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As new government ministers begin their work, one decision that is being keenly awaited is the possible sign-off to budget cuts for High Street pharmacies in England.
The Department of Health says the changes are an opportunity to bring pharmacists' skills closer to GP practices and care homes.
But trade bodies fear thousands of pharmacies could close, with the supply of medicines becoming a purely logistical, automated, operation.
At Kennet Pharmacy in Marlborough, Wiltshire, which has been run by the same family for 50 years, there was a steady stream of customers and patients during a typically busy weekday morning.
Half the market town's 8,000 residents have signed a petition to support community pharmacies - the petition garnered more than two million signatures nationwide.
One of the pharmacists, Nick Jephson, who runs the business with his brother Tim, said: "We went into pharmacy to help people. Giving out medicines is about trust.
"Pharmacy has met its efficiency targets and saved the NHS £11bn in the past decade, so we're pretty lean.
"This isn't about turning a profit - it's about keeping our heads above water.
"There seems to be a policy mismatch. The government puts out adverts telling people to avoid A&E and their GP, and go to pharmacies first - and yet they're pulling the rug out from under our feet."
ew molecule that blocked ion channels in lab cells could significantly reduce the cycles of airway inflammation and infection that eventually result in fatal destruction of the lungs in people with cystic fibrosis. The researchers who discovered this suggest treatments based on the new molecule - a protease inhibitor - could potentially prolong the lives of people with the life-limiting disorder.
Writing in the American Journal of Respiratory and Critical Care Medicine, the team - including researchers from Queen's University Belfast in the United Kingdom - explains how the new molecule prevents activation of the epithelial sodium channel ENaC.
Experiments on cell cultures in the lab showed that the molecule has the potential to improve airway hydration and significantly improve mucus clearance.
Senior and corresponding author Dr. Lorraine Martin, from Queen's University School of Pharmacy, says:
"This strategy could prevent the significant lung damage that results from chronic cycles of infection and inflammation, with potential impact on quality of life as well as life expectancy."
Cystic fibrosis (CF) is a genetic disorder that damages the internal organs, especially the lungs and digestive system. According to the World Health Organization (WHO), the disease affects around 100,000 people worldwide.
As treatments have advanced, the number of adults with CF has steadily increased. Only 30 years ago, a person with CF was not expected to reach adulthood. Today, around half of patients with CF live more than 30 years, and some even live into their 50s and 60s.
A person must inherit two defective copies of a faulty gene called CFTR - one from each biological parent - to have CF. Each time two carriers of the gene conceive, there is a 25 percent chance that the child will have the disorder.
The faulty gene disrupts channels that allow ions to move in and out of cells, resulting in the mucus coating on tissue surfaces - for example, the lining of airways and the digestive tract - to become dehydrated, thick, sticky, and difficult to clear away.
The sticky mucus traps bacteria, giving rise to chronic infections, inflammation, scarring in the lungs, and difficulty digesting food.
For the study, the researchers tested the effect of the molecule on primary airway epithelial cells cultured in the lab.
Inhibition of the enzymes reduced sodium channel activity, which is known to correlate with improved airway hydration and mucus clearance.
The authors conclude that the molecule could provide "a mechanism to delay or prevent the development of CF lung disease in a manner independent of CFTR mutation."
A drug used to treat alcoholism - called disulfiram - could bring us closer to a cure for HIV, according to the results of a new study led by researchers from the University of Melbourne in Australia.
Study leader Prof. Sharon Lewin, of The Peter Doherty Institute for Infection and Immunity at Melbourne, and colleagues publish their findings in The Lancet HIV.
Disulfiram (brand name Antabuse) is a drug given to individuals with an alcohol use disorder to discourage them from drinking. It works by blocking an enzyme called dehydrogenase, which plays a role in metabolizing alcohol intake.
Inhibiting dehydrogenase causes acute sensitivity to alcohol; if patients consume alcohol while taking disulfiram, they will experience a number of unpleasant side effects, includingheadache nausea, chest pain, vomiting, weakness, blurred vision, sweating and mental confusion
But as well as helping to treat alcoholism Prof. Lewin and colleagues found the drug could lead to a cure for one of the world's most serious and challenging diseases: HIV.
Antiretroviral therapy (ART) is the primary treatment for HIV, involving a combination of at least three antiretroviral drugs that slow disease progression. While the treatment has led to reductions in HIV death rates worldwide, it is not a cure.
ART is unable to eliminate HIV from patients completely; the virus can lay dormant in cells, hiding from immune system attack.
But in their phase 2 clinical trial, the researchers found disulfiram helped "wake up" dormant HIV cells, allowing them to be destroyed - a "shock-and-kill" approach that researchers believe is key to curing the virus.
Numerous studies have investigated such an approach. In September, for example, Medical News Today reported on a study that suggested a class of drugs being tested for the treatment of cancer could rewaken dormant HIV cells
However, Prof. Lewin and colleagues note that to date, the drugs trialed to reawaken latent HIV have produced toxic side effects - a major barrier to moving the shock-and-kill approach forward
For their study - conducted in collaboration with researchers from the University of California-San Francisco - the team gave disulfiram to 30 HIV-positive patients in the US and Australia who were receiving ART
Disulfiram was administered daily for 3 days. Patients received 500 mg of the drug on the first day, 1,000 mg on the second day and 2,000 mg on the third day
"The dosage of disulfiram we used provided more of a 'tickle' than a 'kick' to the virus, but this could be enough," says Prof. Lewin. "Even though the drug was only given for 3 days, we saw a clear increase in virus in plasma, which was very encouraging."
"This trial clearly demonstrates that disulfiram is not toxic and is safe to use, and could quite possibly be the game changer we need."
First study author Dr. Julian Elliott, head of clinical research in the Department of Infectious Diseases at Monash University and Alfred Hospital in Australia, notes that waking dormant HIV is only the first step to eliminating it; they now need to find a way to destroy it.
"This is a very important step as we have demonstrated we can wake up the sleeping virus with a safe medicine that is easily taken orally once a day," he adds. "Now we need to work out how to get rid of the infected cell. A kick-start to the immune system might help. We have an enormous amount still to learn about how to ultimately eradicate this very smart virus."
MNT recently reported that the US Food and Drug Administration (FDA) have approved a single-tablet drug called Genvoya for the treatment of HIV
In a new study published in Nature Genetics, researchers have uncovered mutations in a gene that they say are strongly linked to the development of breast cancer.
Worldwide, breast cancer is the most common cancer in women. In 2012, almost 1.7 million women were diagnosed with the disease, accounting for around 12% of all new cancer cases.
It is estimated that around 5-10% of all breast cancer cases are hereditary, resulting from mutations in genes passed down from a parent.
Mutations in the BRCA1 and BRCA2 genes are the most common causes of hereditary breast cancer. Women with BRCA1 mutations have an average 55-65% chance of developing the disease, while the average risk of breast cancer among women with BRCA2 mutations is around 45%.
A number of other gene mutations have been associated with hereditary breast cancer, including mutations in the ATM, CHEK2 and TP53 genes. However, it is believed that to date, researchers have only discovered half of the gene mutations associated with breast cancer development.
Now, it is possible another one can be added to the list. Dr. Mohammad Akbari, of the University of Toronto and the Women's College Research Institute at Women's College Hospital - both in Canada - and colleagues have linked mutations in a gene called RECQL with onset of breast cancer among Polish and French-Canadian women.
To reach their findings, the team used whole-exome sequencing to analyze around 20,000 genes among 195 Polish or French-Canadian patients with breast cancer who had a strong family history of the disease but who were free of BRCA1 and BRCA2 mutations.
The researchers say they chose Polish and French-Canadian women for the study because they are very similar genetically.
In both of these populations, the researchers identified rare recurrent RECQL mutations.
In order to confirm that RECQL mutations are linked to onset of breast cancer, the researchers assessed the genes of an additional 25,000 Polish and French-Canadian women with or without breast cancer.
From this, the team identified specific, recurrent RECQL mutations among both populations that were associated with greater breast cancer risk. For example, they found one RECQL mutation in Polish women that was linked to a fivefold increased risk for breast cancer, compared with Polish women without this mutation.
In the French-Canadian women, the researchers identified a RECQL mutation that occurred 50 times more often among those with a family history of breast cancer than those without a family history of the disease.
A new study by Dana-Farber Cancer Institute investigators demonstrates that vitamin D can protect some people with colorectal cancer by perking up the immune system's vigilance against tumor cells. The research, published by the journal Gut, represents the first time that a link between vitamin D and the immune response to cancer has been shown in a large human population. The finding adds to a growing body of research showing that vitamin D - known as the "sunshine vitamin" because it is produced by the body in response to sunlight exposure - plays a key role in cancer prevention.
"People with high levels of vitamin D in their bloodstream have a lower overall risk of developing colorectal cancer," said the study's senior author, Shuji Ogino, MD, PhD, of Dana-Farber, Harvard School of Public Health, and Brigham and Women's Hospital. "Laboratory research suggests that vitamin D boosts immune system function by activating T cells that recognize and attack cancer cells. In this study, we wanted to determine if these two phenomena are related: Does vitamin D's role in the immune system account for the lower rates of colorectal cancer in people with high circulating levels of the vitamin?"
Ogino and his colleagues theorized that if the two phenomena were connected, then people with high levels of vitamin D would be less likely to develop colorectal tumors that are permeated with large numbers of immune system cells. Colorectal tumors that do develop in these individuals would, by the same logic, be more resistant to the immune response. To determine if this is indeed the case, the research team drew on data from 170,000 participants in the Nurses' Health Study and Health Professionals Follow-up Study, two long-term health-tracking research projects. Within this population, researchers compared carefully selected groups of 318 colorectal cancer patients and 624 individuals who were free of cancer. All 942 of them had blood samples drawn in the 1990s, before any developed cancer. The investigators tested these samples for 25-hydroxyvitamin D, (abbreviated 25(OH)D), a substance produced in the liver from vitamin D.
They found that patients with high amounts of 25(OH)D indeed had a lower-than-average risk of developing colorectal tumors that were enriched with immune system cells. "This is the first study to show evidence of the effect of vitamin D on anti-cancer immune function in actual patients, and vindicates basic laboratory discoveries that vitamin D can interact with the immune system to raise the body's defenses against cancer," Ogino said. "In the future, we may be able to predict how increasing an individual's vitamin D intake and immune function can reduce his or her risk of colorectal cancer."
Funding for the study was provided by the National Institutes of Health, the Friends of Dana-Farber Cancer Institute, the Bennett Family Fund, the Entertainment Industry Foundation, and the Paula and Russell Agrusa Fund for Colorectal Cancer Research. The co-lead authors of the study are Mingyang Song, MS, of the Harvard School of Public Health, Reiko Nishihara, PhD, of Dana-Farber and Harvard School of Public Health, Molin Wang, PhD, of Harvard School of Public Health, and Andrew Chan, MD, MPH, of Massachusetts General Hospital and Brigham and Women's Hospital.
In recent years, salt has become somewhat less of a culprit in heart disease, and sugar has, at least in some researchers’ eyes, taken its place. Now, authors of a new study in Open Heart argue that sugar consumption may be considerably worse for blood pressure than salt intake. In fact, they say, “It is time for guideline committees to shift focus away from salt and focus greater attention to the likely more-consequential food additive: sugar.” Whether it’s really valuable to pit one white crystal against the other is unclear, but what we do know is that neither salt nor sugar, in high amounts, is very good for anyone’s heart. For people who already have heart disease or high blood pressure, it’s probably best to keep an eye on both.
But here’s the rationale for the argument that sugar is worse for blood pressure than salt. Sugar, in high amounts, has many well-documented negative effects on the body, and in particular, on one’s metabolic profile. There’s an established link between sugar and metabolic syndrome, a conglomeration of cardiovascular markers that includes insulin resistance, high cholesterol, high blood pressure, high triglycerides (blood fats), and excess weight, especially in the form of belly fat. Sugar also seems to lead, in a series of steps, to an increase in blood pressure per se. “Consuming sugar increases insulin levels,” study author James DiNicolantonio tells me, “which activates the sympathetic nervous system, leading to increases in heart rate and blood pressure.” It also apparently reduces the sensitivity of the receptors that regulate our blood pressure. Finally, sugar depletes ATP, cells’ energy stores, which, again through a cascade of events, constricts blood vessels, and increases blood pressure.
Some studies have also suggested that consuming a high-sugar diet for just two weeks may have a measurable effect on blood pressure. “Twenty-four hour ambulatory blood pressure studies,” adds DiNicolantonio, “indicate an increase of BP of around 7mmHg/5mmHg with a high-sugar diet. That’s much stronger than what we see with sodium, which is perhaps around 4mmHg/2mmHg.” Other studies comparing the effects of drinking a single 24-oz fructose-sweetened drink, vs. a sucrose-sweetened drink, have shown effects on blood pressure and other cardiovascular markers in the hours following. So, the authors argue, reducing sugar may be a more meaningful way of reducing blood pressure than reducing salt. And because too little sodium in the diet has been linked to adverse health effects, the argument goes, it’s all the more important to keep a moderate, rather than a very low, salt intake.
“The best thing people can do for their health,” says DiNicolantonio, “is eat real whole food and avoid added sugars – worrying less about the salt.” Jennifer Haythe, a cardiologist at New York-Presbyterian/Columbia, who was not affiliated with the study, says we should use some discretion when interpreting studies like the current one. “It doesn’t need to be a comparison,” she says. “We don’t need to pit one against the other.”
Looking at a patient’s history and current diet is important – what’s not advisable is to let salt off the hook and turn our attention completely to sugar. She does say that high-fructose corn syrup (HFCS) isn’t good for anyone? “It’s a driving force for metabolic syndrome. And excess sugar intake leads to insulin problems. It’s hard not to pay attention to fact that people who eat a lot of sugar are at higher risk for metabolic syndrome and obesity, which are serious risk factors for heart disease.”
As with most things, for better or for worse, it’s all about moderation. For people with existing high blood pressure or who have had cardiovascular disease in the past, salt intake is certainly worth keeping an eye on. But to say we should trade concern for salt for that of its sweeter crystalline counterpart, may not be advisable at all. In the end, it may do more harm than good. “Which white thing is worse for you? That’s not really the right question to ask,” says Haythe. “I certainly wouldn’t tell my heart failure patients that salt isn’t bad for them.”
In US, UK and World Health Organization guidelines, children born prematurely are not deemed to be high risk for flu-related complications. But the researchers of a new study published in The Lancet Respiratory Medicine say these guidelines need to be reviewed, after finding that preterm children are at greater risk of such complications.
The research team, including Dr. Kay Wang of the University of Oxford in the UK, says their findings indicate that children born prematurely should be prioritized for receiving seasonal flu vaccinations.
According to the researchers, children with underlying medical disorders who develop flu are at much greater risk of flu-related complications than otherwise healthy children. "Around 20% of children who present with influenza or influenza-like illness have at least one medical disorder," they add, "and the presence of comorbidities increases the rates of influenza-related hospital admissions almost six times in children aged 5 to 14 years. After being admitted to hospital, such at-risk patients are also at higher risk of further complications."
The World Health Organization (WHO) and the UK Department of Health recommend that all populations deemed to be at high risk of flu-related complications should be vaccinated against flu.
Although the US Advisory Committee on Immunization Practices recommend that all individuals aged 6 months and over should receive flu vaccinations, the guidelines state that antiviral medications should be targeted toward certain populations at high risk of flu-related complications.
But Dr. Wang and colleagues say the "guidelines are based on consensus opinion rather than evidence, and do not specify risk factors in children." As such, the team set out to identify which children are at highest risk of developing complications from flu.
Cigarette smoking and heavy alcohol use cause epigenetic changes to DNA that reflect accelerated biological aging in distinct, measurable ways, according to research presented at the American Society of Human Genetics (ASHG) 2015 Annual Meeting in Baltimore.
Using data from the publicly available Gene Expression Omnibus, Robert A. Philibert, MD, PhD and colleagues at the University of Iowa and other institutions analyzed patterns of DNA methylation, a molecular modification to DNA that affects when and how strongly a gene is expressed. Prior research had shown that methylation patterns change in predictable ways as people age, as well as in response to environmental exposures, such as cigarette smoke and alcohol. In these earlier studies, Dr. Philibert's laboratory identified two specific locations in the genome, base pairs cg05575921 on the AHRR gene and cg23193759 on chromosome 10, at which methylation levels were highly associated with smoking and alcohol consumption, respectively.
In fact, they showed, DNA methylation levels at these two locations was a better measure of substance use than people's self-reported estimates. Thus, in this follow-up study, Meeshanthini Dogan, MS, and Dr. Philibert used methylation levels as a proxy for tobacco and alcohol consumption. They estimated each person's biological age using a previously validated epigenetic "clock" based on methylation levels at 71 locations in the genome, as measured by the widely used Infinium HumanMethylation450 BeadChip. Then, they calculated the difference between biological age and chronological age, and assessed the relationship between tobacco and alcohol use and premature aging.
They found that all levels of exposure to smoke were associated with significantly premature aging. Interestingly, moderate alcohol use -- about one to two drinks per day -- was correlated with the healthiest aging, while very low and high consumption were linked to accelerated aging.
"These new tools allow us to monitor smoking and alcohol use in an objective way, and to understand their effects quantitatively," Ms. Dogan said. "Furthermore, our methods could be used to analyze any set of 450 BeadChip data, which means that existing data can be used to identify new patterns and that all such results can be easily compared."
"Being able to objectively identify future smokers and heavy alcohol users when they are young, before major health issues arise, can help providers and public health practitioners prevent future problems, improve quality of life, and reduce later medical costs," Dr. Philibert added.
The researchers' next step is to unravel the details of how methylation patterns change in response to lifestyle changes during the life course, so that their assessments can be more informative.
"For example, we want to study how the intensity of current tobacco and alcohol use and cumulative levels of use throughout a lifetime affect methylation, including what happens when a person quits smoking or drinking," Ms. Dogan said. "By clarifying at what point the epigenetic changes become tougher to stop or reverse, we can inform decisions about how best to use the limited public health resources we have."
As new government ministers begin their work, one decision that is being keenly awaited is the possible sign-off to budget cuts for High Street pharmacies in England.
The Department of Health says the changes are an opportunity to bring pharmacists' skills closer to GP practices and care homes.
ew molecule that blocked ion channels in lab cells could significantly reduce the cycles of airway inflammation and infection that eventually result in fatal destruction of the lungs in people with cystic fibrosis.
The researchers who discovered this suggest treatments based on the new molecule - a protease inhibitor - could potentially prolong the lives of people with the life-limiting disorder.
A drug used to treat alcoholism - called disulfiram - could bring us closer to a cure for HIV, according to the results of a new study led by researchers from the University of Melbourne in Australia.
Study leader Prof. Sharon Lewin, of The Peter Doherty Institute for Infection and Immunity at Melbourne, and colleagues publish their findings in The Lancet HIV
In a new study published in Nature Genetics, researchers have uncovered mutations in a gene that they say are strongly linked to the development of breast cancer.
Worldwide, breast cancer is the most common cancer in women. In 2012, almost 1.7 million women were diagnosed with the disease, accounting for around 12% of all new cancer cases.
A new study by Dana-Farber Cancer Institute investigators demonstrates that vitamin D can protect some people with colorectal cancer by perking up the immune system's vigilance against tumor cells. The research, published by the journal Gut, represents the first time that a link between vitamin D and the immune response to cancer has been shown in a large human population.
In recent years, salt has become somewhat less of a culprit in heart disease, and sugar has, at least in some researchers’ eyes, taken its place. Now, authors of a new study in Open Heart argue that sugar consumption may be considerably worse for blood pressure than salt intake.
To reach their findings, the team analyzed 27 studies involving 14,086 children who visited a health care professional as a result of flu or flu-like illness. Of these children, 3,086 had underlying medical conditions.
From assessing seven studies involving 3,142 children, the team found that children born prematurely - before 37 weeks gestation - were twice as likely to be hospitalized for flu-related complications than children without underlying medical conditions.
Cigarette smoking and heavy alcohol use cause epigenetic changes to DNA that reflect accelerated biological aging in distinct, measurable ways, according to research presented at the American Society of Human Genetics (ASHG) 2015 Annual Meeting in Baltimore.
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