Staying #Up2Date 🚨

1. Colorectal cancer screening (CRC)

In this study, data from over 195K participants across three US population-based cohorts was analyzed to evaluate long-term CRC risk after negative colonoscopy screening. Low- and intermediate-risk individuals could safely extend rescreening intervals to 16–25 years without exceeding the 10-year CRC risk observed in high-risk individuals. 

2. HIV guideline updates

The International AIDS Society-USA has released some new recommendations, including:

• High- or moderate-intensity statin for persons living with HIV aged 40–75.

• Limited data on GLP-1 agonists for weight loss suggest similar efficacy among PLHIV and the general population (with the caveat that modest loss of muscle mass may occur).

• A focus on screening for anal cancer and prevention of STIs with postexposure prophylaxis (doxycycline after condomless or oral sex i.e. doxyPEP

3. New mean arterial pressure (MAP) targets 

In this study, a meta-analysis of over 3K critically ill patients with vasodilatory shock, showed that patients with a lower MAP target (60–70 mm Hg) experienced a nonsignificant 2.6% absolute reduction in mortality compared to those with higher targets (70–85 mm Hg).The survival benefit did not reach statistical significance, but the findings suggest a lower MAP target may confer advantages in patients with pressor-limiting side effects.

Nerves of Steel 🧠

How a decades-old device offers hope for depression

What happened: A new study has found that vagus nerve stimulation (VNS), a therapy approved nearly 20 years ago, may alleviate symptoms for people with treatment-resistant depression.

Why it’s interesting: In 2005, the FDA had just approved the treatment for adults who were diagnosed with chronic or recurrent depression and who had a poor reaction to at least 4 antidepressant therapies.

The therapy involves implanting a small device under the collarbone. A wire runs to the neck to stimulate the vagus nerve. The vagus nerve has over 100,000 individual nerves in a bundle and has been called the “bidirectional superhighway” that gives information to the brain from the body. The device sends regular pulses to areas of the brain associated with mood regulations for 30 seconds every 5 minutes.

A yearlong trial involving 493 adults with severe depression found that VNS therapy helped to improve their quality of life. Participants continued their existing treatments while receiving VNS. 18% reported a 50% reduction in symptoms. 53% reported improved quality of life.

But: The study didn’t meet its primary endpoint. Because of its large participant group, the study may not have been constant in terms of illness. One neuroscientist said some people may not respond to the device at all, while others have a stronger response. Side effects of VNS – like shortness of breath, site irritation, or vocal hoarseness – are also potential downsides.

Bottom line: While VNS treatment shows promise for folks battling severe forms of depression, its effectiveness varies and  side effects remain a concern. Doctors still recommend that patients seek out other forms of therapy as VNS research continues to evolve.

Hot Off The Press

1: 🧪 Hydroxychloroquine hype finally hits a hard stop: the infamous 2020 paper that fueled global COVID-19 treatment buzz has been retracted for ethical breaches and dodgy science, including dropped data that skewed results. Critics have long flagged this study as the “cornerstone” of unnecessary COVID-19 treatments with life-threatening side effects — underscoring the medical principle primum non nocere (“first, do no harm”).

2: 💉 Imagine cutting new hepatitis C cases in prisons by 15% and injection-related infections by 8% — all while saving money. A new study, published in the Canadian Medical Association Journal, shows that expanding needle exchange programs (PNEPs) in federal prisons could make this a reality by 2030. These programs not only reduce blood-borne infections but also improve access to care and support recovery. With benefits like these, shouldn’t PNEPs be a top priority everywhere?

3: 🚑 It’s well documented that paramedics across Canada face significant violence on the job, including physical assaults, verbal abuse, and sexual harassment. A new nationwide survey — the first of its kind — aims to figure out exactly how much by providing a comprehensive picture of the problem and its impacts on paramedics and their families. Researchers and advocates hope the findings will drive systemic changes to improve safety and raise public awareness of these first responders’ day-to-day challenges.

4: 🧬 The world’s first Crispr drug has been out for a year, but it’s not exactly flying off the shelves. Why? It’s complicated — literally. The treatment, called Casgevy, is groundbreaking and offers new hope for people with sickle cell disease. But it’s not just a quick shot or a pill; it’s a whole journey involving stem cell editing, chemo, and months of recovery. This slow start aside, there’s hope that this “dawn of a new age” will pick up speed.

Notable Numbers 🔢

96%: the effectiveness of lenacapavir in preventing HIV in clinical trials, earning it the title of "Breakthrough of the Year" from Science. This twice-yearly injection offers a game-changing alternative to daily oral PrEP, which has struggled with adherence and stigma in real-world settings. If made widely accessible, lenacapavir could significantly reduce new infections and bring the world closer to ending the HIV epidemic.

100,000: the number of people in the US currently waiting for organ transplants — which is why breakthroughs like pig-to-human kidney transplants matter so much. Despite the death of Rick Slayman, the first patient to receive a genetically modified pig kidney transplant, his case offers valuable insights for future procedures, and medical experts remain optimistic.

27%: the drop in Novo Nordisk's share price after its obesity drug candidate, CagriSema, fell short of expectations in a Phase III trial. While the drug achieved a 22.7% weight loss, it missed the 25% target, leading to a $125 billion market value wipeout. Novo plans another trial in 2025 to explore the drug’s potential.

Postcall Picks

🧠 Learn: Want to level up your MOA’s approach to patient privacy? Doctors of BC is covering the cost for a small group — sign up here.

📆 Year-end money: MDM has put together a helpful list of dates to keep track of as we get into the end of the year, including deadlines for RRSP and charitable donation write-offs.

🍾 Drink: responsibly this holiday season with 5 tips from Drs. Kilmer and Gupta on CNN’s Chasing Life podcast. Our favourite is “bubbles equal trouble.”

🥳 Enjoy: all the things to do around Toronto over the next few days, highlighted in this BlogTO article.

Relax

First Question: What is a blood clotting disorder that used to be known as Christmas Disease?

If you enjoyed the puzzle, please share it!

Share Postcall, Get Rewards

Help Us Get Better