WMJ : official publication of the State Medical Society of Wisconsin最新文献

{"title":"Statistical Thinking in Medicine, Part 5: Descriptive Statistics and Quantifying 'Unusual'.","authors":"Robert A Calder, Jayshil J Patel","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":"124 2","pages":"192-195"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683861","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}

{"title":"Post-infection Symptomatology of Human Metapneumovirus Infection.","authors":"Dorothy Kenny, Samuel Martin, David Quimby","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Though there has been much discussion about post-acute sequelae of SARS-CoV-2 infection, there has been limited study on symptoms following infection with other respiratory viruses.</p><p><strong>Methods: </strong>In this retrospective chart review, we reviewed the medical records of 92 patients admitted to the hospital with a diagnosis of human metapneumovirus for 17 of the common symptoms associated with post-acute sequalae of SARS-CoV-2 that were either new or worse than baseline in the time frame of 90 to 270 days after diagnosis.</p><p><strong>Results: </strong>Of those patients hospitalized with human metapneumovirus, 55.4% had at least 1 new or worsening symptom more than 3 months after diagnosis. The most common symptoms noted were shortness of breath (29.3%) followed by fatigue and cough (17.3% each).</p><p><strong>Conclusions: </strong>Our data suggest that other respiratory viruses - not just SARS-CoV-2 - may carry a significant burden of post-infection sequelae.</p>","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":"124 2","pages":"135-137"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683935","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}

{"title":"Primary Care Clinicians' Satisfaction and Clinical Confidence After Participation in the Wisconsin Child Psychiatry Consultation Program.","authors":"Jakob Anibas, Cody Schreiner, Jacob Elliot, Amy Prunuske, Michelle Broaddus","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>To help combat a shortage of child and adolescent psychiatrists and assist primary care providers in managing pediatric mental health care cases, the Medical College of Wisconsin established the Wisconsin Child Psychiatry Consultation Program. The program provides educational support to primary care providers with mild to moderate pediatric mental health concerns via phone or email consultation with board-certified child and adolescent psychiatrists, as well as offering on-demand didactic training sessions and assistance locating therapeutic resources.</p><p><strong>Objective: </strong>We sought to assess participating primary care clinicians' satisfaction with consultations and their perceptions of program services, specifically its impact on self-reported diagnostic decision-making and patient outcomes.</p><p><strong>Methods: </strong>Primary care providers' responses to both post-consultation and annual surveys were analyzed to determine the program's impact. Five survey questions used a 5-point Likert scale, and 1 \"select-all-that-apply\" question was included on the post-consultation survey.</p><p><strong>Results: </strong>Overall, 99.2% of respondents were satisfied with their most recent consultation. Additionally, mean Likert scale scores assessing provider confidence after program enrollment in the areas of diagnosing (mean 3.7, SD 0.8), prescribing medications (mean 3.6, SD 0.9), and managing child mental health problems (mean 3.5, SD 0.9) were all significantly greater than provider confidence before enrollment (<i>P</i> < 0.0001 for all).</p><p><strong>Conclusions: </strong>Our study revealed that most primary care providers utilizing the Wisconsin Child Psychiatry Consultation Program find it a valuable resource for diagnostic decision-making and improving patient outcomes. This suggests that expanded utilization of the program should be encouraged.</p>","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":"124 2","pages":"111-115"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683937","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}

{"title":"Next Steps: Teaching Future Generations an Interprofessional Approach to Diabetic Foot Ulcer Care.","authors":"Shalvi B Parikh, Jamie N LaMantia, Meghan B Brennan, Jessica S Tischendorf","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to assess the effectiveness of interprofessional teaching sessions focused on the care of patients with diabetic foot ulcers.</p><p><strong>Methods: </strong>We conducted a pre-/post-intervention, quasi-experimental study with repeat evaluations on either side of the teaching sessions (n = 28). Surveys and chart reviews were used to assess changes in attitude, knowledge, practice, and patient outcomes.</p><p><strong>Results: </strong>All 5 infectious disease fellows favorably reviewed the sessions. Positive baseline attitudes towards interprofessional care further improved with respect to shared learning and teamwork (5-point Likert scale scores pre- and post-session: 4.13 vs 4.44, respectively, <i>P</i> < 0.01). No other significant changes were observed.</p><p><strong>Discussion: </strong>Our sessions were associated with improved attitudes toward interprofessional care but likely need to be augmented with experiential learning to achieve practice and outcome improvements.</p>","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":"124 1","pages":"55-58"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056364","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}

{"title":"Association of Rare Variants in Kidney Developmental Genes With Chronic Kidney Disease and Blood Pressure: A UK Biobank Study.","authors":"Benjamin L Spector, Byunggil Yoo, Neil Miller, Monica Gaddis, Isabelle Thiffault, Laurel Willig","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic kidney disease (CKD) and hypertension are heritable traits. The source of this heritability remains largely unknown, and exploration has been limited principally to common genetic variants, with few studies having examined rare variants.</p><p><strong>Methods: </strong>In this cross-sectional observational study, we evaluate whole exome sequencing data using the UK Biobank to identify the ability of rare variants in 58 kidney developmental genes to predict CKD or elevated blood pressure using logistic regression models with subgroup analysis performed by ancestry.</p><p><strong>Results: </strong>Significant predictors of CKD included rare variants in <i>CLCN5</i> (OR 1.59; 99% CI, 1.02-2.47; <i>P</i> = 0.007). Predictors of blood pressure included rare variants in <i>SIX1</i> (OR 0.57; 99% CI, 0.35-0.94; <i>P</i> = 0.004) and <i>NPHS1</i> (OR 0.84; 99% CI, 0.72-0.99; <i>P</i> = 0.005), which were protective against blood pressure elevation, and <i>WT1</i> (OR 1.58; 99% CI, 1.02-2.45; <i>P</i> = 0.007), which was associated with elevated blood pressure. In individuals of White British ancestry, rare variants in <i>SIX1</i> protected against elevated blood pressure (OR 0.58; 99% CI, 0.34-0.99; <i>P</i> = 0.009). Among individuals of non-White British ancestry, predictors of CKD included rare variants in <i>SLC12A3</i> (OR 2.02; 99% CI, 1.08-3.78; <i>P</i> = 0.004) and <i>CALB1</i> (OR 3.12; 99% CI, 1.15-8.47; <i>P</i> = 0.003). Presence of rare variants in <i>WT1</i> significantly predicted elevated blood pressure (OR 2.49; 99% CI, 1.08-5.78; <i>P</i> = 0.005).</p><p><strong>Conclusions: </strong>From this study, we conclude that rare variants in kidney developmental genes contribute to the risk of developing CKD and elevated blood pressure. These associations vary by ancestry.</p>","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":"124 1","pages":"27-35"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036477","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}

{"title":"Assessing the Educational Needs of Wisconsin Primary Care Clinicians Caring for Persons Living With Dementia.","authors":"Tyler Ballweg, Tamara J LeCaire, Uriel Paniagua, Molly Schroeder, Tammi Albrecht, Sarina Schrager, Cynthia M Carlsson, Art Walaszek","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Nearly 90% of persons living with dementia experience behavioral and psychological symptoms of dementia (BPSD). Primary care clinicians may require more training to address these symptoms.</p><p><strong>Methods: </strong>We surveyed Wisconsin primary care clinicians to assess their current approaches, needs, and interest in future educational interventions related to managing BPSD.</p><p><strong>Results: </strong>Over 60% of clinicians reported lack of ability or training in managing BPSD, while over 75% expressed interest in educational interventions that included discussion of treatment algorithms or virtual didactics.</p><p><strong>Discussion: </strong>Given the apparent widespread demand and need for educational interventions on BPSD for primary care clinicians, future studies are needed to assess the efficacy of such interventions in improving clinicians' preparedness to care for patients with BPSD.</p>","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":"124 2","pages":"153-156"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683920","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}

{"title":"A Case of Allopurinol-Induced Drug Reaction with Eosinophilia and Systemic Symptoms in a Patient With Polycystic Kidney Disease and Chronic Kidney Disease.","authors":"Emily Koller, Neil Dixit, Remy Lee, Pinky Jha","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe drug hypersensitivity reaction.</p><p><strong>Case presentation: </strong>A 59-year-old male with a history of stage IV chronic kidney disease, polycystic kidney disease, hypertension, and hyperuricemia on allopurinol presented to the emergency department directly from an outpatient nephrology appointment with concern for severe DRESS syndrome with acute-on-chronic kidney failure, liver failure, and pancreatic involvement.</p><p><strong>Discussion: </strong>The existing literature on the course of DRESS syndrome in patients with preexisting kidney dysfunction is limited.</p><p><strong>Conclusions: </strong>We report a case of DRESS syndrome in a patient with chronic kidney disease who presented after initiating allopurinol for hyperuricemia. Care should be taken to quickly identify DRESS, stop the offending agent, and initiate systemic corticosteroids to prevent long-term morbidity and mortality. Furthermore, patient counseling should emphasize follow-up to identify and treat potential long-term sequelae, including thyroiditis and cardiac disease.</p>","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":"124 2","pages":"169-172"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683917","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}

{"title":"Epidemiology of Xylazine-Positive Fatal Overdoses in Milwaukee County, Wisconsin, 2019-2023.","authors":"Max Mantych, Cassandra Laibly, Hunter Russell, Kirsten M M Beyer, Yuhong Zhou, Ronald Anguzu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Xylazine association with fentanyl poses an emerging threat to public health. We conducted a retrospective study to analyze xylazine-related fatal overdoses in Milwaukee County, Wisconsin from 2019 through 2023.</p><p><strong>Methods: </strong>Using medical examiner data, we compared fatal xylazine overdoses (n = 243) with fentanyl overdoses without xylazine (n = 1946). Demographic, polysubstance, temporal, and geographic characteristics were analyzed.</p><p><strong>Results: </strong>Xylazine fatalities have surged since 2019, exhibiting different polysubstance profiles than fentanyl overdoses without xylazine. We identified 8 geospatial clusters contributing to 64% of xylazine overdoses.</p><p><strong>Discussion: </strong>We encourage localized interventions to address the xylazine-fentanyl syndemic. Policy measures such as Wisconsin Act 217, which legalized xylazine testing materials, promote evidence-based harm reduction tools to mitigate the risks associated with xylazine's increasing prevalence in the Midwest.</p>","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":"124 2","pages":"148-152"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683926","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}

{"title":"Proceedings from the 2024 Medical College of Wisconsin Innovations in Healthcare Education Research Annual Conference.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":"124 2","pages":"196-198"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683938","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}

{"title":"A Qualitative Assessment of Interprofessional Knowledge Gaps in the Setting of Child Physical Abuse.","authors":"Elizabeth A Cleek, Lynn K Sheets, Joshua P Mersky, Joan P Totka, Kristin A Haglund","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Health care professionals can protect children by identifying and reporting injuries concerning for child physical abuse, such as sentinel injuries (bruising and intra-oral injuries in precruising infants). Citing knowledge and collaboration barriers, health care professionals sometimes fail to recognize sentinel injuries as concerning for abuse. Interprofessional education may be an ideal format to improve health care professional's responses to sentinel injuries. However, it is traditionally limited to health care professions, while responding to suspected child physical abuse requires collaboration between health care professionals and non-health care professionals. This study's purpose was to understand if an interprofessional education framework could support the need and development of interprofessional education for child physical abuse beyond health care professions.</p><p><strong>Methods: </strong>Data were collected through semistructured interviews and analyzed using a qualitative descriptive methodology. Participants included 27 professionals who had engaged in child physical abuse responses in a US midwestern urban county. Participant professions included health care, child protective services, law enforcement, courts, victim advocates, and child advocacy center employees.</p><p><strong>Results: </strong>Six themes were identified: 4 themes aligned with competencies of the interprofessional education framework, 1 described engaging with families, and 1 described features unique to sentinel injury investigations.</p><p><strong>Conclusions: </strong>This study supports the need for child physical abuse interprofessional education beyond health care professions. Legal thresholds for responding to suspected abuse differ by profession, and there is no shared interprofessional language around child physical abuse. This contributes to a steep learning curve for new professionals. This study also supports that an existing interprofessional education framework can provide the foundational framework for development of such education.</p>","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":"124 1","pages":"10-16"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059403","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}