Staying #Up2Date 🚨

1. Arm yourself with this knowledge: 

The ARMS crossover trial of 133 adults studied the effect of nonstandard arm positions on BP readings. Arm supported on the lap and arm unsupported at the side each led to significantly higher readings by 4 mm - 6 mm Hg for both systolic and diastolic measurements. Having the arm supported on a desk with the midcuff positioned at heart level is the most appropriate technique.

2. Skip the skin test?

De-labelling patients without true penicillin allergies sometimes requires referral to allergy & immunology for a skin test, which can be resource-draining. This systematic review examined the safety of direct penicillin challenges without preceding skin tests. Since only 3.5% of the 9K+ patients experienced reactions, this study suggests that going straight to the penicillin challenge may be a safe alternative that can be performed in the primary/urgent care setting.

3. A case for population-specific growth curves

This retrospective cohort study found that Inuit children had consistently larger head circumferences across all age points compared to the World Health Organization (WHO) growth curve medians. At 12 months, head circumferences were 1.3 cm (males) and 1.5 cm (females) larger than WHO medians. This raises the possibility of macrocephaly overdiagnosis/microcephaly underdiagnosis if relying on WHO growth curves.

Stop And Smell

Why the saying ‘if you smelt it, you dealt it’ could save someone’s life

What happened: A new study has found that the loss of smell can be linked to depression.

Why it’s interesting: The study included 52 volunteers who, over a 24 hour period with a normal sense of smell had little sniffs during each breath but people with a loss of smell didn’t. 1 in 4 people in the US have anosmia from either COVID-19 or from birth.

In 2023 it was reported that more than 60% of people diagnosed with COVID-19 developed anosmia. 72% of those regained their sense of smell while nearly 4% didn’t after they recovered.

The reason for the study was for researchers to better understand some of the mental issues that some COVID-19 patients faced after losing their sense of smell. Research has shown that anosmia comes with a wide range of negative outcomes including dulled emotions, depression, and a shortened lifespan.

Researchers said that losing the ability to smell can lead to impaired memory of invents that are linked to different odors. This can make everyday activities seem mundane such as eating and socializing with friends and family. It could also cause people to not smell things that are harmful to them like smoke.

But: This study is just the first step as scientists are still piecing together more reasons why they need to pay attention to the sense of smell. Most health care providers don’t ask about or test for anosmia and that needs to change since some studies have shown that the loss of smell could be linked to serious disorders like Alzheimer’s and Parkinson’s.

Bottom line: The more doctors know about how the sense of smell affects the lives of patients, the better chance they have at possibly catching certain diseases or mental illnesses early on.

Hot Off The Press:

1: 🧍 A new study from the University of Sydney suggests that standing desks don’t reduce the risk of stroke or heart failure — and may increase the risk of circulatory issues such as deep vein thrombosis and varicose veins. Researchers advise that those who sit or stand for long periods should incorporate regular movement throughout the day to support cardiovascular health.

2: 🧠 A cohort study involving over 6,900 adolescents with obesity found that those treated with glucagon-like peptide 1 receptor agonists (GLP1R) had a 33% lower risk of suicidal ideation or attempts compared to those receiving lifestyle interventions. The study suggests that GLP1R treatment may offer psychiatric benefits for adolescents with obesity, but further research is needed to understand this effect and the mechanisms.

3: 🎤 Former One Direction member Liam Payne passed away at the age of 31 after reportedly jumping from his balcony in Buenos Aires last week. An initial toxicology report revealed the singer had multiple drugs in his system at the time of his death including “pink cocaine.”

4: ⛈️ Surgeries in the US are expected to be pushed back a few weeks after crucial IV and sterile fluids factories remain shut down due to hurricane related damage. Hospitals have begun postponing planned procedures that can wait like certain heart and orthopedic procedures. So far there isn’t a concrete timeline for when production will return to pre-hurricane levels.

Notable Numbers 🔢

70,500: the number of previously unknown viruses discovered using AI, many of which thrive in extreme environments like salt lakes and hydrothermal vents. This study — led by researchers from the University of Toronto and published in Cell — highlights AI's potential to uncover viral RNA "dark matter"… and may aid in understanding the evolution and origins of viruses.

91: the age Stanford psychologist who was responsible for the ‘Stanford Prison Experiment’ was when he died. In 1971 Philip G. Zimbardo recruited a team of college-aged men to spend two weeks in a mock prison. The experiment is now studied in psychology classes all around the world.

49: the amount of people who contracted e-coli poisoning in the US after eating a McDonald’s Quarter Pounder. The fast food chains shares dropped 7% after the news broke out. So far only one person has died as a result.

Postcall Picks ✅

😭 Laugh: at the ED classic, “Hey, my colleague also has a couple of admissions they want to discuss with you.” 

🎧 Listen: to this week’s episode of The White Coat Investor to learn more about how to navigate your first attending job.

📖 Read: All in Her Head by Elizabeth Comen! The books discusses women’s bodies and provides a new conversation around women’s health. It’s currently 44% off on Amazon!

🍽️ Try: one of these quick and easy one pot meals!

Relax

First Question: What is a common childhood virus that causes Clue #7?

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