Sunday, September 30, 2012

Novo Nordisk invests in the creation of a new R & D-center in China

Representatives of the company Novo Nordisk announced their intention to invest an additional $ 100 million. U.S. to build its R & D-center in Beijing.

The new building of the research center area of ​​12 thousand m2 will increase staff scientists from 130 to 200 and increase the scientific potential. This decision was made in the implementation of Novo Nordisk its core strategy, which is to provide opportunities for the entire spectrum of protein in China.

Mads Krogsgaard Thomson (Mads Krogsgaard Thomsen), executive vice president, said that China has a serious scientific study, and by investing in the creation of a new R & D-center, Novo Nordisk plans to use innovative approaches of Chinese scientists.

The current research center has made a significant contribution to the company's portfolio of research in the field of drugs for the treatment of diabetes and biopharmaceutical drugs used in other diseases.

Novo Nordisk was the first multinational corporation, opened a research center in China (1997). The current research center Novo Nordisk was founded in 2002 and over the years it has become one of the leaders in the field of molecular biology, protein chemistry and cell biology.

Those that were born before term pregnancies often occurs with complications

Prematurely born women have a higher risk of complications during their pregnancy. In addition, for women who were born before 32 weeks, the risk of complications almost doubled. This conclusion Canadian scientists, who published his findings in the Canadian Medical Association Journal.

Researchers in the past have assumed that complications during pregnancy is more common in women born with low birth weight, but so far there have been no studies with a proper number of participants and the correct view of the additional factors. Dr. Anne Monique Newt (Anne Monique Nuyt) from the University of Montreal (University of Montreal) in Quebec and colleagues turned to a database of Quebec newborns, which has been going on for decades. They selected data on 554 women who were born before 32 weeks of pregnancy from 1976 to 1995., 6851 women born between 32 and 36 weeks, and 16 thousand women who were born at term. All the participants of the study gave birth to at least one child between 1987 and 2008. The scientists analyzed the pregnancy each participant for the development of complications such as gestational diabetes and preeclampsia (hypertension, preeclampsia and eclampsia).

After accounting for factors such as age and weight at onset of pregnancy, researchers found that during at least one pregnancy complications developed in 11.7 per cent of women born in the period from 13.2 per cent of women born between 32 and 36 weeks, and 19.9 percent of women born before 32 weeks. The risk of each of the above complications in women born before 32 weeks, significantly higher than the risk for women in the other groups: gestational diabetes - a 2.34 times higher hypertension - 1.56 times more likely, pre-eclampsia or eclampsia - 1, 79 times more often.

The scientists also found that prematurely born women for life in most developing hypertension (1.4 times faster), and type 2 diabetes (0.5 times faster). It is also interesting that these women are much more likely to have at least 12 years of education (44.6 percent versus 41.7 percent in the group born between 32 and 36 weeks and compared with 36 percent in the group born at term).

According to scientists, the mechanism of effect of premature birth on the long-term effects on women's health is not yet entirely clear. Apparently, in preterm infants impaired microcirculation and metabolism of insulin. In the future, this leads to the development of cardiometabolic complications in pregnancy. Scientists urge obstetricians sure to take into account whether a pregnant woman was born in time to be alert to possible complications.

Sunday, September 23, 2012

These geneticists and archaeologists about the ancestors of man finally coincided

Previously, archaeologists can learn about the life of human ancestors only the bones, tools and implements, but from 1960 a stronger position in archeology began to take DNA studies. In-depth research geneticists sometimes offered their version of events other than the opinions of archaeologists. Now archaeologists and geneticists were finally able to get the same information about the study and confirm each other.

The situation changed with the Restatement genetics method for determining the frequency of mutations in DNA. This frequency - a sort of molecular "clocks" that allow us to calculate the exact age of the genetic type. The method is simple: the number of different nucleotides in the DNA of the two species shows how much time has passed since he was alive common ancestor of these species. To make the calculations as accurate as possible, geneticists need to know the rate at which changes in DNA nucleotides. Previous studies suggested that the rate of change of nucleotides - 1 mutation in one billion years. However, recent studies have shown that in human DNA nucleotide mutates every 1 time in 2 billion years, ie molecular "clock" actually work 2 times slower than previously thought.

Therefore geneticist Oylin Scully (Aylwyn Scally) and his colleagues at Wellcome Trust Sanger Institute in Hinxton, UK, re-counted data obtained before the ancestors of man, based on a new rate change nucleotides. They studied DNA samples from bones belonging to Homo heidelbergensis, grandparent Neanderthals. According to archaeologists, the age is 400-600 thousand years, and that was when there was an offshoot of the ancestors of modern humans. Earlier Geneticists believe that this event occurred much earlier - 270-435 thousand years ago, but given the newly defined mutation rate of DNA, the researchers came to the conclusion that the separation occurred 600,000 years ago, which fully corresponds to archeologists.

Archaeologist Jeff Rose (Jeff Rose) from the University of Birmingham (University of Birmingham) confident that an agreement between the archaeologists and geneticists - a significant event. It will help to confirm many archaeologists received data. In particular, the earlier genetics estimate that the ancestors of Europeans and Asians left Africa 60,000 years ago, while archaeologists have dated this outcome 100,000 years. Recalculation of genetic data with the new speed of the molecular "clock" shows that this result did not occur 60 and 120 thousand years ago, which coincides with the opinion of archaeologists.


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Roche is recognized as the most sustainable company in the world in the health

Roche announced that it is the fourth consecutive year, recognized as the most sustainable company in the world in the health sector, according to the index of the Dow Jones Sustainability (DJSI). World and European indices Dow Jones Sustainability (DJSI World and DJSI Europe) track leading indicators, in terms of sustainable development, the companies on the basis of best-in-class approach to environmental, social and economic criteria. Indexes serve as benchmarks for investors, who account for sustainable development in the formation of their portfolios.

"Rating Roche as the most sustainable company in the field of health is based on our ongoing effort to conduct business for the benefit of all stakeholders. Roche is actively tuned to this interaction with the public, patients and the public health system, which allows you to create long-term value for all "- said Severin Schwan (Severin Schwan), CEO of the Roche Group.

"In particular, we have set ourselves the goal of diversification and conservation, which are integrated into the system of material incentives for the company's management, which helps to implement our activities in these destinations. We are also launching new initiatives to expand access to our innovative medicines in emerging markets, to the greatest possible number of people were able to take advantage of our products. At the same time, we continue to remain a world leader in pharmaceuticals and diagnostics, "- said Schwan.

This year, the DJSI assessment process were highlighted measures taken by Roche as a sustainable company. These include strategy Roche's innovation and personalized approach to medicine, which increases efficiency and improves health outcomes. Were also recognized for the development of programs Roche future leaders and human rights, and pilot programs to establish the company in developing a differential pricing in order to substantially increase access to medicines Roche.

In 2009, the company has set a number of corporate objectives, designed for five years, the progress in the attainment of which can be measured by key performance indicators. Roche has also set a goal to diversify in order to increase the percentage of women in key positions at least 50%, as well as the problem of increasing energy efficiency by reducing energy consumption by 10% by 2014 and to optimize the use of energy resources.

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Lack of sleep has a negative impact on the formation of new bone

Scientists at the Medical College of Wisconsin (Medical College of Wisconsin), United States, found that rats that lack of sleep, there are pathologies of bone and bone marrow. In particular, slowing growth and the formation of new bone, and the bone marrow is reduced fat and doubled the number of precursor cells of platelets. Scientists suggest that similar changes may occur in humans. The results of this study are published in the journal Experimental Biology and Medicine.

A team led by professor of neurology, cell biology, neurobiology and anatomy Carol Everson (Carol Everson) studied the peculiarities of bone tissue in rats chronically enough sleep. They found that at a constant rate of absorption, ie, destruction of bone tissue, these rodents practically stops the formation and growth of new tissue, which leads to increased bone fragility and frequent fractures.

Moreover, scientists have noted changes in the bone marrow. The amount of fat in it has decreased dramatically, and the number of platelet precursor cells grown in 2 times. As a consequence of these changes will not only reduce the plasticity of the bone marrow, but also increased the concentration of platelets in the blood of rats. This, in turn, may increase the risk of thrombosis and even heart attack and stroke.

If the same processes can be observed with a lack of sleep in humans, it may partly explain why the elderly are prone to suffer "senile" insomnia, increased risk of osteoporosis and slow the growth of new bone. But scientists say that in today's society lack of sleep has become quite common for young people. Therefore, they need to consider the consequences of lack of sleep for your health and to review their busy schedules.

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Saturday, September 1, 2012

Stem cell research in the United States will again have government funding

U.S. Court of Appeals recognized the legitimacy of public funding for research on embryonic stem cells. The decision had become final chord in the three-year struggle of the National Institutes of Health (National Institutes of Health, NIH) with community organizations trying to ban the use of embryonic stem cells on ethical grounds.

"This is a real victory, and we are happy that the court has made this decision," - says Amy Comstock Rick (Amy Comstock Rick), lawyer, president of the Coalition for the Advancement of Medical Research, which supports stem cell research. However, some experts suggest that researchers early to celebrate. The fact that the three appeal judges differently justified rendered in favor of the NIH decision, so the plaintiffs a chance to re-review of the case.

The lawsuit was filed against the NIH in 2009, a month after President Barack Obama lifted restrictions imposed by George Bush on embryonic stem cell research. Some community organizations and individual scientists thought that the abolition of this restriction violates the Dickey-Wicker Amendment, which for the past 16 years, prohibits public funding "research in which embryos are destroyed." In August 2010, U.S. District Judge Royce Lamberth ruled that the executive authorities violated the Dickey-Wicker Amendment and imposed a preliminary injunction, resulting in research funding was suspended. In April 2011, the Court of Appeal decided that Obama can use public money to fund embryonic stem cell research.

One of the three jurors, David Sentell (David Sentelle), respondents agreed with the statement, claiming that the actions do not violate the NIH Dickey-Wicker amendment, as their study "using stem cells already extracted embryos, and we are not talking about destroying them." The Court also took into account the statement of the plaintiffs that such studies "stimulate" the destruction of embryos. The other two judges agreed with the decision, but for different reasons. They believe that the court is limited to the interpretation of Dickey-Wicker Amendment in this case, and that the search for the right balance in matters of bioethics - this is not the task of the court. These differences allowed the plaintiffs a chance to a new review of the case

Renal denervation helps high blood pressure

Renal denervation reduces blood pressure and reduces the stiffness of blood vessels in hypertensive patients resistant to drug therapy. These are the conclusions of Dr. Claes Franzen (Klaas Franzen) of the University Hospital Schleswig-Holstein (University Hospital of Schleswig-Holstein) in Germany. They were presented at the Congress of the European Society of Cardiology (European Society of Cardiology) 2012.

Decades of malignant hypertension was treated by surgical operation - thoracolumbar splanhektomii (excision splanchnic nerves). It is kind of sympathectomy, proposed for the treatment of hypertension in 1938. "More than half of the patients after splanhektomii a marked decrease in blood pressure, - says Franzén. - However, this method of treatment there were serious side effects - orthostatic hypotension, anhidrosis (lack of sweating) and violation of the intestine. After creating a number of effective antihypertensive drugs splanhektomiya gone down in history, and for a long time, no one thought of this method. "

In 2009, the concept of sympathectomy was slightly reorganized, resulting in the technique such as percutaneous intravazalnaya renal sympathetic denervation with a catheter (renal denervation). The method is well established for the treatment of patients with malignant hypertension, are not susceptible to the drugs. Recent studies have shown that within 6 months after renal denervation reduces systolic blood pressure by an average of 32, and diastolic - 12 mm Hg. Art. Since the method is non-invasive, it compares favorably with previous techniques splanhektomii, it had a much smaller number of side effects and a shorter recovery time patient.

In a study conducted by Dr. Frantsenom participated 21 patients with hypertension, the drug resistance (13 men and 8 women, mean age - 64 years). All participants at baseline systolic blood pressure greater than 150 mm Hg. Art. Each patient underwent renal denervation. In general, the systolic blood pressure of all participants decreased by 7,6-9,5 mm Hg. Art. 3 months after surgery and another 5,4-6,6 mm Hg. Art. after six months.

Furthermore, renal denervation improved hemodynamics and condition of the walls of blood vessels. During prolonged hypertension develops stiffness of the vascular wall, and the arteries lose their elasticity. Because of this increased pulse wave velocity. The results showed that all patients who underwent renal denervation, pulse wave velocity decreased by an average of 1 m / s at 3 months or more at 1 m / s - six months after the operation.

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Wednesday, August 22, 2012

In 2012, sales of the company Planmeca increased by more than 30%

Finnish manufacturer of dental equipment company Planmeca, delivers three digital educational complex for the College of Dentistry at the University of King Saud and health management of the National Guard of Saudi Arabia, in the ongoing in Saudi Arabia, large-scale measures to promote health and investment in education.

This is a major agreement for delivery of "turnkey" complex, including more than 1,000 dental units, simulation setup, two-and three-dimensional X-ray systems, as well as innovative software platform to seamlessly integrate our equipment and solutions from other companies in comfortable environment for high-tech training dentists. A similar complex with 127 dental units and a complete set of image processing systems and training systems, supplied the University of Eastern Finland in Kuopio.

A unique solution developed by Planmeca dental schools, is used in many of the leading educational institutions of the region in the world. According to Mr. Heikki Kiostilla (Heikki Kyöstilä), president of Planmeca Oy, in 2012, sales of the company Planmeca increased by more than 30%, except for the agreements with universities.

"Our success proves that universities appreciated leadership of our company in the field of technology, and orientation of the user in product development. We are very pleased to be working with these prestigious institutions. Planmeca competitive advantage achieved through significant investment in research and development activities carried out by the company, as well as through collaboration with leading research institutions, and strong business partners, "- said Heikki Kiostilla.

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Wednesday, August 15, 2012

Nosocomial infections: problems and solutions

In Manila (Philippines) held a working meeting of the APEC economic impact of hospital-acquired infections (HAI). The company BD (Becton, Dickinson and Company), applying its expertise, resources and technology to prevent the spread of infections associated with health care, throughout the world, has become one of the most active participants.

The forum was attended by representatives of the WHO, the International Consortium for the control of nosocomial infection (International Nosocomial Infections Control Consortium INICC), the Centers for Disease Control and Prevention (Centers for Disease Control and Prevention, CDC), and public health authorities in different countries and professional the medical community. The Russian delegation was represented by leading experts in the country HAI: chief physician FGBU "CDC Polyclinic" Office of the President of the Russian Federation, GA Ivanov, MD, PhD, director of the Institute of Antimicrobial Chemotherapy GBOU VPO "Smolensk State Medical Academy" of the Ministry of Health of the Russian Federation, RS Kozlov.

APEC health ministers recognize the growing economic impact caused by infectious diseases, which are becoming more prevalent in developing countries. The forum focused on the issue special panel discussions and roundtables. HAI is a serious burden and significant economic impacts on patients and health systems around the world. Out of every 100 hospitalized patients, at least 7 in developed and 10 in developing countries are infected. According to WHO, in intensive care, this figure could approach 30%.

The forum participants noted that infections acquired in the course of treatment, is one of the most common causes of death and increased mortality in hospitalized patients, to identify urgent measures to address the problem of HAI. Among them, in particular, the development of programs to improve the situation in APEC economies.

Given that most of these infections are treatable and Prevention, the workshop signed a resolution in which APEC countries reaffirm their commitment to prevent the spread of nosocomial infections. "Workable system requires active management of HAI legislative, supervisory and regulatory involvement of the state in the face of official national and regional health authorities, the active position of managerial Institutes of Health, skills, feedback mechanisms (LPU-MOH), the availability of trained personnel in the state of health care facilities (epidemiology), Resourcing, "- said Georgi Ivanov, chief medical FGBU" CDC Polyclinic "Office of the President of Russia.

Particular emphasis was placed on the role of health professionals in the prevention of nosocomial infections. This problem was given to the head of the company's BD in Russia and the CIS, MD Alexei beaver. "In order to effectively limit the spread of nosocomial infections and to reduce the associated economic costs necessary to implement the broad practice of modern biomedical technology, especially in matters of health facility staff hand hygiene, and safety of injections and other invasive clinical procedures," - he said.


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Pfizer has filed papers for an IPO business for the production of drugs for animals

The largest pharmaceutical company in the world - the U.S. Pfizer Inc. - Documents filed with the Commission on Securities and Exchange Commission (SEC) to conduct an initial public offering of its units, producing veterinary drugs for animals, the company said.

Underwriters of the sale of 20 per cent stake in the company, which will be called Zoetis Inc., Made by JPMorgan Chase & Co., Bank of America Corp. and Morgan Stanley.

The deal is scheduled for the first half of next year.

Revenues for the division last year was $ 4.23 billion

Pfizer intends to focus its activities on the key to its pharma business, within the framework of this strategy in April, the company sold the Swiss Nestle SA for $ 11.9 billion his unit for the production of food for children.

Found a way to grow heart muscle cells from the blood

Stem Cell Research Group at the University of California at Los Angeles (UCLA) found a surprising plasticity of embryonic endothelium. Scientists have found that the absence of a transcription factor, allows the cells to progenitors that normally produce blood stem cells and progenitor cells in the hematopoietic organs to differentiate into cardiomyocytes. The results of a two-year study were published in the journal Cell.

To determine which genes are working in the embryonic endothelium, microarray technology was used, which revealed that in the absence of Scl, one of the factors of cell differentiation, rather than genes, aimed at forming a blood stem cells are activated genes that are required for the production of cardiomyocytes. The researchers cultured embryonic yolk sac, which was absent Scl, and received by 4:00 cardiomyocytes are capable of contraction. The same potential has been detected in the endocardium Scl-deficient embryos. Scientists have tried to identify the potential to become endothelial and other related tissues such as skeletal muscle, bone or kidney, but the evidence of such plasticity could not be found.

"If you remove just one factor, Scl, the microenvironment of fetal blood vessels, usually giving rise to blood cells, begins to produce cardiomyocytes, hematopoietic making body in the" cardiogenic "body," - said Dr. Hanna Mikkola (Hanna Mikkola), one of the leading authors of the study.

These data were unexpected and extremely useful for the whole of regenerative medicine, since changing the view of the possibility of reprogramming cells. Usually, this process involves the addition of any factors to change cell "fate." But, apparently, the suppression of factors such as Scl, - a more secure way to push the cell to a different path of development.

Tuesday, July 24, 2012

Contraindicated for women with high levels of job stress

How do I find U.S. researchers from Brigham and Women's Hospital (academic and clinical bases of medical school at Harvard University) in Boston, working in occupations with a HIGH-level stress, women are not only difficult but also harmful to health. In the beautiful half of humanity stress at work was associated with increased risk of cardiovascular disease.

After analyzing the data 22,086 women who participated in the study of Women's Health Study (mean age was 57 years), scientists have identified four types of work on the levels of demand and control over the labor process: passive work (low demands, low control), with low-load (low demand, a lot of control), active work (high demands, a lot of control) and with high levels of stress (high demands, low control). As it turned out, for women with the latter two types of jobs likely to develop diseases such as nonfatal myocardial infarction, and conditions requiring immediate coronary revascularization (stenting) was higher than for their counterparts with more lenient terms and conditions of work.

During the decade of observation of study participants was estimated at 170 myocardial infarctions, 163 ischemic strokes, 440 operations stenting indications for urgent and 52 deaths from cardiovascular disease. The negative effects of stress on the cardiovascular system of the body, scientists explain the behavioral reactions to it - such as depression and smoking - as well as physiological reactions, such as stress-induced hypertension and metabolic syndrome. In addition, chronic stress is dangerous because it can cause dysfunction of the autonomic nervous system regulation, and particularly of the hypothalamic-pituitary-adrenal axis, which leads to the development of neurocirculatory dystonia.

As noted by scholars such as work performed before primarily on specialists, men and their work is the first study of the relation of stress in the workplace with the risk of cardiovascular disease in the fairer sex

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An artificial nanotubes with a pore diameter of less than one nanometer

An international team of scientists led by Bin Zhou Xi (Xibin Zhou) and Guangya Liu Teh (Guande Liu) from the Beijing University of Chemical College (College of Chemistry, Beijing Normal University, China) has established an analogue of biological transmembrane channels. The study of transmembrane transport of substances into the cell was always challenging and exciting task, so the reproduction of this system in vitro - great scientific success.

At the core of the nanotubes are created rigid macrocyclic compounds - complex molecules of several heterocyclic bases covalently assembled into a ring diameter of 8.8 angstroms. The secret of success lies in the fact that these rings have learned to apply to the stack on each other. Stacks are fixed by hydrogen bonds and stekingovymi interactions (such as those that stabilize the DNA helix), resulting in a tube. The tubes are collected and fasten together to form a molecular sieve. The pore diameter can vary depending on the family's base macrocyclic compounds. Such complexes are similar to biological ion channels in its structure and on the basis of the transmission of substances.

The closest application of this technology is to create a molecular filter for water and other low molecular weight compounds. The researchers plan to expand the range of noise substances. In the future, with the help of these nanotubes can be designed to control the delivery of pharmaceutical compounds in the tissues and organs of the body, as well as collect various macromolecular transport systems.

Vitamin B12 was effective addition to standard therapy for hepatitis C

It is known that vitamin B12 inhibits the replication of HCV in vitro. Adding vitamin B12 to therapy with pegylated interferon and ribavirin in previously untreated patients is almost 2 times more likely caused by a viral response (72% treated with vitamin B12, and only 38% received only standard therapy), according to a published in the online edition of the journal Gut article Gerardo Nardon (Gerardo Nardone) and his colleagues at the University of Naples (University of Naples in Italy).

In addition, the viral response was observed more frequently in patients with the most resistant to the treatment of genotype 1 hepatitis C virus (HCV) and high viral load. Rapid viral response developed equally frequently in both groups, but significantly more often - in the vitamin B12 in patients with high initial viral load and genotype 1 HCV. In the group with standard therapy was not significantly more responders to treatment. The number of complications and side effects in both groups did not differ.

The researchers note that the cost of treating one patient with genotype 1 HCV exceed $ 15,000, but in their study, the frequency of viral replication in these patients was 41% rise in price during the treatment a little more than $ 20. However, they point out that these results should be interpreted with caution because the study was conducted in small groups of patients and without placebo control.

The importance of a safe, low-cost additional treatment for patients with HCV comes to the fore because of problems with new antiviral agents that are directly applicable to the virus.

"Antiviral drugs are a new generation require careful monitoring and strict application of rules to prevent the emergence of resistant strains of HCV and the development of an overdose patient" - the researchers said. Meanwhile, the standard therapy plus vitamin B12 may be useful for patients with stable chronic infections to treatment.

"This strategy would be especially useful in countries where, because of limited economic means a new generation of antiviral agents can not be applied in routine clinical practice" - the authors conclude.

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British scientists offer to fight obesity with the help of thermal

Scientists from the University of Nottingham (University of Nottingham), UK, proposed a new way to fight obesity through a unique technology that uses thermal imaging and thermal imaging. With it you can detect in the body reserves of brown fat, which is considered "good" fat. Their proposed methodology is described in an article published in Journal of Pediatrics.

Brown fat or brown adipose tissue controls how fast your body burns calories obtained. It produces 300 times more energy than any other tissue in the body. Theoretically, the more a man of brown fat, the less the possibility that all the excess calorie intake will accumulate it as white fat. Symonds, Michael (Michael Symonds), Professor of Physiology, School of Clinical Sciences (School of Clinical Sciences) and his colleagues first used thermal imaging to determine exactly how much of brown fat in the body of each person and how much heat it produces. This technique is not invasive and completely safe even for children.

"We are confident that we have developed technology will fundamentally new development in the fight against obesity - the author writes of development. - Detailed study of the work of brown fat by using thermal, in the future we will be able to place labels on their products thermogenic index. It will show, raises or lowers the product heat brown fat, that is, slow down or speed it burn calories our body. "

Obesity is one of the critical problems of the population of Europe and America. Against the background of this epidemic is a growing number of children who are overweight. In the UK alone in the 1990s, the number of obese children has nearly doubled. Currently obesity affects approximately 155 million children around the world.

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WHO has issued guidelines on the use of antiretroviral drugs for HIV-negative people

WHO issued its first guidance for countries that provide drugs to offer HIV, known as antiretrovirals (ARVs) to protect people who do not have the virus, but at high risk of HIV infection.

Pre-exposure prophylaxis (CEPR)

Guidance is based on the results of clinical trials showing that the reception of HIV-negative people daily dose of oral antiretrovirals as pre-exposure prophylaxis (CEPR) in order to reduce the risk of infection for humans is safe and effective for HIV prevention. Research initiatives iPrEX showed that the use CEPR may reduce the number of HIV infections among men who have sex with men, about 40% and up to 73% among those who take medications regularly. Research Partners PrEP showed 75 percent protection among serodiscordant couples (couples in which one person with HIV-positive) in Kenya and Uganda.

A wide range of results indicates the potential benefits of the CEPR, but also about the importance of its combination with the constant use of condoms, and frequent testing and counseling and treatment for HIV infection, sexually transmitted diseases.

They also emphasize the importance of daily medication. For many people at high risk of HIV infection, punctilious observance of the prescribed treatment regimen can be challenging. Therefore, the next goal is to establish how best to deliver CEPR those who will use it in "real life" in order to ensure the necessary compliance requirements and maximize the benefits to public health.

Projects on the use of pre-exposure prophylaxis in

For a better understanding of how to best contribute to the CEPR combination HIV prevention program, WHO strongly recommends that countries wishing to enact the CEPR, first create a small-scale projects that will help public health professionals better understand and realize its potential benefits. These projects will be provided ARVs to people at high risk of HIV infection. These may include non-infected men or women who have changed their sex, have sex with men who are at high risk of HIV infection. The aim is to identify the groups who benefit the most from the CEPR, and establish how best to deliver them to those services.

WHO will assess the results of these projects, along with changing scientific data. The results will help determine the best way to include guidance on the CEPR in the future the combined WHO guidelines on the use of antiretroviral drugs for prevention and treatment of HIV infection, which is expected to release in summer 2013.

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