Staying #Up2Date 🚨

1. Guideline watch 👀 

The CDC has published guidelines on DoxyPEP and recommends to:

• Discuss DoxyPEP with men who have sex with men and trans women who have had a bacterial sexually transmitted infection (STI) within the past 12 months. DoxyPEP should be taken ASAP after oral, vaginal, or anal sex (within 72h).

• Perform STI testing at baseline and 3- to 6-month intervals thereafter.

• Keep in mind that DoxyPEP is appropriate both for people with and without HIV.

Lastly, watch out for results from the Canadian DISCO trial! 

2. A PSA on PSA 📣

This study from JAMA determined prostate-specific antigen (PSA) values among a nationwide cohort of trans women without known prostate cancer receiving estrogen. The median PSA in this population was 0.02 ng/mL. For reference, similarly aged cisgender men without known prostate cancer have PSAs in the 0.6-1.9 ng/mL range. Results from this study suggest that the historic cutoff of 4 ng/mL, which is often used as a threshold for further evaluation, may be too high a threshold for this population.

3. Burn-out among specialists 🔥

This study in the BCMJ looked at the impact of the family physician shortage on specialists caring for unattached patients via qualitative methods, finding that:

• Specialists were less able to discharge patients. This meant longer waitlists and higher work burden.

• Patients without a family physician sought care from specialists that is beyond their scope.

• Specialists reported a decline in the quality of their professional and personal relationships, including greater levels of moral distress. Specialists mentioned delayed retirement, leaving the workforce early, and concerns over skill erosion.

Best Fur-ends Forever

Who says toys are for kids?

What happened: The state of New York is using robot pets to help combat loneliness amongst the elderly.

Why it’s interesting: A less-talked-about tragedy of the COVID-19 pandemic is loneliness. US Surgeon General Vivek Murthy declared loneliness an epidemic associated with a reduction in lifespan and cognitive declines in older people. That’s why New York State’s Office for the Aging (NYSOFA) acting director Greg Olsen began the robot companion project in 2018.

The robots, made by Ageless Innovations, have the ability to bark, meow, and even tweet. Studies have shown that people who have pets are 36% less likely to feel isolated than those who don’t. But not all older adults have the means to care for a real pet. In the past 6 years, NYSOFA has given out more than 31,500 robot pets to New Yorkers 60+. To receive a pet, patients must contact their local NYSOFA agency to be screened for availability.

One woman (who is 101 years old!) said her dream of owning a dog finally came true. She highly recommends her robot pet, saying it’s provided her with companionship and comfort, especially on nights when she has trouble sleeping.

But: robots aren’t a cure for loneliness. A 2022 study found that even though patients had a positive experience with the pets, human interaction is still vital. Talking to other patients or professional caregivers is important to enhance the therapeutic milieu.

NYSOFA is aware that animatronic pets won’t solve the epidemic on its own. They also offer social robots made by Intuition Robotics. These bots offer casual conversations on infinite topics. They also remember conversations, strengthening relationships with patients and offering more meaningful conversations in the future. 

Bottom line: The real solution to loneliness is social connection. For now, robots can be a great tool to make people feel less alone.

Hot Off The Press

1: 😷 No need to pull out that mask… so far. A new study shows that the bird flu strain found in cows in the US is not easily spread by air — although it does have the ability to do so.

2: 📱 Repeatedly passing your smartphone or tablet to your kid is passing a ticking time bomb, according to a recent study. That’s because if your fussy kid is distracted by a screen, they’re not learning to regulate their emotions — and/or they might develop a technology addiction.

3: 🔥 Good news for our neighbours to the south: physician burnout rates in the US are below 50% for the first time since the pandemic. The rate was 53% in 2022, and, according to a survey from the American Medical Association, it’s now at 48%.

4: 👩🏽‍🚀 An Edmonton doctor will be the first Canadian woman to become a commercial astronaut. Inspired by Dr. Roberta Bonder, Canada's first female astronaut and neuroscientist, Dr. Shawna Pandya will be on the IIAS-02 Mission in a few years, as spacecraft tech continues to develop.

💬 Notable Numbers

5%: the increase in diagnoses of STIs of seniors aged 65+ during the pandemic. Think we need to sit Grandpa down and have The Talk?

$20M: the amount in damages Dr. Brian Nadler, the doctor acquitted of first-degree murder and criminal negligence in connection to the deaths of 4 patients, is seeking from his former employer. He’s accusing the Hawkesbury and District General Hospital of defamation, abuse of process, and conspiracy. 

28.2%: the number of patients over 60 who had asymptomatic valvular heart disease, according to a new UK study. Considering the 60+ population is set to double by 2050, new screening methods might be in order.

💬 In Our Community

About to get a mortgage? A thread on a private Facebook group have shown rates for 3-year fixed uninsured going as low as:

• 4.5% at TD (+$4K cash back)

• 4.65% at RBC (+$4K cash back)

Ask your mortgage broker for a similar deal. As for whether you should take these or wait for rates to drop further… we’ll keep you posted as we get more info.

Getting married soon? Dr. Steph Zhou at Breaking Bad Debt has a great video recently about whether you should consider a prenup.

Giving injections often? There was a great thread with tips on r/emergencymedicine on reddit to make the process less painful for patients.

Our favourite tips:

1. “Rub the everloving crap out of the site with the alcohol pad, helps desensitize the area.”

2. “For people who aren't relaxing, tell them to clench every muscle in their upper body ‘squeeze squeeze squeeze’ then relax with a big breath out, then poke em.”

3. “Make sure the damn alcohol has dried! This is a major cause of stinging. I’ve applied topical analgesia before too.”

4. Use pads like ShotBlocker or Buzzybee.

But the best response?

“I don’t feel a thing when I give injections.”

Insight Event of the Week 🥳 

We don’t toot our own horn often, but this time we can’t resist — we threw a great birthday bash last week in Vancouver. And so many of you staff, residents, and med students turned out for a good time with the local physician community!

If you missed it, don’t worry. We’re eyeing a few different locations for our next event, and we’re working a business/entrepreneurship themed agenda. So look out for your chance to RSVP in the coming weeks.

Postcall Picks

😂Laugh: Nature’s best healer in a hospital setting.

📚Read: The Book of Boundaries by Melissa Urban is a captivating read that lays the roadmap to establishing and maintaining healthy boundaries to prevent burnout, enhance patient care, and achieve sustainable fulfillment.

🧠Learn: Attention all newly minted residents and staff! Efficient documentation is crucial for leaving on time and running an efficient clinic. Learn how with this fantastic seminar by Dr. Smith and Dr. Zhou.

🤑Save: With flight prices sky-high, Next Departure is a great tool so you’ll never pay full price for airfare again. They recently flagged a roundtrip deal from Vancouver to Honolulu for only $295!

Relax

First Question: What do you call vaginal bleeding between periods?

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