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Transmission Electron Micrograph view (TEM) of Hepatitis B virus

An update on the management of chronic hepatitis B and C infectionSubscription

9 AUG 2017By , , , ,

Chronic hepatitis B and C infection are leading causes of liver-related morbidity and mortality worldwide. Current therapies for chronic hepatitis B virus (HBV) infection consisting of nucleos(t)ide analogues (NA) rarely lead to functional cure. With a better understanding of the HBV lifecycle, novel agents have been developed with the hope of achieving functional cure. The development of direct-acting antivirals (DAAs) for hepatitis C virus (HCV) therapy has led to ...

Pharmacist preparing prescriptions at a dispensary

Safe dispensing in community pharmacies: applying the software, hardware, environment and liveware (SHELL) model

Clinical Pharmacist, Vol 9, No 7By , , , ,

The human aspects of the community pharmacy work system are vulnerable to medication-related errors. Established models of human error can identify actual or potential hazards, and are important in our understanding of the interaction between human and system factors that influence performance. The software, hardware, environment and liveware (SHELL) model, a traditional human factors framework, is used in this article to classify potential sources of error in community ...

Telepharmacy, pharmacist in front of computer screen

Examining the implications of analytical and remote monitoring in pharmacy practiceSubscription

5 JUN 2017By , ,

Remote patient monitoring (RPM) incorporates digital technology that collects health data from individuals in one location and electronically transmits secure data to healthcare providers in a different location for review and assessment. This allows healthcare professionals to make recommendations to optimise patient care without the patient having to be in the healthcare setting. With the implementation of RPM, pharmacists can use objective data obtained by remote ...

Micrograph of Acinetobacter baumannii bacteria

Ceftazidime-avibactam: a novel cephalosporin/β-lactamase inhibitorSubscription

10 MAY 2017By , ,

Over the past decade, infections caused by multidrug-resistant Gram-negative organisms have increased. The limited availability in treatment options for these infections prompted both the UK to create a five-year antimicrobial resistance strategic plan to stimulate the development of new antibiotics, and the Infectious Diseases Society of America to call for ten new antimicrobial agents to be developed by 2020. Ceftazidime-avibactam is a combination of a third-generation ...

Fluoroscopic examination of gastrointestinal (GI) tract showing inflammatory bowel disease (IBD)

Management of patients with inflammatory bowel disease: current and future treatmentsSubscription

6 MAR 2017By ,

Inflammatory bowel disease (IBD) is characterised by chronic inflammation of the gastrointestinal tract and affects patients’ quality of life. Treatment of IBD involves induction and maintenance of remission. Current available therapies include anti-inflammatory aminosalicylates and corticosteroids, immunosuppressive agents, antibiotics and biologic agents. Some patients are not fully responsive to conventional treatment or lose efficacy over time. Recently approved ...

Image 1 shows a normal spine and image 2 shows a spine affected by spondylitis

TNFα-inhibitors for ankylosing spondylitis and non-radiographic axial spondyloarthritisSubscription

13 JAN 2017By , , , , , , , , ,

Spondyloarthropathy refers to a group of articular inflammatory diseases that share common genetic, clinical and radiological features in addition to their association with human leucocyte antigen (HLA)-B27 antigen. The aim of therapeutic management of patients with spondyloarthritis is to improve quality of life, control the symptoms of articular inflammation, prevent the structural damage of joints, and preserve the functional abilities, autonomy and social participation of patients. Although

Close up of a woman's hand holding hormone replacement therapy (HRT) pills

Establishing the risk related to hormone replacement therapy and cardiovascular disease in womenSubscription

10 JAN 2017By ,

Hormone replacement therapy (HRT) has a profound impact on the cardiovascular system in postmenopausal women, achieved through its effects on metabolic risk factors for coronary heart disease (CHD) and on arterial function. Observational studies have consistently shown an association between postmenopausal HRT use and a reduced incidence of CHD. However, the largest randomised trial initially reported no overall benefit on CHD risk. Subsequent analyses and follow-up of the study have ...

Geneticist at the French National Institute for Health and Medical Research (Inserm) researches genetic diseases like cystic fibrosis

Conventional therapies and emergent precision medicines for cystic fibrosis: challenges and opportunitiesSubscription

30 NOV 2016By

Around 27 years ago, the discovery of the cystic fibrosis transmembrane conductance regulator (CFTR) gene – responsible for causing cystic fibrosis (CF) – marked a significant moment in the history of the condition. Despite the early promise of this target for gene therapy, a universally successful treatment has proven elusive in the ensuing years. While clinical trials involving gene therapy continue to make progress, the ‘magic bullet’ remains some way off. Survival continues to ...

Coloured X-ray angiogram of a balloon catheter and stent (brown, upper centre) being placed within a coronary artery of a heart

Role of coronary drug-eluting stents in current clinical practiceSubscription

10 NOV 2016By , ,

Percutaneous coronary intervention (PCI) has continued to evolve, from its origins in balloon angioplasty and bare metal stent (BMS) implantation, to the development and application of contemporary drug-eluting stents (DESs). While first generation DESs significantly decreased risk of in-stent restenosis observed with BMSs, their use was complicated by late and very late stent thrombosis. Second generation DESs have dramatically decreased this risk and the rate of one-year stent thrombosis ...

Patients with cancer and cancer survivors have an increased risk of adverse cardiovascular outcomes, including left ventricular (LV) dysfunction, heart failure (HF) and acute coronary syndromes.

Cardiovascular side effects of cancer treatmentsSubscription

8 SEP 2016By , ,

The cardiovascular side effects of cancer treatments remain a challenge in oncologic care. Patients with cancer and cancer survivors have an increased risk of adverse cardiovascular outcomes, including left ventricular (LV) dysfunction, heart failure (HF) and acute coronary events. The treatments most frequently associated with cardiovascular side effects include anthracyclines, monoclonal antibodies (mAbs) targeting the HER2 pathway, and small molecule tyrosine kinase inhibitors (TKIs), ...

Scanning electron micrograph of nasal mucosa in allergic rhinitis

Allergic rhinitis: impact, diagnosis, treatment and managementSubscription

9 AUG 2016By , ,

Allergic rhinitis results from an immunological abnormality in which atopic individuals produce immunoglobulin E (IgE) to allergens (e.g. pollen, house dust mites, animal dander and moulds). IgE activates mast cells, which respond by releasing inflammatory mediators. Histamine stimulates the early symptoms, predominately mucus production, nasal itching and sneezing. Leukotrienes and cytokines attract and activate eosinophils to cause allergic inflammation, which is primarily responsible ...

Statin myopathy stain showing muscle fibres in varying stages of necrosis, phagocytes and regeneration

Statins: general safety profile and association with myopathySubscription

11 MAY 2016By ,

Statin therapy has demonstrated remarkable efficacy in reducing mortalities associated with cardiovascular diseases through preventing myocardial infarction and ischaemic stroke. Despite the proven benefits of statins in this context, there are growing concerns among patients and physicians on the safety of short-term and long-term use and their adverse effects, especially muscle toxicity, resulting in non-adherence and withdrawal of the treatment. Reports and publications ...

Hospital staff at Airedale NHS Foundation Trust use the new electronic prescribing system on the drugs round

Impact of electronic prescribing on patient safety in hospitals: implications for the UKSubscription

5 MAY 2016By , , , ,

NHS hospitals in England are expected to be paperless by 2020, as set out in a comprehensive framework published by the National Information Board. The use of hospital electronic prescribing (EP) systems is therefore likely to increase rapidly in the near future. The aim of this review is to summarise the available evidence of the impact of inpatient EP on patient safety, with a focus on implications for the UK. MEDLINE and EMBASE were searched to identify systematic and narrative ...

Close up of kidney with renal cell carcinoma

Mammalian target of rapamycin (mTOR) inhibitors in solid tumoursSubscription

9 MAR 2016By , , ,

The phosphatidylinositol-3-kinase /protein kinase B/mammalian target of rapamycin (PI3K/AKT/mTOR) pathway plays an important role in cell proliferation, growth, and angiogenesis. mTOR is a critical signalling protein as it serves as precursor to many pathways related to cell growth and survival. When this major pathway is dysregulated, it can cause uninhibited activation of cancer cell growth and proliferation. This commonly results in malignancies that affect the kidney, breast and ...

Micrograph of acute myeloid leukaemia (AML)

Current treatments and future targeted treatments for acute myeloid leukaemiaSubscription

7 MAR 2016By , ,

While the initial therapy for acute myeloid leukaemia (AML) treatment is relatively standardised, the high incidence of refractory/relapsed disease remains a great challenge. Progress has been made in understanding the pathophysiology of both initial and recurrent disease phases, leading to rigorous pre-clinical studies to identify and selectively target cellular pathways that promote leukaemogenesis. In this article, we discuss the ongoing efforts in overcoming relapsed disease, through ...

Statins and other cholesterol-lowering drugs are increasingly being used for primary prevention of atherosclerotic cardiovascular disease. In the image, micrograph of cholesterol crystals

Primary prevention of cardiovascular disease with statins: assessing the evidence base behind clinical guidanceSubscription

12 FEB 2016By

Statins and other cholesterol-lowering drugs are increasingly being used for primary prevention of atherosclerotic cardiovascular disease. Three lines of evidence inform the development of therapeutic goals for both drug and lifestyle intervention. This evidence reveals the following principles for cholesterol lowering in primary prevention: (a) ‘the more (lowering), the better’ for relative risk reduction, (b) ‘the lower, the better’ for absolute risk reduction, and (c) ‘the earlier, ...

Inattention and hyperactive/impulsive symptoms are commonly seen in practice, with up to 6% of children meeting criteria for attention deficit hyperactivity disorder (ADHD). In the image, a crying child looks at the camera

Considerations in selecting pharmacological treatments for attention deficit hyperactivity disorder Subscription

11 FEB 2016By ,

Attention deficit hyperactivity disorder (ADHD) is highly prevalent and is associated with significant impairment across the lifespan. Medication treatments, particularly stimulant medications, are important in the management of ADHD, although non-medication treatments (e.g. therapy to improve organisational, social and emotional regulation skills) are often also needed. The stimulant medications have a high response rate and improve the core symptoms of the disorder, but they are ...

The safety of antiepileptic drug use in pregnancy involves: the pregnant woman in her own right; the foetus while in her womb; and during its subsequent extra-uterine existence as a neonate and infant. Pregnant woman during an ultrasound scan pictured

Antiepileptic drug safety in pregnancy: possible dangers for the pregnant woman and her foetusSubscription

15 JAN 2016By

In addition to the safety issues that apply whenever antiepileptic drugs are taken by patients, additional safety-related matters arise in pregnant women. These may involve the women themselves or their foetuses, and apply both during, and for a time after, pregnancy. During pregnancy, the safety of women with epilepsy may be endangered by loss of seizure control caused by increased antiepileptic drug clearances not being compensated for by appropriate adjustments of drug dosages. ...

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