Staying #Up2Date 🚨

1. Ozempic & osteoarthritis

This RCT with 407 people with obesity and moderate knee OA, weekly semaglutide (2.4 mg) led to a significantly greater reduction in body weight (−13.7% vs. −3.2%) and WOMAC pain scores (−41.7 vs. −27.5 points) compared to placebo. Semaglutide also improved SF-36 physical-function scores more than placebo (12.0 vs. 6.5 points). The rate of serious adverse events were similar between groups. This suggests that semaglutide may benefit weight and pain management in patients with knee osteoarthritis.

2. Central lines & complications

This multivariable analysis of 1,900 central venous access devices in hospitalized adults revealed an overall failure rate of 10%, primarily due to central line–associated bloodstream infections (over half of failures), catheter occlusions (17% of failures), and dislodgements (17% of failures). Antimicrobial nontunneled CVADs significantly reduced the incidence of bloodstream infections but were used in only half of the cases. 

3. Cancer diagnosis & Canadian EDs

This Ontario retrospective study found that 35.3% of ~600K patients visited the ED within 90 days prior to their cancer diagnosis, with over half  of patients being admitted. Rural residence, living in marginalized areas, and specific cancer types (intracranial, pancreatic, and thoracic cancers) were linked with increased ED use. These findings highlight the ED's significant role in cancer diagnosis, especially in those without primary care access.

Bloody Diagnosis

How getting a bipolar diagnosis may be as easy as getting your blood drawn

What happened: A new blood test that uses biomarkers to differentiate bipolar disorder from depression could speed up the time it would take to get an accurate diagnosis from years to weeks.

Why it’s interesting: The test was developed by a French start-up called Alcediag, and uses biomarkers related to RNA editing to diagnose the condition. The test has been available in France since March and in Italy since October 2023.

In the US, 4.4% of adults will experience bipolar disorder at some time in their lives. On average it takes about a year for US residents to get a bipolar disorder, but in some cases the length of time between a person’s first episode and receiving a diagnosis is eight years. Having a blood test that can shorten that time frame could prevent people from having further manic episodes.

Alcediag uses a blood test called EDIT-B that works by measuring subtle differences in RNA editing. The company hopes that their test will eliminate misdiagnoses in bipolar disorder. So far 80 people have used EDIT-B since its commercialization and the feedback has been positive. The co-founder of Alcediag said one of their patients who received a positive test result was able to change to a more effective medication.

But: Some doctors are skeptical about the test. A French psychiatrist said that although there is no evidence that EDIT-B results produce false positives he worries about the inherent limits as the study that was conducted in 2022 only had 410 participants. He said when you take a data set that large with a small number of patients the algorithm might classify them or identify commonalities.

Another criticism is since some of the participants of the study were taking a range of different medications, the algorithm might distinguish people on the basis of their treatments, and classify them according to therapeutic classes. Psychiatrists hope that Alcediag does larger studies before they offer the test to the public, and make them available to independent groups so that they can replicate the findings.

Bottom line: Although this new test brings a sliver of hope to those wanting to get a bipolar diagnosis, more work needs to be done before it’s offered nation wide.

Hot Off The Press

1: 🦠 Four cases of a sexually transmitted fungal infection called trichophyton mentagrophytes have been diagnosed in New York. Symptoms of the disease inculde rashes on the face, buttocks, or genitals and can be successfully treated with antifungals.

2: ⛈ Residents in North Carolina worry after Hurricane Helene threatens their access to healthcare. One woman says she’s unable to get oxygen refills and blood tests to help monitor her organs. Some hospitals in NC are still using bottled water to treat patients. Many volunteers have come together to help the community get back on its feet.

3: 🏥 Maryland recently became the first state to to join a federal program designed to improve health care quality and equity. It will lower costs for all health care payers including Medicare, Medicaid, and private insurers. Known as the AHEAD model, it’s supposed to deliver high-quality health care through greater coordination and health equity.

4: 🐈 Scientists are using cat’s brains to hep them understand cognitive diseases like Alzheimer’s. Since cats share their environments with their owners and experience similar health issues to them like obesity and diabetes, researchers are studying how their genetics and lifestyle affect ageing.

5:💉 A Massachusetts woman is being sued after she pretended to be nurse and injected fake Botox into patients. Since March of 2021 the accused has completed approximately 1,631 Botox appointments, racking in over $500K in client payments. The woman is claiming she never said she was a nurse and didn’t make the injections.

Notable Numbers 🔢

129,000: the number of malaria cases reported in Brazil in 2022. According to a new Harvard study, deforestation in the Amazon escalates malaria transmission risk. Researchers say that seasonal data could guide better malaria policies, but it’s been a struggle to get policymakers on board.

35%: the percentage decrease in diabetes risk for adults conceived during UK sugar rationing in the early 1950s, compared to those born after. A new study links early-life sugar exposure to lifelong health impacts, calling attention to the long-term risks of high sugar intake during pregnancy and early childhood.

38,000: the number of lives that could have been saved in Europe during the 2022 heatwave if it weren’t for greenhouse pollution, according to a new study. The research reveals that over half of the 68,000 heat-related deaths that summer were driven by climate change.

Postcall Picks ✅

😭 Laugh: at the never-ending cycle of dodging colonoscopy prep.  

🎧 Listen: to John Green discuss how the power of coffee and tea are being harnessed to eradicate TB.  

🎫 Learn: why plague doctors wore beaked masks and the real reason behind their increased protection from Yersinia pestis.

🤑 Save: on your favorite skin care products, perfume, and more during Sephora’s annual Sephora Insiders sale! To access the discount use the code “SAVINGS” at checkout.

Relax

First Question: Suspect this with high lipase, abdominal pain, and positive ultrasound.

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