43 years ago today, an article describing 5 cases of Pneumocystis carinii pneumonia (PCP) was published. The young men in L.A. had previously been healthy. 2 then died. It was the first scientific report on AIDS. Since 2014, June 5 is recognized as HIV Long-Term Survivors Awareness Day. ♥️

 ☕️Postcall’s one-sip money update:

If you’re invested in the real estate market, you’re in luck. Last week, PM Trudeau said that it’s his goal to protect the home values that older Canadians depend on for retirement. Balancing that goal with trying to lower home costs for young buyers has sparked debate, as achieving both goals seems contradictory. In other news:

• The US Fed is hinting at a potential rate hike, but stocks remain near all-time highs (due to strong corporate earnings)

• The exception is Lululemon — they’re set to release Q1 results today amid recent struggles like layoffs and slowing sales.

• And a glitch on the New York Stock Exchange caused a few stocks like Berkshire Hathaway to fall as much 99.7% momentarily on Monday.

Ready for this week’s stories?

1. Beta blockers in COPD

2. Ozempic and fertility

3. No new mammogram guidelines

4. What are your hobbies?

5. June 25th: first day of the new cap gains rate

6. Porter flights on sale

7. Postcall’s crossword

Staying #Up2Date 🚨

1. Take my breath away (pls don’t)

An RCT from the UK looked at whether taking bisoprolol reduced COPD exacerbations in >500 patients with moderate COPD and no cardiovascular indications for beta blockers. Patients were randomized to receive bisoprolol (1.25 mg uptitrated to 5 mg daily) vs. placebo. At 1 year follow-up, no significant differences were noted between groups in incidence of COPD exacerbations, suggesting that there is no clinical benefit to beta blockers in COPD. 

2. Keeping an eye (or finger) on things: active surveillance in prostate cancer

A prospective cohort study of over 2,000 men with clinically localized prostate cancer and no prior treatment studied the long-term outcomes of active surveillance. 10 years after diagnosis, 49% of men remained free of progression or treatment, less than 2% developed metastatic disease, and less than 1% died of their disease. Later progression and treatment during surveillance were not associated with worse outcomes, suggesting that active surveillance may be an effective management strategy for patients diagnosed with favourable-risk prostate cancer.

3. Something’s fishy in osteoarthritis (OA)

No one likes the taste of fish oil, but many believe it “lubricates the joints.” In a new Australian study, 260 patients with painful knee OA (+ joint effusion and synovitis on MRI) were randomized to 2g daily of krill oil containing 350 mg of ω-3 fatty acids vs. placebo. At 24 weeks' follow-up, there was no difference in self-reported knee pain between groups and, in fact, there was a reduction in the volume of joint effusion and synovitis in the placebo group. This study supports the American College of Rheumatology guidelines which do not recommend fatty acids for OA.

Speed Reads 🚤

1: 🩸 A new study has shown that girls in the US got their periods earlier over the past 5 decades, and it takes longer for them to experience regular cycles. Women in the oldest bracket (born between 1950 - 1969) got their period at 12.5 years old on average, whereas the youngest bracket (born between 2000 - 2005) got their periods at 11.9.

2: 💉 The FDA has approved Moderna’s new RSV vaccine for people aged 60 and older. Marketed under the brand name mRESVIA, it’s the first mRNA vaccine other than COVID to get approved for a disease.

3: 🏋️ AI is what it eats. If it eats sh*tposts, it becomes…. technology that can’t tell the difference between fact, and an inside joke. So when Google AI was trained on Reddit’s datasets, it was caught recommending squat plugs for deeper squats at the gym. And yes, it’s a joke.

4: 👶🏽 Ozempic is giving some women more than just weight loss. “Ozempic babies” is the phenomenon where women taking GLP-1 agonists have accidental pregnancies. Apparently, it’s not as wild as it sounds — potential explanations being that healthy weight loss can increase ovulation, or GLP-1 might impact the effectiveness of birth control pills.

5: 💊 Yesterday, an FDA advisory panel overwhelmingly voted against the use of MDMA for treating PTSD (they didn’t like the methodology of clinical trials by Lykos Therapeutics). In Canada you can prescribe psilocybin and MDMA only to patients with life-threatening conditions

6: 🇲🇽 Mexico elected Claudia Sheinbaum as its first woman president on Monday. She has a background in science (there’s hope for us doctors yet!) and previously served as mayor of Mexico City.

The Breast Time To Get A Mammogram

What do bras and mammogram screenings have in common? One size does not fit all.

What happened: The Canadian Task Force on Preventive Health Care (CTFPHC) has released their guidelines for breast cancer screenings, suggesting that women at average risk should begin getting regular mammograms at 50 (instead of lowering it to start from age 40, which many expected them to recommend). 

What’s the response from folks?

• The Ontario Association of Radiologists have called for the task force to be disbanded, and Health Minister Mark Holland is asking for accelerated review of the task force’s recommendations.

• Provinces are already getting ahead: women aged 40-49 who live in provinces like Yukon, British Columbia, Nova Scotia, Newfoundland, and Prince Edward Island can self-refer to a breast screening program, while Ontario will cover screening mammograms for women in their 40s this fall. 

• There are DEI implications. Dense Breast Canada says the task force downplayed the benefits of early screenings for women with dense breast tissue, as it’s harder to spot cancer on mammograms. At the same time, the Black Physicians Association of Ontario have accused the task force of using a “one size fits all” approach.

• Other countries are lowering their guidelines. For example, the US Preventive Services Task Force changed their guidelines last month to recommending screenings every other year starting at age 40. 

How did the task force respond to this criticism? They recognize that their new guidelines may be unfair to some people, but they don’t have enough evidence to create race- or dense-breast-specific guidelines. They’re inviting the public to give recommendations on how to improve their decision. 

Another perspective: There would also be risks if the national guidelines were lowered. The increased volume of scans, follow-up biopsies, and treatments may exceed existing capacity within the healthcare system (an increase in cases of both true and false positives) and delay other treatments.

Bottom line: This debate will likely continue between the provinces, physician groups, and the task force. If you’d like your voice to be heard, submit any comments directly to the task force here.

Notable Numbers 🔢

31: the number of years since a Canadian team has hoisted the Stanley Cup trophy. The Edmonton Oilers have won a spot in the finals, beating the Dallas Stars 2-1.

$34.8 million: how much bank Trump’s campaign made off his felony conviction in political donations. Trump was found guilty on 34 counts but still maintains his innocence and has vowed to appeal.

67%: the new capital gains inclusion tax rate, as of next month, for amounts over $250K. (Read about the 93-year-old woman who gifted her daughter and grandson property, not knowing it would mean she had to pay about $40K in taxes.)

Postcall Picks ✅ 

🤣Laugh: Some say looking for the right supplies is the hardest part of the job. 

❓Ask: Sending your kids to a childcare centre in Alberta? Make sure to ask about their food prep policies. Find out why it's a crucial question in this revealing analysis.

📚Learn: Join OntarioMD’s Digital Health Virtual Symposium on June 14 and earn up to 6.5 CME credits while attending sessions about digital health innovations. Register today for a day of learning and inspiration.

📺 Watch: Mark your calendars: the long-awaited season 2 premiere of House of the Dragon is on June 16th. While you wait, discover which character you’re most like by taking this quiz.

🤑Save: Planning an upcoming conference or event and need plane tickets? Grab a $500 Porter flight voucher for just $430 at Costco!

Game ⛳️

First question: what is a symptom, sign, or finding that is classic of a particular disease?

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