Wednesday, 31 August 2016
More rough sleepers 'in need of psychiatric support'
Rough sleepers in England are more likely to be suffering from mental health issues, analysis shows. via BBC News - Health Read More Here..
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Zika vaccine trials begin – but fears remain over virus’s impact
The trial comes amid warnings that even infected babies born with normal-sized heads could be at risk of developmental disorders via New Scientist - Health Read More Here..
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Zika vaccine trials begin – but fears remain over virus’s impact
The trial comes amid warnings that even infected babies born with normal-sized heads could be at risk of developmental disorders via New Scientist - Health Read More Here..
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Junior doctor strikes 'to cause misery' - Jeremy Hunt
Health Secretary Jeremy Hunt condemns the latest planned strike by junior doctors in England. via BBC News - Health Read More Here..
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Alzheimer's drug study gives 'tantalising' results
A drug that destroys the characteristic protein plaques that build up in the brains of patients with Alzheimer's is showing "tantalising" promise, scientists say. via BBC News - Health Read More Here..
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Instagram posts can reveal depression before doctors diagnose it
Software that analyses your Instagram photos could one day act as an early warning that you might want to see your physician via New Scientist - Health Read More Here..
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Tips for sun protection
Avoidance
Sunscreen
Clothing
Self-check
Avoidance
The best sun protection is sun avoidance. Seek shade if you can, especially between 10 AM to 4 PM, which are the peak sun hours.
Sunscreen
Use sunscreen with an SPF (Sun Protection Factor, this is the number on most sunscreen bottles) of 30 to 50, or more, that protects from both Ultraviolet A (UVA) and Ultraviolet B (UVB) wavelength light. Even though the protection is called "broad", it is not complete. Remember: sun avoidance is the best sun protection. Sunscreens with added UVA protection should contain Titanium dioxide, Zinc oxide, or Parsol 1789, also known as Avobenzone.
Use sun protection if spending time outside for 15 minutes or more. Apply 20-30 minutes before going out and remember to reapply every 2 hours. No sunscreen is truly water proof and it will wash away with sweat, swimming and rubbing.
Clothing
Wear tightly woven, loose fitting (cooler) long sleeved clothing, UV-blocking sun glasses (eyes need sun protection as well) and wide-brimmed hat. Straw hats with holes are not suitable because light still gets through. Wear UV protective "Rash Guard" shirts.
Self-check
Consider monthly self-skin checks/examinations, where you check for any color/size change in skin spots/moles.
Related reading:
The Skin Cancer Foundation's Guide to Sunscreens http://buff.ly/2c84ujA
Sunscreen Fact Sheet - British Association of Dermatologists http://buff.ly/2c8450u
Image source: OpenClipArt.org, public domain.
Asthma costs UK health service at least £1bn every year
| Figures likely to be substantial underestimate, say researchers Related items from OnMedica New asthma pill offers hope for people with severe symptoms Unsafe asthma prescribing threatens 22,000 people’s lives Childhood asthma overdiagnosed, warn respiratory doctors |
Antibiotic resistance prompts STI treatment overhaul
| WHO issues new guidelines for chlamydia, gonorrhoea and syphilis Related items from OnMedica Tackling antimicrobial resistance GPs prescribing outdated antibiotics for gonorrhoea Rate of syphilis in London is three times higher than rest of England Doctors told to halve inappropriate antibiotic prescriptions by 2020 Point-of-care diagnostics needed to curb antimicrobial resistance |
Nurse leaders in Scotland have warned of the growing vacancy rate in the profession in the wake of health board workforce projections indicating a further 750 full time staff are set to be recruited in 2016-17
| Health board workforce projections indicate 750 more full time staff for 2016-17 Related items from OnMedica One in three nurses to reach retirement age within 10 years Government urged to save jobs of over 33,000 EU nurses Will removing bursaries for student nurses actually lead to more nursing staff? Plans to scrap nurse bursaries will lead to staff shortages Public believe many more nurses needed for safe care |
Age, weight, general wellbeing all affect survival after chemotherapy
| First national analysis of breast and lung cancer treatment outside clinical trials Related items from OnMedica Radiotherapy during breast cancer surgery cuts cost and time Breakthrough for long-term survival in lung cancer Lung cancer surgery survival increases Low dose chemo and radiotherapy halves bladder cancer relapse rate Hodgkin’s lymphoma survivors at heightened risk of CVD |
Website maintenance
| www.onmedica.com will be offline between 2pm and 3pm on Thursday 1st September |
Evidence-based policy is good medicine for society’s ills
If medical science cannot live up to its own gold standards of evidence, what hope for rational policymaking in general? via New Scientist - Health Read More Here..
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Tuesday, 30 August 2016
Healthy Eating Just Got Easier: Introducing EatingWell Frozen Dinners
After work most nights you'll find me in the kitchen. I pour a glass of wine, get organized and start cooking. I listen to the radio. Or chat on the phone. I'm not in a hurry. I buzz along at my own pace, winding down from the day.
Best BBQ Sauces to Buy
Nothing beats that summer taste of sweet, smoky ribs or barbecued chicken. But many barbecue sauces are loaded to the max with added sugars. Here's how to find the best BBQ sauce at the store that's tasty without going overboard on the sweet stuff.
Growing antibiotic resistance forces updates to recommended treatment for sexually transmitted infections
New guidelines for the treatment of 3 common sexually transmitted infections (STIs) were today issued by WHO in response to the growing threat of antibiotic resistance. via WHO news Read More Here..
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Drug-induced abortion less safe in Ohio after 2011 law
A law intended to improve the safety of abortion by medication tripled the rate of complications because it stopped physicians from following latest research via New Scientist - Health Read More Here..
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Failure of fake babies: Why it doesn’t pay to go with your gut
Many schools give dolls that cry and need changing to teen girls to reduce pregnancy rates. It’s no surprise they seem to have the opposite effect, says Sally Adee via New Scientist - Health Read More Here..
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Genetics Behind Response to Parkinson’s Drugs
Since achieving the goals of the “mission impossible” Human Genome Project in 2003, biomedical sciences entered the new era of genetically informed use of pharmaceuticals. The Project helped in our understanding of how genes affect an individual’s response to drugs.
Although it was known for decades that the response to drugs depends on genetic background of each individual, the knowledge of key mechanisms involved in these processes was mostly missing. Genetics finally provided a definite understanding of pharmacokinetics, the branch of science studying what the body does to the drugs. This article will look at how drug response may vary between individuals, and how genetics play an important role in the drug response in patients with Parkinson’s disease.
Why drug responses vary
In general, there are three main reasons why response to a particular drug may vary from one individual to another. These factors are:
- The responsiveness of the site of drug action
- The drug concentration (reflected by its plasma level)
- The type or sub-type of the disease itself.
Nonetheless, in most cases, the drug plasma concentration plays the central role. Most of the drugs taken orally undergo metabolism once they enter the body. In this process, the drug will be changed into its active or metabolite form. The rate of metabolism differs between individuals, resulting in different drug plasma concentrations. The drug metabolism process is carried out by various enzymes depending on the nature of the drug. The levels and activity of these enzymes are also different between individuals. This is a critical factor in determining or predicting the response to a drug.
The activity and expression level of enzymes involved in drug metabolism is determined by genes. Even single mutations, or single nucleotide polymorphisms (SNPs) in genes’ DNA sequence can cause a huge difference to the individual metabolism of a particular drug. Mutations in genes’ regulatory sequences can also seriously influence the levels of key enzymes.
Parkinson’s disease & drug responses
Parkinson’s disease is an age-related, debilitating neurodegenerative disorder that mainly affects the motor system. People with this disease experience shaking, rigidity, slowness of movement, and difficulties with walking. Parkinson’s disease is marked by a loss of dopamine-producing neurons in the brain.
Today, one of the treatments to improve the condition of patients involves the use of drugs that mimic or increase levels of dopamine. However, using drugs to regain the normal level of dopamine can be complex, as the level of this neuromediator should not go too high (when it produces undesirable side effects), nor remain too low (when no effect is observed).
It is well established that drugs against Parkinson’s disease have different efficiency between patients. Recent research has revealed genetic determinant of this difference. The findings might inform better drug prescription and allow physicians to tailor targeted therapy for individuals suffering from this neurodegenerative condition.
The pharmacogenetics of the drug levodopa
Levodopa is a common medication for Parkinson’s disease and has been considered a gold standard since the 1960s. The drug is a direct metabolic precursor of dopamine in the body and thus can increase dopamine levels. However, 35-40% of patients develop side effects such as dyskinesia and motor fluctuation after 4-6 years of using it.
A number of studies have revealed various mutations and SNPs in genes related to levodopa metabolism, responsible for these side effects. A recent research study published earlier this year demonstrated that SV2C gene variants may modulate the amount of levodopa and suggests that the dose of levodopa should be reduced in people with this gene variant to prevent possible side effects.
Another study published three years ago showed that the effect of levodopa treatment on motor skills varies between individuals. The treatment in patient with low dopamine transmission gives better motor learning outcomes compared to the same treatment in patients with high dopamine transmission. The authors of the study stated that DRD2 gene polymorphism contributes to these varying outcomes.
Fortunately, the mutations or SNPs in the genes are not always a bad news. Recent research published this year demonstrates that two SNPs in the DRD2 gene brings good outcomes in patients treated with rasagiline monotherapy. Rasagiline is a selective, irreversible inhibitor of monoamine oxidase B and has been approved by the FDA as a symptomatic treatment for Parkinson’s disease. This research is the first study to be conducted in patients with early-onset Parkinson’s disease.
Methods for identification of patients who might experience side effects from using the dopamine agonists are also being explored. Recent findings from a group of Australian researchers provide preliminary evidence that dopamine gene profiling may be useful for identifying people at risk of developing side effects from dopamine agonists, the drug called ropinirole in particular. This study also explored the usefulness of an individualized treatment approach.
Unfortunately, the therapeutic options for patients suffering from Parkinson’s disease are very limited at the present time. Personalised genetic profiling may advise the optimal strategy for using this limited arsenal of therapeutic tools in each individual case. This approach will minimize the potential side effects and optimize drug efficiency.
New drugs for Parkinson’s are being developed, and there are several very interesting candidates in the pipeline. But it may still take many years to find something more efficient than we have now. In the meantime, it will be useful to dedicate more research to the issue of genetically determined drug response in relation to Parkinson’s disease. This will likely enable physicians to adjust treatments for individual patients and thus provide them with significant health benefits in the short term.
References
Altmann, V., Schumacher-Schuh, A., Rieck, M., Callegari-Jacques, S., Rieder, C., & Hutz, M. (2016). Influence of genetic, biological and pharmacological factors on levodopa dose in Parkinson’s disease Pharmacogenomics, 17 (5), 481-488 DOI: 10.2217/pgs.15.183
Connolly, B., & Lang, A. (2014). Pharmacological Treatment of Parkinson Disease JAMA, 311 (16) DOI: 10.1001/jama.2014.3654
MacDonald, H., Stinear, C., Ren, A., Coxon, J., Kao, J., Macdonald, L., Snow, B., Cramer, S., & Byblow, W. (2016). Dopamine Gene Profiling to Predict Impulse Control and Effects of Dopamine Agonist Ropinirole Journal of Cognitive Neuroscience, 28 (7), 909-919 DOI: 10.1162/jocn_a_00946
Masellis, M., Collinson, S., Freeman, N., Tampakeras, M., Levy, J., Tchelet, A., Eyal, E., Berkovich, E., Eliaz, R., Abler, V., Grossman, I., Fitzer-Attas, C., Tiwari, A., Hayden, M., Kennedy, J., Lang, A., Knight, J., & , . (2016). Dopamine D2 receptor gene variants and response to rasagiline in early Parkinson’s disease: a pharmacogenetic study Brain, 139 (7), 2050-2062 DOI: 10.1093/brain/aww109
Pearson-Fuhrhop, K., Minton, B., Acevedo, D., Shahbaba, B., & Cramer, S. (2013). Genetic Variation in the Human Brain Dopamine System Influences Motor Learning and Its Modulation by L-Dopa PLoS ONE, 8 (4) DOI: 10.1371/journal.pone.0061197
Image via PublicDomainPictures / Pixabay.
via Brain Blogger Read More Here..Night-time operations could double risk of death
| 2.17 times higher mortality risk from night surgery Related items from OnMedica Set up protocols to iron out differences in emergency surgery, hospitals told Doctors’ lack of sleep is risking patient safety Hospital waits for planned surgery getting longer Competition among hospitals boosts performance Review two-week fast track cancer referrals process, urge facial surgeons |
Brexit and cancer research
| What does Brexit mean for Cancer Research UK? |
Breast cancer and HRT
| No need to panic about recent study results, says Louise Newson Related items from OnMedica HRT may benefit mood but not cognition NICE publishes first guideline on menopause Tackling obesity ‘must be made a national priority’ Vulvovaginal atrophy Combined HRT risk for cancer underestimated |
'I was given paracetamol after heart attack'
Lisa Price shares her account of when she was misdiagnosed after her heart attack. via BBC News - Health Read More Here..
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Record high numbers of diabetes amputations
| 20 diabetes amputations every day, says Diabetes UK Related items from OnMedica Preventing a foot attack Care of the diabetic foot Diabetics suffer 200,000 complications per year Most CCGs sign up to prevent diabetes NHS must hold CCGs accountable for poor diabetes care |
The scary reality of medical U-turns, and how to stop them
From peanut allergy to cancer, total reversals in medical advice are strikingly common. Why did it go so wrong, and how can we make sure we get it right next time? via New Scientist - Health Read More Here..
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Third of heart attack cases misdiagnosed at first
| Women 50% more likely to get wrong diagnosis after heart attack Related items from OnMedica Follow clinical guidance to measure BP in both arms Test could tackle underdiagnosis of MI in women Diabetics suffer 200,000 complications per year Hereditary heart and diabetes problems raise risk for children Radiotherapy during breast cancer surgery cuts cost and time |
Pharmacists call for more integrated future with GPs
Read More Here..
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GPs must have longer patient consultations, says BMA
| BMA calls for 25 consultations per day maximum restriction Related items from OnMedica Doctor, can I have a 20 minute consultation? Most GPs want longer than 10-min consultations GP services reach point of ‘emergency’ warning GP patient care quality sliding into ‘state of emergency’ BMA calls for maximum number of patients per GP |
Monday, 29 August 2016
'I didn't know drinking would harm my child'
South Africa has the highest reported rate of babies born with foetal alcohol syndrome - Nomsa Maseko reports from the Western Cape. via BBC News - Health Read More Here..
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Autism in girls and women 'undiagnosed'
Millie is 14, and was diagnosed with Asperger's syndrome two years ago - a condition that often goes undiagnosed in women and girls. via BBC News - Health Read More Here..
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Deadly bagpipe infection is health warning to all wind musicians
Without regular cleaning, the moist interiors of wind instruments make an ideal home for moulds and fungi that can cause life-threatening lung conditions via New Scientist - Health Read More Here..
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EpiPen maker to sell cheaper generic version
The maker of the EpiPen allergy drug will start selling a generic version in the wake of criticism about steep price increases. via BBC News - Health Read More Here..
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