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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.

A ransomware attack on Change Healthcare, the largest U.S. health care payment processor, is described by the American Hospital Association as the most serious incident of its kind in the industry, affecting health care providers nationwide. The attack has disrupted operations, preventing electronic prescription filling and insurance reimbursements, with the company working with law enforcement and cybersecurity firms to recover from the breach.

The U.S. Centers for Disease Control and Prevention (CDC) has updated its guidance, stating that individuals recovering from COVID-19 no longer need to remain isolated for five days after symptoms end. Instead, people are advised to stay at home until at least 24 hours after their symptoms improve and they don't have a fever without medication. The guidelines suggest continued mask-wearing, keeping distance from others, testing, and practicing enhanced hygiene during the five days after symptoms improve.

CVS and Walgreens have announced plans to dispense mifepristone, a medication used for medication abortions, following FDA certification and a rule change allowing pharmacies to distribute the drug in person or by mail. The move broadens access to abortion pills, with Walgreens set to begin dispensing mifepristone in select locations in California, Illinois, Massachusetts, New York, and Pennsylvania, while CVS plans a phased rollout starting in Massachusetts and Rhode Island before expanding to other states.

During the COVID-19 pandemic, the United States experienced a surge in deaths related to excessive alcohol consumption, averaging about 488 deaths per day, according to a CDC report. The increase in alcohol-related deaths, up by over 29% from 2016-17 to 2020-21, affected all age groups, with a larger increase among women. Stress, isolation, and more permissive alcohol policies during the pandemic contributed to the rise, prompting calls for policies to limit alcohol access and increase prices to mitigate harm.

The FDA announced that food makers can advertise yogurt as potentially reducing the risk of Type 2 diabetes, responding to a petition from Danone North America. While the claim is allowed, it must include caveats stating the limited evidence and recommending two cups of yogurt per week, based on studies linking yogurt consumption with diabetes risk reduction. The decision follows a standard process for "qualified health claims," but food cannot be marketed as curing diseases outright due to regulatory restrictions.

Elizabeth Goldman's hopes for a second baby, made possible through a uterine transplant, have been dashed due to a recent Alabama Supreme Court ruling that froze her IVF treatments. Born with Mayer-RokitanskyKüster-Hauser syndrome, which affects the reproductive system, Goldman had long dreamed of carrying her own child. Her journey led her to the University of Alabama at Birmingham's uterus transplant program, where she received a donated uterus in 2022 and gave birth to her daughter, Zari Grace, in 2023.

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Introduction to Ultra-Processed Foods and Health Concerns: The groundbreaking study by Lane MM, et al., published in the British Medical Journal (BMJ) in 2024, casts a spotlight on the health risks associated with ultra-processed foods. These foods, characterized by high levels of processing and additives such as sweeteners and preservatives, have become ubiquitous in modern diets. They include items like soft drinks, packaged snacks, and ready-to-eat meals, which differ significantly from whole or minimally processed foods in nutritional quality.

Mark's journey with a brain-computer interface (BCI) highlights the transformative potential of neurotechnology in enhancing the lives of individuals with conditions like amyotrophic lateral sclerosis (ALS). Diagnosed with ALS in 2021, Mark's quest for innovative solutions led him to participate in a human trial with Synchron, a company developing a unique type of BCI.

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Is There a Doctor in the House?

In determining the usefulness of a D-dimer assay in ruling out pulmonary embolism as a diagnosis in a 27-year-old woman with pleuritic chest pain and nonproductive cough, a recent study in the medical literature is reviewed. The study evaluates the use of D-dimer assay in 1500 patients (705 female and 795 male) ranging in age from 19 years to 57 years (mean age is 36 years), whose examining physicians had a low clinical suspicion that the patients had pulmonary embolism. All patients in the study underwent a D-dimer assay, followed by CT angiography of the chest to confirm, or exclude the diagnosis of pulmonary embolism. Study results are shown:



Which of the following is the most appropriate conclusion about this data in regard to patients with low clinical suspicion for pulmonary embolism?

Metformin, widely prescribed for type 2 diabetes, is now under investigation for its potential in treating various conditions beyond glycemic control, including cancer, obesity, liver disease, and cardiovascular, neurodegenerative, and renal diseases. Its long pharmaceutical history traces back to 1918, with recent interest spurred by its proposed effects on multiple receptors, particularly in cardiovascular outcomes and cancer prevention.

A recent study highlights the role of a genetic modification called ac4C in helping cells form stress granules, which protect vital genetic information during stress. These findings offer insights into how RNA modifications influence stress response mechanisms, potentially paving the way for targeted interventions in diseases influenced by cellular stress and RNA acetylation.

A recent pilot study suggests that high-intensity exercise could potentially reverse the neurodegeneration associated with Parkinson's disease by preserving and strengthening dopamine-producing neurons. Brain imaging revealed that after six months of high-intensity aerobic exercise, participants exhibited healthier dopamine signals and increased neuromelanin levels in the substantia nigra, shedding light on the neuroprotective effects of exercise in Parkinson's disease management.

A new study suggests that early vocabulary size is genetically linked to various developmental outcomes, including literacy, cognition, and attention-deficit/hyperactivity disorder (ADHD). Researchers conducted a genome-wide meta-analysis of infant and toddler vocabulary size, finding that genetic associations with later-life outcomes varied during development. While infant word production was associated with increased ADHD risk, toddler vocabulary was linked to cognitive abilities and literacy skills, highlighting the evolving role of genetics in early language development and its impact on future behavior and cognition.

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) "A negative D-dimer assay has a high negative predictive value for excluding the diagnosis of pulmonary embolism"

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