Eleni

Internal Medicine Specialist w/ special interest in HTN, CKD & DM. A nerd in my spare time.

[Eleni @miofli]

I think I am quiet quitting life at this point.

[Eleni @miofli]

@nathalie_quoi @kaseropites Ευχαριστώ!

[Eleni @miofli]

@nathalie_quoi @kaseropites Ενδιαφέρον, είναι πρόσφατη η συνταγογράφηση;

[Ihtesham Ali @ihtesham2005]

A Norwegian neuroscientist spent 20 years proving that the act of writing by hand changes the human brain in ways typing physically cannot, and almost nobody outside her field has read the paper.

Her name is Audrey van der Meer.

She runs a brain research lab in Trondheim, and the paper that closed the argument was published in 2024 in a journal called Frontiers in Psychology. The finding is brutal enough that it should have changed every classroom on Earth.

The experiment was simple. She recruited 36 university students and put each one in a cap with 256 sensors pressed against their scalp to record brain activity. Words flashed on a screen one at a time.

Sometimes the students wrote the word by hand on a touchscreen using a digital pen, and sometimes they typed the same word on a keyboard. Every neural response was recorded for the full five seconds the word stayed on screen.

Then her team looked at the part of the data most researchers had ignored for years, which is how different parts of the brain were communicating with each other during the task.

When the students wrote by hand, the brain lit up everywhere at once.

The regions responsible for memory, sensory integration, and the encoding of new information were all firing together in a coordinated pattern that spread across the entire cortex. The whole network was awake and connected.

When the same students typed the same word, that pattern collapsed almost completely.

Most of the brain went quiet, and the connections between regions that had been alive seconds earlier were nowhere to be found on the EEG.

Same word, same brain, same person, and two completely different neurological events.

The reason turned out to be something nobody had really paid attention to before her work. Writing by hand is not one motion but a sequence of thousands of tiny micro-movements coordinated with your eyes in real time, where each letter is a different shape that requires the brain to solve a slightly different spatial problem.

Your fingers, wrist, vision, and the parts of your brain that track position in space are all working together to produce one letter, then the next, then the next.

Typing throws all of that away. Every key on a keyboard requires the exact same finger motion regardless of which letter you are pressing, which means the brain has almost nothing to integrate and almost no problem to solve.

Van der Meer said it plainly in her interviews.

Pressing the same key with the same finger over and over does not stimulate the brain in any meaningful way, and she pointed out something that should scare every parent who handed their kid an iPad.

Children who learn to read and write on tablets often cannot tell letters like b and d apart, because they have never physically felt with their bodies what it takes to actually produce those letters on a page.

A decade before her, two researchers at Princeton ran the same fight using a completely different method and ended up at the same answer. Pam Mueller and Daniel Oppenheimer tested 327 students across three experiments, where half took notes on laptops with the internet disabled and half took notes by hand, before testing everyone on what they actually understood from the lectures they had watched.

The handwriting group won by a wide margin on every question that required real understanding rather than surface recall.

The reason was hiding in the transcripts of what the two groups had actually written down.

The laptop students typed almost word for word, capturing more total content but processing almost none of it as they went, while the handwriting students physically could not write fast enough to transcribe a lecture in real time, which forced them to listen carefully, decide what actually mattered, and put it in their own words on the page.

That single act of choosing what to keep was the learning itself, and the keyboard had quietly skipped the choosing and skipped the learning along with it.

Two studies. Two countries. Same answer.

Handwriting makes the brain work. Typing lets it coast.

Every note you have ever typed instead of written went into your brain through a thinner pipe. Every meeting, every book highlight, every idea you captured on your phone instead of on paper was processed at half depth.

You did not forget those things because your memory is bad. You forgot them because typing never woke the part of the brain that would have made them stick.

The fix is the thing your grandmother already knew.

Pick up a pen. Write the thing down. The slower road is the faster one.

[Eleni @miofli]

Because... Internal medicine 😅

[Nelson Mogaka @NelsonMogaka_]

Why do Internal Medicine consultants ask 50 questions that seem unrelated to the chief complaint... then somehow end up with the correct diagnosis?

[Dr. Chacón-Lozsán F .'. @franciscojlk]

💊 Perioperative antiplatelet management is not “stop aspirin 7 days before surgery.”

It is a balance between surgical bleeding and catastrophic arterial thrombosis.

Recent PubMed indexed guidance is clear: in non cardiac surgery, the highest risk patient is not the one taking aspirin. It is the patient with a recent coronary stent, recent ACS, recent stroke, or high thrombotic burden in whom interruption of antiplatelet therapy may trigger myocardial infarction, stent thrombosis, or stroke (Thompson et al., 2024; Douketis & Spyropoulos, 2023).

For elective surgery, timing matters. After PCI, elective non cardiac surgery should ideally be delayed until the minimum recommended DAPT period is completed. If surgery cannot wait, aspirin should usually be continued when bleeding risk is acceptable, especially in patients with coronary stents. P2Y12 interruption, when necessary, should be as short as possible: clopidogrel usually 5 days, ticagrelor 3 to 5 days, and prasugrel 7 days before surgery (Thompson et al., 2024; Swan et al., 2024).

Emergency surgery is different. The decision becomes procedural urgency, bleeding site compressibility, last dose, platelet function recovery, and whether the antiplatelet effect can be tolerated. Platelet transfusion may partially reverse irreversible agents such as aspirin and clopidogrel, but it is much less reliable for ticagrelor because circulating drug can inhibit transfused platelets (Swan et al., 2024).

Recent evidence also challenges dogma. In stable patients with previous drug eluting stents undergoing low to intermediate risk non cardiac surgery, aspirin continuation did not clearly reduce ischemic events compared with temporary interruption, although minor bleeding increased (Kang et al., 2024). This does not mean “stop aspirin in everyone.” It means individualize.

The practical question is not:

“Should antiplatelets be stopped?”

It is:

What is more dangerous for this patient: bleeding today, or thrombosis tomorrow?

#Anesthesiology #PerioperativeMedicine #Cardiology #AntiplateletTherapy #Aspirin #Clopidogrel #Ticagrelor #Prasugrel #NonCardiacSurgery #PatientSafety

References 📚
Douketis, J. D. NEJM Evidence, 2(6). https://t.co/zms5Bz8MAE

Kang, D. Y. Journal of the American College of Cardiology, 84(24), 2380–2389. https://t.co/p9iMZBqx7M

Swan, D., Research and Practice in Thrombosis and Haemostasis, 8(6), 102548. https://t.co/61A5TyzWbO

Thompson, A., Journal of the American College of Cardiology, 84(19), 1869–1969. https://t.co/ExOBujTyfY

[Professor Azeem Majeed @Azeem_Majeed]

When I worked in an emergency department in a rural part of Wales, I sometimes had to provide medical treatment to farmers.

Receptionist: A farmer has just come in. He says he has some mild chest discomfort.

Me: GET THE CRASH TROLLEY!!!

[Stavros_D_S @Stavros_D_S]

The so-called "Greece" runestones are about 30 such memorials found in Sweden, written in the Old Norse Language using the Runic Script. They were carved during the Viking Age (prior to 1100 AD), commemorating the travels and exploits of Nordic warriors to the Eastern Roman (Byzantine) Empire who mostly served as mercenaries, presumably in the renowned Varangian Guard.

In all these stones the Empire is referred to as Grikkland (Greece) and the Rhomaioi (Byzantines) as Grikkjar (Greeks). Similarly, other European peoples such as the Bulgarians, Hungarians and Rus also called the Eastern Roman Empire "Greece" and its inhabitants "Greeks", as did the Western Latins of course. And while the Latins had political reasons to call them that, denying their "Roman" legitimacy that they considered as theirs, the others did not.

Clearly the use of the term "Roman" had become a purely political matter for centuries prior, important for legitimacy and prestige reasons to Greeks and Latins (the two main constituent cultures of the old Roman world). Other European peoples, who did not consider themselves as direct inheritors of the old Roman World and Graeco-Roman Civilisation simply did not really care that much for such semantics. They saw a state primarily inhabited and ruled by Greeks and simply called it Greece...

The specific pictured runestone (tagged as U358) writes:

"Folkmarr had this stone raised in memory of Folkbjörn, his son. He also met his end among the Greeks. May God help his spirit and soul."

[Eva @Evantrik]

Στις 14/7/2022 κάναμε αίτηση αναδοχής, ακολουθώντας τις συμβουλές της @kalinyhta_Jo. 2 χρόνια αργότερα ήρθαν στην οικογένεια μας οι κόρες μας, 3 ετών και 3 μηνών τότε. Απρίλιο 2026 έγινε το δικαστήριο υιοθεσίας και από χθες οι κόρες μας είναι επίσημα στην οικογενειακή μας μερίδα.

[Herald of Rome @HeraldOfRome]

Which peoples produce the most elite scientists and academics relative to their population?

[NEJM @NEJM]

Original Article: Daraxonrasib or Chemotherapy in Previously Treated Metastatic Pancreatic Cancer (phase 3 RASolute 302 trial) https://t.co/y4G27hfORg

#ASCO26 | @ASCO

[Matthew Herper @matthewherper]

People who don't follow cancer research often ask me why we haven't cured cancer. That perception masks a wonderful reality: We make amazing, stepwise progress every year, and the result is that many people live much longer today than they would have previously.

Right now we're in the thick of the annual meeting of the American Society of Clinical Oncology, the biggest research meeting on new cancer medicines, and this morning a bunch of really important studies dropped. I'm going to review them here.

This first image is the result for daraxonrasib, a treatment for pancreatic cancer that is generating consdirable excitement. The green line is the probability of living for patients who got the new drug; the gray one is the chemo control group.

If you follow cancer drugs, a chart like this will make your breath hitch a little. I'm going to review these and some other data here.

[Mark Lewis, MD, FASCO @marklewismd]

Cheers, chills, and a standing ovation when RASolute 302 showed unprecedented survival on daraxonrasib for patients with progressive pancreatic cancer

Seldom do you sense you’re witnessing a historic moment in cancer care but this feels like ras targeting has arrived

#ASCO26

[Eleni @miofli]

@aziot 😅 τώρα το έβαλες στο μυαλό μου χαχα

[Eleni @miofli]

https://t.co/0pWqYeeFDd

[Fandom Pulse @fandompulse]

Greek City Times published an open letter to Christopher Nolan's The Odyssey this week. It reads in part:

"We did not vanish. Greek people did not disappear after the age of myth. Greek culture was not frozen in classical marble. We are still here. For more than 3,000 continuous years, Greek identity has persisted."

The addendum: "Given Hollywood's insistence for minority representation, authenticity and diversity — where are the Greeks, or the Greek Americans in this Greek story?"

The film shot in Greece, with Greek funding, across Greek locations. Not one cast member is Greek.

Hollywood required diversity for every production except this one.

[Eleni @miofli]

@ThomaisERT_RIK I stopped reading at the kilometers of "great" beaches. lol.

Both countries offer nice things, but for different styles of vacation.

[Alex Veremeyenko @alex_verem]

Let me trace the timeline here because nobody's connecting it.

Step 1: Scrape the entire internet. Every book, every article, every conversation, every piece of art, every forum post. Do it without asking. Do it without paying.

Step 2: Train a model on all of it. Call it "artificial intelligence."

Step 3: Go to BlackRock's Infrastructure Summit and announce: "We see a future where intelligence is a utility, like electricity or water, and people buy it from us on a meter."

Step 3 is where you sell people's own knowledge back to them. On a meter.

They took the collective output of human thought, compressed it into a model, and now they want to charge you by the token to access a version of what you and everyone you know already created.

One Reddit user put it perfectly: "They stole all this data from us, the people, our life's work, creativity, art, by devouring the internet and blowing through all copyright laws. Now they want to sell it back to us in the form of a utility."

Imagine if someone photocopied every book in the public library, burned the library down, and then opened a subscription service for the copies.

That's the metered intelligence business model.

And they're pitching it to infrastructure investors as though they invented water.

[Eleni @miofli]

@Titsalitsa Ευχαριστώ πολύ!

[Raven @MLakonias]

Black Panther and Wakanda were fictional and no one would dare cast white actors.
There is one more difference, Wakanda is fiction the Odyssey is a myth.Let me me give you a head's up.
Fiction is a made-up story created primarily for entertainment, where both the author and the audience know it is not literally true. In contrast, a myth is a sacred, culturally significant narrative meant to explain the world, human origins, and moral truths, often treated as deeply meaningful or historically valid by its originating culture.
Hope that helps!