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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.

The proportion of U.S. kindergartners exempted from school vaccination requirements has reached its highest level ever at 3%, reflecting a trend of increasing parental hesitancy toward routine childhood vaccinations. Despite this rise in exemptions, the national vaccination rate for kindergartners remained steady at 93% for the 2022-2023 school year, the same as the previous year but down from 95% before the COVID-19 pandemic.

US public health officials are sounding the alarm about a significant rise in the number of babies born with syphilis, a preventable and sometimes life-threatening infection. The Centers for Disease Control and Prevention (CDC) reported that more than 3,700 babies were born with syphilis in the US in 2022, marking a 32% increase from the previous year and a tenfold rise since 2012. The CDC termed the situation "dire" and "alarming", emphasizing the preventability of congenital syphilis with timely treatment during pregnancy.

Puerto Rico has declared an influenza epidemic as the island reports over 25,900 flu cases since July, with 42 deaths and over 900 hospitalizations. Health officials note a significant increase compared to the same period last year, particularly affecting those aged 0 to 19 years, and emphasize the availability of vaccines, tests, and treatments.

The newly approved postpartum depression drug, Zurzuvae, is priced at $15,900 for a 14-day course, raising concerns about accessibility. While Sage Therapeutics aims to work with insurers to enable broad access, the high cost has sparked worries about potential barriers, particularly for patients without adequate insurance coverage. Mental health specialists emphasize the importance of accessibility to such treatments, given the severity of postpartum depression and its impact on maternal and infant well-being.

Amazon has launched a virtual care service for its Prime customers, allowing them quick access to healthcare providers for $9 per month or $99 annually. This move comes after Amazon's acquisition of One Medical, a membership-based primary care provider, last year. The virtual care service includes video chats and the option for in-person visits at One Medical locations. The membership fee covers the cost of virtual visits, but patients would need to pay separately for in-person visits to One Medical offices, where insurance can be used.

Surgeons at NYU Langone Health have successfully completed the world's first whole eye transplant.

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In a world filled with stress and pain, the undeniable power of music as a remedy shines through. Music profoundly influences mood and emotions, and recent research investigates its correlation with pain perception. This article explores a study revealing how pleasurable music inducing 'chills' significantly reduces pain sensitivity. Discover how music-induced hypoalgesia provides a natural approach to pain management and enhances overall well-being.

A study presented at the American Heart Association’s Scientific Sessions 2023 suggests that adhering to the American Heart Association's "Life’s Essential 8" checklist may have a positive impact on biological aging.

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Is There a Doctor in the House?

A 70-year-old man is brought to the emergency department by his son because of a 2-day history of right upper quadrant abdominal pain, chills, and confusion. He has vomited twice during this time despite decreased food intake. The patient has hypertension controlled with hydrochlorothiazide. Medical and surgical history is otherwise unremarkable. Vital signs are temperature 40.2°C (104.4°F), pulse 110/min, respirations 18/min, and blood pressure 100/60 mm Hg. The patient appears seriously ill without evidence of jaundice. Abdominal examination discloses tenderness to palpation over the liver without guarding. Results of laboratory studies are shown:



Serum urea nitrogen and creatinine concentrations are within the reference ranges, as are results of liver function tests. Ultrasonography of the abdomen shows multiple stones in the gallbladder and a common bile duct measuring 9 mm in diameter. Intravenous fluids and a broad-spectrum antibiotic are administered. Which of the following is the most likely diagnosis?

A Harvard Medical School study in mice reveals that exercise-induced muscle inflammation mobilizes inflammation-countering T cells, enhancing the muscles' energy utilization and overall endurance, shedding light on the molecular aspects of exercise benefits. While cautioning that mice aren't humans, the research provides valuable insights into the immune system's role in exercise and the potential for naturally reducing inflammation through physical activity.

Experimental drugs for cholesterol, presented at the American Heart Association's annual conference, show promise in controlling cholesterol levels, targeting people with a genetic predisposition to high cholesterol. Verve Therapeutics' gene-editing approach, using base editing, and a second therapy using lepodisiran to target lipoprotein(a) levels, both demonstrated safety and efficacy, potentially heralding a new era of cholesterol control, though further research is required for FDA approval.

Researchers from Ginkgo Bioworks warn that zoonotic diseases, those transmitted from animals to humans, could cause 12 times more deaths in 2050 than in 2020. Climate change and deforestation increase the risk of zoonotic disease spillovers, and the study emphasizes the need for urgent action to address this growing threat to global public health.

The weight-loss drug Wegovy has shown promise in reducing the risk of heart attacks and strokes by 20% in adults with heart disease and obesity, according to a first-of-its-kind clinical trial. This could represent a breakthrough in the treatment of heart disease, the leading cause of death in the United States, and may lead to changes in insurance coverage for weight-loss drugs.

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 C) "Cholangitis"

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