HIV and ID Observations

October 8th, 2012

With One Month To Go, Candidates Eke Out Votes Wherever They Can

From the Department of Opportunistic Expediency, we have this brazen pitch from one of our two presidential hopefuls: Romney and Ryan will do more to fight the spread of Lyme Disease … As president, Mitt Romney will ensure that real action is taken to get control of this epidemic that is wreaking havoc on Northern […]

---

October 2nd, 2012

The Drug-Resistant Gonorrhea: How Much of a Threat?

By now, all ID docs know about the ceftriaxone-resistant Neisseria gonorrhoeae. Or, more accurately, we’ve read about it, since the vast majority of gonorrhea cases are treated in emergency rooms, STI clinics, college health facilities, and various primary care settings — not places that most ID doctors typically work. Plus, hardly anyone does susceptibility testing […]

---

September 24th, 2012

Quick Question: An Etiquette Column for ID Specialists

(First in what will undoubtedly be a recurring series.) Hi Paul: What do you do when someone in a non-medical setting gets something really wrong, and it’s in our field? Here’s why I’m asking: I was picking up my 9-year-old son from school the other day, and his teacher reported to me that they were […]

---

September 19th, 2012

It’s Time to Dump the HIV Western Blot

Hard to believe, but we have to get rid of the HIV Western blot — at least as our HIV confirmatory test. Here’s why (case adapted from several seen the past few years; I’m sure most of you have seen similar): 30-year-old man, high risk for HIV. He’s worried he might have become infected due […]

---

September 11th, 2012

Are Fluoroquinolones Really More Dangerous Than Other Antibiotics?

In today’s New York Times, health writer Jane Brody slams quinolone antibiotics: Part of the problem is that fluoroquinolones are often inappropriately prescribed. Instead of being reserved for use against serious, perhaps life-threatening bacterial infections like hospital-acquired pneumonia, these antibiotics are frequently prescribed for sinusitis, bronchitis, earaches and other ailments that may resolve on their own or can […]

---

September 8th, 2012

People Fear EEE and West Nile, but not Influenza — Can Someone Explain Why?

OK, here’s a quick quiz — match the viral infection with the average annual US deaths: 1.  Eastern Equine Encephalitis A.  36,000, mostly in the elderly 2.  Influenza B.  < 10, mostly in the elderly I know, it was an easy one — 1 goes with B, and 2 with A. Here’s a good reference for more […]

---

August 31st, 2012

“PEARLS” Study a Massive, Impressive Accomplishment

One of the most frequent criticisms of randomized clinical trials of HIV therapy is that certain patient groups — in particular gay men — are over represented compared to the HIV population as a whole. For example, in the recently published and presented clinical trials of the Quad and dolutegravir, women accounted for < 20% of […]

---

August 28th, 2012

“Quad” Approved by FDA

We now have a third single-pill treatment available for HIV treatment, co-formulated tenofovir/emtricitabine/elvitegravir/cobicistat. From the FDA announcement: The U.S. Food and Drug Administration today approved Stribild (elvitegravir, cobicistat, emtricitabine, tenofovir disoproxil fumarate), a new once-a-day combination pill to treat HIV-1 infection in adults who have never been treated for HIV infection. Stribild contains two previously approved […]

---

August 17th, 2012

Beeper, An Enthusiastic Farewell!

August 17, 2012, is the first day in over 25 years that I left for work without clipping a beeper to my belt. Yes, our hospital now offers paging through cell phones. Eureka! As I’ve written before, it was a long time coming. Here are some advantages: Spares the embarrassment of wearing a circa-1980s device around non-MD […]

---

August 15th, 2012

Brush with Greatness: Atul Gawande

I was an English major in college, so when my acceptance to medical school (miraculously) arrived, several people gave me books written by doctors about their experience in the medical profession. “See,” these gifts implied, “Just because you’re going to medical school doesn’t mean you need to become a science drone. Doctors can write too!” […]

---