Tag: Medication

Posted on

Efficacy of an e-Learning Module on Endocrine Disruptors for Family Medicine Residents: Matched Before-And-After Cohort Study

<strong>Background:</strong> Environmental factors account for 23% of global deaths and 25% of chronic diseases. In France, the Fourth National Environmental Health Plan prioritizes training health professionals in environmental health. Endocrine-disrupting chemicals (EDCs) are chemical substances that interfere with hormonal systems, contributing to a range of health effects. In 2024, the Primary Care and Environmental Health (PCEH) program at the University of Montpellier–Nîmes introduced an innovative e-learning module on EDCs for first-year family medicine residents. <strong>Objective:</strong> This study aimed to evaluate the impact of the PCEH e-learning module on participants’ satisfaction, knowledge, and self-reported behaviors regarding EDCs in household environments. <strong>Methods:</strong> This monocentric, matched before-and-after cohort study included all first-year family medicine residents at the University of Montpellier–Nîmes. The module, developed collaboratively by clinicians and educators, integrated interactive images, artificial intelligence–generated virtual rooms, short educational videos, games, and flash cards. Participants were assessed using pretraining and posttraining questionnaires administered immediately before and after the module. These questionnaires evaluated satisfaction (using a 5-point Likert scale), knowledge (using binary “yes” or “no” questions), and behaviors (using a 5-point Likert scale). Statistical analyses included the McNemar test for paired categorical variables and paired 2-tailed <i>t</i> tests for continuous variables, with a significance threshold set at a <i>P</i> value of less than .05. <strong>Results:</strong> This study aimed to evaluate the impact of an e-learning module on knowledge and behaviors related to endocrine disruptors. Our findings show significant improvements across all measured domains. Of 148 eligible residents, 78 (52.7%) completed both assessments over a 17-day period. Overall satisfaction was high (mean 4.0/5, SD 0.9), with positive ratings for the e-learning format (mean 4.1/5, SD 1.0) and module duration (mean 4.2/5, SD 1.0). Knowledge improved significantly, with a mean 55.56 (SD 13.54) increase in correct identification of EDCs across all substances (<i>P</i>&lt;.001). Self-reported behaviors improved by an average of 2.13 points (95% CI 1.71-2.56) on the 5-point scale (<i>P</i>&lt;.001), exceeding those reported in previous PCEH modules. Secondary outcomes showed high posttraining identification of at-risk populations and exposure locations, although recognition of some substances (eg, alkylphenols and phenoxyethanol) remained low. <strong>Conclusions:</strong> This innovative e-learning module significantly improved residents’ knowledge and preventive behaviors related to EDCs. These findings support the integration of environmental health training into medical curricula and highlight the potential of scalable e-learning interventions to strengthen preventive competencies in primary care.
Posted on

Mechanisms of action and advances in application of music therapy in improving cognitive impairment based on the theory of neuroplasticity

As global population aging accelerates, preventing and treating cognitive impairment has become a major public health priority. Music therapy is a safe, well-tolerated non-pharmacological intervention with substantial potential to improve cognitive function. This review synthesizes the neurologic music therapy (NMT) framework, encompassing techniques targeting attention, memory, and executive function, delivered through both active and receptive approaches. Clinical investigations indicate that music therapy may improve cognition and neuropsychiatric symptoms in Alzheimer’s disease (AD), vascular cognitive impairment (VCI), Parkinson’s disease–related cognitive impairment, mild cognitive impairment (MCI), and traumatic brain injury (TBI); however, effects appear to vary by intervention duration and disease stage. This narrative review aims to provide a theoretical foundation and practical guidance for the non-pharmacological intervention of cognitive impairment by collating evidence on the neuroplasticity theoretical foundations, technical systems, and clinical applications of music therapy.
Posted on

Genetic interaction of DISC1 and Neuroligin in regulation of glutamatergic synaptogenesis

Synaptic development and functionality have been considered as fundamental mechanisms underlying a range of neuropsychiatric disorders, including schizophrenia. Emerging evidence from biological and clinical studies implicates mutations in the Disrupted-in-Schizophrenia-1 (DISC1) gene in the pathogenesis of schizophrenia. In this study, genetic interactions among a select set of risk factor genes are examined using the unique model system: neuromuscular junctions (NMJs) in Drosophila. We found that dnlg1, the Drosophila homolog of the human Neuroligin-1, which encodes the NLGN1 protein, genetically interacts with DISC1 in synaptic development. We show that DISC1 overexpression in the dnlg1null heterozygous background causes synaptic alterations at the NMJs that are distinct from those in the wild-type background. Loss of dnlg1 enhanced the DISC1 overexpression phenotype in synaptic formation, strongly suppressing the formation of synaptic boutons. These results thus suggest an intriguing converging mechanism regulated by DISC1 and Neuroligin in the developing glutamatergic synapses.
Posted on

STAT+: Experimental hepatitis B treatment was a ‘functional cure’ for nearly 1 in 5, new data show

An experimental medicine helped vanquish hepatitis B in clinical trials in nearly 1 in 5 people with chronic infections caused by the virus, far outperforming available treatment options in an illness that kills 1 million people every year. 

Some 250 million to 300 million people globally have chronic hepatitis B infections, which can cause serious issues including cirrhosis and liver cancer. Current treatments, known as nucleoside analogues, lead to so-called functional cures in only 1% to 3% of patients.

But in a pair of Phase 3 trials, GSK’s bepirovirsen, or “bepi,” helped 20% and 19% of patients achieve functional cures, with no patients on placebo reaching that point, according to data released Thursday. 

Continue to STAT+ to read the full story…

Posted on

STAT+: Trump’s drug-pricing deals set to be tested by new product launches

WASHINGTON — The public is about to get its first look at the prices of drugs launched since President Trump struck his most-favored-nation deals with 17 drugmakers.

Briefly, those deals require companies to launch new drugs in the U.S. at net prices roughly equal to those in other wealthy nations, though the precise terms are secret. Three prescription medicines that are set to launch in the coming months will provide the most public view yet of the practical impacts of Trump’s dealmaking.

The drugs are Baxfendy for hypertension from AstraZeneca, the insulin Awiqli from Novo Nordisk, and Veppanu, a cancer drug developed by Arvinas and Pfizer that’s set to be licensed to Rigel Pharmaceuticals. Baxfendy and Veppanu aren’t yet available in other wealthy countries that are used as comparisons for reference pricing.

Continue to STAT+ to read the full story…

Posted on

[Articles] The effects of the Rx Kids unconditional cash prescription programme during pregnancy and infancy on birth outcomes in the USA: a population-based, quasi-experimental study

With significant reductions in adverse birth outcomes, the treatment of perinatal poverty with a place-based intervention as replicable and scalable as Rx Kids has important implications for infants and society. These findings suggest that the economic hardship of the perinatal period, starting in utero, contributes to adverse outcomes and is addressable.

Posted on
<![CDATA[New real-world data in obese, antidepressant-naive patients with MDD shows bupropion edging SSRIs on remission, though rates stay low.]]>
Posted on

Precision, Gene-Edited Antimicrobial Targets Difficult-to-Treat E. Coli

An oral, next-generation antimicrobial created using CRISPR-Cas gene editing could one day reduce the severity of a serious, food-borne infections that are generally untreatable with antibiotics.

The preclinical findings offer a potential new weapon in the armamentarium against Shiga toxin-producing Escherichia coli (STEC), a bacterium that causes nearly three million acute illnesses worldwide, mostly in children each year.

The precision gene therapy, called EB003, was able to significantly reduce the disease severity in an animal model of STEC infection.

“Although challenges such as dosing, resistance emergence, and delivery optimization remain, our findings provide a compelling foundation for the further development of EB003 and other CRISPR-based therapeutics,” reported Matthieu Galtier, PhD, of the Pasteur Institute in Paris, and co-workers in in Science Translational Medicine.

STEC is a notable public health threat, potentially causing bloody diarrhea that can progress to hemolytic uremic syndrome (HUS), a life-threatening condition with long-term implications.

Many antibiotics can stimulate the production of Shiga toxin, making infections worse and increasing the risk of HUS. They are therefore not generally recommended for infections and patients are typically only treated symptomatically.

Noting the need for strategies to eradicate STEC strains while preventing toxin release, the researchers examined the value of deploying phages—a type of virus that selectively infects and kills bacteria.

Phage-based products are already used to decontaminate food products but, as natural phages do not directly inhibit toxin production, the team investigated whether genetic engineering offered promising solution.

Galtier and colleagues engineered a delivery vector that recognized most clinical isolates from O157:H7 E. coli strains that are commonly associated with human disease, while ensuring a direct shutdown of toxin production.

Previously, the investigators had successfully used a λ phage-derived particle with engineered receptor binding proteins (RBPs) to deliver a base editor to E. coli colonizing the mouse gut.

Building on this λ-based platform, they developed EB003, a rationally engineered antimicrobial that delivers a nonreplicative CRISPR-Cas12 system programmed to target more than 99% of gene variants for stx toxins in E. coli O157 clinical isolates.

The team demonstrated that their nonreplicative CRISPR-Cas antimicrobial was efficient targeting of most clinically relevant O157 E. coli strains in vitro.

It led to a reduction of bacterial load in a mouse gut colonization model, as well as the mitigation of symptoms in an infant rabbit disease model, including reduced toxin production.

Oral administration of the engineered CRISPR-Cas delivery particle, EB003, significantly reduces disease severity in an infant rabbit model of Shiga toxin-producing E. coli (STEC) infection. [Eligo Bioscience]
Oral administration of the engineered CRISPR-Cas delivery particle, EB003, significantly reduces disease severity in an infant rabbit model of Shiga toxin-producing E. coli (STEC) infection. [Eligo Bioscience]

“A key advantage of EB003 over conventional antibiotics is its ability to eliminate O157 STEC without inducing Stx release, a major limitation of current treatments such as fluoroquinolones,” they reported.

“This could translate into a safer therapeutic option, reducing the risk of HUS in patients with a STEC infection.”

The post Precision, Gene-Edited Antimicrobial Targets Difficult-to-Treat <i>E. Coli</i> appeared first on Inside Precision Medicine.

Posted on

Women’s Memory Decline Linked to ECM Changes from Brain Estrogen Loss

New research from investigators at Northwestern Medicine, published in Aging Cell, shows that loss of estrogen production in the brain after menopause is associated with changes in the brain’s extracellular matrix (ECM), a structure between brain cells that supports communication and memory. The findings suggest that estrogen decline may alter hippocampal brain environment in ways that contribute to memory impairment and may help explain why nearly two-thirds of all people with Alzheimer’s disease (AD) are women.

“This study tells us that females—but not males—may be uniquely sensitive to loss of brain estrogen at old age, potentially contributing to an increased risk of Alzheimer’s disease,” said senior author Hong Zhao, MD, PhD, a research professor of obstetrics and gynecology in the division of reproductive science in medicine at Northwestern University Feinberg School of Medicine.

The researchers found that estrogen loss, aging, and female sex are closely linked to changes in the ECM in the hippocampus, a brain region central to learning and memory. The ECM is a network of molecules that fills the spaces between neurons and glial cells to support cell communication and function. It makes up nearly 20% of brain volume and is important for memory and brain development.

To date, most research into AD has focused on neurons and glial cells, with less attention paid to the ECM. In the Northwestern study, ECM changes were examined as a central feature of brain biology affected by estrogen loss, the first study of its kind, the researchers noted.

For their research, the investigators use genetically engineered mouse models in which estrogen production was disrupted by removing aromatase, an enzyme required for estrogen synthesis. The enzyme was eliminated either throughout the body or restricted to the brain. The investigators examined young and old male and female mice, allowing comparison of sex-specific and age-related effects. The team assessed, behavior and social function, and also collected data on genome-wide gene expression changes in the hippocampus.

The research also built upon the current understanding of estrogen’s role in brain function. In the brain, estrogen has been associated with memory and mood-related functions.

“We have provided some of the most compelling evidence that estrogen is so important for memory function and other mood functions in the female brain,” said author Serdar Bulun, MD, chair of the department of obstetrics and gynecology at Feinberg and a Northwestern Medicine physician. “This should motivate clinicians to be more aware of the essential role of estrogen for women’s brains, because once memory is gone, it’s gone.”

The findings indicate that loss of brain estrogen may disrupt ECM organization in the hippocampus, which may impair communication between brain cells. Because the ECM provides a structural and signaling environment for neurons, any alterations of the ECM potentially affect processes required for memory formation and maintenance.

Prior research has shown that women with AD may have lower brain estrogen levels than women without AD. Hormone replacement therapy (HRT), created restore estrogen levels, has produced mixed results in clinical studies however.

The investigators noted that understanding how estrogen affects brain structures such as the ECM may help explain variability in HRT outcomes and could serve as a new avenue for developing future treatments. Rather than focusing only on restoring hormone levels, future therapies could address downstream changes in brain architecture.

ECM restoration could represent one such therapeutic approach. If estrogen loss leads to ECM disruption in the hippocampus, then interventions aimed at normalizing ECM structure before memory decline may support brain function in postmenopausal women.

The Northwestern team are continuing their investigation of how estrogen regulates ECM composition and signaling in specific brain regions, and whether these changes directly drive memory impairment. The noted that more research is also needed to determine how ECM-related mechanisms interact with other known AD pathways.

The post Women’s Memory Decline Linked to ECM Changes from Brain Estrogen Loss appeared first on Inside Precision Medicine.