Your dose of health news

MorningMed is the best way to keep up with the world of health and medicine through curated round-ups, useful insights and other practical resources.

Retired Maj. Gen. Paul Friedrichs will lead the White House's new Office of Pandemic Preparedness and Response Policy starting August 7. The office will focus on preparing for and responding to biological threats that could lead to a pandemic, coordinating technology efforts, and collaborating with the Department of Health and Human Services on Covid-19 vaccines and treatments, as well as addressing potential outbreaks of other pathogens. The White House's Covid response team, originally set to conclude in May, will transition out of the emergency phase of the response, with the new office taking over its tasks.

A tornado severely damaged Pfizer's pharmaceutical plant in North Carolina, particularly impacting the warehouse storing raw materials and finished medications. The FDA is working with Pfizer to assess the damage's impact on the nation's drug supply, with many essential medicines at risk of shortages even before the tornado. The facility produces about 25% of Pfizer's sterile injectable drugs used in U.S. hospitals and repairing the damage and resuming production may pose challenges. The situation comes amid an already strained drug supply in the U.S., with concerns that the incident could exacerbate drug shortages.

As the nation faces vaccine fatigue, the CDC is preparing for a winter with three viruses circulating: Covid, flu, and RSV. The CDC has started detecting slight increases in positive Covid tests and Covid-related emergency department visits. For the first time this fall, the U.S. will have access to vaccines for respiratory syncytial virus (RSV), which can significantly reduce cases of the virus that disproportionately affects infants and older adults. Americans will be urged to get three different vaccinations this fall, presenting a challenge for the healthcare system to deliver them effectively, considering vaccine fatigue.

Johnson & Johnson has been ordered to pay $18.8 million to a California man who developed mesothelioma, a deadly cancer, allegedly due to exposure to the company's baby powder containing asbestos. The jury ruled in favor of Emory Hernandez Valadez, but declined to award punitive damages. This verdict comes as the company faces thousands of similar cases over its talc-based products in U.S. bankruptcy court, where most litigation has been halted during the proceedings.

Children's Hospital Colorado has decided to halt gender-affirming surgical procedures for transgender patients aged 18 and older due to "unprecedented referrals." The hospital clarified that it never provided such surgery for minors and will continue to offer other gender-affirming treatments like hormone therapy and counseling. LGBTQ advocates expressed concern over the decision, fearing it could set a dangerous precedent, while Children's Hospital Colorado is referring patients to other facilities that still provide such procedures. Colorado has not passed any laws restricting medical care for transgender people, but many other states have enacted legislation limiting gender-affirming care for minors.

• She plans to work with both Republican and Democratic lawmakers to address concerns and emphasizes clear and repetitive messaging to combat vaccine misinformation.
• Her focus on data-driven approaches and investment in data will aid in addressing ongoing health threats and ensuring the CDC's information is accessible and understandable to all.
• Despite the daunting tasks ahead, Cohen brings a sense of joy and commitment to the agency's mission, striving to bring her A-game and provide the American people with the healthcare they deserve.

Dr. Mandy Cohen, the new director of the Centers for Disease Control and Prevention: "We have to first make sure that we are building trust with the American people, and I know some of that trust was lost in the last few years," she said. "But I'm here to refocus the organization on building that trust, and I think trust can have an intentional plan. And if you use transparency and really good execution, deliver what you say you're going to do and you do it transparently and you communicate well, I think you can build trust."

Ambient energy usage readings have the potential to revolutionize remote patient monitoring in healthcare. Developed by the Eaton Corporation, this technology uses algorithms and machine learning to enhance energy usage data, providing valuable insights into patients' daily routines. By capturing data from smart circuit breakers, it can flag anomalies and potential health issues, enabling timely interventions. RPM with ambient energy readings reduces the need for in-person visits and hospitalizations, particularly beneficial for the aging population with chronic conditions. Despite challenges like data accuracy and security, the future looks promising, with more personalized and efficient treatments expected to emerge, contributing to sustainable healthcare practices.

A European man who underwent a stem cell transplant to treat blood cancer is now in a state of remission from HIV for almost two years. Unlike the five other cases of HIV remission after stem cell transplants, this patient's donor did not have a rare genetic resistance to HIV. The case, known as the "Geneva Patient," has shown no signs of viral rebound for 20 months after stopping antiretroviral treatment.

Key takeaways

• Scientists are cautious about calling it a cure, as trace amounts of defective virus were found, but the case offers hope and insights for HIV cure research.
  
  
• Additionally, researchers in sub-Saharan Africa have identified boys born with HIV who maintained low viral loads even after prolonged interruptions in antiretroviral treatment. Another study from China found that circumcision in gay and bisexual men reduced the risk of HIV acquisition.
  
  
• Meanwhile, a study investigating the relationship between HIV and mpox (formerly known as monkeypox) found that while HIV itself did not increase the likelihood of hospitalization, immunocompromised individuals, including those with HIV, faced higher hospitalization risks from mpox.
  
  
• Overall, these cases and studies offer promising insights into HIV remission and prevention, but scientists remain cautious and acknowledge that finding a widely scalable cure for HIV could take decades. Nevertheless, these findings contribute to the ongoing efforts in the work toward a cure.

By the digits

• 6: If enough time passes with no signs of viable virus, the European man could join the rarefied club of five people who are considered either definitely or possibly cured of HIV.
  
  
• 50% to 60%: In the mid-2000s, a trio of randomized controlled trials in sub-Saharan Africa determined that circumcising men reduced the risk of female-to-male sexual transmission of HIV by about 50% to 60%
  
  
• 82,290 mpox cases from 2022: There was information about the HIV status for 39% of these people, among whom 52% — 16,633 people, or 20% of the total — had that virus.
  
  
• 58 of the people with HIV died.
  
  
• 4 of the 15,371 people without HIV died as well.

Is There a Doctor in the House?

A 47-year-old woman is brought to the emergency department by ambulance 30 minutes after a motor vehicle collision in which the car she was driving overturned. At the scene, the patient was immobilized, and an intravenous line was started. On arrival, the patient indicates pain in the right lower extremity caused by an open wound in the right popliteal fossa. She appears distressed. Vital signs are temperature 36.5°C (97.7°F), pulse 120/min, respirations 18/min, and blood pressure 90/75 mm Hg. Pulse oximetry on 50% oxygen via nonrebreather mask shows an oxygen saturation of 95%. Lungs are clear to auscultation and cardiac examination discloses no abnormalities. The abdomen is soft without tenderness. The right lower extremity is bruised and ecchymotic above the knee. The femoral pulse is 2+ bilaterally and the popliteal and tibial pulses are absent on the right and 2+ on the left. Neurologic examination discloses decreased motor function below the right knee and decreased sensation over the distal right lower extremity. X-ray and intraoperative arteriogram of the right lower extremity are shown.



Which of the following is the most likely cause of the findings on the arteriogram?

New research presented at the Alzheimer's Association International Conference highlights the connection between gut health and brain health. Studies have found that chronic constipation is associated with worse cognitive abilities, certain gut bacteria are linked to dementia risk, and an imbalance in gut microbiomes is connected to various disorders like anxiety, depression, and obesity. Understanding the gut-brain axis could lead to new ways to prevent and treat Alzheimer's and other dementias, as lifestyle modifications, including exercise, proper diet, and sufficient sleep, have been shown to promote both gut and brain health.

A new study presented in JAMA reveals that "weekend warriors" who exercise 150 minutes of moderate to vigorous activity over one or two days have a 27% lower risk of heart attack and a 38% lower risk of heart failure, compared to regular exercisers who spread their activity throughout the week. The study analyzed data from over 89,000 participants in the UK Biobank and highlights the importance of getting the recommended amount of exercise each week, regardless of how it is distributed. Experts suggest that building up to weekend workouts and selecting low-impact activities can help prevent injuries.

A new study published in JAMA Network Open shows that hospitalizations and emergency room visits related to suicide attempts and ideation among children and teens have increased from 2016 to 2021. The study revealed seasonal trends, with higher visits in April and October compared to January. Nearly 66% of the cases were girls, and the average age was 15. The findings highlight the importance of addressing youth mental health and providing support and interventions to those at risk. Experts suggest focusing on school programs and mental health support during seasonal patterns may be effective in reaching those in need.

A new study published in the journal Nature suggests that people who carry a specific genetic variation of the human leukocyte antigen (HLA) protein are less likely to develop Covid symptoms even if they are infected with the virus. The HLA protein helps the body's immune system detect infections, and genetic variations make each person's HLA proteins unique. The study found that 20% of people who never developed Covid symptoms had a specific variant called HLA-B*15:01, compared to 9% of those who had symptoms. This variant was linked to a lower likelihood of developing symptoms. However, experts emphasize that genetics are just one of many factors that determine a person's susceptibility to Covid and that more diverse research is needed to understand the impact in different populations.

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) "Posterior dislocation of the right knee"

New Jersey, 66023, US