than 50,000 parents, students, and educators since 2008 with in-class and after-school electives focused on bringing science to inner-city and rural public schools. Funded in part by the NLM, MIM has organized programs in New York; Washington, D.C.; Florida; Maryland; Montana; Michigan; and Georgia. To learn more about MIM, visit www.mentoringinmedicine.org. Glen P. Campbell, Chairman Friends of the National Library of Medicine Dr. Lynne Holden (upper right), president of Mentoring in Photos: Bill Branson, NIH Photos: Bill Branson, Medicine, with scenes from Science Pathfinders Day. www.fnlm.org contents Volume 11 Number 2 Summer 2016 NATIONAL LIBRARY OF MEDICINE at the NATIONAL INSTITUTES OF HEALTH 8600 Rockville Pike, Bethesda, MD 20894 www.nlm.nih.gov 2 Understanding www.medlineplus.gov Zika Virus NLM Supports Outreach Efforts Betsy L. Humphreys, MLS Acting Director, NLM 5 Alcohol, Medicines, and to Diverse Communities Kathleen Cravedi Director, Office of Communications Aging and Public Liaison (OCPL), NLM Patricia Carson 8 Confronting Special Assistant to the Director, NLM Endometriosis Melanie Modlin Deputy Director, OCPL, NLM Fedora Braverman MedlinePlus and MedlinePlus en español 2 teams, NLM ▲ Zika virus is relatively mild as infectious Kathryn McKay diseases go, but there are challenges causing Writer–Editor, NLM concerns for pregnant women. Alla Keselman, PhD Senior Social Scientist, NLM Elliot Siegel, PhD Oral Health and Aging Outreach Consultant, NLM 14 Selby Bateman Colorectal Cancer Senior Editor 18 Christopher Klose Contributing Editor 22 A Precision 8 Peter Reinecke Medicine Leader ▲ Padma Lakshmi, author, actress, model, and Strategic Advisor Emmy-nominated producer of Top Chef, speaks Donations and Sponsorships about endometriosis and supporting young women. If you are interested in providing a sponsorship or other charitable donation to support and extend the reach of this publication, please contact 24 Treatment Friends of the NLM (202) 679-9930 Advances for Macular 4720 Montgomery Lane, Suite 500 Degeneration Bethesda, MD 20814 Friends of the NLM Officers Glen P. Campbell, Chairman HealthLines: Research Barbara Redman, PhD, RN, President 28 H. Kenneth Walker, MD, News You Can Use Executive Committee Chairman Naomi C. Broering, MLS, MA, Secretary 18 Dennis Cryer, MD, Treasurer 29 Contact Us NIH MedlinePlus magazine is published by ▲ American designer Carmen Marc Valvo, who Photos: Cover: Inez & Vinoodh; (Top) James Friends of the NLM in conjunction with speaks out about colorectal cancer, stands Gathany, CDC; (Center) Christina Paige; (Bottom) among his latest women’s fashion designs. Phil Fisch Photography The National Institutes of Health (NIH)—the Nation’s Medical Research Agency—includes 27 Institutes and Centers and is a part of the U.S. 407 Norwalk St., Greensboro, NC 27407 Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical, and translational (336) 547-8970 medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov. Bill Moore, President Richard Krisher, Senior Editor Terri Poindexter Smith, Managing Editor Jan McLean, Creative Director/Designer Linda Lowe, Web Designer/Developer Follow us on Facebook Traci Marsh, Production Director Articles in this publication are written by professional journalists. All scientific and medical information is reviewed for accuracy by www.facebook.com/mplus.gov representatives of the National Institutes of Health. However, person- al decisions regarding health, finance, exercise, and other matters should be made only after consultation with the reader’s physician and or professional advisor. Opinions expressed herein are not necessarily those of the National Library of Medicine. www.facebook.com/ Follow us on medlineplusenespanol @medlineplus FEATURE: ZIKA VIRUS Understanding ZIKA Dr. Anthony S. Fauci, director of the NIH National Institute of Allergy and Infectious Diseases (NIAID) Photo: NIAID VIRUS Discovered in the Zika Forest of What does the American public need to know about Uganda in 1947, the mosquito-borne Zika virus? It is a bit complicated because as a disease—excluding the Zika virus has very recently become a presentation in pregnant women—Zika is relatively mild. It is public health concern in the United characterized by a few days or a week of aches, pains, fever, rash, and inflamed eyes—called conjunctivitis. The majority of people do not States and throughout Latin America show symptoms. and the Caribbean. NIH MedlinePlus Zika is a flavivirus, part of the same family of viruses that cause yellow fever and dengue fever. Aedes mosquitoes spread all three magazine spoke about Zika with viruses. In terms of severity, yellow fever and dengue fever are Dr. Anthony S. Fauci, director of the deemed more serious than Zika. NIH National Institute of Allergy and What about the Zika virus and pregnant women? If you are a pregnant woman and get infected with Zika during Infectious Diseases (NIAID). pregnancy, there is a chance—perhaps as high as one in three—that your fetus will have a congenital abnormality. The virus can cause 2 Summer 2016 NIH MedlinePlus microcephaly, a condition in which the fetus’s head is What is NIAID’s timetable for developing a abnormally small and can be associated with incomplete brain vaccine? development and destruction of brain cells. We are also seeing other Zika-associated fetal developmental problems Likely in September, NIAID will begin a Phase I vaccine such as eye defects, hearing loss, and impaired growth. trial to determine whether the experimental vaccine is a safe vaccine and induces the predicted protective What risks does Zika pose for average response. The trial will likely enroll about 80 people and Americans? take about four months for preliminary results. By the first quarter of 2017, NIAID could begin a much larger safety I use the analogy of the relative risk of those who and efficacy trial to see if the vaccine can prevent disease. frequently, or daily, drive on the Washington, D.C., Beltway, where serious accidents happen every day. That kind of The amount of time needed to determine efficacy will accident happening to you is much more likely than getting depend on the infection rate of the location where we infected in this area by some of the diseases people are test the vaccine. We could know as early as the beginning concerned about, like dengue fever, chikungunya, or Zika. of 2018, but it may take much longer. Nonetheless, we are moving ahead expeditiously on the vaccine. By June 8, the Centers for Disease Control and Prevention (CDC) had identified Zika cases in 46 states. So far, none of Any additional thoughts? these infections was acquired locally through infected mosquitoes. So far, all of these cases have been acquired In collaboration with the Eunice Kennedy Shriver through travel (or sexual contact with someone who has National Institute of Child Health and Human traveled) to countries or territories where Zika is circulating. Development, we’re conducting the Zika in Infancy and In the continental U.S., it is almost certain that mosquito Pregnancy Study—referred to as ZIP. We’re doing a lot of bites will spread Zika virus—but I do not expect we will see basic work to determine the natural history of the widespread or sustained outbreaks. condition and associated congenital abnormalities, particularly microcephaly. Are there other Zika-related conditions? There are some other conditions that have been associated with Zika infection. One is Guillain-Barré syndrome (GBS), which occurs following an infection (like Zika) in the neurological system.

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