Good morning. Have you noticed that your parents or grandparents seem to be getting sharper with age? Well, it's not just a fluke. Recent studies reveal a fascinating trend: while younger adults’ cognitive abilities are staying relatively steady, the minds of older adults are actually improving. This shift, historically driven by advancements in education, healthcare, and nutrition, suggests that what we once considered inevitable cognitive decline might be becoming less common. Way to go, gramps!

☕️Postcall’s one-sip markets update:

It’s been down and up — specifically, down on inflation news and prolonged interest rates, but up on strong tech earnings. The S&P 500 finished up 2.3%, with mega-caps like Tesla and Apple announcing some positive developments — Tesla’s about self-driving cars, Apple’s about AI. Meanwhile, shares in marijuana brands soared after news broke the U.S. moved to ease marijuana classifications.

Here’s what we got for you today:

1. RCTs on calorie restrictions

2. Pharma reps - should we meet with them?

3. Stocks are ramping up

4. So are campus protests

5. Learning opportunities on earning more

6. Discounts on stethoscopes

Staying #Up2Date 🚨

1. Guideline watch 👀 

The US Preventive Services Task Force now recommends q2y screening with mammography for women ages 40 - 74. This represents an update from 2016 in which women ages 40 - 49 were advised to make individual decisions.

2. Clocking calories

This RCT looked at whether time-restricted eating leads to greater weight loss. Among 41 adults with obesity and prediabetes or diet-controlled diabetes, there was no significant difference in weight loss between those instructed to eat between 8AM - 6PM vs. those allowed to eat until midnight. Weight loss in both groups over the 12-week period was modest and primarily linked to controlled calorie intake based on individual metabolic needs.

3. Should we be screening kids for high cholesterol? 

This observational study investigated whether lowering high non-HDL cholesterol from childhood to adulthood resulted in cardiovascular risk (CV) factor modification. After pooling data from six prospective cohort studies, resolution of non–HDL cholesterol dyslipidemia from childhood to adulthood was associated with the same risk for adverse CV events as when lipids were at recommended levels through both childhood and adulthood. Although this study cannot prove causality, it makes an argument for lipid screening in childhood to reduce CV outcomes into adulthood. 

4. Plain films a little too plain in early rheumatoid arthritis (RA)

A retrospective cohort study looked at the utility of routine hand and feet XRs in patients with suspected RA. Only 4% of these XRs showed erosions with overall impact on patient management and outcomes being minimal. These findings challenge the utility of performing plain films of the hands and feet in early RA diagnosis (currently UptoDate does say that obtaining this imaging can help track disease progress)

Should we meet with pharma reps?

As part of our day-to-day work, we may come across invites to lunches, sponsored talks, and other interactions with representatives from pharmaceutical companies. Like all drugs… just say no, right?

Before we condemn the industry that gave us vaccines and PReP, here’s some considerations.

Why might we say yes?

1. Meeting with reps can provide lunches for the staff, which saves the practice money and offers a perk to the staff, compensating them indirectly.

2. Reps provide samples, which can be beneficial for patients, especially when trying new medications.

   • Pro tip: You can ask reps to just drop off samples, without meeting with them.

3. CME: Interactions with reps can introduce physicians to new treatments and medications, potentially benefiting patients with more options.

4. The educational pamphlets from reps on drugs or general drugs classes are very well made, which can prove useful during discussions with patients.

5. Some argue that it's part of the industry and treating them fairly could contribute positively to patient care (since their revenues do fund scientific innovation).

Why we may say no:

1. There's a strong ethical stance against accepting anything that could be perceived as a bribe or affecting the impartiality of prescribing practices (basically, we may be influenced to act against the best interest of patients, even subconsciously).

2. Meeting with reps can be seen as a poor use of the our limited time, which could be better spent on patient care or other (less-biased) educational activities.

3. Some physicians prefer to maintain professional integrity by not relying on perks or benefits offered by pharma companies.

4. We’re sometimes skeptical of the real educational value of interactions with reps compared to unbiased, peer-reviewed sources of medical education.

If you’re curious how your peers feel about meeting with pharmaceutical companies, vote below and see what others do.

At the end of the day, we’re advocates of you making the choices that allow you to deliver the best care to your patients and yourself.

Speed Reads 🚤 

1: 🚬 Better late that never? The DEA is planning on reclassify marijuana as a less dangerous drug. This move wouldn’t legalize or decriminalize cannabis, but it would help the revenue of legal businesses and ease barriers to research. Is this based on the DEA finally admitting the medicinal benefit of marijuana, or that Uncle Sam is getting a cut? 🤷‍♀️

2: 🐮 The Department of Agriculture recently reported that dairy cows have been infected with H5N1 bird flu, a virus previously not considered a threat to bovines. Researchers are urgently investigating the extent of the virus's spread among cows, its duration, and the likelihood of halting its transmission, which appears to be facilitated by standard milking and herd management practices.

3: 💻 Google stock surged after buying back stock from investors, increasing as much as 13% in after-hours trading. They also announced their first quarterly cash dividend of $0.20 / share.

4: 👮 Following a police raid on a Gaza protest at Columbia University, students have called for the police to leave the campus, citing over 100 arrests and describing the police's actions as rough and aggressive. The university atmosphere is tense, with canceled classes and ongoing protests, while the university president expresses regret and acknowledges the need for community healing, amidst widespread student and faculty dissatisfaction.

5: 🎳 The FDA has finalized regulations to oversee the $10 billion lab test industry, aiming to ensure the accuracy of approximately 80,000 medical tests from around 1,200 labs. Despite being largely grandfathered in, the industry opposes these regulations, arguing they will stifle innovation and may pursue legal action to prevent the rules from being implemented.

Notable Numbers 🔢

50 - 60: the safest window of time when women can start hormone therapy and get the most benefit. According to a new study in JAMA, the benefits of hormone therapy for the treatment of menopause symptoms outweigh the risks.

15%: how much taking aspirin can reduce the risk of preeclampsia. Pregnant people who are at risk of developing preeclampsia are advised to start taking baby aspirin when they’re 12 weeks along.

$6.5B: the amount Johnson & Johnson offered to pay over 25 years in its third attempt to resolve lawsuits. There have been thousands of lawsuits against the company claiming that its talc-based products caused ovarian cancer.

Postcall Picks ✅ 

💰️ Earn: Postcall reported that non-competes are becoming obsolete soon, but you’re still wondering what you should do. No problem, the WCI podcast this week has 12 finance principles, as well as tips on negotiating an employment contract. Listen here.

💳️ Buy: a new 3M Littmann CORE Digital Stethoscope 15% off, from here.

🚰 Drink: clean water by washing your reusable water bottle at least once a week (and ideally every day). A microbiologist and professor of virology at the University of Arizona says that’s the minimum to avoid things like staph infection and mold poisoning.

🤣 Laugh: at why doctors should never assume.

Image Challenge 🖼️ 

Source: Originally published on NEJM

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