�鶹Ů��

One Thursday in September, I woke up with achy knees. That was nothing new. I’ve had knee pain on and off for a few years. Before the pandemic, I had visited an orthopedist, who told me that I’d lost some cartilage in my knee joint — an early sign of osteoarthritis. “Come on, I’m just over 50,” I told her. “That’s much too young for arthritis.” “Yeah,” she laughed, “I hear that a lot.” (Paul T. von Hippel, 1/20)

Chicago is one of a handful of American cities where a deadly fungal infection, Candida auris, has been spreading rapidly. It was first detected five years ago. By 2019, researchers were noting the emergence of a strain of the infection that is resistant to antifungal medications. (Latania K. Logan, 1/19)

Antimicrobial resistance is a critical global health threat, affecting the human, animal, and environmental health sectors. Although many countries have national action plans to combat this growing and deadly problem, their implementation in low- and middle-income countries has been stalled by the lack of evidence from robust data to quantify and surface the problem for policy makers. In countries around the world, doctors are being left powerless to treat common infections such as Streptococcus pneumoniae, Staphylococcus aureus, and others that are often acquired in the very hospitals they work at. Yet clinicians have lacked the data needed to encourage government ministers to invest more in interventions that can control antimicrobial resistance (AMR), such as infection prevention and control, or better diagnostics. (Janet Midega, 1/19)

Late last year, at 3 a.m. in what is a now-normal night, Kim Hoffman awoke with “an unbelievable headache.” These are related to the 30 brain lesions, and the steroids needed to reduce the swelling of the brain. After dawn that day, she said, speaking by phone from her home in Glastonbury, Conn., “I felt a new neck lesion.” She has so many skin lesions that “it feels as though my skin is being torn like someone has a serrated knife.” What began as ovarian cancer has, she said, metastasized to “both breasts, my right lung, the lining of my spine, and many lymph nodes.” She says, “I’m a pretty sick puppy.” (George F. Will, 1/19)

As critical care and emergency physicians on the front lines of the COVID-19 pandemic we were saddened and frustrated to read of the recent court order requiring Mercy Hospital in Coon Rapids to keep a patient on life support after it appears medical teams had determined that continued treatment would not benefit the patient ("Judge: COVID patient must be kept on ventilator," Jan. 15). Since the advent of critical care in the 1950s, cases have been common in which a patient has no chance of survival despite best efforts, and essentially is dead but for the machines and interventions that keep the patient in medical purgatory, awaiting an infection, stroke or other event that yields final closure. This can take weeks, months or even years, but the outcome is a foregone conclusion. (John Hick, Michele LeClaire and Heidi Erickson, 1/19)

About 60% of older Americans take a cholesterol-lowering statin to prevent heart attack, stroke, and other forms of cardiovascular disease. In contrast, only 25% of eligible, HIV-negative people take pre-exposure prophylaxis (PrEP), a safe, highly effective way to prevent HIV infection. But recent changes in how health care providers should think about PrEP and who it is for have the potential to transform the HIV epidemic in the U.S. and possibly put it in the rearview mirror. (Kathryn Macapagal, 1/20)

I’m not sure how old I was when I started experiencing anxiety. It might have started the first time I translated an immigration form for my parents. I didn’t know I was translating. They pointed to English words and I told them what they meant in Spanish, and I started to understand that my parents could be taken away from me at any moment. I was terrified of police cars or anything or anyone that might be connected to the government. I was 7 years old. (Ashley Juarez, 1/20)