Focus On....Bioterrorism

Academic Dogs, or In Praise of Mutts

Kerry J. Russell

Over the years, I have come to realize that there are many breeds of dogs represented in the academy. Perhaps you will recognize yourself or a colleague in this brief canine compendium.



Author Affiliations: Mary Brydon-Miller, aka Kerry J. Russell, is Assistant Professor of Educational Foundations in the College of Education at the University of Cincinnati. She lives in Louisville, Kentucky with her husband, 10-year-old twin sons and neurotic dog, Mickey.

Corresponding Author: Please address correspondence to the Wisconsin Medical Society at 608.442.3800

Focus On... Technology in Medicine

The Internet as a medical education tool

Darold A. Treffert, MD

There are numerous ways to educate patients about general medical matters as well as specific patient problems. The best way, of course, is one on one communication with the doctor carefully explaining the specifics of that patients particular circumstance. But there seems to be less and less time for that in todays increasingly busy practices.



Author Affiliations: Doctor Treffert, past-president of the Wisconsin Medical Society and psychiatrist at St. Agnes Hospital in Fond du Lac, has studied Savant Syndrome for years. He is the author of the book Extraordinary People Understanding the Savant Syndrome, which chron

Corresponding Author: Please address correspondence to the Wisconsin Medical Society at 608.442.3800

Pocket Sized Power

Miriam Karmel

Arnold is one of a growing number of physicians who are convinced that PDAs allow them to keep more accurate medical records, lead to fewer medication prescribing errors, and give them more time with patients.



Author Affiliations: Miriam Karmel is a freelance writer living in Minneapolis. This article first appeared in the Minnesota Medical Associations journal.


Corresponding Author: Please address correspondence to the Wisconsin Medical Society at 608.442.3800

Saving Patients, Time and Trees

Marc Kennedy

Since the early 90s, computer gurus have been proclaiming the coming of the paperless society. However, most organizations, including medical centers and clinics, have remained stapled to the paper trail. For physicians, that usually meant the medical file in the manila folder that is available to one set of eyes at a time. But today, the promise has become reality, at least to an extent. With the advent of more sophisticated communications technology in the last few years, dovetailed with the dogged efforts during the last decade by many larger medical facilities to establish medical informatics systems that allow rapid access by multiple users, physicians are revolutionizing the way they maintain, update and access records. Now, many are taking the fast track instead of plodding along the paper trail while improving care and reducing medical errors along the way.


Author Affiliations: Special to WMJ

Corresponding Author: Please address correspondence to the Wisconsin Medical Society at 608.442.3800

Editorials

Technology changing medicine in the 21st century

Thomas C. Meyer, MD

Electronic medical records, physician websites, tele-medicine.

Author Affiliations: Medical Editor, WMJ

Corresponding Author: Please address correspondence to Wisconsin Medical Society at 608.442.3800

Wisconsin Medical Society helping patients and physicians connect on-line

Mark H. Andrew, MD

The solutions vary, but one thing is clear: patients and physicians alike long for simpler days. Ironically, technology may hold the key.



Author Affiliations: Doctor Andrew, president of the Wisconsin Medical Society, is a general surgeon practicing in Viroqua, WI.


Corresponding Author: Please address correspondence to the Wisconsin Medical Society at 608.442.3800

Original Research

Internet Prescribing

Arthur Thexton, JD

Prescribing prescription-only medications solely on the basis of a questionnaire filled out on an internet site is merely an updated version of “diagnosis by mail” and has been condemned by all respectable authorities for over 100 years. The Wisconsin Medical Examining Board has disciplined 1 physician for the practice, and authorities in other states have taken similar actions.



Author Affiliations: Arthur Thexton, JD, is a Prosecuting Attorney for the Wisconsin Department of Regulation & Licensing, prosecuting professional misconduct cases involving physicians, pharmacists and other health care professionals.


Corresponding Author: Please address correspondence to the Wisconsin Medical Society at 608.442.3800

Effectiveness of Intradiscal Electrothermal Therapy in Increasing Function and Reducing Chronic Low Back Pain in Selected Patients

Stephen M. Endres, MD, DABPM; Great A. Fiedler, RA; Katie L. Larson, RA

Intradiscal electrothermal therapy (IDET) is a percutaneous intervention used to treat pain from internal disc disruption. We reviewed the patients who under-went this procedure in our practice. We found, in an appropriately selected group of patients, an increase in sitting and standing tolerances and a decrease in pain levels. After completion of post-IDET rehabilitation, 66% of the patients returned to work. There were no complications.



Author Affiliations: Doctor Endres is the Medical Director of the Pain Clinic of Northwestern Wisconsin. He has been practicing pain management for over 15 years.


Corresponding Author: Please address correspondence to the Wisconsin Medical Society at 608.442.3800

A Comparison of Apparent Life-Threatening Events Before and After the Back to Sleep Campaign

William M. Gershan, MD; Nathaniel S. Besch, BS; Ralph A. Franciosi, MD

Objectives. The incidence of the Sudden Infant Death Syndrome (SIDS) has decreased significantly in the United States since the 1992 recommendation that healthy term infants be placed on their backs or sides during sleep. However, little is known regarding the effect that this recommendation has had on the incidence and epidemiology of apparent life-threatening events (ALTEs) in this country. Methods. To examine this, we completed a retrospective chart review study of all infants admitted to the Children’s Hospital of Wisconsin with the diagnosis of an ALTE during two study periods before and after the back to sleep initiative: January 1, 1991 to December 31, 1992 and January 1, 1996 to December 31, 1997. Results. There were 81 ALTEs in 1991-1992 vs. 102 in 1996-1997. Infants in both groups were similar with respect to gender, race, and age, with approximately 80% in each group < 4 months of age. ALTEs occurred equally throughout the year during both time periods. The majority of episodes occurred during sleep; 74% of the 1991-1992 cohort and 59% of the 1996-1997 infants did not have information in the medical record describing their position during the ALTE. Three infants (2 during 1991-1992) died during the hospitalization and were subsequently diagnosed with SIDS or probable SIDS. Conclusions. In a large midwestern city, the epidemiology surrounding ALTEs has not been appreciably affected by the Back to Sleep Campaign. In addition, historical data for infants with ALTEs is frequently lacking. These data also suggest that ALTEs and SIDS are influenced by different factors.



Author Affiliations: Doctor Gershan and Mr. Besch are with the Pediatrics Department, Medical College of Wisconsin. Doctor Franciosi is with the Department of Pathology, Medical College of Wisconsin, Milwaukee, WI.

Corresponding Author: Correspondence and reprint requests to: (W.M.G.) Pulmonary Office, Children’s Hospital of Wisconsin, MS #777A, 9000 W Wisconsin Ave, Milwaukee, WI 53226; e-mail wgershan@mcw.edu; phone 414.266.6731; fax 414.266.6742

Scar Endometrioma: Awareness and Prevention

Joseph S. Bachir, MD, FRCS (Ed); Natalie M. Bachir

This article presents two cases of abdominal wall endometrioma. Endometrioma develops after surgery due to transportation and subsequent implantation of endometrial cells. Abdominal wall endometrioma can cause pain, anxiety, and morbidity. Therefore implementation of preventative measures during surgery is paramount to avoid extraneous surgery and hospital expenses. Diagnoses are rarely established prior to surgery, but surgeons often suspect the syndrome in women who have a history of a mass associated with cyclical pain. Radiological examination is useful to exclude hernia and metastatic malignancy, and to delineate the extent of the mass. Wide excision of endometrioma is usually curative.



Author Affiliations: Doctor Bachir is with the Department of Surgery, Rusk County Memorial Hospital, Ladysmith. Ms. Bachir is a fifth year medical student, University College Dublin, Ireland.


Corresponding Author: Please address correspondence to the Wisconsin Medical Society at 608.442.3800

Where have all the applicants gone

Michael J. Dunn, MD, Dean, Medical College of Wisconsin

For the past five years, medical school applications nationwide have been dropping steadily.

Author Affiliations: Dean, Medical College of Wisconsin


Corresponding Author: Please address correspondence to the Wisconsin Medical Society at 608.442.3800

Your Practice

Imagine Wisconsin practitioners providing optimal care to patients with diabetes

Jay A. Gold, MD; Carolyn Coffey; Shanin Pepple

MetaStar is currently enrolling clinics, private physician offices and health care delivery systems in the MetaStar Diabetes Breakthrough Collaborative a project to improve systems for caring for patients with diabetes. The project, which is based on the Institute for Healthcare Improvement breakthrough series model, provides an opportunity for clinics to implement a comprehensive approach to providing care for patients with diabetes.



Author Affiliations: Doctor Gold is Senior Vice President and Principal Clinical Coordinator for MetaStar; Ms. Coffey is MetaStars Vice President of Marketing; and Ms. Pepple is a Communications Specialist for MetaStar. This material was prepared by MetaStar under a contract

Corresponding Author: Please address correspondence to the Wisconsin Medical Society at 608.442.3800

Telemedicine Increase in use calls for new safeguards

Ruth Heitz, JD, Associate General Counsel, Wisconsin Medical Society

Thanks to advances in technology, the way physicians practice medicine on a daily basis has changed dramatically in recent years. Many use desktop and handheld computers to create and store electronic medical records, to e-mail patients and other physicians, and to send electronic prescriptions to designated pharmacies. In addition to the convenience these advances afford, technology particularly telemedicine also has the potential to improve patient access to health care, centralize specialists and reduce costs for specialty care.


Author Affiliations: Associate General Counsel, Wisconsin Medical Society

Corresponding Author: Please address correspondence to the Wisconsin Medical Society at 608.442.3800