Tularemia is a rare but often serious infectious disease caused by Francisella tularensis, a bacterium with an extremely low infectious dose and the ability to cause illness through several routes including arthropod bites, contact with infected animals and exposure to contaminated water, food or soil. Tularemia is found throughout the northern hemisphere, and cases have occurred in all U.S. states except Hawaii. Thirteen cases have been reported to the Minnesota Department of Health since 1994, including 3 in 2016. This article presents the 2016 cases as well as data on all the reported cases. Clinicians should consider tularemia in patients with a compatible clinical illness and exposure history, particularly those who present with acute fever and regional lymphadenopathy. Treatment should be initiated early in highly suspect cases, without waiting for laboratory results.
{"title":"Tularemia in Minnesota: an emerging and underappreciated infection.","authors":"Tory Whitten, Jenna Bjork, Dave Neitzel, Kirk Smith, Maureen Sullivan, Joni Scheftel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Tularemia is a rare but often serious infectious disease caused by Francisella tularensis, a bacterium with an extremely low infectious dose and the ability to cause illness through several routes including arthropod bites, contact with infected animals and exposure to contaminated water, food or soil. Tularemia is found throughout the northern hemisphere, and cases have occurred in all U.S. states except Hawaii. Thirteen cases have been reported to the Minnesota Department of Health since 1994, including 3 in 2016. This article presents the 2016 cases as well as data on all the reported cases. Clinicians should consider tularemia in patients with a compatible clinical illness and exposure history, particularly those who present with acute fever and regional lymphadenopathy. Treatment should be initiated early in highly suspect cases, without waiting for laboratory results.</p>","PeriodicalId":18639,"journal":{"name":"Minnesota medicine","volume":"100 3","pages":"40-43"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36684676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Apples and oranges Our drug pricing system does not compute.","authors":"Charles R Meyer","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":18639,"journal":{"name":"Minnesota medicine","volume":"100 3","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36696966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Every corner of the country is touched by drug abuse and addiction--Minnesota is no exception. Drug-induced deaths have tripled since 1990 and now outnumber fatalities from motor vehicle accidents. Deaths from opioid overdoes in particular have skyrocketed; they now outnumber cocaine and methamphetamine overdoes deaths, combined.
{"title":"The changing landscape of drug abuse What's new? What can we do?","authors":"Carol Falkowski","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Every corner of the country is touched by drug abuse and addiction--Minnesota is no exception. Drug-induced deaths have tripled since 1990 and now outnumber fatalities from motor vehicle accidents. Deaths from opioid overdoes in particular have skyrocketed; they now outnumber cocaine and methamphetamine overdoes deaths, combined.</p>","PeriodicalId":18639,"journal":{"name":"Minnesota medicine","volume":"100 3","pages":"30-31"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36684674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Two lawsuits filed this year in federal court claim that three drugmakers have colluded in order to simultaneously raise the price of insulin.
今年在联邦法院提起的两起诉讼声称,三家制药商串通一气,以同时提高胰岛素的价格。
{"title":"Expensive Medicine: Drug prices are increasingly hard to swallow. Effective remedies prove elusive.","authors":"Howard Bell","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Two lawsuits filed this year in federal court claim that three drugmakers have colluded in order to simultaneously raise the price of insulin.</p>","PeriodicalId":18639,"journal":{"name":"Minnesota medicine","volume":"100 3","pages":"10-17"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36696967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In the exam room, providers can identify--and often treat--patients who need help with a substance use disorder.
在检查室里,提供者可以识别并经常治疗需要帮助的物质使用障碍患者。
{"title":"Tackling addiction in primary care.","authors":"Brian Grahan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In the exam room, providers can identify--and often treat--patients who need help with a substance use disorder.</p>","PeriodicalId":18639,"journal":{"name":"Minnesota medicine","volume":"100 3","pages":"32-33"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36696973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
As awareness of the opioid epidemic in this country has grown, so has the number of efforts to respond to it. This article reviews national and state efforts involving the medical community. It also reports on new funding coming to Minnesota with passage of the 21 st Century Cures Act, and it calls for increased involvement at the health system level. The hope is that with greater awareness of these efforts, health care providers will be better equipped to address the full spectrum of the epidemic.
{"title":"Addressing the opioid epidemic in general medical settings.","authors":"Gavin Bart","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>As awareness of the opioid epidemic in this country has grown, so has the number of efforts to respond to it. This article reviews national and state efforts involving the medical community. It also reports on new funding coming to Minnesota with passage of the 21 st Century Cures Act, and it calls for increased involvement at the health system level. The hope is that with greater awareness of these efforts, health care providers will be better equipped to address the full spectrum of the epidemic.</p>","PeriodicalId":18639,"journal":{"name":"Minnesota medicine","volume":"100 3","pages":"34-37"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36684678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Insomnia is a common complaint among people with substance use disorders. The relationship between sleep problems and substance abuse is bidirectional: People who have trouble sleeping may medicate with alcohol or illicit drugs or misuse prescription medications. And taking certain substances can interfere with sleep. This article reviews that relationship and presents information about the two evidence-based treatments for insomnia: prescription sleep medications and cognitive behavioral therapy for insomnia. Clinicians treating people with a substance use disorder or insomnia should be aware of the risks of comorbidity, and they should understand the risks and benefits of treatment for the insomnia.
{"title":"Substance abuse and insomnia.","authors":"Mark Rosenblum","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Insomnia is a common complaint among people with substance use disorders. The relationship between sleep problems and substance abuse is bidirectional: People who have trouble sleeping may medicate with alcohol or illicit drugs or misuse prescription medications. And taking certain substances can interfere with sleep. This article reviews that relationship and presents information about the two evidence-based treatments for insomnia: prescription sleep medications and cognitive behavioral therapy for insomnia. Clinicians treating people with a substance use disorder or insomnia should be aware of the risks of comorbidity, and they should understand the risks and benefits of treatment for the insomnia.</p>","PeriodicalId":18639,"journal":{"name":"Minnesota medicine","volume":"100 3","pages":"38-39"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36684673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Wing Man.","authors":"Carmen Peota","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>On a gray March day, Stephen Wagner, MD, putters in the large hanger where he keeps his Beechcraft King Air E90.</p>","PeriodicalId":18639,"journal":{"name":"Minnesota medicine","volume":"100 3","pages":"6-7"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36696965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Minnesota's immunization information system excels at population health surveillance.
明尼苏达州的免疫信息系统在人口健康监测方面表现出色。
{"title":"The merits of MIIC.","authors":"Zeke J McKinney","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Minnesota's immunization information system excels at population health surveillance.</p>","PeriodicalId":18639,"journal":{"name":"Minnesota medicine","volume":"100 3","pages":"20-22"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36696969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Only a few weeks remain n what has been a frustrating legislative session for physicians (it must conclude by May 22). Here's a rundown of the MMA's priorities.
{"title":"The session so far.","authors":"Dan Hauser","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Only a few weeks remain n what has been a frustrating legislative session for physicians (it must conclude by May 22). Here's a rundown of the MMA's priorities.</p>","PeriodicalId":18639,"journal":{"name":"Minnesota medicine","volume":"100 3","pages":"24-28"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36696970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}