Staying #Up2Date 🚨

1. Mortality/hospitalizations from EtOH use in Canada 

In this retrospective cohort study from April 2020 to December 2022, mortality and hospitalizations fully attributable to EtOH in Canada increased by 17.6% and 8.1%, respectively. Mortality rose by 55.4% in 25–44 y.o., 19.1% in 45–64 y.o., and 2.6% in 65+. Deaths rose by 11.7% in the highest income quintile, compared to 17.0%–21.5% in lower quintiles. Mortality increased most in the prairies (28.1%) and BC (24.2%) and hospitalizations increased most in the territories (27.3%) and prairies (14.6%). 

2. 8Termination of resuscitation (TOR) rules

This multicenter prognostic study developed and validated five TOR rules for in-hospital cardiac arrest using registries from Denmark, Sweden, and Norway (n=23,952). The best-performing rule included four variables: unwitnessed arrest, unmonitored status, asystole as initial rhythm, and resuscitation duration ≥10 minutes. This rule had a false-positive rate of 0.6% (incorrectly predicting death in patients who survived) and a positive rate of 11% (proportion of arrests where termination was proposed).

3. GLP-1 receptor agonists (GLP-1 RAs): start & stop trends

In this cohort study of 125K adults with overweight/obesity initiated on GLP-1 RAs from 2018-2023, one-year discontinuation rates were 64.8% in patients without type 2 diabetes (T2D) vs. 46.5% in those with T2D. Higher weight loss and income were linked to lower discontinuation rates. Among 41,792 patients with available data post-discontinuation, one-year reinitiation rates were 36.3% for those without T2D and 47.3% for those with T2D, with weight regain significantly associated with reinitiation. 

What Doctors Should Know About Trump's Trade War 💸

How it took the US President a little over a week to start a trade war 

What happened: US President Donald Trump slapped a 25% tariff on imports from Canada and 10% from Mexico, set to begin in 30 days.

What does this mean for doctors? Medical equipment has been off limits from tariff hikes for 7 years, thanks to a free trade agreement between the US, Canada, and Mexico. Trump has agreed to delay the tariffs in both countries for a month, but if a deal isn’t reached, food and drinks aren’t the only costs rising; MRI machines, ventilators, and wheelchairs will, too. 

Commonly used medical supplies like syringes, surgical gloves, and other protective equipment come from China. It’s predicted that 80% of costs for hospitals and health systems will rise by at least 15% in the next 6 months if Trump goes through with the tariffs. 7 out of 10 industry professionals believe drug costs will increase by 10% as well.

The tariff threats started when Trump blamed Canada for the fentanyl overdose crisis. But a quick Google search found that only 0.2% of fentanyl in the US comes from the north. Canada’s Prime Minister Justin Trudeau has since appointed a “fentanyl czar” to oversee the border 24/7 in hopes of confronting the issue.

Here’s what some doctors on Reddit had to say in response to tariffs:

So, what now? Before the delay was announced, Trudeau planned to impose 25% tariffs on $155B of US goods, which has since been paused. The fight’s far from over, though, and we’ll keep a lookout for updates.

Hot Off The Press

1: 🇺🇸 "Special government employee” Elon Musk — tasked with shrinking the US government — is shutting down USAID, an independent agency that handles most of America’s foreign aid and represents less than 1% of the federal budget. The White House claims “lifesaving” aid won’t be affected, but USAID and other non-profits say it’s blocking the fight against the global HIV/AIDS epidemic.

2: 🧠 Researchers have found and quantified microplastics in post-mortem human brain tissue, including PET, polycarbonate, and polystyrene. The study showed that particles accumulate in the frontal cortex, cerebellum, and hippocampus — areas critical to cognitive function — and that individuals with dementia had higher levels.

3: 💊 A New York doctor has been charged after sending abortion pills to Louisiana. This is the first time criminal charges have been filed against someone for sending pills to a state with an abortion ban. The pill was ordered by a mother for her underage daughter. Her mother has since been charged with violating the state’s abortion ban.

4: 💨 Lung cancer is on the rise, but it’s not affecting who you think. Folks who don’t smoke cigarettes or tobacco are getting diagnosed with the disease at a much higher rate. A study found that adenocarcinoma, which accounts for 45.6% of global lung cancer, comes from air pollution and is affecting about 200K people yearly. Scientists hope to do more research into air pollution to help combat the issue.

Notable Numbers 🔢

25: how many years it’s been since the FDA approved a new pain reliever. US feds just signed off on Vertex Pharmaceuticals’ Journavx for short-term pain, which promises to eliminate opiate-associated risks of addiction and overdose. They’re priced at $15.50 USD per pill — over 15x more than comparable opioid generics.

100k: the amount of eggs stolen from a trailer in Pennsylvania. The theft could be linked to the avian flu outbreaks as their prices have reached near-record highs. The stolen eggs are worth about $40,000 and police have launched an investigation to find the culprits.

30x: the increased likelihood of women getting UTIs versus men, which translates to hundreds of millions annually. Some women suffer antibiotic-resistant infections for years — and there’s been a shocking lack of research on prevention.

Postcall Picks

📘 Read: Tim Ferriss, author of The 4-Hour Workweek and Tools of Titans, recently teased his upcoming book — a guide to protecting priorities by saying "No" to everything else.

🤖 Try: Deepseek, the Chinese AI app making all the headlines (and your investments go down, probably).

🤑 Save: on boots, gloves and more with Lands’ End sale! Use code FABULOUS on selected items to keep you and your loved ones warm this winter.

Relax

First Question: What’s bluish due to hypoxia?

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