Tom Fusillo, DO

@kai_xbt I gotta know what physician is prescribing selegiline in 2026.

Clavicular reveals his current daily drug protocol "Adderall 30mg a day dosed 10, 10 and 10. Last dose is variable depending on whether I'm streaming or want to go to bed early. Selegiline which is an MAO-B inhibitor, basically blocks your body from breaking down dopamine, that's a transdermal patch. Pregabalin to block excitatory neurotransmitters so I'm less anxious and can handle crowded spaces. And Baclofen which is a GABA-B agonist similar to the receptor alcohol hits since I'm quitting drinking."

Among patients with atrial fibrillation at high risk for stroke and bleeding, left atrial appendage closure was not noninferior to medical therapy in reducing the risk of stroke, embolism, major bleeding, or death at 3 years. Full CLOSURE-AF trial results: nejm.org/doi/full/10.10… Editorial: Left Atrial Appendage Closure — Another Overused Method in Cardiology? nejm.org/doi/full/10.10…

@mcuban @costplusdrugs For those wondering how this drug works x.com/t_fus/status/1…

Summary - @costplusdrugs is cheaper than your insurance copay or coinsurance! Medication Costs for Dofetilide: Comparison of Insurance Copayments Versus Generic Pricing Through Cost Plus Drug Company | Circulation ahajournals.org/doi/10.1161/CI…

Cool part about being a physician is that you get accused of being a pharma shill & forcing pills down peoples’ throats and get yelled at for not prescribing antibiotics for asymptomatic bacteriuria both in the same day.

Taxi ride in NYC today: Fare: $9.30 Fees: $7.25 Congestion surcharge: $2.50 Rush hour surcharge $2.50 Central business district surcharge $0.75 Taxi improvement surcharge $1.00 MTA State surcharge $0.50

@Nowooski Cefepime?

My dad was in the hospital for a few weeks over Christmas. 4 days into his stay, he started starting having wild hallucinations. I asked the doctors if it could be any new medications, they all insisted it wasn’t. ChatGPT identified that a small number of older men with his profile can experience hallucinations as a side effect of an antibiotic they put him on the previous evening. I insisted they take him off that medication and the hallucinations stopped. New York progressive what to make that illegal and think I should have just trusted the doctors who were dismissing his suffering.

@AmmousMD I'll add that sure, their hypothesis of mental stress causing HTN causing plt activation in theory may have an effect, but they chose not to reference or site anything to support this. Why?

The authors in that paper suggest that mental stress causes more ASCVD than actual plaque. How does that work? "Here, the authors found that LDL-C was significantly higher among those with subclinical atherosclerosis (125.7 vs.117.4 mg/dl). However, association does not prove causation. Mental stress, for instance, is able to raise cholesterol by 10–50% in the course of half an hour[18,19], and mental stress may cause atherosclerosis by mechanisms other than an increase in LDL-C; for instance, via hypertension and increased platelet aggregation." Hundreds if not thousands of studies have supported LDL increasing ASCVD risk. Here's a more recent one from 25 years of data: "During follow-up (mean: 5 years), the early target LDL-C group (n = 5702) had a lower risk of recurrent MACEs compared with the non-early target LDL-C group (n = 11,232; adjusted hazard ratio [95% CI]: 0.89 [0.82–0.96]). The effect was most pronounced in patients with ACS (0.73 [0.63–0.85]), particularly for recurrent MACEs within 6 months (0.61 [0.44–0.87]). The early target LDL-C group had 19% lower frequency and 31% shorter LOS for cardiovascular-related hospitalizations than the non-early group." pmc.ncbi.nlm.nih.gov/articles/PMC11…

One of the darkest moments in my medical education was understanding that "high cholesterol" was a made up disease to sell pills.

@Papa_Heme I use it occasionally for lit review but the problem I have had when asking about differentials or management decisions is that its responses differ somewhat substantially depending on how the question is phrased.

If you are not blown away by the power of OpenEvidence AI then you are not using it correctly. I recently tried some pretty complex cases and it provided a perfect differential, next diagnostic steps, areas of uncertainty, and follow up plan.

The Department of War has officially put Scouting America on notice. It’s time to get back to basics — and DoW is leading the charge.

@ohiotate Can’t interpret on its own. Would need to see TSH and free T4 as well.

Need a medical expert. Took a blood test for a potential thyroid (idk what that is) problem and these are the results. My doctor is ON VACATION and can’t review the results. How bad is it? Grave danger? Did lemon eyes cause this?

@DocDifferently @EndeavorHlth Imagine putting a child on ecmo for $75 an hour

@EndeavorHlth wants to hire a pediatric intensive care physician to work nights and weekends for $75/hr. Please nobody take this job.

@rushadpatell Yes they are! Great seeing you again Dr Patell

@T_Fus Congrats ! And I agree, they are awesome 🙌🏽

Presented two posters at #ASH25 last weekend! Shared research on NLP vs. manual review for detecting bleeding in cancer patients & post-op thrombocytopenia in CABG. Grateful for my mentors' invaluable guidance on my hematology journey—their support means everything! #Hematology

Went to @MetOpera last night for Porgy and Bess- a wonderful performance! Truly the great American opera!

@BarstoolChief @EddieBarstool @barstoolWSD @DannyJConrad Triple nut & burrata crew all the way 💪🏽

@T_Fus @EddieBarstool @barstoolWSD @DannyJConrad thanks for all the support, tom

These guys are the best in the business! Happy new year boys. @EddieBarstool @BarstoolChief @barstoolWSD @DannyJConrad

Headed out to #ASH25 !