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Drugmaker Eli Lilly provides instant relief by capping the out-of-pocket cost of its insulin at $35 a month. Effective immediately, this decision puts Eli Lilly in line with a provision in the Inflation Reduction Act.

Norovirus, which carries symptoms such as diarrhea vomiting, nausea, and stomach pain, continues to spread as latest rate exceeds 12-month high. According to data from the Centers for Disease Control and Prevention, the average rate of positive tests over the past three weeks was measured at 17%.

20,000 people may have been exposed to measles while attending a large religious gathering at Asbury University in Kentucky. The CDC responded by instructing unvaccinated attendees to quarantine and monitor symptoms over 21 days.

Walgreens announces that they must halt sales of abortion bills in 20 GOP-controlled states or face legal consequences from republican attorneys general in the area impacted. Republican attorneys general have also sent letters to CVS, Rite Aid, Albertsons, Costco, Kroger, and Walmart, with the intent of limiting the pharmacies from subverting state and federal law.

Last resort arrest warrant issued for a woman with an active case of tuberculosis. The Washington state woman has repeatedly refused to isolate or get treatment for the infectious disease for over a year.

A new approach to lowering cholesterol for that avoidant or intolerant to statins

Statin drugs remain the gold standard when it comes to lowering LDL, also labeled ‘bad’ cholesterol, but many patients at risk for heart disease are turned off by the severe side effects including muscle pain and weakness. For those who refuse to take statin drugs, a replacement treatment is necessary, and bempedoic acid, a daily pill with FDA approval, is the newest and perhaps best alternative.

• A new phase 3 placebo-controlled study featuring bempedoic acid, a drug aimed to lower LDL while avoiding muscle aches and pains, with 14,000 patients was found to modestly reduce the risk of heart attacks, strokes, and other complications of heart disease.
  
  
• The drug lowered LDL cholesterol by 21%, reduced myocardial infarction by 23%, and reduced coronary revascularization by 19%.
  
  
• Statins do remain as the first line of defense in lowering LDL and protecting cardiac health, but for those who cannot tolerate statins, bempedoic acid works effectively, and does not cause the muscle pain that vilifies statins.

Dr. Steven E. Nissen, chief academic officer of the Heart and Vascular Institute at the Cleveland Clinic, states: “Statins are the cornerstone of cardiovascular disease prevention, and they are recommended to a large number of people who either have or are at risk for cardiovascular disease. Anywhere from 7% to 29% of patients experience adverse effects they can’t tolerate. The primary problem is muscle pain.”

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Finding why colorectal cancer rates in young people are rapidly ramping up

Colon and rectal cancer rates are spiking amongst adults in the United States, with particularly alarming numbers being reported from those 55 years of age and younger. In addition to the concerning rates of cancer diagnoses, there is a significant shift in severity as well.

Key takeaways

• Known lifestyle risk factors including rising rates of obesity, younger people living more sedentary lifestyles than they previously accounted for and diets full of processed foods and sugars.
  
  
• Genetics account for only about 25% of cases in young people, with the 75% considered to be unknown causes. Environmental factors seem to be at play, especially a phenomenon coined the birth cohort effect.
  
  
• Colorectal cancers can hide for years before showing warning signs. Symptoms to be aware of include blood in the stool, abdominal pain, unintentional weight loss, a change in bowel habits, anemia, shortness of breath, and/or fatigue.

By the digits

• 1 in 5 new cases of colorectal cancers in the U.S. are in their early 50s or younger.
  
  
• 20% of colorectal cancer cases occurred in people under the age of 55 in 2019, which has doubled since 1995.
  
  
• 60% of all 2019 colorectal cancer cases in the U.S. are at advanced-stage, which is up from 52% in the mid-2000s.
  
  
• Age 45: The American Cancer Society’s recommended age to begin regular screening for colon and rectal cancers, which used to be age 50.
  
  
• 52,547 people died of colorectal cancers in 2017 alone.
  
  
• 7 years from now colorectal cancer will be the leading cause of cancer deaths in people ages 20-49.
  
  

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A 52-year-old man returns to the office for reevaluation of an ulcer on his right great toe. The patient has a 15-year history of diabetes mellitus and takes glipizide and rosiglitazone. He first noticed the ulcer 2 months ago. One month ago, a 14-day course of oral amoxicillin-clavulanate therapy was prescribed. He has smoked one pack of cigarettes daily for the past 37 years. He is 178 cm (5 ft 10 in) tall and weighs 102 kg (225 lb); BMI is 32 kg/m2. Today, vital signs are temperature 38.8°C (101.8°F), pulse 96/min, respirations 12/min, and blood pressure 130/85 mm Hg. Physical examination of the right great toe discloses a 1.5-cm nontender ulcer with a depth of 0.5 cm, a moist base, yellow exudate, and surrounding erythema to the level of the malleoli. Vibration sense and sensation to monofilament examination are absent. Pulses are diminished in both feet. Capillary refill time is 2 seconds in the right great toe. Urinalysis discloses 3+ protein.
Which of the following historical factors or physical examination findings is most strongly associated with development of this patient's foot ulcer?

New exercise research estimates that 1 in 10 premature deaths are preventable with just 75 minutes of physical activity each week. The data utilized in making this conclusion comes from nearly 200 studies with a total of 30 million participants worldwide.

“Keto-like” diet consisting of low-carb and high-fat intake found to be associated to higher levels of “bad” cholesterol and potentially double the risk of cardiovascular events. This increased risk of heart disease includes blocked arteries, heart attacks, and strokes.

New CDC report highlights the importance of proper sanitation of breast pump equipment along with safe storage and careful preparation of powered infant formula to avoid Cronobacter sakazakii contamination. Most cases of Cronobacter sakazakii can be treatable with antibiotics, but some cases can lead to meningitis, sepsis, and other complications such as permanent brain damage.

Recent CDC discovery of increasing Shigella bacterial infections. This drug-resistant stomach bug is a major cause of inflammatory diarrhea and is now considered a serious public health threat.

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) "Neurologic findings"

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