Gut Bacteria Encode Reductases that Biotransform Steroid Hormones.

The metabolism of steroids by the gut microbiome affects hormone homeostasis, impacting host development, mental health, and reproductive functions. In this study, we identify the Δ -3-ketosteroid 5β-reductase, 3β-hydroxysteroid dehydrogenase/Δ isomerase, and Δ -3-ketosteroid reductase enzyme families encoded by common human gut bacteria. Through phylogenetic reconstruction and mutagenesis, We show that 5β-reductase and Δ -3-ketosteroid reductase have evolved to specialize in converting diverse 3-keto steroid hormones into their 5β- and Δ -reduced derivatives.

Neighborhood Social Vulnerability and Access to Expedited Partner Therapy Prescriptions: A Secret Shopper Audit Survey.

Background: Sexually transmitted infections (STIs) disproportionately impact populations with higher social vulnerability. Expedited Partner Therapy (EPT), which allows the treatment of partners without requiring a medical visit, reduces STI reinfection rates and expands treatment access for underserved groups. However, EPT remains underutilized, particularly in the electronic prescription era, which introduces logistical complexities.

Preoperative medication management turnkey order set for nonemergent adult cardiac surgery.

Objective: The management of preoperative medications is an essential component of perioperative care for the cardiac surgical patient. This turnkey order set is part of a series created by the Enhanced Recovery After Surgery Cardiac Society, first presented at the Annual Meeting of The American Association for Thoracic Surgery in 2023. Numerous guidelines and expert consensus documents have been published to provide guidance in preoperative medication management.