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.

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.

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?

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.

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.

🧠 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.

First clue: ___ disability, 5150 criteria

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