Conclusion:  Meta-analyses have an important role in the implementation of evidence-based practice and shaping of future research. Despite the undoubted advantages, meta-analyses are no panacea. Caution, therefore, has to be applied when using the results of meta-analyses in clinical practice, due to methodological limitations of the meta-analyses and limitations in the primary studies used. “
“Osteoarthritis (OA) of the knee

is a common, debilitating condition. Twelve percent of people aged 60 years or older have symptomatic knee OA. With increasing global incidence of obesity, the prevalence of OA is set to dramatically rise Cartilage deterioration is a hallmark of the disease, but other areas are equally as important, such as changes to the subchondral bone. Magnetic resonance imaging (MRI) has enabled us to view bone marrow lesions (BMLs) in selleck compound the subchondral bone, allowing progress to be made in understanding their natural history, effect on pain, structural deterioration and other factors. The focus of this review is to try to put a new clinical perspective for the patients with BMLs in relation to pain, functional decline and prognosis. “
“Aim:  To test whether treatment

with celecoxib reduces the incidence of gastroduodenal click here ulcers compared to diclofenac in Asian patients with osteoarthritis (OA) or rheumatoid arthritis (RA) with minimal significant risk factors. Methods:  Patients with a clinical diagnosis of OA or RA of at least 3 months were randomized to 12 weeks of double-blind treatment with celecoxib 100 mg twice daily (n = 440) or diclofenac 50 mg twice

daily (n = 440). The primary outcome was the gastric and/or duodenal ulcer rate at endpoint as determined by upper gastrointestinal endoscopy performed during the screening week, Inositol monophosphatase 1 and at endpoint. Results:  There was no significant difference in the overall incidence of gastroduodenal ulcers at 12-week endpoint for celecoxib compared to diclofenac (2.8%vs. 5.1%; Cochran–Mantel–Haenszel [CMH] χ2P = 0.083). However, there was a significantly lower incidence of gastric ulcers on celecoxib versus diclofenac (0.5%vs. 3.6%; CMH χ2P = 0.002). Approximately 59% of patients in both treatment groups had no visible gastric lesions at endpoint; and a similar proportion were found to have one or more erosions on celecoxib (n = 85; 21.4%) and diclofenac (N = 91; 23.3%). A survival analysis of time to ulcer was significant for gastric ulcers (log-rank P = 0.004), but not for duodenal ulcers, or for gastroduodenal ulcers combined. Fewer patients reported at least one adverse event on celecoxib compared to diclofenac (42.4%vs. 50.3%; χ2, 5.52; P = 0.019). Conclusions:  In Asian patients with minimal significant risk factors, treatment with celecoxib was associated with a modest but significantly reduced incidence of gastric ulcers at the end of 12 weeks.

In the hypertrophic stage of rhinoscleroma, both T1- and T2-weighted images show characteristic mild-to-marked high signal intensity.[6] Nasal endoscopy may reveal signs of all three stages of rhinoscleroma and aids accurate diagnosis based on histopathological

buy SGI-1776 examination and isolation of K rhinoscleromatis in culture.[7] A positive culture in MacConkey agar is diagnostic of rhinoscleroma, but it is positive in only 50 to 60% of patients. The diagnosis is confirmed by histology. Classic histopathologic findings include plasma cells and large vacuolated Mikulicz cells with clear cytoplasm that contains bacilli and Russell bodies (which are transformed plasma cells). Treatment of rhinoscleroma requires a combination of appropriate antibiotics and surgical debridement if there is significant airway obstruction. The results of current treatment are unsatisfactory and recurrence often occurs.[8] Moreover, no randomized controlled trials exist to compare various antibiotic treatment choices and their efficacy.[8, 9] De Pontual and colleagues in their retrospective series of 11

patients report a treatment duration of 3 to 9 months with ciprofloxacin (7 patients), ceftriaxone (2), tetracycline (2), and clofazimine (2). Relapses occurred in 3 of the 11 patients. They recommend fluoroquinolones as the first drug of choice, because of its good activity against Gram-negative bacilli, intracellular efficacy, and low toxicity profile.[10] Gaafar and colleagues in their

retrospective case series of 56 cases over 10 years report a medical http://www.selleckchem.com/products/epz015666.html treatment duration of 3 months with a combination of co-trimoxazole and rifampicin. Since 2003, this was replaced by ciprofloxacin for 3 months. Results were disappointing, as a high incidence of recurrence was found reaching L-NAME HCl up to 25% within 10 years.[8] Fawaz and colleagues in their study of 88 cases report a treatment duration of 4 to 20 weeks with rifampicin (63 patients), co-trimoxazole (11), and ciprofloxacin (14). Relapses occurred in 24 out of 88 patients (27%).[11] Recently, Suchanova and colleagues in their study of three cases suggest that management with long-term antibiotics (3–6 months) with the fewest side effects (ciprofloxacin and co-trimoxazole) plus or minus surgical debridement is the mainstay of therapy.[2] Zhong and colleagues in their retrospective case series of 40 patients over 30 years report that 27 patients remained relapse-free 1 to 10 years following treatment with antibiotics supplemented in some cases with surgery or radiotherapy.[12] Tan and colleagues in their study of four cases recommend a treatment regime consisting of a combination of ciprofloxacin and doxycycline for at least 6 months.[13] The cases of recurrences reported in the literature are not associated with any particular treatment regimen.

SensiMixPlus (Quantace, Norwood, MA) was used for real-time RT-PCR with the following set of primers: eapRTFwd (5′-ATCAAAAGCGAATGCAGAGC-3′) and eapRTRev, or nptaseRTFwd and nptaseRTRev (5′-AGAATCACGCAGACAAATGG-3′), or 16SRTFwd (5′-TCCGGAATTATTGGGCGTAA-3′) and 16SRTRev. Control reactions lacked RT enzyme to ensure that DNA contamination was minimal. Biofilm assays were performed essentially as described previously (Christensen et al., 1985). Strains were cultured in

96-well tissue culture-treated polystyrene plates (Greiner, Monroe, NC) in TSB, TSB supplemented with 1% glucose (TSBG), TSBG supplemented with 3% NaCl selleckchem (TSBGN), TSB or TSBG supplemented with 5% human serum, brain–heart infusion broth (BHI), BHI containing 1% glucose (BHIG), and BHI or BHIG containing 5% serum. To analyze the effect of pH, TSB was buffered with 100 mM Tris, pH 5.5 or 9.0. Cultures were incubated in the polystyrene plates under static conditions at 37 °C for 24 h before removal of nonadherent bacteria. For complementation assays, 1 mM IPTG was added to the media used to culture all strains and 10 mg chloramphenicol mL−1 was added to the strains containing pCL15 plasmids. Nonadherent bacteria Belnacasan mw were removed by gentle washing with

phosphate-buffered saline and adherent bacteria (biofilms) were dried and stained with safranin and photographed. For a more quantitative measure of biofilm formation, the safranin was released from the biofilms with 30% acetic acid and the OD470 nm was determined using an enzyme-linked immunosorbent assay plate spectrophotometer. We tested the biofilm-forming activity of wild-type SA113 and the eap and nptase deletion mutants in a variety of media. Figure 1 shows that there was no significant role for Chloroambucil EAP or Nptase in biofilm formation in TSB, TSBG, TSBGN, BHI, or BHIG. We hypothesized that because EAP binds to serum proteins and inclusion of serum in the growth medium might alter the role for EAP in biofilm formation. We found that while 5% human serum

augmented biofilm formation (Fig. 1), higher concentrations of serum actually inhibited the biofilm-forming ability of SA113 (data not shown). Interestingly, EAP and Nptase were required for biofilm formation in the presence of 5% serum (P-values for the difference between SA113 vs. SA113Δeap∷erm and SA113 vs. SA113Δnptase∷erm calculated using Student’s t-test were <0.0001). When TSBG was supplemented with 5% human serum, the requirement for EAP and Nptase was substantially reduced, but the difference between wild-type and deletion mutant strains was still significant (for SA113 vs. SA113Δeap∷erm, P=0.005 and for SA113 vs. SA113Δnptase∷erm, P=0.0016). Glucose is known to induce the production of PNAG/PIA; therefore, PNAG/PIA production may partially obviate the need for the serum protein-binding effect of EAP. However, both EAP and Nptase were required for biofilm formation in BHIG containing 5% serum.

2 g in 100 mL of 2 N HCl). The mixtures were incubated for 30 min at 30 °C, after which 2 mL of 2 N NaOH was added. The A540 nm was measured.

ACCD activity was evaluated quantitatively by measuring the amount of α-ketobutyrate produced by the deamination of ACC. ACCD activity was expressed in μmol of α-ketobutyrate mg−1 protein h−1 . Protein selleck concentrations were determined using the BioRad (Promega) reagent. Three independent replicate flasks were analyzed. The experiment was repeated three times. To evaluate ACCD activity and expression in mycelia induced by plant interaction, 1 g sterile cucumber root tissue was added to fungus cultures (previously grown in rich SM) in SM with no ammonium or carbon sources. Canola (Brassica napus cv. SARI) seeds (1 g=200 seeds) were surface sterilized (10 min in 1.5% sodium hypochlorite) and incubated for 1 h at room temperature either in sterile 0.03 M MgSO4 as a blank control, in Trichoderma fungal spores (109 g per seeds) or in a bacterial suspension of P. putida UW4 or E. coli tac∷Tas-acdS, at OD600 nm=0.5. The E. coli ACCD overexpressors were tested with and without isopropyl-β-d-1-thiogalactopyranoside (IPTG) induction of the transcription of the tac promoter. selleck chemicals llc Six seeds were placed in each seed-pack growth pouch (125 × 157 mm; Mega International) filled with 12 mL of distilled water. Ten replicate pouches were used

for each treatment. The assay was repeated three independent times. The pouches were incubated upright in a plastic tray partially filled with water at 25 °C in a growth chamber with a 12-h photoperiod and a light intensity of 12.9 μmol m−2 s−1. After 4–5 days, the seedling root length was measured. Root colonization assays were performed according to Viterbo et al.(2005). Briefly, at the end of pouch assay experiments, canola roots were sterilized in 1% NaOCl for 2 min, washed with sterile-distilled water, weighed and homogenized using an ULTRA-TURRAX apparatus (Janke & Kunkel) in 20 mL of water for 1 min. Serial dilutions were plated for CFU counts on Trichoderma selective medium

(Vargas Gil et al., 2009) at 28 °C. jmp8 software (SAS Ceramide glucosyltransferase Institute Inc., Cary, NC) was used for statistical analyses. Data were analyzed using one-way anova. Mean comparisons were made using the Tukey–Kramer honestly significant difference multiple range test at P<0.05. Degenerate primers designed according to conserved amino acid sequences (VQEHWVDW and AFITDPVYEG) of fungal ACCDs (see Material and methods) enabled isolation of a 650-bp DNA fragment. Segments 750-bp and 250-bp long, of the upstream and downstream regions, respectively, were obtained by nested PCR amplification with specific primers according to the Genome Walker procedure (Viterbo et al., 2002). The Tas-acdS ORF encodes a 348-amino acid protein with an expected molecular mass of 37 kDa. blast search shows extensive homology to fungal and bacterial ACCD sequences. Figure 1 shows an alignment of ACCD from T.

With this in mind, we investigated whether changes in ADMA levels (Δ-ADMA) at an altitude of 4000 m can predict an individual’s susceptibility to AMS or HAPE. Twelve subjects spent two nights in a hypobaric chamber, the first night without exposure to altitude conditions and the second night at a simulated altitude of 4000 m. At identical

time points during both nights (after 2, 5, and 11 hours), we determined ADMA serum levels, PAP by Doppler echocardiography and estimated hypoxia Wortmannin solubility dmso related symptoms by Lake Louise Score (LLS). Contrary to our initial hypothesis, subjects with a marked increase in ADMA at 4000 m showed PAP levels below the critical threshold for HAPE and were not affected by AMS. By contrast, subjects with a decrease in ADMA suffered from AMS and had PAP levels above 40 mmHg. After 2 hours of hypoxia we found a significant relationship between Δ-PAP t2 (Spearmans ρ = 0.30, p ≤ 0.05) respectively Δ-ADMA t2 (ρ = −0.92, p ≤ 0.05) and LLS. After 2 hours of hypoxia, the Δ-ADMA (positive or negative) can predict an LLS of >5 with a sensitivity of 80% and a specificity of 100% and can help assess

Natural Product Library cell assay the risk of an increase in PAP to more than 40 mmHg and thus the risk of HAPE (ϕ coefficient: 0.69; p ≤ 0.05). Worldwide, 40 million tourists are at risk of getting acute mountain sickness (AMS) each year, because they travel to altitudes of higher than 2500 m (AMS-incidence at altitudes of 2500–3000

m: 10–30%).[1-4] In general, the following conditions are distinguished: AMS, high-altitude cerebral edema (HACE), and high-altitude pulmonary edema (HAPE). An increase in pulmonary artery pressure (PAP), which is subject to individual differences, plays a crucial role in the development of HAPE.[5] The risk of developing HAPE increases massively when PAP exceeds 40 mmHg.[6] The measurement of PAP by Doppler echocardiography usually allows individuals at Sodium butyrate risk of developing HAPE to be identified, especially in the setting of hypoxia.[7] For methodological reasons, however, Doppler echocardiography can be used only in individuals with (at least minor) tricuspid valve insufficiency. Although this insufficiency is often seen in association with an altitude-induced increase in PAP, high-altitude medical research has revealed the absence of tricuspid reflux in 5–30% of the subjects.[8] In addition, this method requires an experienced examiner and the availability of a suitable (mobile) system. This explains the need for simpler procedures. Against this background, the measurement of serum levels of asymmetric dimethylarginine (ADMA) may provide a new diagnostic approach. ADMA is a potent inhibitor of nitric oxide synthase (NOS). By increasing cyclic guanosine monophosphate (cGMP), nitric oxide (NO) causes smooth muscle relaxation and therefore induces rapid vasodilatation.

We, and other members of the Swedish national group for recommendations on malaria prophylaxis,22 therefore consider doxycycline at least as safe as mefloquine for use as malaria prophylaxis during early pregnancy. This will add doxycycline

as a choice for pregnant women, especially for those who do not tolerate mefloquine or who travel to areas with resistance to mefloquine. The authors state that they have no conflicts of interest to declare. “
“Schistosoma haematobium infection is mainly associated with urinary schistosomiasis. Here, we describe two cases of S haematobium infection in workers returning to China from Tanzania and Angola. They had hematuria and were misdiagnosed as having tuberculosis or tumor of the bladder. The diagnosis was established by discovery of eggs in the urine. Schistosoma haematobium is an important zoonotic parasite associated mainly with urinary schistosomiasis. Infection in humans Protein Tyrosine Kinase inhibitor occurs by skin contact with cercaria-contaminated freshwater during swimming, fishing, and bathing. The U0126 in vivo cercariae burrow into the skin and enter the blood stream of the host where they migrate to the sinusoids of liver to mature into adults. Then, they migrate from that organ and reach the vesical, prostatic, and uterine plexuses by way of the hemorrhoidal veins. Eggs deposited by them in the wall of the urinary bladder and other

organs may cause a granulomatous response Dapagliflozin in the host. The main clinical manifestations of S haematobium infection are hematuria, urinal tract blockages, and fibrosis of the bladder.[1] Schistosoma haematobium infection is endemic to 53 countries and is confined to Africa, the Middle East, India, and Portugal. With economic globalization and rapid development of tourism, the movement of population has become increasingly frequent, which has made possible the spread of this infection to nonendemic countries. In England, France, Italy, Germany, Israel, Denmark, and the

Netherlands, imported schistosomiasis haematobium has been happening for decades.[2-5] However, it is a relatively recent phenomenon in China and other Asian countries.[6] In Africa, it is estimated that there are about 1 million Chinese workers employed mainly in building, water supplying, oil exploiting, and road paving.[7, 8] But, the knowledge of African diseases is lacking among Chinese workers, as well their physicians. As a result, when they are exposed in Africa and present clinical manifestations after returning to China, they are often misdiagnosed. From 2005 to 2009, 17 imported falciparum malaria cases (with one death) in workers returning to Henan Province of China from Africa were misdiagnosed for more than 1 week.[9] In this article, we report two imported cases of S haematobium infection in workers returning to China from Tanzania and Angola.

Community pharmacy was seen to offer incomplete services which did not co-ordinate well with other primary-care services. The pharmacy environment and retail setting were not considered to be ideal for private healthcare consultations. This study suggests that despite recent initiatives to extend the role of community pharmacists many members of the

general public continue to prefer a GP-led service. Importantly GPs inspire public confidence as well as offering comprehensive services and private consultation facilities. Improved communication and information sharing between community pharmacists and general practice could support community pharmacist-role find more expansion. “
“To explore the attributes of pharmacy choice for people with chronic conditions. Semi-structured interviews were conducted between May and October 2012, across four regions in three Australian states. Purposive sampling was used to recruit participants with chronic conditions and unpaid carers. Interviews were analysed via the constant comparison method. Ninety-seven interviews were conducted. The majority of participants were regular patrons of one pharmacy and five attributes influenced this choice: patient-centred care, convenience, price, personal trait or preference and service/medication need. Patient-centred

DZNeP care, such as providing individualised medication counselling, Urease continuity of care, development of relationships and respectful advice, emerged as an important attribute. There was minimal discussion as to choosing a pharmacy based on the provision of professional services, underscoring the limited consumer knowledge of such services and related standards of care. Patient-centred care is an important attribute of quality care as perceived by people who are regular community pharmacy users. These findings highlight the need for pharmacy staff to implement a patient-centred approach to care, thus meeting the perceived needs of their customers. A greater effort is also necessary to raise the profile of pharmacy

as a healthcare destination. “
“The aim of this study was to examine pharmacists’ perceptions of their professional identity, both in terms of how they see themselves and how they think others view their profession. A qualitative study was undertaken, using group and individual interviews with pharmacists employed in the community, hospital and primary care sectors of the profession in England. The data were recorded, transcribed verbatim and analysed using the framework method. Forty-three pharmacists took part in interviews. A number of elements help determine the professional identities of pharmacists, including attributes (knowledge and skills), personal traits (aptitudes, demeanour) and orientations (preferences) relating to pharmacists’ work.

Sulfate was quantified turbidimetrically as a suspension of BaSO4 (Sörbo, 1987). 3-Sulfolactate Doxorubicin price was quantified by ion chromatography (IC) with the conditions described for sulfoacetate (Denger et al., 2004). DHPS was assayed qualitatively by the reaction of DHPS dehydrogenase [HpsN (EC 1.1.1.308) catalyzes the NAD+-dependent oxidation of DHPS to sulfolactate] from the soluble fraction of C. pinatubonensis JMP134 (Mayer et al., 2010). The reaction mixture contained in 50 mM Tris/HCl,

pH 9.0, 2 mM NAD+, soluble fraction (about 0.3 mg protein mL−1) and outgrown medium of K. oxytoca TauN1 after growth with sulfoquinovose. Standard methods were used for the Gram reaction and to assay catalase or cytochrome c-oxidase activity (Gerhardt et al., 1994). SQ was assayed with a colorimetric assay for reducing sugars (2,3-dinitrosalicylic acid method; Sturgeon, 1990). SQ was quantified by HPLC after separation on a Nucleodur HILIC (hydrophylic-interaction liquid chromatography) column (125 × 3 mm) (Macherey-Nagel, Düren, Germany) and evaporative light-scattering detection (ELSD). The isocratic eluent was 0.1 M

ammonium acetate in 80 % acetonitrile with a flow rate of 0.5 mL min−1. Samples were dissolved in the eluent. Under those conditions, DHPS, taurine (2-aminoethanesulfonate), and glucose could also be analyzed directly in culture medium, which did not interfere with the analyses (Fig. 2); sulfolactate could also be quantified, but it interfered with the peak of sulfoquinovose. The chemical synthesis of SQ is simple: two hydroxyl groups of glucose are protected, and the hydroxyl group at C-6 tosylated Pexidartinib concentration and the tosyl group are displaced by sulfite. This yields two organic products, SQ and 4-toluenesulfonate, and, finally, Resminostat sodium sulfate. The problem is to separate the two organic products, in which we were not fully successful. The consequence was that all organisms, with which we worked, had to be checked for growth with 4-toluenesulfonate. No organism used in the work utilized (or was inhibited by) 4-toluenesulfonate. We initially assayed SQ, a reducing sugar, with a standard method (Sturgeon, 1990) (e.g. Fig. 3). At low concentrations

of sugar, the standard curve is, indeed, a curve and the interpolation had to be made manually. We required a different method, IC, for the metabolic product, 3-sulfolactate (Fig. 3), which eluted on the tail of the peak for sulfate (not shown). These methods were just adequate (Fig. 3), but inadequate for the next product, DHPS, which we could not detect by IC. What was needed was a detector which was sensitive for nonchromophores and a column which could separate highly polar compounds. The ELSD detector and the HILIC column met our demands (Fig. 2). We optimized the system for our purposes and had linear standard curves between 0 and 5 pmol per injection (R2 > 0.99); a fresh standard curve was needed with each set of experiments.

He had been working in Rukwa region of

Tanzania from April 2009 to March 2010 where he often went to Epigenetic inhibitor swim and bathe in Mpanda River and Tanganyika Lake. The hematuria started 2 weeks before his return from Tanzania. He was treated for suspected cystitis, which did not improve, and was admitted to a local hospital. Then, he was suspected to have tuberculosis of the urinary bladder. Despite antituberculosis treatment with pyrazinamide/isoniazid for 4 months, he still had the visible hematuria. On August 3, he was transferred to the urology department for further diagnosis and treatment. Physical examination revealed a healthy male with no abnormal signs on abdominal and genitourinary examination. The results of blood biochemical and hematological tests were normal. Cystoscopy was performed, and erosion and ulceration in the bladder trigone area were observed. Histological sections of the biopsy specimen showed a diffuse granulomatous process with an intense inflammatory infiltrate of mostly plasma lymphocytic cells, eosinophils, and neutrophils. Multinucleated giant cells were also found, but parasite eggs were not seen. Because Ponatinib in vitro of the suspected parasitic infection, 24-hour urine sample was collected and examined by sedimentation, which revealed nonglomerular red blood cells and eggs of S haematobium in the urine (Figure 1A). He was treated with praziquantel

tablet (40 mg/kg/day in three doses for a single day). Three weeks after treatment, hematuria disappeared and the eggs in the urine were eliminated. A 42-year-old man from Yuanyang county of Henan Province worked in Caxito city in Angola from April 2008 to April 2011. During GPX6 this period, he and his colleagues sometimes went swimming in Kwanza River. He complained of abdominal pain and hematuria 1 month after his return, and was first suspected

to have renal calculi at a local clinic. On July 29, 2011, he was admitted to a local central hospital with progressive hematuria. He was diagnosed with tumor of the bladder on the basis of cystoscopy. He underwent open laparotomy for resection of the mass. But, he still had visible hematuria 2 months after the surgery. On October 14, he was transferred to the urology department. Physical examination was unremarkable, as were blood biochemical and hematological tests. The subsequent abdominal ultrasound examination showed bladder wall irregularities and polyps; hydronephrosis of the right kidney and hydroureter were also observed. Eggs of S haematobium were found in the urine. Following this, formalin-fixed, paraffin-embedded tissue sections of the bladder resection specimen were re-examined and many S haematobium eggs were found in the eosinophilic granuloma (Figure 1B). He was treated then with praziquantel (same dosage as in case 1). After 1 month, the laboratory findings indicative of hematuria returned to normal.

It’s a bit like a diary’ (7) information included in the SPA needs to be endorsed by a trustworthy source, (8) SPA to include links for further advice including social networking facilities, ‘building something social into the app so kind of use the app to chat to other patients as well, share your feelings’ and (9) using the SPA would improve care and make patients feel more empowered, ‘it’s kind of empowering to be able to kind of log

your own process. The large volume of information given to patients has shown to be ineffective in dealing with patients’ information needs and ADR management, with patients feeling H 89 cut off from help once they are back at home. The use of an SPA is acceptable to patients for accessing information to manage ADRs as well as keeping in touch

with their healthcare team. These findings pave the way for the introduction of SPAs to support patients on oral chemotherapy with potential for pharmacists to take on the role of monitors, triaging alerts accordingly. 1. Nabhani-Gebara S, Kayyali R, Olszewska A. Patient Perception of Educational Materiel Surrounding their Cancer treatment. Eur J Oncol Nurs 2012; 16: S30. 2. Moretti F, van Vliet L, Bensing J, Deledda G, Mazzi M, Rimondini M,

Zimmermann C, Fletcher I. A standardized approach see more to qualitative content analysis of focus group discussions from different countries. Etomidate Patinet Educ Couns 2011; 82: 420–428. Michelle King, Fiona Kelly, Sara McMillan, Adem Sav, Jennifer Whitty, Amanda Wheeler Griffith University, Gold Coast, Queensland, Australia Pharmacy staff know little about the roles and needs of carers despite them being regular clients of the pharmacy The burden of being a carer may result in sacrifices, including the health of the carer Carers want information and assistance that can help relieve their burden Pharmacy can support the health needs of carers, and provide information and signposting to relevant services Carers are regular clients of community pharmacy but are often overlooked as pharmacy staff focus on the prescriptions or needs of the person they care for. Unless carers divulge information about their role and how it affects them, pharmacy staff are often oblivious to what that role entails. This lack of awareness may mean that opportunities to ease the carer’s burden are missed.