Staying #Up2Date 🚨

1. Periop aspirin (ASA) 

In the ASSURE DES trial, 926 patients s/p drug-eluting stent (DES) placement >1 year prior were randomized to continue/switch to ASA periop vs. stop all antiplatelet agents 5d before low-to-intermediate risk elective, noncardiac surgeries. The primary outcome (composite of death, MI, stent thrombosis, stroke) did not differ between groups (0.6% for ASA group vs. 0.9%), though minor bleeding (but not major) was higher in the ASA group (14.9% vs. 10.1%). 

2. MRI-guided prostate biopsy (bx)

This Swedish trial had an MRI-targeted group, where patients with elevated PSA (3–10 ng/mL) underwent MRI, and only those with suspicious lesions received bx. In the systematic group, patients with elevated PSA also had an MRI, but all patients underwent standard systematic biopsies (10–12 cores), plus additional bx if MRI showed suspicious lesions. Only 4% of men in the MRI-targeted group underwent bx vs. 9% in the systematic group, with fewer prostate cancer diagnoses overall (2.8% vs. 4.5%), mostly due to fewer clinically insignificant cancers (1.0% vs. 2.4%).  Rates of potentially incurable cancers were also similar (23 vs. 15 cases), suggesting MRI can reduce unnecessary biopsies and overdiagnosis of prostate cancer.

3. False-negatives in mammography screening

This US observational study found that women with false positive mammography results were less likely to return for screening, especially Asian and Hispanic/Latinx women. The decrease in adherence was minor if women required additional imaging (2% less likely) but much larger if women required short-term follow-up (16% less likely) or biopsy (10% less likely). Multiple consecutive false positives further reduced adherence.

Pancake Bones?

How 3D-printers can change the way bones heal

What happened: The University Of Waterloo is developing 3D-printed bones that can improve outcomes for cancer patients. 

Why it’s interesting: Associate Professor Thomas Willet developed the idea while working with orthopedic surgeons at Mount Sinai Hospital, where he observed bone defects that couldn’t heal on their own. While simple fractures can heal naturally, bone cancer and trauma patients often require new bone grafts.

Willet developed a specialized material that can be 3D-printed to fit each patient’s unique needs. What sets it apart is the absence of cellular material, which reduces the risk of rejection. The synthetic bone has a texture similar to pancake batter and is made from biopolymers such as soybean oil and hydroxyapatite—an essential mineral found in natural bones.

Once placed in the body, the 3D-printed bone eventually dissolves as the body grows natural bone to replace it. Although the design is still in its early stages, researchers believe it could enhance quality of life and lower healthcare costs.

What’s next? Right now, researchers are printing small-scale bones and skulls to better understand the material. It’ll take years and substantial funding before this tech is ready for the public. In the meantime, the team is preparing for clinical trials and plans to continue development.

Bottom line: 3D-printed bones, made from innovative biopolymers, could revolutionize the way complex bone defects are treated for bone cancer and trauma patients. Still, it’ll be a few years before the technology is ready for hospital use.

Condom Conundrum

Why doctors are asking young people to brush up on their sex ed

What happened: As condom use amongst young people decreases, some doctors are trying to help folks learn about the importance of safe sex.

Why it’s interesting: In a study published last year it found that fewer young people are having sex, but the teens and young adults who are sexually active aren’t using condoms regularly… if at all. This caused young people aged 15 to 24 to make up half of the chlamydia, gonorrhea, and syphilis cases in 2022.

The decrease in condom use can be linked to long-term birth control options, STI prevention drugs, sex education in high schools, and the destigmatization of HIV. One medical director said that old condom ads were meant to scare people, but with changing perception of sex and birth control, sex ed has shifted the focus to what works for people instead.

But: Some doctors said that just because society has progressed past its taboo stance on sex, doesn’t mean people should stop using condoms. The CDC stated that condoms are still an effective tool that can be used along with new prevention strategies.

Some doctors said that telling people to use condoms isn’t enough and that there should be comprehensive sexual education in all high schools. This includes consent, intimate relationships, gender identity, and sexual orientation. But in states like Mississippi where things like condom demonstrations are banned, it can be difficult to educate students. There is also currently no set standard for sex education in the US nationally.

Bottom line: While using prophylactics such as long-term birth control can be a beneficial in preventing pregnancy, doctors still strongly suggest young people also use condoms for extra protection against STIs.

Hot Off The Press

1: 🏥 A Minnesota woman made history as the first Stage 4 colorectal cancer patient in the US to receive a double lung transplant. On her 42nd birthday, she celebrated being officially cancer-free. After fighting the disease since 2017 and running out of treatment options, she turned to Northwestern Medicine’s DREAM program as a last hope. Now, doctors believe this breakthrough could open new doors for using lung transplants to treat advanced cancers that have spread.

2: 💔 The tragic death of Alice Webb—the first known UK fatality from a liquid Brazilian butt lift (BBL)—has people calling for stricter regulations. Experts say both surgical and non-surgical BBLs come with serious risks, such as embolisms and unlicensed practitioners doing dangerous procedures. The bottom line? BBLs shouldn’t be banned, but they should definitely be done only by qualified pros under tighter rules.

3: 💊 Pharma is targeting Gen Z with a new male birth control pill. With abortion restrictions tightening, researchers are looking into new, non-hormonal options that could help make shared responsibility the norm. California-based YourChoice Therapeutics just kicked off a human trial for a once-a-day pill that blocks sperm production — but it could be a while before it gets full FDA approval.

✝️ 4: The state of California is suing a Catholic hospital after it was reported that they denied an emergency abortion. The patient was 15 weeks pregnant with twins when her water prematurely broke and she needed an abortion to avoid-life threatening complications. After being denied the woman was rushed to a hospital 12 miles away where she was given the care she needed.

Notable Numbers 🔢

5x: the number of whooping cough cases this year compared to 2023, bringing infections back to pre-pandemic levels. There have been over 15,600 cases in the US, and public health officials say it's mostly due to lower vaccination rates and fading immunity. Teens with dropping immunity are driving the outbreaks, and experts are looking into better vaccine options to tackle the resurgence.

100: the age Former President Jimmy Carter turned on Oct. 1st! He is the first US president to ever live to 100. Carter served in the White House from 1977 to 1981 and is best known for his humanitarian work that won him a Noble Peace Prize in 2002.

$4,000: the amount of money a Texas man paid for a signed Taylor Swift guitar, just for him so smash it moments later. The proceeds from the guitar went to a charity that provides agricultural based education for local youths.

Postcall Picks ✅

😭 Laugh: at anesthesia’s patients who always need a little (lot) more…

👀 Watch: this video explaining Alzheimer's and the challenges in its treatment. Then read the latest controversy surrounding the recently approved FDA breakthrough drug Donanemab.

🇺🇸 Debate: On Oct 1, CBS News hosted the first (and likely only) vice presidential debate ahead of the US election, between Tim Walz and JD Vance.

🤑 Save: On all pet essentials! New Chewy customers will receive a $20 gift card and free shipping with code WELCOME when they spend more than $50!

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