Missouri medicine
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Despite the widespread knowledge that tobacco use causes death and debilitating disease, tobacco control efforts in Missouri remain inadequate. No other health issue combines the prevalence, lethality, and neglect of tobacco addiction. ⋯ Successful tobacco control efforts change society by creating an environment in which nonsmoking is the norm and quitting smoking is supported. This paper concludes that it is time for medicine and public health professionals to communicate, collaborate, and assume leadership in reducing the health burden of tobacco use in Missouri.
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Methicillin-resistant Staphylococcus aureus (MRSA) infections are an emerging problem in both children and adults throughout the United States. Skin and soft tissue infections are most common, however serious invasive disease can occur and may involve any anatomic site. The initial empiric therapy of suspected S. aureus infections will be influenced by the regional antimicrobial susceptibility patterns for the organism as well as the severity of the infection being treated. This article will review the epidemiology, clinical features, and treatment considerations for MRSA infections in children.
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The treatment of sepsis and septic shock is an important clinical problem. While effective antibiotic intervention and strong supportive care have improved survival, mortality remains at unacceptable levels. ⋯ The available evidence would support the conclusion that microbial mediators can function synergistically in the induction of host inflammation, providing a potential explanation that anti-endotoxin and anti-inflammatory agents have not been particularly successful in clinical trials to treat septic shock. The identification of specific recognition molecules on the surface of inflammatory mediator cells responsible for initiation of signal transduction, as well as the elucidation of the specific molecular pathways leading to gene expression, provide new opportunities for the development of effective intervention strategies for treatment of septic shock.
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Review
Substance abuse and dependence in physicians: an overview of the effects of alcohol and drug abuse.
Substance abuse and dependence (alcohol and drugs) are behavioral disorders and treatable medical diseases. Early intervention followed by appropriate treatment can often help return physicians to healthy personal and professional lives. Current scientific evidence suggests the prevalence of substance abuse or dependence among the medical profession over a lifetime is approximately 10-15%, slightly in excess of the general population. The initiation of intervention is critical and ultimately may be lifesaving.