Trends & Technology 2023

Chronic obstructive pulmonary disease (COPD) is a leading cause of death in the United States, and over 15 million Americans are currently diagnosed with COPD, although experts say millions live with it undiagnosed. The COPD Assessment in Primary Care to Identify Undiagnosed Respiratory Disease and Exacerbation Risk (CAPTURE), a new tool developed with support from the National Institute of Health’s (NIH) National Heart, Lung, and Blood Institute (NHLBI), was designed to identify adults with COPD symptoms severe enough to treat, but who haven’t received a diagnosis. In a clinical trial involving over 4,000 adults, ages 45-80, COPD was diagnosed in 2.5% of the study sample. All participants received COPD testing so researchers could assess the tool’s effectiveness. CAPTURE was responsible for identifying 48% of newly diagnosed cases, but also provided false positives for 479 participants who did not have COPD. While the gold standard for testing for COPD is still through spirometry, the ultimate goal of the CAPTURE screening criteria is not to diagnose COPD, but to identify patients who would benefit from COPD testing. One benefit of the CAPTURE screening, the researchers said, is that it gives doctors information to further assess patients with respiratory symptoms. Doctors tend to underuse spirometry – only about a third of COPD assessments include it – in part because some find the tests difficult to integrate into shorter primary care office visits. Based on the researchers’ analysis, one in 81 CAPTURE screenings would identify an adult with treatable but previously undiagnosed COPD.

Source: asamonitor.pub/3IN8Psk

Researchers have found that a device using ultrasound to calm overactive nerves in the kidneys during outpatient ultrasound renal denervation consistently reduced daytime ambulatory blood pressure by an average of 8.5 points among middle-aged people with hypertension. The study pooled data from three randomized trials of more than 500 middle-aged patients with varying degrees of hypertension and medication use. Twice as many patients who received the ultrasound therapy reached their target daytime blood pressure (less than 135/85 mmHg) compared to patients in the sham groups. Currently, antihypertensive drugs work in different ways to lower blood pressure – by dilating blood vessels, removing excess fluid, or blocking hormones that raise blood pressure. But none of these medications target the renal nerves directly. Ultrasound therapy calms overactive nerves in the renal artery, disrupting signals that lead to hypertension. The therapy is delivered to the nerves via a thin catheter that is inserted into a vein in the leg or wrist and threaded to the kidney. The procedure was well-tolerated, and most patients were discharged from the hospital the same day. Improvements in blood pressure were seen as soon as one month after the procedure. The investigators expect the treatment could be offered as an adjunct to medication therapy and lifestyle changes for patients with uncontrolled hypertension. The device is still investigational and will be evaluated by the FDA in the coming months.

Source: asamonitor.pub/3SKgX1t

A multi-country, NIH-funded clinical study found that a single oral dose of the antibiotic azithromycin can reduce the risk of postpartum sepsis and death among women who deliver vaginally by one-third. Pregnancy-related infections account for roughly 10% of maternal deaths worldwide, and sepsis is a leading cause of maternal and newborn deaths worldwide.

The study enrolled more than 29,000 women in seven low- and middle-income countries. Within the first six weeks after delivery, 1.6% of participants who received azithromycin developed sepsis or died, compared to 2.4% in the placebo group. Deaths were rare in both groups. Sepsis occurred in 1.5% of participants in the azithromycin group and 2.3% in the placebo group (2.3%). Additionally, women who received azithromycin were less likely to develop endometritis and other infections. They also had fewer hospital readmissions and unscheduled health care visits compared to the placebo group.

Source: asamonitor.pub/3SFr7QY

Researchers have developed types of nanoparticles inspired by the structure of amyloids, capable of neutralizing the SARS-CoV-2 virus. The nanostructures, named OligoBinders, are soluble, biocompatible, and stable in plasma and have a high potency to bind viral particles. This binding blocks the interaction between the virus spike protein and the ACE2 receptor on the cell membrane responsible for the infection. To develop the nanoparticles, scientists exploited the self-assembly capacity of a small yeast peptide to which they fused two miniproteins, LCB1 and LCB3. Their modular approach allowed them to design two spherical nanoparticles, each carrying more than 20 copies of LCB1 or LCB3 on their surface, giving the nanoparticles avidity for the virus and allowing them to bind simultaneously to several spike proteins. The researchers carried out the study on particles similar to the SARS-CoV-2 virus and reported the inhibitory power of these nanoparticles and their potential as an efficient alternative to the use of monoclonal antibodies for capturing or neutralizing the virus. The developed nanospheres could have applications in biomedicine, in biotechnology, or as a potential prophylactic agent. Large-scale production would be easy and inexpensive, as assembly occurs spontaneously after incubation of the molecules.

Source: asamonitor.pub/3ycxZvv

The Nerivio^® prescription wearable has received FDA clearance as a dual-use acute and preventive treatment for migraine with or without aura in people 12 years of age or older. In a double-blind randomized placebo-controlled clinical trial, 248 participants who used Nerivio experienced a mean reduction of four migraine days per month from baseline compared to a reduction of only 1.3 days in the placebo group, a net therapeutic gain of 2.7 days per month. Participants also experienced statistically significant reductions from baseline in the mean number of headache days of all severities and in the number of days on which they required acute migraine medication. Nerivio is a physician-prescribed treatment for migraine that is non-disruptive to everyday living. Controlled with a smartphone and self-administered, Nerivio wraps around the upper arm and uses remote electrical neuromodulation (REN) to activate peripheral nerves, inducing the internal pain management mechanism called conditioned pain modulation (CPM) in remote body regions. Each treatment lasts 45 minutes and is recommended for use every other day for prevention or at the start of a migraine attack for acute treatment. Beyond the wearable, the Nerivio app allows users to customize their migraine treatments, receive reminders for preventive treatments, track their migraine patterns, and optionally share migraine data with their doctor. The application also leads users through Guided Intervention of Education and Relaxation (GIER), utilizing techniques such as diaphragmatic breathing, muscle relaxation, and guided imagery.

Source: asamonitor.pub/3y4n8nk