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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.

U.S. Senators Chuck Grassley and Sheldon Whitehouse have launched a bipartisan investigation into the involvement of private-equity firms in the nation's healthcare sector. The inquiry focuses on private-equity deals affecting hospital systems and aims to assess the financial arrangements and potential harm to patients and clinicians. The investigation aims to understand the impact of private-equity firms on healthcare delivery, patient care, and safety.

An outbreak of Rocky Mountain spotted fever has been reported in Southern California, causing at least five illnesses, including three deaths, since July. The U.S. Centers for Disease Control and Prevention (CDC) warns healthcare providers to consider immediate treatment with the antibiotic doxycycline for patients with symptoms of Rocky Mountain spotted fever who have recently traveled to northern Mexico, where the tickborne disease is endemic.

The Biden administration is considering overriding patents for high-priced drugs developed with taxpayer money, allowing competitors to produce their versions to reduce costs. The move is part of the administration's broader efforts to address drug pricing issues, and it signals a willingness to use "march-in rights" to challenge drug patents. Pharmaceutical companies, including the lobbying firm Pharmaceutical Research and Manufacturers of America (PhRMA), argue that such actions would hinder innovation and collaboration between the public and private sectors.

The PrEPVacc prevention study, a significant HIV vaccine trial, has ceased its vaccine component due to disappointing results in preventing HIV. The trial, which evaluated two experimental HIV vaccines alongside a new form of oral pre-exposure prophylaxis (PrEP), involved 1,500 volunteers in Uganda, Tanzania, and South Africa. The failure is a setback in the decades-long pursuit of an effective HIV vaccine.

The Biden administration has once again delayed the ban on menthol cigarettes, pushing the implementation to at least March, with expectations that it will take years for menthol products to be removed from store shelves. Public health organizations, including the American Heart Association, have been advocating for a menthol ban for over a decade, citing its role in contributing to tobacco-related diseases and disproportionately affecting Black Americans.

Following the overturning of Roe v. Wade last year, a wave of legal battles and extensive travel for abortion care has been unveiled across the country. In this week’s opinion piece, we dive into a few examples of such cases.

• A pregnant Texas woman asked a court for permission to get an abortion, despite a ban. What's next?

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• Pregnant woman in Kentucky sues for the right to get an abortion.

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• 1 in 5 patients travel to other states for abortion care, according to new data.

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In the ever-evolving landscape of healthcare, UCSF Health is making remarkable strides in the treatment of atrial fibrillation, a common heart condition characterized by irregular heartbeat rhythms. Their pioneering approach involves a groundbreaking therapy known as pulsed field ablation, which has demonstrated tremendous potential in helping patients combat heart arrhythmias. In this article, we delve into the intricacies of this innovative method, exploring its advantages, applications, and the hope it brings to individuals seeking relief from atrial fibrillation.

The groundbreaking approval has been eagerly anticipated by patients and doctors alike. The treatment is priced at $2.2 million per person.

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Is There a Doctor in the House?

A 5-year-old boy is brought to the emergency department by his parents because of a 2-day history of favoring his right leg when walking. Today, he has refused to bear weight on the right leg and had a temperature to 38.2°C (100.8°F). Treatment with ibuprofen has relieved the fever but has not improved the leg pain. The child has no known history of trauma. His parents report that he has been healthy except for a recent upper respiratory tract infection that has resolved. The child is lying supine on a gurney with his right lower extremity flexed and externally rotated at the hip. Vital signs are temperature 37.8°C (100.1°F), pulse 110/min, respirations 20/min, and blood pressure 88/50 mm Hg. Internal rotation of the right hip causes the child to cry. Examination of the right lower extremity discloses no deformity, ecchymosis, erythema, or swelling. The right foot is neurovascularly intact. Plain x-ray of the hips is shown:



Which of the following is the most appropriate additional imaging study to obtain at this time?

Researchers at Case Western Reserve University and University Hospitals have discovered a novel enzyme, SCAN, which blocks insulin production in the body, providing a potential target for new diabetes treatments. The study suggests that blocking the SCAN enzyme could offer a novel therapeutic approach, not only for diabetes but also for diseases associated with excessive nitric oxide binding to key proteins.

The study led by USF Health doctors, including Dr. Da-Zhi Wang, delves into the challenge of repairing heart muscle damage, especially after a heart attack, emphasizing the critical role of mitochondria in cardiac regeneration. The research suggests that manipulating mitochondrial activity could be a key to facilitating heart regeneration after injury, offering potential breakthroughs in treating heart disease.

In a study led by UC San Francisco, researchers discovered that taste, rather than signals from the stomach, plays a crucial role in controlling eating speed. Neurons activated by the perception of flavor, specifically prolactin-releasing hormone (PRLH) brain cells, were found to slow down food intake, providing new insights into appetite control and potential implications for weight-loss drugs like Ozempic.

A study from the Gladstone Institutes has provided insights into how different oxygen levels affect protein creation and degradation in the lungs, heart, and brain of mice. The research revealed the accumulation of a protein called MYBBP1A in response to high oxygen levels, suggesting it may play a role in hyperoxia signaling. The findings could have implications for conditions where supplemental oxygen is used and may inform new treatments targeting proteins associated with hyperoxia.

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 hips"

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