Wisconsin Medical Journal最新文献

Providing Feedback Is Essential for Professional Growth. 提供反馈对专业成长至关重要。

Wisconsin Medical Journal Pub Date : 2023-09-01

Fahad Aziz, Kian S Djamali

引用次数: 0

An Unusual Presentation of Blastomycosis. 一种罕见的爆炸菌病表现。

Wisconsin Medical Journal Pub Date : 2023-09-01

Ryan Lokkesmoe, Acacia Dishman, John C Feemster, Daniel McKee, Pinky Jha

{"title":"An Unusual Presentation of Blastomycosis.","authors":"Ryan Lokkesmoe, Acacia Dishman, John C Feemster, Daniel McKee, Pinky Jha","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Blastomycosis is a rare pyogranulomatous infection that most commonly involves the lungs and sometimes the skin. Other manifestations are much less common. Diagnosis relies on biopsy, histopathology, and culture of suspicious lesions.Case presentation: In this case, a healthy 42-year-old male from Wisconsin presented to the emergency department with a chief complaint of 2 weeks of knee pain without a clear mechanism of injury. Upon further examination, he was found to have lesions on his abdomen, which he had first noticed over 3 years prior and had been treated with antibiotics as cellulitis for nearly 18 months. Biopsy of these lesions was consistent with blastomycosis infection, and further work-up and examination was notable for brain and laryngeal lesions without any pulmonary involvement. Intense anti-fungal treatment was immediately initiated with dramatic improvement in his symptoms.Discussion: This case highlights the importance of a thorough physical exam and consideration of rare infections in cases without clear answers. To our knowledge, this is the first published example of a blastomycosis infection involving brain, laryngeal, skin, and knee lesions without pulmonary infection.","PeriodicalId":38747,"journal":{"name":"Wisconsin Medical Journal","volume":"122 4","pages":"290-293"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41147434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Maintenance of Ionized Calcium During Prolonged Extreme Massive Transfusion During Liver Transplantation. 肝移植过程中长时间极大量输注过程中电离钙的维持。

Wisconsin Medical Journal Pub Date : 2023-09-01

Ricardo P Dorantes, Stylianos Voulgarelis, Harvey J Woehlck

{"title":"Maintenance of Ionized Calcium During Prolonged Extreme Massive Transfusion During Liver Transplantation.","authors":"Ricardo P Dorantes, Stylianos Voulgarelis, Harvey J Woehlck","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Massive transfusion may cause ionized hypocalcemia, a complication that, when severe, causes hemodynamic instability. Extant literature fails to provide effective guidance on replacement strategies to avoid severe ionized hypocalcemia in the most extreme situations.Case presentation: We discuss a liver transplant in which our empiric calcium replacement strategy resulted in no critically low ionized calcium values during the pre-reperfusion phase of a liver transplant with over 140 000 mL of bank blood transfusion, with an average of 10 000 mL per hour for 14 hours.Discussion: Few comparable reports exist. Most rely upon monitoring with subsequent replacement, but these have not been effective at avoiding severely low ionized calcium values.Conclusions: Our empiric calcium replacement strategy of 1 gram of calcium chloride per liter of citrated bank blood transfused, in 200 mg/200 mL increments, resulted in successful maintenance of ionized calcium during the anhepatic phase of liver transplantation while on continuous veno-venous hemofiltration.","PeriodicalId":38747,"journal":{"name":"Wisconsin Medical Journal","volume":"122 4","pages":"294-297"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41160029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Trends in Adult Suicide Rates in Milwaukee County, Wisconsin, 2002 through 2020. 2002年至2020年威斯康星州密尔沃基县成年人自杀率趋势。

Wisconsin Medical Journal Pub Date : 2023-09-01

Andrew T Schramm, Jacey Kant, Carissa W Tomas, Arnitta R Holliman, Hason Khan, Vaynesia T Kendrick, Susan Cronn, Terri A deRoon-Cassini, Sara A Kohlbeck

引用次数: 0

Assessment of Uterine Fibroid Knowledge and Educational Interests Among Health Care Professionals. 卫生保健专业人员子宫肌瘤知识和教育兴趣的评估。

Wisconsin Medical Journal Pub Date : 2023-09-01

Morgan Briggs, Benjamin Beran

引用次数: 0

Unmeaningful Work and the Practicing Physician. 无意义的工作和执业医师。

Wisconsin Medical Journal Pub Date : 2023-09-01

Joseph Edward Fojtik

引用次数: 0

Health at Every Size Principles: Clinician Perspectives To Limit Weight Stigma in Medical Care. 各种尺寸的健康原则：临床医生在医疗保健中限制体重污名的观点。

Wisconsin Medical Journal Pub Date : 2023-09-01

Shelbey J Hagen, Mary F Henningfield

{"title":"Health at Every Size Principles: Clinician Perspectives To Limit Weight Stigma in Medical Care.","authors":"Shelbey J Hagen, Mary F Henningfield","doi":"","DOIUrl":"","url":null,"abstract":"Objective: Health At Every Size is a paradigm that encourages body acceptance, intuitive eating, and other principles to increase healthy, peaceful living. The model is accepted by many in the mental health field, but in order for its principles to become standard in clinical (medical) care, clinician perspectives on Health at Every Size should be sought and understood.Methods: Ten clinicians were interviewed (4 physicians, 2 nurse practitioners, and 4 physician assistants). Participants reviewed the HAES principles, and identified facilitators and barriers to respectful, weight-inclusive care.Results: Most clinicians felt that body mass index is a useful, standard metric, but it is inadequate and can be a cause of distress. Providing non-weight-focused care was identified as the primary facilitator to respectful care.Discussion: Participants viewed body mass index as useful in some scenarios but do not think it encompass a patient's well-being and has the potential to cause the patient distress (eg, perpetuating weight stigma). Barriers to using Health At Every Size in clinical practice included the need for clinician education, bias/stigma, and a focus on weight.","PeriodicalId":38747,"journal":{"name":"Wisconsin Medical Journal","volume":"122 4","pages":"277-279"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41159865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Audit of Sex and Gender Medicine Topics in Preclinical School of Medicine Curriculum. 医学院临床前课程中性和性别医学主题的审计。

Wisconsin Medical Journal Pub Date : 2023-09-01

Kendall Trieglaff, Madeline J Zamzow, Bryn Sutherland, Amy Farkas, Sandra Pfister

{"title":"Audit of Sex and Gender Medicine Topics in Preclinical School of Medicine Curriculum.","authors":"Kendall Trieglaff, Madeline J Zamzow, Bryn Sutherland, Amy Farkas, Sandra Pfister","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: The importance of the inclusion of sex and gender medicine (SGM) in medical education has been recognized formally by both the American Association of Medical Colleges and the Department of Health and Human Services since 1995. Yet, few medical schools, including the Medical College of Wisconsin, have a standard SGM curriculum. This work mapped the SGM health topics taught in the Medical College of Wisconsin preclinical curriculum.Methods: Seven medical students audited 16 basic science preclinical courses in 2020-2021. SGM characterizations, including epidemiology, diagnosis, presentation, treatment, prognosis, pharmacology, and disparity, were captured by an online survey tool. Comparisons were made to 38 high-yield topics presented in the textbook \"How Sex and Gender Impact Clinical Practice: An Evidence-Based Guide to Patient Care.\"Results: Of the 604 preclinical sessions audited, 54% contained some SGM content. Epidemiology was the most common characterization (23% of total). Thirty-four of the 38 high-yield clinical SGM topics received mention in the basic science sessions. Breast cancer, stroke, osteoporosis, sex and gender considerations in therapeutic response, and systemic lupus erythematosus had the most frequent SGM-specific coverage (representation in at least 4 of the 16 preclinical courses).Conclusions: Utilizing a medical student cohort to thoroughly audit courses was an effective way to document that Medical College of Wisconsin preclinical curriculum introduces many clinically relevant SGM topics. However, the audit also discovered varying levels of detail among the high-yield topics with concern that students may not be adequately prepared to treat all patients. These results establish the groundwork for a more formalized and integrated approach to include SGM in preclinical curriculum.","PeriodicalId":38747,"journal":{"name":"Wisconsin Medical Journal","volume":"122 4","pages":"243-249"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41152425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Case That Will Take Your Breath Away: Acquired Methemoglobinemia Related to Trimethoprim-Sulfamethoxazole and Phenazopyridine Ingestion for Treatment of Urinary Tract Infection. 一个会让你大吃一惊的病例：服用甲氧苄啶、磺胺甲恶唑和苯并吡啶治疗尿路感染相关的获得性甲氧苄胺血症。

Wisconsin Medical Journal Pub Date : 2023-09-01

Vinay Sharma, Kevin Robertson, Jason Domagalski

引用次数: 0

Age-Appropriate Cancer Screenings Through a Dermatology Len. 适合年龄的癌症皮肤科筛查。

Wisconsin Medical Journal Pub Date : 2023-09-01

Brandon Calley, Philip Berce, Catherine K Chang, Sophia Neman, Ana Maria Viteri, Alexander Means, Olushola L Akinshemoyin Vaughn

{"title":"Age-Appropriate Cancer Screenings Through a Dermatology Len.","authors":"Brandon Calley, Philip Berce, Catherine K Chang, Sophia Neman, Ana Maria Viteri, Alexander Means, Olushola L Akinshemoyin Vaughn","doi":"","DOIUrl":"","url":null,"abstract":"Background: Primary care physicians are often the first to identify signs and symptoms concerning for cancer. An important aspect of cancer screening is thorough skin examinations and subsequent referral to a dermatologist for atypical cutaneous presentations, which may be associated with an underlying visceral malignancy. Diagnostic considerations for pruritus without dermatitis (\"itch without rash\") in adults include senile pruritus, medication reaction, and paraneoplastic syndrome. Recognition of cutaneous manifestations of cancer should prompt cancer screening by primary care providers.Objective: To update practicing physicians on current cancer screening guidelines with a specific focus on cutaneous clues to prompt further workup.Methods: American Cancer Society and United States Preventive Services Task Force guidelines were systematically reviewed using PubMed and organizational websites during August and September, 2021, with review of Task Force Guidelines during October, 2022.Results: Colorectal, cervical, breast, lung, skin, prostate, ovarian, hematologic, pancreatic, thyroid, testicular, bladder, oral, and gastric cancer screening guidelines are summarized.Conclusions: Primary care physicians can recognize atypical cutaneous conditions and facilitate referral to a dermatologist for evaluation and/or directly order tests themselves to initiate appropriate cancer screening.","PeriodicalId":38747,"journal":{"name":"Wisconsin Medical Journal","volume":"122 4","pages":"262-267"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41137012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0