Happy Wednesday - Dog-tor Postcall here and ready for a walk through the headlines of the week.

Let’s get into the good stuff:

• Hold my beer 🍺 Ozempic

• Your patients may ask about… 👂️ 

• I got LK-99 problems ⚡️

• ☀️ It’s a hot strike summer

• Show me the MONEY 💰️

• Quick bites 🍉

• 💼 Job opportunities

Hold my 🍺 Ozempic 

Going under? You might wanna cut back on Ozempic (or any drug that contains semaglutide) up to three weeks ahead of OR.

What happened: The popular diabetes drug causes delayed gastric emptying, putting the patient at risk for aspiration during induction. Many anesthesiologists suggest holding it for 1-3 days prior to surgery. But new recommendations from the Canadian Journal of Anesthesia suggest Ozempic should be held up to three weeks beforehand. What does this mean for patients with diabetes? Well, the paper says to consult your Endocrinologist (which you’ll be doing anyways to manage your patient’s sugars post-op - sorry Endo).

Why it's interesting: This isn’t the first time GI issues have literally come up. Pharma companies are getting sued over failing to warn patients about gastroporesis. One woman claimed she got severe stomach injury while this study linked the drug to cholecystitis. Looks like the flood-gates have opened for lawsuits against our fave weight-loss drug.

Post-call’s take: Delayed gastric emptying is as much of an aspiration risk as it is a lawsuit risk. If you’re in a pinch, be sure to ditch that LMA and consider performing RSI* for someone on Ozempic undergoing GA. And maybe holding Ozempic isn’t the worst thing in the world considering that we’re facing an Ozempic shortage in Canada this fall.

Details at Canadian Journal of Anesthesia/Journal canadien d'anesthésie

*Rapid Sequence Intubation

What you may hear from patients this week 👂️ 

1: “Do I NEED to get radiation for my breast cancer treatment”? The comforting answer might be no for women 55 years and older with low-risk, stage 1 breast cancer, as a new NEJM study suggests.

2: “Should I be worried about the EG.5 variant?“ Symptoms remain similar (fever, cough, fatigue, runny nose, etc) and there’s no indication it’s more severe. But you probably want an updated monovalent XBB.1.5 booster.

3: “Never complete the course of antibiotics that you're prescribed; you never know when you're going to pick up a nasty viral infection and need to take a few various antibiotic tabs that you've saved up!“ This, and other terrible medical tips heard from patients were shared on Reddit.

I got LK-99 problems but a superconductor ain’t one ⚡️

Physicists and investors need some tissues after a big disappointment last week.

What happened: Researchers at the Quantum Energy Research Centre in Seoul claimed a few weeks ago that they discovered a room-temperature superconductor (RTS) 🤯 called LK-99. A video of the material went viral, further driving the hype.

Why the big deal: When an electric current flows through normal conductors, such as copper or aluminum, energy is lost in the form of heat (this is resistance). Superconductors don’t have any resistance, but need to be super-cooled, which is super difficult and super expensive. So finding a room-temperature one would mean some wild things become possible:

• 🏥 MRI machines could become portable and cheaper to power

• 🪴 Fusion energy becomes way cheaper (green energy possibilities)

• 🧲 Maglev trains can gain widespread adoption

So many technological innovations become possible with a RTS that whoever discovers it is almost guaranteed a Nobel Prize 🏆️.

Where it went wrong: Hopes were deflated as subsequent studies suggest LK-99 is likely a type of magnet rather than a superconductor, and other teams couldn’t reproduce the findings.

Despite the scientific roller coaster, most experts are glad the public came along for the ride. “At the end of the day, science fails more often than not. This would be not surprising if [LK-99] went the way of most experiments — that’s how science is” said Christopher H. Hendon, an associate professor in the department of chemistry and biochemistry at the University of Oregon.

Guess we’ll all have to keep buying those MRIs in bulk for now.

Details at Washington Post

Hot Strike Summer ☀️

Shade is being thrown all over the place as CEOs and disgruntled workers alike seek relief from the Summer of Strikes.

What happened: Employee groups across Canada and the world are going on strike as they reject their existing employment terms. For example, the Writers Guild of America, Hydro Ottawa workers, Ontario elementary and secondary teachers, and Metro grocery workers across the GTA.

Why it’s happening: Strikes usually revolve around compensation disagreement, but this time there are other catalysts, too:

• The pandemic: Awareness of inequalities grew when employers didn’t treat “essential workers” with well-earned respect and care.

• Tech advancements: Concerns about AI, like actors being replaced by CG versions of themselves

• Corporations reporting record profits—like Warner Bros. Discovery saying their streaming division banked $50 million in the first quarter of 2023, and Metro Inc. announcing a 26% rise in profits

• Inflation: Wages aren’t keeping up with the rising cost of living. (The U.S. inflation rate for July is 3.2%. In Canada, it’s 3.3%.)

Why don’t corporations just pay more to avoid strikes? Sometimes they do, if it’ll cost less. One of their concerns is that if people are paid more, they’ll have to keep paying them those wages in a recession or disruption to the economy.

What’s next? We’re probably not entering a prolonged period of labour action. Canada has a relatively low unemployment rate right now (5.5% -- whereas it was 9.46% in 2020 and 7% in 2016) so employees feel secure enough to strike. But, according to the numbers, Canada’s actually on the decline for work stoppages (181 work stoppages in 2021, but only 87 work stoppages so far in 2023, projected to end up at about 130)

It just feels like Hot Strike Summer because the strikes have been so high profile. But because labour disruptions and inflation seem to be the zeitgeist of the times, we may see more strikes pop up in Cool Strike Fall.

Show me the MONEY 💰️ 

Professional investors reconsidering their earlier projections that the Bank of Canada (BoC) would reduce interest rates by mid-2024. Recent data from Statistics Canada revealed that Canada's headline inflation rate surged to 3.3% in July, marking a notable increase from the 2.8% recorded in June. This unexpected jump raises concerns about the difficulty of reining in inflation. Although there was a slight decrease in core inflation, a metric that excludes volatile food and energy costs, the overall trend suggests inflation might be more persistent than anticipated.

Details at CBC

🍔 Quick Bites

1: A British nurse was found guilty of murdering seven babies, and attempting to kill six others at the hospital where she worked. Doctors were early to raise concerns over the pattern of infant collapses under her care, but were initially brushed off by hospital management.

2: That rain whose absence caused the dry conditions for our wildfires? Turns it out it was busy flooding Burning Man. Hilary, the first tropical storm to hit Southern California in 84 years, is overrunning roads and toppling trees.

3: Trump says he will surrender Thursday on Georgia charges tied to efforts to overturn 2020 election. Trump has denied any wrongdoing, and he characterizes the case — and the three others he is facing — as efforts to hurt his 2024 presidential campaign

4: The international chess governing body, FIDE, is under fire for effectively banning trans individuals from competing in the women’s section. And yes, for those of you that didn’t know, chess is segregated by gender at tournaments. Queen’s Gambit would not approve y’all.

5: 🍁 Calgary is the next city facing an affordability crisis in the housing market, with one bedroom rents jumping to $1800 (+13% in a year). The market has heated up in the last several years due to increased immigration, interprovincial migration, low interest rates, and changing housing preferences.

6: In case you made it this far, Patagonia is having a legendary 50% off sale across their products to celebrate their 50th anniversary. Stock is running low at patagonia.ca, but don’t forget to also check other Canadian retailers including patagoniaelements.ca and bushtukah.com. Postcall’s got your threads covered! 👀🧵

We’re hiring! 💼 

Role: Family Physician

• Location: Anjou Mehta Medical Consultancy (Greater Toronto Area)

• Compensation: Fee for Service ($235,000-$335,000)

• Apply here

Role: Hematologist

• Location: Saskatoon Cancer Centre, 20 Campus Drive, Saskatoon

• Compensation: $340,263-$439,113

• Apply here

Role: Family Physician

• Location: Burnaby, Langley, and Maple Ridge

• Compensation: Various (90-10 overhead split)

• Apply: Email [email protected] 

Role: Committee Member

• Location: College of Physicians and Surgeons of Ontario

• Compensation: $184 per hour

• Apply here

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