Staying #Up2Date 🚨

1. Semaglutide vs. Tirzepatide for weight loss  🏋️

This cohort study is the first to perform a head-to-head comparison of tirzepatide vs. semaglutide for weight-loss in individuals with increased BMI or obesity. In a 40K propensity score-matched population, patients receiving tirzepatide were significantly more likely to achieve weight loss. For achieving ≥5% weight loss, the hazard ratio (HR) was 1.76, with a 95% confidence interval (CI), 1.68, 1.84. For ≥10% weight loss: HR, 2.54; 95% CI, 2.37, 2.73; and ≥15% weight loss: HR, 3.24; 95% CI, 2.91, 3.61. The GI adverse events were similar between groups.

2. Anticoagulation in cirrhosis and afib 🩸

There’s not much guidance on anticoagulation in patients with cirrhosis and afib. In this retrospective cohort study ,1:1 propensity score-matched patients with cirrhosis and nonvalvular atrial fibrillation received apixaban vs. rivaroxaban vs. warfarin. Patients on apixaban were less likely to have major bleeding than patients who received rivaroxaban (5.1% vs. 8.7% annually) or warfarin (5.1% vs. 7.9% annually). There were no differences between groups in ischemic embolic events such as stroke or all-cause mortality. 

3. M & M (multivitamins and mortality) 💊

In this study, researchers pulled data from observational cohort studies comprising almost 400,000 patients who were taking multivitamins. Taking multivitamins was not associated with lower all-cause mortality risk in the first (multivariable-adjusted HR, 1.04; 95% CI, 1.02-1.07) or second (multivariable-adjusted HR, 1.04; 95% CI, 0.99-1.08) halves of follow-up.

Around the Clock Care

Is subscription-based care of the future of medicine?

What happened: Some doctors are turning to concierge medicine to help treat patients.

What is concierge medicine? Patients have the opportunity to pay a membership fee to gain access to a doctor’s practice. The average price for concierge services ranges anywhere from $2-20K a year. Some of the perks include: 

• Running multiple tests (labs, EKG, imaging)

• Extended visits with primary care physicians

• No wait times with appointments 

• Quick refills on prescriptions

• Unlimited text/telemedicine follow ups

One doctor, said she became overwhelmed with patients who came to her with complex health issues because she knew her patient load didn’t allow her enough time to help them. So in 2023 she decided to open up her own concierge clinic where she’s able to treat a wide range of patients. She believes that concierge medicine allows her to be the doctor she always wanted to be.

But: People have criticized concierge medicine for not being accessible to everyone due to the cost. Others say it’s immoral to charge patients money for primary care, as they believe it's a basic right. And south of the border, patients might still need to visit and pay for the hospital or emergency room.

Concierge medicine may make the delivery of care more convenient for patients but some physicians believe the practice is nothing more than a cash grab:

Curious about it? Here’s how you could get involved:

1. Join an existing concierge medical practice. Having a support staff to help make the transition is important, as they can give advice on how to retain as many patients as possible from your previous practice. 

2. Convert your current practice. Although this might seem straightforward, there are a few steps you must take, including recruiting and training a team of staff, determining your ideal panel size, and communicating with your existing patients about the switch.

3. Merge your practice with an existing concierge practice. While this might be the most complicated option as the process is much longer, it can be beneficial for doctors who don’t want to run a business anymore but instead focus on their patients. 

Hot Off The Press

1: 🇺🇸 Donald Trump — now the official Republican nominee for president — is “fine” but injured after an apparent assassination attempt at a rally last Saturday. Republicans are looking to capitalize on the attack (“We will not tolerate this attack from the left,” said Rep. Mike Kelly), though there is still little evidence about the shooter’s motivations. Oh, and Trump announced Senator JD Vance as his VP running mate.

2: 💜 Researchers may have found a root cause behind lupus, a disease that affects more than 200,000 people in the US. A new study in Nature discovered an imbalance of types of T cells — that lupus hinders the production of T cells that heal wounds on the barrier of the skin, lungs, and gut, but stimulates the production of T cells that create autoantibodies.

3:🦟 There’s a new tick in town that can cause people who are infected to contract a meat allergy. It’s being nicknamed the ‘Lone star tick,’ and is generally found in the Southern-eastern US, but with climate change on the rise and the growing deer population, Northern states are also being affected.

4:🏛 Three years after actor Alec Baldwin was charged with involuntary manslaughter for accidentally killing a cinematographer on set, a California judge has dismissed the case. If convicted Baldwin could have served up to 18 months in prison.

5:🏫 A Southern California school district is suing Democratic Governor Gavin Newsom over a new law that bans districts from requiring parents to be notified if their child changes their gender identification while at school. Enraged parents argue that the law violates their rights under the US Constitution.

Notable Numbers 🔢

2-1: the final score when Spain defeated England and won their 4th European Championship last Sunday in Berlin. It was a great day for Spain, since on Sunday, Carlos Alcaraz won his second Wimbledon title.

200: the number of reported cases of dengue virus in New York and New Jersey. Dengue virus is spread through mosquito bites and the infection usually lasts between 2-7 days. The CDC is asking residents to wear bug spray and watch for symptoms if they are bitten.

2: the number of times you should be going number two each day according to a study by Cell Reports Medicine. Researchers took blood and stool samples from volunteers to look at the genetic sequence of each person’s gut microbiome to determine the magic number.

Laugh of the day

@megthesurgtech

😬😬😬 #megthesurgtech #medicaltiktok #surgicaltechnologist #surgery #nurse #doctor #healthcare #fypシ #viral #operatingroom #Meme #medicalhum... See more

Remember, diamonds are made under pressure!

Postcall Picks ✅

😂Laugh: This should replace the century-old Hospital emergency codes modules they force us everyone to do yearly. 

🧠Learn: Tune in to Sawbones episode on the medicinal history of chocolate and learn whether it should be added to your go-to-prescription list. 

🪞Reflect: An important story that reminds us to always imagine the person behind the disease and all of the reasons that got them to where they are – it's rarely as simple as it may appear. 

🤑Save: Thinking about taking a vacation? Earn $15.00 when you book your flight with OneTravel through Rakuten! (There’s also a 10% welcome bonus when you join!)

In fact, there’s great deals everywhere this week since there’s Prime Days on Amazon.

Relax

First Question: What is the life threatening hypersensitivity reaction that prompts you to use Clue #7 Across?

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