A Californian dog that went missing over the summer was found… 2,000+ miles away in Michigan. A Detroit animal shelter identified Mishka, the terrier mix, via her implant chip. Who knows where her adventure led her — she turned up healthy and clean. Maybe she just wanted to go on a road trip?

 ☕️Postcall’s one-sip markets update:

There’s lots of optimism in the markets: last week’s US jobs report was strong, with wages still climbing. TSX is now up 7% — all at or near all-time highs (similar to the US indices), and BoC is likely holding interest rates steady this morning. As long as the big US banks’ earnings reports this Friday go well, we should see this “long boom” continue.

Now we have some stories fresh out of the Postcall oven (5m read):

Staying #Up2Date 🚨

1. Inpatient delirium: a path to dementia?

A retrospective cohort study from Australia looked at 55K elderly patients who had been diagnosed with inpatient delirium but no dementia at baseline. These patients were matched 1:1 to patients hospitalized around the same time but without developing delirium. During the 5-year follow-up, both mortality and incident dementia were more common in the delirium group than in the no-delirium group (relative risks of 1.4 and 3.4, respectively). Mortality and incident dementia rose with the number of delirium episodes in the first 12 months of follow-up (by 10% and 20% per episode of delirium, respectively). 

2. Canadian teen vaping trends 

A new article in the CMAJ has published vaping trends & practice recommendations:

• 29.4% of students (grades 7–12) have tried an e-cigarette and 8.1% vape nicotine daily.

• Adolescents should be asked about vaping in all healthcare settings.

• Nicotine replacement therapy (NRT) is recommended for adolescents with moderate to severe nicotine use disorder. Combine a nicotine patch (7–21 mg) with short-acting NRT (2–4 mg gum, 1–2 mg lozenge) for breakthrough cravings.

3. GPs with low Covid vaccine uptake 

A cross-sectional, population-based analysis using Ontario data looked at the characteristics of family physicians with the largest proportion of unvaccinated patients for Covid. Family physicians with the top 10% of unvaccinated patients were more likely to be male, to have trained outside of Canada, to be older, and to work in an enhanced fee-for-service model than those in the remaining 90%. Primary care practices with the largest proportion of unvaccinated patients also served marginalized communities and were less likely to use team-based care models. 

👨‍💻Tech Bites

1: 👾 Watch out, AI scribes — Google has filed multiple patent applications that indicate it wants to explore the convergence of AI and healthcare. For example, they’re exploring the application of machine learning on doctors’ notes and diagnostic assistants. Nothing we can download and use yet though.

2: 🚗 Tesla is settling a lawsuit over a 2018 crash that killed an Apple engineer when a Model X on Autopilot collided with a highway barrier. Scheduled to begin in the California Superior Court this week, the case would have brought more attention to the safety of Tesla Autopilot and Self-Driving tech.

3: 🧠 Neurovalens, a startup building “noninvasive neurostimulation“ tech, has been given FDA clearance for two devices: one for generalized anxiety disorder and one for insomnia. It’s interesting because it’s not just a fuzzy “wellness” approval - the FDA 510(k) approval means it’s approved for prescription by physicians for specific use cases like GAD. Canadian regulators haven’t approved it yet though.

How often do cancer drugs that receive accelerated approval actually work?

The American Association for Cancer Research just held its annual meeting last week, and Postcall’s here to give you the scoop. Specifically, we came away with 3 interesting notes:

1. Researchers have struggled for a long time to explain the rising trend in cancer cases among younger people. Now, data from 150K people from the UK Biobank has give us a clue: people born after 1965 might be aging faster. They were 17% more likely to show accelerated aging (based on 9 blood based markers) compared to those born between 1950 and 1954. This then translated to increased risks for lung, stomach, intestinal, and uterine cancers. Read more.

2. Pancreatic cancer — hard to find, harder to treat (due to nonspecific symptoms, and the pancreas is difficult to palpate). But a liquid biopsy might have the answer. Large cohorts from multiple countries tested for a combined liquid biopsy signature with CA19-9 (biomarker) showed a 97% accuracy rate in detecting stage 1-2 pancreatic cancers. Read more.

3. The US FDA created an accelerated approval pathway 30 years ago to support development of HIV treatments, but now 80% of approvals from that pathway is for cancer drugs instead. If that sounds like a good thing, consider this: half of those speedy cancer drugs fail to improve patient survival OR quality of life in subsequent trials after 5+ years of follow-up. Read more.

Notable Numbers 🔢

650 million: the light-years distance of the neutron star-black hole merger observed by a group of researchers, including UBC scientists. This is the first gravitational-wave detection of a mass-gap object.

−2.3%: If you follow the advice of the majority of financial influencers, or finfluencers, that’s how much your investments will likely underperform expectations each month, according to the Swiss Finance Institute.

1.6 million: the number of seniors who have signed up for the Canadian Dental Care Plan (CDCP), set to start providing coverage next month. But dentists have said “brush it yourself“ as the government contracts are too vague.

85%: how much death by prostate cancer is projected to increase from 2020 to 2040, according to the Lancet and the largest study of its kind.

Postcall Picks ✅ 

🛫 Travel: This Nov. 14-30, Docs on Tour is offering a CME trip to Malaysia that spans historic Malacca, cosmopolitan Kuala Lumpur, Penang's colonial beaches, and Borneo's ancient rainforests. The CME program includes visits local hospitals and clinics, and presentations on traditional local and western medicine. Details here.

🥂 Drink: "This is not Whisky," a whiskey from an Alberta distillery, beats out Ireland and Scotland for the top prize for new spirits at the World Whiskies Awards.

💳️ Monetize: your friends courtesy of American Express — our friends at Price of Travel noted that if you hold the American Express Platinum Card (personal or business), you can now earn referrals for the Cobalt Card and the Gold Rewards Card. Instructions here.

👀 Watch: Good Work looks into whether politicians should be allowed to trade stocks:

🤣 Laugh: at ortho bro’s rods.

Game ⛳️

A Wednesday crossword, this week only! … because we forgot it on Saturday last week 😬

First question: What do you call an MSK cause of chest pain?

Average playtime last week: 5:26

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