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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.

Experts advocate for permanent standard time as it better aligns with the natural body's sleep-wake cycle, aiming to reduce the health disruptions associated with changing clocks. The debate emphasizes potential benefits, highlighting a shift to year-round standard time to enhance sleep patterns, minimize mental health impacts, and alleviate health issues linked to time changes.

The American Cancer Society's updated guideline extends lung cancer screening recommendations to adults aged 50 to 80 with a history of 20 or more pack-years of smoking, irrespective of the duration since they quit smoking, aiming to prevent more lung cancer deaths. This expanded criterion aligns with newer evidence that suggests risks persist beyond the 15-year quitting point and hopes to reach more high-risk individuals, particularly in underserved communities.

The CDC reports a 3% increase in the infant mortality rate in 2022 compared to the previous year, marking the first such rise in more than two decades, attributed to factors such as maternity care deserts, limitations on abortion access, and subsequent impact on the health of pregnancies and infants. The increase is a concern particularly in relation to restrictions on abortion access and maternity care, impacting both minoritized and non-minoritized communities, leading to disparities and increased risk for adverse outcomes.

A newly developed antibiotic, zoliflodacin, has demonstrated efficacy akin to current treatments against drug-resistant gonorrhea, marking a potential breakthrough for managing the infection. If approved, this antibiotic could offer a crucial solution in addressing the rising concerns surrounding drug-resistant strains of gonorrhea.

Lawrence Faucette, the recipient of a genetically modified pig heart in an experimental transplant, passed away six weeks post-procedure due to signs of heart rejection, despite initial progress, sparking reflections on the challenges and uncertainties in xenotransplantation. His tragic demise echoes a similar outcome with the first recipient, David Bennett, reiterating the complexities and potential risks associated with these innovative yet challenging medical endeavors.

Today we will highlight one of the first studies, titled "Cost-Effectiveness of Pharmacist Prescribing for Managing Hypertension in the United States" published in Jama Network Open, designed to explore the economic fallout of treating hypertension patients directly via pharmacists themselves prescribing treatments to improve patients’ blood pressure control.

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In the realm of medical discussions, the topic of “Testosterone Therapy and Anemia” has sparked a considerable amount of debate and intrigue. Anemia, characterized by a deficiency of red blood cells or hemoglobin in the blood, can lead to symptoms like fatigue and weakness. On the other hand, testosterone, typically associated with male sexual characteristics, also has a role in red blood cell production. Recent studies have raised questions about whether testosterone therapy can effectively correct anemia. In this article, we will delve into this ongoing discussion, exploring the potential benefits, considerations, and implications of using testosterone therapy to address anemia.

The association between statin use and a possible risk of developing type 2 diabetes has prompted continuous discussions and research, with recent studies affirming that statins' cardiovascular benefits outweigh the risks, as suggested in recent guidelines and clinical practice recommendations.

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Is There a Doctor in the House?

A 15-year-old girl is brought to the office by her parents because of a 2- month history of progressively worsening gait disturbance. She has fallen several times, once striking her head and causing a brief loss of consciousness. Her parents say, "She's been acting like a delinquent lately. We think she might be using drugs." Medical history is remarkable for asthma treated with a corticosteroid inhaler as needed. Family history is remarkable for multiple sclerosis in a maternal aunt, parkinsonism in her paternal grandfather, and cancer in several paternal relatives, including a grandmother who died from a hemangioblastoma. Vital signs are normal. The patient is awake and alert, but she avoids eye contact and will not answer questions. Auscultation of the lungs discloses expiratory wheezing. Cardiac and abdominal examinations disclose no abnormalities. She has mild bilateral papilledema. Her stance and gait are wide-based, and she is unable to perform a tandem walk. Toxicology screening of the urine is positive for marijuana and cocaine metabolites.

Which of the following is the most likely initial working diagnosis?

A potential groundbreaking sickle cell treatment using CRISPR gene editing, called exa-cel, is under FDA review, offering hope for a cure that modifies the DNA in the patient’s blood cells, potentially eliminating the need for a bone marrow transplant, if approved by the FDA by December 8. While the drug aims to treat severe illness for patients aged 12 and above, the FDA advisory committee's recent meeting addressed concerns about the "off-target" effects of CRISPR, prompting a focus on evaluating possible risks arising from unintended DNA edits, creating uncertainties and questioning the thoroughness of research analysis.

A recent study involving surgical patients with major depressive disorder (MDD) found that ketamine was not more effective than a placebo in reducing depressive symptoms, with both groups displaying considerable improvement. The research suggests that participant expectations, often referred to as hope, may play a significant role in driving reductions in depression symptoms observed in antidepressant trials.

The study by the Ontario Institute for Cancer Research demonstrates that smoking causes 'stop-gain mutations' in DNA, inhibiting the production of tumor-suppressing proteins and promoting cancer growth across various cancer types. This research underscores how smoking affects DNA, deactivating essential proteins within cells, providing insights into the molecular mechanisms that contribute to cancer risk, reinforcing the necessity of quitting smoking for improved health.

Adherence to the Portfolio diet, rich in cholesterol-lowering foods, is associated with a 14% lower risk of total cardiovascular disease, coronary heart disease, and stroke based on an observational study pooling results from three major cohorts. This study, conducted by Andrea J. Glenn, PhD, and colleagues at the Harvard T.H. Chan School of Public Health, supports the potential benefits of the plant-based Portfolio diet in reducing cardiovascular risk, emphasizing the importance of a diet rich in plant-based proteins, nuts, fiber, and specific fats as recommended by the American Heart Association.

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 A) "Cerebellar tumor"

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