HIV and ID Observations

February 5th, 2014

Electronic Medical Records, Eye Contact — and Dogs

A few thoughts on the importance of eye contact during patient care, no doubt inspired by my puppy’s first birthday, and his insistent and adoring (at least that’s how I see it) gaze: Long piece in the New York Review of Books — all doctors subscribe, of course — by Arnold (Bud) Relman, describing his experience […]

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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 years […]

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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 multiple […]

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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 readers, […]

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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 who […]

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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 […]

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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 telaprevir […]

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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 as […]

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November 16th, 2013

Janssen to Stop Offering “Virtual Phenotype” Testing, and Musings on Progress

Head over to this page from Janssen Diagnostics, and you’ll receive this little pop-up message: Must say it’s in some ways sad to see it go — in my opinion the nifty work they did correlating genotype results with their database of phenotypes gave the clearest representation of what a genotype actually means. If you didn’t […]

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November 13th, 2013

How Doctors, Nurses, and Other Medical Providers Spend Their Free Time

More absurd paperwork follies, this time from our friends at a mail-order pharmacy: Here, confronted with the challenge of refilling a patient’s HIV medications — which for the record he has been receiving unchanged for over 3 years — the pharmacy decides for the first time to reject the request and send the prescription back to […]

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