Physician MD, FIDSA. Interests: Inf diseases, bedside medicine, diagnosis, SUD, HIV/HCV. Assoc. Prof @UMMedschool @IHVMaryland I seek knowledge not followers
Baltimore, MD
Joined February 2008
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A paraplegic patient with a suprapubic catheter was upset when I wouldn’t culture cloudy urine. Years of “cloudy urine = UTI” had taught him otherwise.
Bad medicine doesn’t just overtreat. Repeated enough, it teaches bad beliefs, and makes good medicine look like neglect.
The Jason Arday tragedy makes me wonder if academia should examine how it actually needs fewer heroes and for people with opportunity for accomplishment to remain human and not fall prey to credential inflation and the subsequent ruthless audit.
Cardiology seems to have taken over this week’s @NEJM. Saw DAPT and instinctively thought daptomycin; should’ve stayed a little longer to SAVR all that TAVR.
New @OFIDJournal paper shows cefadroxil is a robust, well-tolerated oral step-down for Gram-positive bacteremia & osteomyelitis. Rethink the "Linezolid or bust" reflex! academic.oup.com/ofid/articl…
week on clinical service and I’ve encountered the holy grail: "bilateral monocular diplopia." Nice to know every specialty has its own version of "bilateral lower extremity cellulitis." #IDsky #MedicalMyths #MedTwitter
I fed known information about DOR/ISL, the most unexciting new drug in the ARV armamentarium and asked Gemini to make a slide infographic
As we use tools like #openevidence more, what are the guardrails against knowledge collapse? Is it all up to the user's volition, good habits? Can knowledge seeking be an addiction like doomscrolling?
pewresearch.org/?p=301967 - do Doktors need to be TickDockers?
The THRIVE Program at the University of Maryland is looking for a HIV/ID Nurse Practitioner who wants to do meaningful, patient-centered work in a truly mission-driven setting.🔗 Apply here: umb.taleo.net/careersection/… #HIVCare #InfectiousDiseases #PublicHealth #Baltimore
Proof that we need to reconsider or abandon this practice academic.oup.com/cid/article…
Shiva Narayanan retweeted
Congratulations to Team India on a fantastic T20 World Cup win 🇮🇳 Tough luck today, New Zealand.
@Jaspritbumrah93, once again a match winner when it mattered most. @IamSanjuSamson, what a tournament and what an impact. Absolutely incredible.
Shiva Narayanan retweeted
Jeff Bezos's lifetime charitable giving: ~$4 billion, or about 2 months of his wealth's passive growth. Half a percent of his fortune would fund the Washington Post in perpetuity. Even Gilded Age plutocrats were far more generous. Where's a good robber baron when you need one?
I love how GPT turns Amelia Bedelia in converting random value to irregular esteem....:-) nature.com/articles/d41586-0…
The 3-dose regimen for late latent syphilis rests on remarkably thin evidence. The logic: organisms dividing more slowly in long-standing infection require prolonged treponemicidal penicillin levels → hence weekly benzathine penicillin G (BPG) ×3.
So what can we conclude?
➡️The 3-dose late latent syphilis regimen is built on an assumed treponemicidal level.
➡️ There is no data about this dosing in the HIV era!! ➡️There are differences in PCNG levels in young vs old populations. (PCN is renally excreted).