Ayesha Appa, MD

This group is not on the OUD care cascade but dying/need our attention.

@ucsfhividgm.bsky.social
@csuhsfdph.bsky.social
@ucsfhealth.bsky.social
@uclachipts.bsky.social

🚨New pub: We looked for past-month fentanyl in hair of mostly PWH using daily or weekly meth (self-report, urine 🚫 opioids) - detected fentanyl in >20% 👀 👀

While small study, hope it makes us think about OD prevention in people using stimulants with unintentional fentanyl use.

FDA cancels meeting to select flu strains for next season's shots The canceled meeting comes just days after a CDC vaccine advisory committee meeting was abruptly postponed.

86 children and 19000 adults have died from flu this season in the U.S. and that's with a vaccine. If we have no vaccines come September these numbers will increase.
www.nbcnews.com/health/healt...

BACKGROUND INFORMATION • The identified case is a non-Los Angeles County resident who traveled to LAX on February 19, 2025. • The person arrived on: Korean Air Flight KAL11/KE11 Tom Bradley International Terminal B • Individuals who were at Terminal B from approximately 1:00 p.m. to 4:00 p.m. may be at risk of developing measles from 7 to 21 days from the exposure date. Exposed individuals who have been free of symptoms for more than 21 days (March 11th) are no longer at risk.

PEOPLE WHO WERE AT THE EXPOSURE LOCATION ON THE DATE AND TIME MENTIONED SHOULD • Review their immunization records to determine if they are protected against measles. • Those who have not had measles in the past and have not yet received a measles vaccine are at risk of developing measles after being exposed. Notify their health care provider as soon as possible about potential exposure if they are pregnant, an infant, have a weakened immune system and/or are unimmunized Monitor for illness with fever and unexplained rash from 7 days to 21 days after exposure. If symptoms develop, stay home, avoid school, work or any large gathering and call a healthcare provider immediately • Call any healthcare facility before entering and let them know about their measles exposure and symptoms

#Measles case reported in Los Angeles County

LAX is a big airport and this is a long time frame = many people w/ potential exposure

A good plug for #vaccines, because you never know when you might be exposed.

publichealth.lacounty.gov/phcommon/pub...

Oral Versus Intravenous Antibiotic Therapy for Staphylococcus aureus Bacteremia or Endocarditis: A Systematic Review and Meta-Analysis of Randomized, Controlled Trials We conducted a systematic review of randomized, controlled trials (RCTs) to generate more precise estimates of the efficacy and safety of oral versus intravenous antibiotic therapy for Staphylococcus aureus bacteremia or endocarditis.

Oral Versus Intravenous Antibiotic Therapy for Staphylococcus aureus Bacteremia or Endocarditis: A Systematic Review and Meta-Analysis of Randomized, Controlled Trials

#IDSky

Rapid initiation of antiretrovirals at a syringe services program for people with HIV who inject drugs People who inject drugs (PWID) living with HIV are less likely to receive care at early disease stages and have low rates of viral suppression. This study examined the feasibility and acceptability...

HIV treatment @ harm reduction organizations is the future! Avoids interacting with the traditional healthcare system as much as possible and bring treatment to the people. 79% viral suppression at 12 months in this pilot study. Multi-center RCT is ongoing @hivma.bsky.social doi.org/10.1080/0785...

The NIH’s drastic cut to indirect cost rates is a critical threat to U.S. research infrastructure The drastic reduction in indirect costs is not a path to innovation or cost savings — it’s a threat to U.S.’s position as global leader in medical research.

My #Yale colleague Harlan Krumholz explains why the cuts to indirect costs are a disaster for biomedical research in the United States. Want to do something about it? I'll list those who have to hear from us below. Share, recruit friends and family to help. 1/ www.statnews.com/2025/02/08/n....

1. Today the NIH director issued a new directive slashing overhead rates to 15%.

I want to provide some context on what that means and why it matters.

grants.nih.gov/grants/guide...

list of banned keywords

🚨BREAKING. From a program officer at the National Science Foundation, a list of keywords that can cause a grant to be pulled. I will be sharing screenshots of these keywords along with a decision tree. Please share widely. This is a crisis for academic freedom & science.

NIH Office of Research On Women's Health. At top: Putting science to work for the health of women. Just below that: Page not found. The link: dead. I guess....improving the health of women is...no longer a priority. Or, even allowed?

STI Treatment Guidelines are down, for now go to nnptc.org where our group has housed STI and HIV PrEP guidelines #HIVSky #STISky #IDSky

A forest plot of the primary efficacy analysis at week 73.

In the endTB phase 3 trial, three 9-month, all-oral regimens were found to be noninferior to standard treatment (typically 18 to 24 months) for rifampin-resistant tuberculosis. Read the full trial results: nej.md/3WFFJTv

#MedSky #IDSky

Show me the American visiting the doctor who wants the dystopian clinician panic that these cornerstone Infectious Diseases references are gone in a flash.

#EndingtheEpidemic was a Trump 1.0 initiative to end HIV. How is the #CDC controlling disease by eliminating tools in our 🩺 kit?

I'm just here to say for the 2nd week in a row, the CDC has not released its morbidly and mortality weekly report on schedule. Everyone who provides healthcare to patients in the US is less informed and less up to date as a direct result. This impacts negatively at the population level.

We default to buttocks but don't know if that's just ahem habit (e.g., IM penicillin, naltrexone, CAB-RIL, etc.)

DM me for the whole article, @levfacher.bsky.social great work as always!

Biden administration allows larger incentives for people who reduce meth use The White House gives agencies more leeway with one of the few tools against meth use: financial incentives, or "contingency management."

Helloooo #medsky #addictionmed #IDsky fam! After a post-X cleanse, looking forward to scrolling over here in 2025...

On that hopeful note, check out this promising step toward increasing access to contingency management:
$75 incentive cap --> $750! Let's go.

www.statnews.com/2025/01/08/m...

Yes!! Levels are 10% lower in upper arm, so package insert only recommends switching to arm after steady state achieved! www.brixadi.com/pdfs/brixadi...