Email exchange with a colleague who works at one of our community health clinics:
Guy: Hi Paul, your patient 17432862 [that's a made-up medical record number] came to our walk-in clinic with a rash on her hand. OK that I gave her a week of topical steroids? I know how inhaled steroids interact with some meds -- wasn't sure about the creams.
Me: Could be, good thought. Regardless, a short course should be fine. Tell me, who is the patient? What meds is she on?
Guy: I didn't want to put her name or meds in the email, what with her disease state, HIPAA, etc.
As Physician's First Watch noted, we sure know what the folks at the FDA were doing this holiday season -- and most emphatically they weren't visiting Aunt Selma in Boca Raton.
The CDC has recently issued the latest report on HIV incidence (i.e., new infections) in the United States, and as always it's fascinating to review the numbers.
A flurry of coverage recently appeared about the U.S. Preventive Services Task Force's recommendation for one-time HIV screening for all Americans, ages 15-64.
Some might wonder why this is news -- um, hasn't this been recommended now for years? -- and I think I've figured it out.
The FDA has approved an 800-mg tablet of darunavir for treatment naive patients. This single tablet will obviously replace the two darunavir 400-mg tablets in first-line therapy. (Yes, my math is that good.) Darunavir will still require 100-mg ritonavir boosting plus two NRTIs to make a complete regimen.
Now that the election is over, we can get back to something that really matters -- namely vitamins, and specifically whether they really help people.
Got this challenging curbside consult from a colleague, and it has an interesting wrinkle.
In the latest treatment-naive trials of elvitegravir and dolutegravir, there's a striking consistency in the results of the "test" regimen. Here are the studies, with the percentage of responders by treatment arm ...
As has often been the case in the history of the HIV epidemic, the HIV/AIDS Division at San Francisco General Hospital and the San Francisco Department of Health were ahead of the curve in 2010 when they issued a recommendation that all people with HIV should receive treatment, regardless of CD4 count. Of course, U.S. guidelines (first DHHS, now IAS-USA) followed suit -- but how did the San Francisco experience play out?
Over in JAMA, there's a large study out today that (yet again) failed to demonstrate a benefit of vitamins.