HIV and ID Observations

July 28th, 2019

Really Rapid Review — IAS 2019 Mexico City

As I noted last week — and you did read last week’s post, didn’t you? — the International AIDS conference first took place in Mexico City in 2008. Last week we returned to this sprawling, vibrant city for the 2019 meeting. It was an excellent, well-run conference — with one small complaint. But more on that later… […]

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July 21st, 2019

AIDS Conference Returns to Mexico City, Where We Saw an Underrated, Great Advance in HIV Therapy

If you’ve been an ID or HIV specialist for only a decade or so, the following statement might seem unfathomable to you: Until 2008, there were lots of people with HIV whose medication adherence was perfect — but they still had virologic failure. How could that be? The simple answer is that their virus had too […]

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July 14th, 2019

The House of God Profiled Physician Burnout Long Before We Called It That — Should Aspiring Doctors Still Read It?

Many consider the novel The House of God, written by Samuel Shem (pen name for Stephen Bergman), to be a must-read for any physician or soon-to-be physician. A fictionalized account of his internship year, the book details how the accumulated stress, fatigue, and powerlessness of being a first-year doctor inexorably accumulates during that year — […]

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June 30th, 2019

Antibiotic Development Is Broken, Brothers in ID Practice, and This Year’s Winner of the ID-Related Social Media Award

I am currently rounding on the inpatient ID service, the new ID fellows arrive shortly, and Louie needs intensive doggy psychotherapy after yesterday’s strong thunderstorms here in Boston. Busy times! As a result, today’s post has no unifying theme. But what it lacks in cohesiveness it more than compensates in value, as here are three highly interesting […]

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June 23rd, 2019

Advice to Incoming Subspecialty Fellows — Don’t Underestimate or Belittle Your Interns and Residents

Around a million years ago, early during the first year of my ID fellowship, a medical intern consulted me about an elderly patient with a urinary tract infection. Me:  Does she have a catheter? Intern: I don’t know. Me: Has she been admitted before with a UTI? Any cultures? Intern:  I think so — wait, I’m […]

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June 16th, 2019

On Father’s Day, a Tribute to a Father Who Isn’t Allowed to Celebrate Father’s Day

Part 1. My Father and How I Became a Doctor I became a doctor with encouragement from my father. Wait, let me rephrase that to capture what happened more accurately. I became a doctor with a fair amount of pressure from my father. Fresh off an adventure abroad, in my early 20s, I had all kinds of pretentious ambitions […]

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June 9th, 2019

Is It Safe to Alter the CCR5 Receptor? And How Will This Influence HIV Cure Studies?

The HIV cure effort suffered a potential setback this week, as researchers reported an association between having two copies of the CCR5-∆32 mutation and shorter survival. (Quick reminder — the CCR5 receptor is required for most HIV strains to enter target cells. People homozygous for the CCR5-∆32 mutation are almost completely protected from contracting HIV.) By evaluating […]

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June 2nd, 2019

A Highly Subjective Guide to Clinically Important Infections That Have Changed Names

Why do many clinically important microorganisms change names? They haven’t married and taken their spouse’s name or gone to Hollywood and adopted a stage name. Instead, through the tireless work of microbiologists, taxonomists, and geneticists, they have undergone sufficient reclassification so that their old name just doesn’t make sense anymore. Or more graphically: Why do clinical microbiologists love taxonomy? […]

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May 27th, 2019

A Day in the Life of a Malaria Diagnosis “Lab” — with Apologies to Twitter’s “Thoughts of Dog”

Scene: A quiet morning, somewhere in sub-Saharan Africa. A few roosters crow in the distance. A black Labrador Retriever slowly rouses herself from sleep. ah. nice long nighttime snoozle. my favorite thing. ending soon. but many favorite things. partial list. i’m good with lists. 1. belly rub. c. peanut butter. 4: stuffed toy lamb, with squeak. though missing […]

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May 19th, 2019

CDC Does Us a Huge Favor by Advising Against Annual Screening of Healthcare Workers for Latent TB

There are definitely things we do in medicine just because that’s how we’ve always done them. Among these evidence-free actions, we can include yearly screening for latent TB infection (LTBI) in all healthcare workers If we carefully examine the rationale behind this practice — as this thorough review nicely does — one would be hard-pressed to find any […]

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