An ongoing dialogue on HIV/AIDS, infectious diseases,
June 24th, 2009
An Irrational Fear of IRIS?
One of the most important recent studies in HIV has just been “published” in (on?) PLoS ONE. It’s ACTG 5164, led by Andrew Zolopa, which compared “early” versus “deferred” antiretroviral therapy in 282 patients presenting with acute opportunistic infections. (Full disclosure: I am on the protocol study team — but am not an author on […]
June 20th, 2009
More HIV in the Adult Film Industry (Maybe)
From the New York Times last week: Health officials in Los Angeles said Friday that 22 actors in adult sex movies had contracted HIV since 2004, when a previous outbreak led to efforts to protect pornography industry employees. (snip) Occupational health officials have long argued that failing to require that performers wear condoms during intercourse […]
June 16th, 2009
Q: What is the Purpose of a Note in the Patient Chart?
A: Depends who you’re asking. The best guidance I ever received on how to write a good note came from my residency program director, who told us that a note needn’t be encyclopedic to be excellent; in fact, he urged us to get away from the “second-year medical student” style, which typically includes absolutely everything. […]
June 13th, 2009
Occupational Exposures and HIV Testing
A couple of years ago, an ID-colleague of mine told me about a tough case: While working in the ICU, an anesthesiologist sustained a pretty severe needle stick. Approached for HIV testing, the source of the exposure felt threatened by the providers in the ICU, and refused to sign the consent. The patient then deteriorated […]
May 28th, 2009
The Paul Farmer Watch
Our pal Paul Farmer keeps racking up the titles: Dr. Paul Farmer, a pioneer in improving health services in the Third World, has been named chairman of Harvard Medical School’s Department of Global Health and Social Medicine … (snip) Peter Brown, spokesman for Brigham and Women’s Hospital, said Farmer also had been named to succeed […]
May 24th, 2009
Another State Gets Ready to Make HIV Testing Easier
Don’t look now, Massachusetts, but Connecticut could be next: AN ACT CONCERNING REVISIONS TO THE HIV TESTING CONSENT LAW. This bill revises the law on consent for HIV-related testing. Specifically, the bill: 1. eliminates the requirement for separate, written or oral consent for HIV testing and instead allows general consent for the performance of medical […]
May 7th, 2009
Human Rabies from Bats: Another Look at the Numbers
The gang from Canada is at it again, reviewing human rabies cases from bats and trying to make some sense of the data. (For a summary of their outstanding prior paper in CID, read this.) But before we get to their latest masterwork, here are some questions to ponder. While doing so, keep in mind […]
May 3rd, 2009
H1N1! Didn’t You Used to Be Swine Flu?
At the end of last week, “swine flu” became “H1N1”. The CDC web site explains why: This virus was originally referred to as “swine flu” because laboratory testing showed that many of the genes in this new virus were very similar to influenza viruses that normally occur in pigs in North America. But further study […]
April 29th, 2009
Swine Flu Treatment Guidelines — For Now
The swine flu situation is so dynamic that what I wrote earlier this week now seems hopelessly dated — except that from the perspective of a clinical ID doctor, it still feels eerily similar to the anthrax and SARS outbreaks. But related to that post — specifically the use of antivirals — these interim guidelines […]
April 26th, 2009
Swine Flu Curbsides: Anthrax, SARS Redux?
In my email in-box yesterday AM from a primary care doc: A patient of mine, 40 year old woman totally healthy, is going to Cancun on Tuesday for a conference. She’ll be there for 6 days. I know there are no cases of swine flu in Cancun yet, and the situation is evolving, but here’s […]
Paul E. Sax, MD
Associate Editor
NEJM Clinician
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