A new mRNA cancer vaccine successfully attacked glioblastoma in its first-ever human trial. Published in Cell on May 1, the personalized vaccine triggers a fierce immune response to fight the aggressive, most-lethal type of brain tumour. As a tech, mRNA is looking more like a mIRACLE.

 ☕️Postcall’s one-sip markets update:

Stocks are again at an all time high, as 96% of companies reporting earnings have beat expectations (according to WS). But they were down to start this week, which suggests concern around inflation data and its corresponding effect on interest rate cuts. One exception: Loblaws, which is surging despite the boycott.

Ready for this week’s stories? (8 min read)

1. Pregnancy weight gain outcomes

2. Apple Watch can now be used for Afib studies

3. Why hard drugs are now a crime, again

4. Lululemon may not be green

5. Should we be doing full body MRIs?

6. “We the North” says We-govy

7. Salary vs. dividends?

Staying #Up2Date 🚨

1. Vaping cessation 

Vaping may soon have a cessation toolkit of its own. A double-blind, placebo-controlled RCT compared 12 weeks of treatment with cytisinicline vs. placebo for vaping cessation. Continuous e-cigarette abstinence in cytisinicline and placebo groups occurred in 31.8% vs 15.1% of participants (odds ratio, 2.64; 95% CI, 1.06-7.10; P = .04) at end of treatment (weeks 9-12). 

2. Antipsychotics in dementia

An observational study of 25K individuals with dementia over a 10-year period found that compared with non-use, any antipsychotic use was associated with increased risks of adverse outcomes. Current use (90 days after a prescription) was associated with elevated risks of pneumonia, AKI, VTE, stroke, fracture, MI, and HF.

3. Pregnancy weight

A Swedish population-based cohort study with 16K singleton pregnancies examined the association between total pregnancy weight gain and a composite of neonatal and maternal outcomes. In a nutshell, weight gain <5 kg was not associated with risk for the composite outcome among women with BMIs of ≥30–39.9. These results support minimizing pregnancy weight gain so long as nutritional balance is maintained (particularly in women with class 3 obesity).

👨‍💻Tech Bites

1: ⌚️ The US FDA has qualified Apple Watch’s atrial fibrillation (AFib) history feature for use in medical device clinical trials, the agency said Wednesday. It’s the first-ever digital health tech to get this approval, and has already been credited with saving lives.

2: 🔉 GE HealthCare scored a $44M Gates Foundation grant to bring its AI-powered ultrasound guidance technology to low- and middle-income countries.

3: 🫣 Google’s updated ad policy now prohibits “promoting synthetic content that has been altered or generated to be sexually explicit or contain nudity” — a.k.a. deepfake porn, and sites/apps that teach people how to make it. According to The Verge, Google removed 1.8 billion ads for violating its rules on sexual content in 2023.

Drug Decriminalization 🥦 

Effective immediately, it's illegal to consume hard drugs in public in B.C.

Wait, wasn’t it always illegal? Not for the last year — BC had a pilot program that started at the end of Jan. 2023, which had decriminalized the possession of small amounts of drugs like opioids and meth for personal use. But Premier David Eby, moved by instances of public drug use in places like hospitals and restaurants, has asked Health Canada to reinstate criminal penalties for public drug consumption.

Why It's Interesting: The decriminalization initiative was designed to reduce the stigmatization of drug users, redirect police resources to more serious crimes, and shift the paradigm towards solving a public health challenge. However:

• According to the BC Coroners Service, 2,546 people died of overdoses in 2023 — the highest number ever recorded and a 7% increase compared with 2022.

• Police needed tools “to address extraordinary circumstances where people are compromising public safety through their drug use,” Eby said.

• Adriane Gear, president of the BC Nurses’ Union, said drug use inside some hospitals did become an issue after decriminalization came into effect at the end of Jan. 2023. Some nurses were also concerned about drug dealers coming into hospital rooms to sell to patients.

• But at the same time, Eby acknowledged that addiction should be treated as a health problem rather than a crime. He said that years ago as a junior prosecutor, he’d prosecuted a young Indigenous woman for drug offences and described the experience as “the worst day of my life. She left that courthouse worse, after taxpayers paid how much money to prosecute her.”

Yes, but: The number of drug seizures dramatically dropped from 1,283 in 2022 to just 86 in 2023. Similarly, drug possession charges fell by 77% compared to the previous 4-year average. Law enforcement agencies have reported being able to redirect resources previously spent on low-level drug offences to tackle more serious crimes — not only improving community safety, but also allowing police forces to operate more efficiently.

Postcall’s Take: While Premier Eby’s backtrack might seem like a setback, we think it’s a step in the right direction since it underscores the complex dance of drug policy reform. Effective drug policy must balance public health benefits with community safety.

Speed Reads 🚤

1: A high dose of the steroid prednisone can reduce the rate of subsequent pregnancy in post-vasectomy reversals. Prescribed since the ‘70s for the purpose of preventing scarring and blockages, prednisone may “be detrimental to sperm function in some way,” according to this study.

2: A new report says a growing number of Canadians are moving abroad due to Canada’s high cost of living — 5x as many as US citizens living abroad. 31% more new citizens emigrated elsewhere between 2017 and 2019. The report suggests that Canada doesn’t support its expats as well as other countries do — for example, not providing healthcare abroad or the ability to vote.

3: The NDP government in BC has launched a secondary suite program in an attempt to help the housing affordability crisis. The pilot program offers $40k in forgivable loans to add a garden suite or laneway house to their property. When they rent it out, it has to be 40% below the market rate. At first glance, we love that’s it’s bringing more housing supply. But critics also point out that it’s giving money to people who are already in advantageous positions to potentially make even more revenue.

4: Canada’s emissions are the lowest they’ve been in 25 years (not including the first 2 years of the pandemic). Most of the change comes from the electricity sectors. Some people say that the oil and gas sector — which is the most polluting industry in Canada — has yet to follow suit.

5: We are sick… of sick notes. The BC Family Doctors organization and the BC College of Family Physicians have created a template for patients to give their employers, stating that doctors need to focus on medical care, not paperwork. Also, the BC Family Doctors president added, having sick people visit their doctors just to get a note is “putting other people at risk.”

6: After nonprofit Stand.earth accused Lululemon of “greenwashing,” Canada’s Competition Bureau is investigating the BC-based athleisure company’s sustainability claims. Lululemon promised in 2020 to reduce greenhouse gas emissions. Rather, one type of gas emissions — indirect emissions — nearly doubled from 2020 to 2022.

MR Lies?

Full body MRIs have been gaining popularity after high profile celebs like Kim Kardashian and Cindy Crawford have begun endorsing them. But are they worth the price?

What happened? 

Private companies are now offering full-body MRIs to people who wish to take preventative measures regarding their health — but some doctors remain cautious, due to lack of long term data and the strain on public health systems.

Why it’s interesting: Although full-body MRIs aren’t covered under Canada’s health insurance, many people in both Canada and the US are forking over around $2,000 to private companies like Prenuvo to help them “stay on top of their health.” 

• One woman from Texas claimed the machine caught a cancerous nodule on her lung. Upon further inspection, doctors were able to remove the nodule, preventing the cancer from spreading. 

• Prenuvo is currently relying on 14 years of clinical practice and says they have 30 licensed radiologists on their team.

• The machine can take an image of the body in under an hour, and the scans can detect cancers as early as Stage 1, fatty liver disease, hemochromatosis, and multiple sclerosis.

• The cost of the full body MRI may be much lower overseas (could cost as low as a few hundred dollars)

But: Full-body MRIs add pressure to the Canadian healthcare system, as they sometimes produce false positives or “incidentalomas”. As a result, some have accused Prenuvo of taking away resources from the public health system, while adding to patient anxiety and unnecessary treatments. One doctor who received the scan said it found a one-centimetre lesion in his prostate, and it wasn’t clear if it was cancerous. The doctor said that although the lesion won’t hurt him, knowing it’s there has turned his identity from “being healthy to being a patient.” 

Bottom line: Full-body MRIs have a long way to go before they become the new norm in healthcare. So until then, Postcall will keep scanning the news for future updates. 

Notable Numbers #️⃣ 

27: The BMI over which Wegovy is indicated as a treatment (patients should also have one comorbidity). The drug arrived in Canada this week.

$40K: The price of “Optimize by Equinox,” a high-end longevity program. The gym chain says includes everything from personal training and nutrition plans to sleep coaching and massage therapy. We say you can probably get most of the health benefits by just… working out at the gym.

2: The number of Boeing whistleblowers who have suddenly died. Joshua Dean, former quality auditor at a key Boeing supplier, had accused Boeing of ignoring defects of the 737 MAX. He claimed he’d been fired for raising those concerns. This comes less than two months after the death of another whistleblower, John Barnett.

Postcall Picks ✅ 

🧠 Learn: Endless paperwork getting you down? Join Dr. Anish Mody to gain valuable insight on efficiency in an increasingly complex practice environment, complementary for OMA members on May 15th. Register here.

🦧 Jungle Apothecary: For the first time ever, a wild orangutan was spotted treating his own wounds by activating medicinal properties of a plant. Learn more about our great ape relative’s remarkable healing journey here. 

💰️Finances: Curious if salary or dividends are the best fit for your corporation? Tune in as Dr. Zhou (@breakingbaddebt) and Dr. Soth (the Loonie Doctor Blog) dissect the pros and cons of each approach. Gain insight on setting your pay, finding the right balance, and optimizing your earnings trajectory throughout your career. Watch here. 

🎮 Gaming: Hades, crowned the Game of the Year 2021, is now on sale at an all-time low for just $11.05! Grab your controller and game your stress away as you hack and slash your way through the underworld.

📕 Read: The NY Times’ list of the best books published since 2000.

🍻 Drink: outside this summer. Both Vancouver and Toronto have extended pilot programs allowing alcohol in parks and beaches.

🏡 Housing $: The National Price Map from the Canadian Real Estate Association shows average prices throughout Canada. Want to guess where’s the most affordable? Here’s the answer. **

** This is sponsored content.

🕹️ Game ⛳️

First question: What do you call firm scar tissue in the dermis?

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