Development of oral immunomodulatory agents in the management of multiple sclerosis

The emergence of oral disease-modifying therapies in multiple sclerosis (MS) will have a significant impact on the evolving scenario of immunomodulatory treatments in MS where current therapies are all injectable. Reducing relapses in trials translates for individuals with MS into a therapeutic aim of stopping future events. Thus the possible absence of any perceived benefits to the individual together with the long disease course, variable outcome, and a younger age group affected in MS makes side effects the major issue. The use of disease-modifying therapies as a whole needs to be placed in the context of a widening therapeutic indication where the use of these therapies is being justified at an increasingly early stage and in pre-MS syndromes such as clinically isolated and radiologically isolated syndromes where no fixed disability is likely to have accumulated. The five oral therapies discussed (cladribine, fingolimod, laquinimod, BG-12, and teriflunomide) have just completed Phase III studies and some have just been licensed. New oral drugs for MS need to be placed within this evolving marketplace where ease of delivery together with efficacy and side effects needs to be balanced against the known issues but also the known long-term safety of standard injectables

Overview of ICTs and health

Open access journal.Community informatics links economic and social development efforts at the community level with emerging opportunities in Information and Communication Technologies (ICTs). In recent years in public health there has been an increased focus on the broader social determinants of health and on social inclusion, as evidenced in the 2008 Final Report of the Commission on Social Determinants of Health1. Broader determinants include education, income, social connection, and other opportunities that support improved health and wellbeing

Prevalence and Antibiotic Susceptibility Pattern of Pseudomonas aeruginosa Isolated from Hospital Environment in South Libya

Pseudomonas aeruginosa has been emerged as a significant pathogen and is the most common dreadful gram-negative bacilli found in various health care-associated infections all over the world due to its virulence, well-known ability to resist killing by various antibiotics and disinfectants. The aim of this study was isolation and identification of Pseudomonas aeruginosa in the hospital environment and determining the antibiotic susceptibility of the isolates to four antibiotics (Ciprofloxacin, Amikacin, Imipenem, and Piperacillin). A total of 200 sterile cotton swab samples were collected from hospital environment including ground, walls, beds, bed sheets, blankets, doors, doors handle, nurse tables, trays, chairs, electronic equipment's, medicine cabinet, windows and (operation theater) (Sabha medical center and Brack general hospital were enrolled in this cross-sectional study). Bacterial isolates were identified by standard microbiological procedures. Antibiotic susceptibility testing was carried out by disc diffusion method. Results revealed that out of the 200 collected samples, 12 Pseudomonas spp. (6%) were isolated. Other different bacterial species isolated were 148 (74%) and 40 samples (20%) were negative for growth. Most isolates were obtained from sinks 6 (50%) and then ground 2 (16.7%), Air conditions 2 (16.7%), walls 1 (8.3%), Chairs 1 (8.3%). we found that all Pseudomonas spp. isolates were sensitive to Ciprofloxacin, Amikacin, Piperacillin, and Imipenem

Effect of high-dose simvastatin on brain atrophy and disability in secondary progressive multiple sclerosis (MS-STAT): a randomised, placebo-controlled, phase 2 trial.

BACKGROUND: Secondary progressive multiple sclerosis, for which no satisfactory treatment presently exists, accounts for most of the disability in patients with multiple sclerosis. Simvastatin, which is widely used for treatment of vascular disease, with its excellent safety profile, has immunomodulatory and neuroprotective properties that could make it an appealing candidate drug for patients with secondary progressive multiple sclerosis. METHODS: We undertook a double-blind, controlled trial between Jan 28, 2008, and Nov 4, 2011, at three neuroscience centres in the UK. Patients aged 18-65 years with secondary progressive multiple sclerosis were randomly assigned (1:1), by a centralised web-based service with a block size of eight, to receive either 80 mg of simvastatin or placebo. Patients, treating physicians, and outcome assessors were masked to treatment allocation. The primary outcome was the annualised rate of whole-brain atrophy measured from serial volumetric MRI. Analyses were by intention to treat and per protocol. This trial is registered with ClinicalTrials.gov, number NCT00647348. FINDINGS: 140 participants were randomly assigned to receive either simvastatin (n=70) or placebo (n=70). The mean annualised atrophy rate was significantly lower in patients in the simvastatin group (0·288% per year [SD 0·521]) than in those in the placebo group (0·584% per year [0·498]). The adjusted difference in atrophy rate between groups was -0·254% per year (95% CI -0·422 to -0·087; p=0·003); a 43% reduction in annualised rate. Simvastatin was well tolerated, with no differences between the placebo and simvastatin groups in proportions of participants who had serious adverse events (14 [20%] vs nine [13%]). INTERPRETATION: High-dose simvastatin reduced the annualised rate of whole-brain atrophy compared with placebo, and was well tolerated and safe. These results support the advancement of this treatment to phase 3 testing. FUNDING: The Moulton Foundation [charity number 1109891], Berkeley Foundation [268369], the Multiple Sclerosis Trials Collaboration [1113598], the Rosetrees Trust [298582] and a personal contribution from A Pidgley, UK National Institute of Health Research (NIHR) University College London Hospitals/UCL Biomedical Research Centres funding scheme

Overview of ICTs and Health

Community informatics links economic and social development efforts at the community level with emerging opportunities in Information and Communication Technologies (ICTs). In recent years in public health there has been an increased focus on the broader social determinants of health and on social inclusion, as evidenced in the 2008 Final Report of the Commission on Social Determinants of Health1. Broader determinants include education, income, social connection, and other opportunities that support improved health and wellbeing