Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽 @Rfonsi1 Twitter profile

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

3 years

What is human existence, but our daily quest to defend our domain from entropy?

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

1 year

*** Dear IMG research volunteers *** We all understand you want to get some research experience and would like to have that help towards residency match. Many of us have been there. It is difficult to find a spot as we only have so much space/time. Tips: 1/x

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

4 months

@Muktab_ Pretty hilarious. My parents always double check dose of Tylenol when I suggested.

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

4 years

On 10-15-20 baby Lulu Fonseca arrived (9:23 PM). 👶🏼 🍼 3 lbs 7 oz beautiful girl. Mom and baby doing great!

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

11 months

I heard yesterday that a presenter from China at #ASCO23 was struggling to answer questions due to language barriers, after she did an excellent presentation. Dr. @YiLinMDPhD stepped in and said: “I’m here to translate.” Well done!

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

3 years

Monoclonal Gammopathy of Renal Significance | NEJM This graphic is a great summary of all of what you need to know about immunoglobulins and the kidney. #mmsm

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

1 year

@CarlosTorresF_ Oncólogo aquí: no conozco a la señora, ni se sus intenciones. La gran mayoría de los cánceres infantiles, si no todos, no se pueden prevenir.

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

4 years

WHAT IS THE RISK CLASSIFICATION OF THE t(11;14) in MM? This has been a long-debated question and probably asked in the wrong way. I have always had a special interest in the t(11;14) and want to tell a story and how it relates to venetoclax. #mmsm #ASH19 1/x

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

4 years

* Sweden, #COVI19 , and the light at the end of the tunnel * 4 months later the veredict is in for Sweden. They “paid upfront” but their life seems to back to normal & the net effect in mortality is not dissimilar to what has been seen in many similarly developed nations. 1/x

Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

4 years

Sweden will be either the most reckless event in recent history and catastrophic, or a brilliant approach. Some would argue it was reckless, no matter what - probably true. Regardless the numbers will inform the reality. #COVID19

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

4 years

Released without his permission a conversation I had with @VincentRK on March 11th and 12th regarding the data in Wuhan. Empirical did has always suggested S<1.0. #COVID19

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

9 months

@EmmaRincon Todo esto es mucho peor que el episodio de Watergate…

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

4 years

Pretty frustrating to see so much misunderstanding with the antimalarial drugs chloroquine and hydroxychloroquine (C/HC) as presented by politicians and the media. The nuances, which are critical, are lost. My short primer on this. The "skinny" on C/HQ 1/x #COVID19

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

1 year

My last tip: commit to 2 years. No one wants to have someone visit for a short time and make that just a check on their resume. It is likely that in 2 years, you will have projects and papers. I wish you all the best. I also was an IMG. END

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

1 year

@beneaththeheart @historyinmemes So interesting

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

4 years

*** 𝙏𝙝𝙚 𝘾𝙊𝙑𝙄𝘿-19 𝙥𝙖𝙣𝙙𝙚𝙢𝙞𝙘 𝙬𝙞𝙡𝙡 𝙚𝙣𝙙 *** One possible analysis of recent data would suggest that there is an end in sight (cannot be soon enough) and that perhaps that will happen even before we have a useful vaccine against COVID-19. #COVID19 1/x

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

4 years

@PeterKolchinsky So I have been pondering on this. We clearly want to have N95 saved for the care of patients but any other mask could remind people to create distance, follow hygiene, avoid putting fingers in mucosas, etc. Homemade - easy to do.

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

8 months

@TansuYegen I've been collecting a list of risks or medical conditions that could be favored by being overweight - one more!

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

4 years

I hope you all agree this is the cutest picture of a boy ready ready for a haircut? My youngest son!

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

2 years

Yesterday was such a special day. My son Bernardo graduated from law school and is officially a JD. To do so at the @UVA law school is extra special. The culmination of a lifetime of work and effort. @palemex @UVALaw #UVA

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

2 years

The world is not ready for Lulu!

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

3 years

I share with great pride a highlight from last year. For each myeloma patient every visit is so important. I tell residents every visit should be treated as a final exam. I enjoy all of what I do, but what I can professionally do best, is as a clinician. #mmsm

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

4 years

*** Natural immunity against COVID-19? *** SARS-CoV-2 is one of several coronaviruses. Coronaviruses sometimes cause the common cold, buts sometimes produce very serious infections such as SARS and MERS. #COVID19 1/x

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

2 years

A reminder (forgot source, sorry), the personal evolution at ASH: 1) You know no one, no one knows you 2) You know everyone, no one knows you 3) You know everyone, everyone knows you 4) You know no one, everyone knows you 5) You know no one, no one knows you! #ASH21 #mmsm

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

5 months

What an amazing time in Hematology

BowTiedBiotech 🧪🔬🧬

@BowTiedBiotech

5 months

3️⃣2️⃣ FDA APPROVED Cell & Gene Therapies 1️⃣8️⃣ EMA APPROVED C> ✅ Haematology: 18 (FDA), 9 (EMA) ✅ Ophthalmology: 1 (FDA), 2 (EMA) ✅ Neurology: 3 (FDA), 3 (EMA) ✅ Gastroenterology: 0 (FDA), 1 (EMA) ✅ Immunodeficiency: 1 (FDA), 1 (EMA) ✅ Musculoskeletal: 1 (FDA), 1 (EMA) ✅…

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

11 months

And just like that 25 years have gone by. An honor to work @MayoClinic and to serve patients. But I am far from done! Thanks for the opportunity @MorieGertz @VincentRK @ADispenzieri

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

3 years

Happy New Year!

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

3 years

My toddler is not into the crust.

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

2 years

When doctors handwriting is converted into a badge…😹

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

3 years

My plans for the weekend!

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

2 years

1 Telemedicine is impressive 2 Saw a patient (Zoom) in Brazil 3 Accompanied by his 2 local hematologists 4 One of them presented the case in a Power Point 5 The patient provided his story 6 A Rx plan was proposed 7 He told me he wants to "avoid entropy" (my pinned Tweet) #mmsm

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

5 years

Rant. It is never Ok to be disparaging about drug reps. You don't find value in meeting them? Don't meet them. They have families, are moms and dads, and need to be treated with basic human respect. No one forces you to see them. Many are quite smart and often have useful info

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

3 years

Dear meeting organizer, If I agreed to join a very early meeting to accommodate others (say 5 AM), do not ask me to join 45 minutes in advance to check audio and video. If you text me at 4:15 to check on me you are ahead of my alarm clock. I will join at 4:59:5999! Thanks

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

5 years

Classic ASH dinner night - Induction 🍸🥜 - Consolidation 🍷🍱 - Maintenance 🍺🍺 Duration of maintenance undefined? Measure MRD? Avoid Grade 2 toxicity or higher day after. #ASH18

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

3 years

Two prior SCT. Novel agents no longer of help. A bispecific trial and bam! Sustained MRD negative at 10⁻⁶ (9 months apart negative). Phone call made. 💥 "This is the way" #mmsm

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

2 years

Started my soccer coaching career today with the 5-6 Forza AC Milan. Our first game we won!

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

2 years

And just like that she is using jeans #lululane

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

2 years

Another day trying to identify colleagues at #ASH21 #mmsm

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

3 years

And just like that Lulu turns one!

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

7 months

The clinical development curse against venetoclax for t(11;14) MM - How CANOVA was reported and why it is still critical patients with the t(11;14) have access to Ven. #IMS23RF #mmsm 1/x

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

1 year

I told a patient that sometimes dexamethasone is like a credit card: the short term can be good, but you will have to pay later. #mmsm

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

1 year

Spot on! The best piece of advice I got from my dad was “Time goes by, whether you do things or not, so you might as well be doing things”

Sahil Bloom

@SahilBloom

1 year

Harsh Truth: You'll literally never know what you want to be when you grow up. The idea that you should know what you want to do with your life by the time you are 20 is one of the worst lies we are told. I spent years stressing out over my lack of a clearly defined path...…

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

6 months

My favorite videos. T cells killing cancer cells

The Innovation | Medicine

@Innov_Medicine

6 months

A killer T cell of the immune system destroying a monstrous ovarian cancer cell. #cancer #science #AACR23 Credit: @RitterLab

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

1 year

Dr. @IreneGhobrial receiving the William Dameshek Prize. Congratulations Irene! #ASH22RF #mmsm

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

2 years

The ultimate test for a scientist is how your react to when your hypothesis is proven to be wrong. Painful as it may be, you rejoice because you know you’re closer to the truth. Science celebrates failure.

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

1 year

So telling

rony schaffel

@rschaffel

1 year

No legends necessary. Friendship and science. #ASH2022

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

1 year

When you get a consult with elevated light chains and creatinine with a normal ratio #mmsm

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

4 years

We must strive to cure myeloma. It is now within our reach. A brief conversation with ⁦ @VincentRK ⁩ and ⁦ @Leif_Bergsagel ⁩ ⁦ @szusmani ⁩ ⁦ @myelomaMD ⁩ ⁦ @MayoMyeloma ⁩ Project Cure coming soon #MMSM .

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

3 years

An incredible gift I got yesterday from a patient a puzzle, a piece of art, framed and an epitaph. “Apoptosis” In memory of the plasma cells we have slain together. #MRDneg

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

2 years

The man who will put myeloma doctors out of business. Congratulations #ASH21RF #mmsm ⁦ @TomBmt133 ⁩

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

4 years

19) Should politicians tell us what to do? No 20) Bureaucrats? No 21) Dr. Oz? No 22) Facebook? No 23) Fish tank stores? No End Doctors, innovators, statisticians, and scientists will figure this out.

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

3 years

@CNN *** Por favor! *** NO a LatinX!!! We don’t like it!

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

3 years

Beware your heart can melt - mine did

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

3 years

So today I turn double nickels. It’s been a great ride and lucky to have my family, my friends, my health and my profession! One of the best things about aging - you become calmer! Be kind Be based.

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

11 months

And just like that my mom in her mid 80s in her piano recital.

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

5 months

History in the making at LBA. A phase 3 trial of Daratumumab-VRD vs RVD for TE MM. Superb results with PFS that approximates 85% at4 years #ASH23RF #mmsm

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

1 year

Make your e-mails very specific to the person you want to work with. I presume 5 messages with the right context and background, and to the right person, will be more effective than spam mass e-mail. 2/x

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

2 years

I’m a lucky man!

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

4 years

I post this to show how cute my 3 yo old is with a mask. He does not know it better (it is) and neither he asked me a virtual-signaling, profound question (I always cringe when adults say that). It just he’s so cute and asked to wear his mask (no one forced him either!) 😷

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

10 months

The first CT scanner in North America was used at Mayo Clinic in Rochester in 1973 for a brain scan. The first scans were done in England at EMI in the UK in 1972. Amazing to see the first images. ⁦ @MayoClinic ⁩

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

11 months

@XoloElvis Que fortuna el que hubiese padres así.

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

3 years

The evolution of MM therapies, if one only focuses on MRD (10⁻⁵). Lots of caveats, and for older studies some guesses based on the CR rate (very low). But no doubt clear improvement - in time durable/sustained MRD- will convert to cures. #mmsm #MRD

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

1 year

Cite 3-4 papers of the lab you want to join and why you find them interesting, and that you have some ideas to contribute. Also good for you that you volunteer, but that does not help create attention. Your USMLE scores are not of much help for these matters. 6/x

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

2 years

Anybody can cook!

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

2 years

It’s no everyday that as oncologist you get to celebrate a patient that turns 100! 💯🎊🕺🏼🎂🎺🎉🪅

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

8 months

Some musings on myeloma therapy after coming back from ASCO and EHA 2023 (a bit old now). Most of the interesting data used T cell therapies (CARTs and bispecific). A thread with my candid impressions, and without much curation. A thread 🧵 #MedTwitter #mmsm 1/x

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

5 months

Congratulations to my mother - on turning 87 and still appearing to be TE!

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

2 years

I never like it when people capitalize the M's in multiple myeloma. The disease needs to be treated with disdain! I always use lower case, even if grammatically questionable #mmsm

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

5 years

@JohnTuckerPhD @gorskon @michaelshermer @MrAndyNgo @aymanndotcom @cjwerleman The whole logic is nonsense. It is completely irrelevant whether someone thinks he has the credentials or not. An unarmed human was mobbed beaten because misaligned ideologies.

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

1 year

The collective enthusiasm and dedication of the @MayoMyeloma group, and other distinguished partners from @UHN , @FrancescoMaura4 @DrGarethMorgan1 . On the quest to be part of the cure! #mmsm @VincentRK @akeithstewart @MyelomaTeacher @myelomaMD

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

2 years

⁦ @mvmateos ⁩ “We need to challenge the dogma of myeloma being incurable” Agree 100%! We are curing some patients today. We just don’t yet who and how many. #IMS2022 #mmsm

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

2 years

Ok, I refuse to do any more tech checks for platforms like Zoom. If after 2 years and thousands of uses one cannot, then you have other problems. And don’t ask to join an hour in advance to check audio/video

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

3 years

Happy Birthday to the United States of America! I love this country as much as I love Mexico. A place where immigrants like me have been welcome and allowed to participate and thrive in the American dream. The true melting pot of medicine. Forever grateful! #America 🇺🇸

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

4 months

How’s this for a Christmas gift? Patient knows

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

2 years

At Mayo Clinic we have an AI EKG algorithm in our EMR that predicts the likelihood of someone having cardiac amyloidosis. A window into the future! One illustrative case (1=100%) #amyloid @Amyloid_Planet @JLRosenthal @MarthaGrogan1 @vsanchorawala

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

4 years

A quick primer for the non-medical field about the use of antibody tests and a possible scenario on how things evolve. This is only the concept. Not a timeline or accuracy. We do not know yet when things will end. 1/7 Why antibody testing is so CRITICAL! #COVID19 #covid4MDs

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

3 years

Joy in myeloma 5 year sustained sCR and MRD negative 10^-6 #mmsm

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

5 years

My good friend and colleague @VincentRK receives the Michaeli Award at the @LMCongress for his achievements in myeloma. Congrats #mmsm @mtmdphd Beautiful introduction by @myelomaMD

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

1 year

You need to make your skills attractive to the person you are writing. To do that you must commit to your ultimate field of interest in medicine. Don't be general - be very specific. 3/x

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

3 years

Sustained tachycardia causes cardiomyopathy. Sustained #Zoom causes encephalopathy? 🤷🏼‍♂️ 🧠

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

1 year

Dr. Bart Barlogie was quite a visionary in the field of MM. Created the concept of Total Therapy. I aspire to treat with his intention. You have to finish the job! He would have loved all the Rx tools we have & MRD. I’m sure he is following in retirement! Thanks Bart #mmsm

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

2 years

At some point the treatment of AL with t(11;14) (approx 50% of cases) will be anti CD38 ab (like Dara/Isa) + bcl-2i (like venetoclax) + dexamethasone. That is the Tweet

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

2 years

Amrita Krishnan MD “lenalidomide maintenance is like Tom Cruise - it’s been around for a long time, but it still going strong.” #IMS2022 #mmsm

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

2 years

CIRCULATING PLASMA CELLS (cPCs) IN MYELOMA (MM) Several studies have recently reported on the prognostic significance of cPCs in patients with MM. The study of cPCs is of high relevance, but not new. For curation purposes only, I want to cite older studies #mmsm 1/x

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

2 years

I think we cure some MM patients (I know controversial) and some thoughts on how to get there with current therapies 1/x

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

2 years

Long awaited and amazing news! Patients need 4 prior lines of therapy including PI, IMID and CD38. - SQ weekly - STEP up dosing schedule. Hospitalization for 48 hours after step up doses - Comes with REMS #mmsm

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

4 years

I feel compelled to let Twitter know May 17th is Norway’s Independence Day. And in case you forget which day it is, it happens to be my birthday too, easy to remember. 🎂 🎁🎉🍾

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

4 years

Great thread. The empirical data is consistent. If the prevailing hypotheses hold true then there is a lower likelihood of a big second wave. Focal hotspots possible but big flares not as much. It seems that at 15-25% local hot spots “burn out.” #COVID19 1/4 @boriquagato

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

1 year

A paper where we showed that hematological malignancies do not express tissue factor - as opposed to the solid tumors. Myeloma should not be considered "hyper-coagulable." Thrombosis can occur due to immobility or IMIDs, but not tissue factor. #mmsm

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

3 years

Likely the oldest documented case of multiple myeloma. There is the mummy in an Argentina museum (Tweet below). Now this skeleton from the bronze age in China! (Qijia culture horizon (1750-1400 BC), Gansu Province, Northwest China) #mmsm @Jenna_Dittmar

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

1 year

Make every effort possible to read and align with the lab you want to join. It is best if you can come with some lab skills (I know chicken and egg...). Saying you can write papers, know Excel or can do basic stats does not help. 4/x

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

6 years

In myeloma “less is more”: Less dex (low dose) Less waiting before starting therapy Less cells after treatment (MRD-) Less periods without Rx (maintenance) Less waiting prior to introducing innovation Less nihilism #mmsm

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

1 year

If you think AI will be able to provide full medical care soon, you probably still don’t get what medical care is. Decision making is only a very small part of medical care. Intelligence needs context and experience- maybe at some point we will get AW: artificial wisdom.

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

1 year

For instance, if you are interested in oncology, know we don't care if you have done ICU rotations or can assist in surgery - in fact, it is negative. Your personal hobbies and interest are also of no value in creating differences in your favor for research spots. 5/x

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

1 year

We get many emails for requests like this. I presume people buy bulk mailing list. I get about 7-10 per day. The vast majority I delete in just a few seconds. That is the sad reality. But I always scan them. And I know landing a research spot can make a big difference. 7/x

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

4 years

Being able to dissent is the essence of science. Rarely, if ever, truth is fully known - even in the physical sciences. For doctors and scientist to support censoring of unorthodox opinions is anti-science.

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

3 years

When discussing end-of-life care, and DNR, I find that highlighting the "cracking of ribs" as dubious, if not outright unethical. Families suffer enough. In many of these cases, the end is very near. Discuss options, but do not cover up an attempt to persuade.

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

11 months

*** USE OF MEDICINES IN THE US *** I always look forward to this IQVIA report that describes trends, economics, and utilization of drugs in the US. Much can be learned from this report for those interested in healthcare, policy, and the price of drugs. @IQVIA_global 1/x

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

2 years

I suspect leaders/institutions can be gauged by their success ratio between recruitment and retention. Recruitment rests on the persuasive nature of promises, retention is based on reality. I suspect an attrition score would speaks volumes. - Keep your "square root" happy!

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Rafael Fonseca MD 🦔🇺🇸🏜🇲🇽

@Rfonsi1

3 months

For patients with active myeloma, the choices for frontline therapy have been greatly simplified in 2024: - All patients should be treated with Daratumumab-Rd - There are only two remaining questions: 1* Should I also use a PI, and if so which one? (K vs V) 2* Should…

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