Paul Sax
@PaulSaxMD
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Harvard/Brigham Infectious Diseases doctor, writer, @CIDJournal editor, educator. Prefer baseball to football, pizza to sushi, dogs to cats, Beatles to Stones.
Boston, MA
Joined April 2009
The anal cancer screening guidelines for PWH recommend testing every 1-2 yrs. But the evidence base is thin, the tests are meh, and resources are limited. Here's why guidelines may be racing ahead of the data (and certainly the resources). @Amit_Achhra
blogs.jwatch.org
Should every person with HIV over age 35 (if MSM or transgender woman) or 45 (everyone else) have an anal Pap smear, a digital anal rectal exam (DARE), and possibly a high-resolution anoscopy every...
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RT @JWatch: Does the fact that AI is brilliant at writing “learning objectives” prove they’re not really needed? @PaulSaxMD gives his persp….
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Well said, as usual.
Once residency/fellowship applicants can safely acknowledge their lack of interest in conducting research without torching their job prospects, then we will have entered a new utopia with the perfect balance of physicians, scientists, and physician-scientists. It will be.
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New post: If AI can write better Learning Objectives than I can (and it can), what does that say about the value of Learning Objectives? ⬇️.
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The Short Political Half-life of a Medical Contrarian.
blogs.jwatch.org
In early May, I wrote about the surprising FDA appointment of Dr. Vinay Prasad to lead the FDA’s Center for Biologics Evaluation and Research. Prasad is a UCSF hematologist-oncologist known for his...
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Vinay Prasad’s tenure at the FDA was brief -- appointed for his contrarian views, dismissed for doing what we say we *want* regulators to do: demand evidence and protect us from harmful medical interventions. Politics, not medicine, may have driven both decisions. My take ⬇️:.
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Who Gets Sent to ID Clinic? A Field Guide to Outpatient Referrals.
blogs.jwatch.org
Sometimes people ask me what kind of cases get referred to ID doctors in the outpatient setting. Despite what the latest television series might suggest, it’s rarely suspected Ebola (fortunately) or...
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What cases get referred to outpatient ID clinic? The four most common categories:.🔲 Diagnostic dilemmas.🔲 Stuff rare to primary care, common to us (osteo, HIV, mycobacteria. ).🔲 Diagnoses rare EVEN TO US! .🔲 Common infections that keep coming back.⬇️ Link below⬇️.
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Ceftriaxone is a narrow antibiotic now. Plus: ID binomials, BCID magic, linezolid price madness, a Novak Djokovic apology (!), and more. 20 musings, mostly ID-related, videos included.
blogs.jwatch.org
In no particular order, 20 things I’ve found interesting lately — a mix of ID (mostly), language quirks, clinical stuff, even tennis, and an apology (#21) at the very end. Bonus videos embedded...
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Patient had recent surgery, abnormal labs, and clear signs of illness -- so he was admitted. He got better. That, apparently, was the problem. His insurance denied payment because he didn’t get sick enough. You can't make this stuff up. @DGlaucomflecken.
blogs.jwatch.org
Sometimes, you can predict a bad outcome. Examples: Proposing marriage after an awkward first date — and doing so over gas station nachos. Moving to a Cambridge apartment with no off-street parking,...
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“Dr. Sax, what’s it like to have lived through two pandemics as an ID doctor?”. The question came from a brand-new intern during afternoon sign-out. Here's what I wish I had time to say.
blogs.jwatch.org
“Dr. Sax, what’s it like to have lived through two pandemics as an ID doctor?” The question came from a brand-new intern during afternoon sign-out. I took a breath — because wow, were they different....
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Hello ID People Outside of USA:.Looking for information on access to Uromune (MV140). Anyone know?.Thanks!
vax-before-travel.com
Uromune MV140 Recurrent Urinary Tract Infections vaccine is an antibiotic alternative
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The isolated hepatitis B core antibody:.HBsAg ⛔.anti-HBs ⛔.anti-HBc ✅.What does it mean, and what should you do?.A mystery solved (mostly). Plus, a poll and a couple of great videos.
blogs.jwatch.org
(A post inspired by years of doing eConsults, an extremely common query about hepatitis B testing, and the latest BritBox series, “Core Antibody Confidential,” starring a grizzled detective with a...
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This is by far the most common vaccine I strongly recommend in ID adult clinical practice. As ID doctors, we see some truly severe cases of zoster, with post-zoster sequelae that may last months or even rarely be permanent. @CIDJournal
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The federal HIV guidelines are facing a shutdown. A trusted, living resource — used by clinicians, programs, and public health agencies for decades — may disappear due to “budget decreases and revised priorities.”.Big mistake.
blogs.jwatch.org
Each week, our HIV clinical group gathers to review active patients, share updates, and celebrate good news. On our whiteboard, we list four columns: Inpatients, Outpatients, Issues, and Celebratio...
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The head of HHS said he’d preserve ACIP. Then he fired the entire committee. Now a new panel--with mostly unclear expertise in clinical trials, vaccines, and ID--is in place. Time for high alert for changes that could seriously affect public health.
blogs.jwatch.org
There are certain irrefutable verities when, like me, you’re an infectious diseases specialist married to a pediatrician. Here are our top two, which are deeply interrelated: Infectious deaths in...
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In the 3rd (and final) “How ID Doctors Get Paid” series, here are three less-visible salary sources for ID physicians:.• Infusion services.• 340B pharmacy.• Industry-sponsored clinical trials.Plus--why is this topic so taboo in our field?
blogs.jwatch.org
If you’ve made it this far, congratulations! You’re now deep into the ID Reimbursement Rabbit Hole. Part 1 and Part 2 covered how ID doctors contribute immense value through patient care, stewardsh...
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Before the ID salary talk, a quick protest: 3 recent vaccine-related moves — all alarming. Then in Part 2 of How ID Doctors Get Paid:.- Infection control.- Abx stewardship.- Contracts for care .- Telehealth.- Travel clinics.(+ dog video, of course.).
blogs.jwatch.org
Before getting to today’s main topic, allow me a brief protest — three recent vaccine-related actions that reek of profound (and misguided) vaccine distrust from HHS leadership. They are: Cancellat...
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Latest FDA actions on Covid vaccines:.1. Novavax approved: 👏.2. Narrowed indications for all vaccines: ➕/➖.3. Called for more clinical trials:👍.Thoughts about what this might mean -- and 100% agree we need updated data to inform clinical practice.
blogs.jwatch.org
In case you missed it, last week the FDA granted full approval for the Novavax COVID-19 vaccine. This vaccine, which uses a more traditional protein-plus-adjuvant strategy instead of the mRNA...
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