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Former President Jimmy Carter will enter hospice care as he forgoes further medical treatment in order to spend his remaining time at home surrounded by family. At 98 years of age, he is the longest living president in American history.

White House physician Dr. Kevin O’Connor determines that President Joe Biden remains fit to conduct his duties as president. The 80-year-old underwent a routine physical exam as well as a dermatology consult, which resulted in a small lesion on President Biden’s chest being removed and sent for autopsy.

United States Republican legislators have amped up their aggressive pursuit to target transgender youth health care. Their campaign aims to ban certain health care offerings for transgender youths, and in some cases seek legal punishment for parents and doctors who provide treatment.

FDA panel recommends making opioid overdose antidote available over the counter. Narcan, used to quickly reverse the deadly effects of overdose from opioids such as heroin and fentanyl, may receive over-the-counter approval by late March .

A sharp rise in ADHD diagnoses during the pandemic has led to a nationwide shortage in Adderall, which enters its fifth month. Both the DEA and drugmakers alike were surprised by the 15.1% prescription increase in 2020 and have yet to recover.

Senator John Fetterman checked himself into Walter Reed National Military Center to receive treatment for clinical depression

Senator John Fetterman of Pennsylvania has prioritized his mental health and sought out care for clinical depression at Walter Reed National Medical Center . While Fetterman has long suffered from depression, the severity was acute, and as a result he will voluntarily get the treatment that he needs over the next several weeks. Fetterman’s health has been a topic of discussion and a point of concern ever since he suffered a stroke last year before winning the Pennsylvania Senate race by besting Dr. Oz.

• Approximately one third of people who have had a stroke suffer from a form of clinical depression. Many factors are at play when it comes to post stroke depression. The stroke itself affects the functionality of the brain, specifically in the way that the different brain regions communicate with one another. Cognitive difficulties and perceptional changes can lead to depression. Additionally, dealing with diminished abilities following the stroke could have a psychological effect as well.
  
  
• Fetterman, while not suicidal, exhibited symptoms such as weight loss and loss of appetite. Given his pre-existing depression, it is likely that he may be resistant to some forms or treatment or unresponsive to some medications used to treat depression. However, there are a plethora of medication offerings and cognitive behavioral therapy which can be nearly 80% effective within four to six weeks .

Dr. Peggy Drexler of CNN offers her eloquent and encouraging opinion: “The best response, of course, is somewhere in the middle—commending Fetterman for his courage to seek treatment while considering, with sincerity and when the time is right, whether continuing to serve in a stressful position that impacts so many is in both his and his constituents’ best interests. The fact is that it’s a fair question to ask. But it’s crucial to remember that depression is as common as the common cold. Depression simply isn’t prohibitive to thriving in life and career. We’re right to want to know about the health issues facing our leaders and the steps they’re taking to get the help they need, but it’s important to remember that millions of Americans battle depression and lead highly productive, successful lives . We aren’t living in the 1970s anymore; we’ve come far in our understanding of an illness that affects so many people.”

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Natural immunity from a Covid-19 infection has been found to be as effective and protective as vaccination against illness and death

Immunity generated from the Covid-19 infection has been found to be at least as high, if not higher than that provided by two doses of an mRNA vaccine . The immunity, which was studied at length and published in The Lancet, was found to be strong, lasting.

Key takeaways

• The meta-analyses showed that protection from past infection and any symptomatic disease was high for ancestral, alpha, beta, and delta variants , but was substantially lower for the omicron BA.1 variant.
  
  
• Protection from past infection against re-infection from pre-omicron variants was very high and remained high even after 40 weeks.
  
  
• Protection was substantially lower for the omicron BA.1 variant and declined more rapidly over time than protection against previous variants.
  
  
• Dr. Bob Wachter, the chairman of the department of medicine at the University of California, San Francisco and Dr. Christopher Murray, the director of the Institute for Health Metrics and Evaluation at the University of Washington both agreed that the vaccination remains the safest route for protection from infection but having a past Covid infection should at least be considered in policymaking decisions going forward, such as vaccination requirements, they said.
  
  

By the digits

• 65 studies examined
  
  
• 19 countries observed
  
  
• 88% reduction over 10 months in the chance of hospitalization and death for those previously affected with COVID compared to somebody who hasn’t yet been infected.
  
  
• 36% reduction over 10 months in the chance of hospitalization and death specifically against the BA.1 subvariant of Omicron for those previously affected with COVID compared to somebody who hasn’t been infected.
  
  

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A previously healthy 54-year-old man comes to the emergency department at his wife's insistence 6 days after a stray dog bit his right leg while he and his wife were walking near the dog during a trip to South America. The bite punctured the skin. He immediately cleaned the wound thoroughly with soap and peroxide and has done so daily since the incident occurred. The area of the bite is not painful, and the patient has not had fever or chills. He takes no medications. He had a tetanus booster vaccination 3 years ago. Vital signs today are normal. Examination of the right lower extremity shows healing bite puncture wounds. There is minimal erythema, and the area is not fluctuant. Lymph nodes in the groin are not palpable.
Which of the following is the most appropriate next step?

For some older breast cancer patients, skipping radiation after surgery may not impact overall survival for women 65 and older with small hormone-positive breast cancer tumors. A few caveats remain, however, as this appears to only ring true for those who instead receive five years of endocrine therapy, and even then, those patients may have a higher risk of cancer returning to the same affected breast.

A new study suggests that chronic pain, such as arthritis, cancer, or back pain which lasts over three months, significantly raises the risk of cognitive decline and dementia. The hippocampus progressively aged at a much faster rate for those with one and two sites of chronic pain when compared to people without any chronic pain .

1 in 3 parents found to quickly turn to fever-reducing medications for their children for a low-grade fever, defined as below 100.4 degrees Fahrenheit. Furthermore, 1 in 2 parents would use medicine for a fever between 100.4 F and 101.9 Fahrenheit .

A recent CDC report indicates that children under 5 are not eating enough fruits and vegetables but are drinking sugary drinks in spades. Nearly half of the children in the study did not eat a vegetable every day, about a third did not a eat a fruit every day, and over half of the kids drank at least one sugar-sweetened drink the week of the survey.

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) "Administer rabies vaccination"

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