Podcasts about Clinical Infectious Diseases

Today's show is sponsored by Americans for Free Choice in Medicine -- https://www.afcm.orgDr. Adalja is an expert on infectious disease, emergency preparedness, pandemics, and the intersections of public health and national security. is a board-certified physician in internal medicine, emergency medicine, infectious diseases, and critical care medicine. Dr. Adalja's expertise is frequently sought by international and national media.He has also published in such journals as the New England Journal of Medicine, JAMA, Journal of Infectious Diseases, Clinical Infectious Diseases, Emerging Infectious Diseases, Annals of Emergency Medicine, and Health Security.Dr. Adalja is a Fellow of the Infectious Diseases Society of America, the American College of Physicians, and the American College of Emergency Physicians. He is a member of various medical societies, including the American Medical Association, the HIV Medicine Association, and the Society of Critical Care Medicine.Dr. Adalja is a native of Butler, Pennsylvania, and actively practices infectious disease, critical care, and emergency medicine in the Pittsburgh metropolitan area.Dr. Adalja is the Chairman of the board of Americans for Free Choice in Medicine.Reinier Schuur is the Executive Director of AFCM. He holds a PhD in Philosophy from the University of Birmingham in the United Kingdom, where he specialized in the philosophy of medicine, and a Masters of Science in Philosophy of Psychiatry from King's College London. A native of the Netherlands, Reinier was a visiting Fulbright scholar at New York University and at the University of Pittsburgh. Reinier develops AFCM's educational offerings and collaborates with other organizations to educate the American public about how to advocate for their individual rights in healthcare.Show is Sponsored by The Ayn Rand Institute https://www.aynrand.org/starthereEnergy Talking Points, featuring AlexAI, by Alex Epstein https://alexepstein.substack.com/Express VPN https://www.expressvpn.com/yaronJoin this channel to get access to perks: / @yaronbrook Like what you hear? Like, share, and subscribe to stay updated on new videos and help promote the Yaron Brook Show: https://bit.ly/3ztPxTxSupport the Show and become a sponsor: / yaronbrookshow or https://yaronbrookshow.com/Or make a one-time donation: https://bit.ly/2RZOyJJContinue the discussion by following Yaron on Twitter (https://bit.ly/3iMGl6z) and Facebook (https://bit.ly/3vvWDDC )Want to learn more about Ayn Rand and Objectivism? Visit the Ayn Rand Institute: https://bit.ly/35qoEC3#freemarket #healthcare #Rights #individualism #AynRand #science #philosophyofscience #ethics #selfishness #egoism #capitalism #philosophy #Morality ​ ​#Objectivism​ #politicsBecome a supporter of this podcast: https://www.spreaker.com/podcast/yaron-brook-show--3276901/support.

Join Dr. Angelina Davis as she discusses a recent article in Clinical Infectious Diseases on differences in outpatient community-acquired pneumonia treatment regimens. the article reviewed in this episode can be found here: https://pubmed.ncbi.nlm.nih.gov/39442057/ For more information about DASON, please visit: https://dason.medicine.duke.edu/

Episode Notes In this episode, DASON Clinical Pharmacist Liaison Dr. April Dyer walks us through an article from Clinical Infectious Diseases entitled "Beyond Infection: Mortality and End-of-Life Care Associated with Infectious Disease Consultation in an Academic Health System." The article reviewed in this episode can be found here: https://pubmed.ncbi.nlm.nih.gov/38867715/ For more information about DASON, please visit: https://dason.medicine.duke.edu/

Today we provide you with an update on the sexually transmitted infection: Trichomonas vaginalis, a protozoan which infects the vagina, urethra and paraurethral glands. It is an uncommon cause of vaginal discharge and penile urethritis and can persist for a long time if left untreated. Up to 50% of people with vaginal infections and especially people with urethral infections remain asymptomatic. Persistent trichomonas infection has been associated with facilitating the transmission of human immunodeficiency virus (HIV) and adverse poor reproductive health outcomes. Dr Christina Munzy, Professor in Infectious Diseases at University of Alabama, Birmingham, USA, will present on published clinical trial data on novel treatment against trichomoniasis. Relevant publications: Van Gerwen OT, Aaron KJ, Schroeder J, et al. Spontaneous resolution of Trichomonas vaginalis infection in men. Sexually Transmitted Infections. Published Online First: 27 June 2024. Muzny CA, Van Gerwen OT, Kaufman G, Chavoustie S. Efficacy of single-dose oral secnidazole for the treatment of trichomoniasis in women co-infected with trichomoniasis and bacterial vaginosis: a post hoc subgroup analysis of phase 3 clinical trial data. BMJ Open. 2023;13:e072071 Kissinger PJ, Gaydos CA, Seña AC, McClelland RS, Soper, Secor WE, Legendre D, Workowski KA, Muzny CA, Diagnosis and Management of Trichomonas vaginalis: Summary of Evidence Reviewed for the 2021 Centers for Disease Control and Prevention Sexually Transmitted Infections Treatment Guidelines, Clinical Infectious Diseases, Clinical Infectious Diseases, Volume 74, Issue Supplement_2, 15 April 2022 Howe K and Kissinger PJ. Single-dose compared with multidose metronidazole for the treatment of trichomoniasis in women: a meta-analysis. Sex Transm Dis 2017; 44: 29–34. Kissinger P, Muzny CA, Mena LA, et al. Single-dose versus 7- day-dose metronidazole for the treatment of trichomoniasis in women: an open-label, randomised controlled trial. Lancet Infect Dis 2018; 18: 1251–1259. Sherrard J, Pitt R, Hobbs KR, Maynard M, Cochrane E, Wilson J, Tipple C. British Association for Sexual Health and HIV (BASHH) United Kingdom national guideline on the management of Trichomonas vaginalis 2021. Int J STD AIDS. 2022 Jul;33(8):740-750. STI Guidelines Australia - Trichomoniasis Host: Dr Fabiola Martin, STI BMJ Podcast editor, a Sexual Health, HIV and HTLV Specialist, Canberra & University of Queensland, Brisbane, Australia Guest: Dr Christina Munzy, Professor in Infectious Diseases at University of Alabama, Birmingham, USA

In this episode, Dr. Steven Fine discusses some of the latest data that might be used to support starting patients who are unable to take oral antiretroviral medications on long acting, injectable ARV. Patients who consider this off label use because their HIV viral load was not suppressed on oral treatment would have to be carefully selected and well supported. Related Content:  Long-acting Injectable Cabotegravir/Rilpivirine Effective in a Small Patient Cohort With Virologic Failure on Oral Antiretroviral Therapy. James B. Brock, Peyton Herrington, Melissa Hickman, and Aubri Hickman. Department of Medicine, Division of Infectious Diseases, University of Mississippi Medical Center. Jackson, Mississippi, USA. Clinical Infectious Diseases, Volume 78, Issue 1, 15 January 2024, Pages 122–124, https://doi.org/10.1093/cid/ciad511 CROI 2024: Abstract number 628 24 Week Viral Suppression in Patients Starting Long-Acting CAB/RPV Without HIV Viral Suppression. Matthew D Hickey, Janet Grochowski, Francis Mayorga-Munoz, Elizabeth Imbert, John D. Szumowski, Jon Oskarsson, Mary Shiels, Samantha Dilworth, Ayesha Appa, Diane V Havlir, Monica Gandhi, Katerina Christopoulos. Division of HIV, Infectious Disease, & Global Medicine, University of California, San Francisco, CA, United States. CROI 2024: ABSTRACT NUMBER 212. SESSION TITLE. Special Session. Clinical Late-Breaking Oral Abstracts. SESSION NUMBER Oral Session-14. Long-Acting Injectable CAB/RPV is Superior to Oral ART in PWH With Adherence Challenges: ACTG A5359. Aadia I. Rana, Yajing Bao, Lu Zheng, Sara Sieczkarski, Jordan E. Lake, Carl J. Fichtenbaum, Tia Morton, Lawrence Fox, Paul Wannamaker, Jose R. Castillo-Mancilla, Kati Vandermeulen, Chanelle Wimbish, Karen T. Tashima, Raphael J. Landovitz CEI toll free line for NYS providers: 866-637-2342 https://ceitraining.org/

This StAR episode features the CID State-of-the-Art Review on evaluation and management of diabetes-related foot infections.Our guest stars this episode are:Dr. Meghan Brennan (ID physician at University of Wisconsin)Dr. Marcos Schechter (ID physician at Emory University)Dr. Tze-Woei Tan (Vascular surgeon at University of Southern California)Dr. David Armstrong (Podiatric surgeon at University of Southern California)Journal article link: Nicolas W Cortes-Penfield, David G Armstrong, Meghan B Brennan, Maya Fayfman, Jonathan H Ryder, Tze-Woei Tan, Marcos C Schechter, Evaluation and Management of Diabetes-related Foot Infections, Clinical Infectious Diseases, Volume 77, Issue 3, 1 August 2023, Pages e1–e13, https://doi.org/10.1093/cid/ciad255Journal companion article - Executive summary link: https://academic.oup.com/cid/article/77/3/335/7242512From Clinical Infectious DiseasesEpisodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA)

In today's episode, Dr. Rachael Forsythe (@ROForsythe), consultant vascular surgeon at NHS Lothian, leads a fictional case-based discussion with leaders in managing diabetic foot ulcers. Joining the conversation are Professor Andrew Boulton, Mr. Patrick Coughlin, Dr. David Armstrong, Dr. Dane Wukich, and Dr. Edgar Peters. Professor Boulton is a professor of medicine at Manchester University in England and is co-chair of the Malvern  Diabetic Foot Conference meeting. He served as president of numerous distinguished societies, including the International Diabetes Federation. Dr.  Coughlin (@Coughlin_pa) is a consultant vascular surgeon in Leeds, England. He is a very active member of the Vascular Society of Great Britain and Ireland Council and has a special academic and clinical interest in peripheral artery disease. Dr. Armstrong (@DGArmstrong) is a podiatric surgeon and professor of surgery at Keck School of Medicine of the University of California and director of the Southwestern Academic Limb Salvage Alliance. Dr. Armstrong is very well known for his work on amputation prevention, the diabetic foot and wound healing. Dr. Wukich (@DaneWukich) is a professor and chair of the Department of Orthopedics at the University of Texas, Southwestern and Medical Director of Orthopedic Surgery at UT Southwestern University Hospitals. Dr. Wich has an interest in foot and ankle surgery, including the management of diabetes-related complications. Dr. Edgar Peters is an associate professor of internal medicine, infectious diseases, and acute medicine at Amsterdam University Medical Centers, Dr. Peter's main interest is infection of the musculoskeletal system, particularly in patients with diabetes and is the Scientific Secretary of the International Symposium on the Diabetic Foot.    Malvern Diabetic Foot Conference info: https://www.facebook.com/MalvernDiabeticFootConference/ https://eu.eventscloud.com/website/8151/   If this episode was of interest to you, please take a listen to this Transatlantic Series episode where we speak with the authors of the SVS, ESVS, and IWGDFU joint guidelines on the management of peripheral arterial disease (PAD) in patients with diabetes.    Articles, resources, and societies referenced in the episode: DF Blog. “Oral Is the New IV. Challenging Decades of Blood and Bone Infection Dogma: A Systematic Review @bradspellberg @lacuscmedcenter @usc,” January 1, 2022. https://diabeticfootonline.com/2022/01/01/oral-is-the-new-iv-challenging-decades-of-blood-and-bone-infection-dogma-a-systematic-review-bradspellberg-lacuscmedcenter-usc/. Gariani, Karim, Truong-Thanh Pham, Benjamin Kressmann, François R Jornayvaz, Giacomo Gastaldi, Dimitrios Stafylakis, Jacques Philippe, Benjamin A Lipsky, and Lker Uçkay. “Three Weeks Versus Six Weeks of Antibiotic Therapy for Diabetic Foot Osteomyelitis: A Prospective, Randomized, Noninferiority Pilot Trial.” Clinical Infectious Diseases 73, no. 7 (October 5, 2021): e1539–45. https://doi.org/10.1093/cid/ciaa1758. Li, Ho-Kwong, Ines Rombach, Rhea Zambellas, A. Sarah Walker, Martin A. McNally, Bridget L. Atkins, Benjamin A. Lipsky, et al. “Oral versus Intravenous Antibiotics for Bone and Joint Infection.” New England Journal of Medicine 380, no. 5 (January 31, 2019): 425–36. https://doi.org/10.1056/NEJMoa1710926. Magliano, Dianna, and Edward J. Boyko. IDF Diabetes Atlas. 10th edition. Brussels: International Diabetes Federation, 2021. Østergaard, Lauge, Mia Marie Pries-Heje, Rasmus Bo Hasselbalch, Magnus Rasmussen, Per Åkesson, Robert Horvath, Jonas Povlsen, et al. “Accelerated Treatment of Endocarditis—The POET II Trial: Ration ale and Design of a Randomized Controlled Trial.” American Heart Journal 227 (September 2020): 40–46. https://doi.org/10.1016/j.ahj.2020.05.012. Price, Patricia. “The Diabetic Foot: Quality of Life.” Clinical Infectious Diseases 39 (2004): S129–31. Sharma, S., C. Kerry, H. Atkins, and G. Rayman. “The Ipswich Touch Test: A Simple and Novel Method to Screen Patients with Diabetes at Home for Increased Risk of Foot Ulceration.” Diabetic Medicine: A Journal of the British Diabetic Association 31, no. 9 (September 2014): 1100–1103. https://doi.org/10.1111/dme.12450. Shin, Laura, Frank L. Bowling, David G. Armstrong, and Andrew J.M. Boulton. “Saving the Diabetic Foot During the COVID-19 Pandemic: A Tale of Two Cities.” Diabetes Care 43, no. 8 (August 1, 2020): 1704–9. https://doi.org/10.2337/dc20-1176. Tone, Alina, Sophie Nguyen, Fabrice Devemy, Hélène Topolinski, Michel Valette, Marie Cazaubiel, Armelle Fayard, Éric Beltrand, Christine Lemaire, and Éric Senneville. “Six-Week Versus Twelve-Week Antibiotic Therapy for Nonsurgically Treated Diabetic Foot Osteomyelitis: A Multicenter Open-Label Controlled Randomized Study.” Diabetes Care 38, no. 2 (February 1, 2015): 302–7. https://doi.org/10.2337/dc14-1514. Wukich, Dane K., Katherine M. Raspovic, and Natalie C. Suder. “Patients With Diabetic Foot Disease Fear Major Lower-Extremity Amputation More Than Death.” Foot & Ankle Specialist 11, no. 1 (February 2018): 17–21. https://doi.org/10.1177/1938640017694722.

The queens discuss some unusual, at times outlandish (or downright made-up), and unfortunate ends  some poets have met. Support Breaking Form!Review the show on Apple Podcasts here.Buy our books:     Aaron's STOP LYING is available from the Pitt Poetry Series.      James's ROMANTIC COMEDY is available from Four Way Books. Read more about Charlotte Brontë (including some of her poems) here. Brad Gooch's biography of Keith Haring is called Radiant: The Life and Line of Keith Haring, and like Diane Seuss's book Modern Poetry, is releasing on March 5, 2024.Here's a cartoon rendition of the totally made-up story of Aeschylus's death.Francis Bacon died after contracting a chill, which he developed after stuffing a chicken full of snow. Read some of his--Bacon's, not the chicken's--poems here.Read some Oscar Wilde poems here.To read more about Christopher Marlowe and also some of his poems, click here.Here's an entertaining and educational video about Dante Alighieri. Watch a (kinda long but totally worth it, girl) documentary about Zelda Fitzgerald (60 min). Also, read Aria Aber's poem "Zelda Fitzgerald" here. You can read some of Rupert Brooke's best poems here. Read more about Frank O'Hara's tragic death on Fire Island here. As outlined in the medical journal Clinical Infectious Diseases, Keats, who was often in poor health, was regularly in contact with one of the deadliest diseases of his day: tuberculosis. Keats cared for his infected brother, Tom, before contracting the disease, then known as consumption, himself. As his illness took hold, Keats relocated to Italy in the hope that the climate would have a positive effect on his ailments. He was buried in Rome, where his gravestone describes him as "one whose name was writ in water." Read more here.Here's a great 10-minute talk on Elizabeth Barrett Browning.Watch Suzanne Somers's Thighmaster commercial here.

In science, failure is as important as success. In this week's episode, our storytellers share times when they failed at science or science failed them. Part 1: Samuel Scarpino is convinced that the paper he wrote about how hard it is to predict infectious diseases should win a Nobel Prize. Part 2: It's grad student Moronke Harris' turn with the deep-sea robot that no one can find, and she needs to conduct her research.. Samuel V. Scarpino, PhD, is the Director of AI + Life Sciences at Northeastern University and a Professor of the Practice in Health and Computer Sciences. He holds appointments in the Institute for Experiential AI and the Network Science, Global Resilience, and Roux Institutes. In recognition for his contributions to complex systems science, he was named an external Professor at the Santa Fe Institute in 2020. Prior to joining Northeastern, Scarpino was the Vice President of Pathogen Surveillance at The Rockefeller Foundation, Chief Strategy Officer at Dharma Platform (a social impact, technology startup), and co-founded a data science initiative called Global.health, which was backed by Google and The Rockefeller Foundation. Scarpino is a regular presence in the news, providing over 500 interviews to outlets such as Good Morning America, The Wall Street Journal, Vice News, The Atlantic, and NPR. He has authored more than 100 academic publications, which have been cited over 8,000 times. Scarpino's work has appeared in journals such as Nature, Science, Nature Medicine, PNAS, Clinical Infectious Diseases, and Nature Physics. The New York Times, Wired, the Boston Globe, National Geographic, and numerous other venues have covered his research. Moronke Harris (moronkeharris.com) is a deep-sea explorer and oceanographer with experience in climate engineering, blue economy, and intergovernmental (Canada, USA, Russia, Japan, and the Republic of Korea), multi-vessel research expedition planning in the high seas. Currently completing a PhD in Oceanography at the University of Victoria (BC, Canada), her research focuses on the most unexplored areas of the ocean, containing the most potential for discovery. Moronke specializes in the alien world of seafloor superheated geysers: hydrothermal vent ecosystems 1000-4000 m under the ocean's surface. She has spent over 110 days of her life exploring Earth's final frontier. Beyond academic pursuits, she is the founder of ‘The Imaginative Scientist' (linktr.ee/imaginativesci): a science communication and creative consulting brand blending traditional outreach and artistry to produce an audience-first approach that engages, invites, and inspires curiosity. Brand experience includes 50+ national and international speaking engagements, video production and content creation collaborations garnering 50,000+ views, and consultation for gallery installations, video game development, and film production. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Wondering why you have symptoms but are still testing negative for COVID?Today On Medical Grounds, we are speaking with Dr. Jennifer Frediani. Dr. Frediani is an assistant professor at the Nell Hodgson's Woodruff School of Nursing at Emory University in Atlanta, Georgia. She is the lead author on a recent article published in Clinical Infectious Diseases entitled, “The New Normal: Delayed Peak SARS-CoV-2 Viral Loads Relative to Symptom Onset and Implications for COVID-19 Testing Programs.” Dr. Frediani is going to explain her findings and how the changes in COVID viral loads may be affecting home COVID tests. She will also tell us her ideas about what we can do to make sure we are testing the right way to catch positives.(00:12) Introduction to Dr. Jennifer Frediani(00:58) Dr. Frediani's study hypothesis(01:48) Study testing(03:08) Study population(04:28) Study results(05:28) Low viral loads and contagious period(06:52) Do we need to change how we test at home?(07:42) Expense of home tests(08:58) Public education on viral delay and testing(09:36) Is COVID the new normal?(10:13) Can we handle the next pandemic?(11:17) Lifestyle factors that affect infectious diseasesVisit us at OnMedicalGrounds.com for more podcasts! You can subscribe through your podcast platform, our website, or follow us on social media for podcast updates and medical news. Some of our podcasts offer FREE CME/CE credits.LinkTreeTwitterLinkedInInstagram

Episode 155: Diabetic Foot Infection GuidelinesFuture Dr. Perez presents the updates on lung cancer screening by the American Cancer Society. Future Dr. Danusantoso explains the classification, diagnosis, and treatment of diabetic foot infections according to the guidelines published by the International Working Group on the Diabetic Foot (IWGDF). Dr. Arreaza adds comments and anecdotes.  You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Intro: Lung cancer screening update.Written by Luz Perez, MSIII, Ross University School of Medicine. Editing by Hector Arreaza, MD.Hello, my name is Luz Perez and today I will talk about lung cancer screening.As a reminder, lung cancer is the top cause of cancer-related death in men and women worldwide. In the United States, lung cancer causes the death of about 154,000 people each year[4]. Smoking is the most significant risk factor for developing lung cancer, a risk that directly correlates to how much and how long a person has smoked[2]. Despite the efforts to decrease lung cancer-related deaths, which include screening of patients at risk and counseling on smoking cessation, many patients go undiagnosed in part because lung cancer can be asymptomatic but also because many people at risk did not meet the criteria for screening, according to previous guidelines… BUT On November 1, 2023, the American Cancer Society updated its guidelines for lung cancer screening to decrease mortality by lung cancer in the US. The updated lung cancer screening guidelines were published in November, which is Lung Cancer Awareness Month. This guideline aims to expand eligibility criteria for lung cancer screening. Previously, the guidelines covered people only between the ages of 55-74 who were current smokers or had quit within the past 15 years and had a 30 or more pack-year smoking history[3].The new guidelines recommend annual screening with low-dose CT (LDCT) scan for people who are 50-80 years old who are current or former smokers and who have a 20 or more pack-year of smoking history [1]. This change means that about 5 million people who would previously not qualify for screening are now eligible for this potentially lifesaving screening exam.Additionally, the American Cancer Society emphasizes the significance of shared decision-making between patients and healthcare providers on lung cancer screening and smoking cessation. This includes ways to help patients stop smoking by providing counseling and interventions including medications. For patients who are eligible for screening, having a full discussion of the lung cancer screening process including the purpose of the procedure, risks and benefits of low-dose CT, and recommendations from other organizations, is key in the shared decision-making process[1]. Perhaps, the most important step in the implementation of these new guidelines is ensuring that medical professionals talk to their patients about them and make them aware of the importance of screening for lung cancer. In this way, we can reduce mortality and other consequences of this devastating disease. Written by Maria Danusantoso, MSIV, Ross University School of Medicine. Editing by Hector Arreaza, MD.Update to Guidelines for Treatment of Diabetic Foot InfectionsIntroductionIn October 2023, the International Working Group on the Diabetic Foot (IWGDF) and the Infectious Disease Society of America (IDSA) collaborated and published an update to the 2019 guideline on the diagnosis and management of infections of the foot in persons with diabetes mellitus.The present guidelines include a list of 25 recommendations for diagnosis and management and clinically useful figures and tables including a treatment algorithm, a classification system for defining diabetic foot infections, and empirical antibiotic therapy according to clinical presentation and microbiological data.The goal of this episode is not to provide an exhaustive review of the updated guidelines and algorithms but to highlight what I believe are the most important recommendations. I hope this brief presentation is viewed as an introduction and that this encourages you, the listener, to independently read the guidelines in full and implement them into your own clinical practice.Wound Colonization Versus Wound InfectionBefore jumping into some of the recommendations, I want to take some time to discuss briefly how to classify diabetic foot infections. Most clinicians, including myself, will see a patient with diabetes with a foot ulcer or wound and want to treat it with antibiotics or admit the patient to the hospital. However, the updated guidelines propose that antibiotics and/or admission are not always indicated. For clinicians, there needs to be an awareness that wound colonization and wound infection are not the same. Wound colonization by bacteria is defined by the presence of bacteria on a wound surface without evidence of invasion of the host tissues. Colonization, then, can be considered a constant phenomenon as we live in a bacteria-filled world. Comment: If we culture our intact skin, we may find pathogens, that's why wound cultures even if they are positive, do not indicate there is infection. Tell us about infection.In contrast, wound infection is a disease state caused by the invasion and multiplication of microorganisms in host tissues that induce an inflammatory response in the host, usually followed by tissue damage. Therefore, since all wounds are colonized – often with potentially pathogenic microorganisms – we cannot define wound infection using only the results of wound cultures. Instead, diabetic foot infections are a clinical diagnosis based on the presence of manifestations of an inflammatory process involving a foot wound located below the malleoli. These signs and symptoms of inflammation may be masked in persons with diabetes especially if they have some level of baseline peripheral neuropathy, peripheral artery disease, or immune dysfunction.Classification of Diabetic Foot Infections.To assist with the classification of diabetic foot infections, the updated guidelines include a table for defining the presence and severity of an infection of the foot in a person with diabetes. Again, diabetic foot infections are a clinical diagnosis, and the clinical classification of infection can be described as: 1) uninfected, 2) mild, 3) moderate +/- O if osteomyelitis is present, 4) severe +/- O if osteomyelitis is present. Uninfected has no systemic or local symptoms or signs of infection. Mild infection is when at least two of the following are present: local swelling or induration, erythema between 0.5-2 cm around the wound in any direction, local tenderness or pain, local increased warmth, purulent discharge, and there is no other cause of an inflammatory response of the skin present (e.g., trauma, gout, acute Charcot neuro-arthropathy, fracture, thrombosis, or venous stasis).Moderate infection is without systemic manifestations and involves erythema extending 2 cm or more from the wound margin and/or involves tissue deeper than skin and subcutaneous tissues (e.g., tendon, muscle, joint, and bone) +/- the presence of osteomyelitis. The surrounding erythema and the depth of wound are key element in the classification of the wounds. Severe infection is associated with systemic manifestations and meets systemic inflammatory response syndrome (SIRS) criteria as manifested by 2 or more of the following: temperature below 36°C or above 38°C, heart rate greater than 90 beats per minute, respiratory rate greater than 20 breaths per minute, white blood cell count greater than 12,000/mm3 or greater than 10% immature (band) forms +/- presence of osteomyelitis. Features of Osteomyelitis on Plain X-RayWe have mentioned osteomyelitis quite a few times in this episode, so what are some ways we can diagnose osteomyelitis? Most commonly, osteomyelitis is diagnosed via imaging either with plain X-rays  or MRI. When looking at plain X-rays, there are a few features that are characteristic of diabetes-related osteomyelitis of the foot of which we should be aware regardless of our status as radiologists. Some of these features include bone sclerosis with or without erosion, abnormal soft tissue density or gas density in the subcutaneous fat, or new or evolving radiographic features on serial images spaced several weeks apart such as loss of bone cortex, focal demineralization, periosteal reaction or elevation. Changes in x-ray may be a late finding and indicate that the osteomyelitis is established.General Treatment Recommendations for Diabetic Foot InfectionsIn the updated guidelines, recommendation 11 states to not treat clinically uninfected foot ulcers with systemic or local antibiotic therapy when the goal is to reduce the risk of new infection or to promote ulcer healing. As previously said, diabetic foot infections are a clinical diagnosis. So if clinically the wound does not meet criteria to be classified as a mild, moderate, or severe infection, this recommendation proposes that no antibiotic treatment is the best treatment so as not to expose patients to potentially unnecessary and harmful treatment and to not promote antibiotic resistance in patients, which would potentially make treating diabetic foot infections more challenging in the future. We still want to very closely monitor the wound every 2-7 days and promote wound healing with pressure offloading, keeping the wound and the surrounding skin clean and dry, and other non-antibiotic management for local wound care.What are some common bacteria?.When it is indicated to treat diabetic foot infections per the guidelines, recommendation 14 states to target aerobic gram positive pathogens only for people with a mild diabetes related foot infection. These pathogens include beta hemolytic streptococci and Staphylococcus aureus including methicillin-resistant strains if indicated. Additionally, recommendation 15 advises not to empirically target antibiotic therapy against Pseudomonas aeruginosa in cases of diabetes-related foot infection in temperate climates. However, it is appropriate to use empirical treatment of P. aeruginosa if it has been isolated from cultures of the affected site within the previous few weeks or in a person with moderate or severe infection who resides in tropical/subtropical climates.Antibiotic Treatment Duration RecommendationThe final recommendation we have time to discuss in this episode is regarding antibiotic treatment duration. For mild infections, oral antibiotics (such as cephalexin or Bactrim) for a duration of 1-2 weeks is appropriate. However, if the infection is improving but is extensive and is resolving slower than expected or if the patient has severe peripheral artery disease, it is reasonable to consider extending treatment for up to 3-4 weeks.For moderate or severe infections without osteomyelitis, a total treatment duration of 2-4 weeks is recommended starting initially with IV antibiotics before transitioning to oral antibiotics. Antibiotic selection will depend on multiple factors, such as recent antibiotic use, or MRSA risk factors. For example, if the patient took antibiotics recently, they could receive Zosyn® and ceftriaxone. If osteomyelitis is present, antibiotic treatment duration can be anywhere from 2 days to 6 weeks depending on the amount of source control achieved. Ideally, we should wait to have bone resection before giving antibiotics, but we know that antibiotics are given promptly in the ER.In the cases of a resected infected bone or joint (when complete source control is achieved), a duration of 2-5 days is recommended, starting with IV antibiotics before transitioning to oral antibiotics. If there is minor amputation of the infected foot but there remains a positive wound culture or positive margins are seen on pathology (inflammatory cells are seen at the proximal margin of the amputated section), a 3-week antibiotic treatment duration is recommended, again starting with IV before transitioning to oral antibiotics.For diabetes-related foot osteomyelitis without bone resection or amputation, a 6-week course of antibiotics is recommended, again initially with IV antibiotics before transitioning to oral. In all the situations where there is a transition from IV to oral antibiotics, this transition may only occur once there are clinical signs of improvement, for example, improving erythema surrounding the wound, resolution of tenderness or purulent drainage, or SIRS criteria is no longer met.Summary: For more details regarding the 2023 update to the guidelines on the diagnosis and treatment of foot infection in persons with diabetes, please refer to the complete guidelines which can be accessed on the IWGDF Guidelines website and via the citations listed in the References. As a reminder, this podcast episode is not an exhaustive review of the guidelines, but, instead, a brief introduction to some of the recommendations. Thank you for listening and I hope you learned something new!_____________________________Conclusion: Now we conclude episode number 155 “Diabetic foot guidelines.” Future Dr. Perez started this episode with an introduction about the new guidelines to screen for lung cancer, then future Dr. Danusantoso gave an excellent summary about the classification and treatment of diabetic foot infections. Our patients with diabetes must have foot self-awareness and report any concerns to their family physicians or podiatrists so they can get prompt treatment.This week we thank Hector Arreaza, Luz Perez, and Maria Danusantoso. Audio editing by Adrianne Silva.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:McDowell, Sandy, New Lung Cancer Screening Guideline Increases Eligibility. American Cancer Society, published on November 1, 2023, Cancer.org. https://www.cancer.org/research/acs-research-news/new-lung-cancer-screening-guidelines-urge-more-to-get-ldct.htmlWolf AMD, Oeffinger KC, Shih TY, et al. Screening for lung cancer: 2023 guideline update from the American Cancer Society [published online ahead of print, 2023 Nov 1]. CA Cancer J Clin. 2023;10.3322/caac.21811. doi:10.3322/caac.21811. Link: https://pubmed.ncbi.nlm.nih.gov/37909877/Moniuszko, Sara. Lung cancer screening guidelines updates by American Cancer Society to include more people. CBS News, updated on November 3, 2023. https://www.cbsnews.com/news/lung-cancer-screening-guideline-american-cancer-society-update/Deffebach, M. E., & Humphrey, L. (2023). Screening for lung cancer. UpToDate. Retrieved November 6, 2023, UpToDate. https://www.uptodate.com/contents/screening-for-lung-cancerÉric Senneville, Zaina Albalawi, Suzanne A van Asten, Zulfiqarali G Abbas, Geneve Allison, Javier Aragón-Sánchez, John M Embil, Lawrence A Lavery, Majdi Alhasan, Orhan Oz, Ilker Uçkay, Vilma Urbančič-Rovan, Zhang-Rong Xu, Edgar J G Peters, IWGDF/IDSA Guidelines on the Diagnosis and Treatment of Diabetes-related Foot Infections (IWGDF/IDSA 2023), Clinical Infectious Diseases, 2023; ciad527, https://doi.org/10.1093/cid/ciad527Senneville, Éric et al. 2023. “IWGDF/IDSA Guidelines on the Diagnosis and Treatment of Foot Infection in Persons with Diabetes.” IWGDF Guidelines. Retrieved November 6, 2023 (https://iwgdfguidelines.org/wp-content/uploads/2023/07/IWGDF-2023-04-Infection-Guideline.pdf). Royalty-free music used for this episode: Gushito, “Gista Mista”, downloaded on November 16th, 2023, from https://www.videvo.net/ 

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-352 Overview: Keep your practice at the forefront of outpatient COVID-19 management with this informative episode. Listen in as expert faculty discuss the latest recommendations and review ineffective treatments, helping you provide the best care during this new phase of the endemic. Episode resource links: https://www.covid19treatmentguidelines.nih.gov/management/clinical-management-of-adults/clinical-management-of-adults-summary/?utm_source=site&utm_medium=home&utm_campaign=highlights Abdool Karim, S. S., & Devnarain, N. (2022). Time to stop using ineffective COVID-19 drugs. New England Journal of Medicine, 387(7), 654-655. Hayden, M. K., Hanson, K. E., Englund, J. A., Lee, F., Lee, M. J., Loeb, M., ... & Mustafa, R. A. (2023). The Infectious Diseases Society of America guidelines on the diagnosis of COVID-19: antigen testing. Clinical Infectious Diseases, ciad032. Guest: Mariyan L. Montaque, DNP, FNP-BC   Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-352 Overview: Keep your practice at the forefront of outpatient COVID-19 management with this informative episode. Listen in as expert faculty discuss the latest recommendations and review ineffective treatments, helping you provide the best care during this new phase of the endemic. Episode resource links: https://www.covid19treatmentguidelines.nih.gov/management/clinical-management-of-adults/clinical-management-of-adults-summary/?utm_source=site&utm_medium=home&utm_campaign=highlights Abdool Karim, S. S., & Devnarain, N. (2022). Time to stop using ineffective COVID-19 drugs. New England Journal of Medicine, 387(7), 654-655. Hayden, M. K., Hanson, K. E., Englund, J. A., Lee, F., Lee, M. J., Loeb, M., ... & Mustafa, R. A. (2023). The Infectious Diseases Society of America guidelines on the diagnosis of COVID-19: antigen testing. Clinical Infectious Diseases, ciad032. Guest: Mariyan L. Montaque, DNP, FNP-BC   Music Credit: Richard Onorato

Today we speak with Prof Mola, Dr Welch and Dr Visiliu about their amazing work tackling TB in pregnancy in Papua New Guinea. They talk about the epidemiological, geographical and social challenges of providing maternal TB care in PNG along with some insights into treatment and control.REFERENCES:Hamada, Yohhei, et al. "The safety of isoniazid tuberculosis preventive treatment in pregnant and postpartum women: systematic review and meta-analysis." European Respiratory Journal 55.3 (2020).Gupta, Amita, et al. "Timing of maternal isoniazid preventive therapy on tuberculosis infection among infants exposed to HIV in low-income and middle-income settings: a secondary analysis of the TB APPRISE trial." The Lancet Child & Adolescent Health 7.10 (2023): 708-717Lotia Farrukh, Ismat, et al. "Pregnancy and Birth Outcomes in Patients With Multidrug-Resistant Tuberculosis Treated With Regimens That Include New and Repurposed Drugs." Clinical Infectious Diseases (2023): ciad445.Arvidsson, Åsa, et al. "The cascade of care for pregnant women with latent tuberculosis infection in a high-income country." Infectious Diseases 55.9 (2023): 635-645.Gupta, Amita, et al. "Isoniazid preventive therapy in HIV-infected pregnant and postpartum women." New England Journal of Medicine 381.14 (2019): 1333-1346.Alene, Kefyalew Addis, Akilew Awoke Adane, and Alemken Jegnie. "Impact of multidrug-resistant tuberculosis and its medications on adverse maternal and perinatal outcomes: protocol for a systematic review and meta-analysis." BMJ open 9.12 (2019): e034821.

Trial of the Week: Linezolid v Daptomycin in VRE BSI Special Guest: Nick Britt, PharmD, MS, BCPS, BCIDP Nick Britt joins to highlight his first-author research comparing the use of linezolid v. daptomycin for treatment of vancomycin-resistant Enterococcus bloodstream infection (VRE BSI) published in Clinical Infectious Diseases in 2015. We review what the standard of care was for treatment at this time, how this study became to be, covering this featured article and discussing outcomes/results, then reviewing studies published since, how we still use results from this study, and much, much more. Reference list: https://pharmacytodose.files.wordpress.com/2023/09/dapto-v-linez-vre-bsi-references.pdf PharmacyToDose.Com  @PharmacyToDose  PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices

Artificial intelligence (AI) has the potential to change the way we practice medicine and public health. The tools and AI approaches can substantially impact a broad range of fields from the manner we approach patient care to strategies to discover new antimicrobials, track pandemics and deploy public health measures. AAC recently published a commentary on the impact of AI in infectious diseases and we have a conversation with the lead author of the manuscript and a expert guest who is applying these concepts in real time.    Topics discussed: Basic concepts of AI and different applications. How AI can affect the practice of infectious diseases and antimicrobial research. Specific examples in which AI may have a transformative effect in the future. Guests: Lilian Abbo, MD MBA. Associate CMO Infectious Diseases, Professor of Clinical Infectious Diseases, Jackson Health System, University of Miami Miller School of Medicine, Miami Transplant Institute Masayuki Nigo, MD, MSc.  Associate Professor of Clinical Medicine, Houston Methodist Hospital, Section of Transplant Infectious Diseases. This episode is brought to you by the Antimicrobial Agents and Chemotherapy journal available at aac.asm.org. If you plan to publish in AAC, ASM Members get up to 50% off publishing fees. Visit asm.org/membership to sign up. Visit journals.asm.org/journal/aac to browse issues and/or submit a manuscript.

Time to "idiot proof" the myth of bactericidal being better than bacteriostatic agents onthis collaborative episode with the ID_IOTS podcast.About our Guest: Jame and Callum are the hosts of the ID_IOTS podcast, an Infectious Disease podcast. You can find them through https://idiotspodcasting.buzzsprout.com/share wherever you get your podcasts and also on Twitter as @IDiots_pod References from this episode: https://idiotspodcasting.buzzsprout.com/1782416/12537247-44-the-basics-of-beta-lactamase-inhibitorsWald-Dickler N, Holtom P, Spellberg B. Busting the Myth of ‘Static vs Cidal': A Systemic Literature Review. Clin Infect Dis. 2018 17;66(9):1470–4.Use of bacteriostatic agents in Neutropenic fever: DOI: 10.1586/eri.09.11. Jaksic B, Martinelli G, Oteyza JP, Hartman CS, Leonard LB, Tack KJ. Efficacy and Safety of Linezolid Compared with Vancomycin in a Randomized, Double-Blind Study of Febrile Neutropenic Patients with Cancer.Clinical Infectious Diseases. 2006 Mar 1;42(5):597–607https://www.bradspellberg.com/shorter-is-better Visit the Microbe Mail website to sign up for updates E-mail: mail.microbe@gmail.comYouTube: Microbe MailInstagram: Microbe_Mail

Jame and Callum were delighted to be invited as guests to the podcast Microbe Mail by host Vindana (Vin) Chibabhai. Check out the Microbe Mail podcast:https://microbemail.captivate.fm/  @microbemail We discuss how bactericidal and bacteriostatic are defined, what the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) are and why this isn't as simple as it first seems. We then discuss specific clinical situations and where bactercidal vs static have been compared. Links/papers mentioned in this episode:The basics of beta lactamasesWald-Dickler N, Holtom P, Spellberg B. Busting the Myth of ‘Static vs Cidal': A Systemic Literature Review. Clin Infect Dis. 2018 17;66(9):1470–4.Use of bacteriostatic agents in Neutropenic fever: The RCT referred to in the abstract is here: Jaksic B, Martinelli G, Oteyza JP, Hartman CS, Leonard LB, Tack KJ. Efficacy and Safety of Linezolid Compared with Vancomycin in a Randomized, Double-Blind Study of Febrile Neutropenic Patients with Cancer. Clinical Infectious Diseases. 2006 Mar 1;42(5):597–607Support the showQuestions, comments, suggestions to idiotspodcasting@gmail.com or on X/Threads @IDiots_podPrep notes for completed episodes can be found here (Not all episodes have prep notes).If you are enjoying the podcast please leave a review on your preferred podcast app!Feel like giving back? Donations of caffeine gratefully received!https://www.buymeacoffee.com/idiotspod

In this extraordinary episode we speak with renowned historian Professor Christoph Gradmann about the life and work of German physician Robert Koch. In this episode we look at how Koch came to discover tuberculosis and what it meant for the field of medicine in the late 19th century.REFERENCES:Gradmann, Christoph. "Robert Koch and the pressures of scientific research: tuberculosis and tuberculin." Medical history 45.1 (2001): 1-32.Gradmann, Christoph. "Robert Koch and the white death: from tuberculosis to tuberculin." Microbes and Infection 8.1 (2006): 294-301.Gradmann, Christoph. "Robert Koch and the invention of the carrier state: tropical medicine, veterinary infections and epidemiology around 1900." Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 41.3 (2010): 232-240.Gradmann, Christoph. "Money and microbes: Robert Koch, tuberculin and the Foundation of the Institute for Infectious Diseases in Berlin in 1891." History and philosophy of the life sciences (2000): 59-79.Gradmann, Christoph. "A spirit of scientific rigour: Koch's postulates in twentieth-century medicine." Microbes and infection 16.11 (2014): 885-892.Gradmann, Christoph. "A harmony of illusions: clinical and experimental testing of Robert Koch's tuberculin 1890–1900." Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 35.3 (2004): 465-481.Gradmann, Christoph, Mark Harrison, and Anne Rasmussen. "Typhoid and the Military in the Early 20th Century." Clinical Infectious Diseases 69.Supplement_5 (2019): S385-S387.Gradmann, Christoph. "The traveling laboratory: Robert Koch investigates cholera 1883/84." Medizinhistorisches Journal38.1 (2003): 35-56.Gradmann, Christoph. "Laboratory disease: Robert Koch's medical bacteriology." Isis 102 (2011).

Det finnes vel ikke enklere diagnoser enn urinveisinfeksjon? Tro om igjen! Ingrid og Jørgen snakker om UVI – fra hippokratisk pussdrenasje, videre til vår tids diagnostikk, profylakse og behandling. Og hvorfor skal man ikke behandle asymptomatisk bakteriuri? Få svar på ting du ikke visste at du lurte på i denne episoden om urinveisinfeksjoner. Vi minner forøvrig om retningslinjene på https://www.antibiotika.no/ både når det gjelder profylakse og behandling. Referanser: Tefekli A, Cezayirli F. The history of urinary stones: in parallel with civilization. ScientificWorldJournal. 2013;2013:423964.Nickel JC. Management of urinary tract infections: historical perspective and current strategies: Part 1--Before antibiotics. J Urol. 2005 Jan;173(1):21-6Cai T, Tiscione D, Cocci A, Puglisi M, Cito G, Malossini G, et al. Hibiscus extract, vegetable proteases and Commiphora myrrha are useful to prevent symptomatic UTI episode in patients affected by recurrent uncomplicated urinary tract infections. Arch Ital Urol Androl. 2018;90(3):203-7.Harding C, Chadwick T, Homer T, Lecouturier J, Mossop H, Carnell S, et al. Methenamine hippurate compared with antibiotic prophylaxis to prevent recurrent urinary tract infections in women: the ALTAR non-inferiority RCT. Health Technol Assess. 2022;26(23):1-172.Lee BS, Bhuta T, Simpson JM, Craig JC. Methenamine hippurate for preventing urinary tract infections. Cochrane Database Syst Rev. 2012;10(10):CD003265.Relis Metenamin (Hiprex) som profylakse ved residiverende urinveisinfeksjoner. https://relis.no/artikler/32945/ (28.04.23)Recurrent Uncomplicated Urinary Tract Infections in Women: AUA/CUA/SUFU Guideline (2022) https://www.auanet.org/guidelines-and-quality/guidelines/recurrent-uti (28.04.23)Clinical Practice Guideline for the Management of Asymptomatic Bacteriuria: 2019 Update by the Infectious Diseases Society of America. Clinical Infectious Diseases. Published CID, 3/21/2019. Hansson S, Jodal U, Lincoln K, Svanborg-Eden C. Untreated asymptomatic bacteriuria in girls: II--Effect of phenoxymethylpenicillin and erythromycin given for intercurrent infections. BMJ. 1989;298(6677):856-9.Hartman EAR, van de Pol AC, Heltveit-Olsen SR, Lindbaek M, Hoye S, Lithen SS, et al. Effect of a multifaceted antibiotic stewardship intervention to improve antibiotic prescribing for suspected urinary tract infections in frail older adults (ImpresU): pragmatic cluster randomised controlled trial in four European countries. BMJ. 2023;380:e072319.Jansaker F, Li X, Vik I, Frimodt-Moller N, Knudsen JD, Sundquist K. The Risk of Pyelonephritis Following Uncomplicated Cystitis: A Nationwide Primary Healthcare Study. Antibiotics (Basel). 2022;11(12).Vik I, Bollestad M, Grude N, Baerheim A, Damsgaard E, Neumark T, et al. Ibuprofen versus pivmecillinam for uncomplicated urinary tract infection in women-A double-blind, randomized non-inferiority trial. PLoS Med. 2018;15(5):e1002569. Hosted on Acast. See acast.com/privacy for more information.

Today I had the pleasure of speaking with Dr Emily MacLean about the exciting modern tests both commercially available and in research development for diagnosing tuberculosis. Emily talked to us about how GeneXpert has evolved and how we can get the most out of this amazing test but also about the extraordinary diagnostic tests being investigated at the moment from blood tests of host response to bacilli to AI learning cough acoustic markers of tuberculosis!REFERENCES:MacLean, Emily, et al. "Diagnostic accuracy of stool Xpert MTB/RIF for detection of pulmonary tuberculosis in children: a systematic review and meta-analysis." Journal of clinical microbiology 57.6 (2019): e02057-18.Singhroy, Diane N., et al. "Adoption and uptake of the lateral flow urine LAM test in countries with high tuberculosis and HIV/AIDS burden: current landscape and barriers." Gates open research 4 (2020).MacLean, Emily Lai-Ho, et al. "Integrating tuberculosis and COVID-19 molecular testing in Lima, Peru: a cross-sectional, diagnostic accuracy study." The Lancet Microbe (2023).Zifodya, Jerry S., et al. "Xpert Ultra versus Xpert MTB/RIF for pulmonary tuberculosis and rifampicin resistance in adults with presumptive pulmonary tuberculosis." Cochrane Database of Systematic Reviews 2 (2021).APA | Mishra, Hridesh, et al. "Xpert MTB/RIF Ultra and Xpert MTB/RIF for diagnosis of tuberculosis in an HIV-endemic setting with a high burden of previous tuberculosis: a two-cohort diagnostic accuracy study." The Lancet Respiratory Medicine 8.4 (2020): 368-382.APA | Kohli, Mikashmi, et al. "Xpert MTB/RIF Ultra and Xpert MTB/RIF assays for extrapulmonary tuberculosis and rifampicin resistance in adults." Cochrane Database of Systematic Reviews 1 (2021).APA | Branigan D. Tuberculosis Diagnostics. Nov 2022. Available at:https://www.treatmentactiongroup.org/wp-content/uploads/2022/11/pipeline_TB_diagnostics_2022.pdfMacLean, Emily, et al. "Advances in molecular diagnosis of tuberculosis." Journal of clinical microbiology 58.10 (2020): e01582-19.Sweeney, Timothy E., et al. "Genome-wide expression for diagnosis of pulmonary tuberculosis: a multicohort analysis." The Lancet Respiratory Medicine 4.3 (2016): 213-224.Sutherland, Jayne S., et al. "Diagnostic accuracy of the Cepheid 3-gene host response fingerstick blood test in a prospective, multi-site study: interim results." Clinical Infectious Diseases 74.12 (2022): 2136-2141.Moreira, Flora Martinez Figueira, et al. "Blood-based host biomarker diagnostics in active case finding for pulmonary tuberculosis: A diagnostic case-control study." EClinicalMedicine 33 (2021): 100776.Peter, Jonny G., et al. "Effect on mortality of point-of-care, urine-based lipoarabinomannan testing to guide tuberculosis treatment initiation in HIV-positive hospital inpatients: a pragmatic, parallel-group, multicountry, open-label, randomised controlled trial." The Lancet 387.10024 (2016): 1187-1197.

In this 165th in a series of live discussions with Bret Weinstein and Heather Heying (both PhDs in Biology), we discuss the state of the world through an evolutionary lens. This week we discuss mis-, dis-, and mal- information, and terrorism, in light of testimony before Congress regarding the Twitter files and government interference in the exchange of information. We learn how the government would like us to quash narratives that it finds displeasing or inconvenient. We discuss the nature of respiratory disease and pandemics, and consider how much of the destruction that happened in the last three years might have been iatrogenic: caused by medical treatment (rather than by the virus). We consider what happened in 2018-2019, during the Spanish Flu, and the evidence that much of the damage then might have been iatrogenic—specifically from exceedingly high doses of aspirin. And we share the words of theologian Paul Tillich, who broadcast warnings and passion into Nazi Germany, his homeland, to reach the people and encourage resistance. ***** Sponsors: Mindbloom: at-home ketamine therapy. Use code DARKHORSE at www.Mindbloom.com to receive $100 off your first six session program. American Hartford Gold, Trusted Leader in Precious Metals: https://offers.americanhartfordgold.com/darkhorse/” Get up to $5,000 of free silver on your first qualifying order. Call 866-828-1117 or text “DARKHORSE” to 998899.  Vivo Barefoot: Shoes for healthy feet—comfortable and regenerative, enhances stability and tactile feedback. Go to www.vivobarefoot.com/us/darkhorse15 to get 15% off, and a 100-day free trial. ***** Our book, A Hunter-Gatherer's Guide to the 21st Century, is available everywhere books are sold, including from Amazon: https://a.co/d/dunx3at Check out our store! Epic tabby, digital book burning, saddle up the dire wolves, and more: https://darkhorsestore.org Heather's newsletter, Natural Selections (subscribe to get free weekly essays in your inbox): https://naturalselections.substack.com Find more from us on Bret's website (https://bretweinstein.net) or Heather's website (http://heatherheying.com). Become a member of the DarkHorse LiveStreams, and get access to an additional Q&A livestream every month. Join at Heather's Patreon. Like this content? Subscribe to the channel, like this video, follow us on twitter (@BretWeinstein, @HeatherEHeying), and consider helping us out by contributing to either of our Patreons or Bret's Paypal. Looking for clips from #DarkHorseLivestreams? Check out our other channel:  https://www.youtube.com/channel/UCAWCKUrmvK5F_ynBY_CMlIA Theme Music: Thank you to Martin Molin of Wintergatan for providing us the rights to use their excellent music. ***** Mentioned in this episode: Select Subcommittee on the Weaponization of the Federal Government Hearing on the Twitter Files (3-9-23): https://www.youtube.com/live/i-Ip_MHYmkY?feature=share Anyone, at anytime, can spread malinformation (clip from DarkHorse Livestream #115, first aired 2-13-22): https://www.youtube.com/watch?v=UTOWCZEkNiI Rumor Control Page Startup Guide: https://www.cisa.gov/sites/default/files/2023-01/rumor-control-startup-guide_508.pdf The Greatest Lie Told During Covid, by gato malo, in bad cattitude, 3-8-23: https://boriquagato.substack.com/p/the-greatest-lie-told-during-covid Starko 2009. Salicylates and pandemic influenza mortality, 1918–1919 pharmacology, pathology, and historic evidence. Clinical Infectious Diseases, 49(9): 1405-1410. https://academic.oup.com/cid/article/49/9/1405/301441?fbclid=IwAR0m4SSuPqedlg8Support the show

Today we speak to Professor Jan-Willem Alffenaar from Westmead Hospital and the University of Sydney about Therapeutic Drug Monitoring in Tuberculosis. Professor Alffenaar reviews the PK/PD issues with common TB medications, the strengths and weaknesses of TDM and how best to utilise TDM in the treatment of TB patients. REFERENCES1) personalised dosing of TB drugsClinical standards for the dosing and management of TB drugsAlffenaar JW, Stocker SL, Forsman LD, Garcia-Prats A, Heysell SK, Aarnoutse RE, Akkerman OW, Aleksa A, van Altena R, de Onata WA, Bhavani PK. Clinical standards for the dosing and management of TB drugs. The International Journal of Tuberculosis and Lung Disease. 2022 Jun 1;26(6):483-99.Population Pharmacokinetics and Bayesian Dose Adjustment to Advance TDM of Anti-TB Drugs.Sturkenboom MG, Märtson AG, Svensson EM, Sloan DJ, Dooley KE, van den Elsen SH, Denti P, Peloquin CA, Aarnoutse RE, Alffenaar JW. Population pharmacokinetics and Bayesian dose adjustment to advance TDM of anti-TB drugs. Clinical pharmacokinetics. 2021 Jun;60:685-710.2) drug exposure - pathogen susceptibility - treatment outcomeDrug exposure and susceptibility of second-line drugs correlate with treatment response in patients with multidrug-resistant tuberculosis: a multicentre prospective cohort study in China.Zheng X, Forsman LD, Bao Z, Xie Y, Ning Z, Schön T, Bruchfeld J, Xu B, Alffenaar JW, Hu Y. Drug exposure and susceptibility of second-line drugs correlate with treatment response in patients with multidrug-resistant tuberculosis: a multicentre prospective cohort study in China. European Respiratory Journal. 2022 Mar 1;59(3).Drug Exposure and Minimum Inhibitory Concentration Predict Pulmonary Tuberculosis Treatment Response.Zheng X, Bao Z, Forsman LD, Hu Y, Ren W, Gao Y, Li X, Hoffner S, Bruchfeld J, Alffenaar JW. Drug exposure and minimum inhibitory concentration predict pulmonary tuberculosis treatment response. Clinical Infectious Diseases. 2021 Nov 1;73(9):e3520-8.3) TDM frameworkTherapeutic Drug Monitoring of Anti-infective Drugs: Implementation Strategies for 3 Different Scenarios.Kim HY, Byashalira KC, Heysell SK, Märtson AG, Mpagama SG, Rao P, Sturkenboom MG, Alffenaar JW. Therapeutic drug monitoring of anti-infective drugs: implementation strategies for 3 different scenarios. Therapeutic Drug Monitoring. 2022 Feb 1;44(1):3-10.4) point of care TDMA mobile microvolume UV/visible light spectrophotometer for the measurement of levofloxacin in saliva.Alffenaar JW, Jongedijk EM, van Winkel CA, Sariko M, Heysell SK, Mpagama S, Touw DJ. A mobile microvolume UV/visible light spectrophotometer for the measurement of levofloxacin in saliva. Journal of Antimicrobial Chemotherapy. 2021 Feb;76(2):423-9.Levofloxacin pharmacokinetics in saliva as measured by a mobile microvolume UV spectrophotometer among people treated for rifampicin-resistant TB in Tanzania.Mohamed S, Mvungi HC, Sariko M, Rao P, Mbelele P, Jongedijk EM, van Winkel CA, Touw DJ, Stroup S, Alffenaar JW, Mpagama S. Levofloxacin pharmacokinetics in saliva as measured by a mobile microvolume UV spectrophotometer among people treated for rifampicin-resistant TB in Tanzania. Journal of Antimicrobial Chemotherapy. 2021 Jun;76(6):1547-52.

Today we speak with Professor Jann-Yuan Wang, a clinician and researcher in Taiwan, about his work in latent tuberculosis. Professor Wang speaks about his experience using 3HP and the challenges of systemic drug reactions. Professor Wang talks about his research into predicting which patients will experience systemic drug reactions based on research algorithms of clinical characteristics, plasma drug levels and transcriptomic factors.REFERENCES:1) Lee, Ming‐Chia, et al. "Isoniazid level and flu‐like symptoms during rifapentine‐based tuberculosis preventive therapy: A population pharmacokinetic analysis." British journal of clinical pharmacology (2022).2) Peng, Tzu-Rong, et al. "Advantages of short-course rifamycin-based regimens for latent tuberculosis infection: an updated network meta-analysis." Journal of Global Antimicrobial Resistance 29 (2022): 378-385.3) Huang, Hung-Ling, et al. "Whole-blood 3-gene Signature as a Decision Aid for Rifapentine-based TB Preventive Therapy." Clinical Infectious Diseases: an Official Publication of the Infectious Diseases Society of America (2022).4) Huang, Hung-Ling, et al. "Impact of age on outcome of rifapentine-based weekly therapy for latent tuberculosis infection." Clinical Infectious Diseases 73.5 (2021): e1064-e1071.5) Lee, Meng-Rui, et al. "Isoniazid concentration and NAT2 genotype predict risk of systemic drug reactions during 3HP for LTBI." Journal of clinical medicine 8.6 (2019): 812.6) Sun, Hsin-Yun, et al. "Twelve-dose weekly rifapentine plus isoniazid for latent tuberculosis infection: A multicentre randomised controlled trial in Taiwan." Tuberculosis 111 (2018): 121-126.7) Lee, Meng-Rui, et al. "Plasma Concentration of Isoniazid and Single-Nucleotide Polymorphisms of N-Acetyltransferase 2 Predict Risk of Systemic Drug Reactions During Weekly Rifapentine and Isoniazid Therapy for Latent Tuberculosis Infection: A Prospective Observational Cohort Study." Available at SSRN 3297903 (2018).

In the final podcast of the year, we reflect on some lighthearted moments from 2022 and share our thoughts on a few favourite papers, reflections and podcasts. Being the Christmas special, it isn't too serious.. See you in 2023! Brett's highlighted papers: 1. Peters A, et al. Impact of environmental hygiene interventions on healthcare-associated infections and patient colonization: a systematic review. Antimicrob Resist Infect Control. 2022;11(1):38.  https://doi:10.1186/s13756-022-01075-1 2. Dancer SJ, et al. One size does NOT fit all: why infection prevention is difficult to randomise or control. Journal of Hospital Infection. 2022.  https://doi:10.1016/j.jhin.2022.02.008 3. Mac Giolla Eain M, et al. Aerosol release, distribution, and prevention during aerosol therapy: a simulated model for infection control. Drug Deliv. 2022;29(1):10-17.  https://doi:10.1080/10717544.2021.2015482   Phil's papers: 1. Grae N, et al. Prevalence of healthcare-associated infections in public hospitals in New Zealand, 2021. J Hosp Infect. 2022;131:164-172.  https://doi:10.1016/j.jhin.2022.10.002 2. Bolten A, et al. The carbon footprint of the operating room related to infection prevention measures: a scoping review. J Hosp Infect. 2022.  https://doi:10.1016/j.jhin.2022.07.011 Martin's papers: 1. Kato H, et al. Expansion of droplets during speaking and singing in Japanese. PLoS One. 2022;17(8):e0272122.  https://doi:10.1371/journal.pone.0272122 2. Juskevicius LF, et al. Lessons learned from a failed implementation: Effective communication with patients in transmission-based precautions. Am J Infect Control. 2022.  https://doi:10.1016/j.ajic.2022.09.029 3. Cawcutt KA, et al. #SoMe the Money! Value, Strategy, and Implementation of Social Media Engagement for Infectious Diseases Trainees, Clinicians, and Divisions. Clin Infect Dis. 2022;74(Suppl_3):S229-S236.  https://doi:10.1093/cid/ciac063 Link to the whole Clinical Infectious Diseases social media supplement: https://academic.oup.com/cid/issue/74/Supplement_3   Link to the Norovirus song: https://youtu.be/ci7migUwURc Hotel Quarantina (Full version) https://mcdn.podbean.com/mf/download/jh65s2/hotel_quarantina.mp3

In the final podcast of the year, we reflect on some lighthearted moments from 2022 and share our thoughts on a few favourite papers, reflections and podcasts. Being the Christmas special, it isn't too serious.. See you in 2023! Brett's highlighted papers: 1. Peters A, et al. Impact of environmental hygiene interventions on healthcare-associated infections and patient colonization: a systematic review. Antimicrob Resist Infect Control. 2022;11(1):38.  https://doi:10.1186/s13756-022-01075-1 2. Dancer SJ, et al. One size does NOT fit all: why infection prevention is difficult to randomise or control. Journal of Hospital Infection. 2022.  https://doi:10.1016/j.jhin.2022.02.008 3. Mac Giolla Eain M, et al. Aerosol release, distribution, and prevention during aerosol therapy: a simulated model for infection control. Drug Deliv. 2022;29(1):10-17.  https://doi:10.1080/10717544.2021.2015482   Phil's papers: 1. Grae N, et al. Prevalence of healthcare-associated infections in public hospitals in New Zealand, 2021. J Hosp Infect. 2022;131:164-172.  https://doi:10.1016/j.jhin.2022.10.002 2. Bolten A, et al. The carbon footprint of the operating room related to infection prevention measures: a scoping review. J Hosp Infect. 2022.  https://doi:10.1016/j.jhin.2022.07.011 Martin's papers: 1. Kato H, et al. Expansion of droplets during speaking and singing in Japanese. PLoS One. 2022;17(8):e0272122.  https://doi:10.1371/journal.pone.0272122 2. Juskevicius LF, et al. Lessons learned from a failed implementation: Effective communication with patients in transmission-based precautions. Am J Infect Control. 2022.  https://doi:10.1016/j.ajic.2022.09.029 3. Cawcutt KA, et al. #SoMe the Money! Value, Strategy, and Implementation of Social Media Engagement for Infectious Diseases Trainees, Clinicians, and Divisions. Clin Infect Dis. 2022;74(Suppl_3):S229-S236.  https://doi:10.1093/cid/ciac063 Link to the whole Clinical Infectious Diseases social media supplement: https://academic.oup.com/cid/issue/74/Supplement_3   Link to the Norovirus song: https://youtu.be/ci7migUwURc Hotel Quarantina (Full version) https://mcdn.podbean.com/mf/download/jh65s2/hotel_quarantina.mp3

COVID-19 infections may look different in 2022 than they did in 2020, thanks to vaccines, infection-induced immunity, and new treatments—but that doesn't mean we can rest easy. Dr. Paul Sax, clinical director of infectious diseases at the Brigham and Women's Hospital and editor-in-chief of the Journal of Clinical Infectious Diseases talks with Dr. Josh Sharfstein about the overall state of COVID-19 treatments and vaccines, what we still don't know about this virus, and why it's important to stay vigilant. 

This week on Pharm5 with special guests Karl Meyer and Shana Morrison: OTC oral contraceptive Post-surgical VTE prophylaxis with apixaban WHO fighting to end bacterial meningitis FDA approvals: Sotyktu, Rolvedon COVID vaccine decreases MIS-C risk Connect with us! Listen to our podcast: Pharm5 Watch us on TikTok: @LizHearnPharmD Follow us on Twitter: @LizHearnPharmD References Park B. FDA panel meeting scheduled to discuss RX-to-OTC switch of oral contraceptive opill. MPR. https://bit.ly/3BnOTZm. Published September 13, 2022. Accessed September 15, 2022. ASHP Policy week 2022. ASHP. https://bit.ly/3SbbeA2. Accessed September 15, 2022. Pharmacist-prescribed contraceptives. Guttmacher Institute. https://bit.ly/3Bn44Cg. Published August 24, 2022. Accessed September 15, 2022. Westerman ME, Bree KK, Msaouel P, et al. Apixaban vs enoxaparin for post-surgical extended-duration venous thromboembolic event prophylaxis: A prospective quality improvement study. Journal of Urology. 2022;208(4):886-895. doi:10.1097/ju.0000000000002788 Henderson Rby E. Oral anticoagulant drug may be safe, effective in preventing blood clots after Urologic Cancer surgery. News. https://bit.ly/3BJFlcA. Published September 13, 2022. Accessed September 15, 2022. Mutsaka F. Who launches drive to fight bacterial meningitis in Africa. AP NEWS. https://bit.ly/3BJETLl. Published September 8, 2022. Accessed September 14, 2022. Uhl R, Riga T. Spectrum Pharmaceuticals receives FDA approval for Rolvedon™ (eflapegrastim-xnst) injection. Spectrum Pharmaceuticals, Inc. https://bit.ly/3BiRowg. Published September 9, 2022. Accessed September 14, 2022. Dykes L. Deucravacitinib receives FDA approval for moderate-to-severe plaque psoriasis. Rheumatology Network. https://bit.ly/3eRss7m. Published September 10, 2022. Accessed September 14, 2022. Zambrano LD, Newhams MM, Olson SM, et al. BNT162B2 mrna vaccination against COVID-19 is associated with a decreased likelihood of multisystem inflammatory syndrome in children aged 5–18 years—United States, July 2021 – April 2022. Clinical Infectious Diseases. 2022. doi:10.1093/cid/ciac637

This week on Pharm5: NM vs. Purdue Pharma, et al. Antibiotic timing in bloodstream infections Spevigo for pustular psoriasis flares Annual COVID-19 boosters Dolutegravir for pregnant patients living with HIV1 Connect with us! Listen to our podcast: Pharm5 Watch us on TikTok: @LizHearnPharmD Follow us on Twitter: @LizHearnPharmD References Siegel D. Three major pharmacy operators begin latest opioid trial in New Mexico, watch online via CVN. CVN News. https://bit.ly/3RtFcQ9. Published September 7, 2022. Accessed September 8, 2022. Pierson B. Pharmacy Operators Walmart, Walgreens, Kroger begin opioid trial in New Mexico. Reuters. https://reut.rs/3Rwi43e. Published September 6, 2022. Accessed September 8, 2022. Van Heuverswyn J, Valik JK, van der Werff SD, Hedberg P, Giske C, Nauclér P. Association between time to appropriate antimicrobial treatment and 30-day mortality in patients with bloodstream infections: A retrospective cohort study. Clinical Infectious Diseases. September 2022. doi:10.1093/cid/ciac727 Boehringer. https://bit.ly/3x7N1mi. Published September 1, 2022. Accessed September 8, 2022. Spevigo. Package Insert. Boehringer Ingelheim Pharmaceuticals, Inc; 2022. Bendix A. Covid vaccines will likely become annual like flu shots, health officials say. NBCNews.com. https://nbcnews.to/3cWpcXU. Published September 6, 2022. Accessed September 8, 2022. Statement by President Biden on FDA and CDC authorizing updated COVID-19 vaccines. The White House. https://bit.ly/3KYpABy. Published September 6, 2022. Accessed September 8, 2022. Patel K, Huo Y, Jao J, et al. Dolutegravir in pregnancy as compared with current HIV regimens in the United States. New England Journal of Medicine. 2022;387(9):799-809. doi:10.1056/nejmoa2200600

Description: COVID sucks, no doubt about it. Vaccination has been a game changer for how we live through the pandemic, but we still need therapeutics for those breakthrough cases and the unvaccinated amongst us. Paxlovid is a novel anti-viral agent that showed promise in an initial industry-sponsored trial among unvaccinated patients with the delta strain. But does it hold up in the real world where vaccination is common, and omicron has pushed delta to the wayside? Dr. Jarvis reviews the initial RCT and a recent Israeli observational trial where more than 75% of patients were vaccinated. He also covers the contraindications for its use. Finally, he'll no doubt massacre the almost impossible-to pronounce generic names for the drugs in Paxlovid. Citations. 1. Najjar-Debbiny R, Gronich N, Weber G, et al. Effectiveness of Paxlovid in Reducing Severe Coronavirus Disease 2019 and Mortality in High-Risk Patients. Clinical Infectious Diseases. Published online June 2, 2022:ciac443. doi:10.1093/cid/ciac443 2.Hammond J, Leister-Tebbe H, Gardner A, et al. Oral Nirmatrelvir for High-Risk, Nonhospitalized Adults with Covid-19. N Engl J Med. 2022;386(15):1397-1408. doi:10.1056/NEJMoa2118542See omnystudio.com/listener for privacy information.

This week on Pharm5: FTC launches investigation into PBMs COVID vaccines coming soon for kids

Welcome to our USMLE Prep Question and Answer series!We posed the following question on our social media (@sjsm_medicalschool) on Friday, April 15, 2022.In this episode of the series, Dr. Aqsaa Chaudhry will break down this USMLE Step 1 Prep question and explain how you can get to the correct answer in order to prepare for the USMLE Step 1 Exam!Question:  A 15-year-old boy comes to the clinic with complaints of a bump on his stomach. He noticed the lesion a few days ago. He is currently sexually active with multiple partners and does not use protection consistently. He has not had a sexually transmitted infection in the past and his last annual check-up was 2 years ago. The lesion is flesh-colored with central umbilication near the lower abdomen. What is the most probable cause of this patient's lesion?a. DNA virus, non-enveloped, single- stranded and linear structureb. DNA virus, non-enveloped, double- stranded and circular structurec. DNA virus, non-enveloped, double- stranded and linear structured. DNA virus, enveloped, partially double- stranded and circular structuree. DNA virus, enveloped, double- stranded and linear structureCORRECT:e) This patient's lesion describes molluscum contagiosum, a flesh-colored papule with central umbilication. Molluscum contagiosum belongs to the poxvirus family and is a enveloped, double- stranded linear DNA virus. It is often seen in children, however may be sexually transmitted in adults.Shandera, Wayne X., and Eva Clark.. "Other Exanthematous Viral Infections." Current Medical Diagnosis and Treatment 2020 Eds. Maxine A. Papadakis, et al. New York, NY: McGraw-Hill,, http://ezproxy.sjsm.org:2096/content.aspx?bookid=2683§ionid=225055143."Classification of Medically Important Viruses." Review of Medical Microbiology & Immunology: A Guide to Clinical Infectious Diseases, 15e Eds. Warren Levinson, et al. New York, NY: McGraw- Hill, , http://ezproxy.sjsm.org:2096/content.aspx?bookid=2381§ionid=187690830.INCORRECT:a) Parvovirus virus, a non-enveloped, single- stranded linear DNA virus, presents as erythema infectiosum (fifth disease, “slapped cheek” rash) in children. It may also present as aplastic crisis in sickle cell disease patients or hydrops fetalis.b) Papillomavirus is a non-enveloped, single- stranded circular DNA virus, the family is human papilloma virus (HPV), which can cause papillomas (warts) without central umbilication and certain strains can lead to cervical carcinoma.c) Adenovirus is a non-enveloped, double- stranded linear DNA virus, that may present with febrile pharyngitis, upper and lower respiratory tract disease.d) Hepadnavirus is an enveloped, partially double- stranded circular DNA virus, that leads to hepatitis B virus that may lead to either acute or chronic hepatitis."Classification of Medically Important Viruses." Review of Medical Microbiology & Immunology: A Guide to Clinical Infectious Diseases, 15e Eds. Warren Levinson, et al. New York, NY: McGraw- Hill, , http://ezproxy.sjsm.org:2096/content.aspx?bookid=2381§ionid=187690830.| Socials |Med School Minutes Podcast: https://www.buzzsprout.com/1904744Instagram: https://www.instagram.com/sjsm_medica...Facebook: https://www.facebook.com/mdsjsmLinkedIn: https://www.linkedin.com/school/saint...Website: https://www.sjsm.orgStore: https://sjsmstore.com* These links are affiliated with the channel and support the channel when used*

As we enter year three of the COVID-19 pandemic, we would like to review the latest updates about HIV and COVID-19. In the first segment we will speak with Dr. Robert Fullilove, EdD, about the social and historical factors which have led to racial health disparities for HIV and COVID-19. In the second segment we will speak with Dr. Keith Sigel, MD, PhD, MPH, who will unpack the latest research and data about COVID-19 outcomes for Persons Living with HIV (PLWH). The goal of this episode will be to provide information for providers about how to understand and meet their patients' needs in relation to HIV and COVID-19. Part 1: Robert Fullilove, EdD, Robert Fullilove Columbia University Mailman School of Public Health https://www.publichealth.columbia.edu/people/our-faculty/ref5 Burns, D Learning for Our Common Health Association of American Colleges and Universities Washington, DC 109-119 1999 Golembeski C, Fullilove R Criminal (in)justice in the City and Its Associated Health Consequences. American Journal of Public Health 95 1701-6 2005 Green LL, Fullilove MT, Fullilove, RE. Remembering the Lizard: Reconstructing Sexuality in the Rooms of Narcotics Anonymous. Journal of Sex Research 42 28-34 2005 Fullilove RE HIV Prevention in the African American Community: Why Isn't Anybody Talking about the Elephant in the Room? AIDScience 1 1-7 2001 Fullilove MT and Fullilove RE What's housing got to do with it? American Journal of Public Health 90 183-4 2000 Fullilove RE, Green LL, Fullilove MT The Family to Family Program: A Structural Intervention with Implications for the Prevention of HIV/AIDS and Other Community Epidemics. AIDS. Vol 14 (1S) 2000.63-67 14(1S) 63-67 2000 Levine RS, Foster JE, Fullilove RE et al. Black-White Inequalities in Mortality and Life Expectancy, 1993-1999 :Implications for Healthy People 2010. Public Health Reports 116 474-83 2001 Malebranch DJ, Peterson JL, Fullilove RE, Stackhouse RW. Race and Sexual Identity: Perceptions about Medical Culture and Healthcare among Black Men Who Have Sex with Men. Journal of the National Medical Association 96 97-107 2004 Part 2: Keith Sigel, MD, PhD, MPH Braunstein, S. L., Lazar, R., Wahnich, A., Daskalakis, D. C., & Blackstock, O. J. (2021). Coronavirus disease 2019 (COVID-19) infection among people with human immunodeficiency virus in new york city: a population-level analysis of linked surveillance data. Clinical Infectious Diseases, 72(12), e1021-e1029. Centers of Disease Control and Prevention. (2021) COVID-19 and HIV. https://www.cdc.gov/hiv/covid-19/index.html Cooper, T. J., Woodward, B. L., Alom, S., & Harky, A. (2020). Coronavirus disease 2019 (COVID‐19) outcomes in HIV/AIDS patients: a systematic review. HIV medicine, 21(9), 567-577. Garret, N., Tapley, A., Andriesen, J., Seocharan, I., Fisher, L. H., Bunts, L., ... & Corey, L. (2021). High rate of asymptomatic carriage associated with variant strain Omicron. MedRxiv. Sigel, K., Swartz, T., Golden, E., Paranjpe, I., Somani, S., Richter, F., ... & Glicksberg, B. S. (2020). Covid-19 and people with HIV infection: outcomes for hospitalized patients in New York City. Clinical Infectious Diseases. Verity, R., Okell, L. C., Dorigatti, I., Winskill, P., Whittaker, C., Imai, N., ... & Ferguson, N. M. (2020). Estimates of the severity of coronavirus disease 2019: a model-based analysis. The Lancet infectious diseases, 20(6), 669-677.

Episode 87: Latent TB Infection.  By Mariana Gomez, MD (Romulo Gallegos University School of Medicine, Carillion Clinic Infectious Disease), and Hector Arreaza, MD (Romulo Gallegos University School of Medicine, Rio Bravo Family Medicine Residency Program). Dr. Gomez explains how to screen for and treat Latent TB infection. Today is March 18, 2022.Dr. Mariana Gomez graduated from medical school at the Romulo Gallegos University in Venezuela. She completed her residency in Internal Medicine in St Barnabas Hospital, which is affiliated with the Albert Einstein School of Medicine, Bronx, New York. She then completed a fellowship in Infectious Diseases at Carilion Clinic, which is affiliated with Virginia Tech School of Medicine. She currently works in Virginia, United States.  This is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it's sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. Some questions discussed during this episode: Who should be screened for latent TB infection? A CDC questionnaire can determine the risk for latent TB infection. Some patients who may be screened are those who resided for 1 month in a country with high TB prevalence, those who are currently immunosuppressed or planning immunosuppression in the near future (50 mg of prednisone or equivalent a day for 1 month), and those who had close contact with patients with TB infection (Latent Tuberculosis Infection: A Guide for Primary Health Care Providers (cdc.gov)). The USPSTF recommends screening for latent tuberculosis infection (LTBI) in populations at increased risk.Screening Tests: Currently, there are two types of screening tests for LTBI in the United States: the tuberculin skin test (TST, also known as PPD) and the Interferon Gamma Release Assay (IGRA, brand names QuantiFERON®-TB and T-SPOT®.TB). The TST requires intradermal placement of purified protein derivative and interpretation of response 48 to 72 hours later. The induration is measured in millimeters. The induration is the palpable, raised, hardened area or swelling, not the erythema.IGRA requires a single venous blood sample, and the result is obtained in 1-2 days. Two types of IGRAs are currently approved by the US Food and Drug Administration: T-SPOT.TB (Oxford Immunotec Global) and QuantiFERON-TB Gold In-Tube (Qiagen). The CDC recommends screening with either test (TST or IGRA) but not both. IGRAs is preferred for patients who received a BCG vaccine (bacille Calmette–Guérin) or if they are unlikely to return for TST interpretation.Why should we screen for LTBI? How can we decide between Questionnaire only vs PPD vs QuantiFERON Gold? What is the next step in assessing asymptomatic individuals with positive PPD?A useful resource is the online TST/IGRA Interpreter (tstin3d.com). You can calculate the risk of latent TB infection and the risk of INH-induced hepatitis. How can we decide to treat LTBI? What are the recommended regimens? CDC recommends three preferred regimens. These are chosen for effectiveness, safety, and high treatment completion rates. These regimens are rifamycin-based. They are:INH+rifapentine for 3 months: once-weekly isoniazid plus rifapentine for adults and children older than age 2, regardless of HIV status.Rifampin for 4 months: daily rifampin.INH+rifampin for 3 months: daily isoniazid plus rifampin. ____________________________Now we conclude our episode number 86 “Latent TB Infection.” Dr. Gomez taught us how to screen and treat latent TB infections. Remember to screen only those who are at risk of TB infection. Once you get a positive screen test, select the patients who will receive treatment of LTBI to prevent reactivation of TB infection. You have at least 4 regimens to treat LTBI. The regimens that include rifamycin are recommended by the CDC. Even without trying, every night you go to bed being a little wiser.Thanks for listening to Rio Bravo qWeek. If you have any feedback about this podcast, contact us by email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created for educational purposes only. Visit your primary care physician for additional medical advice. This week we thank Hector Arreaza and Mariana Gomez. Audio edition: Suraj Amrutia. See you next week! _____________________References: Latent Tuberculosis Infection: Screening, September 06, 2016,  United States Preventive Services Taskforce, uspreventiveservicestaskforce.org. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/latent-tuberculosis-infection-screening. Lewinsohn, David M., et al, Official American Thoracic Society/Infectious Diseases Society of America/Centers for Disease Control and Prevention Clinical Practice Guidelines: Diagnosis of Tuberculosis in Adults and Children. Clinical Infectious Diseases, 2017;64(2):e1–e33, Infection Diseases Society of America, https://www.idsociety.org/globalassets/idsa/practice-guidelines/official-american-thoracic-society.infectious-diseases-society-of-america.centers-for-disease-control-and-prevention-clinical-practice-guidelines-diagnosis-of-tuberculosis-in-adults-and-children.pdf.   Sterling TR, Njie G, Zenner D, et al. Guidelines for the Treatment of Latent Tuberculosis Infection: Recommendations from the National Tuberculosis Controllers Association and CDC, 2020. MMWR Recomm Rep 2020;69(No. RR-1):1–11. DOI: http://dx.doi.org/10.15585/mmwr.rr6901a1. The Online TST/IGRA Interpreter, McGill University and McGill University Health Center Montreal Quebec, Canada, http://tstin3d.com/. 

In this, the first episode of 2022, Martin Kiernan talks to Dr Matt Butler, Consultant Geriatrician (Addenbrookes Hospital, Cambridge, UK), Dr Christine Peters, Consultant Microbiologist (NHS Greater Glasgow, Scotland) and Dr Evonne Curran, now an independent IPC Consultant. We start off by discussing how Matt came to design a study that looks at the effect of air filtration on a range of infections, including respiratory viruses and more 'common' pathogens like Clostridium difficile. We also discuss why it had taken so long for airborne transmission to be accepted as a mode of transmission. Books recommended by Evonne in the podcast are listed below.   Think Again: The power of knowing what you don't know by Adam Grant (https://www.adamgrant.net/book/think-again/) ISBN: 9780753553886 Seeing what others don't by Gary Klein ISBN: 9781857886788 Paper by Andrew Conway-Morris referred to in the podcast: Andrew Conway Morris, Katherine Sharrocks, Rachel Bousfield, Leanne Kermack, Mailis Maes, Ellen Higginson, Sally Forrest, Joana Pereira-Dias, Claire Cormie, Tim Old, Sophie Brooks, Islam Hamed, Alicia Koenig, Andrew Turner, Paul White, R Andres Floto, Gordon Dougan, Effrossyni Gkrania-Klotsas, Theodore Gouliouris, Stephen Baker, Vilas Navapurkar, The Removal of Airborne Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and Other Microbial Bioaerosols by Air Filtration on Coronavirus Disease 2019 (COVID-19) Surge Units, Clinical Infectious Diseases, 2021;, ciab933, https://doi.org/10.1093/cid/ciab933

In this, the first episode of 2022, Martin Kiernan talks to Dr Matt Butler, Consultant Geriatrician (Addenbrookes Hospital, Cambridge, UK), Dr Christine Peters, Consultant Microbiologist (NHS Greater Glasgow, Scotland) and Dr Evonne Curran, now an independent IPC Consultant. We start off by discussing how Matt came to design a study that looks at the effect of air filtration on a range of infections, including respiratory viruses and more 'common' pathogens like Clostridium difficile. We also discuss why it had taken so long for airborne transmission to be accepted as a mode of transmission. Books recommended by Evonne in the podcast are listed below.   Think Again: The power of knowing what you don't know by Adam Grant (https://www.adamgrant.net/book/think-again/) ISBN: 9780753553886 Seeing what others don't by Gary Klein ISBN: 9781857886788 Paper by Andrew Conway-Morris referred to in the podcast: Andrew Conway Morris, Katherine Sharrocks, Rachel Bousfield, Leanne Kermack, Mailis Maes, Ellen Higginson, Sally Forrest, Joana Pereira-Dias, Claire Cormie, Tim Old, Sophie Brooks, Islam Hamed, Alicia Koenig, Andrew Turner, Paul White, R Andres Floto, Gordon Dougan, Effrossyni Gkrania-Klotsas, Theodore Gouliouris, Stephen Baker, Vilas Navapurkar, The Removal of Airborne Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and Other Microbial Bioaerosols by Air Filtration on Coronavirus Disease 2019 (COVID-19) Surge Units, Clinical Infectious Diseases, 2021;, ciab933, https://doi.org/10.1093/cid/ciab933

Fred e Raphael trazem nesse bolus especial, muita informação essencial para essa nova onda de Influenza: quando pensar? E a diferença com COVID? Como diagnosticar e como tratar? Tudo isso aqui! Referências: Call, Stephanie A., et al. "Does this patient have influenza?." Jama 293.8 (2005): 987-997. World Health Organization. "Recommended composition of influenza virus vaccines for use in the 2022 southern hemisphere influenza season–Composition" Punpanich, Warunee, and Tawee Chotpitayasunondh. "A review on the clinical spectrum and natural history of human influenza." International Journal of Infectious Diseases 16.10 (2012): e714-e723. Uyeki, Timothy M., et al. "Clinical practice guidelines by the Infectious Diseases Society of America: 2018 update on diagnosis, treatment, chemoprophylaxis, and institutional outbreak management of seasonal influenza." Clinical Infectious Diseases 68.6 (2019): e1-e47. Gaitonde, David Y., Faith C. Moore, and Mackenzie K. Morgan. "Influenza: Diagnosis and treatment." American family physician 100.12 (2019): 751-758. Rodrigo, Chamira, et al. "Corticosteroids as adjunctive therapy in the treatment of influenza." Cochrane database of systematic reviews 3 (2016). Lansbury, Louise, et al. "Corticosteroids as adjunctive therapy in the treatment of influenza." Cochrane Database of Systematic Reviews 2 (2019). Ni, YN., Chen, G., Sun, J. et al. The effect of corticosteroids on mortality of patients with influenza pneumonia: a systematic review and meta-analysis. Crit Care 23, 99 (2019).

COVID-19 Treatment Guideline co-authors Rajesh Gandhi, MD, FIDSA of Harvard University and Adarsh Bhimraj, MD, FIDSA of the Cleveland Clinic give an update on COVID-19 therapeutics and discuss two recently published papers in Clinical Infectious Diseases. Lessons learned from COVID-19 therapies: Critical perspectives from the IDSA COVID-19 treatment guideline panel: https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciab882/6398589 Therapeutic Emergency Use Authorizations (EUAs) During Pandemics: Double-Edged Swords: https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciab880/6398590

Drs. Molly Sinert and Jon Furuno join Dr. David Ha (@DHpharmd) to discuss the prevalence of antibiotic use and its harms and benefits in reducing suffering and providing comfort during end-of-life care. Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/ References: Sinert et al. Guidance for Safe and Appropriate Use of Antibiotics in Hospice Using a Collaborative Decision Support Tool. Accessed October 6, 2021. https://oce-ovid-com.laneproxy.stanford.edu/article/00129191-202008000-00005/HTMLA Albrecht JS, McGregor JC, Fromme EK, Bearden DT, Furuno JP. A Nationwide Analysis of Antibiotic Use in Hospice Care in the Final Week of Life. Journal of Pain and Symptom Management. 2013;46(4):483-490. doi:10.1016/j.jpainsymman.2012.09.010 Furuno JP, Noble BN, Fromme EK. Should we refrain from antibiotic use in hospice patients? Expert Review of Anti-infective Therapy. 2016;14(3):277-280. doi:10.1586/14787210.2016.1128823 Servid SA, Noble BN, Fromme EK, Furuno JP. Clinical Intentions of Antibiotics Prescribed Upon Discharge to Hospice Care. Journal of the American Geriatrics Society. 2018;66(3):565-569. doi:10.1111/jgs.15246 Gaw CE, Hamilton KW, Gerber JS, Szymczak JE. Physician Perceptions Regarding Antimicrobial Use in End-of-Life Care. Infection Control & Hospital Epidemiology. 2018;39(4):383-390. doi:10.1017/ice.2018.6 Broom J, Broom A, Good P, Lwin Z. Why is optimisation of antimicrobial use difficult at the end of life? Internal Medicine Journal. 2019;49(2):269-271. doi:10.1111/imj.14200 Kwon KT. Implementation of Antimicrobial Stewardship Programs in End-of-Life Care. Infect Chemother. 2019;51(2):89-97. doi:10.3947/ic.2019.51.2.89 Datta R, Topal J, McManus D, et al. Perspectives on antimicrobial use at the end of life among antibiotic stewardship programs: A survey of the Society for Healthcare Epidemiology of America Research Network. Infection Control & Hospital Epidemiology. 2019;40(9):1074-1076. doi:10.1017/ice.2019.194 Lopez S, Vyas P, Malhotra P, et al. A Retrospective Study Analyzing the Lack of Symptom Benefit With Antimicrobials at the End of Life. Am J Hosp Palliat Care. 2021;38(4):391-395. doi:10.1177/1049909120951748 Ito H. Antibiotics in end-of-life care: What is the driving factor? Infectious Diseases Now. Published online July 7, 2021. doi:10.1016/j.idnow.2021.07.003 Kates OS, Krantz EM, Lee J, et al. Association of Physician Orders for Life-Sustaining Treatment With Inpatient Antimicrobial Use at End of Life in Patients With Cancer. Open Forum Infectious Diseases. 2021;8(8). doi:10.1093/ofid/ofab361 Hickman SE, Nelson CA, Moss AH, Tolle SW, Perrin NA, Hammes BJ. The consistency between treatments provided to nursing facility residents and orders on the physician orders for life-sustaining treatment form. J Am Geriatr Soc. 2011; 59(11): 2091–2099. doi:10.1111/j.1532-5415.2011.03656.x. Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clinical Infectious Diseases, Volume 62, Issue 10, 15 May 2016, Pages e51–e77, https://doi.org/10.1093/cid/ciw118

En Estados Unidos, así como en muchos países en Latinoamérica, los niños regresaron a la escuela de manera presencial, de forma híbrida y mientras otros continúan el aprendizaje en línea. ¿Qué es lo que ha pasado? Aumento de contagios, sobre todo en aquellos grupos que desafortunadamente no tienen la edad mínima requerida para recibir la vacuna contra el COVID19, como son los menores de 12 años.  Nuestro invitado ha centrado su investigación precisamente en nuevas vacunas pediátricas. El Dr. Miguel O´Ryan es Profesor Titular en el Programa de Microbiología y Micología de la Facultad de Medicina de la Universidad de Chile, donde tiene el cargo de Director de Asuntos Internacionales. El Dr. O´Ryan se graduó de la Universidad Católica de Chile y realizá la subespecialidad de enfermedades infecciosas pediátricas en el Centro de Ciencias de la Salud de la Universidad de Texas. Es past-Presidente de la Sociedad Chilena de Enfermedades Infecciosas de 1998 a 1999 y su investigación se ha centrado en dos áreas principales: aspectos moleculares y clínicos de la enfermedad entérica y el desarrollo de vacunas, siendo el investigador principal del ensayo multinacional de la vacuna contra el rotavirus humano.    Durante la pandemia del COVID19 ha sido miembro de los Comités de Consultoría del Ministro de Salud de Chile y el Ministro de Ciencia y Tecnología, trabajó en ensayos de vacunas y estudios epimediológicos, dados a conocer en prestigiosas publicaciones como el Clinical Infectious Diseases y Lancet Infectious Diseases.   ¿Tienes algún comentario sobre este episodio o sugerencias de temas para un futuro podcast? Escríbenos a pediatrasenlinea@childrenscolorado.org.

In this podcast we discuss the reported impact of HIV infection on people who are hospitalised with COVID-19, by reviewing three publications: 1. Outcomes of COVID-19 Related Hospitalization Among People With HIV in the ISARIC WHO Clinical Characterization Protocol: A Prospective Observational Study. Clinical Infectious Diseases, 23 October 2020 (https://www.who.int/publications/i/item/WHO-2019-nCoV-Clinical-HIV-2021). 2.Epidemiology and outcomes of COVID-19 in HIV-infected individuals: a systematic review and meta-analysis.Nature, Scientific Reports, 18 March 2021 (https://www.nature.com/articles/s41598-021-85359-3). 3. Clinical features and prognostic factors of COVID-19 in people living with HIV hospitalized with suspected or confirmed SARS has just been released. WHO Global Clinical Platform, 15 July 2021 (https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa1605/5937133). STI's Podcast Editor, Dr Fabiola Martin, interviews Prof Anna Maria Garretti, Diseases at the Policlinico Tor Vergata, University of Rome Tor Vergata, Chair of the British HIV Association Vaccination Guidelines Panel, and Editor in Chief of the STI Journal; and Associated Research Professor Dr Paddy Ssentongo, from the Penn State University, Pennsylvania, USA. Read the blog post: https://blogs.bmj.com/sti/2021/09/16/c19-plwh-revisited/

Aspirgillosis is a deadly fungal infection that is a major cause of mortality in patients with impaired immune systems. The current standard of care has been voriconazole due to the favorable side effect profile compared to amphotericin. However, posaconazole may not have there adverse effects and be a reasonable course of therapy. Is voriconazole just just a phase? Today's episode is sponsored by a special CEimpact FREE Law focused webinar:  Save your spot - FREE LIVE LAW CE webinar on April 1st.  SPOTS ARE LIMITED! https://ceimpact.com/law  Reference: Maertens JA, Rahav G, Lee DG, et al. Posaconazole versus voriconazole for primary treatment of invasive aspergillosis: a phase 3, randomised, controlled, non-inferiority trial. Lancet. 2021 Feb 6;397(10273):499-509. doi: 10.1016/S0140- 6736(21)00219-1. PMID: 33549194. Practice Guidelines for the Diagnosis and Management of Aspergillosis: 2016 Update by the Infectious Diseases Society of America, Clinical Infectious Diseases, Volume 63, Issue 4, 15 August 2016, Pages e1–e60, hMps://doi.org/10.1093/cid/ciw326 CPE details for GameChangers Podcast March 2021 Learning Objective: Develop appropriate treatment of aspergillosis infections based on clinical studies. 0107-0000-21-097-H01-P 0.25 CEU/2.5 Hrs (Knowledge) Initial Release Date: 03/02/21 Expiration Date: 03/02/24 Additional CPE information is located at https://www.ceimpact.com/podcast See omnystudio.com/listener for privacy information. Learn more about your ad choices. Visit megaphone.fm/adchoices

วาระนี้ #Analysand มาพูดคุยเรื่อง Fully Automated Luxury Communism ซึ่งเป็นเรื่องเบาๆ พักสมองจากเรื่องทฤษฎีกันอีกครั้ง รอบนี้คุยสบายๆ ว่าด้วยเศรษฐกิจและความเป็นไปได้ของสังคมที่ก้าวข้ามความขาดแคลน . ขอขอบคุณสหายศิริวัชรผู้ช่วยปรับ/ตัดแต่งเสียง ครั้งนี้เราไม่ได้ใช้สตูดิโอ เนื่องจากอัดเสียงทางไกล เสียงอาจไม่คมชัดเหมือนเท่าใด แต่ฟังได้แน่นอนครับ . เช่นเคย หากผู้ฟังท่านใดสนใจติชมสามารถ comment ไว้ได้ที่ SoundCloud, YouTube, @the_analysand ใน Twitter, หรือส่ง E-mail มาได้ที่ analysand@protonmail.com ครับ . ข้อมูลเพิ่มเติม ========== - Novara Media คือสื่อฝ่ายซ้ายจากสหราชอาณาจักร สนใจโปรดดู https://novaramedia.com/ . - Aaron Bastani (เกิด 1984) นักข่าวและหนึ่งในสมาชิกก่อตั้ง Novara Media ซึ่งเราได้นำหนังสือของเขามาพูดในวันนี้ นั่นก็คือ Aaron Bastani, Fully Automated Luxury Communism: A Manifesto (London ; New York: Verso, 2019). - Moses Hess (1812-1875) คอมมิวนิสต์ยุคแรกๆ (ก่อนที่ Karl Marx จะเรียกตัวเองว่า Communist) มีผลงานเช่น Hess, Moses. 2012. Cambridge Texts in the History of Political Thought: Moses Hess: The Holy History of Mankind and Other Writings, ed. by Shlomo Avineri (Cambridge, England: Cambridge University Press). - Thomas Robert Malthus (1766-1834) นักเศรษฐศาสตร์กระฎุมพีชื่อดัง มีผลงานเช่น Malthus, T. R. 2008. T. R. Malthus: Principles of Political Economy: Volume 1, ed. by John Pullen (Cambridge, England: Cambridge University Press). - Noam Chomsky (เกิด 1928) นักกิจกรรมทางการเมืองชาวอเมริกัน หรือในทางวิชาการหลายคนอาจรู้จักเขาในนามนักภาษาศาสตร์ ผลงานล่าสุดของเขาคือ Noam, Chomsky, and Marv Waterstone. 2021. Consequences of Capitalism (Chicago, IL: Haymarket Books) . - เรื่องดวงอาทิตย์เทียมในเกาหลีใต้ โปรดดู https://phys.org/news/2020-12-korean-artificial-sun-world-sec-long.html - เรื่อง Communism & Socialism ในยุค Karl Marx โปรดดู Sven-Eric Liedman, A World to Win: The Life and Works of Karl Marx (London ; Brooklyn, NY: Verso, 2018). - Paper เรื่องยาปฏิชีวินะที่ปฐมพงศ์พูดถึง คือ B. Spellberg and others, ‘The Epidemic of Antibiotic-Resistant Infections: A Call to Action for the Medical Community from the Infectious Diseases Society of America', Clinical Infectious Diseases, 46.2 (2008), 155–64. - เรื่อง The Human Genome Project โปรดดู https://www.genome.gov/human-genome-project - คอร์สเรียนออนไลน์เรื่อง Genome ที่ปฐมพงศ์พูดถึงโปรดดู https://www.futurelearn.com/courses/whole-genome-sequencing - เรื่องข้อตกลงทางอวกาศระหว่างสหรัฐอเมริกากับสหภาพสาธารณรัฐสังคมนิยมโซเวียตโปรดดู https://www.govtrack.us/congress/bills/85/hr12575/text ส่วนข่าวเรื่องประธานาธิบดีทรัมป์เซ็นให้เอกชนสามารถนำทรัพยากรในอวกาศมาเป็นกรรมสิทธิ์ (property) ได้ โปรดดู https://phys.org/news/2020-04-trump-moon-asteroids.html - คลิปอ.สรวิศพูดเรื่องต่างๆ ที่ปฐมพงศ์พูดถึง เช่นเรื่องทรัพยากรธรรมชาติในยุคทุนนิยม โปรดดู https://youtu.be/bCrYahhH3qk - เรื่องโรจาวา โปรดดูคลิปของ 'พูด' ใน https://youtu.be/ZNRslk-9RdI และสามารถอ่านบทความของ Dindeng ได้ใน www.dindeng.com/rojava/ - เรื่องเครื่องพิมพ์สามมิติกับความปราถนาดีของรัฐบาลลุงตู่ โปรดดู https://www.blognone.com/node/78242 หรืออ่านใน มติคณะรัฐมนตรี วันที่ 23 กุมภาพันธ์ 2559 ได้ครับ - สนใจบทวิเคราะห์ภาพยนตร์ ฟรีแลนซ์: ห้ามป่วย ห้ามพัก ห้ามรักหมอ (GMM Tai Hub, Jorkwang Films, 2015) โปรดดู http://www.dindeng.com/freelance-the-protestant-work-ethic-th/ - ภาพยนตร์ Spider-Man ที่ปฐมพงศ์พูดถึงคือ Sam Raimi, Spider-Man 2 (Columbia Pictures, Marvel Enterprises, Laura Ziskin Productions, 2004). . - White Collar Labour หรือ แรงงานคอปกขาว โดยทั่วไปหมายถึงแรงงานทำงานที่ 'มีทักษะ' ต่างๆ เช่น ผู้จัดการ พนักงานออฟฟิศ หรืองานวิชาชีพต่างๆ . แก้ไขข้อผิดพลาดที่เกินอภัย =================== - ประมาณ ณ เวลา 27.50 ปฐมพงศ์พูดผิด ขออนุญาตแก้ไขว่า 'กำลังการผลิต' ควรจะเป็น 'อำนาจทางการเมืองของชนชั้นแรงงาน'

Lyme disease is a complex infection and post infection syndrome can lead to serious outcomes, including death. A new guideline was developed for the diagnosis and treatment of this infection. Spoon! This episode is accredited for CPE. Subscribe at CEimpact ( https://www.ceimpact.com/pharmacist ) and claim your CE today! Reference: Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease. Clinical Infectious Diseases, November 30, 2020. https://doi.org/10.1093/cid/ciaa1215. Accessed at https://www.idsociety.org/practice-guideline/lyme-disease/  CPE details for GameChangers Podcast February 2021 Learning Objective: Discuss treatment for different forms of lyme disease infections depending on the severity of symptoms 0107-0000-21-XXX-H01-P 0.2 CEU/2.0 Hrs (Knowledge) Initial Release Date: 02/23/21 Expiration Date: 02/23/24 Additional CPE information is located at https://www.ceimpact.com/podcast  See omnystudio.com/listener for privacy information. Learn more about your ad choices. Visit megaphone.fm/adchoices

With the new plandemic of monkey pox and the PCR test, this is a reminder about the fraud behind Fauci and PCR. Again, this is another fear tatic for compliance. Please be awake this time. It's going to get a lot worse.Recorded January 12, 2021Current Episodes at https://walkinverse.buzzsprout.com/I am moving all podcast here slowly. I will keep buzzsprout for all public reports and here for member only content.Episode #32, "Fauci Comes Clean on PCR: It's False Positives to Keep Fear High" In this episode, we will explore together what CT values mean and why all these test return false positive, when in fact you are not contagious.  Grab a pen and notebook and enjoy the report.Fauci Comes Clean on PCRFauci comes clean on the PCR test. When cycle thresholds rise over 35, false positives sustain to guarantee fear remains high. Cases explode; why? An insurance policy for compliance with illegal mandates and unconstitutional orders.Any value above 35 reflects false results.Watch Video: Fauci and PCR CT ValuesTo our dismay, these crimes against humanity committed by the left and right serve a purpose. To force a vaccine on an unknowing population, they needed to guarantee an out-of-control crisis for their experimental injection without question.The WHO [1] admitted the unreliable nature of PCR to justify vaccine compliance. They state in their notice from December 14 2020 [2], high CT values result in false positives, which we see across the world today.Experts compiled three datasets from Massachusetts, New York, and Nevada. They confirmed up to 90% [3] of the people with a positive restful from the PCR test did not carry the virus. A laboratory in New York, Wadworth Center, reviewed test from July to look at the cycle threshold. They learned 794 positive tests used a CT value 40 and stated, “With a Ct threshold of 35, approximately half of these PCR tests would no longer be considered positive, …And about 70% would no longer be considered positive with a Ct of 30.”An article published in Clinical Infectious Diseases reported patients with Ct > 25 could not be contagious. [4].Friends, the fraud against humanity has one goal, control. Unless you stand up against tyranny, our freedoms will vanish. Our lives forced into servitude as our children's future drifts away.We can no longer sit on the sidelines of compliance. Take off the mask, refuse the orders, and draw your line in the sand.References* Christians for Truth. 2020. “WHO Finally Admits COVID PCR Tests Unreliable But Promoted Them Anyway To Justify Vaccines.” Christians for Truth (blog). December 21, 2020.* WHO. 2021. “WHO Information Notice for IVD Users 2020/05.” Corporation. WHO. January 20, 2021.* Tyler Durden. 2021. “FDA Admits PCR Tests Give False Results, Prepares Ground For Biden To ‘Crush' Casedemic.” Humansarefree. January 5, 2021.* Jaafar, Rita, Sarah Aherfi, Nathalie Wurtz, Clio Grimaldier, Thuan Van Hoang, Philippe Colson, Didier Raoult, and Bernard La Scola. 2020. “Correlation Between 3790 Quantitative Polymerase Chain Reaction–Positives Samples and Positive Cell Cultures, Including 1941 Severe Acute Respiratory Syndrome Coronavirus 2 Isolates.” Clinical Infectious Diseases, no. ciaa1491 (September). https://doi.org/10.1093/cid/ciaa1491. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit walkinverse.substack.com/subscribe

Last month, a multidisciplinary panel led by the Infectious Diseases Society of America, the American Academy of Neurology, and the American College of Rheumatology published the 2020 Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease in Clinical Infectious Diseases. The authors say it provides recommendations aimed to serve as a meaningful resource for the safe, effective, evidence-based care of people with Lyme disease.  Here to give her views on the guidelines is attorney and the Chief Executive Officer of LymeDisease.org, Lorraine Johnson, JD, MBA.

Dr. Baluch provides an overview of how to structure an infection control program for a hospital. She reviews the different types of infection control precautions (standard, contact, droplet, special, airborne). She also addresses specific situations such as with measles and with stem cell transplant patients and other immunocompromised individuals.

Learn a bit more about what makes you, you! References Cresci, G. A., & Izzo, K. (2019). Chapter 4 - Gut Microbiome. In M. L. Corrigan, K. Roberts, & E. Steiger, Adult Short Bowel Syndrome: Nutritional, Medical, and Surgical Management (p. 252). Academic Press. Daniels, I. R., & Allum, W. H. (2005). The Anatomy and Physiology of the Stomach. In Upper Gastrointestinal Surgery. London: Springer. DePaola, D. P. (2008). Saliva: The precious body fluid. The Journal of the American Dental Association, 5S-6S. LibreTexts. (2019, June 2). 5.4: Protein Digestion, Absorption and Metabolism. Retrieved from Medical LibreTexts: https://med.libretexts.org/Courses/American_Public_University/APUS%3A_An_Introduction_to_Nutrition_(Byerley)/Text/06%3A_Proteins/5.4%3A_Protein_Digestion%2C_Absorption_and_Metabolism Muller, T., Nogueiras, R., Andermann, M., Andrews, Z., Anker, S., Argente, J., . . . Tschop, M. (2015). Ghrelin. Molecular Metabolism, 437-460. National Cancer Institute. (2019, November 17). Small & Large Intestine. Retrieved from National Cancer Institute SEER Training Modules: https://training.seer.cancer.gov/anatomy/digestive/regions/intestine.html Ruiz, A. R. (2017, October). Rectum and Anus. Retrieved from Merck Manual Consumer Version: https://www.merckmanuals.com/en-ca/home/digestive-disorders/biology-of-the-digestive-system/rectum-and-anus Shulman, S. T., Friedman, H. C., & Sims, R. H. (2007). Theodor Escherich: The First Pediatric Infectious Diseases Physician? Clinical Infectious Diseases, 1025-1029. Wang, H.-X., & Wang, Y.-P. (2016). Gut Microbiota-brain Axisi. Chinese Medical Jounral, 2373-2380. Music: "Cottages" Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 4.0 License http://creativecommons.org/licenses/by/4.0/

Fluoroquinolones are a type of antibiotic that is an important part of a physicians prescribing arsenal. However, they do carry with them some serious side effects and according to a new study published in the journal, Clinical Infectious Diseases, fluoroquinolones are commonly prescribed for conditions when antibiotics are not needed at all, or when they are not the recommended first-line therapy. Joining me to talk about fluoroquinolones and the study's findings is infectious disease physician and friend of the show, Steven LaRosa, MD.

Mosquito borne viruses that infect humans--the number are plenty with Zika, dengue, chikungunya, West Nile and Keystone virus? University of Florida researchers discuss the first human case of Keystone virus in a recent issue of Clinical Infectious Diseases. Joining me to talk more about this arbovirus and the first human case in a North Central Florida boy is John Lednicky, Ph.D., Dr Lednicky is a research professor in the UF College of Public Health and Health Professions' department of environmental and global health and a member of the Emerging Pathogens Institute. Lednicky is the first author of the report.