Staying #Up2Date 🚨

1. Adding sodium–glucose cotransporter-2 inhibitors (SGLT-2i) 

In this retrospective cohort study of ≈13K adults already on hypertensives, researchers examined the effect of SGLT-2 inhibitors (prescribed for diabetes) on BP. The average reduction in systolic BP was 5mmHg, with slightly greater effect in patients with resistant hypertension, and 13% more patients achieved <130/80 mmHg after starting SGLT-2i.

2. Timing diagnostic paracentesis (para) 

In this meta-analysis, patients with cirrhosis who underwent diagnostic para within 12-24h after admission had lower rates of acute kidney injury (24% vs. 35%), shorter hospital stay (5 fewer days), and lower in-hospital mortality (7% vs. 10%) compared with patients who had more-delayed or no paracentesis. In a subgroup analysis of a higher-risk subgroup, in-hospital mortality was significantly lower with paracentesis within 12h (12% vs. 26%).

3. Overtreating prostate cancer (PCa)

This study examined treatment rates in men with PCa with limited life expectancy for whom interventions are not recommended.  Rates of definitive treatment increased from 38% to 60% in men with life expectancy of <10 years and intermediate-risk disease, and from 17% to 47% in men with life expectancy of <5 years and high-risk disease.

Medical Care For All ⚧️

Nova Scotia’s plan to help folks get things off their chest

What happened: Nova Scotia has launched its first-ever gender-affirming care program, helping residents to look the way they feel on the inside.

Why it’s interesting: Demand for top surgery surged after one of Nova Scotia’s few specialists announced they would stop accepting new patients. Without local options, people were sent to Montreal, paying travel and accommodation costs upfront. Although the government reimbursed these expenses afterward, many people couldn’t afford to make the trip. 

Now, the program has recruited two surgeons who have been trained in top surgery. The Cape Breton Transgender Network founder said having local surgeons takes away barriers for trans, non-binary, and even cisgender people. One of the surgeons said it’s gratifying to be able to provide care for the folks in the 2SLGBTQIA+ community and beyond. 

While many parts of Canada offer gender-affirming care like hormone replacement therapy and top surgery, access varies by region. Provinces like Ontario, Quebec, and Nova Scotia offer care as long as the patient has a letter from a psychologist or primary care physician. Meanwhile, other places like Newfoundland and Labrador (NL), Prince Edward Island, and the territories often refer patients to out-of-province clinics. NL, however, is expanding its coverage. 

But: There are some pushbacks against gender-affirming care. Last month, Alberta introduced 3 different bills that require parents to be notified if their child wants to use a different name or pronoun in the classroom. Also, minors under the age of 15 are not allowed to receive hormone therapy like puberty blockers, and patients over the age of 18 must travel to Quebec for top and bottom surgery.

Advocates and members of the 2SLGBTQIA+ community say they’d like the province to expand its gender-affirming care. Currently, Nova Scotia only provides a small list of procedures, including top surgery. Services such as voice and facial feminization aren’t covered — but are offered in other provinces like the Yukon. Early this year, the Ontario Medical Association reported that access to gender-affirming care reduced the risk of depression by 60%, and the risk of suicide by 73%. 

Bottom line: Nova Scotia’s new program is helping people improve their mental health and possibly save their lives by giving them the opportunity to feel safe and seen in their own bodies.

Hot Off The Press

1: 🤖 Family doctors across Canada are adopting AI scribe software to reduce administrative burdens and reclaim time with patients. The tools, which transcribe and summarize patient visits into medical notes, are being tested in several provinces and have shown promise in cutting paperwork hours and improving efficiency. While some concerns remain about cost and accuracy, physicians say the technology has the potential to enhance care and ease the strain on primary healthcare systems.

2: 📫 Canada Post’s strike drags into its second week with no “major breakthrough” in talks, leaving 55,000 workers off the job and parcel deliveries down by over 8 million. The union demands better wages and job security, while Canada Post warns meeting all demands could deepen its financial struggles after a $315M Q3 loss. Both sides are committed to negotiations, but progress is crawling as Canadians and businesses feel the pinch.

3: 🏥 A recent study reveals that US for-profit hospice facilities, especially those backed by private equity, provide lower-quality care compared to their not-for-profit counterparts. Despite the growing dominance of for-profit hospices in the US, which now account for 70% of the sector, not-for-profits scored higher across key care metrics, prompting calls for more transparency and accountability in hospice ownership.

4: 🐭 Scientists have trained rats to drive tiny cars — and the rodents are loving it. Not only do the rats eagerly anticipate their "joyrides," but the research suggests the anticipation itself boosts brain health, promoting optimism and problem-solving. Turns out, enjoying the journey might be as rewarding as the destination—whether you're a rat or a human!

Notable Numbers 🔢

6.3%: That’s how much of Canada’s health budget goes to mental health care — just half the recommended 12% and far below France’s 15%. A new CMHA report reveals that 2.5 million Canadians lack adequate mental health support, with uneven access to services like psychotherapy and supportive housing. Advocates call for urgent reforms, saying better funding and community care are essential to address rising mental health needs while also strengthening the economy.

27: the number of scurvy cases discovered in La Ronge, Saskatchewan, shining a spotlight on the food insecurity crisis hitting remote communities. With fresh produce pricey and hard to come by, this rare diagnosis shows just how tough it is for many to get the basics needed to stay healthy.

16.3%: How much global antibiotic use spiked between 2016 and 2023. Consumption across 67 countries surged 16.3%, from 29.5 to 34.3 billion DDDs. While high-income nations saw a decline during the pandemic, middle-income countries rebounded rapidly, with some, like Vietnam, more than doubling their use. With the global antibiotic rate projected to jump by 52% by 2030, this trend shows no signs of slowing down.

Relax

First Question: What is the hormonal medication commonly referred to as "Plan B"?

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