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But Technically …

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Published May 30, 2026

Morning Report — Not Your Typical Medical Newsletter

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Morning Report: Not Your Typical Newsletter. Sponsored by Activia.

Good morning! We’re entering the season when the gingers among us migrate indoors beneath a 30-inch hat and a tactical layer of SPF 75. For years, redheads seemed to draw evolution’s shortest straw: fair skin, higher melanoma risk, and recurring internet headlines screaming “REDHEADS WILL BE EXTINCT BY 2100.”

But science has finally handed our freckled friends a win. Researchers studying zebra finches found that pheomelanin—the reddish pigment behind red hair—may help protect cells by locking excess cysteine, a potentially pro-oxidant amino acid, into a stable pigment before oxidative damage can occur. Ironically, the same pigment associated with UV vulnerability may also provide a cellular protective effect.

Evolution, for reasons now slightly clearer, continues to renew the redhead contract—albeit under strict SPF and melanoma-screening provisions.

The Slow March from PCOS to PMOS

WOMEN’S HEALTH SUMMARIES

After decades of confusion, debate, and enough terminology workshops to exhaust a thesaurus, PCOS has a new name: PMOS. It’s a single-letter rebranding—the medical equivalent of WWF becoming WWE—but unlike pro wrestling, the change isn’t just cosmetic. Advocates say PMOS, or polyendocrine metabolic ovarian syndrome, could meaningfully influence diagnosis and care.

What’s in a name?

As you know, the term polycystic ovary syndrome made as much sense as calling a car a cupholder—it’s misleading and reductionist. Coined in the 1930s, the name reflected an era when medicine often named the symptom instead of the system. But in this case, even the symptom was wrong: The ovarian “cysts” seen in some patients were later understood to be arrested follicles, not true cysts. Meanwhile, the fixation on these so-called cysts distracted from the syndrome’s much broader endocrine and metabolic dysfunction. Somehow, the name survived a century of medicine quietly knowing better.

Better late than never

Calls to rename PCOS date back to the mid-1990s, but the modern push began in 2012, when the NIH essentially looked at the terminology and said, “We can do better.” What followed was more than a decade of international consensus-building involving 56 academic, clinical, and patient organizations; more than 22,000 survey responses; multiple workshops worldwide; and endless semantic nitpicking. For example, when the term “reproductive” entered the discussion, many warned that fertility-centered language could unintentionally stigmatize patients. In the end, the group settled on a name that aimed to balance biology, clarity, and cultural sensitivity.

Key takeaways

“Risk of change would be worth the reward,” said the steering committee behind the shift to PMOS. The change may seem small linguistically but could be enormous clinically for the one in eight women living with the condition. Advocates hope the new terminology will reduce the syndrome’s staggering underdiagnosis rate (estimated at 70%) and improve treatment by shifting attention toward endocrine and metabolic dysfunction, not just ovarian “cysts.” Naturally, it will take about three years for the new term to filter into guidelines, educational materials, and everyday clinical use, and even longer for clinicians to stop instinctively typing “PCOS” into the EMR. Medicine changes slowly, and this may be one of its slower corrections. Retiring PCOS means finally retiring its long-running tagline: “But technically…”

Rethinking Knee-Jerk Arthroscopic Partial Meniscectomy

OSTEO OUTCOMES

For decades, arthroscopic partial meniscectomy (APM) has been an orthopedic reflex: Knee hurts, MRI shows a meniscal tear, trim the meniscus. But the 10-year follow-up from Finland’s FIDELITY trial suggests APM for degenerative tears may belong beside universal tonsillectomy and “just in case” antibiotics in the museum of “medical reversals.”

APM buckles under scrutiny

Published in The New England Journal of Medicine, the 10-year FIDELITY follow-up adds long-term weight to concerns about APM for degenerative meniscal tears in middle-aged and older adults. In the original sham-controlled trial, investigators randomly assigned patients to actual surgery or a sham procedure and followed them for a decade. Of the 146 participants, more than 90% completed follow-up—a statistical unicorn in longitudinal research. At 10 years, the surgery group tended to report more symptoms, worse knee function, greater osteoarthritis progression, and more subsequent knee surgery than the sham group.

It’s a familiar story: Intuitive treatments often fail rigorous testing. The premise behind APM—that knee pain stems from a mechanically fixable meniscal tear—made sense. But degenerative meniscal tears seen on MRI may be less a pain generator than an aging marker, the orthopedic equivalent of gray hair. Worse still, APM may not help and may contribute to downstream harms. Previous observational studies hinted at worsening osteoarthritis and later knee surgery but stopped short of proving causation.

Key takeaways

Will the FIDELITY findings finally move the needle away from the knee? History suggests not quickly. Once a procedure becomes culturally and financially embedded, changing medical practice is like turning a cruise ship with a canoe paddle. Multiple randomized trials have shown limited or no benefit from partial meniscectomy for degenerative tears, yet the procedure remains widely performed. The takeaway for clinicians: MRI findings in middle-aged and older adults with degenerative knee pain do not always point toward a surgical solution. Many patients are better served by reassurance, exercise, physical therapy, and time than by an arthroscope. That said, patients with true mechanical locking, acute traumatic tears, or significant instability may still warrant orthopedic evaluation.

For more education on knee pain management, check out this CME podcast: Flexibility in Treatment: What Yoga Can Offer Patients with Knee Osteoarthritis

New Research Clears the Air on Overprescribing Sinus Antibiotics

SPECIAL CONTRIBUTOR—FRANK DOMINO, MD

It is spring, and everyone thinks they have a sinus infection—when it is likely seasonal allergies. “Shouldn’t I be on an antibiotic?” should usually receive an emphatic “NO.”

But come late fall and winter—when bacterial sinusitis becomes more common—your prescribing habits may change. In 2012, the Infectious Diseases Society of America (IDSA) recommended treating with amoxicillin plus clavulanic acid based on low-quality evidence and resistance concerns. Now, in a retrospective analysis of more than 230,000 adults, researchers found that amoxicillin alone was similarly effective in treating acute sinusitis compared with amoxicillin/clavulanic acid.

BUT (no pun intended), amoxicillin/clavulanic acid caused TRIPLE the rate of diarrhea (number needed to harm = 10) vs amoxicillin, was associated with more than double the rate of Clostridioides difficile infection and caused 40% more vaginal yeast infections.

Remember, the diagnostic criteria for acute sinusitis (2025 AAO-HNS guideline and the IDSA) recommend antibiotics only if the patient has:

Persistent symptoms ≥10 days without improvement
Severe symptoms for ≥3 consecutive days—fever >39°C (102°F), purulent nasal discharge, and facial pain
“Double worsening” symptoms that initially improve then worsen after 5 to 10 days

The 2025 guideline also supports an initial period of watchful waiting with close follow-up for healthy adults with uncomplicated acute bacterial sinusitis, even after diagnosis.

Recommended treatment: Amoxicillin 500 mg TID or 875 mg BID for 5 to 7 days maximum may be sufficient for many uncomplicated adult cases. Nasal irrigation, intranasal corticosteroids, and analgesics are helpful, but evidence for many over-the-counter cough and cold agents remains limited.

Key takeaways

For now, intranasal steroids, second-generation antihistamines, and saline irrigation are likely best for our patients with springtime congestion; come winter, plain amoxicillin may be a reasonable option for many uncomplicated bacterial sinusitis cases

For more education on sinus infections, check out this CME podcast: The Nose Knows: Nasal Therapies on the Rise