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The Centers for Disease Control and Prevention (CDC) data indicates a significant rise in sexually transmitted infection (STI) rates among adults aged 55 and older, prompting calls from medical professionals for more open discussions about sexual health in this demographic. Matthew Lee Smith, an associate professor at the Texas A&M School of Public Health, highlights the historical lack of formal sexual education among older adults, contributing to gaps in knowledge about STIs, their transmission, symptoms, and prevention.

The CDC issues a health alert urging doctors to be vigilant for rare meningococcal infections showing unusual symptoms, with a higher fatality rate observed in middle-aged adults compared to typical cases. These infections, caused by a specific strain of Neisseria meningitidis bacteria, have led to a concerning rise in cases in the United States, prompting recommendations for immediate antibiotic treatment and emphasizing the importance of vaccination, particularly for vulnerable populations.

A study published in the journal Nature reveals that a common type of bacteria, Fusobacterium nucleatum, found in dental plaque, may be linked to a treatment-resistant form of colorectal cancer, with implications for new treatments and screening methods. The bacteria's ability to shield tumor cells from cancer-fighting drugs was observed in 50% of tested tumors, highlighting its potential impact on prognosis and response to chemotherapy. This discovery could lead to targeted therapies, including antibiotic treatments before chemotherapy, and possibly even the development of new antibiotics or the use of genetically modified bacteria for cancer treatment.

During recent Supreme Court arguments, justices expressed skepticism toward nationwide bans or new restrictions on mifepristone, the primary drug for medication abortions, with the case addressing lower-court rulings that sought to limit access to the drug. Questions arose regarding the legal standing of the plaintiffs, the scope of federal conscience protections for healthcare providers, and detailed medical inquiries about medication abortion procedures and potential complications. Additionally, discussions touched on the implications of judicial injunctions, referenced the historic Comstock Act, and highlighted the influence of judicial appointments in politically charged cases.

Princess Kate of Wales is undergoing the early stages of "preventative chemotherapy" which refers to a course of chemotherapy treatment administered after surgery to remove cancerous tissue, aiming to eliminate any remaining cancer cells that may be too small to detect. This approach, also known as adjuvant chemotherapy, is like an "insurance policy" against cancer recurrence and is tailored to the type of cancer diagnosed. The treatment aims to reduce the risk of cancer returning in the future and is typically administered within a specific timeframe to maximize its effectiveness. Side effects may include fatigue, nausea, and hair loss, and the decision to undergo adjuvant chemotherapy depends on various factors, including the individual's age and overall health.

Hospitals are increasingly venturing into concierge medicine, a practice where patients pay premium annual fees for privileged access to physicians.

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The use of force by police, intended to subdue individuals without lethal consequences, has resulted in over 1,000 deaths in the United States from 2012 to 2021. Despite not posing a public safety threat, individuals like Carl Grant, Taylor Ware, and Donald Ivy Jr. died after encounters with law enforcement that involved tactics such as physical holds, Tasers, and body blows.

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Is There a Doctor in the House?

A 45-year-old man comes to the office for a follow-up examination 2 days after he was seen in the emergency department for a generalized tonicclonic seizure. He was prescribed chlordiazepoxide upon being discharged but did not fill the prescription. The patient says that this was his third seizure in the past 2 years; prior to that he had no history of seizures. Medical history is also remarkable for a 10-year history of daily ingestion of two six-packs of beer. He has not had any alcoholic beverages for the past 5 days. He takes no medications. The patient says that his seizures usually occur after he abstains from alcohol for a period of time. Vital signs are normal. Physical examination shows scattered spider angiomata on his chest and abdomen. Liver is enlarged, smooth, and nontender. CT scan of the head with contrast done in the emergency department 2 days ago showed no abnormalities.

Which of the following is the most appropriate next step?

Fiber, primarily derived from plants, is essential for maintaining a healthy gut microbiome. It serves as a food source for beneficial bacteria, such as Ruminococcus, which produce enzymes called cellulosomes to break down cellulose into digestible sugars. However, industrialized diets low in fiber have led to a decline in these cellulosedegrading bacteria in the human gut microbiome, potentially impacting overall health. Eating more fiber-rich foods can help counteract this decline and support a diverse and healthy gut microbiome.

Researchers from Trinity College Dublin examined ancient microbiomes from 4,000-year-old teeth, revealing changes in oral health and microbial evolution since the Bronze Age. They identified Streptococcus mutans, a major cause of tooth decay, and found its rarity in ancient samples may be due to its acid-producing nature hindering plaque fossilization. The study suggests recent cultural shifts, notably the introduction of sugary foods, have had a significant impact on the evolution of disease-causing bacteria.

New research suggests that the brain's hippocampus uses sharpwave ripples during sleep to prioritize important experiences for long-term memory storage, as observed in experiments with mice navigating a maze. Relaxation periods following significant events aid this memory consolidation process, highlighting the importance of pauses in solidifying memories. Additionally, findings imply that bursts of brain activity during idle moments may also contribute to long-term memory formation, shedding light on how certain events are prioritized for retention.

A 62-year-old man, Richard Slayman, became the first living recipient of a genetically modified pig kidney in a historic surgery at Massachusetts General Hospital, offering hope to those on organ transplant waiting lists. While Slayman is recovering well, the procedure remains experimental, conducted under the FDA's compassionate use program due to the shortage of human donor organs. The genetically modified kidney, containing 69 gene edits to reduce rejection and infection risks, marks a significant advancement in xenotransplantation research, though widespread implementation may still be years away pending further clinical trials and regulatory approval.

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 further evaluation is necessary"

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