Kyle Walding
@tbrnaughttb.bsky.social
TB doc, Manhattan TB consultant @ NYC Dept of Health NYU Clinical Asst Professor of ID @ Bellevue Hospital Loyola Med/Peds & Stanford ID ❤️: TB, ID, med ed, public health, health equity, immigrant safety/rights Views = mine = great, & ≠ my employers' | 🏳️🌈
#TBSky presenting the available data re high-dose (or dose-optimized) rifampin (HDR/DOR) is anyone trialing HDR/DOR for pulm, non-CNS extrapulm, or CNS TB? if so, which, and when? if not, why? a) awaiting more PK data b) awaiting mortality benefit data c) concerns re tolerance/toxicity d) combo
Important #TBSky paper @lancetmicrobe.bsky.social by @mnoursad.bsky.social & @innate2adaptive.bsky.social Diagnosing TB in lymph nodes or pericarditis a challenge RNA biomarkers better than CRP to trigger confirmatory testing, but still not as good as what WHO specifies for TB triage tests #IDSky
Blood RNA biomarkers and C-reactive protein for triage of adult patients with tuberculosis lymphadenitis and pericarditis in South Africa: a single-centre, prospective, observational, diagnostic accur...
Our results suggest RNA biomarkers show better accuracy and clinical utility than C-reactive protein to trigger confirmatory tuberculosis testing in patients with tuberculosis lymphadenitis and tuberc...
thelancet.com
gave an ED provider some very gentle (but important!) clinical feedback today and the person said “we hardly ever get feedback — thank you so much for letting me know!” this is so gracious! we could all take lessons
if you’re a physician yelling about vaccine committee removals but not about flagrant human rights abuses & genocide, check your priorities there are no ‘lanes’ when it comes to the preservation of human life and dignity—we have a moral responsibility to speak out and act to protect the vulnerable
just a quick reminder to the medical community that ~the concept of race has no basis in scientific evidence and should not impact your *medical* decision-making~ race *does have* social implications (which can affect access/quality) bc of the disproportionate global power assigned to ‘whiteness’
as i prepare to present data (epi, pathogenesis, presentation, detection, TB control considerations) on subclinical TB tomorrow for the NYC TB bureau, i have relied on this *incredible* review pubmed.ncbi.nlm.nih.gov/30021818/ thank you, @sgschumacher.bsky.social et al!
Incipient and Subclinical Tuberculosis: a Clinical Review of Early Stages and Progression of Infection - PubMed
Tuberculosis (TB) is the leading infectious cause of mortality worldwide, due in part to a limited understanding of its clinical pathogenic spectrum of infection and disease. Historically, scientific ...
pubmed.ncbi.nlm.nih.gov
#TBSky saw this note today: “M africanum in sputum; pt doesn’t meet criteria for NTM disease, stop all therapy” “MTB complex” includes several closely related human pathogens: - M tb - M bovis - M africanum - (& M microti, caprae, pinnipedii, orygis, canetti) all should be treated as ‘TB disease’!
#TBSky: have any clinical TB folks seen hearing loss with BPaLM? this is not a documented/common adverse effect that i’m aware of, but moxi does have post marketing reports of hearing loss and linezolid could potentially cause it via peripheral neuropathy thoughts?
Are you interested in #TB and have experience in #modelling infectious diseases? Come join us in the TB Modelling Group at #LSHTM! We're advertising for a 1 year Research Fellow position, with a closing date of 30 May 2025 👉 jobs.lshtm.ac.uk/vacancy.aspx...
Job Opportunity at LSHTM: Research Fellow
The London School of Hygiene & Tropical Medicine (LSHTM) is a world-leading centre for research and postgraduate education in public and global health. Our mission is to is to improve health and healt...
jobs.lshtm.ac.uk
This wasn’t built by an institution or backed by funding. It was built by clinicians, pharmacists, scientists, & anonymous contributors. No sponsors. No conflicts. Just evidence. I’d log in at midnight and see Anonymous Koala editing rows. That’s public science: open, people-powered, and shared.
Jake Scott, MD@jakescottmd.bsky.social · last yr.105 controlled vaccine trials. 110 yrs. 1.8 M participants. All in one live, crowd-sourced sheet. Built by contributors worldwide to counter the myth that vaccines weren’t tested with controls. Quiet work still breaks through the noise. www.bradspellberg.com/vaccine-rcts @bradspellberg.bsky.social
Alright folks, the amazing @jakescottmd.bsky.social has set up a google sheets for you to crowd source published RCTs of vaccines. Editable sheet (starter trials seeded): bit.ly/3EuYzqI As data are imported, the website will autoupdate. Have at it! www.bradspellberg.com/vaccine-rcts
Placebo-Controlled Vaccine RCTs – Living Reference Sheet
Placebo-Controlled Vaccine RCTs – Living Reference Sheet Purpose: A one-stop, crowdsourced catalogue of randomized controlled trials (RCTs) in which routine vaccines were tested against an inert or s...
bit.ly
in my opinion, *particularly* at a safety net hospital in this current political climate, there is absolutely *no medical necessity* to document citizenship status in a patient’s medical record if this becomes commonplace, its absence could be taken by some to mean “undocumented”
important learning re calcified granulomas vs LTBI (i get asked this Q a lot) — this is nuanced, but here are some important considerations #TBSky
a patient (w/ a complex infection) messaged me saying she’s terrified about what’s happening in the US—said she has to return to her previous country ASAP she begged for an urgent visit so i could give her months of meds in case she can’t find care fact: this admin’s policies are hurting patients
We are pleased to announce the availability of the following archived webinar: The Riddle of TB Drug Resistance www.currytbcenter.ucsf.edu/trainings/ar... #GotCurry #Webinar #Tuberculosis #EndTB @theunion-tblh.bsky.social
[Archived] The Riddle of TB Drug Resistance | Curry International Tuberculosis Center
currytbcenter.ucsf.edu
>100,000 of us took to the streets of Manhattan (and >400,000 ppl nationwide!) today to stand against dangerous attacks on the federal workforce, immigrants, healthcare, and social safety nets for vulnerable populations #handsoff
New — Here is a running list of Dept. of Health and Human Services (HHS) offices that have either been fully eliminated or gutted into non-functionality as a result of today's mass firings (provided to me directly by a CDC staffer):
graduating ID fellows: if you’re okay with slightly less money in exchange for intrinsically meaningful work, less toxicity, and a higher quality of life, consider public health! i love my job(s) so much
#IDSky: if you order a CBC diff, please remember to look at the diff, even in pts you don’t expect to find certain abnormalities (like in this asymptomatic US-born patient) this level of eosinophilia is dangerously high! this patient needs an urgent eval for infectious and hematologic etiologies
the NYC DOH Bureau of TB Control just released our data for 2024 — another staggering increase in TB cases in NYC NYC’s current prevalence is 9.5/100k US national prevalence is ~3/100k at a time when global and national TB control resources are extremely vulnerable #TBsky
Monday is #worldtuberculosisday and a vaccine developed by the Gates Medical Research Institute is being studied in a phase 3 trial. If approved, the vaccine could potentially prevent pulmonary TB in adults and adolescents. #IDsky
A Late-Stage Tuberculosis Vaccine is Making its Way Through Clinical Trials
Monday is World Tuberculosis (TB) Day, and a vaccine developed by the Gates Medical Research Institute is being studied in a phase 3 trial. If approved, the vaccine could potentially prevent pulmonary...
contagionlive.com
public health & city hospital doctors march for medicaid! medicaid provides health insurance to over 80 million americans (nearly 1 in 4 people / almost 25% of the population!), including low-income families, pregnant people, children, elderly individuals, & people with disabilities
if you can’t bring yourself to care about people who live far away from you in their own right, remember that more TB in the world means more TB here, too — in a globalized society, countries don’t exist in a vacuum www.nytimes.com/2025/03/11/h...
Tuberculosis Resurgent as Trump Funding Cut Disrupts Treatment Globally
The United States was the major funder of tuberculosis programs. Now hundreds of thousands of sick patients can’t find tests or drugs, and risk spreading the disease.
nytimes.com
i work in two different settings which serve predominantly low resource communities and many undocumented folks—fewer & fewer patients are showing up for their in-person medical appointments can you blame them? even without “raids” the fear & uncertainty have real effects on patients’ lives
a dark time for TB control (and the rest of public health…) #TBSky news.un.org/en/story/202...
Funding cuts jeopardise global fight against tuberculosis, WHO warns
The UN World Health Organization (WHO) warned on Wednesday that severe funding cuts – particularly in the United States – are threatening decades of progress in the fight against tuberculosis (TB), st...
news.un.org
dear #TBSky please share your favorite articles/reviews/resources about subclinical TB disease! i’m specifically interested in info about differing pathophys/host differences, prevalence, and infectiousness/transmission — i’m prepping a talk from our bureau MDs!
any trainees on the fence about taking a lower-paying job doing something they love with a higher quality of life? i love my job(s)—i could make more doing full time clinical work (even in academia), but i am genuinely happy, my work is meaningful, and my quality of life is excellent—happy to chat!
remember, during Ramadan, you can recommend that patients take their medications at night when the fasting period is over — otherwise, consider deferring nonurgent treatments (HCV, HBV, LTBI) to after
