Pharmacyhttp://hdl.handle.net/20.500.12904/153672024-03-29T11:26:44Z2024-03-29T11:26:44ZPharmacological management of fragile X syndrome: a systematic review and narrative summary of the current evidenceBarwell, Julianhttp://hdl.handle.net/20.500.12904/182932024-03-07T11:18:42Z2024-02-23T00:00:00ZPharmacological management of fragile X syndrome: a systematic review and narrative summary of the current evidence
Barwell, Julian
Introduction: Fragile X Syndrome (FXS) is the most common inherited cause of Intellectual Disability. There is a broad phenotype that includes deficits in cognition and behavioral changes, alongside physical characteristics. Phenotype depends upon the level of mutation in the FMR1 (Fragile X Messenger Ribonucleoprotein 1) gene. The molecular understating of the impact of the FMR1 gene mutation provides an opportunity to target treatment not only at symptoms, but on a molecular level. Methods: We conducted a systematic review to provide an up-to-date narrative summary of the current evidence for pharmacological treatment in FXS. The review was restricted to randomized, blinded, placebo-controlled trials. Results: The outcomes from these studies are discussed and the level of evidence assessed against validated criteria. The initial search identified 2377 articles, of which 16 were included in the final analysis. Conclusion: Based on this review to date there is limited data to support any specific pharmacological treatments, although the data for cannabinoids is encouraging in those with FXS and in future developments in gene therapy may provide the answer to the search for precision medicine. Treatment must be person-centered and consider the combination of medical, genetic, cognitive and emotional challenges.
2024-02-23T00:00:00ZExtrapulmonary nontuberculous mycobacterial infections: a guide for the general physicianGadsby, Jessicahttp://hdl.handle.net/20.500.12904/182752024-03-05T16:12:02Z2024-01-01T00:00:00ZExtrapulmonary nontuberculous mycobacterial infections: a guide for the general physician
Gadsby, Jessica
Non-tuberculous mycobacteria (NTM) infections predominantly present as pulmonary disease. Although relatively rare, 20-30 % originate from extrapulmonary sites resulting in a wide range of clinical syndromes. Immunocompromised individuals are particularly susceptible. Clinical manifestations include skin and soft-tissue infections, lymphadenitis, musculoskeletal infections and disseminated disease. Diagnosing extrapulmonary NTM is challenging, and management is complex, often involving multiple radiological and microbiological investigations, long courses of combination antibiotic regimens and may require adjuvant surgical interventions. We highlight both the importance of involving NTM experts at an early stage and the role of a multidisciplinary approach in the diagnosis and management of these infections.
2024-01-01T00:00:00ZLifestyle or pharmacotherapy in cardio-metabolic disease preventionOsman, Hanadhttp://hdl.handle.net/20.500.12904/178382023-11-16T12:27:18Z2023-01-01T00:00:00ZLifestyle or pharmacotherapy in cardio-metabolic disease prevention
Osman, Hanad
Cardio-metabolic diseases are the leading causes of premature death worldwide. The conditions are together some of the most prevalent and severe multimorbidities and include conditions such as diabetes, hypertension, coronary heart disease and stroke. People with these conditions are at a higher risk of all-cause death and have a reduction in life expectancy when compared to patients without cardio-metabolic disorders. As a result of the increasing prevalence and impact of cardio-metabolic multimorbidity on disability, no healthcare system can 'treat' its way out of this pandemic. 'Treating our way out' requires the use of multiple medications which can lead to improper prescribing, insufficient compliance, overdosing or underdosing, improper drug choice, insufficient monitoring, unfavourable drug effects, and drug interactions and inappropriate wastes and costs. Therefore, individuals living with these conditions should be empowered to adopt lifestyle changes that foster independent living with their conditions. Adopting these healthy lifestyles such as smoking cessation, improving dietary habits, sleep hygiene and physical activity is a suitable adjunctive measure if not an alternative to polypharmacy in cardio-metabolic multimorbidity.
2023-01-01T00:00:00ZUnderstanding the feasibility and environmental effectiveness of a pilot postal inhaler recovery and recycling schemeMurphy, Annahttp://hdl.handle.net/20.500.12904/170582023-05-23T10:39:40Z2023-01-21T00:00:00ZUnderstanding the feasibility and environmental effectiveness of a pilot postal inhaler recovery and recycling scheme
Murphy, Anna
All inhalers have an environmental impact; the majority are not recycled, with many disposed of inappropriately through domestic waste. To assess the feasibility of a method for recovering and recycling inhalers, Chiesi Limited (Chiesi) set up and funded 'Take AIR (Action for Inhaler Recycling)', a 12-month pilot postal scheme facilitated by community pharmacies across Leicester, Leicestershire, and Rutland, and hospitals in Leicestershire. All inhalers were accepted in the scheme. The recovered pressurised metered-dose inhalers (pMDIs) were dismantled and component parts recycled where possible; the remaining propellant gas was extracted for reuse in refrigeration and air conditioning industries. Other inhaler types were incinerated in an 'energy-from-waste' facility. From February 2021 to February 2022, 20,049 inhalers were returned; most (77%) were pMDIs. So far, Take AIR has saved the equivalent of an estimated 119.3 tonnes of carbon dioxide emissions from entering the atmosphere. Our experience demonstrates the feasibility and effectiveness of a postal inhaler recovery and recycling scheme, which could be used as a foundation to build future initiatives.
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