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The American Red Cross has declared a national blood shortage in the United States, with the blood supply falling by nearly 25% since early August. This shortage is affecting medical care, particularly emergency cases and those requiring blood transfusions for conditions like cancer or sickle cell disease. Factors contributing to the shortage include low donor turnout during the summer months and the cancellation of blood drives due to climate-driven disasters, such as Hurricane Idalia. Other organizations, like OneBlood and Blood Centers of America, report meeting local demand but express concerns about sustaining the blood supply in the long term, citing a decline in younger donors.

The U.S. Centers for Disease Control and Prevention (CDC) has launched a new ad campaign called "Wild to Mild" to reset expectations about the annual flu vaccine. The campaign aims to increase confidence in the vaccine by emphasizing that it may not entirely prevent illness but can significantly reduce the severity of the infection. The campaign features messages like "Don't Let the Flu Get You Wild" and "Let's Tame the Flu Together," along with images of ferocious animals next to harmless ones to illustrate the concept of reducing the severity of flu symptoms. The CDC hopes that by clarifying the purpose of the flu vaccine, more people will choose to get vaccinated, especially pregnant women and parents of young children who are at higher risk. The campaign is also designed to address misconceptions about flu vaccines and their effectiveness.

Novo Nordisk, the maker of weight loss drugs Ozempic and Wegovy, is grappling with overwhelming demand for its products. The CEO, Lars Fruergaard Jorgensen, suggests it could take years to meet the needs of the more than 100 million Americans with obesity who are seeking treatment. Despite investments and efforts to expand production, the company is still just "scratching the surface" of the demand for these medications, which have shown significant weight loss and potential heart benefits in clinical trials. However, the high cost and the need for continued treatment pose challenges, and safety concerns are also under scrutiny.

The US Preventive Services Task Force has recommended that all pregnant individuals, especially those without a known diagnosis of a hypertensive disorder of pregnancy or chronic hypertension, should be screened for disorders related to high blood pressure, such as gestational hypertension and preeclampsia, through blood pressure monitoring throughout pregnancy. This recommendation aims to address the high rates of maternal deaths and complications associated with hypertensive disorders of pregnancy and improve maternal health outcomes in the US. Blood pressure measurements are already a standard practice during prenatal visits, but this formal recommendation emphasizes the importance of ongoing monitoring for early detection and intervention.

The 988 Suicide and Crisis Lifeline in the United States has launched American Sign Language (ASL) services for callers who are deaf, deaf-blind, or hard of hearing. This service enables ASL users to connect with a 988 Lifeline counselor trained in ASL via videophone or by calling 1-800- 273-TALK (8255) from their videophone. The initiative aims to make mental health support more inclusive and accessible for underserved groups, contributing to the broader effort of reducing stigma around mental health and suicide discussions.

Scientists take ‘pioneering steps’ toward growing human kidneys in pigs In a groundbreaking study published in the journal Cell Stem Cell, researchers describe how they successfully grew kidneys containing mostly human cells inside pig embryos. These kidneys, when implanted in surrogate pig mothers, developed normally. This achievement marks the first-time scientists have been able to grow a solid humanized organ inside another species.

• The process involved genetically modifying pig embryos to create space for human cells to grow, while also modifying human cells to survive in the pig embryo environment. Kidneys were chosen for this experiment as they are among the most transplanted organs, with a significant shortage worldwide.
• The goal of this research is to create organs from a patient's own cells, significantly reducing the risk of organ rejection. While it's a significant step forward, the researchers acknowledge that producing mature human organs for transplantation or disease modeling is a complex and challenging process that will take time.
• This work raises ethical questions, including concerns about animal welfare and potential unintended consequences, such as human cells affecting the animal's brain. However, the researchers have taken precautions to minimize these risks.
• Growing human organs inside animals is an innovative approach to addressing the shortage of organs available for transplantation, and while this research is promising, it's still in the experimental stages. Further studies and advancements are needed before it can be applied in a clinical setting.

Miguel Esteban, principal investigator at the Guangzhou Institute of Biomedicine and Health, Chinese Academy of Sciences: “Making the cells adapt to the pig embryo environment and differentiate faithfully into the kidney lineage was challenging,” Esteban said. “It is a kidney in the middle stage of development, and hence underdeveloped, not a mature kidney,” Esteban said. “Yet, this is a very big step forward as it encourages us and other researchers to think that it is possible to produce a mature kidney once other technical obstacles are solved.”

In today’s fast-paced world, congestion can quickly become an unwelcome hindrance to our daily lives. Whether it’s due to allergies, a common cold, or other respiratory issues, finding relief from congestion is essential. Phenylephrine, a commonly used decongestant, has been a go-to solution for many. However, recent developments have led the FDA to seek public comments on the efficacy and recommended dosage of phenylephrine, raising questions about its effectiveness in treating congestion. In this article, we will delve into the world of phenylephrine, its role as a decongestant, and the FDA’s quest for public input.

COVID and RSV see a significant rise in collective cases across the United States

As we progress into the Fall, the healthcare community, and most notably the CDC, have reported on a drastic uptick in both COVID and RSV cases across the country. To best understand the threat level to our nation, we will investigate and summarize various reports to update our readers appropriately.

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Key takeaways

• ICU doctors are reporting a change in the severity of COVID-19 cases in hospitalized patients. While hospitalizations are on the rise again, patients admitted to ICUs with COVID-19 are responding faster to treatment, experiencing lower mortality rates, and being discharged earlier compared to earlier in the pandemic. Factors contributing to this change include the less severe nature of omicron subvariants, reduced targeting of individuals with underlying health conditions, the availability of antiviral medications like Paxlovid, and the higher proportion of the population with some level of protective immunity through vaccination or prior infection. However, immunosuppressed individuals, such as older adults and certain cancer patients, remain at higher risk. Experts anticipate a seasonal increase in hospitalizations in the winter but do not expect a return to the severity seen in previous years.
  
  
• Multiple indicators are pointing to a rise in COVID-19 activity in the United States as fall approaches. Hospitalizations are increasing, deaths have slightly risen, wastewater samples are showing an uptick in the virus, and lab data confirms increased transmission. While hospitalizations are on the rise, they do not yet approach the levels seen in previous surges. Emergency room visits with a COVID-19 diagnosis have increased since early July, and wastewater samples indicate higher SARS-CoV-2 levels. Deaths appear to be up slightly compared to recent weeks. The rise is attributed to the XBB subvariants, not the BA.2.86 variant, which remains rare and may not be as concerning as initially thought. The guidance to protect against COVID-19 remains the same, including masking, testing, vaccination, and improving indoor ventilation.
  
  
• The Centers for Disease Control and Prevention (CDC) has alerted doctors about an increase in severe cases of respiratory syncytial virus (RSV) among young children in Florida and Georgia. This regional increase typically marks the beginning of the RSV season nationally, which then spreads north and west over the following 2-3 months. The late-summer increase suggests that RSV is returning to its typical seasonal pattern after several years of early viral activity due to the pandemic. Hospitalizations related to RSV have increased among children under 4 years old, with the majority being babies under a year old. The CDC has advised doctors to prepare for a new RSV shot called Beyfortus (nirsevimab) for young children to help prevent the virus. It's expected to be available in early October.

Is There a Doctor in the House?

A 23-year-old woman is brought to the emergency department by her friend because of headache, vomiting, and diarrhea that developed rapidly 6 hours ago. She also has had associated fever, chills, generalized muscle pain, and diffuse rash. The patient previously was healthy and has had no known exposure to anyone who has been ill. Medical history is unremarkable, and her only medication is an oral contraceptive. She is currently menstruating. She does not smoke cigarettes or use illicit drugs. She drinks one to two alcoholic beverages weekly. She is disoriented to person, place, and time. Vital signs are temperature 39.2°C (102.6°F), pulse 114/min, respirations 26/min, and blood pressure 82/44 mm Hg. Pulse oximetry on oxygen at 2 L/min via nasal cannula shows an oxygen saturation of 90%. Examination of the skin shows diffuse macular erythema. Lungs are clear to auscultation. Cardiac examination discloses normal heart sounds and no murmur. Bowel sounds are hypoactive. Results of laboratory studies are shown:



A response to which of the following is the most likely cause of this patient's condition?

Abortion rates have increased in most states where the practice remains legal, with notable rises in places that have enacted policies to protect abortion rights, such as Colorado, Connecticut, Illinois, and Washington. There's also a substantial increase in New Mexico, where abortions more than tripled from January to June compared to 2020, suggesting people are crossing state lines for terminations, possibly due to nearby states' abortion bans. These findings come from data collected by the Guttmacher Institute, providing insight into abortion trends following the Supreme Court's Roe v. Wade decision overturn.

The FDA is set to re-evaluate the effectiveness of the oral decongestant phenylephrine, a common ingredient in over-the-counter cold and allergy medications. Many doctors and pharmacists have expressed doubts about its effectiveness, and a committee vote declaring it ineffective as an oral decongestant could lead to the drug's removal from store shelves. Studies have suggested that when taken orally, phenylephrine is not very effective at relieving nasal congestion and comes with side effects such as headache and insomnia.

A study in Canada has found a significant increase in traffic accidents related to marijuana use since the legalization of recreational cannabis in 2018. The study revealed a 475% rise in marijuana-related traffic accidents between 2010 and 2021, while alcohol-related accidents only increased by 9.4% during the same period. Experts warn that driving under the influence of marijuana can be more dangerous than driving drunk, as marijuana impairs reaction time, cognitive functions, and the ability to multitask. The rising potency of cannabis and the combination of cannabis with alcohol amplify these impairing effects.

A new study has found that individuals with premenstrual disorders (PMDs) such as premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) have more than twice the risk of experiencing early menopause. Early menopause, defined as occurring before age 45, is associated with a shorter reproductive period and potential health concerns. PMD sufferers were also found to be more likely to have severe vasomotor symptoms such as hot flashes and night sweats, which are linked to later cognitive decline and heart issues. While this study shows a correlation between PMDs and early menopause, further research is needed to understand the underlying causes.

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 B) "Bacterial exotoxin"

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