45 research outputs found
The European Medicines Shortages Research Network and Its Mission to Strategically Debug Disrupted Pharmaceutical Supply Chains
No full textThe problems created by supply shortages of medicines have been widely reported by healthcare professionals and patients over recent years and acknowledged by the European Medicines Agency and European Commission. Shortages result in the suffering of individuals and negative consequences for an economy. An option to overcome shortage situations is to use a different medicine as a substitute. However, alternatives are not always feasible and available. When shortages arise, risk increases through substitution from other excipients, other concentrations, foreign language vials, or untranslated package leaflets. Such risks have not yet been quantified in a scientifically credible way. Thus, a decrease of the number of shortages will have a global economic and societal impact which is in the interest of clinicians, patients, public health, and of taxpayers. The supply chain can be parted into processes such as production of active ingredients, manufacturing, wholesaling, clinical need, and measures of poor clinical, financial and quality of life outcomes arising from shortages. The cited causes are multifaceted ranging from production disruptions, natural disasters, discontinuations, difficulties created by various restrictive and disincentive legal, trade and pricing frameworks, unfavorable decision making in medicines production and trade, insufficient stocks, as well as conflicts of interest of stakeholders. The European Medicines Shortages Research Network addresses these causes and debugging strategies by the bottom-up approach of COST (cooperation in science and technology) Action CA15105 which joins together all stakeholders and particular interests along the supply chain. The COST platform is sustained by nationally funded research projects which aim to respond to clinical, financial and quality of life interests, to achieve analytical clarity on disruption causes, to simulate decision making in order to anticipate new shortages, and to reflect on best coping practices. Approach to improvements of the situation comprises novel approaches such as System Dynamics and the repromotion of hospital pharmacy manufacturing and preparation. Activities of the European Medicines Shortages Research Network will make a significant contribution to strategic thinking about how to respond to product shortage problems by systematically analyzing the situation from key player perspectives. This includes round table negotiations with the stakeholders. It is the declared aim of the project to bring together all the primary stakeholders in the medicines supply chain process to find an agreement on the paths towards resolution by a bottom-up approach. The final objective is to stimulate constructive agreement between all participating stakeholders and to reveal any restrictive legal and economic frameworks, erroneous incentives in the supply chain, conflicts of interest, and problematic cost-benefit ratios that induce or exacerbate shortages
Verbindung von Ernährung und Lebensmitteltechnologie im Fokus
No full text«Du bist, was du isst.» Immer mehr Menschen interessieren sich für eine gesunde Ernährung. Die muss auch nicht teurer sein, wie sich in einer Studie der BFH-HAFL herausgestellt hat. Spezielle Ernährungsformen wie Veganismus nehmen zu und die Bedürfnisse nach Produkten für Personen mit Lebensmittelunverträglichkeiten steigen. Ein Trend in Richtung personalisierter Lebensmittel oder Lebensmittel für bestimmte Zielgruppen ist deutlich wahrzunehmen
Missing to Meet Dieticians and Nutritionists’ Educational Needs is Not Only a Question of Governmental Austerity Measures
No full text
Missing to Meet Dieticians and Nutritionists’ Educational Needs is Not Only a Question of Governmental Austerity Measures
No full textInternational audienc
Nutrigenomics-Associated Impacts of Nutrients on Genes and Enzymes With Special Consideration of Aromatase
No full textInteractions are occurring in the course of liberation, absorption, distribution, metabolism,
and excretion of active ingredients, or at the target receptors. They are causing therapy
failures and undesirable events. Forty-seven of fifty-seven human hepatic isoenzymes are
specific and relevant in hormone and vitamin metabolism and biosynthesis. Aromatase
(syn. CYP19A1) is one of the specific CYP450 isoenzymes so far not elucidated in detail.
As aromatase-inhibiting phytochemicals are currently recommended for breast cancer
prevention and as add-on accompanying aromatase-inhibitor pharmacotherapy, it was
the aim of this literature review to assess whether a common interpretation on genetic
and -omics basis could be found. Articles retrieved showed that traditional antioxidation
diet is one of the most approved explanations of inhibition of aromatase by phytonutrients
of flavonoid derivatives. Flavonoids compete for the oxygen provided by the heme moiety
of aromatase in the course of aromatase-catalyzed conversion of steroid precursors to
estrogens. Flavonoids are therefore promoted for breast cancer prevention. A further
explanation of flavonoids’ mechanism of action proposed was related to enzymatic
histone deacetylation. By keeping DNA-structure wide through a high acetylation degree,
acetylated histones favor transcription and replication. This mechanism corresponds
to a procedure of switching genes on. Inhibiting acetylation and therefore switching
genes off might be an important regulation of repressing cancer genes. Aromatase
expression depends on the genotype and phenotype of a person. Aromatase itself
depends on the expression of the heme moiety encoded in the genotype. Biosynthesis
of porphyrins in turn depends on the substrates succinate and glycine, as well as
on a series of further enzymes, with ALA synthetase as the rate-limiting step. The
effect of the heme moiety as prosthetic group of aromatase further depends on the
absorption of iron as a function of pH and redox state. To assess the function of
aromatase precisely, multiple underlying biochemical pathways need to be evaluated.
As a conclusion, the genetic regulation of metabolism is a complex procedure affecting
multiple pathways. To understand a metabolic step, multiple underlying individually
performing reactions need to be considered if personalized (nutritional) medicine should
bring an advantage for a patient. Nutrition sciences need to consider the genome
of an individual to truly find answers to nutrition-derived non-communicable diseasesWith current GWAS (genome-wide association study) approaches, inherited errors of
metabolism are identified and ideally treated effectively. It is much more difficult to get
a precise genetic profile for non-communicable diseases stemming from multifactorial
causes. Polygenic risks evaluation is feasible but diagnostic tools are not yet available in
a desired extent. Neither flavonoid researchers nor providers of genetic testing kits are
going into the details needed for a truly personalized nutritional medicine. The next step
with profiling the exome and then the whole genome is on the threshold of becoming
routine diagnosis and of bringing the desired details.
Keywords: nutrients, nutrigenomics, aromatase, CYP19A1 isoenzyme, food-drug interactions, healthy aging,
personalized nutritional medicine, flavonoid
The Dietitian’s Interest to Gain Insight into the Nutrition Black Box
No full textInternational audienc
Availability of Medicines.
No full textFundamental changes and new challenges have been emerging in the last decades as a result of the globalisation of markets and of production, new economic doctrines, tight
budgets as weil as the development of information technology. This has brought with it a shift in the security of supply, which now has to cope with drug shortages to prevent a
decrease in safety and a worse outcome for the patients. Medicines are made available as authorised medicines, pharmacy preparations, or investigational medicinal products. For many diseases active substances are available, and yet groups of 'neglected' patients or special patient groups will not receive the medicines they need. lf a patient needs a medicine, which is not on the national market, it may be imported from abroad or prepared in a pharmacy. The complicated rules, which are nationally determined, Ior reimbursement (in some Countries) and long procedures render importation a laborious way to make medicines available for the patient. Tobe reimbursed some Countries require that medicines are to be shown to be efficacious, appropriate and economic. Specials (unlicensed medicines) are being produced according to GMP and PIC/S guidelines to cover these shortages. The European Association of Hospital Pharmacists (EAI-IP) has dedicated a big effort to animating and harmonising pharmacy production. The need for flexibility in preparation and manufacturing processes and the added value of a broad range of pharmacy production have been clearly unc\erlinec\ by the Council of Europe's resolution CM/ResAP (201 l)l
Discovery of Association Rules of the Relationship between Food Consumption and Life Style Diseases From Swiss Nutrition’s (menuCH) Dataset & Multiple Swiss Health Datasets from 1992 To 2012
No full textThis article demonstrates that using data mining methods such as Weighted Association Rule Mining (WARM) on an integrated Swiss database derived from a Swiss national dietary survey (menuCH) and 25 years of Swiss demographical and health data is a powerful way to determine whether a specific population subgroup is at particular risk for developing a lifestyle disease based on its food consumption patterns. The objective of the study was to discover critical food consumption patterns linked with lifestyle diseases known to be strongly tied with food consumption. Food consumption databases from a Swiss national survey menuCH were gathered along with data of large surveys of demographics and health data collected over 25 years from Swiss population conducted by Swiss Federal Office of Public Health (FOPH). These databases were integrated and reported in a previous study as a single integrated database. A data mining method such as WARM was applied to this integrated database. A set of promising rules and their corresponding interpretation was generated. As an example, the found rules of the sample show that the consumption of alcohol in small quantities does not have a negative impact on health, whereas the consumption of vegetables is important for the supply of vitamins of the B group, which help the energy metabolism to provide energy. These vitamins are particularly lacking in alcoholics and should then be taken with supplements. Another finding is that dietary supplements do little specially by diabetes. Applying WARM algorithm was beneficial for this study since no interesting rules were pruned out early and the significance of the rules could be highly increased as compared to a previous study using pure Apriori Algorithm
