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Does paracetamol (acetaminophen) help you recover from a febrile illness?

Tom Boyles @tomboylesid.bsky.social · 6d

Me too

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Tom Boyles @tomboylesid.bsky.social · 7d

Why do many spineless men make it to the top of institutions like the Royal Society?

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Tom Boyles @tomboylesid.bsky.social · 14d

If unclear please see my Substack post explaining that fever is a protective reflex, not a sign of bodily dysfunction.
thediagnosticdetective.substack.com/p/does-parac...

Or is fever actually protective?

thediagnosticdetective.substack.com

Tom Boyles @tomboylesid.bsky.social · 14d

@newsagents.bsky.social

Does paracetamol (acetaminophen) help you recover from a febrile illness?

Tom Boyles @tomboylesid.bsky.social · 14d

Of course paracetamol doesn't cause autism but can the media stop saying 'not treating fever in pregnancy will lead to harm to the baby' without any EVIDENCE to back this up. It's conceivable that treating fever actually causes harm (this is a hypothesis not a statement of fact). #thenewsagents

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Tom Boyles @tomboylesid.bsky.social · 21d

The Diagnostic Detective asks- should you take paracetamol (acetaminophen) for a fever? Will it help, will it hinder?
thediagnosticdetective.substack.com/p/does-parac...

Or is fever actually protective?

thediagnosticdetective.substack.com

Virologic Failure and Emergent Integrase Strand Transfer Inhibitor Drug Resistance With Long-Acting Cabotegravir for HIV Treatment: A Meta-analysis

Tom Boyles @tomboylesid.bsky.social · 21d

This is why indiscriminate use of CAB/RIL in Africa will be a disaster. INSTI resistance emerged in approximately 40%–70% of individuals experiencing VF. VF is rare in clinical trials (per diems), it will be much higher in standard of care settings in Africa. academic.oup.com/cid/article/...

Although 48-week virological failure rates were low, emergent integrase resistance among those failing injectable cabotegravir was common (41%–71%), and cr

academic.oup.com

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Tom Boyles @tomboylesid.bsky.social · 22d

I will be delighted to present a case from South Africa at this meeting

Royal College of Physicians of Edinburgh @rcpedin.bsky.social · 23d

This RCPE symposium explores the intersections of pandemic recovery, humanitarian crises and health inequality.

Ideal for professionals in Infectious Diseases, Public Health, Global Health, and more.

Link to book: www.rcpe.ac.uk/events/infec... @tomboylesid.bsky.social @tomwingfield.bsky.social

Is cramp caused by dehydration and low salt levels?

Tom Boyles @tomboylesid.bsky.social · 27d

Today the Diagnostic Detective asks- are cramps caused by dehydration and salt loss? Can you guess the answer?
thediagnosticdetective.substack.com/p/is-cramp-c...

Or is it a bit more complicated than that?

thediagnosticdetective.substack.com

Tom Boyles @tomboylesid.bsky.social · 27d

For me the Holy Grail is a test which can tell us 'you've had enough treatment now and can stop' but we are a long way from that. In the mean time we need trials for each phenotype. e.g RADIO-TB is for CXR +ve but sputum -ve. We need similar for sputum +ve by low burden (high CT value) etc.

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Tom Boyles @tomboylesid.bsky.social · 28d

www.medrxiv.org/content/10.1... This is the re-working of Rifashort I was referring to.

Xpert MTB/RIF® cycle threshold as a marker of TB disease severity; Implications for TB treatment stratification

Introduction Recent trials have demonstrated that shortened four-month treatment durations are effective for the majority of people with tuberculosis (TB). However, there is a population of TB patient...

www.medrxiv.org

A 3-month clofazimine–rifapentine-containing regimen for drug-susceptible tuberculosis versus standard of care (Clo-Fast): a randomised, open-label, phase 2c clinical trial

Tom Boyles @tomboylesid.bsky.social · 28d

Basically the standard 6 month duration is a blunt instrument, covering most bases but overtreating many and undertreating a few. Current research should be to match drugs and duration to phenotype (burden of disease). eg rifashort shows that short 4 months works find in low burden disease.

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Tom Boyles @tomboylesid.bsky.social · 29d

It's not surprising at all. Shortened regimens for high burden disease basically never work.

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Tom Boyles @tomboylesid.bsky.social · 29d

Another failed shortening study in patients with extensive disease (mostly). I am reminded of Einstein's definition of insanity. Shortening studies need to focus on patients with minimal disease. #tuberculosis - The Lancet Infectious Diseases www.thelancet.com/journals/lan...

Although the trial was stopped early, we found that a 3-month regimen containing clofazimine and rifapentine had 12-week culture conversion rates that did not differ statistically from the standard of...

www.thelancet.com

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Tom Boyles @tomboylesid.bsky.social · Sep 1

The Diagnostic Detective asks 'Can your body become resistant to antibiotics?' open.substack.com/pub/thediagn...

Can your body become resistant to antibiotics?

The Lore

Tom Boyles @tomboylesid.bsky.social · Aug 28

They aren't pro life, they're just pro gestation

Tom Boyles @tomboylesid.bsky.social · Aug 8

It's incredible the #microsoft make any money when their products suck

Does vitamin C prevent common colds and 'flu?

Tom Boyles @tomboylesid.bsky.social · Aug 7

Can you prevent colds and 'flu with vitamin C. The Diagnostic Detective takes a look.

open.substack.com/pub/thediagn...

Or is it another Old Wives Tale?

Should you finish a course of antibiotics, even if you feel better?

Tom Boyles @tomboylesid.bsky.social · Aug 5

Now all we have to do is persuade people to eat that diet.

Tom Boyles @tomboylesid.bsky.social · Aug 4

Should you finish a course of antibiotics even if you feel better? The Diagnostic Detective takes a look, including the Special Case that is #Tuberculosis open.substack.com/pub/thediagn...

Will that cause or prevent antibiotic resistance?

Do probiotics protect your digestive system from antibiotics?

Tom Boyles @tomboylesid.bsky.social · Jul 29

Free access to our article on the inclusion of LMICs in platform trials of bloodstream infections. SNAP in Johannesburg. @steventong.bsky.social @gurujosh.bsky.social

authors.elsevier.com/a/1lVzy,RGPg...

authors.elsevier.com

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Tom Boyles @tomboylesid.bsky.social · Jul 28

The Diagnostic Detective looks at the evidence behind probiotics to restore gut health after a course of antibiotics. the results might surprise you.

open.substack.com/pub/thediagn...

Or do they cause more harm than good?