Category: 8. Health

The results of randomized clinical trial show that a single shot of the antibiotic benzathine penicillin G (BPG) is as effective in treating early syphilis as the three-injection regimen used in many patients, researchers reported today in the New England Journal of Medicine.

The findings come at a time when the United States and other countries around the world have been experiencing shortages of BPG, which has been the standard treatment for early syphilis since the early 1950s. Syphilis, caused by the bacterium Treponema pallidum, is one of the most common sexually transmitted infections, with an estimated 209,000 US infections in 2023. Though US syphilis incidence slowed in 2023, cases have risen by 61% since 2019, and shortages of BPG have hampered treatment.

The authors of the study, which was led by researchers at the University of Alabama at Birmingham (UAB) and funded by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), say the findings could boost syphilis control, aid antibiotic stewardship efforts, and simplify treatment for syphilis patients.

“Benzathine penicillin G is highly effective against syphilis, but the three-dose regimen can be burdensome and deter people from attending follow-up visits with their healthcare providers,” Carolyn Deal, PhD, chief of the enteric and sexually transmitted infections branch of NIAID, said in an NIH press release. “The new findings offer welcome evidence for potentially simplifying treatment with an equally effective one-dose regimen, particularly while syphilis rates remain alarmingly high.”

‘No observable benefit’ to multiple doses

For the multicenter trial, investigators enrolled and assigned participants with early syphilis (which includes the primary, secondary, and early latent stages of the disease), with or without HIV, to receive an intramuscular injection of BPG in a one-time dose of 2.4 million units or a series of three 2.4-million-unit injections at weekly intervals. The primary end point was serologic response at 6 months, with a noninferiority margin of 10 percentage points.

The authors note that although a single dose of BPG has been the accepted regimen for early syphilis since it was introduced, there has long been concern that one dose may not be enough for people with HIV who have early syphilis.

“Despite recommendations from the Centers for Disease Control and Prevention [CDC] for single-dose benzathine penicillin G therapy, many clinicians treat persons who have HIV infection with multiple doses,” they wrote.

A total of 249 participants (97% men, 62% Black, 61% living with HIV) were enrolled in the trial from October 31, 2018, through March 2, 2022, with 124 in the single-dose group and 125 in the three-dose group. Of the participants, 19% had primary syphilis, 47% had secondary syphilis, and 33% had early latent syphilis. Fifty participants were excluded from the final analysis.

The new findings offer welcome evidence for potentially simplifying treatment with an equally effective one-dose regimen, particularly while syphilis rates remain alarmingly high.

The percentage of participants with serologic response at 6 months was 76% (95% confidence interval [CI], 68% to 82%) in the single-dose group and 70% (95% CI, 61% to 77%) in the three-dose group, for a between-group difference of –6 percentage points (90% CI, -15 to 3), indicating noninferiority. When the treatment groups were further stratified according to HIV infection, the results were similar, with serologic response observed in 76% of participants with HIV infection in the one-dose group and 71% of participants with HIV in the three-dose group.

The most common adverse events were local injection-site pain and tenderness, observed in 76% of participants in the single-dose group and 85% in the three-dose group. The authors note that the cumulative discomfort from three shots may have been a factor in why 21 participants in the three-dose group did not receive all three treatments, though participants’ reasons for not receiving all treatments weren’t consistently recorded.

“With no observable benefit to multiple treatments, a single treatment at a dose of 2.4 million units should be, in our opinion, the preferred treatment for early syphilis,” they wrote.

Findings should provide reassurance

“We hope these promising results will be complemented by scientific advances in syphilis prevention and diagnosis,” lead investigator Edward Hook, MD, an emeritus professor of medicine and epidemiology at UAB, said in the release.

In an editorial on the study in the same journal, CDC scientists Lindley Barbee, MD, MPH, and Laura Bachmann, MD, MPH, wrote, “The findings from this trial should provide reassurance to clinicians, particularly those caring for patients with HIV infection, that a single dose of benzathine penicillin G is sufficient to treat early syphilis.”

“The question remains whether persons with late latent syphilis or syphilis of unknown duration should receive the CDC-recommended regimen of three 2.4-million–unit doses of benzathine penicillin G. The data supporting the CDC recommendation are theoretical.”

Women treated with beta-blockers (β-blockers) for post-myocardial infarction (MI) without reduced left ventricular ejection fraction (LVEF) have a 45% increased risk of MI, heart failure hospitalization, or death compared with men, according to new study findings. The results, published in the European Heart Journal, suggest a need to re-evaluate β-blocker use in post-MI women without reduced LVEF, with a view toward more sex-specific prescribing strategies.¹

“Despite the underlying reasons not being fully understood, it is well established that women and men do not receive equal management—including pharmacological therapies—following an ACS [acute coronary syndrome],” the authors discussed. “Moreover, although findings vary across studies, several reports suggest that women may experience worse long-term outcomes than men after ACS.”¹

Cardiovascular disease (CVD) affects nearly 60 million women in the United States alone, and only 44% see it as a significant health threat for women. This is largely in response to the prioritization of male enrollment in CVD clinical trials due to dissimilarities in women’s and men’s hormones, platelet reactivity, P2Y12 inhibitors, and the likelihood of developing comorbidities, which greatly impact responses to treatment. Continued evidence shows that women with cardiovascular conditions have increased adverse responses to cardiovascular drugs compared with men, with a risk that is 1.5 to 1.7 times higher. This underscores the critical need for inclusion of women in cardiovascular trials, as well as sex-based treatment guidelines.²

The authors assessed a pre-specified sex-specific subgroup analysis of REBOOT (NCT03596385), the largest randomized trial evaluating the effect of beta-blockers after acute MI with LVEF less than 40%. The assessment included a total of 8438 patients, of whom 1627 were older, had more comorbidities, and received fewer guideline-based therapies than men.^1,3

Over nearly 4 years of follow-up, women who had a heart attack were more likely than men to experience serious health problems such as death, another heart attack, or hospitalization for heart failure. Among women, these events happened more often in those who were taking beta-blockers compared with those who were not (about 30 vs 21 cases per 1,000 patients each year). This means women on beta-blockers had about a 45% higher risk of adverse events.¹

For men, there was no meaningful difference between taking beta-blockers or not. The higher risk seen in women was mostly due to increased deaths, and it was especially noticeable in women who had normal heart pumping function and in those who received higher doses of beta-blockers.¹

“Despite women and men differing with respect to baseline risk, causes, and prognosis of MI, current guidelines do not differentiate between the use of beta-blockers in women and men,” wrote the authors. “… our study provides robust evidence of an interaction between sex and beta-blocker therapy and suggests an increased risk of the composite endpoint of all-cause death, MI, or HF hospitalization, mainly in women with preserved LVEF receiving higher doses of beta-blockers.”¹

REFERENCES

1. Rossello X, Dominguez-Rodriguez A, Latini R, et al. Beta-blockers after myocardial infarction: effects according to sex in the REBOOT trial. European Heart Journal. August 30, 2025. Doi:10.1093/eurheartj/ehaf673

2. Gerlach A. Closing the gap: Addressing underrepresentation of women in cardiovascular clinical trials. Pharmacy Times. May 24, 2024. Accessed September 3, 2025. https://www.pharmacytimes.com/view/closing-the-gap-addressing-underrepresentation-of-women-in-cardiovascular-clinical-trials

3. TREatment With beta-blockers After myOcardial Infarction withOut Reduced Ejection fraction. Updated June 6, 2025. Accessed September 3, 2025. https://clinicaltrials.gov/study/NCT03596385

We know exercise is good for the body and mind. This may be especially true for people with early-stage Parkinson’s disease (PD). According to recent research by UCLA scientists, exercise may help fend off PD symptoms like worsening tremors, stiffness and balance issues.

Chronic inflammation happens when the immune system becomes overactive in the brain and nervous system. This can bring on PD symptoms.

“Prior research has found that a decrease in inflammation can play a crucial role in preventing or delaying the progression of PD,” says Yang Chen Hu, PhD, lead study author.

There is still much to learn about long-term inflammation, says Dr. Hu. However, the study findings suggest that exercise can help people with PD feel better for longer.

Dr. Hu is an epidemiology student in the laboratory of Beate Ritz, MD, PhD, a professor of epidemiology at the UCLA Fielding School of Public Health with a co-appointment in the department of neurology at the David Geffen School of Medicine at UCLA.

Dr. Ritz was one of the study’s senior authors, as was Cynthia Kusters, MD, PhD, an assistant professor in the Department of Epidemiology at the UCLA Fielding School of Public Health.

“Our work takes a novel approach to studying inflammation, helping us understand how behavior and environmental exposures influence biological processes,” says Dr. Kusters.

“This offers promising opportunities for studying how lifestyle factors and exposures relate to disease risk and progression.”

Conducting the study

The researchers gathered data on demographics, lifestyle and physical activity from 555 people with PD in the Parkinson’s Environment and Gene (PEG) Studies.

This long-term research project was a joint effort of the UCLA Fielding School of Public Health and the UCLA Neurology Department. Its goal was to learn more about what causes the factors that contribute to PD.

Using this data, Dr. Hu and colleagues calculated DNA-based measures that acted as stand-ins for immune system signals known as cytokines.

Next, they compared data from physically active study participants to data from less active participants.

This made it possible to see whether physical activity is linked to immune-related DNA markers – which is exactly what they found, according to Dr. Hu.

The findings suggest that physical activity lowers chronic inflammation, which may slow disease progression.

What this means for patients 

People with PD should consider doing higher-intensity activities, such as fast walking, seated dancing or chair aerobics, if possible.

“We found that having a higher day-to-day activity level is associated with both lower levels of pro-inflammatory signals and higher levels of anti-inflammatory signals,” Dr. Hu says.

Some of these signals have been linked to the progression of PD, he says. This points to regular physical activity being helpful in managing the condition.

Overall, says Dr. Hu, patients should know that “staying physically active could be a simple yet powerful way to improve long-term health outcomes in PD.”

Another of the study’s coauthors – Jeff Bronstein, MD, PhD – agrees about the importance of exercise for people with PD.

Dr. Bronstein is the director of movement disorders at UCLA’s David Geffen School of Medicine.

“We have yet to find a medication that can slow the progression of the disease,” he says. “However, we have several therapies that can improve symptoms and help maintain a high quality of life,”

Physical activity is the one treatment that slows disease progression, but we simply do not understand how it works, he notes.

“This study found that physical activity is associated with changes in our DNA that alters inflammation,” he continues.

“Inflammation may contribute to the cause of PD – and therefore, these changes in DNA might give us insight into how physical activity slows disease progression. It might also be important in other diseases as well.”

Working together to help people with PD

A study like this would not be possible without high-quality data, notes Dr. Hu.

All the data was collected from the PEG study, which enrolled residents from Fresno, Tulare and Kern counties in Central California.

The PEG study brought researchers and community members together to learn more about PD. Trained professionals gathered a wide range of information, according to Dr. Hu.

Detailed neurological examinations for PD patients were performed by UCLA movement disorder specialists at the UCLA Department of Neurology at the initial visit and at follow-up visits.

Their expertise was crucial in confirming that participants had PD symptoms.

“Their in-depth knowledge of PD diagnosis, treatment and pathology was instrumental in interpreting some of the study’s results,” Dr. Hu says.

“Drs. Ritz and Bronstein have contributed a strong clinical perspective to the conversation, connecting the observed changes in cytokine levels to potential and meaningful differences in the progression of PD.”

Discussions with experts were key to understanding the study results, he adds, especially around the changes to immune cells like B-cells and T-cells.

“These are vital pathological alterations observed in PD patients.”

New evidence suggests that adults may not need routine tetanus and diphtheria booster shots after all, potentially saving the U.S. around $1 billion annually.

The protection from childhood vaccinations appears to last for decades, matching findings from the U.K., where boosters haven’t been given since the 1950s, yet disease rates remain extremely low.

Potential Billion-Dollar Savings

A new review led by scientists at Oregon Health & Science University suggests the United States could safely eliminate routine tetanus and diphtheria booster shots for adults and save roughly $1 billion every year.

The researchers stressed that these savings and safety depend on keeping childhood vaccination rates consistently high.

“By maintaining high childhood vaccination coverage, we not only protect kids, but we may actually be able to reduce adult booster vaccinations,” said lead author Mark Slifka, Ph.D., professor of microbiology and immunology in the OHSU School of Medicine and the Oregon National Primate Research Center. “That would save $1 billion a year in the U.S. while maintaining the safety and protection of the general population.”

Slifka added that ending the 10-year booster schedule would bring U.S. practices more in line with recommendations from the World Health Organization.

Decades of Immunity Confirmed

The review builds on earlier OHSU studies published in 2016 and 2020, which found that the combined tetanus and diphtheria vaccine provides immunity lasting at least 30 years. That protection far exceeds the current guidance from the U.S. Centers for Disease Control and Prevention, which advises adults to receive a booster every 10 years. The vaccine is most often administered as the combination shot for tetanus, diphtheria, and pertussis, known as DTaP.

In the United States, children are scheduled to receive six doses of this vaccine between infancy and age 12.

According to the review, eliminating routine adult boosters would be safe as long as childhood vaccination coverage remains strong. Boosters could still be given in specific situations, such as after serious injuries like workplace accidents or car crashes, where tetanus exposure is a concern.

Natural Experiment in Europe

Published recently in the journal Clinical Microbiology Reviews, the review highlights a comparison between two industrialized countries just 21 miles across the English Channel: France and the United Kingdom. Both countries have excellent childhood vaccination coverage, similar to the U.S.

“This represents sort of an experiment of nature,” Slifka said. “We have one country with over 60 million people that for decades has continued to vaccinate adults throughout their lifetime and another nearby country that also has over 60 million people, but over the past 50 years, they have never recommended adult booster vaccinations.

“The question we asked is, ‘What happens if we don’t vaccinate the adults? Are there more cases of disease or are these people protected after completing their childhood vaccination series?’”

France vs. United Kingdom Outcomes

Similar to the United States, France has a recommended booster vaccination schedule for adults. In contrast, except during pregnancy or for wound management, the United Kingdom hasn’t recommended boosters for tetanus and diphtheria beyond age 14 since the 1950s.

Yet, despite decades of adult booster vaccination, the review found that France had virtually no advantage over the U.K. in the rates of tetanus or diphtheria. In fact, the review found that the UK had a slightly lower rate overall.

Herd Immunity Holds Strong

In addition, “herd immunity” held strong even in 2022 when the U.K. reported an outbreak of 73 imported diphtheria cases among immigrants seeking asylum. This spike in cases was almost equal to the total number of diphtheria cases reported in the entire country over the previous 20 years combined.

“Remarkably, despite this proportionally large influx of imported diphtheria cases, there was no evidence of transmission reported among other asylum seekers who arrived by other routes or among staff or health care workers,” the authors write.

The U.K. Health Security Agency concluded that the country’s current childhood-focused vaccination program is sufficient for preventing the spread of diphtheria and that the risk to the general UK population remains low.

Vaccines’ Life-Saving Impact

The findings highlight the remarkable durability of protection following childhood vaccination against a pair of diseases that were once all but a death sentence.

In 1948, the U.S. mortality rate for tetanus was 91%. Before the introduction of antibiotics and vaccines, the mortality rate for diphtheria was roughly 50%. To this day, diphtheria kills roughly one out of 10 people who aren’t vaccinated against it.

Childhood Vaccinations Keep Us Safe

Today, the public health threat is diminished thanks to childhood vaccinations as well as booster shots recommended in pregnancy.

“Thanks to childhood vaccinations, these diseases are incredibly rare,” Slifka said. “In fact, you’re 10 to 1,000 times more likely to be struck by lightning than to be diagnosed with tetanus and diphtheria in the United States.”

Reference: “Lessons learned from successful implementation of tetanus and diphtheria vaccination programs” by Mark K. Slifka, Archana Thomas, Lina Gao, Ian J. Amanna and Walter A. Orenstein, 15 July 2025, Clinical Microbiology Reviews.
DOI: 10.1128/cmr.00031-25

In addition to Slifka, co-authors include Archana Thomas and Lina Gao, Ph.D., of OHSU; Ian J. Amanna, Ph.D., of Najít Technologies, and Walter A. Orenstein, M.D., of the Emory Vaccine Center at Emory University.

Research reported in this publication was supported by the Office of the Director of the National Institutes of Health, award number P51OD011092. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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SALT LAKE CITY, Sept. 03, 2025 (GLOBE NEWSWIRE) — Myriad Genetics, Inc., (NASDAQ: MYGN), a leader in molecular diagnostic testing and precision medicine, today announced the publication of a new meta-analysis of six prospective controlled studies¹ that included 3,532 adults with major depressive disorder (MDD). The meta-analysis showed that when GeneSight^® Psychotropic test results were available to treating clinicians, there were significant improvements in response and remission rates for patients with MDD, compared to treatment as usual (TAU).

Specifically, compared to TAU, patients in the GeneSight arm were:

• 41% more likely to achieve remission.
• 30% more likely to achieve response.

“This meta-analysis summarizes the clinical evidence of the GeneSight test, demonstrating superiority over treatment as usual—which often involves repeated medication trials,” said Sagar V. Parikh, M.D., FRCPC, study author, professor of psychiatry at the University of Michigan, associate director of the University of Michigan Depression Center. “This study found that the GeneSight test can be a powerful tool to augment a clinician’s knowledge, experience and passion for their patients’ recovery.”

The large-scale data analysis—merging data over many independent studies—provides evidence of the clinical utility of the GeneSight Psychotropic test for patients with MDD who have experienced at least one treatment failure.

“Depression is not just a mental health issue—it’s a public health priority. If we want to improve overall outcomes and enhance quality of life, we must treat depression with the same urgency and resources as any other chronic condition,” said Dale Muzzey, PhD, chief scientific officer, Myriad Genetics. “This meta-analysis adds to our confidence in the clinical validity and utility of the GeneSight test.”

Myriad Genetics plans to submit this data to payers as part of ongoing efforts to increase patient access to the GeneSight test and help patients achieve remission from depression.

About the Meta-Analysis
The study analyzed six prospective, controlled trials to assess the impact of the GeneSight Psychotropic test on clinical outcomes in a total of 3,532 unique adults with MDD who had at least one prior treatment failure. The trials included in the meta-analysis incorporated the widely used depression questionnaires, the Hamilton Depression Rating Scale (HAM-D17) and the Patient Health Questionnaire (PHQ-9), to assess severity of depression symptoms. Response was defined as a 50% or greater improvement in depression scores from baseline to endpoint. Remission was defined as a score of seven or less on the HAM-D17 or a score of five or less on the PHQ-9.

^{1 Pine Rest (Winner et al., 2013), Hamm (Hall-Flavin et al., 2012), La Crosse (Hall-Flavin et al., 2013), GUIDED (Greden et al., 2019), PRIME Care (Oslin et al., 2022), GAPP-MDD (Tiwari et al., 2022)}

About the GeneSight^® Test
The GeneSight Psychotropic test from Myriad Genetics is the category-leading pharmacogenomic test for 64 medications commonly prescribed for depression, anxiety, ADHD, and other psychiatric conditions. The GeneSight test can help inform clinicians about how a patient’s genes may impact how they metabolize and/or respond to certain psychiatric medications. It is designed to provide information that may help reduce the trial-and-error process that often takes place when patients are prescribed certain mental health medications. Learn more at www.genesight.com.

About Myriad Genetics 
Myriad Genetics is a leading molecular diagnostic testing and precision medicine company dedicated to advancing health and well-being for all. Myriad Genetics develops and offers molecular tests that help assess the risk of developing disease or disease progression and guide treatment decisions across medical specialties where molecular insights can significantly improve patient care and lower healthcare costs. For more information, visit www.myriad.com.

Safe Harbor Statement
This press release contains “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995, including statements related to the meta-analysis and how it adds to the company’s confidence in the clinical validity and utility of the GeneSight test, as well as the company’s plans to submit data from the meta-analysis to payors as part of ongoing efforts to increase patient access to the GeneSight test and help patients achieve remission from depression. These “forward-looking statements” are management’s expectations of future events as of the date hereof and are subject to known and unknown risks and uncertainties that could cause actual results, conditions, and events to differ materially and adversely from those anticipated. Such factors include those risks described in the company’s filings with the U.S. Securities and Exchange Commission, including the company’s Annual Report on Form 10-K filed on February 28, 2025, as well as any updates to those risk factors filed from time to time in the company’s Quarterly Reports on Form 10-Q or Current Reports on Form 8-K. Myriad is not under any obligation, and it expressly disclaims any obligation, to update or alter any forward-looking statements, whether as a result of new information, future events or otherwise except as required by law. 

Investor Contact 
Matt Scalo 
(801) 584-3532 
IR@myriad.com 

Media Contact 
Kate Schraml
(224) 875-4493
PR@myriad.com

Concurrent chemotherapy with radiation therapy did not significantly increase the cumulative incidence of second pelvic malignancies, though it did increase the cumulative incidence of second non-pelvic malignancies compared with chemotherapy alone in patients with locally advanced rectal cancer, according to results from a study shared in the International Journal of Radiation Oncology, Biology, Physics.

In the concurrent chemotherapy group, the 5- and 10-year cumulative incidences of second pelvic malignancy development was 2.1% (95% CI, 1.4%-3.0%) and 5.8% (95% CI, 4.2%-7.6%); in the chemotherapy alone group, the rates were 2.3% (95% CI, 0.92%-4.8%) and 4.2% (95% CI, 1.3%-9.8%), respectively. This difference did not reach statistical significance (Gray’s Test P = .3).

A multivariable analysis showed that older age was associated with second pelvic malignancies (MV HR, 3.03; 95% CI, 1.39-6.60; P = .005), though chemotherapy alone was not significantly associated with fewer second pelvic malignancies (MV HR, 0.66; 95% CI, 0.30-1.44; P = .3).

Intensity-modulated radiation therapy and volumetric modulated arc therapy techniques were associated with reduced risk of second pelvic malignancies vs conventional and 3D conformal radiation therapy on univariable analysis (P = .014).

The most common second pelvic malignancies were prostate adenocarcinoma (31%; n = 23) and uterine cancer (28%; n = 21); uterine cancers were mostly serous, clear cell, or endometrioid, though 5 patients in the concurrent chemotherapy group developed carcinosarcomas.

The 10-year cumulative incidence of non-pelvic second malignancies was 11.0% (95% CI, 9.1%-14.1%) in the concurrent chemotherapy group and 4.4% (95% CI, 2.2%-7.9%) in the chemotherapy alone group (Gray’s Test P = .017).

Univariable analysis showed that being older than 50 was significantly associated with increased risk of second non-pelvic malignancies (HR, 2.48; 95% CI, 1.40-4.11; P ≤.001), and being male was associated with a decreased risk (HR, 0.61; 95% CI, 0.44-0.85; P = .004). Further, diabetes was associated with a second non-pelvic cancer (HR, 1.51; 95% CI, 1.05-2.19; P = .028), and abstaining from tobacco decreased the risk of second non-pelvic cancer (HR, 0.63; 95% CI, 0.43-0.91; P = .013).

The most common second non-pelvic cancers were lung cancer (24%; n = 35), breast cancer (15%; n = 21), and hematologic malignancies (13%; n = 19). While 77% of those who developed a second non-pelvic cancer did not have a diagnosis of any other cancer, 13% did also develop a second pelvic malignancy.

Regarding radiation dosimetry and technique, 21 patients who developed a second pelvic malignancy had a chemotherapy plan available; of the 21, 9 developed uterine cancer with a mean dose of 4800cGy (range, 4296-5087).

The median overall survival (OS) in the concurrent chemotherapy group was 12 years (95% CI, 11-13) vs 24 years (95% CI, 15-unreached) in the chemotherapy alone cohort. The 5- and 10-year OS rates for those who received concurrent chemotherapy for rectal cancer was 78% (95% CI, 76%-80%) and 58% (95% CI, 55%-61%), respectively; in those who received chemotherapy alone, the rates were 88% (95% CI, 84%-91%) and 76% (95% CI, 70%-82%).

The 10-year survival for those who did not develop second pelvic malignancies was 60% (95% CI, 57%-63%) vs 77% (95% CI, 67%-87%) in those who did develop a second pelvic malignancy (P = .042).

“These data serve as a foundation for future prospective studies evaluating ways to further reduce the risk of second malignancies in high-risk patients undergoing [concurrent chemotherapy] for rectal cancer,” wrote lead study author Carla Hajj, MD, of the Department of Radiation Oncology at Memorial Sloan Kettering Cancer Center, and coauthors, in the paper. “Areas of potential investigation include personalized treatments using more modern technologies such as proton beam [radiation therapy] or MRI-based treatment deliveries, lifestyle changes, and robust survivorship programs.”

The study included 2624 patients with locally advanced rectal cancer, of whom 460 were treated with chemotherapy without radiation therapy and 2164 received concurrent chemotherapy. The most common adjuvant chemotherapy regimens were folinic acid, fluorouracil (5FU), and oxaliplatin (FOLFOX; 60%), 5FU (32%), and capecitabine/oxaliplatin (CapeOx; 4%).

Eligible patients had disease treated with chemotherapy with or without pelvic radiation therapy who were identified from an institutional database by Cancer Database, ICD-9/10, and ICD-0 histologic diagnosis codes for “rectum” or “rectosigmoid”.

Patients were ineligible for participation if they had received prior pelvic radiation therapy or if their treatment was for recurrent disease.

Second malignancies were defined as those preceding the rectal cancer diagnosis date by more than 6 months, synchronous cancers were defined as within 6 months of diagnosis, and metachronous cancers were defined as occurring between 6 months and 2 years after diagnosis. A second cancer was defined as occurring more than 2 years after diagnosis of locally advanced rectal cancer. The development of a non-pelvic cancer did not preclude capturing the diagnosis of a second pelvic cancer.

Reference

Tringale KR, Patel KH, Hilal L, et al. Development of second malignancies following chemotherapy with or without radiation therapy for the treatment of locally advanced rectal cancer. Int J Radiat Oncol Biol Phys. Published online July 19, 2025. doi:10.1016/j.ijrobp.2025.07.1424

A long-term study suggests that cannabis-based medical treatments may bring lasting relief to people with chronic insomnia.

Over 18 months, patients reported not only better sleep but also reduced anxiety, less depression, and even lower pain levels. Side effects were mild and temporary for most, making cannabis a potential alternative where traditional sleep medications fall short.

Cannabis-Based Products Show Promise

People living with insomnia who used cannabis-based medical treatments reported sleeping better for as long as 18 months, according to research published August 27 in the open-access journal PLOS Mental Health. The study was led by Arushika Aggarwal of Imperial College London, U.K., along with her colleagues.

Sleep problems affect roughly one in three people, and about 10 percent of adults meet the criteria for an insomnia disorder. Standard treatment options are often hard to access, and medications approved for insomnia carry a risk of dependence.

To explore whether cannabis-based therapies might ease insomnia, the researchers reviewed outcomes from 124 patients who were prescribed medical cannabis. They tracked changes in reported sleep quality, anxiety and depression levels, and overall quality of life across one to 18 months of treatment.

Lasting Sleep and Mental Health Benefits

Patients consistently reported better sleep throughout the 18-month period. They also noted reduced anxiety and depression, along with lower levels of pain. Around nine percent experienced side effects such as fatigue, dry mouth, or insomnia, but none were considered serious. While more rigorous randomized controlled trials are required to confirm safety and effectiveness, the results suggest that cannabis-based medical products may provide a new avenue for improving sleep among people with chronic insomnia.

Co-author Dr. Simon Erridge, Research Director at Curaleaf Clinic, explained: “Over an 18-month period, our study showed that treatment for insomnia with cannabis-based medicinal products was associated with sustained improvements in subjective sleep quality and anxiety symptoms. These findings support the potential role of medical cannabis as a medical option where conventional treatments have proven ineffective, though further randomised trials are needed to confirm long-term efficacy.”

Importance of Long-Term Monitoring

He adds: “Conducting this long-term study provided valuable real-world evidence on patient outcomes that go beyond what we typically see in short-term trials. It was particularly interesting to observe signs of potential tolerance over time, which highlights the importance of continued monitoring and individualised treatment plans.”

Reference: “UK Medical Cannabis Registry: A clinical outcomes analysis for insomnia” by Arushika Aggarwal, Simon Erridge, Isaac Cowley, Lilia Evans, Madhur Varadpande, Evonne Clarke, Katy McLachlan, Ross Coomber, James J. Rucker, Mark W. Weatherall and Mikael H. Sodergren, 27 August 2025, PLOS Mental Health.
DOI: 10.1371/journal.pmen.0000390

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Doctors often struggle to get clear images of the inner ear, a tightly protected organ encased in bone. The body’s natural obstacles make it difficult to get magnetic resonance imaging (MRI) contrasts into the ear to diagnose tumors, infections, or malformations. Now a team of researchers has developed a nanoparticle-based MRI contrast that can grab on to inner ear cells and sneak its way inside (Chem. Biomed. Imaging 2025, DOI: 10.1021/cbmi.5c00049).

“Standard . . . imaging agents rarely reach this tissue and clear out very fast, forcing clinicians to use higher doses, which raises the risk of hearing damage and toxicity,” says Huan Wang, a biomedical chemist at Changchun Institute of Applied Chemistry and the study’s senior author. The challenge comes from a protective set of cells lining the blood vessels between the middle and inner labyrinth of the ear—the blood-labyrinth barrier, or BLB.

This cellular defense allows nutrients and oxygen to pass through but blocks other molecules, including many drugs and contrast agents. To address this, Wang’s team has created the first guided MRI nanoprobe shown to cross this BLB and accumulate in the inner ear.

The probe combines three features: an iron oxide core just 3.3 nm across that serves as the MRI contrast, a polyethylene glycol (PEG) coating that keeps the contrast circulating in the bloodstream, and a short peptide intermingled with the PEG called IETP2.

Wang explains that the IETP2 sticks to LRP1—a receptor found throughout the body but especially abundant in the BLB—which is able to ferry useful molecules across the barrier, essentially letting the nanoprobe hitch a ride into the inner ear. “By attaching the nanoparticles to a peptide which targets the receptor on the BLB, the team found a way to push the probes past the barrier,” says Carmen Burtea, a biomedical imaging researcher at Université de Mons who was not involved in the study.

In mice, the nanoprobes crossed the BLB efficiently and stayed in circulation long enough to reach the cochlea. They produced up to 84% stronger MRI signals than untargeted controls, with no damage to any major organs.

“The untargeted version of the nanoprobe is already known to enhance contrast at lower doses than [standard] gadolinium agents,” Burtea says. She adds that if the probe passes risk assessments, it could give doctors a new tool to diagnose both fluid buildup and structural changes within the inner ear.

Wang agrees that clinical translation will require toxicology tests and larger-animal studies. Johannes Gerb, a biomedical imaging researcher at Ludwig Maximilian University Munich who also was not involved in the study, notes that if the probe can match gadolinium’s performance at lower cost and with comparable safety in humans, “it could become a viable alternative.”

Looking ahead, Wang says that “the platform can also be used as a general platform to ferry drugs or gene therapies to the inner ear,” though he cautions that avoiding unintended delivery to other LRP1-expressing tissues would require troubleshooting. The potential also resonates with clinicians. “Modalities such as this are an exciting avenue as they can definitely reduce the toxic loads of current medications,” says Rajesh Bhardwaj, an otolaryngologist at MedFirst ENT Centre in India who was not involved in the study.

Many of us are guilty of scrolling our smartphones on the toilet. But a new study from the United States, published today, has found this habit may increase your risk of developing haemorrhoids by up to 46%.

So, what’s the link? How can time on your phone lead to these painful lumps in and around your anus? Here’s what we know.

What are haemorrhoids?

Every healthy person has haemorrhoids, sometimes called piles. They are columns of cushioned tissue and blood vessels found close to the opening of the anus.

Haemorrhoids have a really important role in maintaining bowel continence or, to put it simply, keeping your poo in.

When all is well, we don’t notice them. But haemorrhoids can get swollen and this can lead to symptoms such as pain, bleeding or feeling a lump just inside your anus (internal haemorrhoids) or protruding outside (external haemorrhoids).

So when someone “has haemorrhoids”, it means they have become inflamed or symptomatic.

This is extremely common: more than one in two of us will experience symptomatic haemorrhoids at some point in our lives.

You are more likely to get haemorrhoids if you:

• are older (over 45)
• are pregnant
• are overweight
• have persistent constipation or diarrhoea
• regularly lift heavy objects
• spend a lot of time on the toilet.

The link between toilet time and haemorrhoids

Prolonged sitting in general has not been linked to developing haemorrhoids.

However, a standard toilet seat – unlike a chair or couch – has a large internal opening that provides no support for the pelvic floor (the group of muscles and ligaments that support the bladder, bowel and uterus).

Prolonged sitting on a toilet seat is believed to increase pressure inside the pelvic floor and lead to blood pooling in the vascular cushions of the anus. This makes haemorrhoids more likely to develop.

What the new study looked at

The new US study recruited 125 adults, aged 45 and older, who were undergoing a colonoscopy at Beth Israel Deaconess Medical centre.

Researchers surveyed them about their smartphone habits while using the toilet, including how often they checked their phone and for how long. Participants also reported on other behaviours such as straining, their fibre intake, and how much physical activity they did.

The researchers recorded whether they had haemorrhoids. Since the participants were all having a colonoscopy, the presence of internal haemorrhoids could be directly confirmed visually.

What did the study show?

Two-thirds (66%) of all participants used smartphones while on the toilet. The most common activity was reading news (54.3%), followed by social media (44.4%).

Those who used their smartphones spent longer on the toilet than those who didn’t. More than one in three (37.3%) toilet smartphone users spent over five minutes on the toilet, compared to just over one in 20 (7%) of those who didn’t use their smartphones.

The smartphone users had a 46% higher risk of haemorrhoids, compared to those who didn’t use their smartphone. To calculate this, researchers took into account other known risk factors for haemorrhoids such as gender, age, body mass index, exercise activity, straining and fibre intake.

However, unlike some other research, this study did not find a link between straining and haemorrhoids.

As a result, the researchers concluded that time spent on the toilet poses a more significant risk for haemorrhoids than straining. However, we can’t rule out straining as a risk factor, based on one study.

Some other limitations to consider

The study relied on participants remembering whether or not they strained, and how long they spent on the toilet.

This kind of recall is subjective, and may also be influenced by taking part in the study. For example, if the participants thought they had haemorrhoids, they may be more likely to report straining.

The study’s small sample size and the participants’ age (all over 45) also mean it is unlikely to be representative of the broader population.

Toilet sitting time

The new study is not the first to study the link between time spent on the toilet and developing haemorrhoids. In 2020, a Turkish study found spending more than five minutes on the toilet was associated with haemorrhoids.

Another 2020 study from Italy of 52 people with diagnosed internal or external haemorrhoids noted the longer they spent on the toilet, the more severe their haemorrhoids.

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Read more:
Do men really take longer to poo?

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So, what are we doing on the toilet?

Defaecation itself usually doesn’t take long. One study found it took healthy adults an average two minutes when sitting, but only 51 seconds when squatting.

The majority of “toilet sitting time” usually means just that – sitting on the toilet, doing other activities aside from pooing (or weeing).

One 2008 study from Israel surveyed 500 adults and found more than half (52.7%) read books or newspapers while on the toilet. It also found toilet readers spent significantly more time on the toilet.

How to avoid haemorrhoids

The usual advice is to increase the amount of fibre in your diet (eating more fruit, vegetables and wholegrains) and ensure you drink enough water. This makes it easier to pass a stool and reduces straining – which you should also try to avoid.

However, the new research confirms previous evidence that cutting down toilet sitting time may also help. So, avoiding distractions by leaving your smartphone outside the bathroom is a good idea (and as a bonus, will expose your device to fewer germs).

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Read more:
Your phone is covered in germs: a tech expert explains how to clean it without doing damage

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If you have any concerning symptoms, such as blood in your stool, a new lump in the anal region, or pain when passing a bowel motion then you should see your local doctor for further investigations and treatment.

Sweeteners found in yoghurts and fizzy drinks can damage people’s ability to think and remember, and appear to cause “long-term harm” to health, research has found.

People who consumed the largest amount of sweeteners such as aspartame and saccharin saw a 62% faster decline in their cognitive powers – the equivalent to their having aged 1.6 years, researchers say.

They concluded: “Our findings suggest the possibility of long-term harm from low- and no-calorie sweeteners (LNCs) consumption, particularly artificial LNCs and sugar alcohols, on cognitive function.”

The findings are the latest to warn about the dangers posed by sweeteners. Previous studies have suggested they may increase the risk of a range of diseases including type 2 diabetes, cancer, heart problems, depression and dementia, and damage the gut wall.

Sweeteners’ association with cognitive decline is of such concern that consumers should instead use either tagatose, a natural sweetener, or alternatives such as honey or maple syrup, the researchers said.

They looked at the impact of seven sweeteners on the health of the study’s participants – 12,772 civil servants in Brazil, with an average age of 52 – who were followed up for on average eight years. Participants completed questionnaires detailing their food and drink intake over the previous year, and later underwent tests of their cognitive skills such as verbal fluency and word recall.

People who consumed the most sweeteners experienced declines in their thinking and memory skills 62% faster than those with the lowest intake, the researchers found. This was “the equivalent of about 1.6 years of ageing”, the researchers said.

Consumption of combined and individual LNCs, particularly aspartame, saccharin, acesulfame K, erythritol, sorbitol and xylitol, was associated with cognitive loss.

“Daily consumption of LNCs was associated with accelerated decline in memory, verbal fluency and global cognition,” the authors say in their paper, published in the American medical journal Neurology.

However, the trend was only observed in participants under the age of 60. That shows that middle-aged adults need to be encouraged to use fewer sweeteners, they added.

The sweeteners studied are also found in flavoured water, low-calorie desserts and energy drinks.

“Low and no-calorie sweeteners are often seen as a healthy alternative to sugar. However, our findings suggest certain sweeteners may have negative effects on brain health over time,” said Claudia Kimie Suemoto, of the University of São Paulo in Brazil, the study’s lead author.

Food and drink industry bodies cast doubt on the findings. “By the authors’ own admission, this study cannot prove cause,” said Gavin Partington, the director general of the British Soft Drinks Association.

“Non-sugar sweeteners are safe, according to all leading health authorities in the world, and that’s why they have been used in a vast array of food, medicine, dental and drinks products for many decades.

“Their use in soft drinks has helped UK manufacturers to remove just under three-quarters of a billion kilograms of sugar from product since 2015.”

The International Sweeteners Association (ISA) said there was an “established scientific consensus” that sweeteners are safe.

“This research is an observational study, which can only show a statistical association, not a direct cause-and-effect relationship,” the ISA said in a statement. “The reported link between sweetener consumption and cognitive decline does not prove that one causes the other.”