iiinova — where your digital self keeps evolving

Kyle Walding @tbrnaughttb.bsky.social · 18/11/2025

#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

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Kyle Walding @tbrnaughttb.bsky.social · 14/07/2025

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

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Kyle Walding @tbrnaughttb.bsky.social · 10/06/2025

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

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Kyle Walding @tbrnaughttb.bsky.social · 04/06/2025

hahahaha, you’d have to ask someone smarter than me!

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Kyle Walding @tbrnaughttb.bsky.social · 04/06/2025

i actually don’t see race as a proxy but a misleading social construct it is significant work to tease out the actual variables, but it’s worth the work to make actual associations (or recognize the lack of association) rather than invent associations/discordances that perpetuate inequity

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Kyle Walding @tbrnaughttb.bsky.social · 03/06/2025

right, it’s not always visible bc colorism and racism are separate -isms; also, being from Africa does not identify a clear “race”

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Kyle Walding @tbrnaughttb.bsky.social · 03/06/2025

educating patients on their risk for conditions is essential, but education about these risks should be based in evidence, not carried on from (however well meaning) racist categorizations use origin/travel, nutrition/supplementation, behaviors, etc to ID risks—these span “racial” categories

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Kyle Walding @tbrnaughttb.bsky.social · 03/06/2025

race (not real) has no correlation w country of origin (real) country of origin (& even smaller regional commonalities like zip code) may have patterns based on cultural characteristics, disease epi, and health access, but even those may not be consistent

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Kyle Walding @tbrnaughttb.bsky.social · 03/06/2025

the concept of race isn’t necessary to understand that less melanated skin is at higher risk for UV damage—that’s true regardless of someone’s ‘background’

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Kyle Walding @tbrnaughttb.bsky.social · 03/06/2025

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’

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Kyle Walding @tbrnaughttb.bsky.social · 31/05/2025

i hadn’t! but i did read it and sent it to my bureau director too

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Kyle Walding @tbrnaughttb.bsky.social · 21/05/2025

#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’!

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Kyle Walding @tbrnaughttb.bsky.social · 19/05/2025

#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?

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Kyle Walding @tbrnaughttb.bsky.social · 16/05/2025

i agree! i do find it useful for identifying references, but i almost never trust the extracted and summarized text because it’s not infrequently misleading or plain wrong! i do use it nearly every day tho to find papers about what i’m trying to understand lol — always read the primary literature!

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Reposted by Kyle Walding

LSHTM TB Modelling Group @lshtm-tbmod.bsky.social · 16/05/2025

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...

jobs.lshtm.ac.uk

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...

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Kyle Walding @tbrnaughttb.bsky.social · 12/05/2025

this statement is too broad! there are so many different genres doing great things right now — are you pretty open?

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Reposted by Kyle Walding

Jake Scott, MD @jakescottmd.bsky.social · 06/05/2025

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.

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Reposted by Kyle Walding

Brad Spellberg @bradspellberg.bsky.social · 23/04/2025

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

bit.ly

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...

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Kyle Walding @tbrnaughttb.bsky.social · 20/04/2025

omg real eggs in this economy? ID could never

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Kyle Walding @tbrnaughttb.bsky.social · 18/04/2025

agreed — it’s a dangerous documentation precedent

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Kyle Walding @tbrnaughttb.bsky.social · 18/04/2025

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”

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Kyle Walding @tbrnaughttb.bsky.social · 16/04/2025

that’s what makes tb fun 🤗

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Kyle Walding @tbrnaughttb.bsky.social · 16/04/2025

important learning re calcified granulomas vs LTBI (i get asked this Q a lot) — this is nuanced, but here are some important considerations #TBSky

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Kyle Walding @tbrnaughttb.bsky.social · 15/04/2025

fyi, this is one of the bigger TB outbreaks within a one-year period over the past several decades, but is not the largest in US history

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Kyle Walding @tbrnaughttb.bsky.social · 15/04/2025

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

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Kyle Walding @tbrnaughttb.bsky.social · 11/04/2025

M marinum is also a human pathogen! we see it in situations where there are breaks in skin while a person is cleaning fish tanks — “fish tank granuloma”

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Reposted by Kyle Walding

Curry International Tuberculosis Center (CITC) @citc-tb.bsky.social · 07/04/2025

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

currytbcenter.ucsf.edu

[Archived] The Riddle of TB Drug Resistance | Curry International Tuberculosis Center

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Kyle Walding @tbrnaughttb.bsky.social · 05/04/2025

>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

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Reposted by Kyle Walding

Marisa Kabas @marisakabas.bsky.social · 01/04/2025

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):

NCCDPHP
Division of Reproductive Health
Division of Population Health
BCSB
EPI branch
Prevention Research Translation Branch
Office of Smoking and Health

NCHHSTP
Division of TB elimination
-Communication, Education, and Behavioral Studies Branch
PBEMB

GLOBAL
Division of HIV and TB
Communications Branch
SPIN
SPICE
PBEMB
MCHB
HIDMSB
EHSRB
Scientific Integrity Branch

NCEH
Division of Environmental Science/Practice Asthma and Air Quality branch

NCIRD
ISD/Partnerships

NIOSH
Miner safety
Health effects lab division
Respiratory health division

NCBDDD
Office of the Director
Disability Health

NCIPC
Division of Violence Prevention
Division of Injury Prevention
OD
Office of Health Equity

OCOO
Office of Human Resources

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Kyle Walding @tbrnaughttb.bsky.social · 01/04/2025

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

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Kyle Walding @tbrnaughttb.bsky.social · 28/03/2025

#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

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Kyle Walding @tbrnaughttb.bsky.social · 27/03/2025

TB is a socially complex disease that disproportionately impacts marginalized communities due to structural inequities and disinvestment — The NYC DOH performs a range of TB services and activities free of charge to all patients, regardless of immigration status or ability to pay

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Kyle Walding @tbrnaughttb.bsky.social · 27/03/2025

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

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Kyle Walding @tbrnaughttb.bsky.social · 15/03/2025

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

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Kyle Walding @tbrnaughttb.bsky.social · 12/03/2025

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...

nytimes.com

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.

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Kyle Walding @tbrnaughttb.bsky.social · 11/03/2025

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

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Kyle Walding @tbrnaughttb.bsky.social · 05/03/2025

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!

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Kyle Walding @tbrnaughttb.bsky.social · 01/03/2025

agree! i also don’t think (many) fellowships do a good job of showing trainees ‘nonstandard’ jobs—like in public health, other govt work, industry, etc! i love teaching as much as patient care but full time academia isn’t for me for many reasons! there are many ways to still teach!

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Kyle Walding @tbrnaughttb.bsky.social · 01/03/2025

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!

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Kyle Walding @tbrnaughttb.bsky.social · 28/02/2025

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

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