{"id":8043,"date":"2016-03-27T13:35:26","date_gmt":"2016-03-27T17:35:26","guid":{"rendered":"http:\/\/blogs.nejm.org\/hiv-id-observations\/?p=8043"},"modified":"2016-03-30T12:50:10","modified_gmt":"2016-03-30T16:50:10","slug":"one-week-to-baseball-id-link-o-rama","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/one-week-to-baseball-id-link-o-rama\/2016\/03\/27\/","title":{"rendered":"One-Week-to-Baseball ID Link-o-Rama"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright wp-image-8044\" src=\"http:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2016\/03\/vaccine-benefits.jpg\" alt=\"vaccine benefits\" width=\"220\" height=\"300\" srcset=\"https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2016\/03\/vaccine-benefits.jpg 600w, https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2016\/03\/vaccine-benefits-220x300.jpg 220w\" sizes=\"auto, (max-width: 220px) 100vw, 220px\" \/><\/p>\n<p><em>(Important note: \u00a0Title has nothing to do with this post&#8217;s content. I just felt like writing something about baseball.)<\/em><\/p>\n<p>As some of us\u00a0eagerly\u00a0await the start of the 2016 baseball season &#8212;\u00a0<a href=\"http:\/\/sportsworld.nbcsports.com\/chicago-cubs-maddon-epstein-curse\/\" target=\"_blank\">especially Cubs fans<\/a>\u00a0&#8212; here are some ID\/HIV items yearning to shag flies, toss around\u00a0the horsehide, and play some pepper:<\/p>\n<ul>\n<li><strong>Famous anti-vaxxer &#8212; and notorious scientific fraud &#8212; Andrew Wakefield was <a href=\"http:\/\/www.philly.com\/philly\/entertainment\/20160325_Reuters_tagreuterscom2016newsmlMT1VRT1201739552_Robert_DeNiro_Responds_to_Anti_Vaccination_Movie_Controversy.html\" target=\"_blank\">going to have his film shown at the Tribeca Film Festival,<\/a> but <a href=\"http:\/\/www.nytimes.com\/2016\/03\/27\/movies\/robert-de-niro-pulls-anti-vaccine-documentary-from-tribeca-film-festival.html?hp&amp;action=click&amp;pgtype=Homepage&amp;clickSource=story-heading&amp;module=second-column-region&amp;region=top-news&amp;WT.nav=top-news&amp;_r=0\" target=\"_blank\">now it&#8217;s been pulled.<\/a><\/strong> Robert De Niro might be a great actor, but he whiffed big time on this one. Here&#8217;s a humorous\u00a0editing of the festival&#8217;s original\u00a0<strong><a href=\"https:\/\/twitter.com\/jtotheizzoe\/status\/713414630572367872\/photo\/1?ref_src=twsrc%5Etfw\" target=\"_blank\">biography of the filmmaker<\/a><\/strong> (notice I don&#8217;t write &#8220;scientist&#8221; or &#8220;doctor&#8221;).<\/li>\n<li><a href=\"http:\/\/www.cdc.gov\/mmwr\/volumes\/65\/wr\/mm6511a2.htm?s_cid=mm6511a2_w\" target=\"_blank\"><strong>TB cases\u00a0in the USA are up for the first time in 23 years.<\/strong><\/a>\u00a0Up a little &#8212; 157 more cases in 2015 than 2014. It&#8217;s the end of a longstanding decline, a remarkable success story (so far).\u00a0The CDC report accurately describes this as a &#8220;leveling&#8221; of TB rates &#8212; it&#8217;s not a <strong><a href=\"http:\/\/perfscience.com\/content\/2143515-number-tb-cases-surges-us-first-time-nearly-quarter-century\" target=\"_blank\">&#8220;surge&#8221;<\/a><\/strong> as the headlines in the popular press write &#8212; but it also makes the complete elimination of TB in this country increasingly unlikely.<\/li>\n<li><strong><a href=\"http:\/\/www.nature.com\/articles\/srep22555\" target=\"_blank\">CRISPR\/Cas9\u00a0eliminates HIV from\u00a0T-cells.<\/a><\/strong> With the caveat and confession that I&#8217;ve never done a single second of basic science research, my gut feeling is that this (or a related strategy) is more likely to be successful at curing HIV than\u00a0giving chemotherapy-like\u00a0drugs to &#8220;awaken&#8221; the latent reservoir. But what do I know? Good review of CRISPR for non-lab scientists\u00a0<strong><a href=\"http:\/\/www.newyorker.com\/magazine\/2015\/11\/16\/the-gene-hackers\" target=\"_blank\">here.<\/a><\/strong><\/li>\n<li>While we&#8217;re curing HIV, let&#8217;s also try <strong><a href=\"http:\/\/www.sandiegouniontribune.com\/news\/2016\/mar\/24\/hiv-vaccine-trial-scripps-liai\/\" target=\"_blank\">a new HIV vaccine strategy.<\/a><\/strong> This one will generate broadly neutralizing antibodies (bNAbs), which are all the rage.<\/li>\n<li><a href=\"http:\/\/www.cdc.gov\/flu\/weekly\/#S1\" target=\"_blank\"><strong>Lots of flu out there right now.<\/strong><\/a> You&#8217;d almost think influenza is seasonal, or something crazy like that.<\/li>\n<li><strong><a href=\"http:\/\/www.pbs.org\/wgbh\/nova\/next\/body\/an-outbreak-of-the-rare-elizabethkingia-disease-is-killing-people-in-wisconsin\/\" target=\"_blank\">The outbreak of <em>Elizabethkingia\u00a0anophelis<\/em> in Wisconsin continues to baffle public health officials.<\/a>\u00a0<\/strong>The bugs are genetically related, but there&#8217;s no obvious environmental source (yet), and cases are widely dispersed geographically. Contaminated injectable medications, or an intravascular medical device, both distributed from the same (unsterile) point of origin? Trivia question &#8212; what was <em>Elizabethkingia<\/em> called before it was named after microbiologist Elizabeth O. King?<\/li>\n<li>CDC has issued an <strong><a href=\"http:\/\/www.cdc.gov\/mmwr\/volumes\/65\/wr\/mm6512e2er.htm?s_cid=mm6512e2er_w\" target=\"_blank\">updated guidance on caring for women and men of childbearing age with Zika exposure or disease.<\/a><\/strong>\u00a0Key take home recommendations: \u00a0After symptomatic disease, women should wait at least 8 weeks before attempting conception, and men at least 6 months. With possible exposure and no symptoms, both should wait at least 8 weeks. As the data linking Zika to birth defects continues to accumulate, these guidelines make a lot of sense.<\/li>\n<li>In other mosquito-related infection news, <strong><a href=\"http:\/\/stm.sciencemag.org\/content\/8\/330\/330ra36\" target=\"_blank\">this dengue vaccine candidate (TV003)\u00a0looks\u00a0very promising.<\/a>\u00a0<\/strong>All 21 vaccine recipients were protected against infection after challenge\u00a0with a weakened form of dengue; by contrast 20 out of 20\u00a0placebo recipients developed viremia, 80% a rash. Importantly, TV003 elicits antibodies to all 4 dengue serotypes. At least two large clinical trials are being conducted, one in Brazil, one in Thailand.<\/li>\n<li>In this observational study, <strong><a href=\"http:\/\/jama.jamanetwork.com\/article.aspx?articleid=2504812\" target=\"_blank\">antibiotic exposure in babies was not associated with\u00a0childhood obesity.<\/a><\/strong> It&#8217;s just one negative study; nonetheless, it would fascinating to get an interpretation from <strong><a href=\"http:\/\/martinblaser.com\/\" target=\"_blank\">Marty &#8220;Missing Microbes&#8221; Blaser<\/a>,\u00a0<\/strong>who writes and speaks quite eloquently on this putative link between antibiotic overuse and the obesity epidemic.<\/li>\n<li>Here&#8217;s the\u00a0study showing that <strong><a href=\"http:\/\/journals.lww.com\/jaids\/pages\/articleviewer.aspx?year=9000&amp;issue=00000&amp;article=97285&amp;type=abstract\" target=\"_blank\">dolutegravir significantly increases metformin exposures.<\/a><\/strong>\u00a0These data led to a dolutegravir label change a few months ago, stating that metformin dosing should not exceed 1000 mg a day in patients taking both drugs. Dolutegravir and\u00a0raltegravir have so few significant drug interactions, it&#8217;s critical to remember the important ones.<\/li>\n<li><a href=\"http:\/\/www.psychiatrist.com\/JCP\/article\/Pages\/2016\/v77n03\/v77n0313.aspx\" target=\"_blank\"><strong>Toxoplasmosis is associated with impulsive behavior and\u00a0aggression.<\/strong><\/a>\u00a0I gather toxo\u00a0does the <strong><a href=\"https:\/\/www.newscientist.com\/article\/dn22599-parasite-makes-mice-fearless-by-hijacking-immune-cells\/\" target=\"_blank\">same thing to mice<\/a><\/strong>, making them more reckless &#8212; and hence more likely to be nabbed by cats (the source of the toxo to begin with). These studies on the neuropsychiatric effects of this parasitic infection\u00a0in immunocompetent humans\u00a0periodically appear in the medical literature; recent review <strong><a href=\"http:\/\/www.jns-journal.com\/article\/S0022-510X(15)00095-7\/abstract\" target=\"_blank\">here.<\/a><\/strong><\/li>\n<li>Good targeted <strong><a href=\"http:\/\/ofid.oxfordjournals.org\/content\/early\/2016\/03\/10\/ofid.ofw058.abstract\" target=\"_blank\">review of rapid TB diagnostics,<\/a><\/strong> in particular their use in low-prevalence settings. We&#8217;ve got a lot to learn from the extensive use of Xpert globally.<\/li>\n<li>Speaking of,\u00a0<strong><a href=\"http:\/\/www.npr.org\/sections\/goatsandsoda\/2016\/03\/24\/471712418\/this-rat-can-smell-a-rat-worldtbday\" target=\"_blank\">the giant-pouched African rat can diagnose tuberculosis.<\/a><\/strong>\u00a0It&#8217;s multi-talented, as it also can find land mines &#8212; here&#8217;s their <strong><a href=\"https:\/\/www.apopo.org\/en\/\" target=\"_blank\">web site<\/a><\/strong>. Maybe it&#8217;s just me, but I find the <strong><a href=\"http:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/dogs-again-shown-to-be-brilliant-diagnosticians\/2016\/03\/15\/\" target=\"_blank\">UTI-detecting dogs<\/a><\/strong> <em>much<\/em> cuter.<\/li>\n<\/ul>\n<p>In case De Niro wants a movie short to replace the one he&#8217;s now cut from the Tribeca Film Festival, he can show this one &#8212; it would be better than <em><a href=\"http:\/\/www.rottentomatoes.com\/m\/dirty_grandpa\/\" target=\"_blank\">Dirty Grandpa.<\/a><\/em><\/p>\n<p>[youtube http:\/\/www.youtube.com\/watch?v=3aNhzLUL2ys]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>(Important note: \u00a0Title has nothing to do with this post&#8217;s content. I just felt like writing something about baseball.) As some of us\u00a0eagerly\u00a0await the start of the 2016 baseball season &#8212;\u00a0especially Cubs fans\u00a0&#8212; here are some ID\/HIV items yearning to shag flies, toss around\u00a0the horsehide, and play some pepper: Famous anti-vaxxer &#8212; and notorious scientific [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,4,5,8,10],"tags":[565],"class_list":["post-8043","post","type-post","status-publish","format-standard","hentry","category-health-care","category-hiv","category-infectious-diseases","category-patient-care","category-research","tag-link-o-rama"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/8043","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=8043"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/8043\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=8043"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=8043"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=8043"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}