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Archive for April, 2009

Swine Flu Treatment Guidelines — For Now

Paul Sax • April 29th, 2009

Categories: Infectious Diseases, Patient Care, Policy

(No Ratings Yet)

The swine flu situation is so dynamic that what I wrote earlier this week now seems hopelessly dated — except that from the perspective of a clinical ID doctor, it still feels eerily similar to the anthrax and SARS outbreaks. But related to that post — specifically the use of antivirals — these interim guidelines [...]

Swine Flu Curbsides: Anthrax, SARS Redux?

Paul Sax • April 26th, 2009

Categories: Health Care, Infectious Diseases, Patient Care, Policy

(1 votes, average: 5.00 out of 5)

In my email in-box yesterday AM from a primary care doc: A patient of mine, 40 year old woman totally healthy, is going to Cancun on Tuesday for a conference.  She’ll be there for 6 days. I know there are no cases of swine flu in Cancun yet, and the situation is evolving, but here’s [...]

Colonoscopy in HIV Patients, Part II: Problem (Mostly) Solved

Paul Sax • April 24th, 2009

Categories: Antiretroviral Rounds, HIV, Infectious Diseases, Patient Care

(No Ratings Yet)

Both here and on the AIDS Clinical Care site, we posted a case of a 50-year-old HIV+ man in need of a screening colonoscopy.  What sedation could he receive while on tenofovir/FTC and ritonavir-boosted atazanavir?  Specifically, would midazolam and fentanyl (“contraindicated” in the ritonavir package insert) be ok? (Same issue for efavirenz, by the way.) [...]

Another HIV Pharmaceutical Partnership

Paul Sax • April 20th, 2009

Categories: Health Care, HIV, Infectious Diseases

(No Ratings Yet)

GlaxoSmithKline and Pfizer have created an alliance for HIV drug development. Since there is only one collaborative effort in the HIV treatment area — the colossally-successful “Atripla” between Gilead and BMS — I had thought this kind of arrangement was fairly rare in the drug biz, but according to this interesting take, apparently not. Perhaps [...]

Ceftriaxone and Calcium — OK Again in Adults!

Paul Sax • April 18th, 2009

Categories: Health Care, Infectious Diseases, Misc

(No Ratings Yet)

As every house officer, hospitalist, intensivist, and ID doc knows, ceftriaxone and calcium have been contraindicated since 2007 due to fears of a potentially fatal precipitation of the two that led to the death of 5 neonates. Pediatricians are fond of saying “kids are not small adults” (I should know), and if that’s true, it’s [...]

Another Drug Linked to PML — Law Firms Waiting for Your Call

Paul Sax • April 11th, 2009

Categories: Health Care, Infectious Diseases, Patient Care

(No Ratings Yet)

The psoriasis drug Raptiva (efalizumab) has been linked to progressive multifocal leukoencephalopathy: On Oct. 16, 2008, FDA updated the FDA-approved labeling for Raptiva to warn of the risk of life-threatening infections, including PML. On Feb. 19, 2009, the FDA issued a Public Health Advisory informing patients and prescribers of the risk of PML in patients [...]

Delayed Opening Day Videos, and More

Paul Sax • April 6th, 2009

Categories: Health Care, HIV, Infectious Diseases, Patient Care

(No Ratings Yet)

Some random HIV/ID issues while awaiting a delayed opening day here in cold, rainy Boston: If you enjoy video highlights, check out these of HIV making its way from T cell to T cell.  If you’re short on time, #’s 9-12 are particularly amazing.  Still, I don’t imagine that this video will make it to Youtube [...]