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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 Affordable Care Act (ACA) health insurance marketplaces are poised to break enrollment records for the third consecutive year, with over nineteen million Americans signing up for Obamacare plans. HealthCare.gov saw its largest day ever on December 15, with 745,000 enrollments, and the current total includes individuals from both state-based and federal marketplaces.

Amidst challenges accessing newer weight loss drugs like Zepbound and Wegovy, older medications in the category, such as Ozempic and Wegovy, are experiencing a resurgence. Insurance hurdles and shortages often impede access to the newer drugs, prompting patients and doctors to turn to older alternatives like bupropion, metformin, and phentermine, which can be more affordable and come in pill form, avoiding the need for injections .

A controversial Census Bureau proposal to change disability estimation methods by shifting from yes-or-no questions to rating difficulty levels has sparked concerns among advocates, potentially reducing the estimated share of the U.S. population with disabilities by about 40%. Critics fear it could impact access to resources and legal protections for disabled individuals.

The U.S. is currently experiencing a "sharp increase" in flu levels, particularly in the southern regions, and COVID-19 cases are also on the rise nationally, according to Dr. Mandy Cohen, the director of the Centers for Disease Control and Prevention. Although cases of respiratory syncytial virus (RSV) have peaked earlier this season, Cohen stated that the U.S. is not yet near the peak for flu or COVID-19, emphasizing the importance of updated vaccinations to address emerging variants like JN.1.

The US Food and Drug Administration (FDA) has approved the AutoGenomics AvertD test, a genetic tool designed to assess the risk of developing opioid use disorder (OUD). The test analyzes 15 genetic markers related to the brain's reward pathways and addiction. While some experts are skeptical about its use in clinical practice, the FDA sees it as a step forward in efforts to prevent new cases of OUD and support treatment, aiming to decrease the misuse of opioid analgesics.

The article investigates concerns surrounding the safety of medical devices in the United States, using specific cases, such as the Medtronic insulin pump, to highlight broader issues. Carlton “PeeWee” Gautney Jr.'s death in 2020 is attributed by his family to a malfunction in the Medtronic insulin pump, leading to a wrongful-death lawsuit.

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In the wake of the tragic passing of the beloved actor, Matthew Perry, discussions have swirled regarding the circumstances surrounding his death. It has been reported that Perry’s demise was attributed to the “acute effects of ketamine,” a powerful psychedelic substance. This shocking revelation has ignited debates about the myths and facts surrounding psychedelics, shedding light on a topic that has long been shrouded in mystery and controversy.

The article delves into concerns about patient monitoring practices at HCA Healthcare facilities, the largest for-profit hospital chain in the U.S. Specifically, it examines the role of telemetry technicians responsible for monitoring patients' vital signs, such as heart rhythms, blood pressure, and respiratory functions. These technicians, rather than nurses, are tasked with alerting healthcare providers to significant changes in patients' vital signs.

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Is There a Doctor in the House?

A 70-year-old woman comes to the office for an annual health maintenance examination. She describes a 1-year history of slowly progressive fatigue, diffuse muscle aches, and generalized pain. Medical history is significant for osteoporosis diagnosed 5 years ago. Medications include alendronate and calcium supplementation. Vital signs are normal. Physical examination is unremarkable for her age, with no point tenderness on palpation. Results of complete blood count, serum electrolyte and thyroid-stimulating hormone concentrations, liver function tests, and erythrocyte sedimentation rate are all within the reference ranges. Screening mammography and colonoscopy done 1 year ago disclosed no abnormalities.

Which of the following is the most appropriate next step in evaluation?

Researchers have discovered dangerous levels of the known carcinogen hexavalent chromium in California wildfire ash, raising concerns about the health impact of breathing air near wildfires. The study, conducted by Stanford University, prompts a shift in public awareness and suggests the need for protective measures as climate change leads to larger and more frequent wildfires globally.

Results from a Phase II clinical trial suggest that psilocybin, a hallucinogenic chemical found in certain mushrooms, may benefit individuals with cancer and major depression by reducing depressive symptoms. The trial involved a single 25 mg dose of synthesized psilocybin in combination with psychological support from trained therapists, demonstrating potential therapeutic efficacy, although further research is needed before implementation into clinical practice.

Researchers at the University of Helsinki have resolved questions around the origin of small regulatory genes, particularly microRNA molecules. The study describes a mechanism that creates DNA palindromes, which, under suitable circumstances, evolve into microRNA genes. The research suggests that the origin of microRNA genes is facilitated by a mechanism that can instantaneously generate complete DNA palindromes, shedding light on the evolution of RNA genes.

Researchers at Tufts University and Harvard University's Wyss Institute have created tiny biological robots, known as Anthrobots, from human tracheal cells. These multicellular robots, ranging in size from the width of a human hair to the point of a sharpened pencil, self-assemble and have been found to encourage the growth of neurons across a region of damage in a lab dish.

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) "No additional evaluation is indicated"

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