Showing papers in "Minnesota medicine in 1999"

Can we predict recovery in chronic fatigue syndrome

Abstract: PURPOSE To determine if selected demographic or clinical features of chronic fatigue syndrome (CFS) are associated with recovery. PATIENTS AND METHODS A follow-up questionnaire was mailed to 341 patients who had been ill on average for nine years to ascertain "recovery" rate (defined as self-reported recovery on a visual analog scale). Baseline demographic and clinical features (functional status and psychological status) recorded at the time of the initial (baseline) clinical visit were analyzed for their association with recovery at the time of follow-up. RESULTS Of the 177 patients who responded to the follow-up questionnaire, only 21 (12%) reported "recovery." Patients with higher levels of physical and social functioning and lower levels of anxiety and obsessive-compulsiveness at baseline were more likely to report recovery at follow-up (p < 0.05). No specific demographic characteristics were associated with recovery. CONCLUSION These findings support previous research that complete recovery from CFS is rare and that patients with less severe illness at the initial clinic visit are more likely to have a positive prognosis for recovery. However, considerable overlap in illness severity was observed between the recovered and nonrecovered groups, suggesting that accurate prediction of recovery in individual CFS patients is not currently feasible.

The hazards of psychotropic herbs.

Abstract: The use of medicinal herbs has increased over the past few years, and psychotropic herbs are among the most popular on the market. Patients and physicians may assume these products are safe; however, dietary supplements are not subject to the rigorous testing required for prescription medications. Problems that may occur with the use of psychotropic herbs include overuse or abuse, side effects, and herb-drug interactions. Ma huang, St. John's wort, and kava are examples of readily available herbs with the potential for negative effects. Physicians should improve their knowledge of these products so they can provide reliable information to their patients.

Banking on blood.

Abstract: “Blood connects us all” is the theme for the WHO's World Blood Donor Day, taking place on June 14, 2016. This event celebrates those who have saved lives through blood donation andmotivates healthy individuals who have yet to donate. Blood is an extraordinary tissue that performs a huge array of vital functions within the body. Red blood cells (RBCs) contain hemoglobin (Hb) that transports oxygen to tissues. White blood cells (WBCs) make up the immune system that protects the body against infectious diseases, and platelets are able to clot blood vessels during injury. Blood supplies the body with nutrients and hormones found in the plasma, removes waste and regulates acidity and temperature. Given these vital functions, when one or more of blood's components fail to work as it should, or if it is lost in sufficient quantities, serious disorders can arise. Approximately one-third of theworld's population has some formof anemia (abnormally low Hb levels), making this range of disorders the most common clinical problemworldwide.Within the European Union alone, the economic burden of hematologic disorders has been estimated at €23 billion per year. A global challenge of this magnitude must be dealt with strategically. At the beginning of 2016, the European Hematology Association (EHA) published a consensus document bringing together experts to identify unmet clinical and scientific needs to facilitate hematology research. This EHA roadmap breaks down hematology into several categories depending on the nature of the condition. Specific priorities within each field are assigned and accompanied by research proposals and anticipated impact. Transfusion medicine is one of the highlighted areas. Blood transfusions are commonly used to reduce maternal mortality, treat patients with blood disorders and enable major surgery including organ transplantation. According to WHO figures, the total number of blood donations collected globally has increased by 25% over the last decade to around 108 million. Although encouraging, the rate of blood donation in low-income countries is 0.39% of the population, compared to 3.7% in high-income countries, creating a disparity in available blood. Socio-economic factors also reflect the way blood is utilized: in lowincome countries, approximately 65% of blood transfusions are given to children under 5 years of age, whereas over 75% of blood transfusions in high-income countries are given to patients over 65 years old. It is therefore essential to ensure that blood supply adequately meets the healthcare system's needs. Having sufficient access to blood is not the only challenge. Particularly in under-resourced countries another problem is determining the quality of donated blood. Transfusion-transmissible infections (TTIs) such as HIV and hepatitis B/C are prevalent in countries that do not implement sufficient blood screening. Themost common reason is insufficient access to test kits, and the issue is compounded by a lack of external quality assessment schemes. Although TTIs are less of a

The health professionals services program. An alternative for physicians with psychiatric disorders.

Abstract: By removing the obstacles of social stigma and board sanction, HPSP offers physicians a way to fulfill their reporting obligations and get confidential help for a psychiatric disorder, chemical abuse, or a medical condition. Physicians who are willing to document how they manage their illness can enroll in HPSP for monitoring without board involvement. Physicians are encouraged to learn more about HPSP--for themselves, colleagues, or any health professional licensed in Minnesota--by calling 651/643-2120 or visiting our Web site at www.hpsp.state.mn.us.

Rural/urban differences in chemical dependency treatment. Results from the Minnesota Adult Household Survey.

Abstract: Research at the national level suggests fairly similar rates of substance abuse in rural and urban areas, with data for 1996 showing a slightly higher rate of drug use in urban areas but no difference in the rates of heavy alcohol use. The current study assesses differences between rural and urban areas in substance abuse and dependence, service utilization, and perceived barriers to services in Minnesota. Analysis of responses of a random sample of 7,508 adults stratified by residence reveals few differences between rural and urban settings. While urban residents have a slightly higher (marginally significant) rate of dependence on drugs and rural residents have a significantly greater tendency to talk to clergy about their problem, the subsamples exhibit remarkably similar patterns of abuse, need for treatment, propensity to seek treatment, service utilization, and perceived barriers to treatment.

Twelve years of emergency medicine at Hennepin County Medical Center. Changing critical care experience.

Abstract: OBJECTIVE To elucidate the critical care experience of emergency medicine faculty and delineate changing patterns of practice. METHOD A retrospective review of the resuscitation room dictations for all patients treated in the emergency department resuscitation room by one emergency medicine physician from July 1, 1985, to June 30, 1997, was performed. RESULTS A total of 1,325 cases were reviewed. The number of cases of arrhythmia (p < 0.01) and medical cardiac arrest (p < 0.01) significantly decreased over time, while the number of cases involving firearm injury (p < 0.01) increased. The percentage of trauma cases steadily rose from 38.5% in year 1 to 50.2% (p < 0.01) in year 12. Significant decreases in the rate of arterial line placement (p < 0.01), central line placement (p < 0.01), nasotracheal intubation (p < 0.01), and thoracotomy (p < 0.05) have occurred. Significant increases were seen in cardiac ultrasound examination (p < 0.01), rapid sequence induction for intubation (p < 0.01), and the use of paralytic medications (p < 0.01). CONCLUSION Significant changes have occurred in the type of case and rate of utilization of various diagnostic and therapeutic procedures.

Community-based screening for childhood lead poisoning. Identification of risk factors and susceptible populations in Duluth.

Abstract: The purpose of this matched case-controlled study was to identify local risk factors and susceptible populations for childhood lead poisoning in Duluth, Minnesota. We mailed questionnaires to the parents of 20 children with known elevated capillary lead levels > or = 10 micrograms/dL; 76 age-matched controls had capillary lead levels < 10 micrograms/dL. The study identified these risk factors for elevated capillary lead levels in children: not attending daycare, having nonwhite parents, living in rental property in central Duluth, and moving with family three or more times in the previous five years. We conclude that these risk factors are related to socioeconomics. Minority children and children living in poverty in the Duluth area should be screened for lead poisoning according to the Centers for Disease Control and Prevention screening guidelines for high-risk lead exposure.

Computed tomography of humans and bowed stringed instruments. Some interesting similarities.

Abstract: We have used computed tomography to evaluate bowed stringed instruments and have noted interesting analogies with CT scans of humans. In humans, CT commonly detects a broad range of normal anatomic variations. Similarly, CT of violins and cellos demonstrates a wide range of normal structural variations. CT, often used to detect infections in humans, also detects defects from wood infestations. In humans, the unrelenting effect of gravity causes deformity of the demineralized spine. In old stringed instruments, plastic deformity of wood results from unrelenting string pressure. Trauma causes bone fractures in humans and wood fractures in bowed stringed instruments, and repairing fractures in both humans and stringed instruments requires various splitting devices. In summary, CT provides the physician and the luthier with a unique, noninvasive tool that can characterize the broad range of normal structures, pathological conditions, and repair.