The efficacy and safety of gene therapy approaches in Parkinson's disease: A systematic review.

BACKGROUND: Parkinson's disease (PD) is a neurodegenerative disorder characterized by the progressive loss of dopaminergic neurons in the brain. Despite existing treatments, there remains an unmet need for therapies that can halt or reverse disease progression. Gene therapy has been tried and tested for a variety of illnesses, including PD. The goal of this systematic review is to assess gene therapy techniques' safety and effectiveness in PD clinical trials. METHODS: Online databases PubMed/Medline, and Cochrane were used to screen the studies for this systematic review. The risk of bias of the included studies was assessed using standard tools. RESULTS: Gene therapy can repair damaged dopaminergic neurons from the illness or deal with circuit anomalies in the basal ganglia connected to Parkinson's disease symptoms. Rather than only treating symptoms, this neuroprotective approach alters the illness itself. Medication for gene therapy is currently administered at the patient's bedside. It can hyperactivate specific brain circuits associated with motor dysfunction. PD therapies are developing quickly, and there aren't enough head-to-head trials evaluating the safety and effectiveness of available treatments. When choosing an advanced therapy, patient-specific factors should be considered in addition to the effectiveness and safety of each treatment option. CONCLUSION: In comparison to conventional therapies, gene therapy may be advantageous for PD. It may minimize side effects, relieve symptoms, and offer dependable dopamine replacement.

Interventions for Health: Why and How Health Care Systems Provide Programs to Benefit Unhoused Patients.

Individuals experiencing homelessness have poorer health than housed individuals, while also utilizing more emergency department care and fewer preventive services. Several interventions - including permanent supportive housing, medical respite, and mobile medical clinics - are cost-effective means to improve health outcomes for homeless populations, yet few health systems have invested in such programs. This study aimed to determine the reasons some health systems initiated these interventions, and the early experience of those health systems that did. Quantitative analyses of health systems in 4 states with high levels of homelessness showed that interventions to improve the health of homeless populations were more common in larger hospitals, teaching hospitals, religious hospitals, network-affiliated hospitals, and hospitals in California. Interviews confirmed that health systems typically were moved to implement these interventions by more than 1 factor, including financial goals, mission-driven motives, a desire to improve care quality, and recognition of local need. Interviewees reported collaborations with community service providers, and some reported targeting services to specific subpopulations. Health systems reported success with some initiatives but noted that success was contingent on overcoming barriers including funding, opposition from the local community, challenges building true partnerships with service providers, and the reluctance of some homeless patients to receive services. Health systems may be encouraged by the results reported by early adopters who navigated these obstacles, while policy makers might consider incentivizing health systems to engage in these interventions by providing a dedicated funding stream.