Staying #Up2Date 🚨

1: Tenecteplase Before Thrombectomy: A One-Two Punch for Stroke?

This RCT assessed the safety and efficacy of IV tenecteplase before endovascular thrombectomy in acute ischemic stroke due to large-vessel occlusion. 90 days post-stroke, functional independence was observed in 52.9% of tenecteplase-thrombectomy patients, compared to  41.1% in thrombectomy alone (RR, 1.20; 95% CI, 1.01-1.43; P = 0.04). Similar rates of symptomatic intracranial hemorrhage and death were observed in both groups, suggesting this combo could become a new standard for stroke care. 

Early Hunger, Lasting Harm

A cohort study of 1K children in 20 US cities examined associations between early childhood food insecurity and cardiovascular health in young adulthood. After 25 years of monitoring, early food insecurity was linked to poorer cardiovascular health and elevated BMIs in young adults. Additionally, food insecurity was more common in households who did not participate in a nutrition assistance program, underscoring the importance of policies that promote food security among children. 

Combined Albuterol-Budesonide for Asthma Relief

This phase-3 trial evaluated use of as-needed albuterol-budesonide for patients with moderate-to-severe asthma. After a year, the combo lowered the rate of severe exacerbations compared to albuterol alone (RR, 0.47; 95% CI, 0.34-0.64). It also reduced the total dose of systemic glucocorticoids required annually — letting patients breathe a sigh of relief. 

A Knee-Jerk Solution🦵

A new knee could be just a hop and a hip away 

What happened: A study found that a centralized referral system is the secret to faster hip and knee surgeries.

Why it matters: About 1 in 3 Canadians who need a new hip or knee replacement are waiting longer than recommended — and some are even turning to private clinics. A CMAJ study found that using an organized referral system is a cost-effective way to address a weak spot in the Canadian healthcare system.

The benchmark for knee and hip replacements in Canada is around 182 days (or 6 months). Only 66% of hip replacements and 59% of knee surgeries are completed within that timeframe. Patients must be referred directly from their family doctor to a specific specialist. Most surgeons are independent practitioners and don’t share referrals, contributing to longer waits. 

But: Researchers found 3 ways hospitals can help patients get seen faster. 

• Single-entry referral model: Instead of being sent to specific surgeons individually, patients who live in the same region are grouped and directed to the next available surgeon for consultation. 

• Team-based care model: A family doctor refers the patient to a surgeon for an initial consult. If surgery is needed, the patient is added to a queue and sees the next available surgeon.

• Fully integrated model: A family doctor submits a patient assessment request to a central intake. If surgery is needed, the patient is placed in a pooled queue and matched with the next available surgeon in their area.

The study, which looked at patients referred by a family doctor in 2017 for non-urgent knee or hip replacements, found that team-based and fully integrated models reduced wait times more effectively than the single-entry model. One author noted that when surgeons share cases and work in teams, fewer patients are left waiting.

Bottom line: It’ll take bold collaboration between health-system leaders and physicians to make these changes work, but researchers believe Canada is up to the challenge — because patient care comes first.

Hot Off The Press

1: 🦠 A new species of bacteria has been discovered aboard China’s Tiangong space station — one that doesn’t exist on Earth. Named Niallia tiangongensis, it likely hitched a ride from the ground but has since adapted to space conditions like microgravity and radiation. Researchers say it’s not harmful, but it’s a sign that microbes adapt fast. Especially in orbit.

2: 🧬 A team at USask may have found a smarter way to stop breast cancer from growing. They studied PLK1 — an enzyme active in nearly all cancers — and instead of targeting it directly (too risky), they looked at the genes that help it do its job. The idea: block the backup crew, not the boss. It’s early-stage, but could lead to safer, more personalized treatments. Published in Cell Genomics.

3: ☀️ Daily vitamin D3 supplements may help slow cellular aging, according to 4-year data from the VITAL trial. In over 1,000 adults, vitamin D3 reduced telomere shortening — a marker linked to aging and disease — by 140 base pairs compared to placebo. Omega-3s, meanwhile, had no effect.

4: 🦟 Researchers may have found a new way to stop Plasmodium falciparum — the parasite behind the deadliest form of malaria — before it ever reaches humans. The lead compounds worked inside mosquitoes, even when insecticides failed, and stayed potent when embedded in bed net–like materials. This study opens the door to smarter, more resilient malaria control.

Notable Numbers 🔢

54.6%: how many girls and young women aged 15 to 29 with a diagnosed mental health or substance use disorder accessed formal health services in 2022, according to a recent Statistics Canada study. The number indicates some progress, but also highlights persistent gaps in care, particularly for marginalized groups and young people in rural areas. Stigma, limited access, and long wait times continue to be major challenges.

400: the number of ostriches on a BC ostrich farm facing a cull order after 2 birds tested positive for avian flu. The Canadian Food Inspection Agency says this policy is crucial for fulfilling Canada’s international disease control commitments. Protesters, including US Health Secretary Robert F. Kennedy Jr., have pushed back, calling the move excessive and arguing the birds could offer insight into the virus.

11: the age of Yaqeen Hammad, one of over 53,000 Palestinians killed since the Gaza war began in October 2023. Yaqeen died on May 24 in an Israeli airstrike on a school shelter that also killed 35 others, including 18 children. The conflict has displaced nearly 1.9 million people (approximately 90% of Gaza’s population) and shows no signs of ending.

Picks

🎧 Listen: to CMAJ hosts Drs. Mojola Omole and Blair Bigham unpack how regulatory changes to mifepristone have reshaped abortion access in Ontario — and what physicians should know about prescribing it.

🤑 Save: Time to open your pool? Pool Supplies Canada has what you need to make this summer the coolest. 

📺 Watch: the new trailer for Netflix’s TITAN: The OceanGate Disaster documentary, premiering June 11th.

😂 Laugh: at these medical one-liners:

🦴 What do you call a doctor who fixes websites?
 An URL-ologist.

🩺 Why did the nurse carry a red pen?
In case they needed to draw blood.

🍁How do you know a Canadian radiologist read your scan?
There’s a “sorry” written next to the incidental finding.

Relax

First Question: Kleihauer-Betke ____, used to quantify fetal blood in maternal circulation

Need a rematch? We’ve got you covered. Check out our Crossword Archive — find every puzzle we’ve ever made, all in one place.

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