The physician-patient relationship has always been built on trust, expertise, and communication, but in recent years, doctors are increasingly encountering a new kind of patient—one who is more informed, more skeptical, and more demanding than ever before. With instant access to medical information, direct-to-consumer advertising, and the rise of patient-centered care, many physicians feel that expectations have shifted dramatically, often creating challenges in clinical practice.

One of the biggest drivers of this shift is the internet. Patients now come to appointments armed with Google searches, social media advice, and self-diagnosed conditions, sometimes challenging the doctor’s expertise. While greater patient involvement is generally positive, misinformation has complicated medical decision-making, leading to longer consultations, more second opinions, and even conflicts over treatment recommendations.

A growing concern is that patients increasingly request tests, medications, or procedures that may not be necessary, expecting their doctor to comply. Physicians often find themselves caught between evidence-based medicine and patient expectations, knowing that refusing a request could damage the doctor-patient relationship or lead to dissatisfaction, poor reviews, or even complaints.

The rise of "healthcare consumerism"—where patients view medical care as a service rather than a professional consultation—has further altered expectations. Many patients see themselves as customers rather than just patients, demanding faster access, personalized treatment, and even alternative therapies that may lack clinical support.

For doctors, this creates a dilemma: Should they focus on meeting patient demands, even when they may not be medically necessary, or risk upsetting patients by sticking strictly to guidelines? Some physicians report feeling pressured to overprescribe medications, order unnecessary imaging, or agree to treatments they don’t fully support just to avoid conflict. This shift has led to increased stress, longer working hours, and even physician burnout. Many doctors now feel that patient satisfaction scores and online reviews are influencing medical decisions more than clinical judgment. Others struggle with the balance between providing thorough, evidence-based care while keeping up with increasing demands for availability, responsiveness, and personalized medicine. What are your thoughts?

The physician-patient relationship has always been built on trust, expertise, and communication, but in recent years, doctors are increasingly encountering a new kind of patient—one who is more informed, more skeptical, and more demanding than ever before. With instant access to medical information, direct-to-consumer advertising, and the rise of patient-centered care, many physicians feel that expectations have shifted dramatically, often creating challenges in clinical practice.

One of the biggest drivers of this shift is the internet. Patients now come to appointments armed with Google searches, social media advice, and self-diagnosed conditions, sometimes challenging the doctor’s expertise. While greater patient involvement is generally positive, misinformation has complicated medical decision-making, leading to longer consultations, more second opinions, and even conflicts over treatment recommendations.

A growing concern is that patients increasingly request tests, medications, or procedures that may not be necessary, expecting their doctor to comply. Physicians often find themselves caught between evidence-based medicine and patient expectations, knowing that refusing a request could damage the doctor-patient relationship or lead to dissatisfaction, poor reviews, or even complaints.

The rise of "healthcare consumerism"—where patients view medical care as a service rather than a professional consultation—has further altered expectations. Many patients see themselves as customers rather than just patients, demanding faster access, personalized treatment, and even alternative therapies that may lack clinical support.

For doctors, this creates a dilemma: Should they focus on meeting patient demands, even when they may not be medically necessary, or risk upsetting patients by sticking strictly to guidelines? Some physicians report feeling pressured to overprescribe medications, order unnecessary imaging, or agree to treatments they don’t fully support just to avoid conflict. This shift has led to increased stress, longer working hours, and even physician burnout. Many doctors now feel that patient satisfaction scores and online reviews are influencing medical decisions more than clinical judgment. Others struggle with the balance between providing thorough, evidence-based care while keeping up with increasing demands for availability, responsiveness, and personalized medicine. What are your thoughts?

A recent study published in JAMA Psychiatry has confirmed a troubling trend: female physicians in the U.S. face a significantly higher risk of suicide compared to women in the general population. From 2017 to 2021, female doctors had a 53% higher suicide rate than their non-physician counterparts, Meanwhile, their male counterparts—who also endure the relentless demands of medicine—actually have lower suicide rates than men in other professions.

The study analyzed suicide deaths among 448 physicians and 97,467 non-physicians across 30 U.S. states and Washington, D.C. Researchers found that physicians who died by suicide were more likely to have experienced depression, job-related stress, and legal issues than non-physicians. Female doctors, in particular, seem to bear a unique burden, facing systemic gender inequities, workplace stress, and barriers to seeking mental health support.

One of the biggest challenges is the stigma surrounding mental health in medicine. Physicians often fear that seeking help could jeopardize their careers, licensure, or professional reputation. This leads to silent suffering, where doctors—especially women—continue working under immense pressure until it becomes unbearable. Researchers are calling for targeted suicide prevention efforts, including anonymous mental health screenings, improved workplace policies, and cultural shifts within medicine to make seeking help safe and stigma-free.

Despite the growing number of women in medicine, the underlying culture hasn’t changed. The statistics speak for themselves, but the real stories remain hidden...Read More

If you take a step back and look at it objectively, do you really notice when your colleagues are distressed? What signs do you see but rarely talk about?

Medpage Today

The physician-patient relationship has always been built on trust, expertise, and communication, but in recent years, doctors are increasingly encountering a new kind of patient—one who is more informed, more skeptical, and more demanding than ever before. With instant access to medical information, direct-to-consumer advertising, and the rise of patient-centered care, many physicians feel that expectations have shifted dramatically, often creating challenges in clinical practice.

One of the biggest drivers of this shift is the internet. Patients now come to appointments armed with Google searches, social media advice, and self-diagnosed conditions, sometimes challenging the doctor’s expertise. While greater patient involvement is generally positive, misinformation has complicated medical decision-making, leading to longer consultations, more second opinions, and even conflicts over treatment recommendations.

A growing concern is that patients increasingly request tests, medications, or procedures that may not be necessary, expecting their doctor to comply. Physicians often find themselves caught between evidence-based medicine and patient expectations, knowing that refusing a request could damage the doctor-patient relationship or lead to dissatisfaction, poor reviews, or even complaints.

The rise of "healthcare consumerism"—where patients view medical care as a service rather than a professional consultation—has further altered expectations. Many patients see themselves as customers rather than just patients, demanding faster access, personalized treatment, and even alternative therapies that may lack clinical support.

For doctors, this creates a dilemma: Should they focus on meeting patient demands, even when they may not be medically necessary, or risk upsetting patients by sticking strictly to guidelines? Some physicians report feeling pressured to overprescribe medications, order unnecessary imaging, or agree to treatments they don’t fully support just to avoid conflict. This shift has led to increased stress, longer working hours, and even physician burnout. Many doctors now feel that patient satisfaction scores and online reviews are influencing medical decisions more than clinical judgment. Others struggle with the balance between providing thorough, evidence-based care while keeping up with increasing demands for availability, responsiveness, and personalized medicine. What are your thoughts?

New York Attorney General Letitia James filed a major lawsuit yesterday, accusing 13 e-cigarette companies of illegally selling flavored vapes and targeting young kids through deceptive marketing.

The 192-page complaint claims the companies -- Puff Bar, Evo Brands, PVG2, Demand Vape, Magellan, Happy Distro, Midwest Goods, Pod Juice, Safa Goods, Mi-One, Mylé, MVH I and Price Point -- violated New York's ban on flavored vapes, which studies show are preferred by young users, The Washington Post reported.

“The vaping industry is taking a page out of Big Tobacco’s playbook: they’re making nicotine seem cool, getting kids hooked, and creating a massive public health crisis in the process,” James said in a statement.

“For too long, these companies have disregarded our laws in order to profit off of our young people,” she added.

The lawsuit seeks hundreds of millions of dollars in penalties and restitution for the companies’ public health impact. This includes fines for violating federal and state laws, recovery of revenue from illegal vape sales and the creation of a fund to address the youth vaping crisis in New York.

The attorney general’s office describes these penalties as a “conservative estimate,” given the widespread impact of youth vaping.

The lawsuit claims companies marketed flavors like “Strawberry Donut” and “Tropical Rainbow Blast” using bright packaging and social media influencers to appeal to teens.

One example cited was a Puff Bar ad during COVID-19 lockdowns, promoting vapes as “the perfect escape from back-to-back zoom calls [and] parental texts," The Post reported.

The complaint also alleges that companies have used illegal shipping methods to supply retailers and that many retailers are concentrated around public middle and high schools.

The Vapor Technology Association, a trade group, dismissed the lawsuit’s claims as “false.”

“The facts are that since President Donald Trump raised the age to buy all tobacco products in 2019, youth vaping has dropped to the lowest level in over a decade,” Tony Abboud, the association's executive director, said.

"This suit is the latest example of why President Trump needs to take bold and decisive action to end the government law-fare against the flavored vaping industry,” Abboud added.

Despite the decline, e-cigarettes remain the most commonly used tobacco product among U.S. middle and high school students, according to the U.S. Centers for Disease Control and Prevention (CDC).

In 2024, 1.6 million students (6%) reported e-cigarette use. What's more, 87.6% of those used flavored e-cigarettes.

But, a federal survey released last fall found youth e-cigarette use has decreased nearly 70% since its peak in 2019.

Anti-tobacco advocates warn that nicotine exposure harms developing brains and can lead to addiction, often alongside traditional cigarette use.

“At every turn, each Defendant’s New York-touching commercial conduct in the Flavored E-Cigarette industry undercuts New York’s efforts and law -- which must be now enforced to protect the public,” the lawsuit says.

“By first dodging all of New York’s regulatory safeguards, then making these products as cheap as possible and as abundantly available as possible in our communities, each Defendant cashes in without regard to the lasting harm they cause,” the complaint says.

More information

Johns Hopkins Medicine has more on the dangers of vaping.

SOURCES: The Washington Post, media report, Feb. 20, 2025; Office of the New York State Attorney General, news release, Feb. 20, 2025; U.S. Centers for Disease Control and Prevention, Oct. 17, 2024

Copyright © 2020 HealthDay. All rights reserved.

The annual International Stroke Conference of the American Heart Association/American Stroke Association was held from Feb. 5 to 7 in Los Angeles and drew participants from around the world, including cerebrovascular research and practice experts. The conference featured presentations that emphasized basic, clinical, and translational medicine and provided insight into the prevention, management, and treatment of stroke.

In one study, Bernard Ofosuhene, of UMass Chan Medical School in Worcester, and colleagues identified a strong association between electrocardiogram (ECG)-age and cognitive performance, which could lead to ECG-age serving as a potential biomarker for detecting cognitive decline.

The authors evaluated 63,800 participants between August 2023 and July 2024 as part of the U.K. Biobank, a large and ongoing study of more than 500,000 volunteers in the United Kingdom who enrolled between 2006 and 2010. Participants went through a number of cognitive tests to determine ECG-age. Based on the results, participants were divided into three categories: normal aging; accelerated ECG-aging (older than their chronological age); and decelerated ECG-aging (younger than their chronological age). Compared with the normal-aging group, the researchers found that participants within the decelerated ECG-aging category performed better on six of eight cognitive tests, while those within the accelerated ECG-aging category performed worse on six of eight cognitive tests.

"In conclusion, this research leverages our understanding on how ECG data could be utilized by artificial intelligence as a potential diagnostic tool for cognitive impairment," Ofosuhene said. "Using ECG data to access cognitive functioning could lead to rapid diagnosis and timely intervention compared to the traditional cognitive tests."

Press Release

In another study, Tamara N. Kimball, M.D., of the Henry and Allison McCance Center for Brain Health at Massachusetts General Hospital in Boston, and colleagues found that adopting healthier lifestyles and improving modifiable risk factors might mitigate some of the negative effects of shorter telomeres, which reflect adverse lifestyle choices and social and environmental determinants of health earlier in life.

The authors examined data from more than 356,000 participants as part of the U.K. Biobank and found that individuals with shorter leukocyte telomere length (LTL) had an increased risk for age-related brain diseases, including stroke, dementia, and late-life depression. In addition, improved modifiable risk factor profiles appeared to mitigate the impact of LTL on these diseases.

"This study suggests that telomere length reflects broader biological stressors such as senescence and inflammation, acting more as a surrogate marker of these processes rather than a direct cause of age-related brain diseases," Kimball said. "Future research should explore the mechanisms linking LTL to disease processes and evaluate how lifestyle and therapeutic interventions influence the cellular aging processes for which LTL serves as a marker."

Press Release

Gabriela Trifan, M.D., of the University of Illinois in Chicago, and colleagues found that a Mediterranean diet independently improves brain health, and even small changes in diet can lead to long-term brain health benefits.

As part of the Study of Latinos-Investigation of Neurocognitive Aging-MRI Ancillary study, the authors evaluated approximately 2,800 participants who completed 24-hour dietary recalls of predefined food and nutritional categories at baseline (2008 to 2011) and again approximately 30 days later. Diffusion tensor imaging and fluid-attenuated inversion recovery were utilized to investigate microscopic and visible changes in the brain, and the American Heart Association's Life Simple 7 score components were used to assess cardiovascular health. The researchers found that following a Mediterranean diet led to a healthier brain, as defined by lesser volumes of white matter hyperintensity (WMH) on magnetic resonance imaging and by improved white matter microstructural integrity (i.e., higher general fractional anisotropy and lower peak width of skeletonized mean diffusivity) as seen on diffusion tensor imaging.

"These results were not entirely explained by higher cardiovascular health scores (measured using the Life's Simple 7 score), suggesting that there are noncardiovascular mechanisms directly impacting the brain structure and function. These mechanisms likely play a key role in protecting against neurodegeneration and cognitive decline," Trifan said. "Our results are of clinical significance as it shows that even a small decrease in WMH volume could be clinically relevant, particularly for cognitive health."

Press Release

ASA: Intra-Arterial Tenecteplase Beneficial for Large Vessel Occlusion

TUESDAY, Feb. 18, 2025 (HealthDay News) -- For patients with large vessel occlusion presenting between 4.5 and 24 hours, intra-arterial tenecteplase after successful thrombectomy results in improved likelihood of excellent outcome (modified Rankin scale score 0 to 1), according to a study presented at the annual American Stroke Association International Stroke Conference, held from Feb. 5 to 7 in Los Angeles.

Read Full Text

ASA: Alteplase Ups Outcomes at 4.5 to 24 Hours After Symptom Onset in Acute Ischemic Stroke

TUESDAY, Feb. 18, 2025 (HealthDay News) -- For patients with acute ischemic stroke whose symptoms began 4.5 to 24 hours earlier, alteplase is associated with a higher percentage of patients achieving a score of 0 or 1 on the modified Rankin scale at 90 days, according to a study presented at the annual American Stroke Association International Stroke Conference, held from Feb. 5 to 7 in Los Angeles.

Read Full Text

ASA: Mechanical Removal of Clot No Better Than Best Medical Treatment for Medium or Distal Vessel Occlusion

MONDAY, Feb. 10, 2025 (HealthDay News) -- Endovascular thrombectomy does not lead to better outcomes at 90 days compared with usual care or best medical treatment for patients with acute ischemic stroke due to medium vessel occlusion, according to two studies published online Feb. 5 in the New England Journal of Medicine to coincide with the annual American Stroke Association International Stroke Conference, held from Feb. 5 to 7 in Los Angeles.

Read Full Text

ASA: Mental Health Conditions Common in Pediatric Stroke Survivors

TUESDAY, Feb. 4, 2025 (HealthDay News) -- Mental health disorders represent a significant problem in pediatric survivors of arterial ischemic stroke, according to a study presented at the annual American Heart Association International Stroke Conference, held from Feb. 5 to 7 in Los Angeles.

Read Full Text

ASA: Propranolol May Reduce Overall Stroke Risk in Women With Migraine

FRIDAY, Jan. 31, 2025 (HealthDay News) -- Propranolol is associated with a reduced risk for overall stroke among women with migraine, with a more pronounced protective effect for ischemic stroke, according to a study presented at the annual American Stroke Association International Stroke Conference, held from Feb. 5 to 7 in Los Angeles.

Read Full Text

ASA: Prehospital Blood Test Can Rapidly Differentiate Stroke Types

FRIDAY, Jan. 31, 2025 (HealthDay News) -- Prehospital measurement of glial fibrillary acidic protein can rapidly differentiate intracerebral hemorrhage from ischemic stroke and stroke mimics, according to a study presented at the annual American Stroke Association International Stroke Conference, held from Feb. 5 to 7 in Los Angeles.

Read Full Text

ASA: Flossing Linked to Lower Risk for Ischemic, Cardioembolic Stroke, A-Fib

FRIDAY, Jan. 31, 2025 (HealthDay News) -- Dental flossing is associated with a lower risk for ischemic and cardioembolic stroke and atrial fibrillation, according to a study presented at the annual American Stroke Association International Stroke Conference, held from Feb. 5 to 7 in Los Angeles.

Read Full Text

Copyright © 2020 HealthDay. All rights reserved.

For the Preeclampsia Integrated Estimate of RiSk (PIERS) Machine Learning (PIERS-ML) model and the logistic regression-based fullPIERS model, consecutive performance deteriorates over time, according to a study published online Feb. 4 in PLOS Medicine.

Guiyou Yang, from the University of Groningen in the Netherlands, and colleagues examined the performance of two models for predicting the risk for adverse maternal outcomes beyond the first 48 hours following admission for women whose pregnancies are complicated by preeclampsia. Data were included for 8,843 women. The risk differentiation performance of the PIERS-ML model and the fullPIERS model was assessed within a two-week postadmission window. The main outcome measures included trajectories of mean risk of each of the uncomplicated course and adverse outcome groups and daily area under the precision-recall curve (AUC-PRC).

The researchers found that the number of daily outcome events decreased from more than 200 to around 10 in the two-week window. Mean risk was consistently higher in the adverse outcome group versus the uncomplicated course group for both PIERS-ML and fullPIERS models. The AUC-PRC values of the fullPIERS model remained low (0.2 to 0.4), indicating low discriminative capacity. The AUC-PRC for the PIERS-ML model peaked at 0.65 on day 0 and decreased thereafter. The PIERS-ML model generally showed good rule-in capacity for the very high-risk group, with positive likelihood ratios ranging from 70.99 to infinity; rule-out capacity for the very low-risk group was also good, where most negative likelihood ratio values were 0. For other risk groups, performance declined beyond 48 hours.

"Clinicians should interpret consecutive predictions with increasing uncertainty," the authors write.

Several authors have an intellectual property claim regarding the PIERS-AI machine learning-based suite of models.

Abstract/Full Text

Stay up to date on the latest in health—subscribe to our weekly newsletter!

Copyright © 2020 HealthDay. All rights reserved.

When it comes to the potential of H5N1 avian flu, otherwise known as bird flu, picking up mutations that might lead to human-to-human spread, that "train has already left the station," warns one infectious disease expert.

If and when bird flu -- already widespread in cattle, cats and other mammals -- gains the ability to transmit between people, the best Americans can hope for is to "control the speed of the train" with vaccines, masks and treatment, said Dr. Peter Chin-Hong. He's a professor of medicine at the University of San Francisco.

Speaking with HealthDay, Chin-Hong stressed that both rapid surveillance and reporting on any new cases of H5N1 that arise are crucial. So the recent silencing of communications from the U.S. Centers for Disease Control and Prevention (CDC) by the Trump administration is worrisome.

"It's not that people won't get the information eventually if it's serious, it's the rapidity of information that I'm worried about," Chin-Hong said.

He compared the recent CDC gag order to a dysfunctional smoke alarm.

"You hope the fire isn't going to come, but if it comes, there will be a delay before you feel it," Chin-Hong said. "Time means lives when we're talking about infectious diseases that really don't know any borders."

As the UCSF expert explained, the current strain of bird flu has been circulating through avian species for about 30 years. It has only occasionally infected people -- usually those who've had extended close contact with birds, such as poultry farm workers.

However, viruses are built to mutate and find new hosts.

That's what's been happening with alarming rapidity in recent years, with more cases of mammals -- such as seals, cattle, cats, dogs and pigs -- coming down with bird flu.

Just one mutation

Over the past year, especially, there's been an uptick of cases among American people, including the recent death of an already frail patient in Louisiana.

In most human cases, H5N1 was thought to have been contracted from close contact with an infected animal.

Unfortunately, human-to-human transmission may only require a few new genetic tweaks by the virus, Chin-Hong warned.

"I think the length of the road before [we see] a mutation that allows easier entry into our lungs is much shorter than people think," he said.

One recent study "looked at the amount of mutations needed before that can occur, and it was very, very short, just one mutation," Chin-Hong noted. "[That] doesn't mean that this mutation will be picked up, but what it means to me is that it's not that far away."

He explained that H5N1 can also interact with "regular" seasonal flu viruses.

"We have a lot of influenza going around and influenza is engineered to really swap genes with each other and they can pick up tricks," Chin-Hong told HealthDay. "And some of those tricks include getting the combination to enter our bodies, which it is not so great at doing right now."

In the relatively few U.S. cases of human bird flu so far recorded, symptoms have typically been mild -- congestion, pink eye and other transitory effects. But if H5N1 mutated so that it could pass easily between people, "all of this may change," Chin-Hong said.

"You might get 'inside' disease, and that includes shortness of breath and you may have other organ involvement," he said.

Vaccines, masks, treatments

Chin-Hong stressed that societies are in a better position to fight mutated H1N1 than they were with COVID-19.

"We're in a very different place from the early days of COVID because we have a test, we have vaccines," he said.

The United States currently has a stockpile of 4.5 million H5N1 vaccines, based on older mutations.

"I think that the stockpiled vaccines would mitigate the effects probably by preventing serious disease, hospitalization and death," Chin-Hong said.

But 4.5 million vaccines would run out very quickly, especially when two doses might be needed to protect each recipient.

"It's a good start and it will be a good way to protect probably frontline workers in the event that we need to," Chin-Hong said, but production of any vaccine would need to be scaled up enormously in a potentially short period of time.

Other forms of prevention would be key, too, such as handwashing and widespread use of N95 masks, he said.

A handful of influenza treatments appear to be somewhat effective against H5N1, including oseltamivir (Tamiflu). "We may also need to stockpile more Tamiflu," Chin-Hong said.

A hobbled CDC and FDA

Key to all of this will be a coordinated effort by key government players, however.

Central to that effort is the CDC, which at the present moment seems hamstrung, Chin-Hong said.

"The CDC is generally the conductor of the orchestra" when it comes to safeguarding public health, he said. "And right now, different parts of the orchestra are playing their own music. And, you know, I think that's that's what we suffered from in the early days of COVID, too."

The potential appointment of anti-vaccine activist Robert F. Kennedy Jr. to head the Department of Health and Human Services (which oversees both the CDC and the Food and Drug Administration) also has Chin-Hong "worried."

"I'm concerned about, you know, any barriers at the FDA level" when it comes to areas such as vaccine research and distribution, he said.

"I know that humans are resourceful and will come up with the science, but the devil is always in the details, and implementing the science is often even more important than the science itself," Chin-Hong concluded.

More information

Find out more about H5N1 avian flu at the World Health Organization.

SOURCE: HealthDay interview, Peter Chin-Hong, MD, professor of medicine, University of California San Francisco

Copyright © 2020 HealthDay. All rights reserved.

Artificial intelligence (AI) can improve detection of congenital heart defects (CHDs) on routine prenatal ultrasounds, according to a study presented at The Pregnancy Meeting, the annual meeting of the Society for Maternal-Fetal Medicine, held from Jan. 27 to Feb. 1 in Denver.

Jennifer Lam-Rachlin, M.D., from the Icahn School of Medicine at Mount Sinai Hospital in New York City, and colleagues examined whether an AI system can improve detection of CHDs on fetal ultrasound exams among general obstetricians and gynecologists (OB-GYNs) and maternal-fetal medicine (MFMs) subspecialists. The AI system analyzed grayscale two-dimensional ultrasound cines of an exam and detected eight morphological findings associated with severe CHDs; the presence of any finding was sufficient to refer the patient for further examination. A dataset of 200 ultrasound exams from 11 centers was obtained; 100 exams had suspicious findings. Fourteen physicians (OB-GYNS and MFMs) reviewed each exam aided and unaided by the AI system in randomized order.

The researchers found that the receiver operating characteristic area under the curve for detection of any finding was significantly higher for AI-aided versus unaided reviews (0.97 versus 0.83). The results were similar for sensitivity (0.94 versus 0.78) and specificity (0.97 versus 0.76). The mean reading time was shorter for AI-aided versus unaided review (226 ± 218 versus 274 ± 241 seconds).

"Our findings show that the AI-based software significantly improved detection of ultrasounds that were suspicious for congenital heart defects not only among OB-GYNs but also among maternal-fetal medicine subspecialists," Lam-Rachlin said in a statement.

Press Release

More Information

Copyright © 2020 HealthDay. All rights reserved.

As a bird flu outbreak escalates across the U.S., the Trump administration has paused the release of key public health studies, stalling research that could provide insight into how the virus spreads to animals and people.

The blocked studies were supposed to be published in the U.S. Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report (MMWR), a respected journal that has reported on health threats since 1952.

One of the studies examines whether veterinarians working with cattle have unknowingly been infected, and another explores whether people may have passed the virus to pet cats, according to CNN.

These reports could help scientists track and prevent future infections.

But a new memo from the Department of Health and Human Services (HHS) has placed an “immediate pause” on communications. Approval is now required from a presidential appointee before publishing, according to the memo.

“This idea that science cannot continue until there’s a political lens over it is unprecedented,” Dr. Anne Schuchat, a former principal deputy director at the CDC, told CNN. “I hope it’s going to be very short-lived, but if it’s not short-lived, it’s censorship.”

Public health experts warn that delaying research on bird flu could put veterinarians, farmworkers and the public at greater risk.

One study, slated to be published last week in the MMWR, looked at cases in Michigan where dairy workers may have transmitted bird flu to their pet cats.

Dr. Jennifer Morse, medical director at the Mid-Michigan District Health Department and a scientist on the pending study, told CNN she got a note from a colleague last week saying that “there are delays in our publication — outside of our control.”

And this isn't the first time the government has disrupted CDC reports.

During President Donald Trump's first term, CNN noted, White House officials interfered with scientific studies on COVID-19.

“What’s happening now is quite different than what we experienced in covid, because there wasn’t a stop in the MMWR and other scientific manuscripts,” Schuchat told CNN.

CDC insiders say the pause will last until at least Feb. 6, though it’s unclear if publishing will resume as scheduled.

The bird flu has infected at least 67 people in the U.S., and claimed the life of one person in Louisiana earlier this year.

It's affected more than 148 million birds and heightened concern about human transmission.

“Maintaining open lines of communication and continuing research with our federal partners is critical as we fight this outbreak.” Dr. Fred Gingrich, executive director of the American Association of Bovine Practitioners, a group for veterinarians specializing in cattle medicine, told CNN.

Schuchat hopes efforts to spin or influence scientific reports won’t happen again.

“The MMWR cannot become a political instrument,” she concluded in a report published by CNN.

More information

The U.S. Centers for Disease Control and Prevention has more on the current situation of bird flu.

SOURCE: CNN, media report, Jan. 30, 2025; U.S. Centers for Disease Control and Prevention

Copyright © 2020 HealthDay. All rights reserved.

The risk for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is increased following COVID-19, according to a study published online Jan. 13 in the Journal of General Internal Medicine.

Suzanne D. Vernon, Ph.D., from the Bateman Horne Center in Salt Lake City, and colleagues estimated the incidence and prevalence of post-COVID-19 ME/CFS among adults enrolled in the Researching COVID to Enhance Recovery study. The analysis included 4,515 acute infected, enrolled within 30 days of infection or enrolled as uninfected who became infected; 7,270 post-acute infected, enrolled >30 days after infection; and 1,439 uninfected participants.

The researchers found that the incidence rate of ME/CFS in participants followed from time of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was 2.66 per 100 person-years compared with 0.93 per 100 person-years in matched uninfected participants (hazard ratio, 4.93). Overall, the proportion of participants who met criteria for ME/CFS following SARS-CoV-2 infection was 4.5 percent versus 0.6 percent in uninfected participants. The most common ME/CFS symptom in infected participants was post-exertional malaise (24.0 percent). Most post-COVID participants with ME/CFS also met criteria for long COVID (88.7 percent).

"These post-pandemic prevalence rates are in contrast to pre-pandemic ME/CFS prevalence estimates, which ranged from 0.2 to 1.0 percent of people in the United States and is in line with what we found in uninfected participants," the authors write.

Several authors disclosed ties to the pharmaceutical industry.

Abstract/Full Text 

Copyright © 2020 HealthDay. All rights reserved.

Unawareness of dementia diagnosis is very common and varies with race, but it is not associated with caregiver burden, according to a study published online Jan. 14 in the Journal of General Internal Medicine.

Josh Martins-Caulfield, from the University of Michigan Medical School in Ann Arbor, and colleagues conducted a population-based cohort study to examine the association of ethnicity with dementia diagnosis unawareness, and further assessed the association of dementia diagnosis unawareness with caregiver burden.

The researchers found that 81 percent of participants with probable dementia were not aware of a dementia diagnosis. Mexican American participants were more likely than non-Hispanic White participants to be unaware of a diagnosis (85 versus 68 percent). Overall, 6.6 percent of the participants with probable dementia had no primary care provider; there was no association seen between unawareness of diagnosis and lack of primary care. No association was seen for diagnosis unawareness and caregiver burden, but unawareness was associated with a lower Montreal Cognitive Assessment score and greater physical impairment.

"Broad unawareness of dementia diagnoses, particularly with notable ethnic disparities, holds important implications for providers. Physicians may not engage in conversations with patients and families about dementia, most commonly due to a lack of training and time," the authors write.

One author reported payment for expert testimony; one author reported payment from Duly Health and Care.

Abstract/Full Text (subscription or payment may be required)

Copyright © 2020 HealthDay. All rights reserved.

Transformer-based neural network models exhibit strong generalization and surpass diagnostic performance of expert and nonexpert examiners for detecting ovarian cancer in ultrasound images, according to a study published online Jan. 2 in Nature Medicine.

Filip Christiansen, from the Karolinska Institutet in Stockholm, and colleagues developed and validated transformer-based neural network models using a comprehensive dataset of 17,119 ultrasound images from 3,652 patients across 20 centers in eight countries. For each center in turn, a model was trained using data from the remaining centers, using a leave-one-out cross-validation scheme.

The researchers found that across centers, ultrasound systems, histological diagnoses, and patient age groups, the models demonstrated robust performance, significantly outperforming expert and nonexpert examiners on all evaluated metrics (F1 score, sensitivity, specificity, accuracy, Cohen's kappa, Matthew's correlation coefficient, diagnostic odds ratio, and Youden's J statistic). Artificial intelligence (AI)-driven diagnostic support reduced referrals to experts by 63 percent in a retrospective triage simulation, while significantly surpassing the diagnostic performance of current practice.

"Our study demonstrates the potential of AI models in improving the accuracy and efficiency of ovarian cancer diagnosis," the authors write. "Our models demonstrated robust generalization and significantly outperformed both expert and nonexpert examiners on all evaluated metrics."

Several authors disclosed ties to medical technology companies, including Intelligyn; several authors have applied for a patent that is pending to Intelligyn.

Abstract/Full Text

Copyright © 2020 HealthDay. All rights reserved.

The A(H5N1) virus generally causes mild illness of short duration, mainly among U.S. adults exposed to infected animals, according to a study published online Dec. 31 in the New England Journal of Medicine.

Shikha Garg, M.D., from the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues analyzed data from persons with laboratory-confirmed A(H5N1) virus infection to describe the characteristics of cases identified from March through October 2024 in the United States.

The researchers found that 20, 25, and one of the case patients were exposed to infected poultry, exposed to infected or presumably infected dairy cows, and had no identified exposure, respectively. All 45 cases with animal exposure had mild A(H5N1) illness; none were hospitalized and none died. Overall, 93, 49, and 36 percent of patients had conjunctivitis, fever, and respiratory symptoms, respectively; 33 percent of patients had conjunctivitis only. Among the 16 patients with available data, the median duration of illness was four days. Eighty-seven percent of the patients received oseltamivir, which was started a median of two days after onset of symptoms. Among the 97 household contacts of case patients with animal exposure, there were no additional cases identified. Workers exposed to infected animals most often used gloves, eye protection, and face masks (71, 60, and 47 percent, respectively).

"Public health efforts should continue to focus on protecting workers exposed to infected animals through implementation of prevention measures on farms, including personal protective equipment use, and ongoing monitoring, early testing, and prompt antiviral treatment," the authors write.

Abstract/Full Text

Editorial

Copyright © 2020 HealthDay. All rights reserved.

Little medical education exposes students to caring for justice-involved populations, according to a review published online Dec. 10 in the Journal of General Internal Medicine.

Claire Stover, from the Boston University Chobanian and Avedisian School of Medicine, and colleagues conducted a systematic literature review to understand the scope and context of medical education in correctional health care.

Based on 49 studies (highlighting 95 unique curricula), the researchers reported that curricula were evenly split between the undergraduate (44) and graduate (50) levels, with the two most represented specialties being psychiatry (43) and general medicine (30). Clinical rotation (48), didactics (14), or a combination (28) were the educational modalities used. Evidence showed curricula increased knowledge in correctional and specialty-specific medicine and improved attitudes toward justice-involved patients. Results showed no significant effect on plans to work with the justice-involved population. Common themes included treating justice-involved patients with respect (23), structure and function of the legal system (20), and career recruitment (16) across curricula.

"There is limited education on the care of the justice-involved population, and most learners are unlikely to experience education on this population during their training despite the extensive and unique health and psycho-social needs of this population," the authors write.

Abstract/Full Text (subscription or payment may be required)

Copyright © 2020 HealthDay. All rights reserved.

A New York doctor has been sued by the state of Texas for prescribing abortion pills via telehealth to a Dallas woman.

In a news release announcing the filing of the lawsuit, Texas Attorney General Ken Paxton claims that Dr. Margaret Daly Carpenter violated state law by illegally providing abortion drugs across state lines.

"In this case, an out-of-state doctor violated the law and caused serious harm to this patient," Paxton said in the news release. "This doctor prescribed abortion-inducing drugs -- unauthorized, over telemedicine -- causing her patient to end up in the hospital with serious complications. In Texas, we treasure the health and lives of mothers and babies, and this is why out-of-state doctors may not illegally and dangerously prescribe abortion-inducing drugs to Texas residents."

The lawsuit is one of the first challenges to shield laws that Democrat-controlled states have passed to protect physicians after Roe v. Wade was overturned in June 2022.

Reaction to the Texas lawsuit was strident.

"Abortion is, and will continue to be, legal and protected in New York. As other states move to attack those who provide or obtain abortion care, New York is proud to be a safe haven for abortion access," New York Attorney General Letitia James said in a statement released Friday. "We will always protect our providers from unjust attempts to punish them for doing their job and we will never cower in the face of intimidation or threats. I will continue to defend reproductive freedom and justice for New Yorkers, including from out-of-state anti-choice attacks.”

New York doctors were equally adamant.

"The Medical Society of the State of New York (MSSNY) is very concerned by the reports of out-of-state public officials bringing legal action against New York physicians seeking to provide reproductive health care services to their patients," MSSNY President Dr. Jerome Cohen said in a statement.

“The MSSNY House of Delegates has adopted policy to protect practitioners licensed and residing in New York from legal or personal liability when delivering health care services to residents of New York State or any other state, whether in person or via telemedicine, when the services provided comply with New York State laws and regulations," Cohen added.

Mary Ruth Ziegler, a law professor at the University of California, Davis, said a challenge to shield laws, which could have a chilling effect on abortion pill prescriptions, was expected.

Still, "will doctors be more afraid to mail pills into Texas, even if they might be protected by shield laws, because they don't know if they're protected by shield laws?" she asked CBS News.

Texas bars nearly all abortions and has been one of the most aggressive states at pushing back against abortion rights.

Neither Carpenter nor the Abortion Coalition for Telemedicine, where she's co-medical director and founder, responded to CBS News' request for comment.

Abortion pill prescriptions are a key reason that the number of abortions nationwide have increased even as state bans on abortion took effect, CBS News reported. Most abortions in this country involve pills rather than procedures, according to the Guttmacher Institute.

But anti-abortion advocates have been emboldened to challenge the pills' use and seek ways to restrict their use under a conservative U.S. Supreme Court and a Republican Congress and White House, CBS News reported.

More information

The Cleveland Clinic has more on the abortion pill.

SOURCE: Texas Attorney General, news release, Dec. 13, 2024; New York Attorney General, news release, Dec. 13, 2O24; Medical Society of the State of New York, statement, Dec. 13, 2024; CBS News

Copyright © 2020 HealthDay. All rights reserved.

There's early evidence that a mysterious flu-like illness that has sickened 416 people and left 75 dead in the Democratic Republic of Congo over recent weeks may be malaria.

Laboratory samples taken from infected people are suggestive of malaria, although more research is needed to confirm that, health officials said.

“Of the 12 samples taken, nine were positive for malaria but these samples were not of very good quality, so we are continuing to research to find out if this is an epidemic,” Dr. Jean-Jacques Muyembe, director-general of Congo's National Institute for Biomedical Research in Kinshasa, told the Associated Press.

According to the World Health Organization, most of the deaths are occurring in children under the age of 14 living in Congo’s western Kwango province.

Children are the most vulnerable to being killed by the mosquito-borne disease.

"It is very likely that it [the outbreak] is malaria, because most of the victims are children,” Muyembe said.

Symptoms have included fever, headache, cough and anemia.

It's been tough to get a handle on the outbreak, because the area where it's occurring is about 435 miles from Kinshasa, Congo's capital, and it takes at least two days to get there. As well, the nearest testing facility is more than 300 miles away, the AP reported.

As the outbreak began and spread, health experts were concerned that it could be due to a wholly new pathogen.

Dr. Abraar Karan, an infectious disease physician at Stanford Medicine, told NBC News that the Congo outbreak “does raise alarm bells” because of its location. Humans and wildlife interact to a high degree in that country, and that could raise the risk of a pathogen moving from animals to humans, he explained.

“Many animal infections that transmit from animal to human can cause pretty severe disease,” Karan added.

The U.S. Centers for Disease Control and Prevention, which has an office in Congo, told NBC News that it was providing technical assistance to a rapid response team dispatched by a local emergency operations center.

International teams on the ground were also collecting information about what risk factors sick people have had in common and who they’ve been in contact with, Amira Albert Roess, a professor of global health and epidemiology at George Mason University in Virginia, told NBC News.

“I think pretty quickly we’ll start to have an answer as to what this is,” Roess said.

More information

The U.S. National Institutes of Health has more on pandemics.

SOURCE: Associated Press; Congo Ministry of Public Health, Hygiene and Social Security, statement, Dec. 4, 2024; NBC News

Copyright © 2020 HealthDay. All rights reserved.

Most patients with intractable Meniere disease (MD) experience symptom relief over time, according to a study published online Oct. 23 in Frontiers in Neurology.

F.R. Gerritsen, from Haga Hospital in The Hague, Netherlands, and colleagues described the evolution of vertigo attacks among patients with intractable MD in whom surgery was considered in a retrospective cohort study. Patients with definite unilateral MD and persisting vertigo attacks despite intratympanic steroid injection treatment were included in the study. All patients had been wait-listed for participation in a trial examining nonablative surgery; they were wait-listed between June 2016 and June 2021. To assess the evolution of the vertigo attacks, their data were collected in September 2022.

The analysis included 35 patients; 25 (71 percent) declined surgery. The researchers found that 21 of the 33 patients (64 percent) with complete information on vertigo attacks were free of vertigo attacks on data collection after a median disease duration of 5.3 years. The duration of disease was longer for patients who did versus those who did not undergo surgery.

"The current population was thought to suffer intractable disease, and yet most patients experienced relieve of symptoms in just over one year," the authors write. "Knowledge of the generally benign evolution of MD may be of value for patients and clinicians when weighing treatment options."

One author was employed by The Novo Nordisk Foundation Center for Stem Cell Medicine.

Abstract/Full Text

Copyright © 2020 HealthDay. All rights reserved.