An ongoing dialogue on HIV/AIDS, infectious diseases,
February 13th, 2014
Jeter is Retiring, and Certain ID Doctors Are Getting Old(er)
It’s safe to say that most of the perspectives on Derek Jeter’s retiring from baseball will not be written by ID doctors, so let me seize the opportunity. And since it’s always risky to dwell on players from a certain team while living in Boston — I have friends for whom a central component of […]
January 30th, 2014
Unanswerable Questions in Infectious Diseases: Persistent MRSA Bacteremia
Ok, here’s a favorite of adult ID specialists everywhere — a real tough one. The case goes something like this: Older person, many medical problems. Probably is on hemodialysis, with the vascular surgeons having some difficulty with access. There’s diabetes, of course, and cardiovascular disease, and oh yeah, a mechanical aortic valve that’s around 10 […]
January 21st, 2014
Unanswerable Questions in Infectious Diseases: The Positive Cultures for Candida in an ICU Patient
OK, gang. You did such a bang-up job on Question #1 that I can’t resist getting another consult. Here’s the case: Patient in intensive care, has been there for some time — at least a week, probably weeks. Perhaps he/she had surgery (especially abdominal surgery) that didn’t go well, or has severe cardiovascular disease, or […]
January 15th, 2014
Unanswerable Questions in Infectious Diseases: The Abdominal Collection and Duration of Antibiotic Therapy
Each time I attend on the inpatient service, the number of questions for which we just don’t have a definitive answer continues to amaze me. And here’s the most remarkable part — many of them come up all the time! In that spirit, I will post a series of these quandaries, and you, the brilliant […]
January 2nd, 2014
A New Year’s Snowstorm ID Link-o-Rama
Some ID/HIV items jangling around in the inbox, just dying to get out, before they are covered in snow: Interesting, balanced piece in the New York Times about the slow uptake for PrEP, in particular among gay men. This caught my eye: “Certainly, fewer people have tried PrEP than many experts had anticipated.” I wonder […]
December 24th, 2013
Brush with Greatness: John G. Bartlett
At the IDSA meeting in 2012, John Bartlett gave a lecture called, “Infectious Diseases Update for the HIV Provider” — what a great title — which was, as usual, information-packed, practical, well-referenced, and just plain fun. It also occurred to me at the time that there is probably no other person on the planet who […]
December 8th, 2013
Simeprevir and (Especially) Sofosbuvir Are Great Leaps Forward — and They Will Cost Plenty
Hepatitis C has been potentially curable for decades, but it’s hardly been easy. “I feel like I’m slowly killing myself,” said one of my patients, memorably, during week 24 of a planned bazillion-week course of interferon-ribavirin. (Actually it was only 48 weeks, but seemed like a bazillion weeks.) Then in 2011 came the addition of […]
November 23rd, 2013
OB/GYN Board Says Their Docs May Only Treat Women
Here’s a surprising move: The American Board of Obstetrics and Gynecology has decreed that gynecologists may only treat women. From the New York Times coverage: In September, the American Board of Obstetrics and Gynecology insisted that its members treat only women, with few exceptions, and identified the procedure [high-resolution anoscopy] in which Dr. Stier has expertise […]
November 6th, 2013
SINGLE Study Underscores Waning of the Efavirenz Era — But Probably Just in the USA
In today’s New England Journal of Medicine, the SINGLE study finally makes its appearance “in print.” (The study results were first presented over a year ago.) The highlights: SINGLE was a double-blind, randomized clinical trial comparing abacavir/lamivudine plus dolutegravir to tenofovir/FTC/efavirenz in 833 treatment-naive study subjects. That’s right, three different drugs in each arm — […]
October 30th, 2013
HIV Treatment of Serodiscordant Couples: The Home Run, Slam Dunk, and Open Goal in Clinical Research
Just in time for Game 6 of the World Series, my colleague Rochelle Walensky has published a paper in theNew England Journal of Medicine (covered here in NEJM Journal Watch). evaluating the cost-effectiveness of treating HIV-infected individuals in serodiscordant couples. The results: In South Africa, early ART was cost-saving over a 5-year period. In both South Africa and […]