Staying #Up2Date 🚨

1: Cutting Recurrence in Chronic Subdural Hematomas

An RCT of 186 patients examined whether middle meningeal artery (MMA) embolization could reduce recurrence of unilateral symptomatic chronic subdural hematomas. After 90 days, patients who received embolization within 72 hours of surgical drainage had significantly lower recurrence rates (4%) compared to those who underwent surgery alone (28%). These findings support MMA embolization as an effective adjunct in chronic subdural management that may improve long-term outcomes.

2: The Physical Cost of Operating

A prospective study of ENTs across 80 cases found that 37% of attending surgeons and 43% of residents and fellows reported moderate to severe ergonomic risk while operating. Increasing case difficulty, longer operative durations, and larger glove sizes were all associated with higher ergonomic risk and increased pain. These findings highlight the need to address occupational strain as part of surgical practice.

3: Symptom-Guided Care in Neonatal Opioid Withdrawal

A cluster RCT of 383 infants suggests that tailoring pharmacologic treatment of neonatal opioid withdrawal syndrome (NOWS) based on symptoms may improve efficiency of care. Infants receiving symptom-based dosing were ready for discharge 2.3 days earlier than those managed with a scheduled opioid taper, with no difference in safety outcomes. These findings support symptom-guided dosing as a more efficient and equally safe approach to NOWS management.

AI vs. Doctor Showdown

In the ER, second opinions are getting a bit… algorithmic

What happened: A recent study tested how a large language model (LLM) performed across key stages of emergency care, using unstructured patient data from real emergency department cases. Researchers had the model work through triage, assessment, and disposition decisions, then compared its performance to physicians.

Why it matters: AI tools like scribes and scheduling assistants are already creeping into clinical workflows, but large language models are different. They’re designed to reason through complex information and generate structured answers, raising the question of whether they could support, or even augment, diagnostic decision-making in high-pressure settings like the ER.

In the study, OpenAI’s o1-preview model was able to arrive at the correct or near-correct diagnosis in many cases, and in some scenarios performed comparably to, or better than, participating physicians. The findings hint at a future where AI could help streamline triage or reduce diagnostic delays, particularly in resource-strained environments.

But: The authors of the study say there were limitations, including a big one: the AI is owned and operated in the US, so it might not apply to Canadian ERs. Also, more research will need to be done to understand how humans and machines can work together effectively in emergency medicine. Cutting back on how often doctors see their patients might not be what’s best for them, so integrating AI into hospitals must be done accurately with the help of experts to ensure patient safety. 

Bottom line: AI is getting better at clinical reasoning, but it is still far from replacing physicians. For now, the more realistic role is as a support tool, one that may help process information faster, but still depends on human judgment to turn decisions into care.

Hot Off The Press

1: 🖥️ Canada has a fax problem dressed up as a digital health system. A new CMAJ study found that while 95% of Canadian physicians use electronic health records, almost none of those systems actually talk to each other. Data exchange between primary care, specialists, and hospitals across Canada still depends heavily on fax or mailed letters. The disconnect is estimated to cost taxpayers more than $9.4 billion annually. A federal fix — the Connected Care for Canadians Act — was killed when Parliament prorogued in 2025 and has since been reintroduced in the Senate.

2: 🧠 Health Canada has authorized Kisunla (donanemab), adding another option to the slowly expanding toolkit for early Alzheimer’s disease. The monoclonal antibody targets amyloid plaques and is indicated for patients with mild cognitive impairment or early dementia, with trials showing modest slowing of cognitive decline, and some patients able to stop treatment. The catch is familiar: ARIA risk (brain swelling and bleeding), IV infusions, MRI monitoring, and ongoing questions around cost and access in the Canadian system.

3: 🇨🇦 Canada just approved its 2nd generic version of Ozempic, and this one is local. Toronto-based Apotex will produce semaglutide, the drug behind one of the most in-demand diabetes and weight-loss treatments. Prices are expected to drop as more generics enter the market — to around half the brand-name cost. Demand is still outpacing supply, though, and it’ll take time for lower prices to actually improve access.

4: 🛢️ Tensions in the Strait of Hormuz remain elevated as the US moves forward with plans to escort commercial vessels through the region, following disputed claims from Iran that it struck an American military target. Iran has warned it could respond to unauthorized transits, keeping one of the world’s most critical shipping lanes firmly in focus. Energy markets have reacted quickly, with oil prices moving higher on disruption fears and analysts warning that prolonged instability could push crude significantly higher. That pressure is already filtering through, with gas prices at risk of rising if volatility in the region continues.

5: 📦 Amazon just opened its logistics network to outside companies, and markets reacted fast. UPS and FedEx shares fell 10% and 11% after the announcement, as Amazon moves to turn its delivery system into a standalone business. Companies can now tap into its freight, storage, and delivery infrastructure, similar to how AWS started. This is what it looks like when Amazon spends years building something for itself, then offers it to everyone else.

Notable Numbers 🔢

3: the number of passengers confirmed dead following a suspected hantavirus outbreak aboard a cruise ship in the Atlantic, with additional cases of severe illness reported as health authorities investigate a rare rodent-borne virus that can cause serious respiratory disease.

$10 million: the amount of capital gains Canadian business owners can avoid when selling their company if they transfer ownership to their employees through an Employee Ownership Trust. Ottawa made this incentive permanent at a good time, with more than 75% of small business owners planning to sell within the next decade — a potential transfer of $2 trillion in assets.

15: the number of airplane seat designs being explored, ranging from glamorous first-class zero-gravity recliners with built-in massage functions to economy configurations that seem to treat legroom as optional (more so than it already is).

Postcall Picks ✅

🎧 Listen: to this CMAJ podcast on cancer in Canada. Rates are declining overall, but young adult survivors are twice as likely to develop a second cancer, and most are discharged back to their family doctor without a follow-up plan.

🎓 Attend: the Best of ASCO Toronto Conference 2026, where leading Canadian oncologists break down the most practice-changing data, translating major advances and current standards of care into practical, Canadian-context takeaways. 

🏃 Workout: this spring and give running a shot. Runner’s World’s beginner guide might peel you off the couch for a comfortable 30 minutes, one slow kilometre at a time.

📖 Read: how chewing gum could earn a place in cancer care. A new study found a bioengineered piece of gum reduced HPV and oral cancer-linked bacteria to near-zero levels in patient samples. It hasn’t been chewed yet — only tested on saliva samples — and flavours and bubble-ability haven’t been announced.

🥗 Make: these meal prep power bowls. Take 25 minutes on a Sunday to sort your lunches for the whole week — quinoa, roasted veggies, beans, and whatever is about to die in your crisper.

🎬 Watch: this physician’s honest breakdown of $800K in student loans, a high cost of living, and what realistic repayment plans really look like in early-career medicine.

Career Corner 🥼💼

Whether you’re looking for a change of pace or just browsing between patients, here are a few jobs worth knowing about this week.

🏔️ General Internists – Comox Valley, BC
Live and work on Vancouver Island in a community general internal medicine role with strong demand and the added benefit of coastal living.
 🔗 Apply

🫀 Gastroenterologist – Oakville, ON
High-demand GI opportunity in a well-established Ontario community with strong referral networks and busy procedural volume.
 🔗 Apply

🧬 Nuclear Medicine Physician – Windsor, ON
Hospital-based diagnostic imaging role with oncology collaboration, clinical reporting, and multidisciplinary care exposure.
 🔗 Apply

🚑 Emergency Physicians – Prince George, BC
Fast-paced ED practice with a broad acuity mix and shift-based structure across high-demand sites.
 🔗 Apply

🩺 Family Physician – North York, ON
Community clinic roles with high patient volume and flexible practice structure in an expanding urban centre.
 🔗 Apply

Relax

First clue: Send to a colleague for a second opinion

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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