Tag: 8/7/25

Categories : Gender Metabolic DisordersTags :

Muscle Metabolism in Men and Women Differs, with Implications for Diabetes

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The skeletal muscles of men and women process glucose and fats in different ways. A recently published study now provides the first comprehensive molecular analysis of these differences. The results possibly give an explanation why metabolic diseases such as diabetes manifest differently in women and men – and why they respond differently to physical activity.

Skeletal muscles are far more than just “movement driving motors.” They play a central role in glucose metabolism and therefore also in the development of type 2 diabetes. This is due to the fact that around 85% of insulin-dependent glucose uptake takes place in the muscles. This means that if muscle cells react less sensitively to insulin, for example in the case of insulin resistance, glucose is less easily absorbed from the blood. This process is specifically counteracted by physical activity. 

Women’s and Men’s Muscles Work Differently

The degree to which muscles work differently in women and men has long been underestimated. It is precisely this issue which has now been investigated by researchers at the Institute for Diabetes Research and Metabolic Diseases at Helmholtz Munich, the University Hospital of Tübingen and the German Center for Diabetes Research (DZD) e.V. The researchers, led by Dr Simon Dreher and Prof Cora Weigert, examined muscle biopsies from 25 healthy but overweight adults (16 women, 9 men) aged around 30 years. The test subjects had not taken part in regular sporting activities beforehand. Over a period of eight weeks, they completed one hour of endurance training three times a week, consisting of 30 minutes of cycling and 30 minutes of walking on the treadmill. 

Muscle samples were taken before they started, after they had the first training session and at the end of the program. Using state-of-the-art molecular biological methods, including epigenome, transcriptome and proteome analyses, the team investigated sex-specific differences at various levels. 

Men React with more Stress to Exercise 

The result: The first training session triggered a stronger stress response at the molecular level in men, which became manifest in the increased activation of stress genes and the increase in the muscle protein myoglobin in the blood. In addition, male muscles showed a distinct pattern of what are called fast-twitch fibers, which are designed for short-term, intensive exercise and preferably use glucose as an energy source. 

Women had significantly higher amounts of proteins that are responsible for the absorption and storage of fatty acids: an indication of more efficient fat utilisation. After eight weeks of regular endurance training, the muscles of both sexes matched and the muscle fibre-specific differences decreased. At the same time, women and men produced more proteins that promote the utilisation of glucose and fat in the mitochondria. 

“These adjustments indicate an overall improvement in metabolic performance, which can help to reduce the risk of type 2 diabetes,” says Weigert. “In future, our new findings might help to better predict individual diabetes risks and tailor recommendations for exercise therapies more specifically to women and men.” 

The scientists next want to investigate the role sex hormones play in these differences – and how hormonal changes in old age influence the risk of metabolic diseases. 

Original publication

Dreher et al., 2025: Sex differences in resting skeletal muscle and the acute and long-term response to endurance exercise in individuals with overweight and obesity. Molecular Metabolism. DOI: 10.1016/j.molmet.2025.102185

About the scientists

Prof. Cora Weigert is head of the research group “Molecular Diabetology and Exercise” at the Institute for Diabetes Research and Metabolic Diseases at Helmholtz Munich and Professor at the University of Tübingen.

Dr. Simon Dreher is scientist at the Institute for Diabetes Research and Metabolic Diseases at Helmholtz Munich and at the University of Tübingen.

Source: Deutsches Zentrum fuer Diabetesforschung DZD

Categories : Healthcare Politics and RegulationsTags :

Global Fund to Cut R1.4-Billion to SA for HIV, TB and Malaria

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Photo by Reynaldo #brigworkz Brigantty

By Liezl Human

The Global Fund to Fight AIDS, TB and malaria (Global Fund) has notified Health Minister Aaron Motsoaledi that it will reduce funding to South Africa by R1.4-billion.

Global Fund said it would be reducing allocations for the seventh grant cycle from R8.5-billion to about R7.1-billion, a 16% reduction. Of this, 55% would be allocated to the National Department of Health and the rest to non-profit organisations such as the Networking HIV & AIDS Community of Southern Africa, Beyond Zero, and the AIDS Foundation of South Africa.

The fund informed recipient countries in May that it would be revising over 200 grants amidst funding shortfalls.

Global Fund was established in 2002 and provides funding for HIV, TB and malaria programmes in over 100 countries. According to its 2024 results report, 72% of its funding from 2021 to 2024 went to sub-Saharan Africa.

Other African countries also received notification of funding cuts. Mozambique’s allocation decreased by 12%, Malawi’s by 8% and Zimbabwe by 11%.

The shortfall in funding is due to Global Fund not having received money pledged by national governments. Over US$4 billion of the shortfall is due to the United States not fulfilling its pledge.

We reported last month how Mozambique’s health system has crumbled amidst USAID funding cuts.

In South Africa, funding cuts from PEPFAR earlier this year have led to clinics closing down, health staff getting retrenched, and people struggling to access HIV medication.

“As you know, the external financing landscape for global health programs is going through significant changes, with substantial impact on lifesaving services for the fight against the three diseases and health and community systems,” the Global Fund said in its letter to South African representatives.

The letter continued that while the Global Fund has “received some significant donor payments in recent days”, prospects to give the full grant cycle 7 (GC7) pledges “remain highly uncertain” and still face a risk of funding shortfalls.

“This is a difficult and unavoidable decision, which may require your country to reconsider how best to use the remaining GC7 grant amounts together with domestic resources and other sources of funds to keep saving lives,” the Global Fund said.

Foster Mohale, Department of Health spokesperson, said that the funding cut did not come as a surprise. Mohale said the department is “working with the provinces” to ensure that “service delivery” is not disrupted, and to apply measures to ensure “efficient use of limited resources”.

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Read the original article.

Categories : CancerTags :

Study Finds 1 in 6 Cancer Medications in Sub-Saharan Africa Are Defective

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Serious quality defects were found in a significant number of cancer medications from sub-Saharan Africa, according to new research from the University of Notre Dame.

For the study published in The Lancet Global Health, researchers collected different cancer medications from Cameroon, Ethiopia, Kenya and Malawi and evaluated whether each drug met regulatory standards. Researchers considered a variety of factors, including appearance, packaging, labelling and, most importantly, the assay value.

The assay value is the quantity of active pharmaceutical ingredient (API) found in each drug. To meet safety standards, most products should be within a range of 90 to 110% of the right amount of API. Researchers measured the API content of each product and compared that number to what was designated on the medication packaging.

“It is important that cancer medications contain the right amount of the active ingredients so the patient gets the correct dose,” said Marya Lieberman, professor of chemistry and biochemistry at Notre Dame and lead author of the study. “If the patient’s dose is too small, the cancer can survive and spread to other locations. If the patient’s dose is too high, they can be harmed by toxic side effects from the medicine.”

One in six cancer medications tested was found to contain the incorrect quantity of API, with tested medications having APIs ranging from 28 to 120%. The study evaluated 251 samples of cancer medications collected from major hospitals and private markets in all four countries.

The study, funded by the National Cancer Institute of the National Institutes of Health, is among the first to evaluate cancer drug quality in sub-Saharan Africa. Currently, sub-Saharan Africa has no pharmaceutical regulatory laboratories carrying out chemical analyses for cancer drugs according to the standards required for regulatory purposes.

Yet, the need for cancer drugs is growing.

“We found bad-quality cancer medications in all of the countries, in all of the hospital pharmacies and in the private markets,” said Lieberman, an affiliate of Notre Dame’s Eck Institute for Global Health and Harper Cancer Research Institute. “We learned that visual inspection, which is the main method for detecting bad-quality cancer drugs in sub-Saharan Africa today, only found one in 10 of the bad products.”

In their study, the researchers explained how a combination of high demand for cancer medications, lack of regulatory capacity, and poor manufacturing, distribution and storage practices likely created a problematic environment throughout sub-Saharan Africa. They also argue that given these factors and the global supply chain for pharmaceuticals, substandard cancer medications are likely present in other low and middle-income countries as well.

Lieberman and her team identified several strategies that could help the global community address poor-quality cancer medications:

  • Provide inexpensive technologies at the point of care to screen for bad-quality cancer medicines and create policies for how to respond to products that fail screening tests.
  • Help regulatory agencies in low and middle-income countries get safety equipment and training so they can analyze the quality of cancer medicines in their markets, conduct root-cause investigations when products fail testing, take quick regulatory actions enabled by lab data and share data about bad-quality products.
  • Perform cost-benefit analyses of interventions that tackle common problems (such as medications being out of stock, unsafe shipping, storage or dispensing practices, and lack of availability or affordability of medications) to help policymakers and funders get the most impact on patient outcomes from their available resources.
  • Work with care providers to develop site-specific response policies and messaging for patients and engage regulators, donors and other resources.

Lieberman and her lab are developing a user-friendly technology called the chemoPAD for screening cancer medications. This low-cost paper device could potentially help hospitals, pharmacies and health care professionals in low and middle-income countries monitor drug quality without restricting a patient’s access to the medication.

“This is all part of a bigger project aimed at developing the ChemoPAD as a point-of-care testing device that we can use, something that’s more accurate in detecting poor-quality products than just visual inspection,” Lieberman said.

“There are lots of medicines where the regulators don’t have enough resources to verify the quality, and some manufacturers take advantage of that to cut corners. There are also problems with distribution systems, so even if a product is good quality when it leaves the manufacturer, it may be degraded during shipping or storage. These products flow into low and middle-income countries, and they get used on patients. I want to change that.”

Source: University of Notre Dame

Categories : Pain ManagementTags :

Podcast: Paracetamol’s Newly Discovered Mechanism Could Unlock Powerful New Analgesics

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Credit: Pixabay CC0

Despite being used for decades as a pain reliever, paracetamol’s mechanism of action was never fully known. Now, new research from the University of Jerusalem points to an unexpected effect, one which may usher in a whole new era of analgesics.

In QuickNews’ first podcast, you can listen to a discussion on how a newly discovered mechanism of action for paracetamol helps it achieve its analgesic effect, and how this could be applied to the development of novel, highly specific pain relievers.

Categories : Mental HealthTags :

Is It Really ADHD? Serious Flaws in Trials With Adult ADHD Patients

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Millions of adults around the world are diagnosed with ADHD every year, and there is a great need for research in the field. Yet much clinical research on adult ADHD suffers from serious methodological shortcomings that make it difficult to use the results in practice, researchers from the University of Copenhagen and the University of Sao Paulo show in a new study.

Originally developed for children, the diagnosis of ADHD is often difficult to make in adults. This is partly because the diagnostic criteria are based on behaviour in children. When diagnosing adults, however, these criteria are often based on adults’ subjective experiences, eg, of having difficulty concentrating or being very impulsive.

“The rising number of adults diagnosed with ADHD raises important questions about diagnostic validity – especially since many were never identified in childhood and are now seeking help, sometimes prompted by ADHD content on social media. That made us curious: how have randomised controlled trials on ADHD dealt with this diagnostic challenge?” explains Dr Igor Studart, who is first author of the study published in European Psychiatry.

Moreover, ADHD shares its symptoms with a number of other mental disorders such as depression, schizophrenia, and bipolar disorder, making it crucial to exclude these disorders when diagnosing ADHD. This requires a thorough diagnostic assessment by an experienced psychologist or psychiatrist.

But it is not always the case that such a thorough assessment is made. The study now shows that even psychiatric research into ADHD often neglects this fundamental work.

“We have examined how 292 of the most credible studies in evidence-based medicine – the so-called randomised controlled trials – diagnosed their adult subjects,” says Professor of Psychiatry and Consultant Psychiatrist Julie Nordgaard, who conducted the study together with Associate Professor and Senior Researcher Mads Gram Henriksen and Dr Igor Studart.

She continues:

“We conclude that half of the studies did not ensure a broad and thorough diagnostic assessment of the patients before the trial to rule out other disorders. This means that they can’t actually know, if their subjects have other mental disorders such as depression or schizophrenia. And that’s not all. More than half of the studies included subjects, who have also been diagnosed with other mental disorders, making the diagnosis even more difficult to allocate”, Julie Nordgaard explains.

According to the researchers, these methodological shortcomings are problematic, because they imply that it is impossible to know which disorders and symptoms the treatment investigated in these trials potentially had an effect on.

“This makes the research results from many of these clinical trials difficult to utilise. Yet, the results of randomised controlled trials are considered particularly trustworthy, and they may inform the guidelines we use to treat adult ADHD patients, even though the results from many of these trials should be assessed very carefully,” says Mads Gram Henriksen.

A need for consistent and robust diagnoses

According to the researchers, one of the problems with the diagnostic assessment in many of the clinical trials is that it seems to have been carried out by people who are not trained to do so. And often with methods that are not thorough enough.

“In 61% of the studies, they do not state who diagnosed the subjects. In only 35% of the studies, it is stated that a psychiatrist or psychologist made the diagnosis. But diagnostic assessment should always be performed by an experienced professional with the necessary training to ensure that the diagnosis is made correctly, and this should be stated in the studies’ method section,” explains Mads Gram Henriksen.

In some cases, the assessment and thus the diagnosis was made by the subject themselves, and in one particularly egregious case, it was done with the help of a computer, the researchers explain.

“In psychiatry, we really need that all diagnoses, not just ADHD, are made with the same uniform criteria and by trained professionals. Otherwise, we cannot rely on the results or compare them across studies,” says Julie Nordgaard and concludes:

“Especially in a situation where a diagnosis such as ADHD in adults is increasing, we need to be very thorough and have a solid foundation. Otherwise, we risk too many people getting a wrong diagnosis and not being able to give them the most effective treatment. Or they risk receiving unnecessary treatment that causes side-effects.”

Source: University of Copenhagen

Categories : Mental HealthTags :

New Study Highlights How to Improve Mental Health Integration in SA Primary Healthcare

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As we commemorate Mental Illness Awareness Month and Psychosocial Disability Awareness Month, a staggering 92% of South Africans living with mental health conditions are not receiving the treatment they need. Yet, research continues to show that collaborative care—where mental health and primary care providers work together—can significantly improve patient outcomes, service satisfaction, and overall quality of life. People with serious mental illness (SMI) are particularly vulnerable as SMI is associated with marked functional impairment and high levels of stigma. SMIs typically include psychotic disorders, bipolar and related disorders, major depression, and severe anxiety and stress-related disorders.

A new study published in Cambridge Prisms’ Global Mental Health explores how integrating community psychiatric services into primary health care (PHC) clinics improves access for individuals with SMI in South Africa. However, the study also reveals persistent challenges related to limited resources, weak management systems, and fragmented collaboration between health care providers as key setbacks.

Conducted in the Sedibeng District, the research forms part of a broader study series focused on patients’ experiences. It is modelled on global evidence to assess the impact of community-based collaborative care—a model increasingly adopted worldwide to strengthen mental health delivery in PHC settings.

Why Integrated Mental Health Care?

Also known as Integrated Care, this health care model plays a vital role in improving access to mental health services by bringing care closer to communities. It relies on bringing together PHC providers such as physicians, nurses and mental health providers to deliver coordinated, person-centred care.  

Integrated care is believed to yield better health outcomes for individuals living with SMIs, who often have comorbid physical health conditions. Saira Abdulla, the lead researcher in the study and Wits PhD fellow based at Centre for Health Policy says the paper highlights key shortfalls in how collaborative care is implemented in this district. This includes poor communication, unclear roles within multidisciplinary teams, and the absence of case managers to coordinate care, with providers instead coordinating care in an ad-hoc manner.

Infrastructure and Staffing Challenges in Integrating Mental Health into Primary Care in Sedibeng

In the Sedibeng District, community-based psychiatry services have been integrated into select primary healthcare (PHC) clinics through two operational models: co-located and physically integrated services. In co-located settings, psychiatric teams operate from separate spaces adjacent to PHC clinics and use independent systems for clinical records. By contrast, physically integrated services are delivered within the same spaces as PHC clinics, using shared management structures and record-keeping systems.

However, a recent study reveals that PHC facilities in the district are not adequately designed to support the specific requirements of psychiatric care. The lack of private, secure consultation spaces compromises confidentiality, as mental health consultations often take place in shared rooms used by multiple healthcare providers.

Physically integrated clinics were found to be particularly constrained, with concerns ranging from overcrowded waiting areas—often without seating—to general safety risks. These conditions compromise the therapeutic environment essential for effective mental health care and highlight the broader systemic challenges of integrating psychiatric services meaningfully within the PHC framework.

The study also underscores a critical shortage of human resources. Most clinics have only five psychiatric nurses on site, while two to four doctors rotate between clinics, offering adult psychiatric consultations just once a week. With monthly patient volumes ranging from 580 to 910, the current staffing levels severely limit the ability to deliver consistent, high-quality care.

Key findings

·        Integration does not guarantee collaboration

While all the elements of full collaboration were not achieved in either setting, the physically integrated setting provided a better opportunity for communication among staff (due to shared files, physical proximity and good management with mental health interest and experience) However, these advantages were still hindered by poor infrastructure and inadequate resources.

·        Integration Models Matter

The study found that physically integrated clinics (shared space and records) had better communication and collaboration between mental health and PHC providers. Co-located clinics (separate buildings and records) suffered from poor communication and siloed teams.

·        Resource and Infrastructure Constraints

Both clinics faced inadequate space, supplies, and staff, although the physically integrated clinic was the most under-resourced. In both settings, insufficient resources were further exacerbated by high caseloads.

·        Leadership is Critical for Collaboration

The study highlighted the importance of management in fostering teamwork. Stronger leadership qualities were evident in the physically integrated clinic, which led to reduced staff conflict and improved communication. In contrast, the co-located clinic was impacted by poor management and a lack of managerial oversight, leading to conflict among staff members. The failure to appoint a permanent Chief Director at the district level has also led to a lack of strategy, and frustration among clinic staff.

·        Resistance from PHC Doctors to Manage Mental Health

PHC physicians and doctors are often reluctant to manage stable psychiatric patients, leading to unnecessary referrals. Some providers did not feel equipped to provide quality care and others felt that collaborating with community psychiatry staff would increase their workload.

As low and middle-income countries move towards integrating mental health into PHC, this paper highlights that the type of integration approach needs to be functional at all levels to enhance the health outcomes of the most vulnerable.

Provided by University of the Witwatersrand