HIV and ID Observations

October 17th, 2022

Big In-Person Medical Meetings and Cognitive Dissonance for ID Docs

Dissonance: lack of agreement; inconsistency between the beliefs one holds or between one’s actions and one’s beliefs; a mingling of sounds that strike the ear harshly. It started shortly after the chaotic, disruptive, and all together unpleasant Omicron wave of 2021–22. It continued through the BA.2 and BA.5 surges, and now plays on through the swarm of […]

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October 10th, 2022

Molnupiravir Results in PANORAMIC Study — It’s Not All Bad News

Last week, the large PANORAMIC trial of COVID-19 treatment in outpatients with mild-moderate disease appeared in a pre-print. This large (25,783 participants!) randomized, open-label study compared molnupiravir vs. usual care in adults 50 or older, or having comorbidities known to make severe disease more likely. The results? Molnupiravir vs standard of care for outpts with Covid19. No […]

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September 28th, 2022

Even if You Think “The Pandemic Is Over” — Let’s Make In-Person Meetings Safer

“The pandemic is over.” Someone very famous used these words recently, triggering all kinds of controversy. While most ID clinicians groaned at the comment, knowing that it would be taken out of context, repeated in headlines without any of the President’s cautionary statements, and fuel COVID denialists, it’s also worth acknowledging that most of the country really […]

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September 8th, 2022

A Back To Work ID Link-o-Rama

A few nuggets are rattling around in the inbox post Labor Day, including this extraordinary photo of our family dogs Zelda, Zoe, and Louie, posing for their latest album cover. Woof! Besides, I haven’t done one of these Link-o-Ramas since January 11, 2021! That was either 20 months ago or 20 years, hard to keep track of […]

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August 16th, 2022

Story as Evidence — Our Story

JAMA has a long-running and quite wonderful weekly feature called A Piece of My Mind, in which clinicians (mostly physicians) write about the human side of medicine. Not the place for dry descriptions of study designs or laboratory methods, A Piece of My Mind instead welcomes anecdotes, opinions, and emotions. After all, as Drs. Preeti Malani […]

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August 8th, 2022

Long-Acting Injectable HIV Therapy for People Who Won’t Take ART?

HIV treatment is so spectacularly effective that you might be surprised to hear that some people with HIV still have uncontrolled viral replication. We HIV clinicians watch with frustration and sadness as they experience progressive immunodeficiency, complications from advanced HIV disease, hospitalizations, and HIV-related deaths. Plus, while viremic, they continue to risk transmitting the virus […]

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July 22nd, 2022

The Paperwork Demands for Academic Medical Teaching Are OUT OF CONTROL

Why all caps in the above title? It’s to call attention to a problem that’s getting worse each year in academic medicine, especially when it involves teaching or talks. The requirement to submit a veritable truckload of forms, documents, attestations, and summaries, all due months before the actual event. Let’s explore in more detail what this might […]

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July 1st, 2022

Fellowship Transition and Developing a Sense of Belonging

It’s July 1, which means that today, or sometime very soon, many internal medicine residents will transition to becoming subspecialty fellows. There are many appropriate words to describe this change, including exciting, nerve-wracking, and challenging, but one that doesn’t get quite enough attention is how strangely lonely it feels. The reason this sensation occurs is because […]

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June 21st, 2022

Mayo Clinic Study on Paxlovid Outcomes is Reassuring — but Likely Underestimates Rebound Rate

Over at Clinical Infectious Diseases, researchers from the Mayo Clinic published a retrospective analysis of nirmatrelvir/r (Paxlovid) treatment, with a careful review of each patient’s chart. The goal was to determine the clinical outcomes after the 5-day treatment course, with a focus on the frequency of rebounds — a topic of great clinical interest but with little […]

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June 6th, 2022

Still More Fun with Old Medical Images

Back in the Before Times, this site would occasionally dabble in lighter fare: Cartoon caption contests Commentaries on doctor attire Thoughts on the first-name “Morgan” Penguins chasing a butterfly (Well, actually, this is a new one!) https://twitter.com/buitengebieden/status/1533022340887486466?s=20&t=ShPbhfDhg-BwCP2bWisXfA And, the subject of today’s post — Fun with Old Medical Images. Here’s how it works: We display an old medical […]

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