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The family of a man who died by suicide has attributed his death to the diabetes medication Ozempic. While the link between Ozempic and suicidal thoughts remains unclear and clinical trials have not found an increased risk, a small number of patients, some with a history of depression, have reported experiencing suicidal thoughts they believe are a side effect of the drug. In the US, the FDA has received reports of suicidal ideation and suicide attempts related to Ozempic but has not confirmed a causal link.

Delta-8 THC, a compound similar to the psychoactive ingredient found in marijuana, has been legally sold in the US thanks to a loophole in the 2018 farm bill. The FDA has called on Congress to create regulations for hemp-derived cannabinoids, including delta-8, while the DEA is evaluating whether to issue rules that would close the loophole entirely. In the absence of federal regulation, several states have taken steps to restrict or ban delta-8 THC. Safety concerns primarily revolve around unregulated delta-8 THC products potentially containing harmful substances like chemicals or heavy metals, with no federal age requirement to purchase them.

The Food and Drug Administration is planning to authorize updated versions of COVID-19 boosters as early as Friday, with the shots targeting the XBB.1.5 omicron subvariant. Although this strain is no longer dominant, the boosters are expected to offer protection against related subvariants that are currently circulating. The FDA is also considering the possibility of granting full approval for the boosters instead of emergency use authorization, but this decision is still uncertain. After FDA approval, the Centers for Disease Control and Prevention and its advisory committee will issue their own recommendations regarding booster usage, with a vote expected at a scheduled meeting next week.

Moderna has announced that its new COVID-19 booster is effective against the highly mutated BA.2.86 omicron subvariant, which has raised concerns due to its numerous mutations. Moderna's updated booster generated a strong antibody response against BA.2.86, although the data provided by the company has not yet been reviewed by external scientists. The Centers for Disease Control and Prevention (CDC) suggests that BA.2.86 may be more infectious for individuals who have had COVID19 or have been vaccinated, but there is no evidence of increased severity. The current surge in cases in the U.S. is primarily attributed to XBB lineage viruses rather than the BA.2.86 variant.

Singer-songwriter Jimmy Buffett passed away from Merkel cell carcinoma, a rare type of skin cancer that affects fewer than 3,000 people in the United States annually. Merkel cell carcinoma is believed to be linked to UV light exposure, a weakened immune system, and the Merkel cell polyomavirus (MCV). Early detection is crucial, as the chance of living at least five years after diagnosis is around 75% if caught early, but it drops to 24% if the cancer has spread beyond the skin. Protection from UV rays and regular skin examinations can help prevent this rare but aggressive skin cancer.

• The Drug Enforcement Administration (DEA) and drugmakers are at odds, with the DEA claiming there are sufficient raw ingredients for production, while drug companies argue they need DEA permission to acquire more.
• The DEA discovered through an internal analysis that pharmaceutical companies only used 70% of their ingredient quota in 2022, and 2023 seems to be trending the same way, furthering the divide between the pharma industry and the federal agencies keeping them in check.
• Experts warn that the shortage may continue through the end of the year, posing challenges for patients who rely on these medications for their daily lives. Changes to telehealth prescriptions could help stabilize demand, but there are concerns about potential health disparities in access to care.

Michael Ganio, senior director of pharmacy practice at the American Society of Health-System Pharmacists: “Big picture, this is what the FDA and DEA are seeing, but it doesn’t give you any insight into what individual manufacturers are seeing,” he said. “Very simply put, this ends when supply matches demand,” Ganio said.

Atrial fibrillation, often abbreviated as AF, is a prevalent cardiac arrhythmia that disrupts the normal rhythm of the heart’s beating. Instead of contracting in a coordinated manner, the upper chambers of the heart quiver or fibrillate, leading to an irregular and oftentimes rapid heartbeat. This article will help us explain atrial fibrillation and the evolution of patient outcomes.

Bacterial infections back on the rise across the United States

Key takeaways

• A rare but serious outbreak of meningococcal disease has claimed five lives in Virginia, with 27 cases reported since June 2022. The outbreak, caused by Neisseria meningitidis type Y bacteria, primarily affects Black or African American adults aged 30 to 60. Health authorities emphasize the importance of vaccination, hand hygiene, avoiding close contact with the sick, and seeking prompt treatment for symptoms like fever, headache, and a stiff neck.
  
  
• The US Centers for Disease Control and Prevention (CDC) has issued a national health alert about Vibrio vulnificus, a flesh-eating bacteria. A rise in severe and fatal infections was reported in Connecticut, New York, and North Carolina during July and August, linked to higher coastal sea surface temperatures. Vibrio vulnificus is naturally found in coastal waters, and infections can occur through contact with seawater with open wounds or by consuming raw or undercooked seafood. Climate change, warming oceans, and extreme weather events like hurricanes have led to more cases in East Coast states.
  
  
• The aftermath of hurricanes, such as Hurricane Idalia, can increase the risk of Vibrio vulnificus infections, a potentially deadly type of flesh-eating bacterium. These bacteria thrive in the brackish waters created when salty seawater mixes with freshwater during heavy rains. Consuming raw oysters also poses a risk. While the risk for most people is low, individuals over 40, especially those with liver disease, are at higher risk and should take precautions.

Is There a Doctor in the House?

A physician is conducting a retrospective review of a trial involving the use of Drug X in patients with a specific disease. It is known that Drug X is associated with an increased probability of cancer in patients who use the drug. A total of 600 individuals with a specific disease were included in the trial. Of the participants, 200 individuals received Drug X and 400 individuals did not receive it. One hundred individuals who received Drug X died of a particular type of cancer and 100 individuals who did not receive the drug died of the same type of cancer.

Based on these data, which of the following is the relative risk of death from this type of cancer in individuals who take Drug X as compared with individuals who do not take Drug X?

A small study suggests that the diabetes and weight loss drug semaglutide, known as Ozempic or Wegovy, may allow newly diagnosed Type 1 diabetes patients to reduce or even stop insulin injections. After three months of semaglutide treatment, all participants were able to stop taking insulin with meals, and within six months, seven out of ten could stop insulin entirely. While these results are promising, experts emphasize the need for larger, controlled studies to validate these findings before changing treatment recommendations.

A novel stem cell transplant procedure called cultivated autologous limbal epithelial cell (CALEC) transplantation shows promise in treating limbal stem cell deficiency, a condition that can lead to vision loss. Researchers conducted a Phase 1 trial on four patients with chemical burns in one eye, using stem cells from the healthy eye, cultivating them in the lab, and transplanting them into the damaged eye. This procedure has the potential to offer hope to individuals with limbal stem cell deficiency, which can lead to painful ulcers, corneal clouding, and blindness, although larger, controlled studies are needed for further validation.

A tablet-based device that tracks eye movements while children watch a video of a social interaction may help diagnose autism spectrum disorder in children aged 16 to 30 months. Research published in JAMA and JAMA Network Open showed that this device could accurately identify autism as effectively as specialists, providing results in just 30 minutes. Early diagnosis is crucial for effective intervention, as younger children's brains are more adaptable. The device has been cleared by the FDA for specialist use and is being studied for use by pediatricians to screen a broader population of children.

A study conducted in Belgium has found that certain paper and bamboo straws, often seen as eco-friendly alternatives to plastic straws, contain low concentrations of PFAS (per- and polyfluoroalkyl substances) chemicals. PFAS chemicals are often referred to as "forever chemicals" because they linger almost permanently in the environment. While the levels found in these straws are low, they raise concerns about the use of such straws as alternatives to plastic. Stainless steel straws are considered a better environmental choice, but researchers question whether they will be widely adopted.

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 D) "Individuals who take Drug X have two times the risk of dying from this type of cancer"

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