Staying #Up2Date 🚨

1. Stones with SGLT-2 inhibitors 

In this Canadian observational study, researchers identified 20K adults with diabetes and previous nephrolithiasis, 22% of whom also had gout. Patients who initiated SGLT-2 inhibitors had a significantly lower rate of recurrent nephrolithiasis vs. those who initiated GLP-1 agonists (156 vs. 103 per 1000 person-years; NNT of 20). Patients with gout who started SGLT-2 inhibitors developed significantly fewer urinary stones and had fewer gout flares than those who started GLP-1 agonists.

2. Secondary hypertension (2HTN) stats 

In this cross-sectional study of 2000 young adults (18–40) with confirmed hypertension, 30% of patients were found to have 2HTN - more common in age 30-40 (compared to 18-30), women, BMI ≤25 kg/m2, and in those with diabetes. Over half of those with 2HTN had primary aldosteronism and 20% had renovascular hypertension.

3. Solo short-acting β-agonists (SABA)

In this systematic review of 50K patients, ICS/formoterol lowered relative risk for severe asthma exacerbations by 35%, and ICS/SABA lowered relative risk by 16%, compared with SABA alone i.e., albuterol, salbutamol, or terbutaline in those at highest risk. ICS/formoterol was associated with fewer exacerbations than ICS/SABA among high-risk patients (RR, 0.78). This study further supports the GINA 2022 guidelines, which recommend against SABA monotherapy.

Newest Stroke Update

How new guidelines can help both doctors and patients prevent the high number of strokes each year

What happened: The American Stroke Association have released new guidelines for the first time in 10 years, aimed at preventing a majority of strokes.

Why it’s interesting: According to the CDC, stroke was the fourth leading cause of death in the US in 2023. But research has shown that 80% of strokes could be preventable with proper exercise and nutrition. Staying away from highly processed foods and drinks, and getting 75-150 minutes of exercise a week can help reduce the risk of stroke. Diet and exercise can help control weight and keep cholesterol levels down.

But: There are new guidelines that don’t include eating healthy or getting active that people should know about.

For the first time the association is recommending doctors screen patients for other factors that could lead to a stroke like sex, gender, economic stability, access to health care, discrimination and racism. Scanning patients for these factors can help save their lives as doctors can point them to resources for low-cost health care or food, as well as ideas on how to get more exercise without a gym membership.

They are also asking doctors to screen woman for things like high blood pressure during pregnancy and early menopause as these conditions can increase the risk o a stroke.

The guidelines even recommend doctors prescribe their patients drugs like Ozempic, Wegovy, Mounjaro, and Zepbound to help manage obesity and diabetes.

Bottom line: These new guidelines are a great way to inform the public on the different ways they can limit the risk of stroke and live healthier lives.

Hot Off The Press

1: 💉 A UK doctor has been sentenced to 31 years for attempting to kill his mother’s boyfriend with a fake COVID-19 vaccine poisoned with pesticides, all due to an inheritance dispute. Dr. Thomas Kwan, disguised as a nurse, injected Patrick O’Hara with a deadly toxin in an elaborate scheme to secure his mother’s home. O’Hara survived after a harrowing hospital stay — and a search of Kwan’s home revealed an arsenal of toxins and weapon-making materials.

2: 🍻 A new study from Sweden has found that Ozempic and Wegovy may help people cut back on drinking. Researchers looked at 228,000 people who were diagnosed with alcohol use disorder from 2006-2023 and who also had obesity or Type 2 diabetes. They found that the participants who weren’t taking the GLP-1 drug were more likely to be hospitalized. There have been multiple theories as to what the connection is between the two including how GLP-1 drugs make sugary alcoholic drinks seem less appealing.

3: ⚖️ A Nebraska health care worker was sentenced to two years in prison after he illegally accessed the health records of Supreme Court Justice Ruth Bader Ginsburg before she died in 2020. According the prosecutors, the man disclosed the health records on forums that had antisemitic conspiracy theories, including that Ginsburg had already died. The man refused to accept responsibility for his actions and declined to comment on the trial.

4: 🧬 Genetic testing company 23andMe cut 40% of its workforce due to financial struggles. The company is still dealing with the aftermath of their massive data breach with many users filing class action lawsuits against them. The company is expecting to save more than $35 million due to the cuts.

Notable Numbers 🔢

400 million: the number of people infected annually by Aedes aegypti mosquitoes, which scientists aim to reduce by making male mosquitoes deaf, stopping them from mating. Researchers at the University of California, Santa Barbara, targeted a hearing-related gene in males, preventing them from finding females mid-air, which could curb mosquito populations and limit disease spread.

17: the number of pathogens identified by the WHO as top priorities for new vaccines to tackle major public health threats. This list — which includes well-known diseases like HIV and tuberculosis, as well as antibiotic-resistant threats like Group A streptococcus and Klebsiella pneumoniae — is part of WHO’s push to guide vaccine R&D toward pathogens causing significant disease burden (especially in vulnerable communities worldwide).

1,200: the number of whooping cough cases in the state of Washington. This is a huge compared to 51 cases that were reported at this time last year. Some doctors say the rise in cases can be linked to the decrease in vaccination rates in young children. Symptoms of the disease can last up to 12 weeks.

966%: increase in sales of emergency contraception after future President Donald Trump was elected. Although anti-abortion advocates are asking Trump to restrict abortion pills,Trump posted on social media that he currently has no plan to restrict birth control and other kinds of contraceptives.

Postcall Picks ✅

😭Laugh: at the reality that real-life medicine is nothing like the MCCQ.

🎧 Listen: to why advocating for a centralized referral system in Ontario is a realistic option to help address anxiety and wait time uncertainty.

📚 Read: The House of God, an unfiltered look at the realities of medical training, which follows 5 interns through their gruelling hours and life-altering lessons.

🤑Save: up to 30% off on artificial Christmas trees at Wayfair! With Halloween 2 weeks behind us, it's the perfect time to put up the tree.

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