Physician-Scientist, Chief, ID Service @sloan_kettering, Lab of Antifungal Immunity, @TriIMDPhD ‘01 @DukeU ‘93 Graduate, #Immigrant Basel🇨🇭
Apr 27, 2023 • 18 tweets • 4 min read
1/ One of the privileges and duties of becoming a full professor is to write letters of evaluation for junior faculty in the promotions process at outside institutions. I give these a lot of thought and have completed 6-8 per year in the past three years.
2/ Usually, I receive an e-mail inquiry from an outside departmental administrator. When I agree to the evaluation, I am sent a promotion package prepared by the faculty member as well as a letter/document with promotions criteria by the host institution.
Dec 22, 2021 • 15 tweets • 9 min read
1/ I'm really excited that the @US_FDA has granted an EUA for #Paxlovid - this is a terrific new option for #OmicronVariant and kudos to the scientists, researchers, and developers at Pfizer. So timely, and so necessary as we face a wave of new #COVID19 infections globally.
2/ I went through the fact sheet and it is critical to highlight that many patients with cancer and organ transplant recipients are on medications that will be effected by the #ritonavir component of #paxlovid.
Dec 21, 2021 • 14 tweets • 7 min read
With #Omicron rapidly spreading nationwide, I am concerned about all the members of our communities with damage and injury in the immune system, particularly to cell-mediated injury (to T cells and Ab-producing cells). In neutralization studies, most monoclonal Abs used to date
2/ have lost activity to #Omicron and are no longer useful in areas with high attack rates (pretty much everywhere in US right now). There are two possible exceptions. The first is #sotrovimab which was originally isolated from an individual with
(1/n)
then NY Hospitals would have acted differently to his prior order of "Use it or Lose it, and Get Fined", issued on January 4, 2021. At this time, hospitals were NOT allowed to vaccinate patients, even though many were clamoring to do so. (2/n)
1/n I read this article with tremendous interest and have some comments on this situation. Why are we in this situation? Conflicting forces are driving the vaccination process. At Elite Medical Centers, Even Workers Who Don’t Qualify Are Vaccinated nytimes.com/2021/01/10/hea…2/n @sloan_kettering there was a deliberative and transparent process to identify and prioritize vaccination among patient-facing healthcare workers. However, hospitals in NY State were not yet allowed to offer vaccine to high-risk patients. Vaccine uptake is not uniform
Jan 3, 2021 • 9 tweets • 5 min read
Concerned about the #COVID19 vaccines and autoimmune disease?
Both the #Moderna and #Pfizer vaccines do not contain an attenuated virus or instructions (via mRNA) to make viral particles that could replicate in vaccine recipients. (1/n)
I have psoriatic arthritis (on #methotrexate for about a decade) and had no hesitation to receive the vaccine @sloan_kettering. I am fortunate and was able to stop methotrexate for one month prior - this is atypical for most patients with autoimmune diseases - and will (2/n)
Apr 5, 2020 • 8 tweets • 2 min read
1/n Much will be made about this case report. I am very pleased that the patient did well and survived #COVID19 after a difficult course. On the heels of tweeting about anti IL-6 therapy (tocilizumab) I'm taking a stab at this case report. ashpublications.org/bloodadvances/…2/n It is a purely correlative, observational study. The title is misleading though. An alternate, equally valid title would be: First case of COVID-19 in a patient with multiple myeloma successfully treated with methylprednisolone. The patient received corticosteroid (MP)
Apr 5, 2020 • 11 tweets • 5 min read
1/n I am thinking about the various modes of #COVID19 transmission. Although not common, gastrointestinal symptoms are routinely reported by COVID patients. In humans, the SARS-CoV2 receptor ACE2 is not only found in alveolar epithelial cells (lung), but also in cells that line
2/n the small intestine, among other sites (heart and kidneys). Humans shed high levels of #COVID19 in the stool, a finding that raised the question whether fecal-oral transmission may occur. This would be very relevant for measures to limit the spread of disease.
Apr 2, 2020 • 6 tweets • 2 min read
1/n I am asked on a daily basis about IL-6 blockade in #COVID19 patients @sloan_kettering . The truth is that I don't know if this intervention is helpful, neutral, or harmful. Colleagues point to the role of IL-6 blockade in treating CAR T cell toxicities and its cytokine storm.
2/n In the CAR T cell setting, IL-6 is clearly pathological and the IL-6 levels observed are typically far higher (10x or more) than those in critically ill COVID19 patients. It is not at clear to me that this concept is applicable to COVID. Why? There are important differences
Apr 2, 2020 • 13 tweets • 4 min read
1/n One of the most challenging things about the #COVID19 outbreak in NYC is having to act both fast and slow. What do I mean by this? On one hand, as an ID physician, I am in state of perpetual impatience. I want to do the best possible thing for the one patient under my care at
2/n any particular moment. I want the instant gratification of feeling I did something important and relevant for this particular human being. So my heart wants to tear open a package of hydroxychloroquine and offer a tablet, to set up the IV for an infusion of convalescent
