Staying #Up2Date 🚨

1. Mortality/hospitalizations from EtOH use in Canada 

In this retrospective cohort study from April 2020 to December 2022, mortality and hospitalizations fully attributable to EtOH in Canada increased by 17.6% and 8.1%, respectively. Mortality rose by 55.4% in 25–44 y.o., 19.1% in 45–64 y.o., and 2.6% in 65+. Deaths rose by 11.7% in the highest income quintile, compared to 17.0%–21.5% in lower quintiles. Mortality increased most in the prairies (28.1%) and BC (24.2%) and hospitalizations increased most in the territories (27.3%) and prairies (14.6%). 

2. 8Termination of resuscitation (TOR) rules

This multicenter prognostic study developed and validated five TOR rules for in-hospital cardiac arrest using registries from Denmark, Sweden, and Norway (n=23,952). The best-performing rule included four variables: unwitnessed arrest, unmonitored status, asystole as initial rhythm, and resuscitation duration ≥10 minutes. This rule had a false-positive rate of 0.6% (incorrectly predicting death in patients who survived) and a positive rate of 11% (proportion of arrests where termination was proposed).

3. GLP-1 receptor agonists (GLP-1 RAs): start & stop trends

In this cohort study of 125K adults with overweight/obesity initiated on GLP-1 RAs from 2018-2023, one-year discontinuation rates were 64.8% in patients without type 2 diabetes (T2D) vs. 46.5% in those with T2D. Higher weight loss and income were linked to lower discontinuation rates. Among 41,792 patients with available data post-discontinuation, one-year reinitiation rates were 36.3% for those without T2D and 47.3% for those with T2D, with weight regain significantly associated with reinitiation. 

What Doctors Should Know About Trump's Trade War 💸

How it took the US President a little over a week to start a trade war 

What happened: US President Donald Trump slapped a 25% tariff on imports from Canada, set to begin in 30 days.

What does this mean for doctors? Medical equipment has been off limits from tariff hikes for 7 years, thanks to a free trade agreement between the US, Canada, and Mexico. Trump has agreed to delay the tariffs in both countries for a month, but if a deal isn’t reached, food and drinks aren’t the only costs rising; MRI machines, ventilators, and wheelchairs will, too. 

Medtech Canada, which represents 120 medtech companies, has been advocating for patients and the industry since the threats began. They’ve been working with the Canadian government and investors to ensure clinics and patients maintain access to medical supplies. 

The tariff threats started when Trump blamed Canada for the fentanyl overdose crisis. But a quick Google search found that only 0.2% of fentanyl in the US comes from the north. Prime Minister Justin Trudeau has since appointed a “fentanyl czar” to oversee the border 24/7 in hopes of confronting the issue.

Here’s what some doctors on Reddit had to say in response to tariffs:

So, what now? Before the delay was announced, Trudeau planned to impose 25% tariffs on $155B of US goods, but this has since been paused. The fight’s far from over, though, and we’ll keep a lookout for updates.

Hot Off The Press

1: 🇺🇸 "Special government employee” Elon Musk — tasked with shrinking the US government — is shutting down USAID, an independent agency that handles most of America’s foreign aid and represents less than 1% of the federal budget. The White House claims “lifesaving” aid won’t be affected, but USAID and other non-profits say it’s blocking the fight against the global HIV/AIDS epidemic.

2: 🧠 Researchers have found and quantified microplastics in post-mortem human brain tissue, including PET, polycarbonate, and polystyrene. The study showed that particles accumulate in the frontal cortex, cerebellum, and hippocampus — areas critical to cognitive function — and that individuals with dementia had higher levels.

3: 📄 BC family doctors continue to protest employer-mandated sick notes, calling them a waste of time and healthcare dollars — the equivalent of about 6 million patient visits a year, according to the CMA. The BC government promised changes are in the works, as doctors continue to juggle bureaucracy instead of patient care.

4: 🔬 New research out of University College London reveals that adults with ADHD may face significantly shorter life expectancies — up to 9 years less for men and 11 years for women — compared to the general population. The reason? Underdiagnosis and lack of proper support — highlighting the importance of care and intervention.

Notable Numbers 🔢

18%: the increase in deaths fully attributable to alcohol between April 2020 and December 2022, according to a new CMAJ study. There was also an increase in alcohol consumption and alcohol-related hospitalizations during the first 2 years of the pandemic.

25: how many years it’s been since the FDA approved a new pain reliever. US feds just signed off on Vertex Pharmaceuticals’ Journavx for short-term pain, which promises to eliminate opiate-associated risks of addiction and overdose. They’re priced at $15.50 USD per pill — over 15x more than comparable opioid generics.

30x: the increased likelihood of women getting UTIs versus men, which translates to hundreds of millions annually. Some women suffer antibiotic-resistant infections for years — and there’s been a shocking lack of research on prevention.

Postcall Picks

📘 Read: Tim Ferriss, author of The 4-Hour Workweek and Tools of Titans, recently teased his upcoming book — a guide to protecting priorities by saying "No" to everything else.

🤖 Try: Deepseek, the Chinese AI app making all the headlines (and your investments go down, probably).

🍽️ Dine: at Quebec’s new ice restaurant Hôtel De Glace! Customers can choose to dine in for the evening or spend a night for the full experience. Does it get more Canadian than this?

🤑 Save: as the weather gets colder Patagonia’s got you covered (literally) with their 50% off sale! Winter’s got nothing on you.

📔 Read: the Wealthy Barber for free, courtesy of RBC (no email/signup required).

Relax

First Question: What’s bluish due to hypoxia?

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