Category: 8. Health

Eight or more alcoholic drinks per week were linked to signs of injury in the brain in a large autopsy study. The finding points to changes in small blood vessels that help feed and clean brain tissue, which is hard to detect during life.

Those lesions are called hyaline arteriolosclerosis, a thickening of tiny arteries that narrows the passage for blood and stresses nearby cells.

This process sits within vascular cognitive impairment as described in an American Heart Association statement, which outlines how damaged vessels relate to thinking problems.

Alcohol and brain health

Alberto Fernando Oliveira Justo, PhD, at the University of Sao Paulo Medical School in Brazil (FMUSP) led the work. His team used human brains rather than only scans, which lets them count lesions directly and measure brain weight.

“Heavy alcohol consumption is a major global health concern linked to increased health problems and death,” said Alberto.

This project analyzed older adults who agreed to donate their organs for research, creating a window into aging and alcohol exposure.

In the United States, one standard drink contains about 14 grams of pure alcohol. That is roughly 12 ounces of beer at 5 percent alcohol, 5 ounces of wine, or 1.5 ounces of distilled spirits, which are the serving sizes researchers use to keep totals comparable across people.

The researchers classified participants as never, moderate, heavy, or former heavy drinkers based on interviews with family members.

Heavy drinking in this work meant eight or more drinks per week, a level that adds up faster than many people realize when pours are generous at home or at restaurants.

How the study was done

This cross-sectional autopsy analysis included 1,781 people with a mean age near 75 at death. All underwent standardized postmortem exams that recorded brain weight and neuropathology using standard stains to label lesions under the microscope.

Researchers looked for signs of brain damage such as tangled proteins, small strokes, buildup in blood vessels, and thickening of tiny arteries.

They also calculated a brain mass ratio by dividing brain weight by height and rated cognition using the Clinical Dementia Rating Sum of Boxes (CDR-SB) to summarize abilities close to death.

Alcohol exposure was reconstructed from detailed interviews with relatives who knew the person well. This approach is common in autopsy cohorts but it depends on memory and records kept during life.

The team used logistic and linear regression to estimate odds of lesions and differences in continuous measures.

Finally, the team tested whether vascular injury mediated any links between drinking and cognition, asking if vessel damage could explain the path from alcohol to poor scores.

Brain vessel damage from alcohol

Compared with people who never drank, the odds of hyaline arteriolosclerosis were higher in moderate drinkers, heavy drinkers, and former heavy drinkers.

Reported odds ratios were 1.60, 2.33, and 1.89 respectively with confidence intervals that excluded 1.00, which signals an association in this dataset.

For tau pathology, only heavy and former heavy drinkers showed higher odds of neurofibrillary tangles. Odds ratios were 1.41 for heavy and 1.31 for former heavy drinkers, indicating a specific link to tangles in this cohort.

Former heavy drinking tracked with a lower brain mass ratio and worse cognitive performance at the end of life.

The beta estimates were negative for mass and positive for impairment, and only former heavy status met the threshold for these outcomes after adjustment for other factors.

The association between alcohol, brain vessels, and cognitive abilities was fully mediated by hyaline arteriolosclerosis in the statistical models.

In plain terms, the vascular injury appeared to sit between reported drinking and measured cognition within this dataset.

What this might mean

When small vessels stiffen, they limit blood flow to fragile brain circuits that handle attention, speed, and memory.

Over time, injuries add up as white matter changes and microinfarcts that often go unnoticed in daily life, yet they can slow everyday tasks.

Excessive alcohol use is a leading cause of preventable deaths in the United States.

Public health estimates attribute about 178,000 deaths per year to heavy and binge patterns across the country, placing alcohol alongside tobacco and obesity among top sources of avoidable harm.

This autopsy analysis cannot prove the cause, and the authors say so. It shows a statistical signal that aligns with what pathologists and stroke specialists see in vascular cognitive impairment.

Adding alcohol to vascular risks like smoking, hypertension, or diabetes can stack the deck. Reducing intake and treating existing vascular risks could limit future small vessel injury.

Brain health, alcohol, future study

The dataset does not track how long people drank or how their habits changed across adulthood. Without a timeline, it is hard to test dose response or recovery during abstinence.

“We found heavy drinking is directly linked to signs of injury in the brain, and this can cause long-term effects on brain health, which may impact memory and thinking abilities,” said Alberto.

Alcohol reports came from informants, so misclassification can occur when records are thin or memories fade. 

These donors came from one urban region with limited formal schooling on average, which can shape both drinking patterns and health access. Future cohort studies can test whether cutting back reverses vascular stress or slows tangle buildup.

Mediation analysis isolates a pathway, but it relies on modeling assumptions.

Trials and prospective cohorts that measure alcohol objectively and track imaging and cognition could answer questions about reversibility and thresholds.

The study is published in Neurology.

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Even millimeter-level misplacements of in ovo vaccines can dramatically reduce immune response in the chick, leaving poultry flocks vulnerable to disease outbreaks despite vaccination efforts.

“Vaccination accuracy is one of the biggest determining factors of whether a vaccine is going to stimulate an immune response and therefore provide protection to that bird for the targeted diseases,” explained Dr. Josh Deines, technical service device lead at Zoetis. “When it comes to in ovo vaccination, where the vaccine is delivered within the egg significantly impacts its effectiveness.”

For example, when vaccines are accurately delivered to the embryo body or amniotic fluid, they can provide more than 93% protection against disease. However, misplaced injections into locations like the allantois reduce protection to 28% or less, while air cell injections provide virtually no protection at all.

How poultry vaccination can go wrong

The process of in ovo vaccination creates multiple potential failure points that can go unnoticed. Bent needles, one of the most common issues, can redirect vaccine placement away from target locations. Gaps in day-to-day equipment maintenance can contribute to equipment problems. For example, slipping tooling — often caused by water or sanitizer leakage onto injection heads — prevents stable positioning during the injection cycle.

Embryo development timing also plays a critical role. The acceptable transfer window ranges from 17 days, 12 hours to 19 days, 4 hours of incubation. Transferring too late reduces accuracy as embryos fill the shell and begin to hatch, increasing the risk of eye or other undesirable vaccination locations. Conversely, transferring too early or with poor incubation conditions can result in abnormally developed or mispositioned embryos.

In addition, “if there’s abnormally developed embryos mispositioned due to extreme overheating or under heating during incubation, then they may also have the vaccine delivered to the wrong location,” Deines noted.

Follow a QC checklist

Implementing a comprehensive quality control (QC) checklist can significantly improve consistency of vaccination accuracy. Key inspection points include running QC plates at the frequency recommended by the technology manufacturer to ensure every needle deposits vaccine properly, visually checking for bent needles by examining injection tooling from a 45⁰ angle and monitoring for slipping tooling throughout the injection process.

Environmental controls are equally important. Hatchery managers should avoid transferring embryos into dirty, wet or cold hatch baskets, and protect injection equipment from water leaks and excessive humidity that can compromise tooling stability.

“There’s no reason not to do it,” Deines emphasized regarding the QC checklist. “It’s such an easy task requiring little time and it can significantly impact results.”

For hatcheries processing millions of chicks monthly, even small improvements in vaccination accuracy can translate to substantial economic benefits.

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KINSHASA, Congo — Limited access and required funding are the key challenges facing health officials trying to respond to the latest Ebola outbreak in southern Congo, the World Health Organization said on Friday.

It is the first Ebola outbreak in 18 years in Kasai province, a remote part of Congo with poor road networks, which is more than 1,000 kilometers (621 miles) from the nation’s capital of Kinshasa.

A United Nations peacekeeping helicopter was used to help deliver 400 vaccine doses to the epicenter, in the locality of Bulape, on Friday, Patrick Otim, WHO’s programme area manager, told a briefing in Geneva.

An additional 1,500 doses will be sent from the capital of Kinshasa, he said.

“We have struggled in the last seven days with access but are collaborating with MONUSCO (UN peacekeeping mission in Congo) now,” Otim said.

While the WHO and Congolese authorities have “ramped up efforts to have a full scale response” on ground, “we need to be able to pay for the operations,” he added.

Since the outbreak was confirmed on Sept. 4, the number of suspected cases has increased from 28 to 68, Africa’s top health agency said on Thursday. The Africa Centers for Disease Control and Prevention, or Africa CDC, has so far reported 16 deaths.

Otim said the most recent confirmed case was located 70 kilometers (43 miles) from the current epicenter. “Our worry is if we get cases in the other health zone, we need to expand and it will be resource-intensive,” he said.

WHO’s projected cost for the current outbreak over the next three months is $20 million while Congo’s national response plan is estimated at $78 million, said Otim.

A major concern has been the impact of recent U.S. funding cuts. The U.S. had supported the response to Congo’s past Ebola outbreaks, including in 2021 when the U.S. Agency for International Development provided up to $11.5 million to support efforts across Africa.

What could GLP-1 drugs, known for their powerful weight loss benefits, have to do with oncology? Potentially “everything,” according to Deborah Phippard, chief scientific officer at the clinical research organization Precision for Medicine.

Popular drugs like Novo Nordisk’s Ozempic and Wegovy and Eli Lilly’s Mounjaro and Zepbound have such versatile effects that they could play a role treating not only diabetes and obesity, but cancer too, Phippard said.

“These are some of the most complicated drugs I’ve seen in my career because they do so many things,” Phippard said. The receptor these drugs bind to “is at the top of so many different pathways, and there are so many downstream effects that feed back in.”

The August U.S. approval of Wegovy for the liver disease metabolic dysfunction-associated steatohepatitis, or MASH, is a testament to the widespread impact a GLP-1 drug might have, as even the Food and Drug Administration acknowledged that the medicine was able to treat the condition through mechanisms that are not “fully understood.”

For the same reasons, GLP-1s could impact cancer patients as well, Phippard said. A large study in 1.6 million people with Type 2 diabetes found that those receiving GLP-1s had lower risk of developing many related cancers.

“If you’re obese and diabetic, you are at higher risk of any number of cancers, which is well-documented,” Phippard said. “Pancreatic, endometrial, ovarian and colorectal cancers in particular have been found to be driven by insulin resistance, so controlling obesity should theoretically take cancer incidents down.”

Beyond the benefits of weight loss to reduce cancer risk, the Swiss-army knife nature of GLP-1s could overlap with different pathways that govern how cancer forms and spreads from an immunological standpoint, she said.

“Looking at the function of specific T cells, NK cells, macrophages, dendritic cells, all of those functions you can demonstrably show change with a GLP-1 agonist,” Phippard said. “The MAP kinase pathway, the NF-kappa B pathway, VEGF — GLP-1 is upstream of all of these.”

The data around these pathways and the health risks associated with them is “messy,” Phippard acknowledged, but understanding clinical outcomes for patients being treated for cancer who are also on a GLP-1 could reveal actual effects.

GLP-1s and cancer therapy

Early research has shown that GLP-1s could potentially help overcome chemotherapy resistance, which would theoretically improve outcomes for cancer patients, though Phippard again noted the exact mechanism “isn’t brilliantly well understood.”

And with the drugs’ known effects on the immune system, they may also boost the effects of cancer immunotherapies like Merck & Co.’s Keytruda or Bristol Myers Squibb’s Opdivo, Phippard said.

“If you look at immune cells in an obese person, they don’t work that well and aren’t very healthy, but a GLP-1 can help,” Phippard said. “I’m always a little hesitant at that because the immune system is very complicated and massively redundant, but we should explore these areas further.”

Earlier research had raised some concerns of a link between GLP-1 drugs and thyroid or pancreatic cancer arose, according to the MD Anderson Cancer Center. But subsequent studies haven’t confirmed that connection.

Still, physicians so far are being careful with GLP-1s in oncology, particularly with pancreatic cancer patients or those already suffering from gastrointestinal problems that a weight loss drug could exacerbate. Muscle loss is also associated with long-term GLP-1 use, which could make patients more frail over time.

Ongoing and future clinical studies for cancer could provide important clues. With nearly 12% of all Americans having taken a GLP-1, the odds of patient overlap with clinical trials are growing, Phippard said, and researchers need to better understand those implications to ensure accurate data.

“We’re right at the beginning of how we work this out, but I think you’ve got to run a clinical study looking at this with a separate statistic even in its own right,” Phippard said. “I don’t think we’ll ever be able to pull it entirely apart, but I’m not planning on retiring anytime soon.”

A standalone oncology treatment?

The idea of using GLP-1s to treat cancer, on their own, is a ways away, Phippard said.

“We are not remotely close to a GLP-1 alone for cancer treatment,” she said. “There may be one or two patients who start a GLP-1 for whatever reason, and their immune system picks up, but that’s an anecdotal n of 1.”

But the drugs may be useful as a combination treatment alongside chemotherapy or immunotherapy.

Currently, “combo therapies are happening by accident” with patients both on a GLP-1 and undergoing cancer treatment at the same time, Phippard said. And companies like Lilly, which sells drugs for cardiometabolic diseases as well as cancer, could start thinking about pairing them up in oncology trials without having to buy new assets.

“I’m expecting to see this coming out at all the big cancer meetings over the next five to 10 years,” Phippard said. “This is starting to buzz in the community.”

When added to standard care, baxdrostat (CIN-107; AstraZeneca) shows benefits in managing high blood pressure and delaying the progression of kidney disease in patients with chronic kidney disease (CKD) and uncontrolled high blood pressure, according to preliminary research presented at the American Heart Association (AHA) Hypertension Scientific Sessions 2025.¹

These findings, which are from the phase 2 FigHTN clinical trial (NCT05432167)², further reaffirm the benefits of baxdrostat when managing blood pressure, such as those demonstrated in the phase 3 BaxHTN trial (NCT06034743).^1,3

About the Trial

Trial Name: A Study to Evaluate CIN-107 for the Treatment of Patients With Uncontrolled Hypertension and Chronic Kidney Disease

ClinicalTrials.gov ID: NCT05432167

Sponsor: AstraZeneca

Completion Date: May 2, 2024

CKD and high blood pressure are closely linked, according to the investigators, and if not managed properly or left untreated, patients can experience serious outcomes such as heart attack, stroke, heart failure, and progression to kidney failure. According to the manufacturers, baxdrostat is a potential first-in-class, highly selective, potent oral small molecule that inhibits aldosterone synthase, an enzyme encoded by the CYP11B2 gene, which is responsible for the synthesis of aldosterone in the adrenal gland. Baxdrostat is currently undergoing investigation in clinical trials as a monotherapy for hypertension and primary aldosteronism and as a combination therapy for CKD and the prevention of heart failure in patients with hypertension.^1,4

“These findings are encouraging for people living with CKD and high blood pressure, 2 conditions that often go hand-in-hand and create a dangerous cycle,” lead study author Jamie P. Dwyer, MD, professor of medicine in the division of nephrology and hypertension at University of Utah Health in Salt Lake City, said in a news release. “High blood pressure can worsen kidney function and declining kidney function can further elevate blood pressure, and these outcomes can be life-altering for patients.”¹

FigHTN is a randomized, double-blind, placebo-controlled phase 2 clinical trial that assessed whether adding baxdrostat to standard care is safe and could lower blood pressure in patients who have both CKD and uncontrolled hypertension. The enrolled patients’ blood pressure remained high even after receiving prior treatment with an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker.^1,2

A total of 192 patients (average age: 66 years) with CKD and hypertension were randomly assigned to receive treatment with a low dose (0.5 mg–1 mg) or high dose of baxdrostat (2 mg–4 mg) or placebo in addition to standard care for a 26-week duration. The primary end point was change from baseline in mean seated office systolic blood pressure at week 26 in the baxdrostat pooled treatment group compared with placebo, and the secondary end point assessed this change by high-dose or low-dose baxdrostat. Additionally, safety outcomes were also evaluated. The findings were presented at the AHA Hypertension Scientific Sessions 2025 and published in the Journal of the American Society of Nephrology.^1,2,5

The data show that the mean baseline systolic blood pressure was about 151.2 mmHg, the mean baseline estimated glomerular filtration rate was 44 ml/min/1.73 m², and the median urine albumin-creatinine ratio was 713.8 mg/g. The mean placebo-corrected change in systolic blood pressure from baseline to week 26 for the baxdrostat pooled group was –8.1 (95% CI: −13.4 to −2.8; P = .003) mmHg, and for low-dose and high-dose, these were −9.0 (95% CI: −15.1 to −2.9; P = .004) mmHg and −7.2 (95% CI: −13.2 to −1.2; P = 0.02) mmHg, respectively.^1,5

Importantly, there were no deaths or unexpected adverse events (AEs) throughout the study population. Hyperkalemia was the most common AE and was observed in approximately 41% (n = 53) of participants in the baxdrostat pooled group and 5% (n = 3) in the placebo group.^1,5

“These new findings are reassuring that this new class of antihypertensive medications are likely to have both kidney- and cardioprotective benefits and to be safe and effective for broad patient populations,” Jordana B. Cohen, MD, MSCE, immediate past chair of the AHA’s Hypertension and Kidney Cardiovascular Science Committee, and deputy director and associate professor of medicine and epidemiology in the Perelman School of Medicine at the University of Pennsylvania, said in the news release. “Patients with CKD were historically often excluded from drug studies. It is particularly reassuring to know that patients with CKD, who have very high rates of hypertension and elevated renin-angiotensin aldosterone activity, were represented in their own study, tolerated the medication well, and had both blood pressure and albuminuric benefits. This medication class could be a game changer in the management of hypertension in this patient group.”¹

REFERENCES

1. American Heart Association. New medication lowered hard-to-control high blood pressure in people with chronic kidney disease. News release. September 6, 2025. Accessed September 11, 2025. https://newsroom.heart.org/news/new-medication-lowered-hard-to-control-high-blood-pressure-in-people-with-chronic-kidney-disease

2. A Study to Evaluate CIN-107 for the Treatment of Patients With Uncontrolled Hypertension and Chronic Kidney Disease. ClinicalTrials.gov identifier: NCT05432167. Updated May 20, 2025. Accessed September 11, 2025. https://www.clinicaltrials.gov/study/NCT05432167

3. Halpern L. Full Phase 3 Results Indicate Reduced Blood Pressure With Baxdrostat in Hypertension. Pharmacy Times. September 8, 2025. Accessed September 11, 2025. https://www.pharmacytimes.com/view/full-phase-3-results-indicate-reduced-blood-pressure-with-baxdrostat-in-hypertension

4. AstraZeneca. Baxdrostat met the primary and all secondary endpoints in BaxHTN Phase III trial in patients with uncontrolled or treatment resistant hypertension. News release. July 14, 2025. Accessed September 11, 2025. https://www.astrazeneca.com/media-centre/press-releases/2025/baxdrostat-met-primary-and-all-secondary-endpts-in-baxhtn-phiii-trial.html

5. Dwyer J, Maklad N, Vedin O, et al. Efficacy and Safety of Baxdrostat in Participants with CKD and Uncontrolled Hypertension: A Randomized, Double-Blind, Placebo-Controlled Trial. J Am Soc Nephrol. Published online September 6, 2025. doi:10.1681/ASN.0000000849

The World Health Organization (WHO) has published its global cholera statistics for 2024, showing an increase in both the number of people who fell sick and died from the disease.

Reported cholera cases rose by 5% and deaths by 50% in 2024 compared to 2023, with more than 6000 people dying from a disease that is both preventable and treatable. While these numbers are themselves alarming, they are underestimates of the true burden of cholera.

Conflict, climate change, population displacement, and long-term deficiencies in water, sanitation, and hygiene infrastructure continue to fuel the rise of cholera, a disease caused by the bacterium, Vibrio cholerae, which spreads rapidly through faeces-contaminated water.

Sixty countries reported cases in 2024, an increase from 45 in 2023. The burden of the disease remained concentrated in Africa, the Middle East, and Asia, which collectively accounted for 98% of all reported cases.

The scope of cholera outbreaks continued to expand in 2024, with 12 countries each reporting more than 10 000 cases, seven of which experiencing large outbreaks for the first time in the year. The resurgence of cholera in Comoros after more than 15 years without reported outbreaks, underscores the persistent threat of global transmission.

The case fatality ratio for Africa increased from 1.4% in 2023 to 1.9% in 2024, revealing critical gaps in the delivery of life-saving care, and signaling the fragility of many health systems, along with challenges in access to basic health services.

One quarter of deaths occurred in the community, outside of health facilities, highlighting serious gaps in access to treatment and the need to strengthen work with communities.

To combat cholera, governments, donors and communities need to ensure people have access to safe water and hygiene facilities, have accurate information on how to protect themselves, and rapid access to treatment and vaccination when there are outbreaks. Strong surveillance and diagnostics will help guide these responses. Further investment in vaccine production is also needed.

A new, innovative oral cholera vaccine (OCV), Euvichol-S®, was prequalified in early 2024 and entered the global stockpile. Its addition helped to maintain average stockpile levels above the emergency threshold of 5 million doses for the first 6 months of 2025. However, due to the continued high demand for OCV, the temporary change from a two-dose to a single-dose regimen remained in effect throughout 2024 and into 2025. Requests for 61 million OCV doses were made to the global stockpile in 2024, and a record 40 million were approved for emergency use in reactive, single-dose campaigns in 16 countries. However, supply constraints continued to outstrip demand in 2024, and into 2025.

Preliminary data show that the global cholera crisis continues into 2025, with 31 countries reporting outbreaks since the beginning of the year.

WHO assesses the global risk from cholera as very high, and is responding with urgency to reduce deaths and contain outbreaks in countries around the world. WHO continues to support countries through strengthened public health surveillance, case management, and prevention measures; provision of essential medical supplies; coordination of field deployments with partners; and support for risk communication and community engagement.

 

“Empathetic communication is key for vaccines to reach those who need them most. It’s not enough for a vaccine to exist and be available; people must understand its importance, trust it, and decide to receive it, based on clear information. Science gives us the tool, and empathy opens the door for people to choose to use it,” explains Fernando González, International Immunization Advisor at PAHO in Colombia.

Results reflected in coverage

Zahira recalls how just weeks ago a vaccination register showed only 62% coverage. After the workshop, however, and applying what she had learned, coverage rose to 85%. In Mesa de Pole, she managed to reverse 7 out of 10 refusals; and in Fortaleza, 9 out of 15.

“Before, many people would reply with a blunt ‘no,’ but now the conversation flows,” says Yamile Reyes, nursing assistant in Ataco, about the changes she noticed when interacting with people after learning how to address common doubts. She recalls that before the workshop, refusals were quick, almost automatic, often leaving no space to explain the vaccine’s benefits. “Now, even when the initial answer is negative, people pause to listen, ask questions, want to know more. That gives us the chance to return, to insist respectfully, and little by little, they change their minds,” she adds.

This renewed confidence was also reflected in surveys carried out at the end of the training for 526 vaccinators, nursing assistants, and doctors from southern Tolima: Average confidence when interacting with communities rose from 4.27 to 4.73 out of 5; 97.6% of participants reached a high confidence level; and 95.3% said they would recommend the course. “It helped us know how to approach people, how to talk to them and answer questions,” adds Claudia Marcela Pérez, who convinced several families to accept the vaccine.

Health is power. Get vaccinated against yellow fever

Yellow fever is a serious viral disease that, in its jungle cycle —the type recorded in Colombia— is transmitted by mosquitoes of the Haemagogus and Sabethes genera. It can cause high fever, severe pain, jaundice, and, in the most serious cases, hemorrhage and even death. While there is no specific treatment, there is a safe, free, single-dose vaccine that provides lifelong protection. This vaccine has been part of Colombia’s disease control strategies for over 70 years.

The current outbreak has caused dozens of cases and deaths in Tolima, one of the country’s most affected departments. For this reason, multiple measures have been implemented: entomovirological surveillance and vector control, including mosquito capture and laboratory identification, primate surveillance, community monitoring to detect cases, and, of course, efficient and timely clinical management to save lives.

In the context of this outbreak, the main lesson from the workshop is clear: assertive, empathetic, evidence-based communication is not an optional extra in public health, but key to strengthening prevention and control actions. “We are a resilient municipality and I am sure that, with heart and joint work, we will overcome this situation,” stressed Secretary Charry.