John Mannisi MD 🇺🇸🇮🇹❤️‍🩹🏃

Physicians are not incentivized to medicate patients. FDA approves medications after rigorous trials. Bias and politics and money are always something to contend with in trial design and interpretation of clinical data. However there is a large national infrastructure dedicated to ethical data integrity so that results of trials are meaningful. That cannot be said of lots of longevity drugs which are recommended by hearsay, friends and medical grifters. The quality of evidence between the two classes of medications is enormous. Vaccines are very effective to prevent illness. Covid was not a vaccine. It was an anti-spike antibody designed to prevent Covid death. In that regard, it was very effective. What is legitimate is the side effect profile of any vaccine or medication that is not obvious in the initial trial data. In that regard, we have ongoing drug registries which monitor long term new adverse effects of approved drugs and vaccines on the market. These new side effects can ultimately lead to drugs being taken off the market (ie fen-fen). The is FDA system of safety in place is unmatched and is funded by our citizens. Skepticism is healthy but we should not dismiss its efficacy.

Joe Rogan: "Doctors are incentivized to medicate people, they're financially incentivized to give people certain medications. Like some get bonuses if they vaccinate more than 60% of their clients..."

Lipoprotein(a), interleukin-6 and cardiovascular risk in a primary prevention setting ☝️New data from UK Biobank (n=34,092): In primary prevention, the cardiovascular risk associated with elevated Lp(a) was significantly influenced by IL-6, a key upstream inflammatory cytokine. 1️⃣ Higher Lp(a) increased MACE risk only when IL-6 was elevated (HR 1.17; 95% CI 1.07–1.28), while no significant association was seen when IL-6 was below median levels. 2️⃣ Inflammation appears to amplify Lp(a) pathogenicity, supporting the concept that not all elevated Lp(a) carries the same biological risk burden. 3️⃣ hs-CRP did not show the same modifying effect, suggesting IL-6 may be a more informative biomarker than conventional inflammatory markers for Lp(a)-related risk stratification. 4️⃣ Clinical implication: Future Lp(a)-lowering therapies may yield greatest benefit in individuals with concomitant elevated IL-6, enabling more precise preventive targeting. 👉 Elevated Lp(a) appears to confer its greatest cardiovascular hazard in the presence of heightened IL-6–mediated inflammation, supporting a biologically integrated model in which inherited atherothrombotic burden and residual inflammatory risk act synergistically @ATHjournal @society_eas 🔗 doi.org/10.1016/j.athe…

Acute hemodynamic effects of a novel algorithm for cardiac resynchronization therapy optimization: Results from the BIO|Adapt study @UniFAU @FHU_PR @Tokai_Univ_ @IISLaFe @PUMS_tweets @BIOTRONIK_News @JihoceskaUni #EPeeps heartrhythmopen.com/article/S2666-…

@Medscape White coat needs frequent laundering as it is a source of antibiotic resistant organisms. I favor regular clothing or which are changed daily

While the white coat remains a powerful symbol in medical education, its daily utility is shifting as clinicians prioritize comfort and approachability. Recent studies suggest that patient trust is built through demeanor and communication rather than attire, leading many physicians to favor fleece jackets or scrubs. Do you still view the white coat as an essential component of professional identity? mdsc.pe/3QARQBb

CardioCore: Foundational Lectures in Cardiovascular Disease Prevention — a monthly webinar series from ASPC designed to deliver high-quality preventive cardiology education to trainees and clinicians. Complimentary and open to all, with sessions led by experts in the field. 📅 Lipid Guidelines 🗓 Wednesday, May 13, 2026 ⏰ 6:00–7:00 PM EDT 🎤 Lecturer: @rblument1 This session will translate the 2026 ACC/AHA Multi-Society Dyslipidemia Guideline into practical, patient-centered care, including: • Assessing cardiovascular risk using contemporary tools • Initiating and intensifying lipid-lowering therapy based on individualized risk • Applying updated treatment targets (LDL-C, non–HDL-C, ApoB) Additional topics: • Incorporating risk markers such as Lp(a) and coronary artery calcium • Triglyceride management in ASCVD and pancreatitis risk • Evidence-based strategies for high-risk populations, including diabetes and chronic kidney disease Register: aspconline.org/new-lipid-guid… #CardioCore #PreventiveCardiology #CardiologyEducation #LipidGuidelines #ASPC

📊 New Research Alert Geographic Variation in Eligibility & Uptake of GLP-1 RAs for obesity in U.S. adults highlights a growing gap between who could benefit—and who actually gets treated. 💡 Key insight: <3% of eligible patients receive GLP-1 therapy, with major regional disparities driven by access, coverage, and socioeconomic factors. As GLP-1 use rises, equity—not just efficacy—may define impact. 🔗 Read more: sciencedirect.com/science/articl… #Obesity #GLP1 #HealthEquity #Cardiology #PublicHealth

Research | Chen et al. developed a self-powered smart magnetoelastic stent for real-time hemodynamic monitoring and stenosis detection. nature.com/articles/s4416…

❤️Our March issue is out❤️Read about an AI model using echocardiography images improves cardiac diagnosis, LVAD unloading alleviates cellular senescence, inhibition of a hematopoietic death regulator shows cardioprotection, and more. nature.com/natcardiovascr…

Carotid Artery Stenting Outcomes in Comprehensive Stroke Hospitals (CASSH): A Prospective Multicenter Study ahajrnls.org/48kocpS

Head down tilt 15° to increase collateral flow in acute ischemic stroke: rationale and study protocol of a multicenter, randomized, proof of concept, phase 2a/b trial in patients treated with mechanical thrombectomy (DOWN-SUITE) ahajrnls.org/4sZTBFx

Paclitaxel Drug-Coated Balloon Angioplasty for Medically Refractory Intracranial Atherosclerotic Disease: A US Single-Center Experience With the AGENT Balloon ahajrnls.org/4t21ZV4

Geneticist J. Craig Venter, best known for his role in sequencing the human genome, has died aged 79. He spoke to Nature in 2023 about AI, sequencing the ocean – and why he had no plans to stop working. go.nature.com/4tHEf9M

@Liathetrader @medieval_bops Thoughtful approach. Young woman can also marry into money and have children early. But that is a woman’s choice. Many man who marry truly want to responsibly build a family with love and respect.

Nobody ever told me this. I grew up in a very strict society where kids were expected in the early 20s. Nobody told me not to have them. I was also never on birth control in my life. I was smart enough to feel the hypocrisy of damaging my body for solely male pleasure. I didn’t have kids because I saw what a shit show and misery it was for my parents: poor, stressed, ill, and never having time for us because they had to work two jobs to afford us. They had cancer in their 40s and 50s. Thus I said, money first and then kids.

I am 51 and deeply regret not having kids. I was stringently brainwashed into believing that I should never have children. I’ve never even been pregnant as far as I know. I was on birth control from age 16 through age 49.

@Liathetrader @MattZirwas Blood hair blue eyed sun-goddess….. see a dermatologist yearly! Sp 60 really helps though!

@MattZirwas If I go to sun covered in 60spf sunscreen does it still count as sun exposure?

Dermatology is wrong about the sun. And it's killing people. I'm a dermatologist. 226 publications. I should know. Avoiding the sun increases the risk of dying as much as being a smoker. We can fix it. For decades, dermatology's message has been simple: avoid the sun. Wear sunscreen. Seek shade. UV causes skin cancer. End of discussion. That message is incomplete and outdated. People are dying because of it. Lots of people. The evidence has gotten strong enough that the field needs to update it.🧵

Starting on July 1, weight loss drugs like #Ozempic, #Zepbound, #Wegovy will be available for a $50 a month co pay for Medicare patients (down from $1,300 per month). x.com/i/trending/205…

5-year FAME 3: FFR-guided #PCI w/ zotarolimus DES for multivessel CAD had 30% lower cost, similar QALYs, & faster early #QoL recovery vs CABG, reinforcing value & patient-centered #revasc decisions. jacc.org/doi/10.1016/j.… 🧵 (n/7) #JACC #cvCAD #cvCABG

@jselanikio Because of high numbers of false positives, this will flood physicians with "unnecessary" followup visits and perhaps even risky followup testing. Not a good trend! Medicine is based on Bayesian mathematics which is not intuitive to consumers.

Oura sells $99 blood panels via Quest. WHOOP and Hims too. Function Health, valued at $2.5B, now integrates with ChatGPT Health for AI-assisted result interpretation. Patients are ordering tests their PCP never ordered, getting results their doctor never saw, and interpreting them with an AI their doctor doesn't control. Three migrations (diagnosis, monitoring, and interpretation) converging in a single consumer workflow. buff.ly/xkIc3eh #DrYou #FiveMigrations

NEWS: Weekly GLP-1 reduced heavy drinking by more than 40%. 🥃 Read the full story ➡️ bit.ly/3QDXnXP

@RevShark No!

Actually, that looks like 405 pounds. There is 8 plates at 45 pounds each plus a 45 pound Olympic bar

HFpEF importance of diet and exercise!