HIV and ID Observations

May 30th, 2016

The Sanford Guide — 46 Editions Later, Still Going Strong

I recently had a chance to visit Portland, Oregon, which for many will conjure up images of bicycles, hipsters, Mount Hood, roses, organic everything, and craft beers. It’s also the lifelong home of Dr. David Gilbert, the lead editor of The Sanford Guide to Antimicrobial Therapy, an invaluable resource well-known to almost every clinician. Dave was […]

---

May 22nd, 2016

Drug Prior Authorizations Are a Very Blunt Tool for Cost Containment — And They’re Annoying

Insurance prior authorizations, or prior approvals (PAs) — those dreaded forms clinicians have to fill out, usually triggered by prescribing a non-formulary drug — are much on my mind these days. And most of it has to do with three letters, specifically “TAF.” As readers of this site probably know, there are now three tenofovir alafenamide (TAF)-based […]

---

May 16th, 2016

Lots of College Graduations ID Link-O-Rama

For those of us living and working in Boston, we are most definitely smack dab in the middle of college graduation season — which means traffic is crazy, restaurants are booked, and energetic young adults are everywhere wearing gowns and funny hats. In other words, a good excuse for an ID Link-o-Rama: FDA advises against use of fluoroquinolones […]

---

May 8th, 2016

Zika, Baseball, and Waiting for a “New Normal”

I received an email from someone who’s known me a very long time. Hint:  She’s known me longer than anyone. Literally. Here’s the email: Baseball cancelled in Puerto Rico because of Zika. This story has you written all over it. (To use a cliche.) Mom I told you she knew me well! For those not obsessed […]

---

April 30th, 2016

A Ridiculously Long Post: How EHRs Expose Unspoken Hierarchies Within Medicine — Or Maybe Are Just Bad

I am consulted by a surgeon about a patient with something that might be infectious, might not. A very appropriate referral. After seeing the patient and reviewing the history and scans, I decide a CT-guided biopsy is the next step. The nice radiology fellow tells me “Just place the order in [enter name of EHR here]”. Since this is the […]

---

April 24th, 2016

Why Getting Old Isn’t Always So Terrible — and Why People with HIV Can Now Get Life Insurance

Two patient-related anecdotes, then a news item. Anecdote #1: A little email exchange I had with one of my patients recently: Hi Paul, Wondering if you got the refill request for my meds from my mail-order pharmacy — their customer service is lousy, and I can’t tell if it’s been approved. I’d like to get […]

---

April 15th, 2016

Mystifying Abbreviations on Daily Medical Rounds

I am currently attending on the inpatient medical service — always a treat, and a great learning experience for me each year. Aside from the refresher on inpatient general medicine — hey, no amount of repetition is too much when it comes to working up hyponatremia — I’m also fascinated by the steady proliferation of abbreviations and acronyms, bits […]

---

April 2nd, 2016

You Too Can Have Fun with Academic Spam

Like most doctors who work at academic medical centers, I get a fair amount of “academic spam” — invitations to bogus meetings that take place in some exotic or at least warm place (China, Dubai, and Orlando are favorites), efforts to sell me monoclonal antibodies or, more recently, CRISPR-altered mice, and of course requests to contribute research papers or […]

---

March 27th, 2016

One-Week-to-Baseball ID Link-o-Rama

(Important note:  Title has nothing to do with this post’s content. I just felt like writing something about baseball.) As some of us eagerly await the start of the 2016 baseball season — especially Cubs fans — here are some ID/HIV items yearning to shag flies, toss around the horsehide, and play some pepper: Famous anti-vaxxer — and notorious scientific […]

---

March 20th, 2016

“Choosing Wisely” in HIV Medicine — Should We Stop Giving MAC Prophylaxis?

(Disclosure:  The following post represents personal opinion, and is in conflict with treatment guidelines. Proceed at your own risk.) E-mail recently from one of our outstanding first-year fellows: Hi Paul, I’ve heard you recommended against the use of MAC [M. avium complex] prophylaxis in most settings in the modern HAART era. We admitted a 21yo F patient, non-compliant […]

---