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Tularemia in Minnesota: an emerging and underappreciated infection. 明尼苏达州的兔热病:一种新出现的未被重视的感染。
Pub Date : 2017-05-01
Tory Whitten, Jenna Bjork, Dave Neitzel, Kirk Smith, Maureen Sullivan, Joni Scheftel

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.

土拉菌病是一种罕见但往往严重的传染病,由土拉菌引起。土拉菌是一种感染剂量极低的细菌,能够通过多种途径致病,包括节肢动物叮咬、与受感染动物接触以及接触受污染的水、食物或土壤。图拉雷米亚病遍布北半球,除夏威夷外,美国所有州都有病例。自1994年以来,明尼苏达州卫生部已报告了13例病例,其中2016年报告了3例。本文介绍了2016年的病例以及所有报告病例的数据。临床医生应考虑具有相容的临床疾病和暴露史的兔热病患者,特别是那些表现为急性发烧和局部淋巴结病的患者。对高度可疑病例应及早开始治疗,而不必等待实验室结果。
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引用次数: 0
Apples and oranges Our drug pricing system does not compute. 我们的药品定价系统不合理。
Pub Date : 2017-05-01
Charles R Meyer
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引用次数: 0
The changing landscape of drug abuse What's new? What can we do? 毒品滥用的变化有什么新鲜事吗?我们能做什么?
Pub Date : 2017-05-01
Carol Falkowski

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.

这个国家的每个角落都被滥用毒品和吸毒成瘾所困扰——明尼苏达州也不例外。自1990年以来,毒品导致的死亡人数增加了两倍,现在超过了机动车事故造成的死亡人数。阿片类药物过量导致的死亡人数尤其激增;现在,它们的死亡人数超过了可卡因和甲基苯丙胺过量死亡人数的总和。
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引用次数: 0
Expensive Medicine: Drug prices are increasingly hard to swallow. Effective remedies prove elusive. 昂贵的药品:药品价格越来越难以接受。事实证明,有效的补救措施难以捉摸。
Pub Date : 2017-05-01
Howard Bell

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。
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引用次数: 0
Tackling addiction in primary care. 在初级保健中解决成瘾问题。
Pub Date : 2017-05-01
Brian Grahan

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。
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引用次数: 0
Addressing the opioid epidemic in general medical settings. 解决一般医疗环境中的阿片类药物流行问题。
Pub Date : 2017-05-01
Gavin Bart

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.

随着对这个国家阿片类药物流行病的认识不断提高,应对这一问题的努力也在增加。本文回顾了涉及医学界的国家和州的努力。它还报告了随着《21世纪治愈法案》的通过,明尼苏达州获得的新资金,并呼吁在卫生系统层面加强参与。希望通过提高对这些努力的认识,卫生保健提供者将能够更好地应对这一流行病的所有方面。
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引用次数: 0
Substance abuse and insomnia. 药物滥用和失眠。
Pub Date : 2017-05-01
Mark Rosenblum

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.

失眠是物质使用障碍患者的常见抱怨。睡眠问题和药物滥用之间的关系是双向的:有睡眠问题的人可能服用酒精或非法药物或滥用处方药。服用某些物质会影响睡眠。本文回顾了这种关系,并介绍了两种基于证据的治疗失眠的方法:处方睡眠药物和失眠的认知行为疗法。治疗药物使用障碍或失眠患者的临床医生应该意识到合并症的风险,他们应该了解治疗失眠的风险和益处。
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引用次数: 0
Wing Man. 翅膀的人。
Pub Date : 2017-05-01
Carmen Peota

On a gray March day, Stephen Wagner, MD, putters in the large hanger where he keeps his Beechcraft King Air E90.

在三月一个灰暗的日子里,医学博士斯蒂芬·瓦格纳(Stephen Wagner)把他的比奇国王E90放在一个大衣架上。
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引用次数: 0
The merits of MIIC. MIIC的优点。
Pub Date : 2017-05-01
Zeke J McKinney

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。
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引用次数: 0
The session so far. 到目前为止的会议。
Pub Date : 2017-05-01
Dan Hauser

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.

对于医生来说,令人沮丧的立法会议(必须在5月22日前结束)只剩下几周时间了。以下是综合格斗比赛的重点。
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引用次数: 0
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Minnesota medicine
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