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Researchers Take a Step Toward Advancing Precision Hormone Therapies to Reduce Alzheimer’s Risk

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A new study from the University of Arizona Health Sciences found that women who received hormone therapy were up to 58% less likely to develop neurodegenerative diseases, including Alzheimer’s disease. The findings could lead to the development of a precision medicine approach to the prevention of neurodegenerative diseases.

The study, published in Alzheimer’s & Dementia: Translational Research & Clinical Interventions, found that women who had undergone menopausal hormone therapy for six years or more were 79% less likely to develop Alzheimer’s and 77% less likely to develop neurodegenerative diseases get sick.

“This is not the first study of the effects of hormone therapy on reducing neurodegenerative disease,” said Roberta Diaz Brinton, PhD, Director of the UArizona Center for Innovation in Brain Science and lead author of the article. “But what is important about this study is that it advances the use of precision hormone therapies to prevent neurodegenerative diseases, including Alzheimer’s.”

Hormone therapy is the most effective treatment for menopausal symptoms, which can include hot flashes, night sweats, insomnia, weight gain, and depression. During the study, Dr. Brinton and the research team evaluated the insurance claims of nearly 400,000 women aged 45 and over who were going through menopause.

They focused on the effects of individual hormone therapy drugs approved by the US Food and Drug Administration, including estrogens and gestagens, and combination therapies on neurodegenerative diseases. They also assessed the effects of the type of hormone therapy, the route of administration – oral vs. skin – and the duration of therapy on the risk of disease.

They found that using the natural steroids estradiol or progesterone resulted in greater risk reduction than using synthetic hormones. Oral hormone therapies resulted in a lower risk of combined neurodegenerative diseases, while hormone therapies administered through the skin reduced the risk of dementia. The overall risk was most reduced in patients aged 65 and over.

In addition, the protective effect of long-term therapy of more than a year in Alzheimer’s, Parkinson’s and dementia was greater than that of short-term therapy of less than a year.

“With this study we gain mechanistic knowledge. This reduction in the risk of Alzheimer’s, Parkinson’s, and dementia means these diseases share a common driver that is regulated by estrogen, and if there are common drivers, there may be common therapies, ”said Dr. Brinton, who researched neurodegenerative diseases and the aging woman, has brains for more than 25 years. “The key is that hormone therapy is not a treatment, it is keeping the brain and system going, which leads to prevention. It is not a reversal of the disease; it prevents disease by keeping the brain healthy. “

To the co-authors of Dr. Brinton owns the first authors Gregory L. Branigan, PhD, an MD PhD student at UArizona College of Medicine – Tucson; Kathleen Rodgers, PhD, Associate Director of Translational Neuroscience at the Center for Innovation in Brain Science and Professor of Pharmacology at UArizona College of Medicine – Tucson; research assistant as postdoc Yu Jin Kim, PhD, at the Center for Innovation in Brian Sciences; and former postdoc Maira Soto, PhD.

Dr. Brinton recently co-authored another article led by researchers at Weill Cornell Medicine and published in Scientific Reports. These results indicated that the menopausal transition phase has profound effects on the structure, connectivity, and energy metabolism of the brain and provides a neurological framework for both vulnerability and resilience.

Aging-related neurodegenerative diseases are a major public health concern as the proportion of the population ages 65 and older increases. There is no known cure for Alzheimer’s disease, which affects more than 5.5 million people in the United States.

This study was funded in part by the Women’s Alzheimer’s Movement and the National Institute on Aging, a division of the National Institutes of Health (P01AG026572, R37AG053589, T32AG061897).

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Oregon health care workers will be required to get vaccinated or face frequent testing

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Oregon Governor Kate Brown speaks during the June 30, 2021 press conference announcing the end of the state mask mandate.

Kristyna Wentz-Graff

Oregon health workers will need to get vaccinated against COVID-19 or undergo weekly tests, which Governor Kate Brown usually plans to introduce in late September.

As an alarming surge in case numbers and hospital admissions threatens to overwhelm public health authorities and local hospitals, Brown announced Wednesday that it has directed the Oregon Health Authority to enact new rules designed to put pressure on health workers. You can either get vaccinated by September 30th or have frequent tests for the virus.

“The more contagious Delta variant changed everything,” Brown said in a press release. “This new security measure is necessary to prevent Delta from causing serious illness on our first line of defense: our doctors, nurses, medical students and health workers on the front lines.”

The new rule falls short of what the state’s largest hospital association had called for: a new rule or regulation that gives individual health systems the power to require Covid-19 vaccination if they so choose. That would have brought Oregon in line with most other states.

Brown feared that vaccination with no alternative could lead to staff shortages, her spokesman said.

The upcoming rules are similar to the testing requirements President Joe Biden and California Governor Gavin Newsom put in place for federal and state employees during the COVID-19 resurgence. But rather than addressing all state or federal employees, Brown limits her focus to health care workers “who have direct or indirect contact with patients or infectious materials.”

Brown’s office is still considering vaccination and testing requirements for government employees, the statement said. The governor, who in recent weeks has emphasized more localized decision-making over state mandates, urged private and public employers across the state to introduce masking requirements and “facilitate employee access to vaccines” with guidelines such as paid time off for vaccinations and others Incentives.

While vaccination assignments are acceptable as a condition of employment in most sectors, Oregon law prohibits health care providers from making them mandatory unless vaccinations are required by state or federal regulations. The governor’s office said Brown plans to “address” this ban when lawmakers meet early next year.

In the meantime, not all providers are waiting. Kaiser Permanente announced Monday that it will make vaccines mandatory for all employees. PeaceHealth’s medical system announced Tuesday that all of its caregivers must be vaccinated against COVID-19 or submit a qualified medical exemption. Those who do not can be removed from patient care.

Health systems across the state have said they support a change in the law, while the Oregon Nurses Association has warned that if nurses are not part of the contract negotiations, they could result in resignation when morale is low and hospitals and long-term care facilities last are already scarce.

The increased demands come as COVID-19 patients are being hospitalized at a worrying rate. As of Wednesday, 393 people with the virus had been hospitalized in the state, 95 more than last Friday and 14 more than the day before.

State health officials released modeling results last week that suggested that nearly 100 people a day could be hospitalized by mid-August if steps are not taken to contain the spread of the Delta variant. The same modeling suggested that the daily case numbers could rise to nearly 1,200 over the same period. The state reported 1,575 new cases on Tuesday.

The state had 393 available beds in a non-intensive care unit and 110 free beds in the intensive care unit as of Wednesday morning.

Despite worrying trends and calls from their own health advisors to get vaccinated as soon as possible, the new requirements for health workers won’t go into effect until September 30th. Brown’s office said an eight week delay will “give employers time” to prepare for implementation and will give currently unvaccinated health care workers time to fully vaccinate.

Vaccination rates for health care workers are higher than rates for the general population, but they vary widely by region, ranging from a low of 43% in Harney County to a high of 81% in Washington County.

Vaccinations for long-term care facilities are particularly critical, the residents of which were responsible for around half of the deaths in the first year of the pandemic.

Approximately 68% of Oregon long-term care workers have been vaccinated – about 10% more than the national average, according to the Oregon Health Care Association, which represents the industry.

In Oregon, by July 3, 70% of all health workers were vaccinated. The rates vary depending on the profession: 87% of vaccinated doctors, 74% of registered nurses and 57% of certified nursing assistants.

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It’s time to expand the definition of ‘women’s health’

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Common diseases such as cardiovascular disease are under-researched in women, making diagnosis, prognosis and treatment difficult in women.Photo credit: BSIP / UIG / Getty

More than one eighth of the world’s population has a condition that can cause pain, profuse bleeding, and decreased fertility, all possible consequences of benign tumors known as uterine leiomyomas or fibroids. Fibroids can be debilitating and are a common reason for surgical removal of the uterus.

Still, fibroids have received relatively little attention from scientists, either in academia or in pharmaceutical companies. The cause of the disease – and how to reduce its impact on fertility – has been debated for decades, leaving doctors unsure how best to treat people.

Unfortunately, fibroids are just one of many underrated aspects of health in people who were female at birth. (This includes cis women, transgender men, and some non-binary and intersex people; the term “women” in the remainder of this editorial refers to cis women.) Clinical and preclinical studies tend to focus equally on men: a third of the Individuals participating in cardiovascular disease clinical trials are women, and an analysis of neuroscientific studies published in six journals in 2014 found that 40% of them used male animals only. Two studies and an article published in Nature on Aug. 5 shed light on the advances in women’s health research – and the need for more.

A study examines the molecular origins of fibroids and reveals a possible mechanism by which tumors form. Drugs targeting key molecular actors in this process could open up new treatment options with further studies.

The other study takes a multidisciplinary approach, examining both the genetic mechanisms and epidemiological factors involved in ovarian aging, which leads to menopause and fertility loss. The age at which women experience menopause varies widely – with a range of around 20 years for healthy women – and fertility can drop dramatically for up to a decade before it begins.

This work expanded the list of genes that contribute to early ovarian aging and highlights the importance of DNA repair mechanisms in determining the age at which women experience menopause.

Both studies illustrate the advances that can be made if the health challenges of women are brought to the fore. However, advocates of women’s health warn that the field is often too narrowly considered. The study of health and disease in women should not be limited to conditions that affect women only. Conditions like type 2 diabetes, Alzheimer’s disease, and heart disease affect men and women differently. Such diseases need to be investigated in both men and women, and the diagnosis, prognosis, and treatment may need to differ between the sexes.

Heart attacks, for example, are one of the leading causes of death in both women and men, but women do not always have the “typical” symptoms that men normally experience. Women are also more prone to blood clots after a heart attack, but are less likely to be prescribed anticoagulant drugs by their doctors. Women are 50% more likely to get an initial misdiagnosis after a heart attack than men and are less likely to be prescribed medication to reduce the risk of a second attack, according to the British Heart Foundation.

When it comes to exercise, women are at risk of serious long-term injury if we continue to model head injury training and management on data from men. As our News Feature reports, it is becoming increasingly clear that women experience head injuries and recover from them very differently than men. Understanding why women are nearly twice as likely to experience concussions as men in sports like soccer and rugby requires multi-disciplinary research – and to understand why women take longer to recover from such injuries.

So far, the evidence is sparse, but preliminary data suggest structural differences in the brain. Axons in the brain of women are wired to thinner microtubules that tear more easily; Hormonal fluctuations should also contribute to this. Biomechanics could also play a role – in rugby, for example, it seems that women fall differently when attacked, which could increase the risk of a concussion. Exercise programs designed specifically for women can help alleviate these injuries.

But the clear message from sports researchers is that it is no longer acceptable to exclusively use data from men in these studies. And when women are included, the data needs to be broken down by gender and include a sufficient number of women. A recent study examining MRI images of elite rugby players included women (KA Zimmerman Brain Commun. 3, fcab133; 2021) but of the 44 elite players, only 3 were women.

But the relative lack of women on committees and scientific advisory boards has meant that few of these decision-makers have direct personal experiences with women’s health needs or research gaps. It is all the more important that funders consult the public when determining research priorities.

Since 2016, the US National Institutes of Health has required researchers to conduct preclinical studies in both male and female animals, tissues and cells, or to provide an explanation as to why it is not appropriate to study both sexes. Now it is up to other funders, researchers, and journals to amplify the impact of this change by making sure to include gender-specific data in publications. Funders should also strengthen the resources allocated to support studies of health and disease in women and keep track of how much money is being used to support such research in all areas, not just gynecological diseases. What is measured is done.

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Coronavirus US: It could be February before all eligible Americans get at least one vaccine dose, analysis shows

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More than 90 million eligible people in the US are still unvaccinated. And although the seven-day average of people who get vaccinated each day is the highest since July 4th at 446,300, many experts say the U.S. is still not where it needs to be to get the pandemic – and the rapidly expanding delta variant – under control.

With less than half of the population fully vaccinated, cases have risen again, leading to serious illness.

On Tuesday, according to new data from the US Department of Health, more than 50,000 hospital beds across the country were occupied by Covid-19 patients for the first time since February. That number is more than three times what it was a month ago.

“We’re not crying for Wolf here. This surge that we are currently going through has the potential to be the worst surge we have ever seen – and it already looks like it, ”said former US surgeon general Dr. Jerome Das Adams said in a live online interview with the Washington Post on Tuesday.

The director of the National Institute for Allergies and Infectious Diseases, Dr. Anthony Fauci said Tuesday he would like the US to get more than a million vaccinations a day to close the vaccination gap.

“We may get there when mandates come, but it can’t be 250,000, 500,000 a day, otherwise it will go well into winter. I want to arrive earlier,” said Fauci.

With the spread of the delta variant, it may not be possible to completely stop the spread of the coronavirus, said Dr. Francis Collins, director of the National Institutes of Health, on Tuesday.

“But we could still get to a place where this becomes a nuisance rather than a threat to your life.”

Experts are considering boosters for immunocompromised people, says Fauci

Although experts have said the data so far does not suggest the general population needs booster vaccines, Fauci said efforts are underway to get them for people who are immunocompromised.

Some conditions – including autoimmune diseases, transplants, and cancer that are treated with chemotherapy – affect people’s immune systems.

“The people we know almost always don’t have an adequate response, so the need to give them an extra boost is much more pressing than the general population,” Fauci said during a virtual event hosted by Virginia Governor Ralph Northam on Tuesday was organized.

The CDC’s vaccine advisors have met to discuss whether immunocompromised people may need additional protection from a booster dose, but have not yet made a formal recommendation or voted on guidelines.

“We are working very hard to put the regulatory mechanism in place very soon to give these individuals a boost that could, if possible, bring their immunity to the level it should be,” said Fauci.

During a discussion hosted by the Center for Strategic and International Studies on Tuesday, Fauci said it was “very likely” that Covid-19 variants have developed in the bodies of immunosuppressed people.

People with immunosuppression may not be able to fight off Covid-19 infections for weeks or even months, which means the virus has plenty of time to develop and change.

“Variations, as we all know, came about because of the pressure the human immune system put on the virus, very likely from people who are immunocompromised … / or died and then essentially created a variant,” Fauci said.

“Significant” increase in the number of children and adolescents

As the new school year raises concerns about protecting children from Covid-19, the American Academy of Pediatrics said Tuesday that the number of cases in children has increased “significantly”.

Almost 72,000 children and young people were infected with Covid-19 last week – five times as many as at the end of June, the group said.

The definition of a child varies by state, but generally includes children up to the age of 17 or 18.

Covid-19 protocols vary across the country, but when kids go back to school, counties need to know how to respond quickly to outbreaks.

Covid-19 cases in US children and adolescents rose 84% in a week, the pediatrician group says

Districts need to be prepared to introduce contact tracing, testing, quarantining people who have been exposed to the virus, and isolating people with infections, Dr. William Schaffner, a professor at Vanderbilt University School of Medicine and medical director of the National Foundation for Infectious Diseases, told CNN.

While most schools follow these steps to isolate cases, conduct contact tracing, and testing, response plans may vary from state and school district to school district, Kim Anderson, executive director of the National Education Association, told CNN.

“As we understand it, it depends on which district you are in. The district should have very well thought out breakout plans that use the voices of educators, parents, and community members in drawing up those plans, and they should have them. ” Plans that follow CDC recommendations, “said Anderson.

“Our recommendation to all students and school districts is to follow the medical experts and adhere to the CDC,” she said.

CNN’s Deidre McPhillips, Matthew Hilk, Jacqueline Howard, Virginia Langmaid, Lauren Mascarenhas and Jen Christensen contributed to this report.

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