Good morning, crew. On this day (June 6th, 1944), our troops were led by U.S. General Dwight D. Eisenhower to land on the beaches of Normandy.

An Allied armada of ships, planes, and landing craft and some 156,000 troops began the invasion of northern France from England, kicking off the famous “D-Day” and ultimately turning the tide of World War II.

 ☕️Postcall’s one-sip money update:

• The US Fed is hinting at a potential rate hike, but stocks remain near all-time highs (due to strong corporate earnings).

• And a glitch on the New York Stock Exchange caused a few stocks like Berkshire Hathaway to fall as much 99.7% momentarily on Monday.

Ready for this week’s stories? (5 min read)

1. Beta blockers in COPD

2. Ozempic and fertility

3. Insurers are buying up houses?

4. FDA says no to the party

5. Gene-editing kidney didn’t work out

6. Postcall’s crossword and image challenge!

Staying #Up2Date 🚨

1. Take my breath away (pls don’t)

An RCT from the UK looked at whether taking bisoprolol reduced COPD exacerbations in >500 patients with moderate COPD and no cardiovascular indications for beta blockers. Patients were randomized to receive bisoprolol (1.25 mg uptitrated to 5 mg daily) vs. placebo. At 1 year follow-up, no significant differences were noted between groups in incidence of COPD exacerbations, suggesting that there is no clinical benefit to beta blockers in COPD. 

2. Keeping an eye (or finger) on things: active surveillance in prostate cancer

A prospective cohort study of over 2,000 men with clinically localized prostate cancer and no prior treatment studied the long-term outcomes of active surveillance. 10 years after diagnosis, 49% of men remained free of progression or treatment, less than 2% developed metastatic disease, and less than 1% died of their disease. Later progression and treatment during surveillance were not associated with worse outcomes, suggesting that active surveillance may be an effective management strategy for patients diagnosed with favourable-risk prostate cancer.

3. Something’s fishy in osteoarthritis (OA)

No one likes the taste of fish oil, but many believe it “lubricates the joints.” In a new Australian study, 260 patients with painful knee OA (+ joint effusion and synovitis on MRI) were randomized to 2g daily of krill oil containing 350 mg of ω-3 fatty acids vs. placebo. At 24 weeks' follow-up, there was no difference in self-reported knee pain between groups and, in fact, there was a reduction in the volume of joint effusion and synovitis in the placebo group. This study supports the American College of Rheumatology guidelines which do not recommend fatty acids for OA.

Speed Reads 🚤

1: 🩸 A new study has shown that girls in the US got their periods earlier over the past 5 decades, and it takes longer for them to experience regular cycles. Women in the oldest bracket (born between 1950 - 1969) got their period at 12.5 years old on average, whereas the youngest bracket (born between 2000 - 2005) got their periods at 11.9.

2: 💉 The FDA has approved Moderna’s new RSV vaccine for people aged 60 and older. Marketed under the brand name mRESVIA, it’s the first mRNA vaccine other than COVID to get approved for a disease.

3: 🏋️ AI is what it eats. If it eats sh*tposts, it becomes…. technology that can’t tell the difference between fact, and an inside joke. So when Google AI was trained on Reddit’s datasets, it was caught recommending squat plugs for deeper squats at the gym. And yes, it’s a joke.

4: 👶🏽 Ozempic is giving some women more than just weight loss. “Ozempic babies” is the phenomenon where women taking GLP-1 agonists have accidental pregnancies. Apparently, it’s not as wild as it sounds — potential explanations being that healthy weight loss can increase ovulation, or GLP-1 might impact the effectiveness of birth control pills.

5: 🏘️ Health insurers are investing hundreds of millions in new affordable housing units. Recently, Centene partnered to invest $900 million in housing in eight states, while UnitedHealth's investment has surpassed $1 billion, creating over 25,000 homes since 2011. At least someone is recognizing that the housing affordability crisis is tied to poorer health.

6: 🇲🇽 Mexico elected Claudia Sheinbaum as its first woman president on Monday. She has a background in science (there’s hope for us doctors yet!) and previously served as mayor of Mexico City.

Pause the Party Pills 💊 

What happened: A Food and Drug Administration (FDA) advisory panel overwhelmingly recommended against using MDMA (commonly known as ecstasy) combined with psychotherapy to treat PTSD. This decision could derail the first psychedelic drug approval in the US.

Why it’s interesting:

• There's a growing effort to use hallucinogenic substances for behavioral health treatments, but regulators struggle with safety and effectiveness concerns.

• 9 of 11 advisory members doubted the efficacy of MDMA-assisted therapy for PTSD, citing missing safety data and clinical trial misconduct allegations.

• Panel member Melissa Decker Barone highlighted, “There are so many problems with the data. Each one alone might be okay, but piled up, there’s just a lot of questions.”

• Despite the panel's stance, many mental health advocates and veterans urged endorsement, noting the lack of new PTSD treatments in over 2 decades.

• Australia was the first country to regulate MDMA and psilocybin as medicine, allowing the two psychedelics to be prescribed to treat PTSD and severe depression.

• A version of ketamine has been approved for treating severe depression in the US.

Yes, but: Some panel members regretted their negative votes, acknowledging the promising early results. Paul Holtzheimer, deputy director of research at the National Center for PTSD, noted, “This is a really exciting treatment. But from an efficacy and safety standpoint, it is still premature.”

Postcall’s Take: While MDMA’s therapeutic promise remains tantalizing, the FDA's decision will hinge on robust evidence. If MDMA is approved, it will face hurdles like side effects, accessibility, and state regulations. Keep an eye on Canada and Australia, where psychedelic treatments are gaining traction and could influence U.S. policy.

Notable Numbers 🔢

$34.8 million: how much bank Trump’s campaign made off his felony conviction in political donations. Trump was found guilty on 34 counts but still maintains his innocence and has vowed to appeal.

47: That’s how many days it took for a gene-edited pig kidney to fail in a woman who got it at NYU Langone Health. She’s stable, but now needs dialysis again.

48%: that’s how much faster you’ll sleep, according to claims from Elemind. They’re launching a “neurotech wellness headband” that improves your sleep, and they ran a (non-peer reviewed) clinical trial to test it out.

Postcall Picks ✅ 

🤣 Laugh: Some say looking for the right supplies is the hardest part of the job. 

📚Learn: about Orthopaedics and Urology on a trip to Antarctica departing Jan 4th, 2025. The 7th continent is adventure in its purest form, where thousands of Gentoo penguins hop around, and cape petrels sweep overhead. At the same time, learn about prostate Cancer, Pain syndromes in Urology, and orthopaedic referral for injured knees.

📺 Watch: Mark your calendars: the long-awaited season 2 premiere of House of the Dragon is on June 16th. While you wait, discover which character you’re most like by taking this quiz.

Game ⛳️

First question: what is a symptom, sign, or finding that is classic of a particular disease?

If you enjoyed our puzzle, please share!

Image Challenge

Source: Originally published on NEJM

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