Shunky B

MD MPH. Hospitalist. Interested in all things medicine & the Detroit Lions.

[Shunky B @shunkheem]

@Grant_Shirley4 Also led to the huerter trade which yielded asa + 8

[Parmita Mishra @parmita]

RAS finally getting drugged is one of the great stories in modern biology, and almost nobody outside oncology understands why it's such a big deal.

YOU'LL LEARN SOMETHING AWESOME TODAY.

i am going to keep this as understandable (and simple) as i can.

OPEN THE THREAD.

🧵

[Earvin Magic Johnson @MagicJohnson]

I can’t wait to watch Game 7 of the Oklahoma City Thunder vs San Antonio Spurs tonight on NBC. This game is must see TV!

[Tony Breu @tony_breu]

3/
PROACT Xa compared apixaban to warfarin in 863 patients.

╰┈➤ As with RE-ALIGN, patients in the apixaban arm had more thrombotic events, though bleeding rates were no different.

These findings have led to continued guidelines recommending vitamin K antagonists (e.g., warfarin) as the standard of care for patients with MVs.

https://t.co/1LntpD0ljH

[Tony Breu @tony_breu]

2/
Early enthusiasm for DOACs in MVs was tempered by the results of RE-ALIGN, published in 2013 in NEJM.

252 patients with MVs were randomized to either dabigatran or warfarin.

╰┈➤ Patients in the dabigatran arm experienced more thrombotic and bleeding events.

https://t.co/F432NRd2oe

[Layne Norton, PhD @BioLayne]

12 years ago, my mother was diagnosed with “incurable” multiple myeloma (MM).

At the time, median survival was roughly 4–6 years.

She listened to her oncologist.

She followed evidence-based treatment.

She is still here 12 years later.

Thriving.

[Shunky B @shunkheem]

Empiricism trumps our understanding of pharmacology and physiology. Misguided dogma often stems from what ‘makes sense.’

There are certainly clinical benefits/applications to understanding MOAs, but what ultimately matters most is ‘does benefit of intervention outweigh risks.’

[Adam Gaffney @awgaffney]

Putting this point aside, it is striking how much emphasis there is in public discourse on the mechanism of drugs like statins, SSRIs, or GLP-1s. Mechanistic questions are interesting & important scientifically, but for most of us they have little practical relevance.

1/4

[Derek Thompson @DKThomp]

Wait, what’s that? Living is *not* strictly about the neurotic whack-a-mole elimination of every single activity that has been shown to increase biomarker distress, no matter how small and uncertain the effect size?

Ah ok carry on with your normal health regimen:

>sleep ~7 hours
>exercise frequently
>avoid chronic caloric surplus
>socialize

[Interesting things @awkwardgoogle]

Just in case you’re having a bad day, remember this is how they weigh koalas 😍

[Kevin Chouinard @KLChouinard]

The Stretch 5 the NBA needs.

[Josh Kraushaar @JoshKraushaar]

Ben Sasse: "What’s really happening is these superdevices in our pockets — the largest tools any median individual’s ever had access to in all of human history — allow our consciousness to leave the time and place where we actually live, the places where we break bread, the people who are living next door to us, the people that you can physically touch and hug, the small platoons of real community, and we allow our consciousness to go really far away"

[Shunky B @shunkheem]

@BTRowland @dlee4three Using FG% as a proxy when OO takes 5.3 3PA a game (nearly 50% of FG attempts) 😂😂😂🤦🏽‍♂️

[Shunky B @shunkheem]

@REGGIES_WORLD Also if they decide to keep CJ, Kuminga, +/- Gabe they probably could do it for around, maybe a little less than what CJ alone is making this yr. Can definitely be buyers this offseason to go along with a potential high impact rookie, growth from all their young/developing pieces

[Adam Gaffney @awgaffney]

My problem with the "public health failures during COVID" discourse is primarily that it fails to foreground that this was a once-in-a-century pandemic that ripped through the entire world's population, slaughtered millions, and that it ...

[NetsMuse @NetsMuse]

@BillSimmons I like the the idea of 72 games but it's impossible because of the financial loss.

Would you make less podcasts to try to "improve quality"? No, because you would make less money.

[Shunky B @shunkheem]

@BillSimmons Why don’t the players & owners want to make less money? Are they stupid??

[Shunky B @shunkheem]

@venkmurthy @drjohnm Agree it’s nonsense to question his credentials as an MD and in general it would be better if people communicated in good faith. Let’s not pretend that the guy who both he & you are defending is the king of decorum on this platform

[Will Blackmon @WillBlackmon]

How Patient Kenneth Walker was every time he had the rock lol

[Cousin Sal @TheCousinSal]

I wasn’t nearly as excited for the birth of my sons as I am for this podcast.

[HoldenCantor @HoldenCantor]

Matthew Stafford threw for 8 touchdowns 0 interceptions and 961 yards against this Seahawks defense. Shoutout to the MVP voters that voted Stafford