Articles matching the ‘Policy’ Category

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August 23rd, 2015

Post-Exposure Prophylaxis for HCV Can’t Be Cost-Effective — But We Might End Up Recommending It Anyway

An email query from a colleague: Hi Paul, Just got a call from one of our surgeons who got a needlestick from a suture needle, small amount of blood. Patient is HCV +. Any post-exposure prophylaxis recommended? Thanks, Dan The quick answer is no, it’s not recommended. From the guidelines: But it’s a natural question to ask for several reasons — […]


July 7th, 2015

For HIV in the USA, Not in Care Exceeds the Undiagnosed — Solutions Welcome

In last week’s post, I asked about two of the key components of the HIV care cascade — the “undiagnosed” vs the “diagnosed but not in care,” and which group was larger in the USA. Here are your answers as of now: The people who read this site are a pretty knowledgeable group when it comes to […]


April 22nd, 2015

Seriously — How Much Would You Pay for a Curbside Consult?

Yes, seriously. Let me start with an email exchange I had with a PCP recently: Hi, Paul, quick question 😉 This lady, 49 YO woman from Haiti, asymptomatic, totally healthy. Got TSpot done for immigration purposes, it’s positive with negative chest Xray. Treated with INH 6 months in 2001. She travels to Haiti annually so could had been reexposed, though […]


April 15th, 2015

Does Scientific Language Come Across as Wishy-Washy?

I had the opportunity to interview author Seth Mnookin recently for a podcast on Open Forum Infectious Diseases, and it was a real treat. He’s Associate Director of the graduate program in Scientific Writing at MIT, and the author of the The Panic Virus: The True Story Behind the Vaccine-Autism Controversy. Not surprisingly given his title, […]


April 8th, 2015

New HIV Treatment Guidelines, and the End of an Era

The new Department of Health and Human Services (DHHS) HIV treatment guidelines are out, and thanks to skillful direction by Alice Pau, it’s as usual a must-read document — all 288 pages, of course! There are several major changes, so a good place to start is the all-important “What’s New in the Guidelines” summary page. Some of the […]


April 3rd, 2015

Melting Snow ID Link-o-Rama

A few ID/HIV tidbits to contemplate as we go from slipping on ice and snow to dodging the mud: Beta-lactam therapy alone is non-inferior to regimens that also cover “atypicals” for hospitalized patients with pneumonia. These results challenge a dogma that has been present for a couple of decades — namely, that all patients admitted with community-acquired pneumonia should get either […]


March 28th, 2015

Quick Question: Should HIV-Negative People in Serodiscordant Relationships All Get PrEP?

From a very thoughtful and experienced primary care provider came this query: Hey Paul, quick question — One of my patients, an HIV-negative gay man, is in a long-term relationship with one of your HIV-positive patients — my patient says his partner has been on successful HIV treatment for years. Obviously I can’t check his partner’s […]


March 8th, 2015

Measles Vaccine Videos and the Challenge of Changing Someone’s Mind

I suspect most of you have already been treated to this highly amusing video about the measles outbreak from Jimmy Kimmel — a comedy segment featuring real-life doctors, imagine that. Not your typical late-night comedy show performers, but they forcefully (and obscenely) get their message across. If you have just returned from a tropical island where the internet connection was iffy, however, […]


February 15th, 2015

Should Antibiotics be Part of End-of-Life Care?

There’s been some truly outstanding work done recently on end-of-life care, and how we deal with it — or more accurately, how we typically don’t deal with it until the very last moment, at which time often many unfortunate decisions and events occur. Here are three I can strongly recommend: Roz Chast’s Can’t We Talk About Something More Pleasant? is probably the […]


January 28th, 2015

Quick Question: Should We Still Be Recommending This Year’s Flu Vaccine?

From a football-obsessed primary care provider, written to me on one very snowy day in New England: Hi Paul, I’ve been reading about this year’s flu vaccine, and how ineffective it is. Not surprisingly, my patients have been hearing this too, and it has only increased their reluctance to go through with it. Should I just […]


HIV Information: Author Paul Sax, M.D.

Paul E. Sax, MD

Contributing Editor

NEJM Journal Watch
Infectious Diseases

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