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The United States is facing a shortage of physical therapists, impacting patient care across the nation. According to the American Physical Therapy Association (APTA), the job vacancy rate for therapists in outpatient settings last year was 17%. The shortage is particularly acute in rural areas and high-cost-of-living areas like California.

The United States received a D+ grade for the second consecutive year in the annual report card on maternal and infant health by the nonprofit March of Dimes. The report highlights that the nation's preterm birth rate was 10.4% in 2022, down only 1% from the previous year. Preterm births are a leading cause of infant deaths.

Warmer winters due to climate change are making ticks, especially the ones that spread Lyme disease, more active during winter months. This increased activity, combined with milder winter days, raises the risk of tick bites and Lyme disease infections even in the colder seasons.

Childhood cancer mortality in the US has decreased by 24% over the past two decades, with a notable drop in death rates for children under 10. However, disparities exist among racial and ethnic groups, as rates continued to decline only for White children between 2011 and 2021, leading to a 20% higher cancer death rate among Black and Hispanic children compared to White children in 2021, according to a report by the US Centers for Disease Control and Prevention.

Nearly 450 patients at Salem Hospital in Massachusetts may have been exposed to hepatitis B, hepatitis C, and HIV during endoscopy procedures over a two-year period. The hospital corrected the practice, and the Massachusetts Department of Public Health determined that the infection risk is extremely small, with no evidence of infections reported to date.

Scientists have spent decades trying to untangle puzzling questions over falling sperm concentrations.

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In recent years, significant advancements have been made in the field of cancer research, specifically in understanding the DNA repair pathways associated with breast, ovarian, and prostate cancers. These breakthroughs hold the promise of revolutionizing cancer treatment strategies and providing hope to millions of patients worldwide.

Recent research suggests a nonsurgical treatment could be as effective.

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Is There a Doctor in the House?

A 70-year-old woman comes to the office because of worsening tremor of her hands. The tremor has been present for most of her life and initially was mild and would occur only when she was tired or stressed. During the past month the shaking has become more noticeable and frequent. She is now embarrassed to eat with other people because of how obvious the tremor has become. The patient has been taking fluoxetine for the past 3 weeks to help her to cope with the death of her husband 2 months ago. Medical history is also remarkable for essential hypertension controlled with lisinopril and hyperlipidemia controlled with atorvastatin. Her only other medication is occasional ibuprofen for joint pain. She used to drink one to two alcoholic beverages monthly but now drinks one glass of wine daily because, she says, it reduces her tremor. She is 168 cm (5 ft 6 in) tall and weighs 70 kg (155 lb); BMI is 25 kg/m2. Vital signs are temperature 36.4°C (97.6°F), pulse 80/min, respirations 18/min, and blood pressure 130/85 mm Hg. Physical examination shows a moderate tremor of both hands that is not present at rest. Complete blood count, serum chemistry profile, and serum thyroid function tests are ordered, and results are pending.

Which of the following is the most likely cause of the patient's worsening tremor?

Liver cells in mice age differently depending on their location within the organ, according to a study by the Max Planck Institute for Biology of Aging and CECAD Excellence Cluster for Aging Research. The research found that the aging process varied based on whether the cells were in regions using oxygen for energy production or in oxygen-deprived areas, emphasizing the significance of considering cell location when studying aging.

A newly discovered tumor marker, stromal cell-derived factor 4 (SDF-4) protein, shows promise in the early detection of gastric cancer with nearly 90% accuracy. The research by Nagoya University suggests that simple blood tests detecting this protein could lead to improved outcomes and increased survival rates through early-stage therapy for gastrointestinal cancers.

A study supported by the British Heart Foundation has revealed that any type of physical activity is better for heart health than sitting, even including sleeping. The study, analyzing data from 15,246 people across five countries, found that moderate-vigorous activity provides the most benefit to heart health, followed by light activity, standing, and sleeping, while sedentary behavior has an adverse impact .

An international study led by the University of Granada has identified that taking 8,000 steps a day significantly reduces the risk of premature death. The research also showed that the pace at which people walk provides additional benefits and that walking faster is better than walking slowly.

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) "Adverse effect of fluoxetine therapy"

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