HIV and ID Observations

May 20th, 2018

Why the Dolutegravir Pregnancy Warning Is Important — and What We Should Do Now

Last week, in response to newly available surveillance data, multiple agencies issued a warning about the HIV integrase inhibitor dolutegravir (DTG) and pregnancy. The warnings cite an increased risk of neural tube defects in babies born to women who became pregnant while receiving the drug. From the U.S. Department of Health and Human Services: The concern stems from […]

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May 13th, 2018

Why Experienced HIV/ID Doctors Leave Clinical Practice

Three of my good friends — they’re way more than just colleagues after all this time — in the HIV/ID world have left clinical practice recently. Abigail (Abbie) Zuger, Joel Gallant, and Chuck Hicks, each of them brilliant in different ways, won’t be caring for people with HIV anymore, something they’ve all been doing since the […]

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April 16th, 2018

Hepatitis C Positive Organ Donors — Coming Soon to a Transplant Center Near You

There’s one immutable fact in solid organ transplantation — the number of patients awaiting transplant exceeds the number of available organs. This shortage means that ethical, medically safe strategies to increase the donor pool are always a high priority. One such strategy would be to allow transplants from people who have chronic hepatitis C. If the thought of […]

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March 18th, 2018

Why with Extremely Resistant Infections, It’s Extremely Important to Consult ID

Since the only procedures most of us Infectious Diseases doctors do with any regularity are biopsies of patient medical records, we have to justify our existence in other ways — such as collecting data on how our expertise improves patient outcomes. There are a bunch of these papers published, with this one being the most widely […]

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February 25th, 2018

Is Self-Administered Postexposure Prophylaxis Another Viable Option for HIV Prevention?

Most of the pivotal trials of pre-exposure prophylaxis (PrEP) have used daily therapy. The lone exception is the IPERGAY study. Men at high risk for acquiring HIV took two tablets of tenofovir DF/emtricitabine (TDF/FTC, Truvada) before sex, and one tablet the next 2 days. The strategy was highly effective in preventing HIV acquisition, and intermittent PrEP is endorsed […]

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February 19th, 2018

Can We Solve the Morass of Outpatient Intravenous Antibiotic Therapy?

If you want to get an ID doctor riled up, here are a few reliable strategies: Get an ID consult on a complex patient just to summarize the chart for your discharge summary. Endorse the view that procedural doctors deserve their vastly higher salaries than MDs in cognitive specialties. Prescribe azithromycin for patients with bad colds. […]

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February 12th, 2018

Shingles Vaccine Video, New Name for C. diff, Flu B Rising, and More — A Pre-Valentine’s Day ID Link-o-Rama

With Valentine’s Day and early spring training baseball both on the horizon this week, it’s obviously time for an extra special ID Link-o-Rama. On to the links, with a bonus non-ID section and a highly recommended video at the end: The ACIP issued its official recommendations for herpes zoster (shingles) immunization. Preferred: the new recombinant zoster vaccine, […]

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February 5th, 2018

The Four States of Clinical Medicine, and a Movie Review (Sort Of)

I finally saw The Big Sick. And hooray, it’s excellent. 9/10. Based loosely on the real-life courtship between comedian Kumail Nanjiani and writer Emily V. Gordon, the movie has great word of mouth, is making gobs of money for an independent comedy, and was nominated for Best Original Screenplay. Deserves both the the accolades and the cash. In […]

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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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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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