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A recent study indicates that individuals using popular injected weight management medications, such as Wegovy, Ozempic, Saxenda, and Victoza, might face a higher risk of experiencing severe digestive issues like stomach paralysis, pancreatitis, and bowel obstructions compared to those using other weight management drugs. While the study notes that the occurrence of these problems in individual patients is relatively rare, the widespread use of these drugs means that even uncommon risks could result in hundreds of thousands of new cases.

The preferred antibiotic treatment for syphilis, Bicillin, is facing a shortage in the United States just as syphilis infections are on the rise. Over 40 public health groups have called on the White House to address this shortage and work with Pfizer, the drug's manufacturer, to ensure an adequate supply. Syphilis cases have increased by 74% from 2017 to 2021, and congenital syphilis, which affects newborns, has surged by over 203%, posing significant public health concerns.

A recent RAND Corporation study found a significant increase in drug overdose deaths among Americans without a college education, highlighting a growing education gap in drug overdose rates. Overdose death rates in 2021 reached 82 deaths per 100,000 individuals for those with no college education compared to 18.6 deaths per 100,000 for those with some college.

A new study suggests that both high and low levels of "good" HDL cholesterol may increase the risk of dementia in older adults, adding complexity to our understanding of its role in health. Participants with HDL levels straying too far from the recommended range of 40 mg/dL in men and 50 mg/dL in women were more likely to develop dementia, with the highest levels associated with a 15% increased risk and the lowest levels with a 7% increased risk compared to the middle group.

A study published in The New England Journal of Medicine found that nasal esketamine, a more potent form of ketamine, was more effective than the antipsychotic drug quetiapine in treating treatment-resistant depression. After eight weeks, 27.1% of patients taking esketamine achieved remission compared to 17.6% of those taking quetiapine.

Barry Kerzin, originally a medical doctor from California, embarked on a transformative journey from medicine to monkhood, guided by existential questions and a near-death experience as a child. Kerzin's significant encounter with the Dalai Lama in 1990, when he administered a vaccination shot during a cholera outbreak, marked the beginning of a teacher-student and doctor-patient relationship that has spanned three decades.

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Sleep apnea, a prevalent sleep disorder characterized by recurring interruptions in breathing during sleep, is a condition that can significantly impact one’s overall health and well-being. In the realm of sleep medicine, one notable and highly effective solution for mitigating the adverse effects of sleep apnea is the consistent use of CPAP (Continuous Positive Airway Pressure) devices. These devices have garnered attention for their potential to not only manage sleep apnea but also to lower certain health risks associated with the condition. CPAP devices have emerged as a frontline treatment for sleep apnea, offering a ray of hope for individuals affected by this condition. But what exactly are these devices, and how do they work?

These accounts shed light on the diverse and transformative nature of near-death experiences during cardiac arrest.

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Is There a Doctor in the House?

A 32-year-old woman comes to the emergency department because of a 3-day history of fatigue and postural lightheadedness. She also reports nausea with one episode of vomiting this morning and adds that her stools and urine have been darker than usual lately. Medical history is significant for stage III-B Hodgkin lymphoma. She started the first cycle of chemotherapy 8 days ago. Additional medications include ferrous gluconate, hydrocodone, and prochlorperazine. She is currently receiving 0.9% saline at 75 mL/hr. Vital signs today are temperature 37.5°C (99.5°F), pulse 76/min supine and 80/min standing, respirations 16/min, and blood pressure 125/65 mm Hg supine and 120/60 mm Hg standing. Pulse oximetry on room air shows an oxygen saturation of 94%. Lungs are clear to auscultation. Cardiac examination discloses a soft systolic murmur at the left upper sternal border. There is no hepatosplenomegaly or tenderness on abdominal examination. Rectal examination discloses no masses. Stool is black and test for occult blood is negative. Results of laboratory studies are shown:



Which of the following is the most likely explanation for the patient's current condition?

A team of neuroscientists from New York University has identified a class of neurons called "prediction-error neurons" in the brain. These neurons respond specifically when sounds violate expectations, providing insights into learning processes and potential applications in understanding speech development and sound-related skills in diseases, like autism or speech disorders.

German researchers have identified new Alzheimer's disease pathways by combining data from multiple biomarkers, revealing the involvement of genes like GRIN2D and immune system-related genes like TMEM106B and CHI3L1. This novel approach may offer insights into disease mechanisms and could potentially improve Alzheimer's diagnosis by detecting it at an earlier stage.

A recent study published in PLOS ONE has identified specific genes associated with individuals who adhere to a vegetarian diet for at least a year. The research suggests that genetics may play a role in determining one's ability to stick with a vegetarian diet, shedding light on the idea that dietary preferences are influenced by genetic factors, particularly those related to lipid metabolism and brain function.

Experiencing discrimination may disrupt communication between the brain and the gut, potentially leading to increased cravings for unhealthy, high-calorie foods, according to a study published in Nature Mental Health. The research found that individuals who reported high levels of discrimination had a stronger brain response to images of sugary and fatty foods, and higher levels of gut compounds associated with inflammation, potentially increasing their risk of obesity.

Thank you for reading! More next week,

My best wishes for a productive and idea-filled week ahead. Thanks for your ongoing efforts to improve the lives of the patients we all serve. Please send any news, comments, suggestions and ideas to hello@morningmed.email.

Quiz answer: The correct answer is A) "Adverse effect of medications"

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