A new mRNA cancer vaccine successfully attacked glioblastoma in its first-ever human trial. Published in Cell on May 1, the personalized vaccine triggers a fierce immune response to fight the aggressive, most-lethal type of brain tumour. As a tech, mRNA is looking more like a mIRACLE.

 ☕️Postcall’s one-sip markets update:

Stocks are again at an all time high, as 96% of companies reporting earnings have beat expectations. Those earnings helped the Dow to its longest winning streak of the year. One stock did the opposite though - Disney fell nearly 10% after it spooked investors with weak forecasts, even though it turned its first streaming profit. And if you invest in crypto: yesterday we finally heard that FTX creditors are set to receive 118% of their funds back.

Ready for this week’s stories? (8 min read)

1. Pregnancy weight gain outcomes

2. Vaping may soon have a cessation toolkit

3. Apple Watch can now be used for Afib studies

4. Should we be doing full body MRIs?

5. Alzheimer’s genes revealed

6. How $40K/year might help you live longer

Staying #Up2Date 🚨

1. Vaping cessation 

Vaping may soon have a cessation toolkit of its own. A double-blind, placebo-controlled RCT compared 12 weeks of treatment with cytisinicline vs. placebo for vaping cessation. Continuous e-cigarette abstinence in cytisinicline and placebo groups occurred in 31.8% vs 15.1% of participants (odds ratio, 2.64; 95% CI, 1.06-7.10; P = .04) at end of treatment (weeks 9-12). 

2. Antipsychotics in dementia

An observational study of 25K individuals with dementia over a 10-year period found that compared with non-use, any antipsychotic use was associated with increased risks of adverse outcomes. Current use (90 days after a prescription) was associated with elevated risks of pneumonia, AKI, VTE, stroke, fracture, MI, and HF.

3. Pregnancy weight

A Swedish population-based cohort study with 16K singleton pregnancies examined the association between total pregnancy weight gain and a composite of neonatal and maternal outcomes. In a nutshell, weight gain <5 kg was not associated with risk for the composite outcome among women with BMIs of ≥30–39.9. These results support minimizing pregnancy weight gain so long as nutritional balance is maintained (particularly in women with class 3 obesity).

👨‍💻Heidi’s Tech Bites

1: ⌚️ The US FDA has qualified Apple Watch’s atrial fibrillation (AFib) history feature for use in medical device clinical trials, the agency said Wednesday. It’s the first-ever digital health tech to get this approval, and has already been credited with saving lives.

2: 🔉 GE HealthCare scored a $44M Gates Foundation grant to bring its AI-powered ultrasound guidance technology to low- and middle-income countries.

3: 🫣 Google’s updated ad policy now prohibits “promoting synthetic content that has been altered or generated to be sexually explicit or contain nudity” — a.k.a. deepfake porn, and sites/apps that teach people how to make it. According to The Verge, Google removed 1.8 billion ads for violating its rules on sexual content in 2023.

Want to use AI instead of just reading about it (or waiting for Google)? Try Heidi, the only free AI scribe.

MR Lies?

Full body MRIs have been gaining popularity after high profile celebs like Kim Kardashian and Cindy Crawford have begun endorsing them. But are they worth the price?

What happened? 

Private companies are now offering full-body MRIs to people who wish to take preventative measures regarding their health — but some doctors remain cautious, due to lack of long term data and the strain on public health systems.

Why it’s interesting: Although full-body MRIs aren’t covered under most health insurance policies, many people in the US and Canada are forking over around $2,000 to private companies like Prenuvo to help them “stay on top of their health.”

• One woman from Texas claimed the machine caught a cancerous nodule on her lung. Upon further inspection, doctors were able to remove the nodule, preventing the cancer from spreading. 

• Prenuvo is currently relying on 14 years of clinical practice and says they have 30 licensed radiologists on their team.

• The machine can take an image of the body in under an hour, and the scans can detect cancers as early as Stage 1, fatty liver disease, hemochromatosis, and multiple sclerosis.

• The cost of the full body MRI may be much lower overseas (could cost as low as a few hundred dollars)

But: Full-body MRIs add pressure to the healthcare system, as they sometimes produce false positives or “incidentalomas.” As a result, some have accused Prenuvo of taking away resources from the public health system, while adding to patient anxiety and unnecessary treatments. One doctor who received the scan said it found a one-centimetre lesion in his prostate, and it wasn’t clear if it was cancerous. The doctor said that although the lesion won’t hurt him, knowing it’s there has turned his identity from “being healthy to being a patient.” 

Bottom line: Full-body MRIs have a long way to go before they become the new norm in healthcare. So until then, Postcall will keep scanning the news for future updates. 

Speed Reads 🚤

1: A high dose of the steroid prednisone can reduce the rate of subsequent pregnancy in post-vasectomy reversals. Prescribed since the ‘70s for the purpose of preventing scarring and blockages, prednisone may “be detrimental to sperm function in some way,” according to this study.

2: Columbia cancelled its university-wide graduation ceremony, citing security concerns after the campus spent weeks as the epicenter of student protests against Israel’s actions in Gaza. It still plans to have smaller events for specific schools.

3: The judge overseeing Donald Trump’s hush money trial has once again found the former president in violation of a gag order. Seeing as it was the 10th time, the judge threatened jail time for future violations. Gag order violations are punishable by fines up to $1k, jail time up to 30 days, or both.

4: After nonprofit Stand.earth accused Lululemon of “greenwashing,” Canada’s Competition Bureau is investigating the BC-based athleisure company’s sustainability claims. Lululemon promised in 2020 to reduce greenhouse gas emissions. Rather, one type of gas emissions — indirect emissions — nearly doubled from 2020 to 2022.

5: Biden says he will stop sending bombs and artillery shells to Israel if it launches major invasion of Rafah. This comes shortly after Israel rejects cease-fire plan okayed by Hamas, saying it was “far from” meeting its demands. At the same time, Israel also sent negotiators to the mediators to continue working toward a cease-fire agreement.

6: Some cases of Alzheimer’s disease might be caused by having two copies of a genetic variant (APOE4) that has long been associated with the ailment, a new study showed.

Notable Numbers 🔢

$40K: The price of “Optimize by Equinox,” a high-end longevity program. The gym chain says includes everything from personal training and nutrition plans to sleep coaching and massage therapy. We say you can probably get most of the health benefits by just… working out at the gym.

2: The number of Boeing whistleblowers who have suddenly died. Joshua Dean, former quality auditor at a key Boeing supplier, had accused Boeing of ignoring defects of the 737 MAX. He claimed he’d been fired for raising those concerns. This comes less than two months after the death of another whistleblower, John Barnett.

1 in 6: how many cases of Alzheimer’s are inherited, according to a new study — by having two copies of a genetic variant that has long been associated with the ailment.

Postcall Picks ✅ 

🦧 Jungle Apothecary: For the first time ever, a wild orangutan was spotted treating his own wounds by activating medicinal properties of a plant. Learn more about our great ape relative’s remarkable healing journey here. 

🎮 Gaming: Hades, crowned the Game of the Year 2021, is now on sale at an all-time low for just $11.05! Grab your controller and game your stress away as you hack and slash your way through the underworld.

🍬 Treat: your patients. Despite major gains in the past two decades, Black women in the U.S. have the highest death rate and the shortest survival rates of any racial or ethnic group for most cancers. That’s why the American Cancer Society announced Tuesday the largest-ever study of cancer risk and outcomes for Black women. If you have patients that qualify, you can enrol them here.

📕 Read: The NY Times’ list of the best books published since 2000.

🕹️ Game ⛳️

First question: What do you call firm scar tissue in the dermis?

If you enjoyed our puzzle, please send it along to friends and coworkers!

Image Challenge 📸

(The % of folks who selected each answer will be revealed after you select an answer)

Source: Originally published on NEJM

🤘 PS. If you’re reading this, you know that our readers are America’s best and brightest physicians. Learn about partnering with Postcall if you’d like to reach them.