Staying #Up2Date 🚨

1. Direct oral anticoagulant (DOAC) in afib and stroke

In this RCT with 3621 patients with afib and ischemic stroke, DOAC initiation was either early (mean of 3.1 days) vs. delayed (mean of 8.3 days). The primary outcome (recurrent ischemic stroke, symptomatic brain hemorrhage, unclassified stroke, and systemic embolism within 90 days) was identical in the two groups (3.3%). Symptomatic intracranial hemorrhage and overall major bleeding were also comparable. 

2. COPD exacerbations (COPDe) from RSV

In this prospective cohort study of over 300 individuals with COPD, 8.7% of community COPDe were caused by RSV. Other infectious causes of COPDe included rhinovirus, influenza, and bacteria. The RSV-related COPDe were significantly shorter in duration but were no different in symptom severity. There are currently three RSV vaccines available in the U.S. 

3. Simultaneous vs. sequential shots 

In this trial, 335 patients were randomized to receive simultaneous COVID-19 + influenza vaccines followed by a placebo injection in 1-2 weeks vs. COVID-19 vaccine + placebo followed by influenza vaccine in 1-2 weeks. At 7 days after the first administration,  ≈28% in each group reported adverse reactions and responses from the two groups at 7 days after the second administration were similar (3%–5%). Health-related quality-of-life measures were similar in both groups, and no serious adverse events likely attributable to vaccine administration occurred in either group during the subsequent 4 months.

Racism Kills

Black babies die at twice the rate of white babies—even as overall infant mortality rates stay the same.

What happened: The CDC released a new report that highlights stark racial disparities in infant mortality rates.

Show me in numbers: In 2023, the US saw 5.61 infant deaths per 1,000 live births on average. But for Black infants, that number shot up to 10.9 per 1,000 – nearly double the rate for white infants and much higher than for babies born to mothers of Asian descent. 

But why? One pediatric physician (not involved in the report) pointed to preterm births, which are more common among Black mothers and closely tied to infant mortality. Why more preemies? Barriers like structural racism and cost often prevent Black mothers from getting the prenatal care they need.

Environmental racism and economic instability also play a role. A Washington survey found that over 53% of Black Americans expressed concern about air pollution where they live. Poorer neighbourhoods with higher pollution levels tend to have fewer options for high-quality healthcare, compounding the problem.

Ohio has one of the country’s worst infant mortality rates. To address this, programs like Cradle Cincinnati work directly with Black mothers, gathering their insights to create targeted solutions. Thanks to their efforts, the state’s Black infant mortality rate dropped to 0.9% – the lowest since 1968. 

Bottom line: Progress is possible, but there’s still a long way to go. Efforts that centre Black parents’ voices, expand access to quality care, and address structural barriers are essential to close this tragic gap.

Hot Off The Press

1: 🇺🇸 Donald Trump has tapped TV personality and surgeon Dr. Mehmet Oz to head the Centers for Medicare and Medicaid Services, where he’ll oversee healthcare for over 140 million Americans. Teaming up with Robert F. Kennedy Jr., Oz aims to tackle "the illness industrial complex" and reform the system without slashing Medicare — a move that’s raising both eyebrows and stock prices. Because nothing says “healthcare reform” like a celebrity endorsement!

2: 💊 A new study suggests that weight loss drugs like Ozempic and Wegovy might help cut down alcohol abuse, with users of GLP-1 drugs showing a lower risk of being hospitalized for alcohol addiction. Promising results, but experts warn that more research is needed before these meds can be considered a reliable treatment for alcohol use disorder.

3: 🎗️ Virologist Beata Halassy successfully treated her own breast cancer using lab-grown viruses in an unapproved form of oncolytic virotherapy (OVT), shrinking her tumour without serious side effects. Her case has sparked interest in this emerging treatment, but experts caution against self-experimentation, citing the ethical concerns and lack of clinical evidence for widespread use.

4:🦠 Health officials have confirmed the first U.S case of a new form of mpox that was first seen in eastern Congo. The patient had traveled to eastern Africa but was treated in Northern California. The patients symptoms are improving and as of right now the risk to the public is low.

5: 🥕 First McDonald’s now carrots! 39 people were infected with e-coli after eating organic whole and baby carrots sold by Grimmway Farms, according to the CDC. The carrots have been taken off the shelves and so far one person has died as a result.

Notable Numbers 🔢

1966: is when the AMA started maintaining billing codes for Medicare. Now, RFK Jr. (who’ll run HHS) is reportedly holding “discussions with advisers about how to remove the American Medical Association from its role in drawing up Medicare’s billing codes, which set doctors’ fees for more than 10,000 procedures”.

14-30: the number of days foodborne pathogens like E. coli and Listeria can survive in treated wastewater when they attach to microplastics, forming protective biofilms. A recent study from Norway reveals that these harmful microbes can persist for weeks, posing a potential health risk when treated water is reused for drinking or irrigation.

110,000: the number of annual deaths from opioid overdoses, a crisis exacerbated by the resistance of many addiction recovery programs to lifesaving medications like buprenorphine. Despite mounting evidence of its effectiveness, many recovery groups, including Narcotics Anonymous, continue to reject medication-assisted treatment, leaving patients with a stark choice between medical care and supportive community resources.

84%: of Atlantic hurricanes between 2019 and 2023 were on average, 1ph stronger because of climate change. This caused 30 hurricanes to reach an entire category higher in strength compared to what it would’ve been without the change in environment.

Postcall Picks ✅

🎧️ Listen: to Dr. Yatin Chadha interview a family physician who took a bold leap into developing retirement residences for seniors.

🤑 Save: with Black Friday right around the corner start shopping now on items like the Garmin Venu Sq 2 GPS Smartwatch on Amazon!

📺 Watch: this TikTok video of healthcare workers choosing between different medical related scenarios! Do you agree with their picks?

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