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đŸ©ș Why your nose works in shifts

PLUS: Holiday gifts for doctors, pregnancy steroid safety, and stem-cell buzz

Good morning!

Here’s something your patients probably won’t ask, but now you can’t un-think: why do we have 2 nostrils instead of 1 big opening? The answer: the nasal cycle. One side takes in more air, filtering, warming, humidifying. The other takes in less, recovering moisture. After a few hours, the dominant side switches. Not only that, each nostril handles odours differently, giving the brain a more detailed sense of smell. So the next time someone reports uneven airflow, the explanation may not be obstruction — just normal anatomy on rotation.

Today’s issue takes 5 minutes to read. Only got one? Here’s what to know:

  • Steroid use in pregnancy not linked to gestational diabetes.

  • Single-dose HPV vaccine offers comparable protection to 2.

  • Canada approves 1st pill to treat postpartum depression

  • New model improves cancer prediction in dermatomyositis.

  • Stem cell therapy hype outpaces evidence and regulation.

  • Canada accelerates licensing pathway for foreign-trained physicians.

Let’s get into it.

Staying #Up2Date 🚹

Reassuring Evidence for Oral Steroids in Pregnancy

This cohort study looked at whether using oral corticosteroids during pregnancy increased the risk of gestational diabetes. In over 1M pregnancies, exposure to oral corticosteroids between 1 and 27 weeks’ gestation was not associated with increased risk of developing gestational diabetes as compared to normal pregnancies. These findings give oral corticosteroids the okay when clinically indicated in pregnancy. 

One HPV Shot Still Packs a Punch

This RCT found that just a single dose of the HPV vaccine could provide similar protection to two doses. In girls 12 to 16 years old, 1 dose was noninferior to 2 in preventing HPV16 and HPV18 infection. With these results holding true in both the bivalent (Cervarix) and nonavalent vaccines (Gardasil9), this could boost coverage for cervical cancer prevention and reduce costs. 

Smarter Screening: Predicting Cancer Early in Dermatomyositis  

This cohort study of 546 adults with dermatomyositis established a tool to optimize early cancer detection in this vulnerable population. The TIP-CA model uses 5 factors to estimate cancer risk: anti–transcriptional intermediary factor 1-Îł antibody, interstitial lung disease, poikiloderma, dermatomyositis subtype, and anemia. Cancer is a life-threatening complication of dermatomyositis, so this model can help guide early detection and ultimately improve patient outcomes. 

Growing Greater Miramichi

Ever thought about having a river view in your backyard and being part of a welcoming, family-like community?

The Greater Miramichi Region offers natural beauty, vibrant culture, and a lifestyle that feels like home.

Stem Cell Therapy’s Viral Moment

Can stem cell therapy relieve chronic pain, or is it just internet hype?

What happened: Celebrities are touting experimental stem cell therapy, even though it’s not approved by the FDA or Health Canada.

Why it matters: After giving birth to her son 3 years ago, internet celebrity Kylie Jenner said she was struggling with chronic back pain and found little relief — until she tried stem cell therapy, a treatment traditionally used for bone marrow transplants that may reduce inflammation linked to pain. The idea came after her older sister, Kim Kardashian, reportedly felt “immediate relief” for chronic back and shoulder pain. Both have promoted the therapy to millions of followers.

About 8 million Canadians live with chronic pain, often struggling to find relief. But that doesn’t mean stem cell therapy is the answer. These procedures typically involve collecting stem cells from living tissue, embryos, or umbilical cord blood and injecting them into the affected area. While stem cells have been used successfully since the 1960s for conditions like blood cancer and sickle cell disease, most therapies for chronic pain remain experimental. Despite growing demand, thousands of clinics (particularly in the US) are marketing unproven treatments, and the evidence for effectiveness is still limited.

But: Many stem cell therapies aren’t covered by health insurance and can lead to infections or lifelong disabilities. Right now, the only stem cell products that are approved by the FDA are made up of blood-forming stem cells called hematopoietic progenitor cells for patients with blood disorders like leukemia.

But did that stop the Kardashians? Of course not. The multi-billion-dollar family reportedly travelled to Mexico for the therapy, as these pain therapies are not approved in either the US or Canada. Even though Health Canada has not approved stem cell therapy for chronic pain, some clinics and health-care practitioners have offered unauthorized treatments — a practice the agency has publicly warned may pose serious health risks.

Bottom line: Kim Kardashian may have taken the bar exam, but she hasn’t gone to med school. While she might mean well, recommending unapproved (and expensive) treatments to her millions of followers can be dangerous, and just because it worked for her doesn’t mean it will work for them. For clinicians, it’s a stark reminder: celebrity endorsements don’t equal clinical evidence.

Hot Off The Press đŸ”„

1: 💊 Health Canada has approved the 1st oral pill specifically for postpartum depression. This is a game-changer, as the drug acts rapidly — in as little as 3 days, and requires only a 2-week course of treatment, unlike traditional SSRI antidepressants which take much longer to work and are taken indefinitely. For women who experience moderate to severe PPD, this fast-acting, short-duration option promises to quickly alleviate symptoms and improve mother-infant bonding.

2: đŸ„ Canada is fast-tracking foreign-trained doctors to help blunt a worsening healthcare crunch. A new express entry stream will open 5,000 spots specifically for international physicians, on top of existing immigration levels, and offer 14-day work-permit processing so qualified doctors can start treating patients almost immediately. The goal: ease ER bottlenecks, shrink wait-lists, and get more physicians into clinics that have been advertising jobs for months.

3: ⚔ Paramount vs. Netflix: the shareholder showdown. Earlier this week, Paramount dropped a $30‑per‑share all‑cash bid (that’s roughly US $108 billion) to grab Warner Bros. Discovery, trying to swoop in ahead of Netflix’s deal. Why? Paramount says its offer is simpler, faster, and more reliable than the Netflix plan, which mixes cash and stock. That combo makes Netflix’s deal a little messier and, in Paramount’s eyes, riskier for WBD shareholders. Now it’s up to the shareholders to pick: stick with Netflix’s mixed bag or take the “clean” cash route with Paramount.

4: 🔬 A new mutant strain of mpox is worrying scientists after the UK identified a rare recombinant version in a recent traveller. The new bug is a blend of the two main global strains, Clade Ib and Clade IIb, and it currently has no formal name. For now, it's a "watch and wait" situation, but this is a clear sign that public health vigilance and pushing the mpox vaccine are still essential.

🎁 The Best (or Worst) Gifts for Doctors

The holiday schedule is hitting harder than a post-call headache. Let's see what you actually need to survive December.

Tired Spongebob Squarepants GIF

What gift actually helps you survive the holidays?

Login or Subscribe to participate in polls.

Can't decide? Reply and tell us the absolute worst (or best) work-related gift you've ever received! We'll feature the best gifts in next week's issue.

Notable Numbers 🔱

10: the number of TV shows Slate named as the best of 2025, from Emmy-winning comedies to binge-worthy dramas.

155: how many people in Canada have gotten sick from Salmonella linked to pistachios and products containing them so far. A reminder to double-check what’s in your snack stash.

2: the number of Canadian-born identical twin brothers who are now Jeopardy! champions, with Ray Lalonde’s 13‑game streak and Ron Lalonde just winning his 3rd game.

Postcall Picks ✅

đŸ©ș The EMR you’ve been waiting for: what if you could instantly streamline your practice? Aeon delivers specialized tools for scheduling, charting, and billing, all in one intuitive interface. Get the EMR you’ve always wanted. Request access today.

đŸ„Ș Make: Martha Stewart’s Test Kitchen favourite grilled cheese sandwich. I’s crispy, buttery bread with melty, gooey cheese, perfect for a quick, comforting snack.

❄ Visit: Lake Ontario’s rare ice volcanoes — when the cold, wind, and waves line up, water bursts through cracks in the ice, freezing into cone-shaped “volcanoes” you can safely admire from shore.

💰 Save: on your next movie night with the Cineplex Holiday Gift Card Deal. Buy $50 in gift cards and score a free movie ticket, free popcorn, and coupons for 2026.

🎧 Listen: to the latest The Curbsiders podcast on menopause care. Get the modern, evidence-based roadmap for prescribing hormone therapy.

Relax

First clue: Podiatric homophone to a 2020 Disney film

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

Think you crushed it? Challenge your physician friends to beat your time.

Meme of the Week

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Help Us Get Better

That’s all for this issue.

Cheers,

The Postcall team.