HIV and ID Observations

May 10th, 2020

Thank You to Inpatient Nurses — The People Doing the Most Direct COVID-19 Patient Care

Anyone who does inpatient medicine or surgery knows well the major imbalance in time spent on direct patient care between doctors and nurses. Nurses spend way more time actually with patients than we do — I’m referring to time in the rooms caring for patients. While we round and review charts, document lab test results, bring up […]

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May 6th, 2020

Early Memories of Burton “Bud” Rose, Founder of UpToDate — and Medical Education Visionary

Let’s rewind the clock a bit — OK, a lot. Ancient history. It’s winter, 1986. An interview day for medical residency at Brigham and Women’s Hospital. A bunch of us nervous medical students sit in a conference room, wearing our interview suits, while Dr. Marshall Wolf tells us what to expect that day. Amazingly, Marshall knows all […]

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April 19th, 2020

Gratitude Before, During, and After Rounding on COVID-19 Service

It snowed in Boston yesterday morning — heavy, wet flakes covered the daffodils and tulips that just started coming up — but this brief return to winter didn’t make my red, itchy eyes from spring pollen feel any better. The flowers didn’t look too happy either. Oh well. But just as the annual misery of a typical […]

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March 8th, 2020

As Testing Ramps Up, Diagnoses of Coronavirus Disease in the U.S. Will Soon Increase Substantially — How Will We Respond?

Brace yourself. As coronavirus disease (COVID-19) occurs at multiple locations around the United States, the number of confirmed cases here is about to increase big time. There are two reasons: New infections More testing Believe it or not, despite statements by certain politicians, COVID-19 tests still cannot be ordered by any clinician who believes it should be […]

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February 25th, 2020

First Week on Service, with One-a-Day ID Learning Units

There is almost always something to be learned from every new patient. It might be buried somewhere in the history, or the physical, or the lab tests, or the micro, or the imaging — but the odds are excellent that, with enough rumination, you’ll find it. I can’t remember now who taught me this important fact, or […]

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February 17th, 2020

Short-Course Treatment of Latent TB, Combination Therapy for Staph Bacteremia, Adult Vaccine Guidelines, Novel Antifungals, and Others — A Non-COVID-19 ID Link-o-Rama

There’s so much out there right now on COVID-19 (the disease) and SARS-CoV-2 (the virus) that the other ID news gets crowded out. Which means it’s time for non-COVID-19 ID/HIV Link-o-Rama! I haven’t done one of these in a while, so there’s plenty of material in the vaults yearning to be free. The CDC now recommends short-course, […]

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February 2nd, 2020

A Coronavirus ID Link-o-Rama, Because I’m Not Watching the Super Bowl

With so much of the ID-related news out there dominated by the novel coronavirus (2019-nCoV, hard to type) outbreak, it seems appropriate to collect some of the more interesting or useful findings in this busy past week. Think of it as an ID Link-o-Rama — Special Novel Coronavirus Edition. As with last week’s post, an important caveat […]

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January 20th, 2020

Telemedicine, eConsults, and Other Remote ID Clinical Services Make So Much Sense — Why Isn’t Everyone Doing it?

The ID group at Mayo Clinic just published a small but important study on the use of remote ID telemedicine consults for hospitals that have no ID services on-site. The consults were “asynchronous”, meaning that the ID consultants at the main hospital finished them within 24 hours — they didn’t have to respond immediately. Importantly, all […]

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January 13th, 2020

Diagnostic Tests for Syphilis Continue to Perplex Even the Experts: An Unanswerable Question in Infectious Diseases

Here’s a tricky clinical scenario: An elderly person with cognitive decline or some other non-specific neurologic symptom sees a clinician. Clinician sends a syphilis screen with a T. pallidum enzyme immunoassay (TP-EIA), which returns positive. Lab runs a confirmatory test — a T. pallidum particle agglutination test (TP-PA), or similar, which also returns positive. The lab […]

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January 6th, 2020

The Decade’s Top 10 Biggest Changes to ID Clinical Practice

Here’s a question for you ID and HIV and other clinicians out there as you start 2020 — what are the 10 biggest changes to ID/HIV clinical practice over the past 10 years? Not necessarily what are the biggest stories or biggest advances (though they certainly are eligible) — but more specifically, when you are seeing […]

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