HIV and ID Observations

January 28th, 2018

Apple Wants to Build an Electronic Medical Record — Here’s Where They Should Start

If you want to get a bunch of clinicians riled up — make them really mad — ask them to describe the problems with their current electronic medical record. So when a company like Apple announces it plans to introduce an electronic medical record of sorts, we should rejoice, right? This is the company, after all, that leveraged […]

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January 21st, 2018

Curbside Consults Complex and Silly, the Medicolegal Angle, and a Whole Podcast About Curbsides

Curbside consults are much on my mind this week for several reasons. First: I received an extremely complex curbside — a case of an HIV patient (from another state) who experienced treatment failure, had developed multi-class resistance, including integrase resistance (hate that), and now faced a tricky treatment regimen. The email was a good 300 words long […]

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January 13th, 2018

Just Wondering: Antibiotics for Cough, PJP vs. PCP, TB-Sniffing Rats, Raw Water, and Other Quick ID Items to Ponder

Here are some “quick questions” with an ID theme for people to consider as we head into week 3 of 52 of this new year. Just think, by the end of next week, we’ll be nearly 6% done with the new year. How time flies! For the various items below, if people know the answers, or want […]

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January 4th, 2018

What’s Your Favorite Diagnostic Test in Infectious Diseases? Another Fantasy Draft

If you’re wondering what to do while hunkering down during the “Bomb Cyclone,” here’s just the thing — the latest podcast on Open Forum Infectious Diseases. (Remember — that’s “O-F-I-D”, not “Oh-FID”.) Again, I welcome my friend and colleague Rebeca Plank, and this time we’re picking our Favorite Diagnostic Tests in ID. While winter storm Grayson gives us […]

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December 24th, 2017

On-Service Digest, December 2017 — Plus a Holiday Song

You youngsters out there might not believe this, but there was a time when passing out copies of published papers — actual hard-copies — was a major part of the teaching hospital experience. Now that this tree-destroying practice is over, many still regularly cite published studies on rounds. The goal is to provide some guidance and reason […]

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December 16th, 2017

CDC Receives List of Additional Forbidden Words and Phrases

Right on the heels of prohibiting certain words or phrases in the Centers for Disease Control’s budget documents, the President’s Office of Financial Services has issued a second list. Now, not only must CDC officials avoid using words such as “vulnerable”, “diversity”, “fetus”, “transgender”, and “evidence-based”, they also have to steer clear of several other words or phrases. […]

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December 10th, 2017

Injection Drug Use-Related HIV Cases Increase in Massachusetts — Is This the Start of a Trend?

Recently the Massachusetts Department of Public Health sent out this concerning notice: The Massachusetts Department of Public Health (MDPH) has noted an increase in newly diagnosed and acute HIV infections among persons who inject drugs (PWID). To date in calendar year 2017 (through November 21), there have been 64 HIV infections reported among individuals who inject […]

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December 3rd, 2017

Why, Even with Depressing Predictions About Flu Vaccine Effectiveness, We Should Still Recommend and Get It

Each year, the print and broadcast media round up a bunch of experts on influenza and ask them to predict the severity of the upcoming flu season. Most of the time their responses are noncommittal — predicting how bad the flu season will be year to year is tricky business, akin to picking stocks, making 12-month […]

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July 19th, 2017

Mystifying Cochrane Library Review on HCV Therapy Elicits Strong Response from IDSA

Last month, the Cochrane Review published a controversial paper on HCV therapy that left many ID doctors and hepatologists perplexed. After reviewing 138 randomized clinical trials using directly acting, non-interferon based therapies, they came to the following conclusions: The use of sustained virologic response (“SVR”) — or “cure”, if you want to use plain English — as a […]

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July 9th, 2017

Should You Answer Medical Questions from Clinicians You Don’t Know About Patients You’ve Never Seen?

This email popped into my inbox the other day from a person I’ve never met: Hi Dr. Sax, I do mostly hospital-based ID in Pennsylvania, and was consulted on a newly diagnosed HIV patient with CD4 10, viral load 210,000, and lymphoma. I started him on Truvada and dolutegravir, which is going well so far. Because he complained […]

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