Ayesha Appa, MD
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ayeshaappamd.bsky.social
Ayesha Appa, MD
@ayeshaappamd.bsky.social
Addiction & HIV/ID Physician Investigator at UCSF | Clinical Lead of The Lobby at Ward 86 [low-barrier ID/HIV/harm reduction services for PWUD]
🚨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.
jama.com JAMA @jama.com · Feb 27
More than 20% of men who have sex with men and use methamphetamine were exposed to fentanyl in the month prior, as detected in their hair, despite no report of fentanyl use.

ja.ma/41xw9VB

#MedSky
February 28, 2025 at 3:41 PM
Reposted by Ayesha Appa, MD
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...
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.
www.nbcnews.com
February 27, 2025 at 12:06 PM
Reposted by Ayesha Appa, MD
#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...
February 26, 2025 at 4:44 PM
Reposted by Ayesha Appa, MD
Oral Versus Intravenous Antibiotic Therapy for Staphylococcus aureus Bacteremia or Endocarditis: A Systematic Review and Meta-Analysis of Randomized, Controlled Trials

#IDSky
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.
buff.ly
February 26, 2025 at 7:58 PM
Reposted by Ayesha Appa, MD
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...
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...
doi.org
February 10, 2025 at 6:25 PM
Reposted by Ayesha Appa, MD
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....
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.
www.statnews.com
February 9, 2025 at 10:29 AM
Reposted by Ayesha Appa, MD
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...
NOT-OD-25-068: Supplemental Guidance to the 2024 NIH Grants Policy Statement: Indirect Cost Rates
NIH Funding Opportunities and Notices in the NIH Guide for Grants and Contracts: Supplemental Guidance to the 2024 NIH Grants Policy Statement: Indirect Cost Rates NOT-OD-25-068. OD
grants.nih.gov
February 8, 2025 at 12:18 AM
Reposted by Ayesha Appa, MD
🚨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.
February 4, 2025 at 1:26 AM
Reposted by Ayesha Appa, MD
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?
January 31, 2025 at 7:39 PM
Reposted by Ayesha Appa, MD
STI Treatment Guidelines are down, for now go to nnptc.org where our group has housed STI and HIV PrEP guidelines #HIVSky #STISky #IDSky
nnptc
nnptc.org
January 31, 2025 at 7:59 PM
Reposted by Ayesha Appa, MD
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
January 31, 2025 at 2:25 PM
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?
They've taken down CDC HIV Awareness Day pages, the HIV Testing page. It appears they've taken down all the HIV pages except for this About HIV page. www.cdc.gov/hiv/about/in...
About HIV
General overview of HIV, including transmission, prevention, and testing.
www.cdc.gov
January 31, 2025 at 9:59 PM
Reposted by Ayesha Appa, MD
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.
Every week, I check the CDC's Mortality and Morbidity Weekly Report. This week for the first time in its 60 years it was not published on schedule. American healthcare workers all over the country are less informed about health crises that affect their patients. CDC led reports matter a 🧵
January 30, 2025 at 5:04 PM
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...
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."
www.statnews.com
January 10, 2025 at 7:08 PM