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Models of human error can be helpful inA determining why errors have occurred in the past, where future vulnerabilities may lie, and how healthcare professionals might take action to make clinical practice safer.
We have mapped many of our learning resources to the RPS Faculty's Advanced Practice Framework and Foundation programme. Disclosing clinical trial data is a step in the right direction towards transparency, which benefits both the public and the pharmaceutical industry.
As a pharmacist working for an international charity, Owen Wood shares his knowledge ofA mass vaccination and medicines procurement. Pharmacodynamic interactionsClinical studies have found the incidence of hypoglycaemia was higher when canagliflozin or dapagliflozin were given with insulin or a sulfonylurea compared with when used alone.
Have your sayFor commenting, please login or register as a user and agree to our Community Guidelines. Related linksPharmaceutical Journal is not responsible for the content of external internet sites.
Maria Sharapova failed a drug test at the Australian Open due to a substance she "has been taking for 10 years for health issues".
Adult stem cell ?? An undifferentiated cell found in a differentiated tissue that can renew itself and (with certain limitations) differentiate to yield all the specialized cell types of the tissue from which it originated. Bone marrow stromal cells ?? A stem cell found in bone marrow that generates bone, cartilage, fat, and fibrous connective tissue. Cell-based therapies ?? treatment in which stem cells are induced to differentiate into the specific cell type required to repair damaged or depleted adult cell populations or tissues.
Cell culture ?? Growth of cells in vitro on an artificial medium for experimental research.
Clone ?? A line of cells that is genetically identical to the originating cell; in this case, a stem cell. Culture medium ?? The broth that covers cells in a culture dish, which contains nutrients to feed the cells as well as other growth factors that may be added to direct desired changes in the cells. Differentiation ?? The process whereby an unspecialized early embryonic cell acquires the features of a specialized cell such as a heart, liver, or muscle cell. Directed differentiation ?? Manipulating stem cell culture conditions to induce differentiation into a particular cell type. Ectoderm ?? Upper, outermost layer of a group of cells derived from the inner cell mass of the blastocyst; it gives rise to skin nerves and brain.
Embryo ?? In humans, the developing organism from the time of fertilization until the end of the eighth week of gestation, when it becomes known as a fetus. Embryoid bodies ?? Clumps of cellular structures that arise when embryonic stem cells are cultured.
Embryonic stem cells ?? Primitive (undifferentiated) cells from the embryo that have the potential to becomea wide variety of specialized cell types.
Embryonic stem cell line ?? Embryonic stem cells, which have been cultured under in vitro conditions that allow proliferation without differentiation for months to years.
Endoderm ?? Lower layer of a group of cells derived from the inner cell mass of the blastocyst; it gives rise tolungs and digestive organs. Gene ?? A functional unit of heredity that is a segment of DNA located in a specific site on a chromosome.
Human embryonic stem cell ?? A type of pluripotent stem cell derived from the inner cell mass of the blastocyst.
In vitro fertilization ?? An assisted reproduction technique in which fertilization is accomplished outside the body. Long-term self-renewal ?? The ability of stem cells to renew themselves by dividing into the same non-specialized cell type over long periods (many months to years) depending on the specific type of stem cell.
Mesoderm ?? Middle layer of a group of cells derived from the inner cell mass of the blastocyst; it gives rise tobone, muscle, and connective tissue. Microenvironment ?? The molecules and compounds such as nutrients and growth factors in the fluid surrounding a cell in an organism or in the laboratory, which are important in determining the characteristicsof the cell.
Neural stem cell ?? A stem cell found in adult neural tissue that can give rise to neurons, astrocytes, and oligodendrocytes. Oligodendrocyte ?? A cell that provides insulation to nerve cells by forming a myelin sheath around axons.
Plasticity ?? The ability of stem cells from one adult tissue to generate the differentiated cell types of another tissue.
Pluripotent ?? Ability of a single stem cell to develop into many different cell types of the body. Proliferation ?? Expansion of a population of cells by the continuous division of single cells into two identical daughter cells. Regenerative or reparative medicine ?? A treatment in which stem cells are induced to differentiate into the specific cell type required to repair damaged or depleted adult cell populations or tissues. Signals ?? Internal and external factors that control changes in cell structure and function. Stem cells ?? Cells with the ability to divide for indefinite periods in culture and to give rise to specialized cells.
Stromal cells ?? Non-blood cells derived fromblood organs, such as bone marrow or fetal liver, whichare capable of supporting growth of blood cells in vitro. Subculturing ?? The process of growing and replating cells in tissue culture for many months. Surface markers ?? Surface proteins that are unique to certain cell types, which are visualized using antibodies or other detection methods.
Transdifferentiation ?? The observation that stem cells from one tissue may be able to differentiate into cells of another tissue. Trophoblast ?? The extraembryonic tissue responsible for implantation, developing into the placenta, and controlling the exchange of oxygen and metabolites between mother and embryo.
The Chlorella ( Micro Green Algae ) is the most diverse group of algae, with more than seven thousand ( 7000 ) species growing in a variety of habitats.
We have tightly controlled the temperature, humidity, hygiene day and night in order to cultivate the first grade quality chlorella. Many friends are interesting in our Chlorella and Spirulina, and intend to buy sample( s ) to test quality first.
After diluted, you can add some peppermint (or any herb spices), honey, or any fruits juice in it for a good taste. They lower blood glucose by blocking the reabsorption of glucose by SGLT2 in the proximal convoluted tubule of the kidneys, promoting excretion of excess glucose in the urine[1]. Effects of rifampin and mefenamic acid on the pharmacokinetics and pharmacodynamics of dapagliflozin. Lack of pharmacokinetic interactions between dapagliflozin and simvastatin, valsartan, warfarin or digoxin. At present there have been no published reports indicating an interaction between lithium and the SGLT-2 inhibitors. This promising area of science is also leading scientists to investigate the possibility of cell-based therapies to treat disease, which is often referred to as regenerative or reparative medicine. But like many expanding fields of scientific inquiry, research on stem cells raises scientific questions as rapidly as it generates new discoveries.
First, they are unspecialized cells that renew themselves for long periods through cell division. Scientists discovered ways to obtain or derive stem cells from early mouse embryos more than 20 years ago.
In the 3 to 5 day old embryo, called a blastocyst, a small group of about 30 cells called the inner cell mass gives rise to the hundreds of highly specialized cells needed to make up an adult organism. As scientists learn more about stem cells, it may become possible to use the cells not just in cell-based therapies, but also for screening new drugs and toxins and understanding birth defects. PD is caused by a progressive degeneration and loss of dopamine (DA)-producing neurons, which leads to tremor, rigidity, and hypokinesia (abnormally decreased mobility). When transplanted into the brains of a rat model of PD, these stem cell-derived DA neurons reinnervated the brains of the rat Parkinson model, released dopamine and improved motor function.
The successful generation of an unlimited supply of dopamine neurons could make neurotransplantation widely available for Parkinson's patients at some point in the future. Discovering the answers to these questions may make it possible to understand how cell proliferation is regulated during normal embryonic development or during the abnormal cell division that leads to cancer.


One of the fundamental properties of a stem cell is that it does not have any tissue-specific structures that allow it to perform specialized functions. Unlike muscle cells, blood cells, or nerve cells ?? which do not normally replicate themselves ?? stem cells may replicate many times.
It has taken scientists many years of trial and error to learn to grow stem cells in the laboratory without them spontaneously differentiating into specific cell types.
When unspecialized stem cells give rise to specialized cells, the process is called differentiation. For example, are the internal and external signals for cell differentiation similar for all kinds of stem cells? A blood-forming adult stem cell in the bone marrow, for example, normally gives rise to the many types of blood cells such as red blood cells, white blood cells and platelets.
What stages of early embryonic development are important for generating embryonic stem cells? Specifically, embryonic stem cells are derived from embryos that develop from eggs that have been fertilized in vitro ?? in an in vitro fertilization clinic ?? and then donated for research purposes with informed consent of the donors. Human embryonic stem cells are isolated by transferring the inner cell mass into a plastic laboratory culture dish that contains a nutrient broth known as culture medium. Another important test is for the presence of a protein called Oct-4, which undifferentiated cells typically make. This is a method to assess whether the chromosomes are damaged or if the number of chromosomes has changed.
Teratomas typically contain a mixture of many differentiated or partly differentiated cell types ?? an indication that the embryonic stem cells are capable of differentiating into multiple cell types. But if cells are allowed to clump together to form embryoid bodies, they begin to differentiate spontaneously. Diseases that might be treated by transplanting cells generated from human embryonic stem cells include Parkinson's disease, diabetes, traumatic spinal cord injury, Purkinje cell degeneration, Duchenne's muscular dystrophy, heart disease, and vision and hearing loss. The primary roles of adult stem cells in a living organism are to maintain and repair the tissue in which they are found. Scientists have found adult stem cells in many more tissues than they once thought possible.
In the 1960s, researchers discovered that the bone marrow contains at least two kinds of stem cells. Despite these reports, most scientists believed that new nerve cells could not be generated in the adult brain. One important point to understand about adult stem cells is that there are a very small number of stem cells in each tissue.
Some examples of potential treatments include replacing the dopamine-producing cells in the brains of Parkinson's patients, developing insulin-producing cells for type I diabetes and repairing damaged heart muscle following a heart attack with cardiac muscle cells.
Scientists tend to show either that a stem cell can give rise to a clone of cells in cell culture, or that a purified population of candidate stem cells can repopulate the tissue after transplant into an animal. Adult stem cells may also exhibit the ability to form specialized cell types of other tissues, which is known as transdifferentiation or plasticity. In a living animal, adult stem cells can divide for a long period and can give rise to mature cell types that have characteristic shapes and specialized structures and functions of a particular tissue. The epidermal stem cells give rise to keratinocytes, which migrate to the surface of the skin and form a protective layer. If such mechanisms can be identified and controlled, existing stem cells from a healthy tissue might be induced to repopulate and repair a diseased tissue ( Figure 3 ). What are the signals that regulate the proliferation and differentiation of stem cells that demonstrate plasticity? Of course, adult and embryonic stem cells differ in the number and type of differentiated cells types they can become. This is an important distinction, as large numbers of cells are needed for stem cell replacement therapies. The use of the patient's own adult stem cells would mean that the cells would not be rejected by the immune system. However, whether the recipient would reject donor embryonic stem cells has not been determined in human experiments.
What are the potential uses of human stem cells and the obstacles that must be overcome before these potential uses will be realized? However, there are many technical hurdles between the promise of stem cells and the realization of these uses, which will only be overcome by continued intensive stem cell research. A primary goal of this work is to identify how undifferentiated stem cells become differentiated. For example, new medications could be tested for safety on differentiated cells generated from human pluripotent cell lines. Today, donated organs and tissues are often used to replace ailing or destroyed tissue, but the need for transplantable tissues and organs far outweighs the available supply. Preliminary research in mice and other animals indicates that bone marrow stem cells, transplanted into a damaged heart, can generate heart muscle cells and successfully repopulate the heart tissue. New studies indicate that it may be possible to direct the differentiation of human embryonic stem cells in cell culture to form insulin-producing cells that eventually could be used in transplantation therapy for diabetics. The blastocyst consists of a sphere made up of an outer layer of cells (the trophectoderm), a fluid-filled cavity (the blastocoel), and a cluster of cells on the interior (the inner cell mass). This continuous process allows a population of cells to increase in number or maintain its numbers. DNA carries the instructions for making all the structures and materials the body needs to function. These cells give rise to the embryonic disk of the later embryo and, ultimately, the fetus.
A number of celltypes come from mesenchymal stem cells, includingchondrocytes, which produce cartilage. Stromal cells that make this matrix within the bone marrow are also derived from mesenchymal stem cells. Like the plants, they use to capture light energy to fuel the manufacture of sugars, but unlike plants they are primarily aqutic.
According to the condition of growing of Algae, we do three stages in indoor Flask Seed cultivation ( small, medium and large Flasks ), and three stages in outdoor Pool cultivation ( small, medium and large pools ). A third SGLT2 inhibitor, empagliflozin, is due to be launched in the UK in autumn 2014.This article looks at known and potential interactions with both canagliflozin and dapagliflozin. As the use of SGLT-2 inhibitors becomes more established, further information regarding drug interactions might come to light.Monitoring of lithium concentrations should be carried out routinely, but if you are concerned, for patients newly started on an SLGT-2 inhibitor, it might be worth considering monitoring them more closely initially. The second is that under certain physiologic or experimental conditions, they can be induced to become cells with special functions such as the beating cells of the heart muscle or the insulin-producing cells of the pancreas.
Many years of detailed study of the biology of mouse stem cells led to the discovery, in 1998, of how to isolate stem cells from human embryos and grow the cells in the laboratory. In the developing fetus, stem cells in developing tissues give rise to the multiple specialized cell types that make up the heart, lung, skin, and other tissues.
It is thought that PD may be the first disease to be amenable to treatment using stem cell transplantation. Much of the information included here is about stem cells derived from human tissues, but some studies of animal-derived stem cells are also described. Importantly, such information would enable scientists to grow embryonic and adult stem cells more efficiently in the laboratory. For example, it took 20 years to learn how to grow human embryonic stem cells in the laboratory following the development of conditions for growing mouse stem cells. Scientists are just beginning to understand the signals inside and outside cells that trigger stem cell differentiation. Can specific sets of signals be identified that promote differentiation into specific cell types? Until recently, it had been thought that a blood-forming cell in the bone marrow ?? which is called a hematopoietic stem cell ?? could not give rise to the cells of a very different tissue, such as nerve cells in the brain. The process of replating the cells is repeated many times and for many months, and is called subculturing. Scientists inspect the cultures through a microscope to see that the cells look healthy and remain undifferentiated.
Oct-4 is a transcription factor, meaning that it helps turn genes on and off at the right time, which is an important part of the processes of cell differentiation and embryonic development.


This finding has led scientists to ask whether adult stem cells could be used for transplants.
One population, called hematopoietic stem cells, forms all the types of blood cells in the body. It was not until the 1990s that scientists agreed that the adult brain does contain stem cells that are able to generate the brain's three major cell types ?? astrocytes and oligodendrocytes, which are non-neuronal cells, and neurons or nerve cells. Stem cells are thought to reside in a specific area of each tissue where they may remain quiescent (non-dividing) for many years until they are activated by disease or tissue injury. Recently, by infecting adult stem cells with a virus that gives a unique identifier to each individual cell, scientists have been able to demonstrate that individual adult stem cell clones have the ability to repopulate injured tissues in a living animal. This ability to differentiate into multiple cell types is called plasticity or transdifferentiation. Why do they remain in an undifferentiated state when all the cells around them have differentiated? This represents a significant advantage as immune rejection is a difficult problem that can only be circumvented with immunosuppressive drugs.
Stem cells, directed to differentiate into specific cell types, offer the possibility of a renewable source of replacement cells and tissues to treat diseases including Parkinson's and Alzheimer's diseases, spinal cord injury, stroke, burns, heart disease, diabetes, osteoarthritis, and rheumatoid arthritis.
Other recent studies in cell culture systems indicate that it may be possible to direct the differentiation of embryonic stem cells or adult bone marrow cells into heart muscle cells ( Figure 4 ).
Neurons function by the initiation and conduction of impulses and transmit impulses to other neurons or cells by releasing neurotransmitters at synapses. Produced experimentally in animals by injectingpluripotent stem cells, in order to determine the stem cells' abilities to differentiate into various types of tissues. She completed her pre-registration year in Ashford, Kent before working as a community pharmacist for several years.
In 2013 she worked within the Pharmacovigilance team at the Medicines and Healthcare Regulatory Agency. In some adult tissues, such as bone marrow, muscle, and brain, discrete populations of adult stem cells generate replacements for cells that are lost through normal wear and tear, injury, or disease. Factors that support this notion include the knowledge of the specific cell type (DA neurons) needed to relieve the symptoms of the disease. However, unspecialized stem cells can give rise to specialized cells, including heart muscle cells, blood cells, or nerve cells. A starting population of stem cells that proliferates for many months in the laboratory can yield millions of cells.
Therefore, an important area of research is understanding the signals in a mature organism that cause a stem cell population to proliferate and remain unspecialized until the cells are needed for repair of a specific tissue. The internal signals are controlled by a cell's genes, which are interspersed across long strands of DNA, and carry coded instructions for all the structures and functions of a cell. Addressing these questions is critical because the answers may lead scientists to find new ways of controlling stem cell differentiation in the laboratory, thereby growing cells or tissues that can be used for specific purposes including cell-based therapies. However, a number of experiments over the last several years have raised the possibility that stem cells from one tissue may be able to give rise to cell types of a completely different tissue, a phenomenon known as plasticity. The embryos from which human embryonic stem cells are derived are typically four or five days old and are a hollow microscopic ball of cells called the blastocyst. The inner surface of the culture dish is typically coated with mouse embryonic skin cells that have been treated so they will not divide. Although spontaneous differentiation is a good indication that a culture of embryonic stem cells is healthy, it is not an efficient way to produce cultures of specific cell types.
Unlike embryonic stem cells, which are defined by their origin (the inner cell mass of the blastocyst), the origin of adult stem cells in mature tissues is unknown.
In fact, adult blood forming stem cells from bone marrow have been used in transplants for 30 years.
The adult tissues reported to contain stem cells include brain, bone marrow, peripheral blood, blood vessels, skeletal muscle, skin and liver. The following list offers examples of adult stem cell plasticity that have been reported during the past few years. Adult stem cells are generally limited to differentiating into different cell types of their tissue of origin. Some of the most serious medical conditions, such as cancer and birth defects, are due to abnormal cell division and differentiation. She then became a medicines management pharmacist at a Primary Care Trust in Kent where she undertook her Clinical Diploma.
However, both canagliflozin and dapagliflozin are extensively metabolised by the UDP-glucuronosyltransferase enzyme UGT1A9.Rifampicin, a multiple enzyme inducer (possibly including UGT1A9), decreases the patienta€™s exposure to dapagliflozin and canagliflozin by 22% and 51%, respectively[1],[2],[6].
The embryos used in these studies were created for infertility purposes through in vitro fertilization procedures and when they were no longer needed for that purpose, they were donated for research with the informed consent of the donor. In addition, several laboratories have been successful in developing methods to induce embryonic stem cells to differentiate into cells with many of the functions of DA neurons.
If the resulting cells continue to be unspecialized, like the parent stem cells, the cells are said to be capable of long-term self-renewal. Such information is critical for scientists to be able to grow large numbers of unspecialized stem cells in the laboratory for further experimentation.
The external signals for cell differentiation include chemicals secreted by other cells, physical contact with neighboring cells, and certain molecules in the microenvironment.
Examples of such plasticity include blood cells becoming neurons, liver cells that can be made to produce insulin, and hematopoietic stem cells that can develop into heart muscle. After six months or more, the original 30 cells of the inner cell mass yield millions of embryonic stem cells. Certain kinds of adult stem cells seem to have the ability to differentiate into a number of different cell types, given the right conditions. Stromal cells are a mixed cell population that generates bone, cartilage, fat, and fibrous connective tissue.
However, some evidence suggests that adult stem cell plasticity may exist, increasing the number of cell types a given adult stem cell can become.
A better understanding of the genetic and molecular controls of these processes may yield information about how such diseases arise and suggest new strategies for therapy. But, the availability of pluripotent stem cells would allow drug testing in a wider range of cell types. Claire started at the Pharmaceutical Press in 2007 as a Staff Editor on the British National Formulary and later became an Assistant Editor. However, this decrease is likely to only be clinically important for canagliflozin.Glycaemic control should be monitored in patients who require canagliflozin and rifampicin concurrently. Therefore, exploring the possibility of using adult stem cells for cell-based therapies has become a very active area of investigation by researchers.
The reason for having the mouse cells in the bottom of the culture dish is to give the inner cell mass cells a sticky surface to which they can attach. Embryonic stem cells that have proliferated in cell culture for six or more months without differentiating, are pluripotent, and appear genetically normal, are referred to as an embryonic stem cell line.
If this differentiation of adult stem cells can be controlled in the laboratory, these cells may become the basis of therapies for many serious common diseases.
A significant hurdle to this use and most uses of stem cells is that scientists do not yet fully understand the signals that turn specific genes on and off to influence the differentiation of the stem cell. However, to screen drugs effectively, the conditions must be identical when comparing different drugs.
Therefore, scientists will have to be able to precisely control the differentiation of stem cells into the specific cell type on which drugs will be tested. Recently, scientists have begun to devise ways of growing embryonic stem cells without the mouse feeder cells. Current knowledge of the signals controlling differentiation fall well short of being able to mimic these conditions precisely to consistently have identical differentiated cells for each drug being tested.
This is a significant scientific advancement because of the risk that viruses or other macromolecules in the mouse cells may be transmitted to the human cells.



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