Staying #Up2Date 🚨

1: When Superfoods Aren’t So Super

A cohort study of patients with inflammatory bowel disease (Crohn’s disease and ulcerative colitis), along with research in mice and cultured cells, found that compared with healthy individuals, those with IBD have lower levels of two transporter proteins responsible for moving oxalate out of the gut. So, although spinach, almonds, and sweet potatoes have high nutritional value, these high-oxalate foods may contribute to intestinal inflammation in this patient group. Further research is needed to determine whether novel therapies targeting oxalate breakdown could be a viable treatment for patients with IBD.

2: A Hot Take on Heart Health in Perimenopausal and Menopausal Women

An observational cohort study assessed the effect of menopausal hormone therapy (MHT) on cardiovascular disease risk in perimenopausal and recently postmenopausal women with hot flashes and other vasomotor symptoms. Among 2,737 women, starting MHT was associated with a 22% lower cardiovascular disease risk. The strongest benefit was seen in women who initiated MHT within 10 years of menopause onset, as well as Black women. Further research is needed to tease out how MHT can be optimized to reduce cardiovascular risk in women.

3: Attention Deficit, Screen Surplus

A prospective cohort study of 11K youth explored whether social media use is associated with changes in attention-deficit/hyperactivity disorder (ADHD) symptoms. Among kids who self-reported increased “social media addiction,” parents also reported increases in ADHD symptoms. The association was stronger in boys than girls. Overall, the findings suggest social media use may be worth screening for in kids with ADHD.

Hot Brew, Higher Risk ☕

It turns out the tea might be too hot to handle after all 

What happened: A new study has found a link between drinking very hot beverages and the risk of esophageal squamous cell carcinoma (SCC).

Why it matters: Around 3,000 Canadians are diagnosed with esophageal cancer each year, and globally, cases are projected to rise by more than 50% by 2040. Tobacco and alcohol use are among the major risk factors for esophageal SCC, which is more common in men. While treatment can include chemotherapy and radiation, the disease can be difficult to cure.

Researchers looked at data from over 900,000 middle-aged adults in the UK who were asked about their hot-drink habits, including how many they drank and whether they preferred them warm, hot or very hot. And temperature mattered.

Compared with people who preferred warm drinks, those who preferred them hot had nearly twice the risk of esophageal SCC. Among those in the very-hot group, the risk was more than 3 times as high. How much people drank mattered, too. Drinking 6 or more hot beverages a day was associated with a 71% higher risk of esophageal SCC. And these findings add to longstanding concerns about temperature: in 2016, the International Agency for Research on Cancer classified drinking very hot beverages — above 65°C — as “probably carcinogenic to humans.”

But: Despite these findings, the chance of esophageal cancer is relatively low. It is considered the 19th most common cancer type. Researchers also didn’t measure the actual temperature of the drinks, relying instead on each participant to describe them as warm, hot, or very hot. One possible explanation is thermal injury: repeated exposure to very hot liquids can damage the cells lining the esophagus and cause inflammation. Letting drinks cool before sipping is a simple way to reduce that exposure.

Bottom line: Sometimes a hot coffee or tea is the only thing getting you through the night shift, or a cold Canadian winter. The findings aren’t a reason to give either up, but they do suggest temperature matters. If your drink is still scalding, waiting a few minutes before taking that first sip may be worthwhile.

Join Our Medical Team

CReATe Fertility is growing, and we are looking for physicians to join our team and help expand access to specialized fertility care across the Greater Toronto Area.

We are currently welcoming applications from GPs and reproductive endocrinology and infertility (REI) specialists interested in joining our team in North York, Etobicoke and Durham Region.

Why CReATe?

For more than 30 years, CReATe Fertility Centre has provided comprehensive fertility care to patients across Ontario. Our multidisciplinary team combines personalized care, advanced reproductive technologies, and expertise across a broad range of fertility services.

Joining CReATe means becoming part of a team with expertise across fertility services, including IVF, IUI, fertility preservation, donor and gestational carrier programs, genetic testing, male factor infertility, and more.

If you or a colleague are interested in joining CReATe, we would be happy to connect and share more about current opportunities.

Get in touch directly with Lisa Hogan, Director of Business Development at lisa.hogan@createivf.com

Hot Off The Press 🔥

1: 💊 That bottle of acetaminophen in the medicine cabinet might be worth a second look. Health Canada has recalled one lot of Novo-Gesic Forte 500 mg because some tablets may have been contaminated with phenolic resin or epoxy, materials that could injure the digestive system if swallowed. The tricky part? The affected pills were shipped to pharmacies in 1,000-count bottles and may have been dispensed into smaller containers, meaning patients might have no idea which lot they received. The recall is nationwide, but only one lot is affected. Here’s how to find out if your acetaminophen is one of them.

2: 🧠 1.9 million people just strengthened the ADHD-gut connection. A new systematic review and meta-analysis of 23 studies found people with ADHD had 48% higher odds of GI symptoms overall, including nearly twice the odds of constipation and 58% higher odds of IBS. What’s behind it is less clear. Researchers point to everything from ADHD medications and eating patterns to differences in the gut microbiome, and stress that the findings show an association, not causation. But the pattern was strong enough that researchers say GI symptoms may deserve more attention in people with ADHD.

3: 🚬 One of smoking’s strangest health paradoxes may finally have an explanation. For decades, studies have found that people who smoke are less likely to develop Parkinson’s disease, even as smoking sends the risk of plenty of other diseases soaring. Now, a study of more than 512K adults points to an unexpected suspect: carbon monoxide. Researchers found higher exhaled CO was associated with a lower risk of Parkinson’s even among people who had never smoked, suggesting tobacco itself may not explain the strange relationship. It’s far from proof of protection, but the finding is intriguing enough that low-dose CO is already being investigated as a potential Parkinson’s treatment.

4: 🇨🇦 Canada is looking across the Atlantic for a new best friend. With the US trade war escalating, Prime Minister Mark Carney says Canada will begin talks on a “unique alliance” with the European Union, one that could deepen ties well beyond the trade deal already in place. Reports suggest discussions have included everything from energy, AI and critical minerals to making it easier for some Canadian goods, services and workers to move between Canada and Europe. Canada isn’t joining the EU, Carney insists, but with the PM heading to Strasbourg this week, just how close could Canada and Europe get?

Notable Numbers 🔢

>10%: the odds one senior AI safety researcher estimates for AI causing human extinction within the next decade. There’s no scientific consensus on that number, but he’s not alone in sounding the alarm. Other AI insiders have now publicly backed the warning.

17.2%: how much the value of Canadian maple product exports jumped in 2025, reaching $844 million. And amid the US trade war, international appetite for Canada's sweetest export appears to be growing.

35 g: the amount of concentrated tomato paste eaten daily in a new study looking at tomatoes and brain health. After 3 months, healthy adults showed improvements in attention, processing speed and memory. Lycopene may deserve some credit, but with just 42 people completing the study, call it food for thought.

Postcall Picks ✅

🥘 Make: one of these easy September dinners for when summer cooking is winding down but you’re not quite ready for full-on soup season, from curry-glazed salmon to crispy gnocchi caprese and basil chicken stir-fry. 

❄️ Save: on this 2-stage snow blower from Home Hardware. We sincerely apologize for bringing up winter in September, but the savings were simply too good to hide from you. 

🧬 Learn: what’s coming next in IBD treatment at this free 60-minute webinar exploring the emerging immune pathways, biomarkers and new mechanisms that researchers hope could push treatment beyond today’s therapeutic ceiling.

✈️ Escape: the usual tourist crowds with these 10 under-the-radar destinations tipped for 2027, from a quiet Greek island to Sri Lanka’s tea country. Canada made the list too, with one destination coming in at No. 2. 

😂 Watch: what doctors admit they'll steal from you every single time.

@dr.ranywoo

A good 0.3-0.4 mm pen hates to see me coming 🥷 #doctor #surgeon #comedy #medicine #healthcare

Relax 🧩

First clue: Movement of water through a semipermeable membrane from low to high solute concentration

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Help Us Get Better

Staying #Up2Date 🚨

1: Holter Your Horses

An RCT across 45 UK hospitals and 2,234 patients explored whether 14-day cardiac monitoring affected diagnosis, treatment, or outcomes for adults presenting to the ED with syncope that remained unexplained after evaluation. Those randomized to 14-day monitoring did not report a significant difference in syncopal episodes after 1 year compared with standard care. The findings highlight the difficulty of diagnosing an underlying cardiac arrhythmia and the need for further research into diagnostic pathways.

2: Where There’s Smoke, There’s… Further Aneurysm Risk?

A cohort study assessed the lifetime risk of de novo intracranial aneurysm formation and modifiable risk factors among young survivors of saccular aneurysm-associated subarachnoid hemorrhage. Over 57 years of radiological follow-up and 13,738 person-years, 106 patients (19.5%) developed 158 de novo aneurysms, 23 of which ruptured. Independent risk factors included female sex (HR, 1.76; 95% CI, 1.16-2.69), family history (HR, 2.17; 95% CI, 1.22-3.87), and smoking (HR, 1.75; 95% CI, 1.13-2.71). Smoking cessation was associated with a dose-dependent lower risk, suggesting that survivors of aneurysmal subarachnoid hemorrhage face a lifelong risk of further aneurysm formation, with smoking cessation as a key modifiable prevention strategy.

3: Don’t Leave Your Statin on Read

A health system-embedded randomized trial of 20K adults found that digital outreach via secure portal messaging, SMS texting, and email increased 14-day statin refill rates to 14.4%, compared with 12.0% with usual communication. A second outreach attempt also improved refill rates among those who did not pick up their prescriptions the first time around. These results support digital outreach as a scalable strategy to improve short-term statin adherence among patients with or at risk for atherosclerotic cardiovascular disease and documented nonadherence.

Your income changed. Should your investment strategy?

Sponsored by Wealthsimple

There’s a strange financial moment that happens in medicine.

For years, you’re training on a resident’s salary. Then, seemingly overnight, you’re an attending earning several times more. There’s finally money left after the bills are paid, and suddenly the financial advice that once seemed straightforward gets a lot more complicated.

Max your TFSA. Contribute to your RRSP. Save for a house. Pay down debt. Invest.

Okay. But in what order? For physicians, that answer can change significantly as income rises.

Take the classic TFSA versus RRSP question. Both let investments grow without being taxed while they remain in the account, but the tax treatment is very different. TFSA contributions are made with after-tax dollars and withdrawals are tax-free. RRSP contributions can reduce taxable income today, while withdrawals are generally taxed later.

That distinction matters more as your tax bracket changes. A resident earning $65,000 and an attending earning $250,000 could look at the same accounts and have very different reasons for where to put the next dollar.

Then life adds another variable.

Maybe buying a home is next. For an eligible first-time buyer, an FHSA allows up to $8,000 in annual contributions, to a $40,000 lifetime maximum. Contributions are generally tax-deductible and qualifying withdrawals toward a first home are tax-free.

And eventually, you may run out of registered room altogether.

That’s when a non-registered investment account can enter the picture. There’s no contribution ceiling, but unlike a TFSA or RRSP, investment income and realized gains may be taxable.

For incorporated physicians, there may be yet another decision: whether surplus money stays within the corporation and is invested through a corporate account, or comes out to fund personal goals.

There isn't one neat order that works for every physician. Your income, tax bracket, unused contribution room, debt, home ownership plans, corporation and retirement goals can all affect what makes sense next.

The important part may not be knowing what every acronym stands for. It’s knowing what your next dollar should do. Wealthsimple advisors can help build a financial plan around your income, goals and where you are in your career.

Hot Off The Press 🔥

1: 💊 The next frontier for semaglutide? Children as young as 6. Novo Nordisk has reported that in its late-stage trial called STEP Young, about 40% of children aged 6 to under 12 treated with semaglutide were no longer considered obese after 68 weeks. Everyone in the trial also followed a reduced-calorie diet and increased physical activity. Novo says kids tolerated the drug much like adults and teens did in earlier trials. With prescriptions among US children under 12 already up 300-fold — despite GLP-1s not being approved for that age group — this could be the next big frontier for the drugs.

2: 😴 Would you prioritize sleep for $4.75? Research says: university students just might. Those who got bedtime reminders, morning feedback and a small cash reward for hitting 7 hours of sleep had 26% more nights meeting that goal. Their average sleep rose by about 19 minutes on weeknights, and their grades improved too. The biggest academic gains showed up among 1st-year students, especially in STEM courses and classes held in the middle of the day. An organization paying healthcare workers for sleep has yet to be established.

3: 🏒 The opposing team wasn’t the biggest threat at this hockey tournament. A new CMAJ report details how 4 Alberta youth hockey teams were exposed to carbon monoxide during a weekend tournament after a blocked heater exhaust released the colourless, odourless gas inside the arena. Players developed symptoms including headache, dizziness and nausea, but the cause wasn’t immediately obvious. The case is a reminder that CO poisoning can show up in unexpected places, and that clusters of similar symptoms should raise suspicion of an environmental exposure.

4: 🇨🇦 If you’ve lost the plot on the Canada-US trade war, here’s where things stand. After talks collapsed last month, Trump’s latest tariffs hit billions of dollars in Canadian goods, and Canada’s dollar-for-dollar response kicked in Tuesday, with new duties ranging from 15% to 50% on hundreds of US products. The fight is spilling beyond tariffs, too: Trump has threatened further action against Canadian autos and, most recently, to block Bombardier aircraft sales in the US unless production moves south of the border. So, what could cost you more? Here are some of the everyday items Canadians could soon pay more for.

Notable Numbers 🔢

405 million: the estimated number of UTI cases worldwide each year, as rising antibiotic resistance has researchers revisiting a century-old treatment: viruses that kill bacteria. Several trials are now testing bacteriophage therapy for recurrent and drug-resistant UTIs, including one recruiting 216 women across Canada, Europe, and the US.

75%: the share of producers of one famous French cheese who stopped production during this summer’s extreme heat, after dried-out pastures made its centuries-old recipe impossible to follow. And some of France’s other iconic cheeses could be in trouble, too.

5 days: how long aged mice given compounds found in edible sea squirts were trained on a learning and memory test before performing more like younger mice. The supplements were also linked to more and healthier brain synapses, less inflammation and, bizarrely, thicker, darker hair. Seafood and anti-aging? Sign us up.

Postcall Picks ✅

💰 Save: 20% on regular-priced merchandise at participating Rexall locations if you work in healthcare. The discount runs through Healthcare Hero Thursdays. Just sign up for their free Be Well program before you go.

🫁 Learn: how to recognize when a persistent cough could signal something more serious, including the early signs of ILD and lung cancer, what to investigate and when to refer. Take the course.

🍳 Make: one of these editor-picked September dinners for when summer is over and figuring out what to cook every night is back.

📚 Read: Exit Party, the new novel from Canadian author Emily St. John Mandel, who wrote Station Eleven. It's set in 2031 Los Angeles after the collapse of the United States, which is a pretty irresistible premise. 

🎧 Listen: to this podcast that investigates the massive data centres powering the AI boom, why communities are pushing back against them and what our growing appetite for AI actually looks like on the ground.

🍕 Watch: this video tour of Europe’s tastiest cheap eats, from pizza in Naples and tapas in Madrid to Venetian cicchetti and Portuguese barnacles. Probably best not watched hungry.

Relax 🧩

First clue:

Give it a go →

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Help Us Get Better

Staying #Up2Date 🚨

1:  AI’ve Got My Eye on That Incision

A diagnostic/prognostic study of +5000 wound images reviewed by a deep learning model trained to identify wounds suspicious for surgical site infection achieved an area under the receiver operating characteristic (ROC) curve of 0.91 in internal testing, 0.82 in external validation, and good calibration and net clinical benefit. The integration of these models into telemedicine workflows may enable a scalable post-operative monitoring system and facilitate earlier triage of patients at risk for surgical site infections.

2: Hear, hear! Two Hearing Aids Beat One!

An RCT of 275 older adults with bilateral mild-to-moderate sensorineural hearing loss explored which option is more beneficial: unilateral hearing aid or bilateral hearing aids. Those using a hearing aid in each ear reported increased benefit when compared to just one side, which was also helpful, just not to the same extent. To do away with muffled sounds, the more hearing aids the merrier!

3: A Tale of 2 Opioid Agonists

A cohort study of nearly 6K residents from Ontario with an opioid overdose in the previous year found that those who started methadone had a significantly lower risk of death compared with those who started buprenorphine-naloxone. Treatment duration was short in both groups, though notably longer for those on methadone, but there was no meaningful difference in opioid overdoses after 1 year of opioid agonist treatment between groups. Further research is needed to better understand these findings, explore unmeasured confounding variables, and continue evaluating outcomes in this high-risk population.

Your patient still smokes. Now what? 🧑🏽‍⚕️

Canada has spent decades trying to get people to stop smoking. By one measure, it’s been remarkably successful. But getting the remaining smokers to quit presents a different challenge.

In 2024, 11.2% of Canadian adults reported smoking, putting smoking rates among the lowest in the world. But buried inside that success story is a more stubborn number. Around 300,000 Canadians who smoked in 2023 quit in 2024. That sounds encouraging, until you consider that they represented only about 8% of people who smoked.

In other words, Canada has become very good at driving smoking rates down. Yet despite this progress, millions of Canadians continue to smoke, underscoring the ongoing challenge of supporting cessation among those who remain dependent on cigarettes.

The patient who has already heard the speech

For physicians, none of this is particularly abstract. It’s the patient whose smoking status hasn’t changed in the EMR for 6 years. The patient who knows the cardiovascular risks, knows the cancer risks and doesn’t need another explanation of why cigarettes are harmful.

Maybe they’ve quit before. Maybe several times.

There’s a biological reason quitting can be so difficult. Nicotine dependence involves both physical and psychological factors, according to CAMH. Nicotine triggers dopamine release in the brain, while repeated exposure can produce long-term changes that reinforce dependence. When nicotine levels fall, cravings and withdrawal can push people back toward smoking.

And quitting often isn’t a one-shot effort. CAMH notes that stopping tobacco can take many attempts, while cravings can persist for weeks or even months after quitting.

Yet in practice, the clinical conversation can sometimes feel binary: smoking or abstinence. Quit or didn't quit. What happens to the patient who falls somewhere in between?

Is abstinence the only meaningful outcome?

Complete cessation remains the goal. There is no ambiguity about the enormous health benefit of eliminating cigarette smoking.

But harm reduction asks a slightly different clinical question: What can we do for someone who isn’t there yet?

It’s an approach already recognized in Canada’s Tobacco Strategy, which acknowledges that giving people who smoke access to less harmful alternatives to cigarettes can reduce health risks. Harm reduction is not a replacement for cessation; rather, it can provide an additional pathway for patients who are not ready or able to stop smoking in one step.

And patients are already taking incremental approaches. In the 2022 Canadian Tobacco and Nicotine Survey, 39.5% of people who smoked or had recently quit and made a quit attempt reported reducing the number of cigarettes they smoked as one of their cessation methods.

That doesn’t change the end goal. It suggests the path to getting there may not look the same for every patient. So perhaps the conversation isn’t simply: “Are you ready to quit?” It may also be: “Where are you now, and what’s the next step we can take?”

Over the coming months, we’ll look at the evidence behind nicotine dependence, cessation and the growing range of harm-reduction tools available to Canadian patients.

Because for someone who still smokes, the path out may not begin with another instruction to quit. It may begin with a better conversation.

Hot Off The Press 🔥

1: 💊 A pill nearly doubled survival in advanced pancreatic cancer. The FDA has approved daraxonrasib, a once-daily treatment targeting a mutated protein that fuels tumour growth in more than 90% of pancreatic cancer cases. Patients taking the pill nearly doubled their median survival time compared with chemotherapy, with fewer severe side effects. The catch? It comes with a price tag of about US$39,800 a month. There’s no Canadian approval yet, but trials are already underway here.

2: 🧬 One gene edit. One year later. LDL is still down by about half. Last year, a one-time CRISPR treatment made headlines for dramatically lowering cholesterol. Now, follow-up results suggest the effect is holding. The treatment works by switching off a liver gene called ANGPTL3, which helps regulate cholesterol and triglycerides. Rather than correcting the underlying cause of high cholesterol, researchers are targeting another biological pathway to bring levels down. Big caveat: this was an early-stage trial of just 15 people, so we're still a long way from replacing the daily statin with a one-time snip.

3: 💊 Health Canada says: don’t start new patients on Tavneos. The agency is reviewing concerns about the integrity of data from the pivotal ADVOCATE trial used to support the approval of avacopan and is advising clinicians not to initiate treatment in new patients while that review is underway. For patients already taking it, clinicians are being asked to reassess continued treatment and discuss the benefits and risks. Tavneos is used alongside standard therapy for adults with severe active granulomatosis with polyangiitis or microscopic polyangiitis. Health Canada says more updates are coming.

4: ❤️ Xylitol may have a less-than-sweet connection to cardiovascular risk. In a large, long-term Canadian cohort, people with the highest blood levels of the sugar alcohol had a 57% higher risk of death, heart attack or stroke than those with the lowest levels. A separate cohort followed for 30 years found an 18% higher risk in the highest group, with cardiovascular events increasing as xylitol levels rose. The findings are observational, so they can't show that xylitol caused the events. But paired with earlier research suggesting xylitol may make platelets more prone to clotting, the sugar substitute is looking a little less sweet.

Taking the Pulse 🫀

Postcall Picks ✅

🧠 Learn: how to recommend topical analgesics for targeted pain relief, from choosing the right option to understanding the evidence and counselling patients on safe, effective use.

💰 Save: $181 on Bose QuietComfort noise-cancelling headphones, now $299 as part of Best Buy’s Labour Day sale. 

🏕️ Escape: One last summer hurrah before the Canada Strong Pass ends Sept. 7, with free Parks Canada admission and 25% off camping and overnight stays.

🍳 Make: these high-protein dinners that take 30 minutes or less and, even better, only leave you with one pan to wash.

🇨🇦 Read: this deep dive from The Walrus on how Trump helped propel Mark Carney to power, rewrote Canada’s political landscape and handed the prime minister an advantage that may not last forever.

🎧 Listen: to this podcast on lecanemab, the anti-amyloid Alzheimer drug that arrived in Canada in January, and why its modest benefit and $35,000–$40,000 annual price tag are raising questions about just how useful it will be in practice. 

👻 Watch: how scientists recently found “ghost DNA” from 2 mysterious human ancestors hiding in our genomes, including one lineage dating back nearly 2 million years.

@tilscience

We got Ghost DNA before GTA VI. The part of your genome scientists assumed was uniquely, distinctly human, isn't. It contains “ghost” DNA ... See more

Relax 🧩

First clue: ___ disability, 5150 criteria

Give it a go →

Need a rematch? We’ve got you covered. Check out our Crossword Archive to find every puzzle we’ve ever made, all in one place.

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Meme of the Week 😂

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Help Us Get Better

Staying #Up2Date 🚨

1: The Cherry on Top of Neurofibromatosis 1

A cross-sectional study of 259 patients found cherry hemangiomas were significantly more common in people with neurofibromatosis 1 (NF1) than controls (48% vs 18%) and appeared at a younger age. Alongside café-au-lait spots, freckling, neurofibromas and Lisch nodules, the findings suggest cherry hemangiomas may be a common but previously unrecognized vascular feature of NF1.

2: Massage Holds Its Own for Goopy Baby Eyes

A noninferiority RCT of 160 infants with congenital nasolacrimal duct obstruction compared standardized lacrimal sac massage with surgical probing. After 3 months, purulent discharge resolved at the same rate in both groups, with no serious complications. The findings support massage as an effective, noninvasive first approach for helping open obstructed tear ducts.

3: The Screen Time Conversation Goes Both Ways…

A cohort study of 747 children followed screen use and language development from ages 5 to 7. Surprisingly, children’s own screen use wasn’t strongly associated with language growth, but greater parental smartphone use was linked to slower growth in receptive vocabulary. Children who already owned a device at ages 4 to 5 also started with lower vocabulary and grammar scores. The takeaway? The screen-time conversation may need to include mom and dad’s phones, too.

💵 Your Corporation has $200K in Cash. Now What?

Sponsored by Wealthsimple

A good year — or a few — can leave a healthy amount of cash sitting inside your professional corporation. But if $200,000 is parked in a chequing account earning next to nothing, inflation alone could quietly chip away $4,000 to $6,000 of its purchasing power every year.

So, where should it go?

The answer depends on what the money is for. A portion belongs somewhere accessible — six months of operating costs, upcoming tax installments, equipment you're planning to buy. That money needs liquidity, not growth. But surplus cash you won't need for years? That's a different conversation entirely — and leaving it idle is its own kind of risk.

For incorporated physicians, the options aren't quite the same as they are personally. Corporate investing accounts have different rules, different tax treatment, and different implications for your overall compensation strategy. Getting that right is worth the conversation.

Your corporate cash worked hard to get there. Wealthsimple can help you figure out where it should go next — and make sure it's actually working for you.

Taking the Pulse 🫀

Summer’s almost over and, sigh, it’s back to the grind. But there’s always time to sneak in a fall escape. 🍂

The Risk at 35,000 Feet ✈️

Cancer risk at cruising altitude

What happened: A new study found that flight attendants and pilots have a higher risk of dying from radiation-linked cancers, raising questions about what decades spent at cruising altitude may be doing to flight crews.

Why it matters: Ionizing radiation is a known carcinogen, and exposure increases at altitude because there’s less atmosphere shielding people from high-energy cosmic radiation. A JAMA Internal Medicine study analyzed more than 12 million death certificates with occupational information. Of more than 500 occupations examined, flight attendants had the highest proportion of deaths from radiation-related cancers, with pilots close behind.

Compared with the general population, flight attendants had about 50% higher odds of dying from these cancers, while pilots had about 36% higher odds. And radiation may not be the only factor at play.

But: The study still has some extra baggage. It can show an association, not prove cosmic radiation caused the excess cancer deaths, and occupations recorded on death certificates may not always have been accurate. Flight crews also face another potential carcinogenic exposure: years of circadian disruption from irregular schedules and crossing time zones.

And despite the known exposure, the US currently has no federal occupational dose limits or routine radiation-monitoring requirements for aircrew. Canada isn’t much further ahead: Transport Canada recommends airlines track and manage cosmic-radiation exposure, with a suggested annual limit of 20 mSv, but those measures remain voluntary.

Bottom line: The findings add to concerns about the long-term health effects of working at altitude and may give physicians another occupational exposure worth asking about. Researchers say more work is needed to untangle how much of the excess risk comes from cosmic radiation versus other features of life in the air. For doctors with pilots or flight attendants in their practice, “What do you do for work?” may carry a little more weight than it seems.

Hot Off The Press 🔥

1: 🤖 AI may be getting better at predicting what comes next for your patients. Harvard researchers have developed a machine-learning model that estimates a patient’s risk of 348 diseases using existing health records and genetic risk data. Trained and validated on more than 683,000 patient records, it updates predictions as patients age and outperformed established cardiovascular and breast cancer risk models. It’s only been tested retrospectively, but researchers say it could eventually help physicians spot disease earlier and rethink who gets screened, and when. Curious what made the cut? Check out the full list in the study.

2: 🥬 Food recalls are having quite a summer. In Canada, prepared foods sold at Whole Foods were recently recalled over possible Salmonella contamination, while the US has seen major recalls and outbreaks involving everything from eggs and lettuce to blueberries and jalapeños. It certainly feels like we’re hearing about contaminated food more often, but are foodborne illnesses actually becoming more common? Experts say there’s more going on than meets the eye. So, is our food getting riskier, or are we just getting better at catching it?

3: 🇨🇦 Looking for a clinical trial in Canada just got easier. Health Canada has launched a new Canadian Clinical Trial Search Portal, swapping out its old clinical trials database with a much more searchable tool. Physicians and patients can look for authorized trials by disease, drug, trial status, province, city or approval date, with information on trial locations, eligibility basics and links to fuller registry records. It currently covers drug trials approved since April 2013, and it’s regularly updated with new trials and status changes. Curious what’s recruiting near you? Try the search yourself.

Postcall Picks ✅

⌚ Save: $750 on a Garmin fēnix 8 smartwatch, currently $699.99 at Best Buy. The 47mm multisport watch packs an AMOLED display, GPS and advanced training and fitness tracking for running, cycling, hiking and more.

🍁 Travel: somewhere worth seeing when the leaves turn. These Canadian destinations put on some of the country’s best fall colours, from Québec’s brilliant reds and oranges to golden aspens in Alberta and the changing forests of Vancouver Island. With peak colour arriving at different times across the country, consider this your reminder that fall getaway season is almost here.

🍅 Make: your way through that end-of-summer tomato haul with Ina Garten’s go-to recipes for when her garden is overflowing. There’s a ridiculously simple summer garden pasta, roasted tomato-basil soup and a flaky tomato-and-goat-cheese crostata. 

📚 Learn: how to spot and treat genitourinary syndrome of menopause (GSM), which affects an estimated 84% of postmenopausal women within 6 years of menopause, yet roughly half receive no treatment. This free 30-minute course covers quick screening across genital, sexual and urinary symptoms, plus evidence-based treatment options and practical ways to start a conversation patients may not bring up themselves.

🎬 Watch: why solving a medical mystery doesn’t always lead to a cure. In this TED2026 talk, science communicator Saloni Dattani explores a frustrating question: if we understand so much more about disease, why aren’t there more cures? 

Relax 🧩

First clue: Pit left by an acne scar

Give it a go →

Need a rematch? We’ve got you covered. Check out our Crossword Archive to find every puzzle we’ve ever made, all in one place.

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Meme of the Week 😂

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Staying #Up2Date 🚨

1: The Fine Print on Alzheimer’s Blood Tests

A cohort study of 2K older adults found that elevated Alzheimer’s disease-related blood biomarkers were associated with faster cognitive decline over 15 years. But the strength of those associations varied by sex and APOE genotype, particularly for p-tau217, p-tau181, neurofilament light chain and GFAP. As blood-based testing moves closer to clinical practice, the findings suggest the same result may not carry the same prognostic weight for every patient.

2: Pregnancy Complications and the Needs Behind Them

A cross-sectional study of 883 Black and/or Latina women found that adverse pregnancy outcomes were associated with a greater burden of health-related social needs. Hypertensive disorders of pregnancy, low birth weight and preterm birth were more common among those facing challenges related to education, family support, employment and financial strain. The findings suggest pregnancy complications could be an important opportunity to identify and address social needs alongside medical care.

3: Rethinking Ventricular Size in Heart Failure

A large cohort study of 273K patients hospitalized with heart failure found that both abnormally small and abnormally large left ventricles were associated with higher mortality. The findings suggest ventricular size could add useful information to routine risk stratification, and that dilation may not be the only size abnormality worth watching.

Retirement Has a To-Do List

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That last one shapes almost everything else. After decades of building up your investments, retirement flips the script - now it's about how and when you spend them down. But the order matters as much as the amount. Withdraw from the wrong account at the wrong time, and you could push yourself into a higher tax bracket, trigger clawbacks on OAS, or leave your corporation's retained earnings taxed less efficiently than they could be. Sequence it well - balancing non-registered accounts, RRSPs/RRIFs, TFSAs, and your corporation - and you keep more of what you built, for longer.

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A Leg Up on Nerve Pain

How one hospital is helping amputees fight painful neuromas 

What happened: A first-of-its-kind Ontario program is taking a page from a cancer treatment to relieve pain for amputees. 

Why it matters: More than 200,000 Canadians live with limb loss or limb difference. After an amputation, severed nerves can develop into painful bundles of tissue called neuromas, sometimes causing chronic pain for years. Now, Hamilton General Hospital is freezing those nerves into submission.

Cryoablation is a minimally invasive procedure that can take about 20 minutes. It involves a very cold probe to freeze the nerves that cause pain at the amputation site. The probe inserted through tiny cuts rather than a large incision. Although the program is new, the procedure isn’t; it’s been used for years to treat cancer tumours and vascular malformations. 

After looking at cases from the US and Japan, an interventional radiologist discovered that the same cryoablation technology could be safely adapted to treat painful neuromas that can occur after an amputation. Since the breakthrough, 35 patients have been treated through the new program at Hamilton General Hospital, with an 85% success rate. 

But: Researchers haven’t yet tracked long-term effects for amputee patients who recieved cryoablation therapy. One man who participated in the procedure said the pain gradually began to creep back up a few months later, proving that the treatment isn’t permanent. The technique also carries risks, such as infection and bleeding. Since the surgery uses a frozen probe, there’s also a chance of skin burns similar to frostbite. 

Bottom line: One of the golden rules in life is sharing, and that teaching works for medicine too. Even though the surgery isn’t a cure, patients say cryoablation therapy has helped sleep through the night, some for the first time in decades.

Hot Off The Press 🔥

1: 🇨🇦 Giving a liver a second chance might give a patient one, too: a Quebec man just became the first patient in North America to undergo a liver transplant using new “regeneration” technology. At Montreal’s CHUM, surgeons used the Liver Assist system to circulate oxygen-rich fluid through a donated liver that might otherwise have been considered too risky to transplant, then tested how it functioned under blood-based conditions meant to mimic the body. CHUM performs about 70 liver transplants a year and estimates the machine could make 20 to 24 additional livers available in its first year alone. That would amount to roughly a third of the centre’s current annual transplant volume.

2: 👩‍⚕️ The Lindsay Clancy trial is putting postpartum psychosis in the spotlight, and raising difficult questions about how the rare but severe condition is recognized. Clancy’s defence argues she was experiencing postpartum psychosis when her 3 children died in 2023, while prosecutors argue she acted intentionally and deliberately. The case has renewed attention on a condition that can emerge rapidly after childbirth and requires urgent psychiatric care. Clancy repeatedly sought mental-health treatment before the deaths, making the trial a conversation about recognition and maternal mental-health care as much as a legal one. The trial has already put a little-known psychiatric emergency before a much bigger audience.

3: 🧠 Blood thinners may be doing more than preventing strokes. A Swedish study of 7,308 people with both Alzheimer’s disease and atrial fibrillation found those taking newer oral anticoagulants (NOACs) had significantly slower cognitive decline than those taking warfarin or no anticoagulant. The difference was modest, at just over 0.2 points per year on the MMSE, but researchers say that could add up over time. NOAC users also had lower risks of stroke, death, blood clots, and fractures, without an increased risk of major bleeding. One rather important asterisk: this was an observational study, so it can’t prove the drugs are protecting the brain. Still, preventing clots and potentially preserving cognition? Not a bad 2-for-1.

Notable Numbers 🔢

10: the number of Canadian youth who died in 2025 from injuries involving e-scooters, e-bikes and other powered micromobility devices, according to a new Canadian Paediatric Society report. Among severe injury cases, 47% involved head injuries, as the authors call for better tracking and more consistent safety rules across Canada.

$5,000: the prize money awarded to Jinny Lu, a 6-year-old rescue pug who was crowned the 2026 World’s Ugliest Dog after finishing 2nd last year. The competition celebrates unconventional pups and promotes adoption, and Jinny Lu also gets to be the face of MUG Root Beer. Beauty is in the eye of the beverage sponsor.

Over 2/3: the share of an octopus’s roughly 500 million neurons that live in its 8 arms, not its doughnut-shaped brain. Each arm can operate independently, and much of an octopus’s intelligence is spread throughout its body rather than localized in the brain. You could say they know it in their bones. Or, well.

Postcall Picks ✅

🚗 Read: whether you should lease, finance or pay cash for your next car. There’s no one-size-fits-all answer: cash avoids interest, financing lets you own without draining your savings, andwhile leasing can mean lower payments but no car at the end.

📚 Learn: what’s new in topical treatment for plaque psoriasis. This free 30-minute course covers where corticosteroids and newer nonsteroidal options fit, plus practical guidance on setting treatment expectations, safety and long-term management. 

🌿 Make: something with those fresh herbs currently taking over your garden. Canadian Living has 20 recipes, from lemony tomato basil pasta and classic pesto to strawberry-rhubarb basil crisp and apple-mint-lime granita. 

🎧 Listen: to why Canada’s emergency physicians are burning out and leaving. This 36-minute CMAJ podcast digs into new research finding burnout has climbed above pandemic-era levels, and how overcrowding, bed shortages and record patient volumes are pushing some physicians to cut their hours or leave emergency medicine altogether.

🎬 Watch: why teens may need some 1-on-1 time with their doctor. Adolescent medicine specialist Dr. Scott Hadland joins Doctor Mike to unpack why asking parents to step outside can help build trust and open the door to conversations teens might otherwise avoid.

Relax 🧩

First clue: Peninsula home to Columbus, Picasso, and Ronaldo

Give it a go →

Need a rematch? We’ve got you covered. Check out our Crossword Archive to find every puzzle we’ve ever made, all in one place.

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Help Us Get Better

Staying #Up2Date 🚨

1: Less Face Time, Fewer Antibiotics

A cross-sectional study of 694 pediatric and family medicine care clinics evaluated the differences in antibiotic management for pediatric acute respiratory tract infections at in-person visits vs telemedicine. For primary care telemedicine visits, antibiotic prescriptions were given in 34.6% of visits, compared to 46.8% of primary care in-person visits. Additionally, children with respiratory tract infections followed via telemedicine visits did not require increased follow-up visits for subsequent antibiotic prescriptions, meaning that the online option may be a strategy for better antimicrobial stewardship. 

2: Steroids Take the Sting Out of Tonsillectomy 

An RCT of 209 children undergoing adenotonsillectomy found that a post-operative course of oral dexamethasone reduces pain compared to a placebo. The steroid group also saw a considerable reduction in postoperative opioid prescription and no increase in complications. These results support steroids for sweet relief after surgery.

3: CGM: One Size Doesn't Fit All

A review of randomized trials and clinical guidelines evaluating continuous glucose monitor (CGM) use beyond type 1 diabetes found that CGM use was associated with a modest yet consistent reduction in HbA1c (roughly 0.3%) when compared to finger-stick monitoring in adults with type 2 diabetes. These findings show that CGM should be deployed in response to a specific patient problem rather than default intervention in those with type 2 diabetes. 

Course of the Week 📚

When is virtual cancer care the right call?

Virtual care is here to stay, but in oncology, knowing when a screen is enough and when a patient needs to be in the room matters.

This free, 30-minute CME gives physicians practical strategies for making virtual cancer care work better. You’ll learn how to identify which oncology scenarios are appropriate for visits, communicate effectively through a screen or phone, and tackle barriers that can leave some patients behind.

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• 4 short video lectures

• 2 interactive quizzes

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The course also explores how virtual care can better serve older adults, rural and remote patients, and other populations facing barriers to care.

30 minutes. Practical takeaways. Better virtual visits.

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A Smaller Door to the Same Heart🫀

Cardiac surgery asks: why break down a door when you can slide through a window?

What happened: A Canadian-led study proves that minimally invasive cardiac surgery is possible.

Why it matters: Bypass surgery is the most common heart surgery in the world, with about 15,000 Canadians undergoing the procedure each year. This study is the first randomized clinical trial to compare minimally invasive coronary artery bypass surgery (MICS CABG) with conventional bypass surgery in patients with multivessel coronary artery disease. Patients who underwent the less invasive procedure regained physical function faster in the first month after surgery, measured by a standard recovery score, and also needed fewer blood transfusions and spent less time on bypass.. 

During a randomized trial of 170 bypass patients, a surgical team performed both types of heart surgery. Instead of opening a patient's chest through the breastbone, the less invasive procedure uses a 5- to 7-cm incision on the side of the chest, leaving a small scar. Patients who underwent this surgery needed fewer blood transfusions and spent less time on breathing machines. 

But: After 1 year, safety outcomes and overall pain levels evened out between the 2 groups, so the early recovery edge didn't translate into a permanent gap. Some questions still linger, like long-term effects and healing, but the surgery does show that less invasive options are possible. That's promising enough that The University of Ottawa Heart Institute says it's committed to training other surgeons from all around the world on how to perform minimally invasive heart surgeries.

Bottom line: Minimally invasive surgeries are not new, with procedures like laparoscopic cholecystectomies and other types of general surgery taking centre stage for years. Cardiac surgery has been slower to catch up, largely because the heart leaves less room for error. This trial suggests that gap is starting to close, and as more surgeons train in the technique, minimally invasive bypass may become less of an exception and more of a standard option.

Hot Off The Press 🔥

1: 💊 A vaccine just did what a century of shigella research couldn't: WRSs2, a live-attenuated oral vaccine, posted 89% efficacy against shigellosis in a phase 2 human challenge trial, with only 3 of 34 vaccinated participants developing shigellosis versus 21 of 26 on placebo after deliberate S. sonnei exposure. The trial wasn't entirely clean, with 6 participants experiencing grade 3 adverse events, and next up is testing in the kids who actually bear the brunt of the disease, since these results came from healthy US adults rather than the low-income settings where shigella does its worst damage,

2: 🦠 Don't panic — you haven't time-travelled to 2020. And yet COVID is back in the news to reveal some truth about its origins: we'll probably never know it. A Senate panel voted to hold former US chief medical adviser Anthony Fauci in contempt of Congress after he pled the 5th more than 100 times during questioning about the pandemic response. Meanwhile, former US COVID-19 response coordinator Ashish Jha freely offered his take: "Here's the truth: no one in America knows for sure," and, "I think lab leak is much more likely." But every theory remains unproven, and no first case has been identified. Don't expect any satisfying answers to come out of this. Maybe just some nightmarish flashbacks of home-baked bread.

3: 🧪 An Ontario trial, PROMPT-LTC, found that rapid on-site testing at long-term care homes could prevent 8,000 ER visits across Canada every year. 10 Ontario-area homes got on-site PCR testing for COVID, flu, and RSV with 35-minute results, versus 3 to 7 days at standard off-site labs, resulting in an 11% drop in ER transfers overall and a 28% drop in transfers or deaths per 100 beds during peak RSV season. Outbreak sizes didn't budge, but that's likely because rapid-testing homes tested more than twice as often, catching milder cases the standard-testing homes were missing entirely.

4: 🥵 💦 Researchers may finally have something more satisfying than “overactive sweat glands” for some hyperhidrosis patients. New data links a subset of inherited cases to rare variants in SCN10A, a gene involved in the nerve signalling that controls sweating. They reproduced excessive sweating by putting one of the mutations into mice, then reducing it with sodium-channel inhibitors. It's still early, but this knowledge could lead to a targeted treatment, rather than suppressing the symptoms with antiperspirants, Botox, and a duffel bag full of dry undershirts.

5: ⌚️ Smart TVs and phones that listen, laptops that see — those are the usual suspects of security precautions. But it seems there's nothing hackers can't infiltrate, because a recent WIRED report showed how even a $30 kids’ GPS watch can become a surveillance device. A reporter wore the watch to work while researchers took it over remotely, tracking, listening, and silently taking his picture. They also found that tens of millions of devices ultimately came from just 3 major underlying supply chains/platforms. Apparently, when it comes to choosing GPS devices, having a sense of choice makes... little sense. Still, maybe go update your Apple Watch.

Notable Numbers 🔢

16: the number of AI-designed viruses that actually worked, out of 300 Stanford scientists built with a model called EVO 2 to hunt E. coli, each far leaner than nature's version (about 6,500 units of genetic code vs. 50,000+). The pitch: new antibiotics take $2B and 10 years, this could take hours, though critics warn the safety rules haven't caught up to the tech yet.

$50,000: the price tag on a private island for sale in Quebec, up 285% from the $13,000 the current owners paid just 3 years ago. The 10,000-square-foot spit of rock and shrub shifts size with the water level, and building on it is basically off the table. Still, the broker says he's already fielding several offers.

9: how many 12-inch stone-fired pizzas on the menu at a full micropizzeria run out of the trunk of a Smart car. The setup swaps the usual roadside kit for olive oil, sauce, and cheese, runs mini ovens off a portable generator, and skips the $8,000-to-$20,000-a-month storefront rent in favour of chasing foot traffic street corner by street corner.

Postcall Picks ✅

🦞 Visit: Oscar, Dalhousie's 1-in-50-million, half-blue, half-orange lobster, now on display at the Beaty Centre for Marine Biodiversity in Halifax. His two-toned colouring is genetic, so it grows back with every new shell. When was the last time you saw a genetic chimera up close?

🧪 Track: Ottawa’s announcement awarding a $10.2M design contract for a brand-new $267M Medical Countermeasures Laboratory in Winnipeg. Co-located with the National Microbiology Lab, it will focus on preclinical research into experimental vaccines and therapeutics for future pandemics.

🧬 Note: Health Canada’s milestone decision to drop all remaining sexual behaviour screening questions for sperm donors. The decision eliminates the final systemic barriers that previously restricted gay and bisexual men from donating.

🛞 Save: on your pre-winter routine. Canadian Tire has Michelin X-Ice Snow winter tires on clearance. Getting ahead of snow season means shorter waits at the garage and extra cash left in your pocket

🎬 Watch: how your brain turns moments into permanent physical structures. The video breaks down the cellular mechanics of memory formation with gorgeous visuals that make neurobiology surprisingly soothing.

Relax 🧩

First clue: IM injection

Give it a go →

Need a rematch? We’ve got you covered. Check out our Crossword Archive to find every puzzle we’ve ever made, all in one place.

Think you crushed it? Challenge your physician friends to beat your time.

Meme of the Week 😂

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Want to reach thousands of Canadian physicians every week? Email denis.bricov@mdbriefcase.com to learn more.

Help Us Get Better

Staying #Up2Date 🚨

1: Sniffles Today, Eczema Tomorrow?

A cohort study of 630 children from Denmark and the US looked at associations between early-life infections and the development of atopic dermatitis (AD) later in childhood. Children who had more episodes of infection, especially respiratory infections, were at higher risk of developing AD between ages 0 and 10. The association persisted regardless of systemic antibiotic treatments, suggesting that infection itself may contribute to AD development in childhood.

2: When Curative Surgery Gets Left on the Table

A cohort study of nearly 44K patients diagnosed with primary hyperparathyroidism (PHPT) through lab work found that 51% already had end-organ damage at the time of diagnosis. PHPT-associated end-organ damage, including osteoporosis, chronic kidney disease, and atraumatic fractures, developed in 16% of patients during follow-up. Despite these numbers, less than 20% of patients with end-organ damage underwent parathyroidectomy. These findings highlight an opportunity to improve PHPT management by optimizing the use of parathyroidectomy to mitigate morbidity.

3: What Immigrant Families Want Us to Study

A survey of 500 immigrant participants across 32 countries, including caregivers, children, and clinicians, found that their top research priorities for their children included addressing health care access, the health effects of migration, and family involvement in care. Other important topics included discrimination and racism and the social determinants of health. These findings could provide a roadmap for future research to improve health equity for pediatric immigrants.

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Night Scares 🌙

Sometimes, the thing that goes bump in the night is still asleep.

What happened: A recent study followed a man in his 40s who had experienced sleep terrors for 2 years, often nearly every night. His episodes involved violent behaviour, including one in which he tried to strangle his bed partner.

Why it matters: Sleep terrors are NREM parasomnias that cause sudden arousals from deep, slow-wave sleep, along with intense fear, autonomic symptoms, complex movement, and amnesia. They affect only about 2.2% of adults and are often linked to stress, alcohol use, or sleep deprivation.

None of those common triggers applied here. A psychiatric evaluation found no anxiety, mood, or other psychiatric disorder, substance use, or recent psychosocial stress. Researchers did detect mild obstructive sleep apnea without symptoms, but no clear cause for the episodes.

The patient spent 2 nights in a sleep lab. Nothing happened the first night. On the second, during N3 sleep, his heart and respiratory rates rose before he briefly screamed, sat up, and tried to leave the bed.

He was diagnosed with idiopathic sleep terror and prescribed 0.5 mg of clonazepam at night, alongside sleep hygiene, stress management, a safer sleep environment, and avoiding possible sleep disruptors. Four weeks later, his episodes had dropped from nearly every night to once a week. Because the medication caused drowsiness, the dose was reduced to 0.25 mg. By 8 weeks, the terrors had stopped. At 12 weeks, he stopped the medication and remained asymptomatic.

But: This was a single-patient case report, not a treatment trial. It can’t tell us whether clonazepam or early intervention will work broadly. What it does show is why violent nighttime behaviour needs a careful workup to rule out other parasomnias, epileptic events, and contributing conditions. BMJ also cautions against using case reports alone to guide treatment.

Bottom line: These terrors are rare. But when we’re not talking daytime grogginess but a person’s, or their bedmate’s, safety, they’re nothing to sleep on. Careful evaluation is needed not only for diagnosis but also for furthering the science — more cases, more sleep labs, and more electrodes — so we can put the dangers of this disorder to rest.

Hot Off The Press 🔥

1: 💉 The Superior Court of Québec just gave the term “research purposes” meaning again. Health Canada just announced it secured a permanent injunction against Canlab Research, banning the Québec-based company from selling or advertising unauthorized injectable peptides in Canada — which, according to Health Canada, haven't been assessed for safety, efficacy, or quality. Potential risks include contaminants and incorrect dosing, as well as liver or kidney damage, blood clots, mood swings, and tumour growth. Canlab doesn't exactly have a great record of compliance, with Health Canada taking enforcement action against the company since Dec. 2023. Hopefully the court order sticks — and they don't just move their shady peptide business elsewhere.

2: 💦 Health Canada has finally agreed to get out of sperm donors’ bedrooms. After a 3.5-year constitutional challenge, it’s dropping sexual-behaviour questions that disproportionately excluded gay and bisexual men. The plaintiff had previously donated and successfully helped a couple conceive a daughter, but after coming out and becoming sexually active with men, the same system deemed him “unsuitable” as a donor. The rules had shifted from an outright ban to a 3-month abstinence requirement, and later to gender-neutral questions that still screened many out. Health Canada’s keeping the infectious-disease testing and 6-month quarantine. They’re just adding — in the words of Egale Canada’s director of legal — “the humanity of queer people.”

3: 💊 Canada's biggest grocer is finding the profits of generic GLP-1s to be… not so generic. Loblaw says pharmacy sales were its strongest-performing category last quarter, as the first generic semaglutide injections began rolling out across Canada. Executives say they're already seeing the impact of GLP-1s going generic, with sales up 40% year-to-date and lower prices being offset by higher prescription volumes. Meanwhile, inflation is apparently changing shopping carts too, with shoppers increasingly swapping fresh vegetables for frozen ones.

4: 🪽 DoorDash is sewing on wings after becoming the 8th commercial drone carrier and 1st major food-delivery platform to earn FAA approval. The ordering company is already in the US drone business — though it’s generous to call operating selectively in Dallas–Fort Worth, TX, and Charlotte, NC “the US drone business.” But their new FAA Part 135 certification means they can now fly independently, unlike Uber Eats and Walmart, which rely on partnerships. DoorDash Air’s goal: target the distances most disliked by humans, i.e. mid-range trips, which apparently take 25% longer to fulfil. Already looking up hungry? Canadian aviation regulations became a little more future-friendly last year by easing drone restrictions. But unless Trump follows through with annexation, your airborne poutine still needs Transport Canada clearance, too.

Notable Numbers 🔢

1 in 3: how many UN HIV-care targets Canada has met. The goal is for 95% of people living with HIV to know their status, 95% of those diagnosed to receive treatment, and 95% of those treated to achieve viral suppression. Canada currently sits at 91%, 86%, and 96%, respectively. Meanwhile, estimated new infections rose 22.8% to 2,517 in 2024, or about 7 per day.

470%: the jump in shares of China’s largest memory-chip maker on their first day of trading. CXMT makes the DRAM chips powering phones, computers, and increasingly hungry AI data centres; the debut made it mainland China’s most valuable listed company. Only 7% of its shares were available to buy, which is one way to turn chip fever into a stampede.

338%: the jump in demand for The Odyssey at New York Public Library after the opening of Christopher Nolan’s film. Print sales of are also up 76% — possibly making Homer’s nearly 2,700-year-old epic the most popular book in the US.

Postcall Picks ✅

🧠 Test: your herpes zoster know-how with Medscape's weekly Fast Five Quiz. We guarantee it's much less painful than shingles.

🏕️ Save: with the Canada Strong Pass and get free Parks admission and 25% off camping until September 7. Under 25-ers get free or half-price museum admission, too. If you're a child — keep up those reading skills, plus get some free VIA Rail if you’re with an adult. Now, go enjoy some national treasures.

🦞 Visit: Oscar, Dalhousie’s one-in-50-million, half-blue, half-orange lobster, at the Beaty Centre for Marine Biodiversity in Halifax. Since his colouring is genetic, it comes back with every new shell. When was the last time you saw a genetic chimera?

❤️ Give: 450 mL of yourself, give or take. Canadian Blood Services is urgently seeking donors after its supply fell nearly 20% since June, with weekly bookings running 1,500–2,500 below what hospitals need. You won't even miss it.

👀 Watch: 2 Canadian doctors revisit berberine, "nature's Ozempic," and see if your patients can find any Ozempic-like benefits from Loblaw’s supplement aisle, too.

Relax 🧩

First clue: Dubious, in Gen-Z slang

Give it a go →

Need a rematch? We’ve got you covered. Check out our Crossword Archive to find every puzzle we’ve ever made, all in one place.

Think you crushed it? Challenge your physician friends to beat your time.

Meme of the Week 😂

Advertise with Postcall 📣

Want to reach thousands of Canadian physicians every week? Email denis.bricov@mdbriefcase.com to learn more.

Help Us Get Better

Staying #Up2Date 🚨

1: Staying in the Sun vs Seeking Shade: Prevalence and Associated Factors with Intentional Outdoor Tanning

A cross-sectional study of nearly 32K US adults found that 35.6% of women and 26.6% of men take part in frequent sun tanning. The highest prevalence of tanning was seen in women and men aged 18 to 29 years, as well as are physically active and report heavy alcohol use. Additionally, the prevalence of sunburn was significantly higher in those who tanned frequently (49.9%; 95% CI, 48.5-51.4%) compared to those who stayed in the shade (28.3%; 95% CI, 27.4-29.3%; P<.001). These findings can help inform future health-education strategies to inform targeted individuals about the risks associated with outdoor suntanning as it relates to skin cancer. 

Prescribing is Easy. Persistence is Hard.  

A cohort study of patients hospitalized for heart failure assessed if individuals are adherent to guideline-directed medical therapy (e.g. beta-blockers, RAS inhibitors, MRAs, and SGLT inhibitors) once they are discharged. After being discharged, prescriptions went unfilled for 51% of new prescriptions of beta-blockers, 48% for RAS inhibitors, 39% for MRAs, and 35% for SGLT2 inhibitors. This means that only half of new discharge prescriptions were initiated within 7 days of discharge. 6 months later, only 42% of patients were adherent to all HF medications used at discharge. Further research is needed to develop interventions to support patients’ medication use beyond their hospital admission. 

Puck Around and Find Out: Eye Injuries in Hockey 

A US-wide cross-sectional study looked at recent trends in hockey-related eye injuries over the last 20 years. In 215 cases, 79% of patients were male, 69% were pediatric (< 18 years), and 83% experienced equipment-related trauma. Of those injured, protective goggle use was reported in only 2% of cases. Injury incidence was similar in various modes of the sport, whether it be ice hockey, field hockey, or street ball. In total, 12% of patients experienced vision-threatening injuries. These results stress that hockey-related eye injuries are common, and most importantly, can be severe and vision threatening. More advocacy for protective eyewear in all forms of the sport should be prioritized to prevent vision-threatening hockey-related injuries.  

When did your practice become a corporate maze?

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Splitting Hairs 💇 

Patients are losing more than just weight on GLP-1s

What happened: A large new BMJ study suggests people taking GLP-1 receptor agonists may be more likely to experience hair loss than those using other diabetes medications.

Why it matters: Researchers analyzed health data from more than 50,000 adults with type 2 diabetes taking GLP-1 receptor agonists and compared them with people using SGLT-2 or DPP-4 inhibitors. They found GLP-1 users had a 37% higher risk of alopecia than those taking SGLT-2 inhibitors and a 68% higher risk than those on DPP-4 inhibitors.

That doesn't necessarily mean the drugs are causing hair loss directly. Instead, experts say the culprit is likely the rapid weight loss many patients experience. When the body is under stress, it shifts more hair follicles into a resting phase, leading to a temporary shedding condition known as telogen effluvium. The good news? The overall risk remained low, and the hair loss is usually temporary.

A Canadian dermatologist told Global News that it takes about 3 months of rapid weight loss for there to be shedding of hair. It lasts for around 6 months, and when the weight stabilizes, the hair grows back. GLP-1s have also been associated with gastrointestinal symptoms like nausea and vomiting, which can also cause nutritional deficiencies like hair loss. The FDA had previously stated that semaglutides and tirzepatides may impact hair loss.

But: Hair loss isn't usually a reason to stop treatment. Experts say slower dose escalation, avoiding overly rapid weight loss when possible, and making sure patients get enough protein and key nutrients may help reduce the risk. If shedding is severe or persistent, it's worth looking for other causes rather than assuming the medication is solely to blame.

Bottom line: Hair loss may not be the side effect patients expect when starting a GLP-1, but it's one worth mentioning. Setting expectations early can reassure patients that, in most cases, the shedding is temporary, and may help keep them from abandoning an otherwise effective treatment.

Hot Off The Press 🔥

1: 🚑 5 years, 1 pandemic, and a whole lot of burnout later, here's where Canada's emergency physicians landed. Researchers tracked a national cohort of ER docs from April 2020 through a January 2025 follow-up survey, and the toll adds up: 1 in 10 have left the specialty entirely, nearly half have cut their clinical hours, and 1 in 5 have taken time off, according to new CMAJ research. Lead author Dr. Kerstin de Wit, didn't mince words, writing that "the prevailing theme was that the health care system is broken." Women and younger physicians reported the highest burnout rates, and the accompanying editorial warns Canada risks squandering 50 years of investment in emergency medicine training if the trend continues.

2: 🦟 West Nile season has officially arrived in Ontario. Positive mosquito pools have turned up in Toronto, Windsor-Essex, Belleville, York Region, and Halton Region over the past couple of weeks, alongside 14 infected dead birds across Ontario and Manitoba. No human cases have been confirmed yet this year, but health units are urging the usual precautions: DEET or icaridin, clearing standing water, and keeping an eye out for a fever, headache, and body aches in patients aged 50-plus or immunocompromised, who face the highest risk of severe illness.

3: 🦠 South of the border, measles just hit a milestone nobody wanted. The US has logged 2,318 confirmed cases so far in 2026, already surpassing all of 2025's record-breaking total, making this the worst year for measles since 1991. 93% of cases are in people who are unvaccinated or have unknown MMR status, and 1 in 10 kids under 5 have been hospitalized. With outbreaks still active in South Carolina, Utah, and Arizona, it's a good week for a routine vaccination status check with your American-adjacent patients, or really, anyone due for their MMR booster.

4: ✈️ Planning a flight on WestJet this long weekend? You'll want a backup plan. The airline is now letting passengers booked between July 30 and Aug. 4 change or cancel their flights for free, as 4,400 flight attendants represented by CUPE Local 8125 could legally walk off the job as early as Aug. 2, after voting 99.4% in favour of a strike. A walkout would ground Canada's second-largest airline right in the middle of the August long weekend, one of the busiest travel stretches of the summer. WestJet says it's "actively engaged" in negotiations and optimistic a deal can still be reached.

Notable Numbers 🔢

330,000: the number of people who have now fled wildfires tearing through southern France and Spain, with authorities in France's Gironde region ordering fresh evacuations ahead of a heat wave forecast to hit this week. Around a dozen countries have sent planes, helicopters, and crews to help battle the blazes, but with temperatures set to climb further, officials warn the worst may still be ahead.

10: the age of Austin Byers when he completed the Toronto Supertri, 4 years after a lawnmower accident nearly cost him both feet. After multiple surgeries at SickKids and years of rehabilitation, he crossed the finish line alongside Canadian Olympian Tyler Mislawchuk and members of the medical team who helped save his legs.

9 hours: the maximum daily eating window linked to slower cognitive decline in a small Rutgers University study of older women classified as overweight or obese. Participants who ate within a 9-hour window for 6 months showed greater improvements in memory, problem-solving and spatial planning than those who spread meals over about 12 hours, despite both groups losing a similar amount of weight.

Postcall Picks ✅

🍅 Make: this burst tomato burrata pasta. Sweet cherry tomatoes are slowly cooked until jammy, then tossed with garlic, fresh basil, Parmesan, and silky burrata for a tasty dinner that comes together with just a handful of summer ingredients.

🐔 Try: raising backyard chickens. With egg prices still keeping shoppers on their toes, this beginner-friendly guide walks through everything from choosing a coop and protecting your flock from predators to the daily care chickens need before you bring home your first hens.

💰 Save: on the Apple AirPods Pro 3, currently 21% off at $259.99 (regularly $329). The latest model adds heart rate sensing and live translation while keeping features like active noise cancellation, spatial audio, and USB-C charging.

🏛️ Visit: the ancient city of Troy. If Christopher Nolan's The Odyssey has you dreaming of Greek myths and epic journeys, this guide explains how to explore the legendary archaeological site in modern-day Türkiye, from its famous ruins to a replica of the iconic Trojan Horse.

📺 Watch: Can You Solve the Virus Riddle? from TED-Ed. This 5-minute animated puzzle challenges you to stop a prehistoric virus from escaping the lab, using nothing but logic and quick thinking.

Relax 🧩

First clue: Early heartbeat with a distinct p wave on EKG, for short

Give it a go ➤

Need a rematch? We’ve got you covered. Check out our Crossword Archive to find every puzzle we’ve ever made, all in one place.

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Staying #Up2Date 🚨

1: Does Skipping Vitamin K Come With A Cost? 

A cohort study of 2 million infants assessed rates of parental refusal of vitamin K prophylaxis and whether this had an impact on bleeding diagnoses during infancy. The number of infants who had no record of receiving the injection more than doubled from 2006 (0.66%) to 2021 (1.50%). Notably, infants without vitamin K administration had 1.5x higher odds of bleeding and 3x higher odds of intracranial bleeding (aOR; 95% CI, 2.13-3.96) during infancy when compared to those who received IM vitamin K at birth. These results highlight the significance of continued education for parents and healthcare providers about the evidence behind newborn prophylactic vitamin K and the risks that come with refusal. 

2: Can a Label Change What You Pick for Lunch?

An RCT of 6,210 adults looked at the effects of putting “ecolabels” on restaurant menus to promote healthy and sustainable choices. Using a traffic-light label to designate choices as red, yellow, or green depending on the item’s impact on greenhouse gas emissions, individuals ended up making selections with 30% lower greenhouse gas emissions from a sandwich restaurant and 15% lower at a burger restaurant. These ecolabels could be an effective and scalable strategy to promote more sustainable choices from fast-food restaurants - for both population and planetary health. 

3: Laparoscopic vs Robotic Approach to Complex Elective Cholecystectomy 

A cohort study of 863 patients found that those who underwent robotic surgery for complex elective cholecystectomy had fewer postoperative complications and follow-up procedures, such as endoscopic retrograde cholangiopancreatography (ERCP). While the operating room costs of robotic cases were higher compared to the laparoscopic approach, overall cost of care - when including management of post-operative complications - was similar. These findings suggest that robotic cholecystectomy is worth the price!

The Thalamus Takes the Heat 🥵 

The forecast may matter earlier than expected

What happened: As heat waves become harder to ignore, researchers say early-life heat exposure may have lasting effects on children’s brain development.

Why it matters: A new study in Environment International linked exposure to high temperatures during pregnancy and early childhood with slower growth of the thalamus, a brain region involved in processing sensory and motor information. The findings land as parts of Canada continue to see extreme summer temperatures, adding another layer to the health risks of heat.

The study followed more than 3,200 children from the Netherlands’ Generation R cohort. Researchers estimated outdoor temperatures during pregnancy and from birth to age 8.5, then analyzed MRI scans taken when the children were 10 and 14 years old. They measured the volume of 11 brain structures over time to see whether earlier exposure to heat or cold was associated with later brain development.

But: The study does not prove heat directly changes brain development, and it looked at outdoor temperatures rather than each child’s exact personal exposure. Still, the thalamus was the only brain region that consistently showed a connection with early heat exposure. Researchers say it may be especially sensitive because it develops early in pregnancy and has a rich blood supply.

Bottom line: Heat warnings may need a longer timeline. For pregnant people, infants, and young children, staying cool and out of extreme temperatures may matter well beyond the day’s forecast.

Hot Off The Press 🔥

1:🥤Think twice before reaching for that diet soda to power through your chart notes. A new study published in Neurology followed nearly 13,000 adults over 8 years and found that high consumers of popular artificial sweeteners – like aspartame, erythritol, and xylitol – experienced a 62% faster decline in thinking and memory skills. That gap equals roughly 1.6 extra years of brain aging, with the strongest associations popping up in adults under 60 and those with diabetes. Before you purge the breakroom fridge, keep in mind the study was observational and relied on self-reported diets, it doesn't prove direct causation. Still, it might make you hesitate before tearing open that artificial sweetener packet.

2: 🌮 A string of lawsuits has been filed against Taco Bell, its supplier Taylor Farms, and several franchisees following a massive multi-state Cyclospora outbreak in the US. American health officials traced the diarrhea-causing parasite back to contaminated Mexican-grown shredded iceberg lettuce served at restaurants across several states, prompting lawsuits, supply chain overhauls, and a whole lot of bad press. For Canadian readers craving a Crunchwrap, you can breathe a sigh of relief: Taco Bell Canada confirmed that the tainted supply chain never crossed the border, and public health officials report no linked outbreaks here at home.

3: 🌲 Talk about cross-border hospitality. Members of the Royal Canadian Air Force came to the rescue of 11 Minnesota teenagers and staff members who found themselves trapped by raging wildfires in Ontario's Wabakimi Provincial Park. After spending nearly 48 hours hunkered down waiting for smoke and wind to clear, the YMCA campers (ranging in age from 16 to 18) were successfully evacuated via RCAF plane and helicopter in coordination with local authorities. Minnesota Governor Tim Walz expressed deep gratitude to the Canadian military, emphasizing that swift international teamwork made all the difference in bringing the group home safely from an incredibly dangerous situation.

4: 🍁 Just when trade talks seemed quiet, US President Donald Trump is threatening a new 50% tariff on selected Canadian exports, ranging from wine and dairy to hockey gear and down jackets. While the White House claims it's retaliating against provincial booze bans and trade barriers, analysts say it's really about stripping Canada's leverage ahead of CUSMA renegotiations. With vital energy and auto parts notably left off the hit list to protect US consumers, Canadian officials are left navigating yet another high-stakes game of trade hardball.

5: 🤖 Apparently in an attempt to bring another Black Mirror episode to life, OpenAI is reportedly planning a self-learning, screenless AI companion, expected to be unveiled later this year. According to Bloomberg, the mobile smart speaker will control smart-home appliances, answer questions, play media, respond to messages, and learn a user’s routines over time. It also reportedly includes mechanical elements that can move on their own, which doesn’t sound creepy at all. Apple is suing OpenAI over its hardware push, alleging the company poached employees and misused trade secrets. OpenAI denies the allegations.

Notable Numbers 🔢

81%: the proportion of Canadians who worry that the rapid expansion of AI data centres will cause spikes in their household electricity bills, according to a recent poll. Nearly as many (79%) expressed concern over the environmental footprint, namely the massive amounts of power and fresh water needed to keep server farms cool. That worry is growing as tech firms scout expansion across provinces like Alberta.

60: the number of days participants were treated with fluvoxamine in a new McMaster-led clinical trial that found the low-cost antidepressant significantly eases long COVID fatigue. The medication successfully reduced symptom severity and improved overall quality of life, with benefits that persisted even 30 days after participants stopped taking the drug.

74%: the share of Gen Zers who reported drinking alcohol in the past 6 months, up from 66% 3 years ago. The supposedly sober generation may not be skipping the bar after all. They just got there a bit later.

Postcall Picks ✅

📚 Learn: how to optimize flu protection for your older patients this coming season. This 20-minute expert brief breaks down why adults 65+ are particularly vulnerable due to immunosenescence, compares available enhanced formulations, and provides practical EMR prompts and messaging strategies to boost vaccine uptake in your practice.

🌮 Make: these grilled beef tacos with watermelon and salsa verde. Thinly sliced, coriander-rubbed beef tenderloin meets a bright, refreshing mix of diced watermelon, cherry tomatoes, and crumbled feta. Top it all off with a zesty, homemade cilantro-and-lime salsa verde for the ultimate 30-minute summer taco night.

🎧 Listen: to The Holy Shiver, a captivating episode of Radiolab that investigates the biological mystery of goosebumps. The show dives deep into how a primitive mammalian survival instinct designed for cold and fear somehow evolved into a deeply emotional reaction to music, art, and awe.

💰 Save: on this portable propane pizza oven. It runs on standard gas tanks and reaches up to 850°F to crisp up 12-inch pies in about 60 seconds, making it a budget-friendly way to upgrade outdoor dinners without committing to a massive masonry setup.

📖 Read: this deep dive in The Walrus on why a new generation is treating aging like an optional inconvenience. The piece explores biohacking, stem cells, and longevity tech, unpacking how extending healthspan turned into a high-stakes obsession and asking how far we should go simply trying not to grow old.

Relax 🧩

First clue: 1, 2, and 3 for trainees

Give it a go →

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Staying #Up2Date 🚨

1: The Other NICU Patient: Parents

A systematic review and meta-analysis of parental mental health interventions in the NICU found that integrated psychotherapy was most effective in reducing parent stress, anxiety, and depression. Across 160 studies, programs such as bonding interventions, family-centred care and education, psychotherapy, and emotional support significantly reduced parent mental health symptoms. Given that some of these interventions are not particularly resource-intensive, hospitals should consider implementing them in NICUs to better support parent mental health.

2: Can Rituximab Put a Stop to Primary Ovarian Insufficiency?

A proof-of-concept study of women with autoimmune premature ovarian insufficiency (POI) assessed whether rituximab could enhance ovarian responsiveness to hormones and restore fertility. In women aged 18 to 35 years who had not previously responded to ovarian hyperstimulation therapies, rituximab helped half of the group achieve follicular development that led to oocyte retrieval. Subsequently, some were able to deliver healthy children via IVF. A randomized controlled trial is needed to further evaluate the safety and efficacy of rituximab in women with autoimmune POI trying to conceive.

3: The Value of Rapid Diagnosis Beyond Outbreak Control

A cluster randomized trial of 20 nursing homes found that using a point-of-care PCR instrument increased testing, improved case detection, and shortened time to antiviral therapy initiation for residents with respiratory virus infections, including SARS-CoV-2, influenza, and RSV. However, seasonal adoption of the on-site test did not reduce the number or size of outbreaks. Nevertheless, the intervention was estimated to avoid 4 hospital transfers per 100 nursing home beds, which could make a meaningful difference in health care utilization during peak-capacity periods.

The hidden impact of small fees

Sponsored by Wealthsimple

Most physicians are careful about big financial decisions: buying a home, paying down debt, planning for retirement.

But one smaller number can quietly have a big impact over time: investment fees.

Many physicians begin investing with the same institution that helped them through medical school — often because it's familiar and convenient. But the cost of holding certain investments can vary, and even small differences in annual fees can compound significantly over a career.

Consider this hypothetical: a physician who invested $100,000 in an average Canadian mutual fund — with a management expense ratio (MER) of 1.47% — and assumed a 5% annual return before fees, would have approximately $238,000 after 25 years. Now imagine that same $100,000 invested instead at a 0.40% MER — it would grow to approximately $307,000. That's a difference of nearly $69,000 — on the same starting amount, in the same market, over the same time period. The numbers will vary, but the takeaway holds: even a small difference in fees can add up to a meaningful amount over time.

The good news? Fees are one of the few parts of investing you can control.

Whether you're a resident just starting out, a new attending building your portfolio, or a physician who hasn't reviewed your investments in years, it may be worth taking a closer look at what you're paying — and whether your money could be working harder for you.

You didn't spend a decade in training to hand your returns over to fees. See exactly what they're costing you — and find out if it's time to find your money a better home.

Disclaimer: MER example provided for illustrative purposes only. All investment involves risk and may involve loss of principal. Past investment performance of a security, asset class, portfolio or firm does not guarantee or predict future performance. To get more info on our products, investment decisions, fee schedules, user testimonials, promos & more visit wsim.co/disclaimers.

Hot Off The Press 🔥

1: ⚽ As the World Cup heads toward the finals, a study from the Alzheimer’s Association International Conference is putting soccer’s long-term brain health risks under the microscope. Retired professional soccer players were more likely to report anxiety, depression, and problems with thinking or decision-making compared with people who hadn’t played contact sports. While some may not think of soccer the same way they think of American football, researchers say repeated head impacts, including headers, may affect brain health over time. Brain scans also showed lower grey matter in regions tied to memory, attention, decision-making, and emotional regulation, though the findings are still preliminary.

2: 🍓 Thinking about picking your own produce this summer? You may want to watch out for an outbreak of a diarrhea-causing parasite. Cyclospora is a microscopic parasite that infects the bowels and is commonly linked to contaminated fresh fruits, vegetables, and herbs. More than 1,500 people in Michigan have been diagnosed, with similar illnesses being investigated in 30 other states, and officials still haven’t identified the exact source. Experts recommend basic hygiene, including washing hands with soap and water, since alcohol-based sanitizer doesn’t kill Cyclospora.

3: 💵 Prime Minister Mark Carney is defending his decision to split net toll profits from the Gordie Howe International Bridge with the US. The bridge, which connects Windsor and Detroit, is set to open on July 27 after weeks of delays. The hope is that it will decrease congestion at the Ambassador Bridge and streamline cross-border trade. Under the new deal, Canada gets the bridge revenues first, then servicing and debt costs are paid, and whatever net profit is left will be split for 15 years, with half going into an economic development fund for the US side of the region.

4: 💔 Anti-gun violence advocates are calling for action after a violent weekend in Toronto that included a shooting at Salsa on St. Clair, where 2 people were killed, and another shooting near Polson Pier hours later. Police data shows there have been 6 firearm discharges in Toronto so far this July, compared with 2 during the same period last year. Robert Bennett, founder of Silence the Violence and Shunning Guns, said officials haven’t done enough to get ahead of gun violence. He said when the economy goes down, crime goes up, and one way to reduce violence is by offering employment opportunities that help close the wealth gap.

Thoughtful therapist matching designed to support your patients’ mental health journey

You've likely had this experience in your practice.

A patient opens up about anxiety, burnout, stress, or low mood and together you discuss treatment options. These options could vary, but sometimes therapy might be a helpful addition to their treatment plan. If your patient agrees, the next question might be: "How do I find the right therapist?" 

For many patients, this is where the process can become overwhelming.

Often people begin searching for support online and encounter hundreds of therapist profiles, varying credentials, therapeutic approaches, fees, and sometimes a waitlist.

What starts as a simple recommendation can quickly become a complicated search. This is where Layla Care can help.

Rather than asking patients to sort through directories and make decisions alone, Layla's team works directly with each individual to understand their unique needs, goals, preferences, and circumstances. A dedicated Care Coordinator will help identify therapists who are a strong fit, provide clear next steps and support that stays with them. 

To date, Layla has guided more than 25,000 people to therapy and facilitated over 250,000 therapy sessions. On average, patients have rated their quality of care 9.5 out of 10, and the quality of their therapist match a 9.3 out of 10. 

For physicians, referring to Layla helps close the gap between clinical recommendation and first therapy session. If you think your patients would benefit from therapy, Layla provides a clear, supported path forward.

Patients can self refer at www.layla.care/get-started, or practitioners can directly refer through most EMRs. 

Notable Numbers 🔢

10,000+: the number of excess deaths reported in Europe during the record-breaking late-June heat wave. The data included deaths from all causes (not just heat) but scientists say there weren’t any other known factors that could have contributed to the surge, other than temperatures which would have been “virtually impossible” without man-made climate change.

78: the age of Martha Lillard, the last known US polio survivor still using an iron lung, when she died. She contracted polio at age 5, 2 years before the vaccine became available, and outlived a childhood prognosis by nearly 6 decades.

5: the number of our basic taste qualities: sweet, sour, salty, bitter, and umami (savoury), all of which are dulled by GLP-1s. To counteract these taste profile changes, Nestlé is enhancing flavours of products specifically for GLP-1 users.

Postcall Picks ✅

📚 Learn: how the GLP-1 landscape is shifting beyond the scale. This 1-hour webinar with Dr. Sean Wharton unpacks the new therapeutic entries reshaping patient access and makes the case for treating GLP-1s as a total metabolic health play, not just a weight loss tool.

🥒 Make: this cucumber salad that turns thinly sliced cucumbers and red onion into a cool, with a tangy summer side. A quick honey vinegar dressing and a fresh finish of dill and chives.

✈️ Save: on a flight to Seoul. WestJet has dropped prices on nonstop Calgary to Seoul flights to $683 CAD roundtrip, about 58% below typical fares, with carry-on luggage still included.

📖 Read: about whether liquid biopsies could finally answer if cancer is really gone. This CBC piece follows a Toronto trial testing blood-based tumour DNA detection in 7,000 cancer survivors, and the ethical questions that come with knowing too soon.

📺 Watch: Doctor Mike react to sitcom medical scenes, from The Office to MASH. This compilation fact-checks TV's most dramatic (and most wrong) moments, on everything from concussions to chest compressions to that infamous junior mint.

Taking the Pulse 🏆

The World Cup started with 48 teams and nearly 6 weeks of matches. It all comes down to Sunday's final.

Relax 🧩

First clue: To be NPO is to ___

Give it a go →

Need a rematch? We’ve got you covered. Check out our Crossword Archive to find every puzzle we’ve ever made, all in one place.

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Help Us Get Better