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A Case of Progressive Cholestatic Drug-Induced Liver Injury Due to Terbinafine. 特比萘芬致进行性胆汁淤积性药物性肝损伤1例。
Wisconsin Medical Journal Pub Date : 2023-05-01
Dana Ley, Jessica Musto, Adnan Said
{"title":"A Case of Progressive Cholestatic Drug-Induced Liver Injury Due to Terbinafine.","authors":"Dana Ley,&nbsp;Jessica Musto,&nbsp;Adnan Said","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Terbinafine is commonly prescribed for onychomycosis. It rarely leads to severe, prolonged cholestatic drug-induced liver injury. Clinicians should remain vigilant for this complication.</p><p><strong>Case presentation: </strong>A 62-year-old woman was started on terbinafine and developed mixed hepatocellular and cholestatic drug-induced liver injury, confirmed on liver biopsy. The injury became predominantly cholestatic. Unfortunately, she developed coagulopathy with elevated international normalized ratio and progressive drug-induced liver injury with severely elevated alkaline phosphatase and total bilirubin, requiring repeat liver biopsy. Fortunately, she did not develop acute liver failure.</p><p><strong>Discussion: </strong>Prior case reports and series have documented severe cholestatic drug-induced liver injury (although with lesser degree of bilirubin elevation) due to terbinafine, which has very rarely been associated with acute liver failure, need for liver transplantation, and/or death.</p><p><strong>Conclusions: </strong>Non-acetaminophen drug-induced liver injury is idiosyncratic. Complications including acute liver failure and vanishing bile duct syndrome can be slow to develop, so monitoring for them is important over longitudinal follow-up.</p>","PeriodicalId":38747,"journal":{"name":"Wisconsin Medical Journal","volume":"122 2","pages":"138-142"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9776961","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
Teprotumumab-Induced Encephalopathy: A Rare Side Effect of a Novel Therapeutic. teprotumumab诱导的脑病:一种新疗法的罕见副作用。
Wisconsin Medical Journal Pub Date : 2023-05-01
Megan D Yee, James McCarthy, Brian Quinn, Asif Surani
{"title":"Teprotumumab-Induced Encephalopathy: A Rare Side Effect of a Novel Therapeutic.","authors":"Megan D Yee,&nbsp;James McCarthy,&nbsp;Brian Quinn,&nbsp;Asif Surani","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Teprotumumab is a novel monoclonal antibody used for treatment of thyroid eye disease (TED). To our knowledge, this is the second reported case of encephalopathy associated with teprotumumab therapy.</p><p><strong>Case presentation: </strong>A 62-year-old White woman with a history of hypertension, Graves' disease, and thyroid eye disease presented with 1 week of intermittent altered mental status following her third teprotumumab infusion. Neurocognitive symptoms resolved following plasma exchange therapy.</p><p><strong>Discussion: </strong>By using plasma exchange as first-line therapy, our patient had a shorter time course from diagnosis to symptom resolution than was reported in the previously published case.</p><p><strong>Conclusions: </strong>Clinicians should consider this diagnosis in patients with encephalopathy after teprotumumab infusion, and our experience suggests plasma exchange is an appropriate initial treatment. Proper counseling of this potential side effect is warranted for patients prior to starting teprotumumab to facilitate earlier detection and treatment.</p>","PeriodicalId":38747,"journal":{"name":"Wisconsin Medical Journal","volume":"122 2","pages":"134-137"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9793106","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
Post Roe v Wade's Overturn: Importance and Methods of Patient-Physician Confidentiality in Conversations Surrounding Isotretinoin and Contraception in Wisconsin. 罗伊诉韦德案推翻后:在威斯康星州围绕异维甲酸和避孕的对话中，医患保密的重要性和方法。
Wisconsin Medical Journal Pub Date : 2023-05-01
Sophia Neman, Stephen R Humphrey
{"title":"Post <i>Roe v Wade's</i> Overturn: Importance and Methods of Patient-Physician Confidentiality in Conversations Surrounding Isotretinoin and Contraception in Wisconsin.","authors":"Sophia Neman,&nbsp;Stephen R Humphrey","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":38747,"journal":{"name":"Wisconsin Medical Journal","volume":"122 2","pages":"88-89"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9675155","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
Proceedings from the 2022 Medical College of Wisconsin Innovations in Healthcare Education Research Annual Conference. 2022年威斯康星医学院医疗保健教育创新研究年会论文集。
Wisconsin Medical Journal Pub Date : 2023-05-01
{"title":"Proceedings from the 2022 Medical College of Wisconsin Innovations in Healthcare Education Research Annual Conference.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":38747,"journal":{"name":"Wisconsin Medical Journal","volume":"122 2","pages":"152-154"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9675156","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
Population-Level Disease Prevalence Rates Correlate With COVID-19 Mortality. 人口水平疾病患病率与COVID-19死亡率相关
Wisconsin Medical Journal Pub Date : 2023-05-01
George L Morris
{"title":"Population-Level Disease Prevalence Rates Correlate With COVID-19 Mortality.","authors":"George L Morris","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Initial reports identified preexisting conditions associated with COVID-19 mortality risk. The Centers for Disease Control and Prevention (CDC) 500 Cities Project provides prevalence rate estimates at the census tract level for these conditions. The frequency of these individual condition prevalence rates may associate with the census tracts with greater risk of COVID-19 deaths.</p><p><strong>Objective/research question: </strong>Can the census tract-level outcome of Milwaukee County COVID-19 death rates correlate with the census tract-level COVID-19 individual mortality risk condition prevalence rates?</p><p><strong>Methods: </strong>This study used the 296 Milwaukee County, Wisconsin census tracts' COVID-19 death rates per 100,000 lives to perform a linear regression with individual COVID-19 mortality risk condition prevalence rates, obtained from the CDC's 500 Cities Project, and a multiple regression with 7 condition prevalence rates. The Milwaukee County Medical Examiner provided census tract identified deaths from COVID-19 from March 2020 through May 2020. Crude death rates for these 3 months per 100,000 population were analyzed in a multiple linear regression versus prevalence rates for these conditions in each census tract.</p><p><strong>Results: </strong>There were 295 assessable COVID-19-related deaths in Milwaukee County in early 2020. The model of crude death rates showed statistical significance with the condition prevalence rates in Milwaukee County. A regression analysis of each condition's prevalence rate showed no association with crude death rates.</p><p><strong>Conclusions: </strong>This study supports a correlation between high COVID-19 mortality rate census tracts and prevalence rate estimates of conditions associated with high individual COVID-19 mortality rates. The study is limited by the small COVID-19 death sample and the use of a single location. The ability to focus COVID-19 health promotion may save future lives if mitigation strategies are applied extensively in these neighborhoods.</p>","PeriodicalId":38747,"journal":{"name":"Wisconsin Medical Journal","volume":"122 2","pages":"101-104"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9793100","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 Convoluted Picture of Diabetic Myonecrosis. 糖尿病性肌坏死的复杂图像。
Wisconsin Medical Journal Pub Date : 2023-05-01
Michael Hii, John Ning
{"title":"A Convoluted Picture of Diabetic Myonecrosis.","authors":"Michael Hii,&nbsp;John Ning","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>A patient with well-controlled type 2 diabetes was found to have diabetic myonecrosis, a rare condition associated with poorly controlled type 2 diabetes. Diagnosis was masked by concern for lumbosacral plexopathy from a history of spinal cord infarct.</p><p><strong>Case presentation: </strong>A 49-year-old African American woman with type 2 diabetes and paraplegia secondary to spinal cord infarct presented to the emergency department with left leg swelling and weakness from her hip to toes. Hemoglobin A1c was 6.0%, and there was no leukocytosis or elevated inflammatory markers. Computed tomography showed evidence of infectious process or possible diabetic myonecrosis.</p><p><strong>Discussion: </strong>Recent reviews show fewer than 200 reports of diabetic myonecrosis since first described in 1965. It typically is seen in poorly controlled types 1 and 2 diabetes, with average hemoglobin A1c of 9.34% at time of diagnosis.</p><p><strong>Conclusions: </strong>Diabetic myonecrosis should be considered in diabetic patients with unexplained swelling and pain - particularly in the thigh - even with unremarkable lab values.</p>","PeriodicalId":38747,"journal":{"name":"Wisconsin Medical Journal","volume":"122 2","pages":"149-151"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9776960","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
Silicosis: Emerging Trends and How to Screen for Early Detection. 矽肺病：新趋势和如何进行早期筛查。
Wisconsin Medical Journal Pub Date : 2023-05-01
Megan Elderbrook, Robert Harrison, Barbara Grajewski, Carrie Tomasallo, Jonathan Meiman
{"title":"Silicosis: Emerging Trends and How to Screen for Early Detection.","authors":"Megan Elderbrook, Robert Harrison, Barbara Grajewski, Carrie Tomasallo, Jonathan Meiman","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>National investigations are finding silicosis in young workers. We developed a silicosis case-finding process and conducted follow-up interviews to identify emerging exposure sources.</p><p><strong>Methods: </strong>Probable cases were identified through Wisconsin hospital discharge and emergency department data and Wisconsin lung transplant programs. Interviews were attempted with case-patients under age 60.</p><p><strong>Results: </strong>We identified 68 probable silicosis cases and interviewed 4 case-patients. Occupational exposures for cases under age 60 included sandblasting, quarry work, foundry work, coal mining, and stone fabrication. Two stone fabrication workers were diagnosed before age 40.</p><p><strong>Discussion: </strong>Prevention is critically important to eliminate occupational silicosis. Clinicians should obtain the occupational and exposure history to identify cases of occupational lung disease and notify public health to identify and prevent workplace exposures.</p>","PeriodicalId":38747,"journal":{"name":"Wisconsin Medical Journal","volume":"122 2","pages":"114-117"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9793104","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
Cannabis-Induced Catatonia in a 15-Year-Old Male: A Case Report. 大麻致15岁男性紧张症1例报告。
Wisconsin Medical Journal Pub Date : 2023-05-01
Trevor Gauthier, Pradeep Bangalore Prakash, Drew Keopple, Ralph Vardis
{"title":"Cannabis-Induced Catatonia in a 15-Year-Old Male: A Case Report.","authors":"Trevor Gauthier,&nbsp;Pradeep Bangalore Prakash,&nbsp;Drew Keopple,&nbsp;Ralph Vardis","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Catatonia is a syndrome of primarily psychomotor disturbances most common in psychiatric mood disorders but that also rarely has been described in association with cannabis use.</p><p><strong>Case presentation: </strong>A 15-year-old White male presented with left leg weakness, altered mental status, and chest pain, which then progressed to global weakness, minimal speech, and a fixed gaze. After ruling out organic causes of his symptoms, cannabis-induced catatonia was suspected, and the patient responded immediately and completely to lorazepam administration.</p><p><strong>Discussion: </strong>Cannabis-induced catatonia has been described in several case reports worldwide, with a wide range and duration of symptoms reported. There is little known about the risk factors, treatment, and prognosis of cannabis-induced catatonia.</p><p><strong>Conclusions: </strong>This report emphasizes the importance of clinicians maintaining a high index of suspicion to accurately diagnose and treat cannabis-induced neuropsychiatric conditions, which is especially important as the use of high-potency cannabis products in young people increases.</p>","PeriodicalId":38747,"journal":{"name":"Wisconsin Medical Journal","volume":"122 2","pages":"131-133"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9793103","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
Four Essential Laws of Connecting With Patients. 与病人沟通的四个基本法则。
Wisconsin Medical Journal Pub Date : 2023-05-01
Fahad Aziz
{"title":"Four Essential Laws of Connecting With Patients.","authors":"Fahad Aziz","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":38747,"journal":{"name":"Wisconsin Medical Journal","volume":"122 2","pages":"86-87"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9675152","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
Addressing Health Disparities Through Rural Training. 通过农村培训解决保健差距问题。
Wisconsin Medical Journal Pub Date : 2023-05-01
Jillian Landeck, Ryan J Spencer, Robert N Golden
{"title":"Addressing Health Disparities Through Rural Training.","authors":"Jillian Landeck,&nbsp;Ryan J Spencer,&nbsp;Robert N Golden","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":38747,"journal":{"name":"Wisconsin Medical Journal","volume":"122 2","pages":"155-156"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9675154","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
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