Staying #Up2Date 🚨

1: Mixed Incontinence, Matched Outcomes 

This RCT compared the effectiveness of two procedural-based treatments for mixed urinary incontinence: intradetrusor onabotulinumtoxinA vs midurethral sling, in 137 women. After 6 months, both groups showed improvement in urogenital distress inventory scores, with no significant difference between treatments. The takeaway: patients’ preferences can help guide management. 

2: Don’t Mix Weed and Womb 

A systematic review and meta-analysis of over 1 million pregnant women across 51 studies found that prenatal cannabis use was associated with increased risk of low birth weight (OR, 1.75; 95% CI, 1.41-2.18), small for gestational age (OR, 1.57; 95% CI, 1.36-1.81), and preterm birth (OR, 1.52; 95% CI, 1.26-1.83). These findings underscore the need for patient counselling and stronger public health messaging around cannabis use in pregnancy. 

3: CAR-T, Take Two: Enhanced Lymphoma Therapy after Previous Failure

This clinical trial evaluated the safety, feasibility, and early efficacy of an anti-CD19 enhanced CAR-T therapy (huCART19-IL18) in 21 lymphoma patients with previous CAR-T failure. At 3 months post-infusion, 81% had complete or partial response (90% CI, 63-93), with no unexpected adverse events detected. The results point to a promising efficacy and safety profile.

A Brainy Mystery 🧠

Why it never hurts to double-check your work

What happened: A scientific study has concluded that New Brunswick doesn’t have a mystery brain disease.  

Why it’s interesting: An independent reassessment of 25 out of 222 patients diagnosed with an unknown neurological syndrome found that all the cases had well-known conditions. While the sample size was small, one of the authors of the assessment said the chances of any of the individuals having an unknown brain disease were less than one in a million. Alzheimer’s, Parkinson’s, traumatic brain injuries, and metastatic cancer are just a few of the conditions researchers diagnosed the patients with. 

Researchers don’t believe that exposure to heavy metals or other environmental factors made the patients ill, as the neurological issues in the study varied, meaning a single cause is unlikely. One neurologist said that if a mystery disease existed, more than one physician would’ve heard and raised concerns about it.

But: The team that concluded the study said patients should get a second opinion to reassure and educate them on their diagnosis. Dr. Marrero, who diagnosed the mystery illness, challenged the study’s findings and methods. He claims the study was conducted without his knowledge during the province’s investigation. 

Out of the 25 patients, only 14 are still alive. Many have gotten a second opinion and researchers found discrepancies between the initial diagnosis and the second assessment’s findings. 11 out of the 14 patients originally had abnormal cognitive testing. Still, upon re-evaluation, nine out of 11 either had no subjective cognitive symptoms or had cognitive testing not compatible with dementia. One patient, who supports Dr. Marrero’s theory, said the study doesn’t go far enough. They believe there should be further testing for the hundreds of New Brunswick patients who are sick with “rare conditions.” 

Bottom line: Despite the study’s findings, there seem to be more unanswered questions floating to the surface, and Postcall will keep a lookout for updates. 

Hot Off The Press

1: 🇺🇸 President Trump just signed an executive order to lower US drug prices — tying them to international benchmarks and authorizing direct-from-manufacturer sales. The move targets countries accused of undercutting US prices and could open the door to cross-border importation. Pharma stocks jumped, but analysts warned the shift could raise costs for hospitals and employers.

2: 💉 A new NEJM trial just gave tirzepatide a major edge over semaglutide. Among adults with obesity (but not diabetes), tirzepatide led to greater weight and waist reductions over 72 weeks — with average weight loss hitting 20.2%, compared to 13.7% on semaglutide. GI side effects were common in both groups.

3: 🏥 Pancreatic and colorectal cancers are rising fastest among younger adults — especially those aged 15–34, according to a retrospective study published in JAMA. Pancreatic cancer rates in that group have been climbing over 4% a year. It’s still uncommon, but clinicians may need to look twice when younger patients show red-flag symptoms.

4: 🐌 A deadly parasite once limited to sub-Saharan Africa is creeping into Europe — and climate change may be helping it spread. Schistosomiasis, a waterborne disease carried by snails, has caused over 120 cases in Corsica and is now appearing in Spain and Portugal. Experts warn that warming waters and reduced global aid could set the stage for wider outbreaks.

Notable Numbers 🔢

90 days: how long the US and China will pause their escalating trade war. After intense negotiations, both countries agreed to slash their tariffs — and markets rallied fast. Political economist Gavin Fridell says the breakthrough opens up space for negotiations with Canada — and could even improve Canada’s trade relations with China.

14%: the increased risk of heart or blood vessel disease in women with a history of infertility. A new meta-analysis of over 3.5 million participants found that infertility isn’t just a reproductive concern — it may be an early warning sign for cardiovascular issues, especially in younger women and those undergoing fertility treatments.

29: the number of ministers in Mark Carney’s newly unveiled cabinet — a leaner, tiered team built to tackle trade, jobs, and rising US tariffs. It’s stacked with familiar faces and a few wild cards (including ex-journalist Evan Solomon as AI minister). Carney says it’s “efficient and focused.” We’re about to find out.

Picks

😂Laugh: at this meme about useless organs:

🤑Save: Got a green thumb? Amazon’s got what you need to make this garden season the best yet.

👂Listen: Are children the answer to a happier life? The Beyond MD podcast invites an expert guest to find out on their most recent episode.

🥟Eat: at the viral restaurant Ding Tai Fung. They’ve just opened up a location in Vancouver and many say the food tastes as good as it looks.

Relax

First Question: Specialty with a Mohs micrographic surgery fellowship

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