Calm yourself my love. No teenage girls are having their healthy breasts removed, just teenage boys are having their gynaecomastia resolved so they can live in freedom in their bodies. Also - BTW - puberty blockers prevent the need for top surgery - FYI 😘 Oh and well done to @LushLtd for recognising all teens.

Brian, for the love of god, you cannot take a health database, click 'sort' and think that the top 5 drugs patients who survive longer happen to be taking are causal to the benefit those patients received. 500k is actually not a large cohort for a database, needs alpha correction, was very unlikely to be prespecified, etc. that's why no one is impressed with these studies and they're published in trash journals. this study showed a slight increase in CV events with PDEs vs placebo pubmed.ncbi.nlm.nih.gov/1452… the mechanistic rationale is not there and your explanation is terrible. ALL PDEs metabolize cAMP/cGMP, thats why they are phosphodiesterases. are you suggesting we should inhibit all PDEs?! by the same logic we should all be taking ERAs too. why not ARBs and ACEs? screw it i'll take inhaled treprostinil too. might extend my life. then i'll run SQL queries on health databases until i see a 'signal', bonferroni may roll in his grave but i will be vasodilated.

A 5% tax on Elon’s net worth would fund every community health center in America for the next 26 years. I’ll say it again. Tax the rich.

All doctors are underpaid.

I am a #Bayesian but I don't endorse Bayesian methods as the primary analysis of #clinical #trials. I prefer standard likelihoodist analysis of the data (which summarize what the study showed), followed by a Bayesian analysis using historical data and/or priors. Whikennon Bayesian meta-analyses could be employed for the same purpose, most meta-analytic methods are closeted Bayesian ones, so I do not view them as an alternative. So be non-Bayesian in the Results and #Bayesian in the Discussion

One unpopular truth about residency programs nobody wants to admit? Let’s hear it.

If you make more than $200k a year get an angiocardiogram before age 40. I know 3 people under 45 with significant blockages. All three healthy, good diets, exercise often.

I understand why many Asian families feel frustrated in elite admissions systems. In intensely competitive environments, there is a real perception — and sometimes evidence — that exceptional academic performance still does not guarantee admission. That feeling should not be dismissed. But admissions committees also confront another reality: if you have 100 applicants from privileged, high-performing educational pipelines with nearly identical scores, resumes, research access, tutoring, and opportunities, it is not irrational to also value the applicant who achieved similar academic success despite poverty, instability, underfunded schools, family hardship, or lack of institutional advantages. That is not abandoning merit. It is recognizing that achievement exists in context. And medicine especially is not merely selecting expert test takers. It is selecting future physicians who will care for human beings across every class, culture, language, and circumstance in society. The irony is that many people who defend “objective merit” often become deeply uncomfortable the moment merit is evaluated in anything broader than a percentile ranking.

RFK Jr wants to financially incentivize doctors to take patients off medications like antidepressants. This assumes doctors are somehow financially motivated to prescribe them in the first place. Hint: most physicians have zero financial ties to pharma. As a physician, I actually take pride in helping patients come off medications they truly no longer need. Many doctors do. But that decision should happen carefully between a patient and their physician based on evidence, symptoms, risks, and outcomes, not because a politician wants to push an ideology. RFK Jr continues to push the narrative that diseases should primarily be treated “naturally,” and that messaging can become dangerous very quickly. Lifestyle changes matter. But so do medications. Some people benefit from meds temporarily. Some long term. Some can safely stop. That nuance belongs in a medical office, not in political motivations.

Why Endless Cardio Fails More cardio doesn’t always mean more fat loss. Over time, your body adapts, burns fewer calories for the same work, and often increases hunger and fatigue. That’s why sustainability matters more than extremes. The best plan is the one you can actually stick to consistently.Why Endless Cardio Fails

If doctors were paid based on how healthy their patients stayed, the entire healthcare system would change overnight. Tell me I’m wrong.