Staying #Up2Date 🚨

1. Is 7 days of abx enough for uncomplicated bacteremia?

The  BALANCE trial showed that 7 days of antibiotics is adequate for uncomplicated bacteremia. Exclusion criteria was: S. aureus bacteremia, neutropenia, severe immunocompromise, prosthetic heart valves or endovascular grafts, or other indications for prolonged therapy. Most infections were monomicrobial (gram-negative 70%; gram-positive 17%) and some were polymicrobial (12%). The 90-day mortality was 261 (14%) in the 7-day group and 286 (16%) in the 14-day group. 

2. Antidiabetics for asthma?

In this self-controlled case series and population-based cohort study of over 12K patients with asthma and diabetes, metformin was associated with 30% lower risk of asthma attacks. Adding GLP-1 receptor agonists resulted in further risk reduction. Associations were found regardless of glycemic control, weight, or asthma phenotype.

3. Urea in syndrome of inappropriate antidiuretic hormone secretion (SIADH)?

This meta-analysis suggests that urea treatment (7.5-90g qdaily) significantly raised serum sodium (mean difference, 9 mEq/L) that was significant at 24h, 2, 5, 7, 14 days, and 1 year. Urea treatment was as effective as fluid restriction or vaptans, superior to placebo, safe, and tolerable.

Seeing Red

The FDA faces pressure on whether or not to ban red dye in food

What happened: The Food and Drug Administration is considering banning Red No. 3 food dye.

Why it’s interesting: Since 2022 the agency has been reviewing a petition to ban the colorant. The dye, which is petroleum-based has been around for over 50 years and can be found in foods like candy and soda.

Last year California passed a law to ban red food dye, which will go into effect in 2027. Since then lawmakers in ten other states have introduced legislation to ban Red No. 3 in foods, which has caused more pressure on the FDA to make a decision.

Evidence has shown that red dye can negatively affect children’s behavior and that there isn’t any reason to add synthetic dyes to food other than for aesthetic purposes. Currently, Red No. 3 is banned in several countries including Australia and Japan.

But: This isn’t the first time questions regarding the possible health effects of red dye have been brought up. The FDA banned the use of Red No. 3 dye in cosmetics and medicated ointments and lotions back in 1990 as research showed the dye could cause cancer in animals in high doses. However the agency reported it was safe in the amounts that were used in food. The FDA has claimed that they have checked the safety of the dye multiple times since they first approved it in 1969.

Bottom line: Postcall will continue to look for updates on whether or not the FDA will make Americans food less colorful.

Hot Off The Press

1: 🩺 How does a London-trained ophthalmologist (who had a knack for reassuring anxious patients) become the architect of a war that’s killed over 400,000 people? Once known for his calm, reassuring presence with patients, Assad now oversees the systematic bombing of civilians, the destruction of over 400 hospitals, and the deaths of nearly 800 medical workers—an unprecedented weaponization of healthcare. His transformation has horrified the global medical community, but calls for solidarity through humanitarian efforts. Their doctor-president may have betrayed his fellow Syrians, but the world hasn’t.

2: 🤢 Formaldehyde — a chemical found in everything from furniture to paper towels — causes more cancer than any other air pollutant, yet regulatory efforts keep facing pushback from the powerful chemical industry. ProPublica’s investigation reveals that the risks are far higher than government estimates suggest, both inside and outside.

3: 🩷 According to a recent study, mobile mammography (MM) is bridging the gap in breast cancer screening for underserved Medicare beneficiaries, especially those in rural and low-income areas. While only 0.4% of women in the study used MM, it was linked to increased mammogram adherence, particularly among American Indian and Alaska Native women. MM isn't a replacement for facility-based screenings, but it offers a crucial supplement for those facing barriers to traditional care.

4: 💊 Luigi Mangione, accused of shooting UnitedHealth Group exec Brian Thompson, has hired top NYC prosecutor Karen Friedman Agnifilo to defend him. The ex-Manhattan DA's right hand is exploring a potential insanity defense, with overwhelming evidence stacking against Mangione, including a manifesto and ghost gun. Meanwhile, the FBI’s manhunt tipped off by multiple sources led to his arrest in Pennsylvania after a 5-day search.

Notable Numbers 🔢

412,164: the number of patients who waited for NHS heart care in October 2024, as delays continue to rise, leaving thousands at risk of premature death. A national investigation has been launched into the cardiology crisis, with many patients suffering harm as they wait for critical surgeries like heart valve replacements. Experts warn that worsening ambulance delays and overcrowded hospitals are exacerbating the problem, leading to a surge in preventable heart failures and deaths.

50%: Feeling stuck in traffic and life? A recent US survey found that using a car for more than 50% of out-of-home trips is linked to lower life satisfaction. So switching to transit, walking, or cycling could lead to more happiness.

Postcall Picks ✅

📚️ Read: about how, for the first time in more than a decade, obesity rates among US adults fell slightly last year. The graph above might have something to do with it.

👂️ Listen: to the newest episode of The Doctor’s Art episode! This week the host talks about how clinicians can cope with grief and guilt from their work.

💰️ Save: up to 50% on dining furniture and more at Ikea!

😆 Laugh: at an inappropriate ER visit. (PCP is Americano for family doctor.)

First Question: What is the tract responsible for voluntary movement on the contralateral side?

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