Staying #Up2Date 🚨

1: Born This Way? How Fetal Size and Maternal Diabetes Shape MS Risk

A cohort study of over 1 million participants in Norway found individuals born large for gestational age or exposed to maternal diabetes in utero had a higher risk of developing multiple sclerosis (MS) as adults. Those born small for gestational age, however, were at lower risk of developing MS later in life. The findings add to growing evidence that prenatal factors may shape neurologic risk decades later.

2: A Prick of Promise: Fremanezumab’s Pediatric Migraine Debut

An RCT of 237 children and adolescents with migraine found that fremanezumab, a humanized monoclonal antibody already approved in adults, was both efficacious and safe in younger patients. Given as a monthly subcutaneous injection, fremanezumab significantly reduced the number of migraine and headache days per month compared with placebo. With injection-site erythema as the most common adverse event, this migraine prophylactic shows promise for pediatric populations.

3: An Incidental Finding, But Not Necessarily an Innocent One…

A cohort study examined outcomes among individuals with incidentally detected splenomegaly. Among 47,000 people, those with a spleen measuring >140 mm in length or >500 mL in volume had a significantly higher risk of developing hematologic cancer within 5 years. The takeaway: an enlarged spleen may warrant a more thorough clinical workup, even when discovered incidentally.

4: The Mind–Heart Connection: Evidence Linking Mental Disorders to Acute Coronary Syndrome

A systematic review and meta-analysis of 25 studies examined associations between mental disorders and acute coronary syndrome (ACS). PTSD and sleep disorders were associated with a significantly increased risk of ACS, pointing to a strong link between sleep quality and cardiovascular outcomes. Anxiety and depression were also associated with increased ACS risk, reinforcing that mental health and cardiovascular disease are more closely linked than we often treat them.

Death Risk? AI May Know ⚠️

AI can write your patient notes. Now it’s flagging deaths.

What happened: Some Canadian hospitals are using AI tools to alert care teams when someone is at high risk of dying or needing ICU care. These systems don’t just record data, they constantly watch vital signs, lab results, and clinical notes, looking for patterns that could signal trouble before it’s obvious to humans.

Why it matters: AI has already seeped into the medical world, acting as a scribe for physicians during appointments with patients. It’s meant to free up doctors' workday by recording and making notes for them during appointments, but it’s also been known to make mistakes, causing physicians to have to go back and edit hours worth of conversations.  

Despite these limitations, AI is going a step further. An AI system called CHARTWatch — developed at St. Michael’s Hospital and now used in other hospitals within the Unity Health Toronto network — continuously monitors patient data to flag who may need urgent help. It analyzes dozens of signals, including heart rate, oxygen levels, blood pressure, lab results, and nursing notes, to predict whether a patient is likely to deteriorate, require ICU care, or even die within the next 48 hours.

For example, if a patient’s oxygen drops slightly while their heart rate trends upward, the AI may flag them as high-risk. That alert prompts the care team to check in sooner, run tests, or adjust treatment — sometimes hours before a crisis would have been noticed. Since its introduction 5 years ago, the tool has contributed to a 26% reduction in unexpected mortality, according to the Canadian Medical Association (CMA).

But: AI isn’t here to replace doctors and nurses, it’s meant to support them. More than 25% of Canadians rely on chatbots like ChatGPT for answers to medical-related questions, which can be risky. But within hospitals, AI can help reduce clinicians’ workload, letting them focus on patients who need care most.

The CMA says AI has huge potential for strengthening the healthcare system — but privacy must come first. Questions remain about who owns patient data, how consent works, and who’s responsible if data is leaked.

Bottom line: Although it may act like it, AI doesn’t have all the answers. It’s limited in many ways, including protecting the privacy of patients. Until it can answer those burning questions, it might be a good idea to not only keep that pen and paper handy, but also keep an extra eye on at-risk patients. 

Hot Off The Press

1: 🌍 Donald Trump’s push to gain control of Greenland is rattling US allies, with the American president framing the Arctic territory as a national-security priority tied to Russian and Chinese influence. World leaders and Greenland’s government have pushed back, calling the claims unjustified and illegal. The rhetoric hasn’t stopped there — Trump has also criticized Canada, saying its “northern border” isn’t secure. Experts stress there’s no legal basis for annexation, but the episode highlights a broader Arctic power play — and why some worry Canada could be pulled into the conversation next.

2: 🧪 A new The Lancet review clears up the Tylenol panic: no link between prenatal acetaminophen use and autism, ADHD, or other neurodevelopmental conditions. Researchers reviewed 43 studies, accounting for genetics and family history, and found no association. Experts say taking Tylenol as directed remains the safest option for pain or fever in pregnancy — and that avoiding it altogether could do more harm than good. For now, expectant parents can breathe a little easier.

3: ⚽ Canada’s health-care system could face a stress test this summer as Toronto and Vancouver prepare to host FIFA World Cup matches. An editorial in the Canadian Medical Association Journal warns that ERs already running at or over capacity may struggle to absorb surges from routine emergencies, trauma, or unexpected crises when hundreds of thousands of visitors arrive. Add festival-season pressures (alcohol-related visits, infectious disease spread, and food-borne illness) and calls for advance planning and surge capacity are growing louder well before kickoff.

4: ♹ Spooked by headlines about microplastics being found everywhere in the human body — brain, blood, placenta, and testes? Apparently, some of that science may not hold up. Some high-profile studies are facing serious pushback, with chemists saying they skipped basic contamination controls, misidentifying ordinary tissue components as plastic, especially in fat-heavy organs like the brain. So it’s probably premature to fork out CA$18,000 for a blood-cleaning treatment — but just because the science is less convincing than we thought, “premature” doesn’t mean false. It just means the science isn’t there yet.

Notable Numbers 🔢

$45,500: the estimated annual pay gap for Ontario female family doctors, who tend to spend 15–20% more time with patients — about 4 extra minutes per visit, according to a new study. To close the gap under Ontario’s current fee-for-service model, the research also found women would need to work roughly 2 additional hours per day.

500 km: how far away a team of doctors hope to perform a remote endovascular thrombectomy, pending Health Canada approval. So far, the surgeons at St. Michael’s Hospital in Toronto have completed 10 brain angiograms remotely via an internet-connected, remote-controlled robot.

20: the number of the world’s most unusual and dangerous airport runways, where pilots navigate cliffs, mountains, and razor-thin approaches just to land safely. Proof that turbulence sometimes starts before takeoff.

Quick Consult 🧠

This January, for Alzheimer’s Awareness Month, we chatted with the Alzheimer Society of Canada about early signs of dementia, supporting patients and families, and breaking the stigma around the disease. Here’s what Sian Lockwood, interim manager of knowledge transfer at the Society shared:

Q: What early signs of Alzheimer’s or other dementias should clinicians watch for?

A: Memory changes affecting daily life, trouble with familiar tasks, disorientation, language difficulties, poor judgment, mood/personality changes, loss of initiative, and challenges with visual-spatial tasks.

Q: How can clinicians help reduce stigma with patients and families?

A: Share the benefits of early diagnosis, provide clear information, and communicate with empathy and compassion. (More tips here).

Q: What’s happening for Alzheimer’s Awareness Month this January?

A: The Alzheimer Society is highlighting stigma as a barrier to care. You can help by joining the #ForgetNoOne campaign on Jan. 28 to show support and connect with local resources. 

Q: How can caregivers be supported?

Refer families to First Link for guidance, local support groups, and provide future planning. First Link is a referral program that helps health-care providers connect a person living with dementia to their local Alzheimer Society, from the time of diagnosis and throughout the duration of their experience living with dementia.

Postcall Picks ✅

🎥 Watch: Dr. Gerald Evans from Queen’s University on infectious threats making a comeback and the patterns clinicians are starting to notice. A smart watch for anyone tracking emerging outbreaks.

🍝 Make: This “million-dollar” baked spaghetti. Layers of seasoned beef, melty cheese, and saucy pasta baked into a rich, crowd-pleasing comfort dish.

🛠️ Simplify: Your workflow with WriteUpp. From scheduling to notes and compliance, it keeps practices running smoothly. Start with a 30-day free trial and get 50% off your first year.

💰 Save: On Under Armour’s semi-annual event, with an extra 50% off outlet items.

📘 Learn: about common infant digestive issues — reflux, gas, and constipation — with a free course offering practical strategies for clinic use.

😂 Laugh: At this sketch of the doctor’s lounge at lunch, where emergency med runs on energy drinks and surgeons manage one bite before getting paged — perfect for a midweek break.

@medschoolbro

Doctor’s Lunch Room part 1 🏥🍴 #medstudent #medschool #medicalstudent #medicalschool #medhumor #doctor #doctorhumor #cardiology #surgery

Relax

First clue: ____-Ganz, used for right heart catheterization

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