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Drug-resilient and potentially deadly fungal infection is spreading rapidly within U.S. healthcare facilities, study finds. Candida auris, a yeast strain, can cause severe illness in people with weakened immune systems.

Frozen fruit recalled at both Costco and Trader Joe’s because of exposure to hepatitis A contamination. According to an announcement shared from the FDA , the potentially contaminated products include Trader Joe's frozen "Organic Tropical Fruit Blend" sold across the nation as well as the frozen organic strawberries sold under the Kirkland Signature brand at Costco locations in Alaska, Idaho, Montana, Oregon, Utah, and Washington .

Novel EPA standards proposed to save our nation’s water from ‘forever chemical’ contaminants. The EPA’s proposed limits set the allowable levels for these chemicals so low that they could not be easily detected. Sanofi becomes the third drug company to announce insulin price cap following the recent lead of Eli Lilly and Novo Nordisk. Those three businesses make up about 90% of the insulin market in the United States, and will all share a $35 per month insulin cap.

A bid for full approval of Paxlovid received support from advisers to the US FDA, who voted 16-1 in favor of the drug’s use for treatment of mild to moderate Covid-19 in adults who are considered high risk for severe disease. The antiviral Paxlovid, a combination of the drugs nirmatrelvir and ritonavir, will next be reviewed by the FDA with a conclusion expected in May .

Sequencing the genomes of 100,000 UK newborns. A slippery slope or a welcomed change in philosophy of medicine?

In the United Kingdom, a massive clinical study is set to begin sequencing the genomes of 100,000 newborn babies later in 2023 . Newborn Genomes Programme will screen for about 200 rare yet treatable genetic conditions , with a truly compassionate purpose and end goal. Their aim is to avoid pain and anxiety associated with the struggles of standard diagnostic practices.

This philosophy of accelerating the diagnostic process leads to earlier treatment that could prevent conditions from taking root or furthering severity. There are serious concerns and questions regarding genetics, consent, data privacy and agency for infants being spoken for.

• The study would see one in twelve newborn babies in England screened on a voluntary basis over two years, and it will serve as an extension to the current newborn testing known as the heel prick test. The routine test has been in practice for over 50 years and covers nine common conditions. While it is a start, it is considered obsolete and outdated. Certain variations of conditions, such as congenital hyperthyroidism, may not register a positive result, and other results may come in too late to make an impactful difference.
  
  
• A feasibility study is currently underway to assess whether a heel prick, cheek swab or umbilical cord blood will be used for sampling, with the quality of the DNA sample determining the final choice. Results will be expected in two weeks’ time, and one in 200 babies are estimated to receive a diagnosis of the 200 conditions being assessed.
  
  
• Genomics England says that each of the 200 conditions that will be screened for has been selected because there is evidence it is caused by genetic variants; it has a debilitating effect; early or pre-symptomatic treatment has a life-improving impact; and treatment is available for all through the UK’s National Health Service (NHS) .

Chief scientist of the American biotech company Illumina, David Bentley states: “People get sick, they get tested using one test after another, and that cost mounts up. (Sequencing) the genome is much cheaper than a diagnostic odyssey… So much of medicine today is given in later life, and saves people for a few months or years,” says Bentley. “It’s so good to see more opportunity here to make a difference through screening and prevention during the early stages of life . It is investing maximally in the long-term future as a society , by screening all young people and increasing their chances of survival through genetics so they can realize their enormous potential.”

Overall, the Sunshine Act is a crucial step towards increasing transparency in the financial relationships between pharmaceutical and medical device companies and healthcare providers. By making this information available to the public, patients are better able to make informed decisions about their care, and the healthcare industry can be held more accountable. While there have been some controversies surrounding the implementation of the Sunshine Act, it remains a valuable tool for increasing transparency in the healthcare industry.

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Standoff between the U.S. and Mexico over a failed drug war

Following what was intended to be a fruitful discussion between neighboring countries, Mexico’s President Andrés Manuel López Obrador announced that fentanyl is an American problem, and refused to take accountability for the drug pouring into the United States. In fact, he went as far as to claim that none of the dangerous and deadly drug is produced in Mexico, which is glaringly false.

Key takeaways

• The oddly inaccurate and ridiculous claim exemplifies how far the relationship between the U.S. and Mexico has deteriorated. Additionally, the Mexican government has not been approving joint raids, nor observation by U.S. law enforcement.
  
  
• The multibillion-dollar trade in illegal drugs has long been a festering sore on the North American continent. U.S. demand for cocaine, methamphetamine and heroin fuels vicious, well- funded criminal organizations that thrive in a Mexico rife with corruption and lawlessness.
  
  
• “The Sinaloa cartel and the Jalisco cartel and their affiliates control the vast majority of the fentanyl global supply chain, from manufacture to distribution,” DEA Administrator Anne Milgram told Congress last month. “The cartels are buying precursor chemicals in the People’s Republic of China, transporting the precursor chemicals from the PRC to Mexico, using the precursor chemicals to mass produce fentanyl, pressing the fentanyl into fake prescription pills, and using cars, trucks and other routes to transport the drugs from Mexico into the United States for distribution.”

By the digits

• 106,000 people died of opioid overdoses in the U.S. in 2021 alone.
  
  
• 70,000 of those 106,000 opioid overdose deaths in 2021 are attributed to fentanyl.
  
  
• 10 cents are all it takes for the cartels to produce a fentanyllaced fake prescription pill.
  
  
• $10 to $30 price point in the U.S. for the fake prescription pill.
  
  

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A 2-year-old girl is brought to the office by her mother for evaluation of fever. You have been the girl's physician since birth. While in the office, the girl stiffens and then has bilateral, symmetrical shaking of her upper and lower extremities; she becomes mildly cyanotic. The episode lasts for approximately 45 seconds, after which she becomes relaxed and appears to fall asleep. Vital signs at this time are temperature 40.0°C (104.0°F), pulse 120/min, and respirations 40/min. On physical examination she has a generally pink complexion and flushed cheeks. She is limp and somnolent and responds with a cry to noxious stimulus. Tympanic membranes are inflamed bilaterally, nose has a scant, clear discharge, and throat is mildly erythematous. Lungs are clear to auscultation except for transmitted upper airway sounds. Heart has rapid rate with a grade 1/6 systolic murmur at the left sternal border. Complete blood count, blood culture, lumbar puncture, and catheterized urine specimen are obtained and sent for stat analysis. Acetaminophen is administered by rectal suppository. Thirty minutes later the patient awakens and is smiling. She is afebrile. Additional history discloses that she was born at term, she had an uneventful neonatal course, she has normal growth and development, and vaccinations are up-to-date. She has never had an episode similar to this. Initial laboratory results are shown: Blood WBC 10,400/mm3 Neutrophils, segmented 25% Neutrophils, bands 5% Lymphocytes 65% Monocytes 5% Cerebrospinal fluid 0 RBC/mm3 Urinalysis Normal Other laboratory studies are pending.
In addition to ampicillin for otitis media and acetaminophen, this child also should receive which of the following?

New analysis of genetic material collected from the Huanan Seafood Market in Wuhan, China reveals racoon dog DNA within samples that tested positive for SARS-CoV-2. These new findings do not prove that the racoon dogs were infected with Covid, nor that they first infected people, but do shed some more light on a shady situation.

CDC discovers a rapid rise of Northeast cases of babesiosis, a tickborne disease. According to their report, 10 states have reached endemic transmission levels of babesiosis including Connecticut, Massachusetts, Minnesota, New Jersey, New York, Rhode Island, Wisconsin, Maine, New Hampshire, and Vermont.

Long Covid patients find relief in acupuncture and Eastern medicine techniques that Western medicine strategies were unable to remedy. Although a skeptical treatment option for many, a connected source claimed at least 75% of her long Covid patients have responded well to acupuncture.

The leader of the World Health Organization estimates the end of Covid pandemic later in 2023. WHO Director General Tedros Adhanom Ghebreyesus made claims at a Geneva briefing stating confidence in the end of the international public health emergency.

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) "No additional medications"

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