Read AMA Morning Rounds®’ most popular stories in medicine and public health from the week of April 21, 2025–April 25, 2025.
Syphilis diagnoses with neurologic manifestations increased from 2012 to 2022
Infectious Disease Advisor (4/18, Basilio) reported a study found that “between 2019 and 2022, the prevalence of reported neurologic manifestations of syphilis increased across demographic groups in patients with early- and late-stage disease and among those with HIV infection.” Although “neurologic manifestations of syphilis were infrequently reported,” researchers found “they increased in prevalence over the study period for patients with early- and late-stage disease (from 0.6% to 1.0% and from 1.3% to 1.8%, respectively).” Furthermore, the “prevalence of neurologic manifestations in early-stage syphilis was approximately 7-fold higher among patients aged 65 years and older compared with those aged 15 to 24 years.” Researchers also observed “higher prevalence among patients with HIV vs without HIV infection for both early-stage disease and late-stage disease.” The study was published in Clinical Infectious Diseases.
U.S. cancer death rates have declined steadily over past two decades
CNN (4/21, Dillinger) reports that a new study on “cancer in the U.S. shows a steady decline in overall deaths from 2001 through 2022. The rate of diagnoses among men fell from 2001 through 2013 and then stabilized through 2021 but these incidence rates among women increased slightly every year between 2003 and 2021.” Those trends were disrupted in 2020, “when cancer incidence rates fell significantly,” possibly due to interruptions in medical care related to the COVID-19 pandemic. Yet after 2020, they returned to expected levels. According to the report, “because fewer cancers were diagnosed in 2020, especially through screening, we may see a larger percentage of cancers diagnosed at a late stage in future years.” The study was published in Cancer.
The AP (4/21, Johnson) reports that “there weren’t huge shifts in late diagnoses” when Americans were “forced to postpone cancer screenings – colonoscopies, mammograms and lung scans—for several months in 2020 as COVID-19 overwhelmed doctors and hospitals.”
You may also be interested in: What doctors wish patients knew about cancer screening and prevention.
Fluctuations in sex hormones can impact brain health
The New York Times (4/22, Gross) reports that “neuroscientists have learned that estrogen is vital to healthy brain development but that it also contributes to conditions including multiple sclerosis and Alzheimer’s. Changes in estrogen levels—either from the menstrual cycle or external sources—can exacerbate migraines, seizures and other common neurological symptoms.” In the brain, “estrogen can bind directly to receptors within neurons and other cells, setting off a cascade of actions. It can also be broken down into metabolites, called neurosteroids, which exert their own far-reaching effects.” Researchers also know that estrogen “can modulate neuron firing, reduce inflammation, increase neuroplasticity, help turn glucose into energy, prevent plaque from building up and improve blood flow in the brain.” A recent review published in Brain Medicine suggests there are a “huge number of neurological diseases that can be affected by sex hormone fluctuations.”
U.S. whooping cough cases surging
Bloomberg (4/23, Nix, Subscription Publication) reports CDC data show “whooping cough cases have surged in the U.S. since the beginning of the year, infecting Americans at a faster pace than any time since the mid-1950s as national vaccination rates decline and protection wanes.” Whooping cough “has sickened 8,077 people in the U.S. through April 16. ... That’s more than double the same period a year ago, when the agency confirmed 3,847 cases, and rivals the 2012 outbreak that was the biggest in half a century.”
You may also be interested in: What doctors wish patients knew about whooping cough.
U.S. nears tipping point for return of endemic measles
The Washington Post (4/24, H. Sun) reports a study published in JAMA says that the U.S. “faces millions of measles cases over the next 25 years if vaccination rates for the disease drop 10%.” Nathan Lo, a Stanford physician and author of the study, said, “Our country is on a tipping point for measles to once again become a common household disease.” He warns that at current state-level vaccination rates, mathematical models used by the researchers predict that measles could become entrenched, resulting in “hundreds of thousands of cases, where deaths are commonplace and hospitalizations are happening all the time.” While the study found that “a small uptick in vaccination—a 5% increase in state-level rates—would prevent huge increases in measles cases.”
You may also be interested in: Measles health alerts, clinical information and other resources from the AMA.
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