Aducanumab is a monoclonal antibody selective for amyloid β (Aβ) aggregates. In June 2021, aducanumab became the first drug underlying the pathophysiology of Alzheimer’s disease (AD) approved by the US Food and Drug Administration (FDA), under the accelerated approval pathway. The decision was based on the ability of aducanumab to remove Aβ plaques, without any evidence that the Aβ clearance is correlated with less cognitive or functional decline. This decision has generated a considerable debate in the scientific community, especially because the results from the two Phase 3 trials, EMERGE and ENGAGE, were divergent and, even after the post hoc analysis, the data were insufficient to prove aducanumab efficacy. Moreover, some researchers think that this approval will be an obstacle to the progress and also demonstrated concerns about aducanumab cost and its safety profile. The European Medicines Agency’s rejection of aducanumab in December 2021 just brought more controversy over FDA’s decision. Now, Biogen is designing the FDA’s required confirmatory study, named ENVISION, which should be complete in 2026. Despite the controversy, the aducanumab showed to affect downstream tau pathology, which could open doors for a combination therapy approach for AD (anti-tau and anti-amyloid drug). This review summarizes the clinical development of aducanumab until regulatory agencies’ decisions, the available trials data and the controversy over aducanumab approval for AD.

Purpose: The increase in drug prescription for the elderly raises the risk of the occurrence of potentially inappropriate medications (PIMs), thus increasing the incidence of drug-related problems. Likewise, potential prescribing omissions (PPOs) are also highly prevalent in the elderly. This study aimed at assessing the prevalence of PIMs in the elderly by using the EU (7)-PIM list, STOPP criteria version 2 and the Beers criteria version 2015, as well as the prevalence of PPOs by applying the START criteria version 2 in elderly nursing home residents and outpatients of the Eastern Central Region of Portugal. Patients and Methods: A descriptive cross-sectional study was carried out in a sample of 90 Portuguese elderly people. Age, gender, diagnoses and medication history were collected from the patients' clinical records. The prevalence of PIMs and PPOs was measured according to each of the criteria applied. Results: The patients' ages ranged from 65 to 103 years, with an average age of 84.15 years. In addition, the average number of medications prescribed was 7.6. The STOPP criteria identified 250 PIMs affecting 77 patients (85.5%), the EU(7)-PIM list detected 94 PIMs in 58 patients (64.4%) and the Beers criteria identified 69 PIMs in 51 patients (56.6%). Therefore, the STOPP criteria version 2 identified substantially more PIMs than the other two tools. Furthermore, by applying the START criteria 68 PPOs were detected in 52 patients (57.7%). Conclusion: A high prevalence of PIMs and PPOs was observed, suggesting the need to implement actions aimed at reducing the phenomenon and thus help to improve the quality of care provided in nursing homes. The variations in prevalence with the different tools suggest the need to carefully choose the tool for medication review in the elderly.

Diabetes mellitus is a pathology with increasing frequency in society, being one of the main causes of death worldwide. For this reason, new therapeutic targets have been studied over the years. 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) is an enzyme responsible for reducing cortisone to its active form cortisol, which can lead to metabolic changes such as insulin resistance and hyperglycemia. Therefore, 11β-HSD1 inhibition may offer a new therapeutic approach for type 2 diabetes mellitus. This work intends to systematically review the available scientific evidence on this subject. For this, a search was conducted in three databases and 15 clinical and in vivo preclinical studies were included in this review. Despite the high inhibitory and selectivity levels achieved with several molecules and the demonstrated clinical efficacy in diabetes treatment, no phase III clinical trials have yet been conducted. This is important because the long-term effects of 11β-HSD1 inhibitors including the consequences in hypothalamic–pituitary–adrenal axis must be evaluated. However, this enzyme remains a promising target for drug development, including due to its effectiveness in controlling various factors that constitute the metabolic syndrome and its potential for multiple indications in patients with diabetes, including wound healing and weight loss.

The conventional BacT/ALERT FA blood cultures supported the ample growth of Mycobacterium tuberculosis in seeding experiments and appeared to perform as reliably as the BACTEC Myco/F-Lytic vials in the recovery of M. tuberculosis from blood in HIV-infected patients. Overall, blood cultures were positive in 39% of patients with tuberculosis

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