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

{"title":"An Initial Evaluation of a Peer Mentorship Program in a Medical School Clinician Educator Scholarly Concentration.","authors":"Zack Gratz, Chase Caswell, Alexa Kambol, Quinn Anderson, Amanda Jentsch, Nawara Abufares, Sean Mackman, Kelsey Ryan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Traditional faculty mentorship in medical education is limited by availability and specificity of advice. Peer mentorship may complement this model by supporting mentees' transition into medical school while promoting mentors' teaching and leadership skills. We implemented a peer mentorship program within an experiential learning course at a private Midwestern medical school to enhance students' understanding of core course components.</p><p><strong>Methods: </strong>First-year mentees were randomly assigned second- and third-year mentors. Six required sessions were embedded into course meetings across the academic year. A pre-implementation survey (pre-1, N = 65) and 2 post-surveys at the end of each semester (post-1, N = 31; post-2, N = 11) assessed students' understanding of course components and perceptions of the program. Survey outcomes were compiled as a total understanding score (TUS).</p><p><strong>Results: </strong>Comparing pre-1 to post-1 and post-2, understanding (P = .0026; P = .001, respectively) and development (P = .0037; P = .0019, respectively) of course competencies improved significantly. Scholarly project understanding and TUS improved significantly from pre-1 to post-1 (P = .0001; P = .0005, respectively) but not from pre-1 to post-2 (P = .0739; P = .0665, respectively). Understanding and development of individualized learning plans did not significantly improve across either interval. Consistent mentor groupings and integration into required sessions were rated most favorably among design components.</p><p><strong>Conclusions: </strong>Participation positively affected students' self-assessed success in competency-based learning. Structured peer mentorship embedded in existing curricula may address limitations of hierarchical models by providing scalable support for students in longitudinal medical education settings.</p>","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":"125 1","pages":"42-47"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694693","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":"An Online, Patient-Guided, Mental Health Tool Improves Anxiety Symptom Scores in Patients With Infertility.","authors":"Micaela Stevenson Wyszewianski, Paige Johnson, Ryan Hanson, Amy Pan, Melodee Liegl, Kate Schoyer, Jayme Bosler, Robert Rydze, Jamie Neary, Stephanie Gunderson","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Patients undergoing infertility evaluation and treatment frequently experience anxiety and depressive symptoms. Easily available and highly accessible online mental health tools have not previously been evaluated using validated screening measures in this population. The objective of this study was to assess whether SilverCloud, an online, self-guided mental health program, is associated with reductions in anxiety and depressive symptom scores among patients experiencing infertility.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted among female patients undergoing an initial infertility consultation at a single academic center. Patients completed Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) questionnaires and were offered enrollment in SilverCloud at their initial infertility consultation. Baseline PHQ-9 and GAD-7 scores from initial consultations were compared between patients who enrolled in SilverCloud and those who did not. For patients who engaged in SilverCloud, Wilcoxon signed-rank tests were used to compare PHQ-9 and GAD-7 scores before and after completion of SilverCloud modules.</p><p><strong>Results: </strong>A total of 354 patients were included in the analysis. Fifty-two patients enrolled in SilverCloud, and 32 completed at least 1 module. Baseline data demonstrated that patients who enrolled in SilverCloud had significantly higher GAD-7 scores (0.5 vs 0; P = .006). Among patients who completed at least 1 SilverCloud module, PHQ-9 and GAD-7 scores decreased significantly decreased after engagement (PHQ-9: 8.0 vs 6.5; P 7lt; .04; GAD-7: 12.5 vs 9.5; P = .02).</p><p><strong>Conclusions: </strong>Patients experiencing infertility who utilized SilverCloud experienced significant decreases in PHQ-9 and GAD-7 scores, suggesting improvement in anxiety and depression symptoms.</p>","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":"125 3","pages":"366-370"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803936","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":"Bridging the Gap: Enhancing Pediatric Readiness in Wisconsin's Community Emergency Departments.","authors":"Maureen Luetje, Carissa Brunner, Lorin R Browne, Michael K Kim","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Quality pediatric emergency care across the United States is inconsistent. Geographic distance, lack of resources and education can affect the care. This project set out to improve pediatric readiness in at least 20 Wisconsin emergency departments (EDs) statewide.</p><p><strong>Methods: </strong>The program developed a pediatric readiness guide, recruited EDs to participate, and implemented pediatric readiness interventions within the EDs. Each ED completed the National Pediatric Readiness Project (NPRP) Assessment at the start of the program and a postimplementation assessment at the end, with the goal to improve ED pediatric readiness scores by 10% or more.</p><p><strong>Results: </strong>Over 36 months, 23 EDs from diverse settings participated in the program. The median [IQR] NPRP score increased from 60.2 (51.5-74.2) to 81.1 (74.7-87.8). Nineteen EDs improved by over 10%.</p><p><strong>Discussion: </strong>The targeted intervention improved pediatric readiness in 20 EDs from diverse settings and emphasizes the role of leadership and structured guidance to improve care provided to children in Wisconsin.</p>","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":"125 3","pages":"398-401"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804025","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":"De Novo Hepatocellular Carcinoma in Primary Sclerosing Cholangitis Post-Liver Transplant: The Case for Surveillance.","authors":"Anneleise Frie, Adnan Said","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>While recurrent primary sclerosing cholangitis and de novo malignancies such as skin cancer are common after liver transplantation, de novo hepatocellular carcinoma (HCC) after liver transplantation for primary sclerosing cholangitis is exceedingly rare.</p><p><strong>Case presentation: </strong>A 72-year-old man with ulcerative colitis underwent liver transplantation for primary sclerosing cholangitis. Thirty years later, abdominal imaging incidentally revealed cirrhotic liver morphology with a new, bulky, and locally invasive hepatic mass. Biopsy confirmed stage IIIA hepatocellular carcinoma, which was treated successfully with Y-90 radioembolization segmentectomy.</p><p><strong>Discussion: </strong>Immunosuppression-related malignancies are prevalent in long-term liver transplant survivors, and HCC recurrence can occur in patients transplanted for HCC. However, de novo HCC is rare in liver transplant recipients with primary sclerosing cholangitis and has primarily been reported in patients with viral hepatitis.</p><p><strong>Conclusions: </strong>Vigilant screening for allograft fibrosis, cirrhosis, and malignancy using emerging modalities in long-time liver transplant survivors warrants consideration.</p>","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":"125 3","pages":"407-409"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804095","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":"Effectiveness of Group Medical Visits for Patient Wellness: A Mixed Method Study Within UW Health.","authors":"Isabella Rodriguez Cardenas, Sarah Walters, Lisa Simpson, Magnolia Larson, Karina Viloria Rodrigues, Kaitlin Tetreault, Alex Pinto, Greta Kuphal, Bruce Barrett","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic medical conditions affect approximately 129 million Americans. The complexities of chronic illness, coupled with limited health care resources and clinician time, can complicate treatment management, and contribute to poor health outcomes. The effect of group medical visits (GMVs) on patient wellness has not been well established.</p><p><strong>Methods: </strong>Mixed-methods approach using both quantitative and qualitative data was used to evaluate wellness following completion of GMV programs. Patients completed pre- and post-GMV assessments using the Patient-Reported Outcomes Measurement Information System (PROMIS)-29. GMV programs included Yoga for Cancer, Stress Reduction and Resiliency, Mindful Eco-Wellness, and Mindfulness for Your Health from 2017 to 2024. The PROMIS-29 is a validated health questionnaire that assesses 7 domains: anxiety, depression, fatigue, sleep disturbance, participation in social roles, pain, and physical function. Clinicians and patients also participated in qualitative interviews regarding their GMV experiences.</p><p><strong>Results: </strong>Among 76 participants who completed pre- and post-GMV PROMIS-29 assessments, fatigue scores improved and participation in social roles increased significantly. Improvements were also observed in anxiety, depression, sleep disturbance, and physical function, although these changes were not statistically significant. Themes identified from interviews with 15 clinicians and 10 patients included patient empowerment, sense of community, patient satisfaction, integrative care, and trust.</p><p><strong>Discussion: </strong>Improvements in PROMIS-29 domains suggest that GMVs may have the potential to enhance patient health and wellness. The themes discovered portray a positive outlook on GMVs, with mindfulness practices and the sense of community that is cultivated within a group setting highlighted as especially important.</p><p><strong>Conclusions: </strong>GMVs were associated with improvements in fatigue and participation in social roles and were viewed favorably by patients and clinicians. Although additional controlled studies are needed, GMVs may represent a promising approach to supporting wellness among patients living with chronic conditions.</p>","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":"125 3","pages":"378-382"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804113","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":"Sitosterolemia: A Rare Cause of Severe Hypercholesterolemia in Children.","authors":"Daniel Beacher, Amy Ott, Rebecca Plier","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Severe hypercholesterolemia in children is commonly caused by familial hypercholesterolemia (FH); however, sitosterolemia, a rare autosomal recessive disorder, should be considered when FH genetic testing is negative.</p><p><strong>Case presentation: </strong>A 4-year-old boy presented with xanthomas on his knees. His total cholesterol was 561 mg/dL. Initially, homozygous FH was suspected, and rosuvastatin was started; however, genetic testing was negative. Subsequent genetic testing identified a homozygous ABCG8 variant, consistent with sitosterolemia. Rosuvastatin was discontinued, and ezetimibe and dietary plant sterol restriction were initiated, resulting in significant improvement in cholesterol levels and resolution of xanthomas.</p><p><strong>Discussion: </strong>Sitosterolemia results from impaired ABCG5/8 transporter function, leading to plant sterol accumulation, which can cause hypercholesterolemia, xanthomas, and hematologic abnormalities. Diagnosis is established by demonstrating elevated plant sterol levels or through genetic testing. Treatment involves dietary plant sterol restriction and ezetimibe.</p><p><strong>Conclusions: </strong>Sitosterolemia, though rare, should be considered in severe hypercholesterolemia when FH genetic testing is negative. This case demonstrates a typical presentation and favorable response to treatment with ezetimibe and dietary modification.</p>","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":"125 3","pages":"414-417"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804166","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":"The Health and Environmental Costs of Artificial Intelligence.","authors":"Caidon Iwuagwu, Abby Novinska-Lois, Joanne Bernstein","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":"125 3","pages":"338-339"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804229","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 Challenging Case of Creutzfeldt-Jakob Disease Presenting as Stroke.","authors":"Kassandra Ogbodu, Morgan Lucero, Pinky Jha","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Early recognition of Creutzfeldt-Jakob disease relies on awareness of its clinical variability, particularly in patients with complex medical comorbidities.</p><p><strong>Case presentation: </strong>A 66-year-old woman presented with generalized weakness, tremor, double vision, and slurred speech. Initial imaging and laboratory studies were unremarkable, except for subtle magnetic resonance imaging findings suggestive of encephalitis. Despite treatment with methylprednisolone, her condition worsened. Repeat magnetic resonance imaging raised suspicion for Creutzfeldt-Jakob disease, which was confirmed by cerebrospinal fluid real-time quaking-induced conversion positivity and elevated total tau protein. She succumbed to the disease within a month.</p><p><strong>Discussion: </strong>Creutzfeldt-Jakob disease is a rare, rapidly progressive prion disease that is often misdiagnosed due to nonspecific early symptoms. Extensive imaging and laboratory investigations may delay diagnosis, as seen in this case.</p><p><strong>Conclusions: </strong>This case highlights the diagnostic challenges and rapid progression of Creutzfeldt-Jakob disease, emphasizing the need for early recognition and standardized intervention to improve patient care.</p>","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":"125 2","pages":"290-293"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206907","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":"ACGME Mandated Scholarship: Process and Product - A Proposed Process to Maximize Trainee Experience.","authors":"Amanda M Jentsch, Alexandra C Istl, Tammy L Kindel, Jacob R Peschman","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":"125 1","pages":"228-230"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694586","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":"Utilization of a Resident-as-Educator Model in Pathology: Unique Challenges, Opportunities, and Recommendations.","authors":"Alex P Tannenbaum, Mary Adenhamm, Matthew R Contreras, Erin G Brooks","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":"125 1","pages":"115-117"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694664","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}