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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 FDA has approved a label change for the obesity drug Wegovy, allowing it to be used to reduce the risk of stroke, heart attacks, and other serious cardiovascular problems in overweight or obese patients. Based on a study showing its effectiveness in cutting heart-related risks, Wegovy is the first medication to receive approval for this purpose, signaling a significant advancement in public health and potentially changing how heart patients are treated.

Amylyx Pharmaceuticals announced that its ALS drug, Relyvrio, did not show significant benefit in a large phase 3 clinical trial and may be withdrawn from the market. Despite gaining FDA approval in September 2022 based on a small phase 2 trial, the drug failed to outperform a placebo in improving participants' ALS functional scale and overall survival. Now, discussions are underway about potentially withdrawing Relyvrio from the market, raising concerns about the drug's effectiveness and its high cost of about $158,000 per year.

Federal regulators have delayed a decision on Eli Lilly's potential Alzheimer's treatment, donanemab, and have requested an advisory committee to examine the drug's safety and effectiveness. Eli Lilly expected the FDA to decide on donanemab's approval by the end of the month, but the agency's request for additional information has postponed the decision. Donanemab, if approved, would be the second drug convincingly shown to delay cognitive decline in Alzheimer's patients, targeting amyloid plaque buildup in the brain, but it comes with serious side effects such as brain swelling and bleeding, similar to other plaque-targeting drugs.

Tissue samples from the brain of Robert Card, who killed 18 people in a shooting rampage in Maine, showed evidence of traumatic brain injury but not chronic traumatic encephalopathy (CTE), according to the Concussion Legacy Foundation. Card, a US Army reservist, had been exposed to low-level blasts during his time at an Army hand grenade training range, potentially contributing to his brain injury.

Florida's Medicaid call center faces significant challenges, with 8 in 10 calls being automatically disconnected, hindering access to health care. Long wait times and disconnection rates are preventing qualifying families from renewing or accessing Medicaid coverage, contributing to a drop in enrollment by 17% since April.

The community of East Palestine, Ohio, faced a crisis when a train derailed and spilled toxic chemicals into the environment. Despite assurances from government officials and Norfolk Southern, the train's operator, that homes were safe, residents continued to experience an odd odor, indicating potential chemical exposure. More than 600 households volunteered for air quality testing, unaware that the handheld devices used couldn't detect one of the main spilled chemicals, butyl acrylate, at levels that could harm health.

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The recent presentation of favorable preliminary results from two HIV vaccine studies at the retrovirus conference has reignited hopes for an effective HIV vaccine. Despite decades of setbacks and failures, scientists are optimistic about recent scientific advances paving the way for a potential breakthrough in developing a highly effective vaccine against HIV, a virus that still infects over 1 million people annually.

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Is There a Doctor in the House?

A 37-year-old man is admitted to the hospital for treatment for cocaine dependency. He says he has tried repeatedly to abstain from cocaine use but lives in a part of town where there are heavy drug sales. He did not like his hospital outpatient group but liked his single session at a 12-step program for cocaine dependency. Vital signs are temperature 37.0°C (98.6°F), pulse 70/min, respirations 16/min, and blood pressure 125/85 mm Hg. He appears thin. Physical examination discloses good muscle strength and no focal neurologic deficits. The patient is using insurance coverage through his wife but does not wish for his diagnosis to be disclosed to anyone. He is on probation after a conviction for aggravated robbery 3 years ago. There is also a warrant for his arrest for assault and battery.

After listening to his requests and weighing your obligations, you should disclose this patient's diagnosis only to which of the following?

A new study led by researchers at NYU Langone Health's Perlmutter Cancer Center and the University of Oxford, published in the journal Science Immunology, unveils insights into the immune cell surface receptor PD-1. The study reveals that PD-1 forms dimers through its transmembrane segment, contrary to previous belief, and suggests new strategies for treating cancer and autoimmune diseases by manipulating PD-1's dimerization to regulate T cell function. This understanding could lead to the development of more effective immunotherapies targeting PD-1 for both cancer and autoimmune disorders.

The presence of microplastics and nanoplastics in plaque lining major blood vessels has been linked to a higher risk of heart attack, stroke, or death, according to a study published in The New England Journal of Medicine. The study suggests a potential link between the presence of micro- and nanoplastics and inflammatory responses associated with heart disease, sparking interest in further research to understand the broader implications for human health and the environment.

Recent research unveiled a crucial snapshot of parental histone transfer during DNA replication, shedding light on the intricate process of epigenetic inheritance. This study, published in Nature, elucidates how the chaperone complex FACT interacts with parental histones at the replication fork, offering insights into gene regulation, development, and disease. These findings open new avenues for targeted therapeutic interventions and innovative strategies in cancer treatment by modulating epigenetic modifications.

The study, published in Science Advances, sheds light on the intricate relationship between emotion and perception, revealing that the brain constructs emotional experiences regardless of sensory input. By involving individuals with congenital sensory deprivation, such as blindness and deafness, the research uncovers a distributed network in the brain that encodes emotional instances, with the ventromedial prefrontal cortex playing a key role in storing abstract representations of emotions independent of sensory experience or modality .

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) "Insurance company"

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