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An Unusual Case of Disseminated Erdheim-Chester Disease. 一个罕见的播散性埃尔德海姆-切斯特病病例
WMJ : official publication of the State Medical Society of Wisconsin Pub Date : 2024-07-01
Samira Samant, Andrii Puzyrenko, Haisam Abid
{"title":"An Unusual Case of Disseminated Erdheim-Chester Disease.","authors":"Samira Samant, Andrii Puzyrenko, Haisam Abid","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Erdheim-Chester disease (ECD) is a rare non-Langerhans histiocytic multisystem disorder, deriving from mononuclear phagocytic cells. It is notoriously challenging to diagnose. Here we present a case of a patient with multisystem ECD.</p><p><strong>Case presentation: </strong>A 76-year-old female with a history of Hashimoto's thyroiditis who presented with persistent leukocytosis was found to have bilateral renal enlargement with a perinephric mass, a recurrent pericardial effusion, and bilateral pleural effusions. Following biopsies of several sites of involvement, a diagnosis of ECD was made.</p><p><strong>Discussion: </strong>The existing literature on ECD is sparse, and no diagnostic criteria have been put forward due to widely differing presentations, although the most common is skeletal. Definitive diagnosis requires a tissue sample.</p><p><strong>Conclusions: </strong>In presenting our clinical reasoning and approach, we hope to contribute to the existing body of literature on ECD, with the aim of ultimately having sufficient data to compile a diagnostic framework for other clinicians who encounter ECD.</p>","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":"141725443","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
The Future of Global Neurosurgery: Invest in People and Education in Areas of Need. 全球神经外科的未来：在需要的领域投资人才和教育。
WMJ : official publication of the State Medical Society of Wisconsin Pub Date : 2024-07-01
Robert J Dempsey, Robert N Golden
{"title":"The Future of Global Neurosurgery: Invest in People and Education in Areas of Need.","authors":"Robert J Dempsey, Robert N Golden","doi":"","DOIUrl":"","url":null,"abstract":"","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":"141725461","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
Partnering is Paramount: Engaging Care Partners to Improve Delirium Identification. 合作至关重要：让护理合作伙伴参与进来，提高谵妄识别能力。
WMJ : official publication of the State Medical Society of Wisconsin Pub Date : 2024-07-01
Blair P Golden, Farah A Kaiksow, Amy Jh Kind
{"title":"Partnering is Paramount: Engaging Care Partners to Improve Delirium Identification.","authors":"Blair P Golden, Farah A Kaiksow, Amy Jh Kind","doi":"","DOIUrl":"","url":null,"abstract":"","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":"141725455","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
Qualitative Pilot Study: Longitudinal Perspectives From People Who Had Second Trimester Abortions for Fetal Anomaly. 定性试点研究：因胎儿畸形进行第二孕期人工流产者的纵向视角。
WMJ : official publication of the State Medical Society of Wisconsin Pub Date : 2024-07-01
Elise S Cowley, Taryn M Valley, Kelsey Christianson, Suzanne Walczak, Jessica A Greenblatt, Laura Jacques
{"title":"Qualitative Pilot Study: Longitudinal Perspectives From People Who Had Second Trimester Abortions for Fetal Anomaly.","authors":"Elise S Cowley, Taryn M Valley, Kelsey Christianson, Suzanne Walczak, Jessica A Greenblatt, Laura Jacques","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>We investigated patient experience with abortion for fetal anomaly, about which little is known.</p><p><strong>Methods: </strong>This qualitative, longitudinal pilot study surveyed 7 patients twice after abortion for fetal anomaly, initially 4 to 5 days after the abortion and a follow-up 3 months post-abortion, at a single Wisconsin hospital from July 2012 to February 2014.</p><p><strong>Results: </strong>Patients indicated that having a choice to have an abortion and choose the modality is imperative, and they remained certain in their decision-making over time. They also described initially strong, then lacking, social support; processed grief; and identified resource constraints.</p><p><strong>Discussion: </strong>Patients emphasized the importance of having the choice to choose abortion and the abortion modality, remaining confident in their decision-making over time. This qualitative pilot study provides areas for future intervention to improve care for people undergoing abortion for fetal anomaly.</p>","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":"141725458","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
'I'm So Proud of How Hard You're Trying': A Photovoice Analysis of Youth Mental Health and Wellness in Wisconsin. 我为你的努力感到骄傲"：威斯康星州青少年心理健康与幸福的摄影选择分析》。
WMJ : official publication of the State Medical Society of Wisconsin Pub Date : 2024-07-01
Sara Kohlbeck, Patricia Monroe
{"title":"'I'm So Proud of How Hard You're Trying': A Photovoice Analysis of Youth Mental Health and Wellness in Wisconsin.","authors":"Sara Kohlbeck, Patricia Monroe","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Understanding youth and young adult mental health and well-being is critical to addressing rates of suicide among this population. This qualitative study sought to gather additional perspectives of students across Wisconsin using photovoice methods to enhance understanding of their experiences and to inform future policies and programs. A total of 11 youth and young adults ages 14 to 26 participated by taking pictures in response to given prompts and then discussing those pictures within a virtual focus group. Spanning the social-ecological framework, 4 themes emerged from the photographs and discussion: (1) individual-level factors drive mental health and well-being; (2) the support of interpersonal relationships is crucial; (3) school-related factors are predominant sources of stress; (4) policies, culture, and systems influence well-being. This study highlights the unique experiences of youth and young adults and underscores the impact of systems and structures on their mental health and well-being.</p>","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":"141725449","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 Electronic Nicotine Delivery System Use Cessation Among Adults in Rural Areas: Implications for Future Studies. 农村地区成人戒烟使用电子尼古丁输送系统的前景：对未来研究的启示
WMJ : official publication of the State Medical Society of Wisconsin Pub Date : 2024-05-01
Seok Hyun Gwon, Vipavee Thongpriwan, Yourim Kim, Imteyaz El Jarrah, Amani Mobarki, Young Ik Cho, Han Joo Lee, Alex Nelson, Devon Noonan
{"title":"Perspectives on Electronic Nicotine Delivery System Use Cessation Among Adults in Rural Areas: Implications for Future Studies.","authors":"Seok Hyun Gwon, Vipavee Thongpriwan, Yourim Kim, Imteyaz El Jarrah, Amani Mobarki, Young Ik Cho, Han Joo Lee, Alex Nelson, Devon Noonan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>More young adults (age 18-24 years) in rural areas versus urban areas use electronic nicotine delivery systems (ENDS) - also known as e-cigarettes. Little is known about young adults' perceptions toward ENDS use and cessation. The objective of this study was to examine barriers and facilitators to ENDS use cessation among young adults living in rural areas, as well as their perceptions about ENDS use and cessation and to determine implications for future cessation studies.</p><p><strong>Methods: </strong>We administered cross-sectional online surveys to young adults living in rural Midwestern counties. A total of 100 individuals responded to the surveys. Descriptive statistics were used to report their perceptions of ENDS use as well as barriers and facilitators to ENDS use cessation. The content analysis method was used to analyze the answers to an open-ended question regarding perceptions about the ENDS use cessation in the context of rural areas.</p><p><strong>Results: </strong>Barriers to ENDS use cessation included perceived advantages to ENDS use, high nicotine dependence, and the perception that ENDS use was less harmful cigarettes. Facilitators to ENDS use cessation included cost of ENDS use, perceived harm, and high confidence in ability to quit. Participants' perceptions about ENDS use cessation in the context of rural areas were conceptualized under the themes of (1) exposure to and initiation of ENDS use, (2) continuation of ENDS use, and (3) prevention and cessation of ENDS use.</p><p><strong>Conclusions: </strong>Health care providers, tobacco control researchers, and public health advocates should be aware of barriers and facilitators to ENDS use cessation among young adults for future cessation intervention studies relevant specifically to rural areas.</p>","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140890637","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
Acute Myelomonocytic Leukemia Presenting as Fournier's Gangrene. 急性髓单核细胞白血病表现为福尼尔坏疽
WMJ : official publication of the State Medical Society of Wisconsin Pub Date : 2024-05-01
Sofie Kjellesvig, Emelyn Zaworski, Antoine N Saliba
{"title":"Acute Myelomonocytic Leukemia Presenting as Fournier's Gangrene.","authors":"Sofie Kjellesvig, Emelyn Zaworski, Antoine N Saliba","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Acute myelomonocytic leukemia is a type of acute myeloid leukemia with monocytic expansion. Both the disease and its treatment can be immunocompromising. Immunocompromised patients are more susceptible to infections, such as Fournier's gangrene, a rare necrotizing infection of the groin.</p><p><strong>Case presentation: </strong>A 56-year-old male presented to the emergency department with abdominal pain, leukocytosis, and perineal ecchymosis. Overnight, his perineal discoloration and tenderness worsened. He underwent irrigation and debridement for Fournier's gangrene and received broad-spectrum antimicrobial therapy. Subsequent workup revealed acute myeloid leukemia with leukemia cutis and central nervous system involvement, necessitating chemotherapy initiation prior to complete wound healing.</p><p><strong>Discussion/conclusions: </strong>This case highlights the challenges in the diagnosis and management of acute leukemia in the setting of a concomitant life-threatening soft tissue infection, as both the hematologic disease and treatment thereof can exacerbate infectious complications.</p>","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140893121","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
Hypokalemia Due to Ectopic Adrenocorticotropic Hormone. 异位促肾上腺皮质激素导致的低钾血症。
WMJ : official publication of the State Medical Society of Wisconsin Pub Date : 2024-05-01
Adil Ghaffar, Tripti Singh
{"title":"Hypokalemia Due to Ectopic Adrenocorticotropic Hormone.","authors":"Adil Ghaffar, Tripti Singh","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Hypokalemia is a common disorder in clinical practice. The underlying pathophysiology can be attributed to 3 main mechanisms: insufficient potassium intake, excessive urinary or gastrointestinal losses, and transcellular shift. Renal loss is the most common cause of hypokalemia. Renal loss of potassium can occur due to diuretics, mineralocorticoid excess or hypercortisolism (Cushing syndrome). Among patients with Cushing syndrome, ectopic adrenocorticotropic hormone (ACTH) is the most frequent cause. We present a case of hypokalemia and hypertension due to ectopic ACTH production leading to Cushing syndrome.</p>","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140893158","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
Follmann Balanitis: An Unusual Case of Syphilis. Follmann Balanitis：梅毒的罕见病例
WMJ : official publication of the State Medical Society of Wisconsin Pub Date : 2024-05-01
Milan Patel, Paige Gioia, Pinky Jha
{"title":"Follmann Balanitis: An Unusual Case of Syphilis.","authors":"Milan Patel, Paige Gioia, Pinky Jha","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 33-year-old man presented with suprapubic abdominal pain and small vesicular lesions on the foreskin of the penis. Based on the presentation, he was empirically treated for genital herpes, although the herpes simplex virus swab was negative. He returned to the emergency department 4 months after his initial presentation with worsening symptoms that were consistent with balanoposthitis and cystitis. He was tachycardic and febrile on presentation. He denied any sexual contact for the last 3 months, with previous negative screening tests for sexually transmitted infections. Syphilis was eventually diagnosed during this admission. The incidence rates of syphilis have increased in recent years, and the infection is often undiagnosed given atypical manifestations. Here we present an atypical manifestation of syphilis that was initially misdiagnosed as herpes simplex virus.</p>","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140893157","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
Use of Intravenous Lipid Emulsion Therapy and Insulin in a Case of Tarka Intoxication. 在一例塔卡中毒病例中使用静脉注射脂质乳剂疗法和胰岛素。
WMJ : official publication of the State Medical Society of Wisconsin Pub Date : 2024-05-01
Emrah Gün, Mahmut Çiçek, Mustafa Kafalı, Hüsnü Demir, İlknur Arslan, Tanıl Kendirli
{"title":"Use of Intravenous Lipid Emulsion Therapy and Insulin in a Case of Tarka Intoxication.","authors":"Emrah Gün, Mahmut Çiçek, Mustafa Kafalı, Hüsnü Demir, İlknur Arslan, Tanıl Kendirli","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Tarka (trandolapril/verapamil hydrohloride extended-release) is a fixed-dose combination antihypertensive drug formed from verapamil hydrochloride and trandolapril. Toxicologic manifestations of Tarka overdose are altered mental status, bradycardia, hypotension, atrioventricular block (first-degree), hyperglycemia, metabolic acidosis, and shock.</p><p><strong>Case presentation: </strong>We report a case of Tarka toxicity in a 2-year-old girl who presented with altered mental status, cardiogenic shock, hypotension, bradycardia, severe metabolic acidosis, hyperglycemia, and first-degree atrioventricular block. We started fluid resuscitation, epinephrine, norepinephrine, and insulin. Because of the patient's hyperlactatemia and hypotension despite standard therapies, we initiated intravenous lipid emulsion (ILE) therapy, after which her condition improved promptly.</p><p><strong>Discussion: </strong>Tarka overdose may be life-threatening as it can cause cardiogenic shock. In our patient, the regression of lactate elevation in a short time with ILE therapy and the improvement of her general condition highlight the importance of ILE.</p><p><strong>Conclusions: </strong>ILE is an alternative treatment method for acute lipophilic drug intoxications, such as Tarka.</p>","PeriodicalId":94268,"journal":{"name":"WMJ : official publication of the State Medical Society of Wisconsin","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140891762","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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