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Neurodegenerative diseases, such as Alzheimer＇s, Parkinson＇s and Huntington＇s diseases, are all character- ized by a component of innate immunity called neuroinflammation. Neuronal loss and neuroinflammation are two phenomena closely linked. Hence, the neuroinflammation is a relevant target for the management of the neurodegenerative diseases given that, to date, there is no treatment to stop neuronal loss. Several studies have investigated the potential effects of activators of alpha 7 nicotinic acetylcholine receptors in animal models of neurodegenerative diseases. These receptors are widely distributed in the central nervous system. After activation, they seem to mediate the cholinergic anti-inflammatory pathway in the brain. This anti-inflammatory pathway, first described in periphery, regulates activation of microglial cells considered as the resident macrophage population of the central nervous system. In this article, we shortly review the agonists of the alpha 7 nicotinic acetylcholine receptors that have been evaluated in vivo and we focused on the selective positive allosteric modulators of these receptors. These compounds represent a key element to enhance receptor activity only in the presence of the endogenous agonist.

Radiopharmacy is a specialized area of hospital pharmacy dedicated to the preparation and appropriate use of radiopharmaceuticals for diagnostic imaging and targeted therapies. While clinical pharmacy activities are well established in many hospital settings, their integration into radiopharmacy remains poorly documented and lacks standardization, particularly in the context of the rapid development of theranostic applications. This descriptive, cross-sectional study aimed to assess current clinical pharmacy practices in radiopharmacy across the HUGOPharm network. Between July and September 2025, an anonymous online questionnaire was distributed to radiopharmacy teams, collecting information on prescription analysis, biological monitoring, interdisciplinary collaboration, and other clinical pharmacy activities. Descriptive statistics were used to analyze responses. All participating centers reported verifying patient identity and key prescription parameters; however, substantial variability in practices was observed. Pharmacotherapeutic analysis was more frequently performed for therapeutic procedures (71%) than for diagnostic procedures (57%). Pre-procedure biological testing was common in therapeutic contexts (86%) but infrequent for diagnostic applications (29%). No center reported conducting structured medication reviews or pharmaceutical consultations. The implementation of radioligand therapies, such as [177Lu]-PSMA, was associated with enhanced safety checks and increased interdisciplinary collaboration. Overall, clinical pharmacy in radiopharmacy is developing but remains inconsistently implemented. Structured clinical pharmacy activities appear particularly relevant for theranostic procedures and may represent priorities for future practice development to support patient safety and integrated care.

Pain is a universal issue and is of particular concern in mechanically ventilated patients, as they require intensive nursing care and multiple invasive procedures, while being unable to communicate verbally. The aim of this study was to assess the effect of music on pain experienced by mechanically ventilated patients during morning bed bathing. Of the 60 mechanically ventilated patients enrolled in this single-center pilot study between March 2013 and October 2015, the first 30 received no music and the next 30 the music intervention, during the morning bed bath. The Behavioral Pain Scale (BPS) score was determined during and at the end of the bath then 30, 60, and 120 minutes after the bath. BPS score changes over time were assessed and the proportions of bath times spent with a BPS score ≥5 and with the maximal BPS score were determined. At baseline, no patient had pain (defined as a BPS score <5) and the median BPS score was 3 [IQR, 3;3] in both groups (P = 0.43). After bed bath initiation, 88% of patients experienced pain. The maximum BPS value during the bath was lower in the music group (5 [5;6.7] vs. 7 [5;7]). Proportions of total bath time spent with BPS≥5 and with the maximum BPS were significantly lower in the music group than in the control group (2.0 [0.3;4.0] vs. 10 [4.3;18.0]; P < .0001 and 1.5 [0;3.0] vs. 3.5 [2.0;6.0]; P = .005; respectively). Two hours after the end of the bath, the BPS values had returned to baseline in both groups. In our population, music significantly decreased pain intensity and duration during the morning bed bath in mechanically ventilated patients. These results warrant further assessment in a large multicenter randomized controlled trial. ClinicalTrials.gov NCT02883959.

Background Many available interventions to reduce challenges of natural caregivers of people living with dementia have limited efficacy since they do not meet the caregiver’s individual needs. This study aims to evaluate caregivers’ needs with the future goal of developing a tailored, multicomponent intervention to ease caregiver challenges through appropriate caregiver-centred interventions. Methods Mixed method study using a convergent design with quantitative and qualitative data collection and analysis performed at similar times. For the cross-sectional quantitative study, questionnaires were sent to natural adult caregivers of a person with dementia identified by local healthcare professionals and general practitioners exercising in a rural and an urban department. For the qualitative descriptive study, individual caregiver interviews and healthcare professional focus groups were conducted in two primary healthcare territories in both departments. Data about screening for caregiver challenges and any help provided to the caregiver were collected. Quantitative data were analysed using descriptive statistics and qualitative data underwent thematic analysis using the grounded theory approach. Quantitative and qualitative results were described using a narrative discussion approach, then results were combined on a theme-by-theme basis using the weaving approach enabling integrated analysis. Results A total of 199 general practitioners and 67 caregivers participated in the quantitative study. In the qualitative study, 10 caregivers from the urban area and 12 caregivers from the rural area participated in the individual interviews, and 9 healthcare professionals participated in the focus groups. Our broad categories of caregiver needs were identified: awareness and early diagnosis, information and training, practical, coordinated support, and psychological support. The integrated analysis highlighted areas for improvement in meeting these needs, especially a better identification of the caregiver role, caregiver distress, better information about what the caregiver has to expect in terms of the disease’s progression and daily management, ways to improve awareness in general population, acceptation of practical support and its coordination and adaptation. Conclusions Identified needs were concordant with those in the literature. The mixed method used enabled expectations to be explored by analysing together the points of view of both patients and healthcare professionals in order to identify ways of improving their care. Trial registration Not applicable.

Background: Enterobacterales are among the most frequent causes of healthcare-associated infections and are increasingly affected by antimicrobial resistance. Antibiotic use disrupts the gut microbiota, facilitating colonization by multidrug-resistant organisms, including carbapenemase-producing Enterobacterales (CPE). While animal studies have suggested that certain antibiotic classes may increase the risk of CPE acquisition, clinical data identifying which classes are most implicated remain limited. Methods: We conducted a single-center, retrospective case-control study (2021–2024) comparing antibiotic prescriptions in patients who acquired CPE with those in controls hospitalized in the same unit and during the same risk period but who did not acquire CPE. The objective of this study was to identify which antibiotic classes or pharmacological properties are associated with the acquisition of carbapenemase-producing Enterobacterales (CPE) in hospitalized patients. Results: During the study period, 35 cases and 70 controls were included. Most cases acquired NDM-type metalloenzymes. Before the risk period, 55 patients had received antibiotic therapy. Univariate analysis identified an association between CPE acquisition and the prescription of fluoroquinolones and antibiotics excreted in bile. During the risk period, only metronidazole prescription was significantly associated with CPE acquisition. Our study has several limitations, including the small sample size, the single-center retrospective design, and the lack of molecular typing (e.g., WGS) to confirm potential clonal transmission. Conclusions: In this preliminary study, metronidazole use was associated with an increased risk of CPE acquisition during risk periods. However, these results should be interpreted cautiously and need to be confirmed in larger, multicenter studies. The high exposure of patients to multiple antibiotic classes highlights the importance of strict antibiotic stewardship policies in the current era of global CPE dissemination.

Background Effective communication in healthcare, among professionals and between professionals and patients is crucial for delivering high-quality care. While simulation effectively translates technical skills to clinical practice, its impact on communication, particularly in pharmacies, is less well documented. Aim This systematic review examined the impact of simulation-based education on communication skills among pharmacy students and pharmacists. It aims to identify the types of simulations used, the outcomes obtained, and the effectiveness of these simulations in enhancing communication skills, perception and confidence. Method We conducted searches in MEDLINE, LISSA, EMBASE, and PsycINFO for articles on communication training through simulation for pharmacy students and pharmacists. The search covered the period from inception to August 31, 2022. To be included, studies had to meet the following criteria: (i) target pharmacy student or graduate pharmacists; (ii) use simulation in the field of clinical pharmacy; (iii) provide a complete description of the outcome measure. Studies for which it was impossible to extract data specific to pharmacy students or simulation were excluded. Three investigators independently evaluated each title and abstract. If each investigator considered the citation eligible, six authors progressed to full-text review. The outcomes related to communication were categorized into three groups: perception of the importance of communication in delivering high-quality patient care, confidence in communication skills, and assessed communication proficiency. The quality of studies included in this review was assessed using the Mixed Methods Appraisal Tool (MMAT). Results The total number of participants was 3337. Among the 20 articles reviewed, which were primarily published in the United States over the last decade, only one focused on community pharmacists. Quasi experimental designs were predominant, and studies often relied on learners' self-assessments with non-validated questionnaires. Simulation-based learning aimed to enhance communication skills and attitudes across interprofessional contexts (involving nursing and medical students), patients, and families, frequently utilizing simulated patients. Studies evaluating outcomes have emphasized communication skills with patients and families, while those involving healthcare professionals often focused on perception of the importance of communication in delivering high-quality patient care. Conclusion Despite study heterogeneity, this systematic review concluded that simulation-based training significantly enhances perception, confidence, and communication skills. The development of clear guidelines and standardized assessment tools to evaluate communication would significantly improve the validity and reliability of future research efforts (PROSPERO registration: n°CRD42022371915).

Neuroinflammation is a common element involved in the pathophysiology of neurodegenerative diseases. We recently reported that repeated alpha-7 nicotinic acetylcholine receptor (α7nAChR) activations by a potent agonist such as PHA 543613 in quinolinic acid-injured rats exhibited protective effects on neurons. To further investigate the underlying mechanism, we established rat models of early-stage Huntington's disease by injection of quinolinic acid into the right striatum and then intraperitoneally injected 12 mg/kg PHA 543613 or sterile water, twice a day during 4 days. Western blot assay results showed that the expression of heme oxygenase-1 (HO-1), the key component of the cholinergic anti-inflammatory pathway, in the right striatum of rat models of Huntington's disease subjected to intraperitoneal injection of PHA 543613 for 4 days was significantly increased compared to the control rats receiving intraperitoneal injection of sterile water, and that the increase in HO-1 expression was independent of change in α7nAChR expression. These findings suggest that HO-1 expression is unrelated to α7nAChR density and the increase in HO-1 expression likely contributes to α7nAChR activation-related neuroprotective effect in early-stage Huntington's disease.

ObjectivesMedication reconciliation (MR) has been identified by the French High Health Authority (HHA) as an advanced criterion for improving the quality of care. Although this activity has been widely developed and evaluated in conventional establishments, few studies have looked at its implementation in ‘hospitalisation at home’ (HAH) settings. HAH is considered to be an alternative to conventional hospitalisation that requires slight changes to be made to the medication process, such as the prominent role of the patient and their caregivers, the intermittent presence of numerous members of multidisciplinary staff in the home environment, and the patient’s own home. So, this study aims to provide an overview of the implementation of MR in our HAH using activity indicators, and to measure the clinical impact of the pharmaceutical procedures carried out as part of this activity.MethodsA retrospective observational study was conducted. A process and MR materials were developed based on HHA tools. The clinical impact of the pharmaceutical procedure was determined using the Clinical Economic and Organisational (CLEO) scale.Results29 patients benefited from MR on admission, carried out by a pharmacy intern with a pharmacy assistant. A total of 38 unintentional discrepancies were identified. The average number of unintentional discrepancies per patient with at least one unintentional discrepancy in their MR was 2.1. The mean time to complete MR was 2.5 hours. 30 (79%) pharmaceutical procedures were accepted by the clinicians, of which 6 (20%) were considered to have a major clinical impact.ConclusionMR for hospitalised patients at home is valuable to ensure safe medication management at this stage of the care pathway. Despite the small sample size of our study, each pharmaceutical procedure has a significant clinical impact. This activity contributed to the certification of our home care facility by the French HHA.

Background Although confidence does not automatically imply competence, it does provide pharmacy students with a sense of empowerment to manage a pharmacotherapeutic problem independently. Among the methods used in higher education, there is growing interest in simulation. Aim To evaluate the impact of simulation on pharmacy students’ confidence in performing clinical pharmacy activities. Method Articles that reported the use of simulation among pharmacy students with fully described outcomes about confidence were included. Studies for which it was impossible to extract data specific to pharmacy students or simulation were excluded. The search was carried out in Medline, Embase, Lissa and PsycInfo from inception to August the 31th, 2022. The results were synthesized into 4 parts: confidence in collecting information, being an expert in a procedure/pathology, counselling and communicating, and other results. The quality assessment of included studies was conducted using the Mixed Methods Appraisal Tool “MMAT” tool. Results Among the 39 included articles, the majority were published in the last 5 years and conducted in the United States. The majority included pharmacy students in years 1 through 3 (69.2%). The most common study design was the pre-post uncontrolled design (66.7%). Studies measuring the effects of human and/or virtual simulation were mainly focused on confidence to counsel and/or communicate with patients and colleagues (n = 20). Evaluations of the effects of these types of simulation on confidence in information gathering by health professionals were also well represented (n = 16). Conclusion Simulation-based training generally yielded positive impact on improving pharmacy students’ confidence in performing clinical pharmacy activities. Rigorous assessment methods and validated confidence questionnaires should be developed for future studies.