Tuberculosis - United States, 2023.

After 27 years of declining U.S. tuberculosis (TB) case counts, the number of TB cases declined considerably in 2020, coinciding with the COVID-19 pandemic. For this analysis, TB case counts were obtained from the National TB Surveillance System. U.S. Census Bureau population estimates were used to calculate rates overall, by jurisdiction, birth origin, race and ethnicity, and age group. Since 2020, TB case counts and rates have increased each year. During 2023, a total of 9,615 TB cases were provisionally reported by the 50 U.S. states and the District of Columbia (DC), representing an increase of 1,295 cases (16%) as compared with 2022. The rate in 2023 (2.9 per 100,000 persons) also increased compared with that in 2022 (2.5). Forty states and DC reported increases in 2023 in both case counts and rates. National case counts increased among all age groups and among both U.S.-born and non-U.S.-born persons. Although TB incidence in the United States is among the lowest in the world and most U.S. residents are at minimal risk, TB continues to cause substantial global morbidity and mortality. This postpandemic increase in U.S. cases highlights the importance of continuing to engage communities with higher TB rates and their medical providers in TB elimination efforts and strengthening the capacity in public health programs to carry out critical disease control and prevention strategies.

Mixed methods study of the potential therapeutic benefits from medical cannabis for patients in Florida.

OBJECTIVES: To evaluate medical marijuana patients' perceptions of therapeutic benefits for self-reported medical conditions. DESIGN: The study was a concurrent mixed methods study with adult medical marijuana patients. Survey data were collected using a web-based survey, and interviews were conducted in person or over the phone. SETTING: The study recruited 196 medical marijuana patients to complete surveys and 13 patients to participate in qualitative interviews in Florida. MEASURES: A validated patient survey was distributed via Florida medical marijuana social media groups to examine the therapeutic benefits of the cannabis plant for medical conditions and overall well-being. Concurrently, qualitative interviews were conducted to understand barriers and facilitators to accessing medical cannabis and explore preferences for different forms and strains, as well as any unexpected side effects. RESULTS: Patients used medical cannabis for relief of chronic pain or depression, followed by arthritis and nausea. Survey results indicated 89 % of patients reported "great relief" for their medical condition. Over 76 % of patients reported a score of 8 or higher on a 10-point scale that their medical condition had improved, and over 68 % reported a score of 8 or higher that medical cannabis had reduced their pain. Interviews indicated medical cannabis was effective for pain relief and reducing the use of prescription medicines, but the drug was perceived as too expensive. CONCLUSIONS: Medical marijuana patients were positive about the health benefits they received and the fact they were able to reduce or eliminate many prescription medications; however, there were concerns about the costs.

Medical Marijuana Policy Reform Reaches Florida: A Scoping Review.

BACKGROUND: Florida became the first state in the U.S. South to legalize the use of medical marijuana to treat a variety of health conditions including chronic pain, epilepsy, and spasticity symptoms from multiple sclerosis. While there are over 200,000 medical marijuana patients in Florida, there remain financial, psychological, and insurance coverage barriers which reduce access for many patients. PURPOSE: This scoping review, with a focus on state health policy, first describes some clinical studies examining the therapeutic benefits of medical marijuana. Next, there is a discussion of the Florida regulatory environment and major legislation. Also, the review describes how the current Florida policy landscape presents challenges for physicians and patients. METHODS: A scoping review of the literature was conducted in PubMed and Google Scholar using the search terms, "medical marijuana" and "medical cannabis" to identify research articles, newspaper reports, and government documents. The purpose of the review was to identify research investigating the therapeutic efficacy of medical marijuana and state policies affecting physician practice. RESULTS: The review concluded there was general scientific consensus of therapeutic benefits for patients, especially for chronic pain, from the use of medical marijuana. The review also identified several barriers for physicians and patients around cost, stigma, and lack of insurance coverage which constrains use and access. DISCUSSION: The review discusses several directions for future medical marijuana policy and research with the aim to improve therapeutic benefits for Florida patients.

A chemoenzymatic synthesis of 5a-carba-α-D-mannose-6-phosphate.

An efficient chemical synthesis of 5a-carba-α-D-mannose and its enzymatic elaboration to 5a-carba-α-D-mannose-6-phosphate, using yeast hexokinase, is described.

Outbreak of tuberculosis among homeless persons coinfected with human immunodeficiency virus.

We investigated a cluster of patients with tuberculosis (TB) in North Carolina and determined the extent of transmission of 1 strain of Mycobacterium tuberculosis. A retrospective cohort study was conducted. Homeless shelter attendance and medical records for 1999 and 2000 were reviewed. The period of exposure to M. tuberculosis was determined, and shelter residents were offered TB screening. DNA fingerprinting was performed on 72 M. tuberculosis isolates. In addition to the initial index cluster of 9 patients, another 16 patients were identified. Isolates of M. tuberculosis from all 25 patients shared a matching DNA fingerprint pattern. All but 1 patient was male, 22 (88%) were African American, and 14 (56%) were human immunodeficiency virus-infected. An epidemiological link to a single shelter was identified for all but 1 patient. Earlier recognition of this shelter as a site of M. tuberculosis transmission could have been facilitated through innovative approaches to contact investigation and through genetic typing of isolates.

Testosterone and occupational choice: actors, ministers, and other men.

Occupational differences in testosterone concentrations, focusing on actors and ministers, were explored in 3 studies. The 1st examined salivary testosterone in 7 occupational groups and an unemployed comparison group and found actors and football players higher than ministers but no other significant differences. The 2nd examined salivary testosterone in 2 kinds of actors (stage actors and comedians) and 2 kinds of ministers (pastoral ministers and missionaries) and found actors high and ministers low but no differences between subgroups within each occupation. The 3rd examined serum testosterone in entertainers and ministers in an archival sample of military veterans and found entertainers high and ministers low. The results are interpreted in terms of dominance and antisocial tendencies, with the conclusion that these variables are complex and can affect occupational preference in subtle ways.