Staying #Up2Date 🚨

1: MS May Start Earlier — Increased Health Care Use Up to 15 Years Pre‑Diagnosis

A matched cohort study tracked health care use over 25 years in 2,038 Canadian patients who were later diagnosed with MS. Compared to the general population, their health care use began rising 14 to 15 years before symptom onset — particularly for mental health concerns and vague or ill-defined symptoms. These early visits may mark the beginning of the prodromal period — appearing up to 11 years before neurology consultations. These findings suggest MS may begin much earlier than previously thought.

2: A Mini But Mighty Copper IUD Shows Promise 

A recent RCT evaluated the efficacy and safety of a new mini copper IUD in participants aged 16 to 40. After 37 months, the cumulative pregnancy rate was 4.8% (95% CI, 2.8 to 6.9%). The mini IUD also had fewer side effects — such as bleeding and pelvic pain — compared to its full-sized counterpart. This smaller device may help lower early discontinuation rates and improve satisfaction among IUD users.

3: Pain Relief With a Price: Pregabalin and Heart Failure

A cohort study explored whether pregabalin — a common nonopioid used for chronic pain — is associated with a higher incidence of heart failure compared to gabapentin. Among more than 245,000 patients aged 65 to 89, the rate of heart failure was higher for pregabalin (AHR 1.48; 95% CI, 1.19–1.77), possibly due to its greater potency in binding to L-type calcium channels. These findings should be considered when managing chronic pain in patients with cardiovascular risk. 

Canadian patients, American rules 🇨🇦🇺🇸

Who really owns your health data?

What happened: Millions of Canadians' electronic health records may be vulnerable to US surveillance and corporate use — all because they’re stored on cloud servers owned by American companies, according to new commentary in the Canadian Medical Association Journal (CMAJ). 

Why it matters: Many Canadian clinics and hospitals use US-based cloud providers like Google, Amazon, and Microsoft to store patient data, even if those servers are physically located in Canada. But because the companies are American, they’re subject to US laws, including the 2018 CLOUD Act, meaning they can be legally forced to hand over that data. In other words, Canadian privacy laws don’t necessarily apply. And that’s a problem.

Michael Geist, a University of Ottawa law professor and co-author of the CMAJ piece, says Canada’s privacy framework is decades out of date. That gap means your encrypted health records — from diagnoses to prescriptions to lab results — could be accessed by foreign governments or used for commercial gain without your knowledge.

So what’s at stake? Your data could be used in US surveillance for criminal and terrorist activity, sold to insurers or tech companies, or used to train AI — with none of the benefits coming back to you.

Some experts say it’s time to ditch foreign cloud services entirely when it comes to health data. “We just need to have this information stored in Canada,” health law professor Lorian Hardcastle said in an interview with the CBC. “And not have those dealings with American companies.”

But: US tech giants say they follow the rules and take privacy seriously. Microsoft says they only disclose data when legally required. Amazon says they’ve never handed over any Canadian government or enterprise health data. Google insists customer data “belongs to the customer” — not to Google.

Still, experts argue that any company bound by US law can’t truly shield Canadian data. And Canada’s own laws don’t offer enough clarity or muscle to push back.

Bottom line: Health data is personal, powerful, and increasingly profitable. As AI continues to reshape medicine, who controls that data — and who benefits from it — matters more than ever. For now, the safest bet may be to keep Canadian health records on Canadian soil.

Hot Off The Press

1: 🌍 President Trump just slapped India with one of the highest tariffs in the world — hiking it to 50% over its continued purchases of Russian oil. India, which called the action “unfair, unjustified and unreasonable,” is now threatening retaliation. Among the top U.S. imports from India? Metals, machinery, chemicals and smartphones, many of which are now assembled in India, including iPhones.

2: 🔥 Israel’s war on Gaza is escalating. Netanyahu is now pushing for full reoccupation — a move criticized by military leaders and hundreds of ex-security officials. On the ground, the crisis deepens: only 85 aid trucks are entering daily for over 2 million people. Canada responded with a 10,000-kg airdrop, but famine and violence persist. UNICEF says 28 children are dying every day, as Gaza’s health and aid systems near collapse, and no ceasefire is in sight.

3: 😷 Respiratory viruses may do more than cause inflammation — they might reawaken dormant metastatic cells. In mice, SARS-CoV-2 and influenza triggered reactivation of HER2+ breast cancer cells in the lungs, leading to metastases. Observational data from the UK Biobank and Flatiron Health suggest this mechanism could be at play in humans, too.

🦟: The CDC has issued a travel warning for southeast China, where a chikungunya outbreak is spreading in Guangdong province. The mosquito-borne virus can cause fever, rash, and joint pain that can linger for months — though most cases are mild. No treatment is available, but 2 vaccines exist. If you're travelling, the usual advice applies: cover up, spray on, and stay alert.

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Postcall Picks ✅

🎧 Listen: to this 22-minute story about cannabis-induced psychosis on White Coat, Black Art.

📺 Watch: your own AI-generated TV show? Showrunner lets you create entire animated episodes — starring you — with just a prompt and a selfie. The catch? It’s in open alpha, but there’s a waitlist to join.

😄 Laugh: at the tale as old as time:

🍽️ Eat: Strawberry-rhubarb crisp — a warm, comforting dessert with a crisp oat topping and juicy fruit filling. Ideal for late summer dinners or a sweet weekend treat.

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