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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.

Capital Health, a New Jersey health system, has reported experiencing network outages believed to be the result of a cybersecurity incident, making it the latest target of a cyber-attack in the healthcare sector. While the extent of the impact and exposure of data, including patient, employee, or financial information, remains unclear, disruptions to services, such as outpatient radiology and certain testing appointments, have been noted, with surgeries being prioritized based on urgency.

The US Environmental Protection Agency (EPA) is proposing a rule that would require water systems in the country to replace millions of lead service lines within 10 years, accelerating progress toward the Biden administration's goal of removing 100% of lead pipes. The proposal states that regardless of the lead levels in tap or other drinking water samples, lines must be replaced within a decade. The Safe Drinking Water Act authorizes the EPA to establish regulations for public water systems, and the proposed rule aims to strengthen the ways the Lead and Copper Rule targets lead in drinking water, with improvements in testing methods and a lower lead action level.

Life expectancy in the U.S. increased in 2022, showing a 1.1-year rise from 2021, primarily due to a decrease in COVID-19 deaths. However, the current life expectancy of 77.5 years still falls short of the 2019 figure of 78.8 years, highlighting the enduring impact of the pandemic on public health. The increase is attributed to declines in COVID-19 deaths, as well as smaller decreases in deaths from other causes such as cancer, heart disease, homicide, and unintentional injuries.

The US Food and Drug Administration (FDA) is investigating certain cancer treatments, including chimeric antigen receptor T-cell (CAR-T) therapies, amid reports of an association with the risk of developing secondary cancers. The agency received 19 reports of T-cell malignancies, such as lymphomas, in individuals who underwent treatment with specific CAR-T therapies, which involve modifying T cells in a lab to attack cancer cells.

The US has seen a record number of suicides in 2022, with an estimated 49,449 individuals taking their own lives, marking a 3% increase from the previous year, according to the Centers for Disease Control and Prevention's National Center for Health Statistics. The suicide rate rose by 1% to 14.3 deaths per 100,000, the highest rate since 1941. Suicides by firearm in the United States have reached an all-time high, rising 11% between 2019 and 2022, with an estimated 27,024 deaths by suicide using firearms in 2022.

Can too much of a healthy habit become bad?

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Youth baseball is a beloved sport that nurtures the dreams of aspiring athletes. However, there’s a growing concern within the baseball community — the alarming rise of elbow injuries among young players. In this article, we will delve into the risks associated with elbow injuries in youth baseball players, focusing on the issues related to bone maturity and the perils of repetitive overuse.

Occupational physical activity (PA) has been associated with an increased risk of mild cognitive impairment (MCI) and dementia in later life, according to a study following more than 7,000 adults from age 33 to 65.

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Is There a Doctor in the House?

A 67-year-old man, who has been recovering in the hospital following surgical repair of a contained ruptured abdominal aortic aneurysm 10 days ago, suddenly develops severe abdominal pain. He does not have chest pain or shortness of breath. The patient's postoperative course had been uncomplicated until 4 days ago, when he developed a low-grade fever. He has been unable to tolerate a full liquid diet during the past 4 days. Medical history is remarkable for hypertension, hypercholesterolemia, and a myocardial infarction 6 years ago. Regular medications include metoprolol, lovastatin, and an 81-mg aspirin daily. He has smoked one pack of cigarettes daily for the past 40 years, and he typically drinks three to five beers daily. Vital signs now are temperature 38.1°C (100.6°F), pulse 68/min and regular, respirations 16/min, and blood pressure 150/90 mm Hg. Physical examination shows bilateral cataracts. Auscultation of the chest discloses diffuse mild wheezes and a grade 1/6 soft systolic ejection murmur at the cardiac apex. Palpation of the abdomen discloses mild to moderate mid and right upper quadrant abdominal tenderness. There is no guarding, rebound, or palpable mass. Rectal examination shows no abnormalities. Peripheral pulses are normal. Neurologic examination discloses no abnormalities. Serum electrolyte concentrations are within the reference ranges. Leukocyte count is 15,800/mm3 with mild left shift. Urinalysis shows no abnormalities. ECG shows an old inferior myocardial infarction. Chest x-ray shows scarring at the left and right cardiac bases; no masses or infiltrates are present.

Which of the following is the most appropriate additional diagnostic study?

Millennial and Gen Z women are facing heightened risks to their health and safety compared to previous generations, with increased suicide rates, maternal mortality, and homicides, according to a report by the Population Reference Bureau. Factors such as harmful social media content, the lingering effects of the COVID-19 pandemic, political divisions, inflation, and restrictions on reproductive health access are cited as contributors to these concerning trends.

An analysis of health records and data found that Eli Lilly's Mounjaro (tirzepatide) led to more and faster weight loss compared to Novo Nordisk's semaglutide-based drugs, Wegovy and Ozempic. Within one year of treatment, patients on Mounjaro were more likely to achieve significant weight loss, raising interest in the competitive landscape of weight loss medications.

A study from the John A. Burns School of Medicine and Kapiʻolani Medical Center for Women & Children at the University of Hawaiʻi at Manoa found microplastic particles in the placentas of women who delivered in Hawaiʻi from 2006 to 2021. The researchers collected and studied 10 placentas from each of the years and found the presence of microplastics grew each year, raising concerns about the potential impact on fetal health.

Researchers at Indiana University have discovered a novel process by which pathogens enter cells with physical force, breaching immune defenses, offering a potential game-changer in combating intracellular pathogens responsible for diseases like tuberculosis and malaria. The study focused on the parasite Toxoplasma, revealing that pathogens can exert a propulsive force during entry into host cells, evading degradation and surviving intracellularly, suggesting a new avenue for infection control.

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 D) "Ultrasonography of the abdomen"

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