WMJ : official publication of the State Medical Society of Wisconsin最新文献_第3页

Use of a PHQ-9 Heat Map to Facilitate Management Decisions in Patients With Depression. 使用 PHQ-9 热图促进抑郁症患者的管理决策。

WMJ : official publication of the State Medical Society of Wisconsin Pub Date : 2024-09-01

Steven L Rosas, Mark E Deyo-Svendsen, Rachael R Taylor, Michael R Taylor, Austin Fowler, Lauren Casey

引用次数: 0

Concurrent Acute Heart Failure and Renal Failure in Amyloid Light Chain Amyloidosis. 淀粉样轻链淀粉样变性并发急性心力衰竭和肾衰竭。

WMJ : official publication of the State Medical Society of Wisconsin Pub Date : 2024-07-01

Kyle Cass, Lila Luna, William Kivlin, Buckley Fechter, Hari Paudel

{"title":"Concurrent Acute Heart Failure and Renal Failure in Amyloid Light Chain Amyloidosis.","authors":"Kyle Cass, Lila Luna, William Kivlin, Buckley Fechter, Hari Paudel","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Amyloid light chain (AL) amyloidosis is a multisystem disease with significant variability in patient presentation. This case describes the presentation and workup of a patient with unique multiorgan involvement on initial presentation.Case presentation: A 69-year-old African American male presented with weakness, leg swelling, and shortness of breath. Initial workup demonstrated acute heart failure and acute-on-chronic renal failure with nephrotic range proteinuria (5.78 protein to creatinine ratio). Further workup showed elevated serum protein electrophoresis, urine protein electrophoresis, and light chains. Subsequent renal biopsy showed lambda-restricted AL-type renal amyloidosis.Discussion: A variety of systemic presentations have been described in the literature; however, concurrent heart and renal failure as primary presentation is uncommon.Conclusions: This case emphasizes the importance of considering systemic inflammatory diseases, such as amyloidosis, in the differential diagnoses of patients with unexplained multiorgan disease. Early diagnosis and treatment initiation are essential for improving patient outcomes. Improved recognition of common clinical manifestations and laboratory abnormalities will likely improve outcomes through earlier diagnosis.","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141725446","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 of Disseminated Mycobacterium Haemophilum in a Kidney Transplant Recipient Presenting With Subcutaneous Nodules. 一例表现为皮下结节的肾移植受者体内播散的嗜血分枝杆菌病例

WMJ : official publication of the State Medical Society of Wisconsin Pub Date : 2024-07-01

Xi Ran Li, Devesh Kumar, Amber Y Bo, Jenna T Le, Ariana Ellis, Kara Young, Karolyn A Wanat, Mohan Dhariwal, Pinky Jha, Jaime Green, Sol Aldrete

{"title":"A Case of Disseminated Mycobacterium Haemophilum in a Kidney Transplant Recipient Presenting With Subcutaneous Nodules.","authors":"Xi Ran Li, Devesh Kumar, Amber Y Bo, Jenna T Le, Ariana Ellis, Kara Young, Karolyn A Wanat, Mohan Dhariwal, Pinky Jha, Jaime Green, Sol Aldrete","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Dermatologic manifestations of diseases in solid organ transplant recipients are common due to long-term immunosuppression.Case presentation: We present the case of a 63-year-old man with a kidney transplant who exhibited subcutaneous nodules on lower extremities, cytopenia, and asymptomatic pulmonary infiltrate. Through a skin biopsy and 16S ribosomal RNA (rRNA) sequencing, Mycobacterium haemophilum was identified. His clinical course was complicated by empyema, septic arthritis, and recurrence of his skin manifestations, despite ongoing antimicrobial treatment.Discussion: This case emphasizes the challenges and potential complications associated with M haemophilum infections in solid organ transplant recipients receiving long-term immunosuppressive therapy. It highlights the importance of employing advanced diagnostic techniques when evaluating dermatologic manifestations in these patients. The patient's complex clinical course also underscores the difficulties involved in effectively addressing and managing complications that may arise even after initiating therapy.","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141725441","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

Peripartum Uterine Clostridial Myonecrosis: A Report of Two Fatal Cases. 围产期子宫梭菌性肌坏死：两例死亡病例的报告

WMJ : official publication of the State Medical Society of Wisconsin Pub Date : 2024-07-01

Laura Jacques, Bridget Kelly, Joen Soehl, Matthew Wagar, Janine Rhoades, Elise S Cowley, Peter G Pryde, Abigail Cutler, David Eschenbach

{"title":"Peripartum Uterine Clostridial Myonecrosis: A Report of Two Fatal Cases.","authors":"Laura Jacques, Bridget Kelly, Joen Soehl, Matthew Wagar, Janine Rhoades, Elise S Cowley, Peter G Pryde, Abigail Cutler, David Eschenbach","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Uterine clostridial myonecrosis is a rare infection associated with a high mortality rate. This report presents 2 cases of maternal mortality resulting from peripartum clostridial myonecrosis of the uterus.Case presentation: Case 1 is a 30-year-old woman (nullipara) who presented in labor at term with an intra-amniotic infection and fetal demise. She rapidly developed septic shock, and cesarean hysterectomy was performed for a suspected necrotizing uterine infection later identified to be Clostridium septicum. Case 2 is an adolescent who presented in septic shock following first trimester medication abortion and died during emergent exploratory laparotomy; cultures grew Clostridium sordellii. Both patients expired within 18 hours of hospital admission.Discussion: Given the rapidly progressive course of clostridial infections, maintaining a high index of suspicion is imperative for ensuring timely diagnosis and effective treatment. Prompt recognition of clinical features associated with clostridial myonecrosis - abdominal pain, tachycardia, leukocytosis and hyponatremia - is essential in preventing mortality. The utilization of point-of-care ultrasound may expedite the diagnosis of uterine myonecrosis. When uterine myonecrosis is suspected, immediate initiation of penicillin-based antibiotics, alongside clindamycin, and aggressive surgical intervention including hysterectomy are essential for ensuring survival. Although the decision to perform a hysterectomy can be challenging, especially in cases involving child-bearing-aged patients, it is a vital step to avert a fatal outcome.Conclusions: By presenting these cases, we aim to raise awareness of this uncommon, but highly lethal infection to expedite diagnosis and treatment to improve patient outcomes.","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141725456","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

Perspectives on Weight Stigma and Bias in Medical Education: Implications for Improving Health Outcomes. 透视医学教育中的体重羞辱和偏见：改善健康结果的意义。

WMJ : official publication of the State Medical Society of Wisconsin Pub Date : 2024-07-01

Erin Lm Bowden, Elizabeth M Petty

引用次数: 0

Abortion Attitudes and Behavioral Intentions of Obstetrics and Gynecology Residents at Four Midwestern Residency Programs Prior to Dobbs v Jackson Women's Health. 在多布斯诉杰克逊妇女健康案之前，美国中西部四个住院医师培训项目的妇产科住院医师对堕胎的态度和行为意向》（Abortion Attitudes and Behavior Intentions of Obstetrics and Gynecology Residents at Four Midwestern Residency Programs prior to Dobbs v Jackson Women's Health.

WMJ : official publication of the State Medical Society of Wisconsin Pub Date : 2024-07-01

Abigail S Cutler, Elise S Cowley, Jessika A Ralph, Jessie Chen, Amy Godecker, Jordan Ward, Sarah Hutto, Laura Jacques

{"title":"Abortion Attitudes and Behavioral Intentions of Obstetrics and Gynecology Residents at Four Midwestern Residency Programs Prior to Dobbs v Jackson Women's Health.","authors":"Abigail S Cutler, Elise S Cowley, Jessika A Ralph, Jessie Chen, Amy Godecker, Jordan Ward, Sarah Hutto, Laura Jacques","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: In June 2022, the United States Supreme Court announced its decision in Dobbs v Jackson Women's Health Organization to overturn Roe v Wade. As a result, half of US states now face proposed or in-effect abortion bans, which affect the ability of obstetrics and gynecology (ObGyn) residency programs to provide abortion training. We sought to establish ObGyn residents' pre-Dobbs attitudes toward abortion, desire to learn about abortion, and intentions about providing abortion care in their future practice.Methods: From January through December 2021, we surveyed 70 ObGyn residents at 4 programs in Wisconsin and Minnesota to assess their attitudes toward abortion, desire to learn about abortion, and intentions about providing abortion care in their future practice.Results: Fifty-five out of 70 (79%) ObGyn residents completed the survey. Most reported highly favorable attitudes toward abortion, nearly all found the issue of abortion important, and the majority planned to incorporate abortion care into their future work. There were no differences in median attitude scores or behavioral intentions among institutions.Conclusions: Prior to the Dobbs decision, ObGyn residents in Minnesota and Wisconsin viewed abortion as important health care and intended to provide this care after graduation.","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141725442","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

Vigilance Needed in Polypharmacy Drugs. 多药合用的药物需要警惕。

WMJ : official publication of the State Medical Society of Wisconsin Pub Date : 2024-07-01

Pugazhenthan Thangaraju, Sajitha Venkatesan

引用次数: 0

Statistical Thinking: Clinical Versus Statistical Significance. 统计思维：临床意义与统计意义。

WMJ : official publication of the State Medical Society of Wisconsin Pub Date : 2024-07-01

Robert A Calder, Jayshil J Patel

引用次数: 0

The Burden of Burnout and Importance of Mentorship for Preclinical Medical Students: Perspectives From a Public University Medical School. 临床前医学生的职业倦怠负担和导师制的重要性：来自公立大学医学院的视角。

WMJ : official publication of the State Medical Society of Wisconsin Pub Date : 2024-07-01

Angela Kristo, Elizabeth M Petty

{"title":"The Burden of Burnout and Importance of Mentorship for Preclinical Medical Students: Perspectives From a Public University Medical School.","authors":"Angela Kristo, Elizabeth M Petty","doi":"","DOIUrl":"","url":null,"abstract":"Background: Physician burnout often stems from burnout in medical students that began during the first year of medical education. Individual factors contributing to burnout must be considered within the demands of rigorous curricula and personal ambitions. This study focused on understanding how burnout is perceived by students and the impact mentorship had on its incidence and onset.Methods: A literature review guided the development of a facilitator guide that outlined factors causing burnout. Preclinical medical students from the University of Wisconsin School of Medicine and Public Health were recruited for online focus groups. Responses were analyzed using hierarchical inductive coding, and identified themes were utilized to create a 2-part electronic Qualtrics survey focused on key aspects and timepoints of burnout. Part A of the survey was sent the summer after the first year of medical school (M1), and Part B was sent after the final course of the second year (M2).Results: Nineteen percent of students agreed they entered medical school burnt out. The percentage of survey respondents who were not burnt out at each consecutive block in their first year decreased from 80% during the first block to 20% at the beginning of the last block. Focus group and survey results found that mentorship had positive effects on burnout, and students noted increased needs for mental health services.Conclusions: Understanding key pressure points and essential resources for addressing student burnout allows for improved education and personal outcomes. Alleviating factors were strong mentorship, mental health resources, and streamlined faculty communication. Increasing burnout highlights the importance of interventions to reduce long-lasting effects on student performance and well-being.","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141725460","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

Assessment of a Pilot Peer Support Program for Suicide Prevention on a Medical School Campus: Impact on Awareness, Stigma, and Self-Efficacy for Outreach. 医学院校园自杀预防同伴支持试点项目评估：对外联意识、耻辱感和自我效能的影响。

WMJ : official publication of the State Medical Society of Wisconsin Pub Date : 2024-07-01

Cassandra Balson, Justin York, David Cipriano, Jeffery D Fritz, Sara Kohlbeck, Shane Huang, Margaret Lieb

引用次数: 0