Transition to adult services: the current and potential role of the UK hospital pharmacist.

PURPOSE: To explore the current and potential role for UK pharmacists in the transition to adult services for young people with chronic health problems. METHODS: UK hospital pharmacists were surveyed using an online questionnaire with closed and open questions covering their involvement in a transition programme, demography and scope of work, experiences of transition, and the barriers encountered in providing an effective transition service. RESULTS: Overall, 74 pharmacists completed the questionnaire. Most were female (70% (52/74)), had ≥6 years of experience (62% (46/74)), were paediatric pharmacists (74% (55/74)), and were based in a teaching hospital practice setting (70% (52/74)). Many participants (57% (42/74)) had a transition programme in place in their hospital; of these, 55% (23/42) were not a part of the service. Respondents identified unique skills that pharmacists could contribute to the transition service, including knowledge of medications (including formulations and unlicensed medications), awareness of medication services beyond paediatrics, commissioning of medications, and familiarity with adult services. Most commonly identified barriers to transition included 'time constraints', 'pharmacists not involved as part of the wider multidisciplinary team', and 'lack of engagement between different services'. Pharmacists noted that their ideal transition service would include specific medication-related transition, for example, adherence, counselling, and supply of medications. CONCLUSIONS: These findings support the role of hospital pharmacists as crucial members of the multidisciplinary team required for transition. The skills and knowledge of the hospital pharmacist is under-utilised within the transition service, yet pharmacists are motivated and uniquely skilled healthcare professionals who have the potential to improve medicines transition.

In Vivo Human Single-Chain Fragment Variable Phage Display-Assisted Identification of Galectin-3 as a New Biomarker of Atherosclerosis.

Background Atherosclerosis is a complex pathology in which dysfunctional endothelium, activated leucocytes, macrophages, and lipid-laden foam cells are implicated, and in which plaque disruption is driven by many putative actors. This study aimed to identify accurate targetable biomarkers using new in vivo approaches to propose tools for improved diagnosis and treatment. Methods and Results Human scFv (single-chain fragment variable) selected by in vivo phage display in a rabbit model of atherosclerosis was reformatted as scFv fused to the scFv-Fc (single-chain fragment variable fused to the crystallizable fragment of immunoglobulin G format) antibodies. Their reactivity was tested using flow cytometry and immunoassays, and aorta sections from animal models and human carotid and coronary artery specimens. A pool of atherosclerotic proteins from human endarterectomies was co-immunoprecipitated with the selected scFv-Fc followed by mass spectrometry for target identification. Near-infrared fluorescence imaging was performed in Apoe-/- mice after injection of an Alexa Fluor 647-labeled scFv-Fc-2c antibody produced in a baculovirus system with 2 additional cysteine residues (ie, 2c) for future coupling to nano-objects for theranostic applications. One scFv-Fc clone (P3) displayed the highest cross-reactivity against atherosclerotic lesion sections (rabbit, mouse, and human) and was chosen for translational development. Mass spectrometry identified galectin-3, a ß-galactoside-binding lectin, as the leader target. ELISA and immunofluorescence assays with a commercial anti-galectin-3 antibody confirmed this specificity. P3 scFv-Fc-2c specifically targeted atherosclerotic plaques in the Apoe-/- mouse model. Conclusions These results provide evidence that the P3 antibody holds great promise for molecular imaging of atherosclerosis and other inflammatory pathologies involving macrophages. Recently, galectin-3 was proposed as a high-value biomarker for the assessment of coronary and carotid atherosclerosis.