Staying #Up2Date 🚨

1: BMI: Not the End-All-Be-All of Post-Surgical Survival 

In a cohort study of 414 older adults (65+) undergoing elective surgery, those labeled “overweight” by BMI had the lowest 30-day all-cause mortality — a significant risk drop compared to patients with a “normal” BMI. At the other end, underweight patients faced the highest post-surgical mortality. The findings hint that extra weight may provide older patients with energy reserves that support recovery, though researchers stress more work is needed to understand why.

2: High-Dose Flu Vaccine Offers Added Protection

An RCT of 300K older adults (65+) found that the high-dose flu vaccine outperformed the standard jab when it came to cardiovascular protection. Hospitalization rates were 2.25% in the high-dose group versus 2.38% in the standard-dose group. A small difference, but significant — and evidence that the high-dose shot is the stronger bet this flu season.

3: Less Invasive = Less Risk for Aortic Stenosis Procedures

A meta-analysis of 2,873 patients with severe aortic stenosis and low–intermediate surgical risk found that transcatheter aortic valve implantation (TAVI) carried a significantly lower 1-year risk of all-cause death (HR 0.73, 95% CI 0.56-0.95) than surgical aortic valve replacement (SAVR) (HR 0.79, 95% CI 0.49-1.27). Researchers noted that a longer follow-up is needed, but these early results favour TAVI for survival.

Presented by CCFP Ready

As you gear up for the OSCE portion of the CCFP exam (family medicine board exam), hands-on, practical experience is key to success. While studying theory is important, nothing compares to practicing in a simulated environment that mirrors the real exam.

That’s where CCFP Ready comes in. Our virtual SOOs (Simulated OSCEs), designed by Canadian family physicians, offer realistic scenarios to help you practice your clinical skills, communication, and decision-making. This year, we’re offering practice SOOs over 2 weekends, each with different cases, providing you with multiple opportunities to practice and refine your skills.

Quick Consult 🥼

It’s the 1st week of September, which means many med students are back hitting the books. Meet Regan, a 3rd-year medical student at Western University. Originally from Ottawa, she studied forensic science at Laurentian, played varsity hockey, and discovered her love for medicine after shadowing a pathologist.

Q: Biggest surprise in med school?
That I can still have a life outside of school! I expected to give everything up, but making time for friends, family, and hobbies has kept me grounded. There’s always more to study, but staying balanced will make me a better physician in the long run.

Q: Advice for new med students?
Don’t compare yourself to others. Everyone’s path looks different, and there will always be another milestone — residency, fellowship, practice. Focus on what works for you, choose activities you care about, and you’ll be more fulfilled and successful. “Comparison is the thief of joy.”

Q: How do you de-stress?
Sports and friends — ideally together! I play intramural and senior women’s hockey, recently picked up golf, and even started adult gymnastics. Trying new activities outside school gives me energy and perspective.

Q: Misconceptions about med students?
That we have it all together. Beneath the surface, most of us feel stress, imposter syndrome, and pressure to perform. We’re learning not only how to care for patients but also how to manage uncertainty and build resilience. None of us have it fully figured out.

Q: What are you watching or reading?
I’m rewatching some favourites, but recently started The Summer I Turned Pretty for a nostalgic summer vibe. I’m also an avid reader  and always have a Romantasy book on the go!

Caffeine Pouches: Buzz or Bust? ⚡️

A viral trend is stirring up concern as energy drinks are swapped for caffeine pouches

What happened: Red Bulls may give you wings but caffeine pouches are giving kids a surge of energy they probably don’t need. Caffeine pouches are spiking in popularity, but Health Canada hasn’t signed off.

Why it matters: Caffeine pouches work like nicotine pouches — they’re placed between the lips and the gums. Coming in a variety of flavours, including chocolate and blueberry, the product can pack as many as 200 milligrams of caffeine. The pouches are blowing up on social media apps like TikTok, which have pretty flimsy restriction guidelines. 27% of users on the app are under 18, meaning kids have access to the posts that promote it. Many creators are sponsored by caffeine pouch brands and make videos outlining how to use the product and even give a discount code to viewers.

Most pediatricians suggest a 200 mg daily limit. But these products aren’t regulated in Canada like food, supplements, or health products, so they skip safety checks and age-limits, making it easier for teens to access them. And too much caffeine can mean more than jitters — it can lead to anxiety, heart palpitations, overdose, or even cardiac arrest. 

A doctor from the Centre for Addiction and Mental Health told CBC he’s worried young people could become addicted to the caffeine rush from prolonged use of these pouches. Research on their long-term effects is still limited, but one thing doctors do know is that caffeine pouches can impact oral health in ways similar to nicotine. Experts are also investigating whether they may worsen sleep problems and other health issues.

But: Health Canada hasn’t authorized any caffeine pouches. Officials say they’d need to review these new caffeine pouches' safety — and how they’re delivered to the body – before making a call. They currently set limits on how much caffeine can go into food and supplements.  

Despite not being approved in Canada, CBC News was able to order a stash online in under 24 hours. Health Canada says it’s investigating whether the laws surrounding caffeine are being respected.  

Companies that sell the caffeine pouches online claim their products aren’t for minors. LyvWell, a Miami-based caffeine pouch company, denied marketing to teens and said its product has a clear caffeine warning on the package, while another brand said its target demographic is 24 to 45. 

Bottom line: It isn’t a crime to enjoy some caffeine throughout the day. Still, they should be kept away from minors until more research is done.

Hot Off The Press

1: 🇨🇳 Hypersonic missiles, sea drones, next-gen nuclear gear, even a high-powered laser system — China rolled them out today at a parade marking the 80th anniversary of Japan’s WWII surrender. The hardware wasn’t the only headline: Putin and Kim Jong-un were in the stands, underscoring the political theatre behind the spectacle. For China, the message was clear — this wasn’t just remembrance, it was deterrence, a reminder of shifting power blocs in plain view.

2: 🇺🇸 Trump is now pressing drugmakers to “justify” Covid vaccines — the very shots his administration once hailed as a miracle. The demand lands just as the CDC is hollowed out by firings and walkouts after RFK Jr. narrowed vaccine access, with a top vaccine chief warning the agency is “past the point of no return.” This isn’t about data. It’s about control. And the collateral is the CDC’s authority.

3: 💊 Aspirin just lost its crown. A study of nearly 29,000 CAD patients, unveiled at the world’s largest heart conference and published in The Lancet, found clopidogrel cuts heart attack and stroke risk 14% more than aspirin — with no added bleeding risk. The evidence is strong enough that guidelines may soon shift to make clopidogrel the default long-term therapy.

4: 🥃 Jack’s been benched in Canada. Sales of Jack Daniel’s and other US whiskies plunged 62% this quarter after provinces removed American spirits from stores following Trump’s tariffs. Jack’s parent company says the boycott is hitting hard, even as its non-US brands like El Jimador tequila keep growing. Canada was once a top market for US spirits, and distillers are eager to get their bottles back on our shelves. Until Jack’s back, we may be sampling local rye.

Notable Numbers 🔢

1.3 °C: the extra heat linked to about 0.03 years of biological ageing. A long-term study of nearly 25,000 people in Taiwan found that repeated heatwaves can age your organs almost like smoking or drinking. Even small increases add up over time — turning climate change into less of a sweaty summer problem and more of a slow-motion hit to the body’s clock.

9.8 mmHg: the drop in systolic blood pressure with 2 mg of baxdrostat, AstraZeneca’s experimental antihypertensive. That’s enough to meaningfully cut heart attack and stroke risk — and AZ says it’ll push for regulatory approval before year’s end.

$32.5 billion: the price tag Canada just handed Big Tobacco — the largest settlement in the country’s history. Over the next 20 years, the money will flow to provinces, territories, and public health groups to fund smoking cessation and prevention programs — a long-delayed bill for decades of damage.

Postcall Picks ✅

😂 Laugh: because in med school, every seat’s in the splash zone:

🤑 Save: on Macs and iPads with Apple’s student discount — the perfect sweetener for the back-to-school grind. Bonus: free accessory included, like AirPods 4. Consider it an academic bribe.

👩‍🍳 Make: your morning cup spicier with this pumpkin spice latte recipe. Starbucks’ got nothing on you.

👀 Watch: the trailer for the Degrassi documentary, Whatever It Takes, premiering Sept. 13th at TIFF. Get ready to peel back the curtain on 40+ years of this Canadian franchise with archival footage, interviews, and yes, Drake too.

🎧 Listen: to this week’s White Coat, Black Art exploring “ask your doctor” ads and their mastery of pharmaceutical suspense — spoiler-free of what the featured drug actually does. Characteristics of this infamous genre often include: confusing viewers, pushing unnecessary prescriptions, and driving up health-care costs.

🎃 Visit: Canada’s most magical pumpkin garden, starting Sept. 13. Abbotsford, BC’s Taves Family Farms transforms into a fall wonderland, complete with a sparkling pumpkin display, apple orchards, corn mazes, hayrides, and pumpkin cider. Flaunt your autumn flex — no filter required.

Relax

First clue: Benign early heartbeat, though it may be concerning if you have more than 30/min

Need a rematch? We’ve got you covered. Check out our Crossword Archive to find every puzzle we’ve ever made, all in one place.

Think you crushed it? Challenge your physician friends to beat your time.

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