Staying #Up2Date 🚨

1. HIV breakthrough

This RCT evaluated the efficacy of twice-yearly lenacapavir, a long-acting HIV capsid inhibitor, in preventing HIV among cisgender women in sub-Saharan Africa. Out of >2000 individuals, none of the participants receiving twice-yearly lenacapavir acquired HIV infection, representing a promising new drug for post-exposure prophylaxis (PrEP) that is yet to be approved by the FDA. 

2. Buprenorphine + naloxone in pregnancy 

This study compared perinatal outcomes between pregnant individuals exposed to buprenorphine + naloxone (B/N) vs. buprenorphine alone. B/N was associated with a lower risk of neonatal abstinence syndrome, NICU admission, and small for gestational age infants compared to buprenorphine alone. No significant differences were observed in major congenital malformations, low birth weight, preterm birth, respiratory symptoms, or cesarean delivery. The results suggest that buprenorphine combined with naloxone is a safe and effective treatment option for opioid use disorder during pregnancy.

3. Abx adverse reactions 

This study analyzed the risk of serious cutaneous adverse drug reactions (cADRs) associated with commonly prescribed oral antibiotics among older adults in Ontario, Canada. Sulfonamide antibiotics and cephalosporins were most strongly associated with serious cADRs, followed by nitrofurantoin, penicillins, and fluoroquinolones, compared to macrolides. Among those hospitalized for cADRs, a significant proportion required critical care, and 5.3% died in the hospital.

Heart to (Metal) Heart

How one patient’s change of heart could be the future of transplants.

What happened: The Texas Heart Institute of Houston performed the first-ever successful implant of a BiVacor Total Artificial Heart (TAH) on a 57-year-old man.

Why it’s interesting: The patient, who was critically ill and in cardiogenic shock, was offered a TAH, a titanium heart that uses magnetic technology to pump blood. It was designed to replace both ventricles of a failing heart. 

The surgery was part of an FDA early feasibility study where new medical devices are used on a small number of patients to test for safety and efficacy. The titanium heart pumps 12 litres of blood flow per minute, similar to a human heart.

Typical artificial hearts use compression sacs to squeeze the blood out of the device and distribute it to the body, but these can fail over time. They can also be too big for patients. Because they don’t have sacs, TAHs are smaller and easier to fit in the body. 

Yes, but: While having a titanium heart sounds cool, BiVacor said TAHs aren't currently available for long-term use, as the company reported that TAHs are just a placeholder. One of BiVacor’s goals is to make their artificial hearts an option for patients on the donor list. The founder of BiVacor said that after 10 years, a lot of patients that have donor hearts end up rejecting them. He hopes his colleagues at BiVacor can create TAHs that can last over 10 years without any complications. 

Bottom line: BiVacor will continue to make history as they continue to implant the titanium hearts into patients who need transplants, and monitor them for any side effects.

Hot Off The Press

1: 🦷 More than 70% of dentists are accepting patients through Canada’s new public dental insurance program — a significant increase from last month, thanks to changes allowing dentists to submit claims without fully registering as providers. The program, which has already served 450,000 Canadians, still faces criticism from Conservatives, who argue it is flawed and confusing.

2: ⚡️ Spark Biomedical is electrifying opioid withdrawal treatment — literally. Sparrow Ascent, a wearable earpiece that uses mild electric pulses to ease symptoms like nausea, insomnia, and anxiety without drugs, is an FDA-approved device that helps patients safely detox at home. The company’s current trying to make this $4,500 device accessible through insurance.

3: 💊 3 papers about MDMA-assisted therapy have been retracted because of “unethical conduct” at one of the study’s sites. This comes on the heels of the FDA rejecting MDMA-assisted therapy to treat PTSD. Lykos Therapeutics, the drug company that applied to the FDA, says it’ll appeal the decision.

4: 📱Starting this fall, several Canadian provinces, including BC, Alberta, Ontario, Nova Scotia, and New Brunswick, are enforcing new cellphone restrictions in classrooms to minimize distractions and improve learning. Quebec has already implemented a similar ban since January. Policies vary by province, ranging from complete bans to restricted usage.

5: 🇺🇸 In a bizarre move, Trump says Kamala Harris looks like wife Melania while calling her “beautiful” at the same time in his recent interview with Elon Musk.

6: 🇮🇳 Doctors at hospitals in large cities around India pledged to strike indefinitely and halt elective procedures after the rape and murder of a medic in a state-run hospital, CBS News reported.

Notable Numbers 🔢

2 million: the number of acres being burned by wildfires in the US right now. A new study in Anesthesiology suggests that inhaling wildfire smoke could affect the safety of surgeries, complicating the effects of anesthesia and potentially hampering recovery.

17: the number of cancers that are on the rise in younger generations, according to a new study. For example, the number of cancers of the small intestine, kidney and pancreas was 2 to 3 times higher in people in their mid-30s than in boomers.

159: the number of calls to US poison control centres this year involving GLP-1s. In 2023, there were only 32.

💬 In Our Community

We found an interesting poll on yearly savings and investments, with 100 physicians responding. The majority (73%) reported saving $150,000 or less per year into savings and investments (see the graph below for distribution). Also, a not-so-negligible percentage (9%) reported $300,000+ in yearly savings and investments!

Some respondents pointed out the limited generalizability of the poll, as income and savings can vary significantly based on individual circumstances. They mentioned that they “save whatever is left after maintaining a reasonable lifestyle.” Another criticism of the poll was that it didn’t focus on savings as a percentage of net income.

Contribute to the poll and read the comments on Facebook here. Link may not work if you’re not already part of the private FB group.

Postcall Picks

😭 Laugh: Baby’s mouth is on a strict no-open policy at the doctor’s office.

🧠 Learn: Red-40 is under scrutiny. Is there a real link between food dyes and hyperactivity, or is it just a colorful debate?

📚 Read: Being Mortal by Atul Gawande for profound perspectives on enhancing patient care when tackling realities of aging and end-of-life care in modern medicine.

🤑 Save: In need of new OR shoes? Birkenstock clogs may not win any fashion awards, but for $99 at Costco (about $20 less than direct from the retailer), they’ll win in comfort and savings!

Relax

First Question: This muscle flexes the arm and is innervated by the musculocutaneous nerve.

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