Rxpharma: March 2011

26 March, 2011

Stop Smoking To Live Better

22 March, 2011

Pharmacists - National Association of Boards of Pharmacy® (NABP®)

Pharmacists
As essential health care providers, your commitment to patient care and optimal medication use improves the health and well-being of the patients you serve. NABP is dedicated to helping you ensure the high standards of pharmacy practice you strive for every day.Pharmacists - National Association of Boards of Pharmacy® (NABP®)

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NIH-funded study finds new possible risk factor of heart disease

Abnormal heart rate turbulence is associated with an increased risk of heart disease death in otherwise low-risk older individuals, according to a study funded by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health.

This study appears in the Feb. 15 edition of the Journal of Cardiovascular Electrophysiology.

Among the nearly 1,300 study participants, heart rate turbulence, which reflects how well the heart reacts to occasional premature contractions, was an even stronger heart disease risk factor than elevated levels of C-reactive protein. CRP is a potential heart disease biomarker that has emerged in recent years.

Study participants considered at low risk of heart disease based on traditional risk factors were on average 8 to 9 times more likely to die of heart disease during the roughly 14-year follow-up period if they had abnormal heart rate turbulence values. Traditional risk factors include age, gender, high blood cholesterol, high blood pressure, obesity, diabetes, and smoking. Low-risk individuals with elevated CRP in their blood were about 2.5 times more likely to die than those with normal or low CRP.

"These findings suggest that apparently healthy people might be at increased risk of death from cardiovascular disease, and heart rate turbulence may help us identify them," said Susan B. Shurin, M.D., acting director of the NHLBI. "It will be important to see if we can replicate this finding in other populations."

This study followed 1,272 adults aged 65 and older as part of the NHLBI's Cardiovascular Health Study. Participants were categorized as healthy (no sign of heart disease risk except possibly diabetes), subclinical (some signs of heart disease) or clinical (had a cardiovascular event, such as a heart attack). At the onset, participants underwent 24-hour monitoring of their hearts’ electrical activity through a small electrocardiographic, or ECG, device called a Holter monitor attached to their skin.

World TB Day March 24, 2011

World TB Day
March 24, 2011

Statement of Christine F. Sizemore, Ph.D., and Anthony S. Fauci, M.D.
National Institute of Allergy and Infectious Diseases
National Institutes of Health

The theme of World TB Day 2011 — "On the move against TB: Transforming the fight towards elimination"— reflects renewed momentum to approach the global problem of tuberculosis with greater intensity and seriousness of purpose. This growing interest is broad-based, emerging from leaders in public health to laboratory scientists, from physicians to activists.

Today, about one-third of the world's population is infected with Mycobacterium tuberculosis (Mtb), the bacterium that causes TB. Most people have no symptoms because the bacterium is inactive, or latent, but individuals with symptoms of active TB disease can infect others. According to World Health Organization (WHO) estimates, in 2009 more than 14 million people had active TB, leading to 1.7 million deaths, or 4,600 deaths each day. Among people infected with the bacteria, those who have certain other conditions, such as HIV/AIDS and diabetes, are more likely to develop active TB and to die from it. Because of this deadly synergy, TB has become the leading cause of death among people with HIV/AIDS.

Although TB control programs have led to a decline in cases worldwide, the emergence and spread of drug-resistant strains of Mtb challenge the way we currently approach TB diagnosis and treatment. Extensively drug-resistant TB, while relatively rare, has been confirmed in 58 countries, including the United States, and likely is present in many more. It has become necessary not just to identify the infection but also to determine the proper therapy for patients at the earliest stages of disease.

Recent developments have created confidence that TB control strategies can be improved to stay abreast of the changing nature of the pandemic. For the first time in decades, a robust pipeline of candidate TB drugs, vaccines, diagnostics, and treatment and prevention strategies are being evaluated in clinical trials. WHO recently endorsed a diagnostic test that enables health care providers to identify drug-resistant TB directly from patient specimens within about two hours rather than waiting months for a conclusive diagnosis. Drugs are being developed that, when combined in novel ways, may significantly improve the way we treat patients with TB. Vaccines are being developed that may one day prevent the disease, even in persons who are already infected with Mtb.

While such advances are crucial to improve patient care, a true transformation in the fight against TB can occur only if we simultaneously deepen our understanding of TB as a disease. For example, a noninvasive means to determine whether an individual is containing the infection or progressing to active disease — what's called a biomarker — would be of enormous benefit to patient care and for conducting clinical trials of therapies and vaccines. Additionally, although 90 percent of people infected with Mtb never develop active disease, latent TB infection remains largely mysterious. Increasing our knowledge in these and other fundamental areas is a research priority for the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health. New and improved laboratory and clinical tools, as well as collaborations between all disciplines of biomedical research, are now being engaged to characterize the interactions at play during the course of Mtb infection and TB disease. The extraordinary complexity of the TB disease process makes it well-suited to being examined as an integrated whole, an approach successful in yielding insights into other complicated diseases.

Together with our global partners, we at NIAID are encouraged by recent progress in TB research. By fostering a comprehensive TB research agenda and innovation at all levels, and by addressing TB with research tools appropriate to the health care challenges we face in the 21st century, we can continue to make great strides. World TB Day reminds us that although TB has afflicted mankind for millennia, we have yet to understand it in modern terms. We must use cutting-edge technologies to ask and answer fundamental questions that have never been adequately addressed. Only in this way will we transform our fight against TB towards elimination of this ancient scourge.

For more information about TB, visit NIAID’s Tuberculosis Web portal (http://www.niaid.nih.gov/topics/tuberculosis/Pages/Default.aspx) and the HHS TB Web site (http://www.hhs.gov/tb/).

Anthony S. Fauci, M.D., is director of the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health. Christine F. Sizemore, Ph.D., is chief of the Tuberculosis and Other Mycobacterial Diseases Section in the NIAID Division of Microbiology and Infectious Diseases.

NIAID conducts and supports research — at NIH, throughout the United States, and worldwide — to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID Web site athttp://www.niaid.nih.gov.

The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational 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.

19 March, 2011

What's Causing Your Back Pain, Neck Pain, and Shoulder Pain?

Pain in your back or neck and shoulder is about as common as sun in San Diego--odds are around 90 percent, to be exact. It can come from damage to soft tissues such as muscles, ligaments, or tendons; bones in the back and neck; and the disks that support and protect the vertebrae in the spine. The first step in treating your pain correctly and effectively is to figure out what's causing the aching, throbbing, or stabbing sensations.

The easy part is pointing to where it hurts. It's a bit trickier terrain from there, but thinking about how your pain feels, when it hurts worst, and what activities trigger painful flare-ups can help you zero in on the cause of your pain. Keeping a pain diary can help. Read on to understand the causes of back, neck, and shoulder pain, from the more common causes to the more obscure.
Read more...
What's Causing Your Back Pain, Neck Pain, and Shoulder Pain? - Prevention.com

How Does Memory Work? The Plot Thickens

NIMH-funded researchers recently reported that a little-known growth factor boosted the strength and staying power of a fear memory. It’s the latest in a flurry of discoveries that are revising the script for what we might think about as a play in 5 acts: “How Memory Works.” Act 1 would be perception and encoding – when the information first comes in – and Act 5 would be the retrieval and expression of the stored information. There is much ferment about Acts 2, 3 and 4. What’s happening as that initial trace gets processed in the brain? Where does it get stored? How does it get stored? What sustains it? Do different kinds of memory have different molecular and cellular mechanisms?
Read more...NIMH · How Does Memory Work? The Plot Thickens

ICRM Global Job & Internship Fair 2011 Pharma & Healthcare

17 March, 2011

Genetically modified fungi kill malaria-causing parasites in mosquitoes

NIH-funded study finds way to reduce transmission of malaria to humans

Spraying malaria-transmitting mosquitoes with a genetically modified fungus can kill the malaria parasite without harming the mosquito, potentially reducing malaria transmission to humans, according to a new study published in the journal Science. Funded by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, the study was led by Raymond J. St. Leger, Ph.D., of the University of Maryland, College Park.

An estimated 225 million malaria cases occur worldwide annually, resulting in about 781,000 deaths each year, according to the World Health Organization. Although the disease is present in 106 countries around the world, most cases occur in sub-Saharan Africa. Treating bed nets and indoor walls with insecticides is the main prevention strategy in developing countries, but the Anopheles mosquitoes that transmit malaria are slowly becoming resistant to these insecticides, rendering them less effective.

"Because mosquitoes increasingly are evolving to evade the malaria control methods currently in use, NIAID-supported scientists are testing new, innovative ways to prevent malaria that we hope can be developed into tools that will be effective for years to come," says NIAID Director Anthony S. Fauci, M.D.

One of these new strategies is killing Anopheles mosquitoes by spraying them with the naturally occurring fungus, Metarhizium anisopliae. Previous studies have found that this method nearly eliminates disease transmission when mosquitoes are sprayed soon after acquiring the malaria parasite. However, this strategy is not sustainable in the long term. If treating mosquitoes with the fungus kills them before they have a chance to reproduce and pass on their susceptibility to the spray, mosquitoes resistant to the fungus, which would reproduce normally, will soon become predominant and the spray will no longer be effective.

Because of this, Dr. St. Leger and colleagues tried a more focused approach. Rather than developing fungi that rapidly kill the mosquito, they genetically modified M. anisopliae to block the development of the malaria parasite in the mosquito.

Eleven days after feeding on blood infected by the malaria parasite, mosquitoes were divided into three groups and either sprayed with naturally occurring M. anisopliae fungi, sprayed with genetically modified M. anisopliae fungi or not sprayed at all. Two weeks after exposing the mosquitoes to the malaria parasite, the researchers looked for the parasite on the salivary glands of mosquitoes in each of the three groups.

Compared with the other treatments, the modified M. anisopliae significantly reduced parasite development. The malaria parasite was found on the salivary glands of just 25 percent of the mosquitoes sprayed with the transgenic fungi, compared with 87 percent of those sprayed with the naturally occurring strain and 94 percent of unsprayed mosquitoes. The transgenic strain also reduced the density of parasites on the mosquitoes’ salivary glands by more than 95 percent compared with the unmodified strain.

"The genes added to the transgenic fungi prevent the parasite from binding to the salivary glands of mosquitoes, so when a mosquito bites a human, the parasite is not transmitted," explains Adriana Costero-Saint Denis, Ph.D., of NIAID's Vector Biology Program (http://www.niaid.nih.gov/topics/vector/Pages/Default.aspx).

The researchers then used a model to estimate how well each fungus strain would reduce malaria transmission, and found that compared with the wild-type strain, the transgenic strain could reduce transmission to humans by fivefold, if not more.

"Our principal aim now is to get this technology into the field," says Dr. St. Leger. "We also would like to test some additional fungal variants to make sure we have the optimized malaria-blocking pathogen," he adds. Although they do not expect this technology to affect the environment any differently than the wild-type strain, the study authors plan to test ways to contain the transgenic fungi in the field.

For more information, see the NIAID Malaria Web portal http://www.niaid.nih.gov/topics/malaria/Pages/default.aspx.

NIAID conducts and supports research — at NIH, throughout the United States, and worldwide to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID Web site athttp://www.niaid.nih.gov.

Reference: W Fang et al. Development of transgenic fungi that kill human malaria parasites in mosquitoes. Science. DOI: 10.1126/science.1199115 (2011).

NIH Study Examines Best Time for Healthy HIV-infected People to Begin Antiretrovirals

A major new clinical trial seeks to determine whether HIV-infected asymptomatic individuals have less risk of developing AIDS or other serious illness if they begin taking antiretrovirals sooner rather than later, based on their level of CD4+ T-cells. An HIV-infected individual’s level of CD4+ T-cells — commonly referred to as their CD4 count — is a key measure of immune system health. The study is co-funded by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

While data from randomized clinical trials exist to support starting antiretroviral treatment when CD4 counts fall below 350 cells per cubic millimeter (mm^³), well-designed clinical trials have not been conducted to guide decisions to support starting treatment above that threshold. As a consequence, guidelines differ with regard to if and when to begin antiretroviral treatment in asymptomatic HIV-infected individuals with CD4 counts above 350 cells/mm^³. Current U.S. guidelines recommend that these individuals should begin antiretrovirals when their CD4 counts fall below 500 cells/ mm^³, whereas the World Health Organization recommends this group start treatment only when their CD4 count falls to or below the 350 cells/mm^³ cutoff.

The new Phase IV study, known as the Strategic Timing of Antiretroviral Treatment (START) clinical trial, is a randomized clinical trial designed to provide definitive evidence of the risks and benefits of early antiretroviral treatment to more clearly define the optimal time to begin medication. It seeks to determine if immediate antiretroviral therapy among HIV-infected individuals with CD4 levels above 500 cells/mm^³ is better than deferring treatment until CD4 counts fall below 350 in terms of potential benefits and risks, such as developing AIDS and other serious illnesses, including cardiovascular disease, cancer, kidney failure, and liver disease, or death. The launch of the START trial follows the successful completion of a pilot study involving more than 1,000 participants.

"Some epidemiological evidence suggests that HIV-infected patients remain healthier when they begin treatment at higher CD4 counts. However, there are also concerns about the health complications and side effects associated with lifelong antiretroviral use and the possibility that the virus may become resistant to medication," says NIAID Director Anthony S. Fauci, M.D. "The START trial will provide a more clear-cut answer as to the best time for HIV patients to begin treatment, taking into account both the risks and benefits associated with early versus deferred treatment."

START will be conducted in 30 countries. It will enroll 4,000 HIV-infected men and women 18 years of age and older who have CD4 counts above 500 cells/mm^³ and who have never taken antiretroviral therapy. Once entered into the study, half of the participants will be assigned randomly to receive immediate antiretroviral therapy. The other half of the study group will not receive antiretroviral therapy until their CD4 counts fall below 350 cells/mm^³ or an AIDS-related event occurs.

Study clinicians will select the appropriate antiretroviral regimen for each participant from a pre-approved list based on U.S. Department of Health and Human Services treatment guidelines. The HIV medicines being used in the trial are approved medications donated by Abbott Laboratories, Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline, Merck & Co. and Tibotec Pharmaceuticals. Participants will be followed for up to five years. Once enrolled, they will return to the clinic to be seen by study staff at one month, four months and then every four months thereafter. At each visit, participants will provide a medical update and undergo a brief medical exam, and CD4 cell counts and viral load (the amount of HIV in the blood) will be recorded.

The study is being conducted by the International Network for Strategic Initiatives in Global HIV Trials (INSIGHT), an HIV/AIDS clinical trial network funded by NIAID. The University of Minnesota in Minneapolis is the trial sponsor with primary funding from NIAID and additional funding provided by other NIH entities, including the National Cancer Institute, the National Heart, Lung and Blood Institute, the National Institute of Mental Health, the National Institute of Neurological Disorders and Stroke, and the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Additional support comes from four government organizations based in Australia, France, Germany, and the United Kingdom.

Although START will primarily look at major health outcomes associated with immediate and deferred antiretroviral therapy, the study will also examine HIV transmission risk behaviors, treatment adherence, drug resistance, health care utilization and the cost of care. "The intent is to fully evaluate the individual and the broader public health implications of earlier antiretroviral treatment," according to James D. Neaton, Ph.D., of the University of Minnesota, principal investigator for INSIGHT.

START will also feature several sub-studies to be conducted across some of the 200 study sites. These sub-studies include examining the effect of genetic variants of the virus on the progression of untreated HIV, as well as the response of patients to antiretroviral therapy; comparing the early and deferred antiretroviral groups for neurocognitive function and measures of vascular function, pulmonary function, and bone mineral density; and evaluating participant understanding of study information and satisfaction with the consent process to better inform future research guidelines.

START is identified on http://www.clinicaltrials.gov as NCT00867048. For more information about NIAID’s HIV/AIDS research, go to: http://www.niaid.nih.gov/topics/hivaids/Pages/Default.aspx.