Annual Meeting

2002 House of Delegates Action on Resolutions and Board Reports

House of Delegates

Action on Resolutions and Board Reports

Author Affiliations: House of Delegates

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

Focus On....Bioterrorism

A Physician’s Notes for Community Education in Bioterrorism

Ayaz M. Samadani, MD

Public interest in bioterrorism increased following the as yet unsolved “anthrax letters” in the US mail system in the fall of 2001. Physicians are being asked to provide information on the topic in community forums and local media. The following summary may be helpful.



Author Affiliations: Doctor Samadani is a family practice physician in Beaver Dam. He was president of the Wisconsin Medical Society from 2000-2001.

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

Bioterrorism Syndromes

California State and Local Health Department

Adapted from California State and Local Health Department Bioterrorism Surveillance and Epidemiology Working Group

Author Affiliations: California State and Local Health Department Bioterrorism Surveillance and Epidemiology Working Group

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

Bioterrorism threat makes preparation essential

Kendi Parvin, WMJ Managing Editor

“The reality of life is that terrorism is here—it can potentially affect all of us,” said Dennis Maki, MD, during a special CME session on bioterrorism at the Wisconsin Medical Society’s 2002 Annual Meeting in March. “It is almost certain we will see more terrorism in our lives in the United States, and we have to prepare.” The session also featured Captain Timothy Tyre, MSC USNR, and Seth Foldy, MD, city of Milwaukee health commissioner.


Author Affiliations: WMJ, Managing Editor

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

The Anthrax Vaccine Is it Safe? Does It Work?

Institute of Medicine

Anthrax Vaccine Adsorbed (AVA) was licensed in 1970 to provide protection against infection with Bacillus anthracis. AVA was initially administered on a limited basis, primarily to protect veterinarians and workers processing animal products such as hair or hides that could be contaminated with anthrax spores. In the 1990s, with growing concerns about the possible use of anthrax as a biological weapon, use of the vaccine was substantially expanded. The Department of Defense (DoD) vaccinated some of the military personnel deployed for the Gulf War in 1991 and in 1998 initiated the Anthrax Vaccine Immunization Program, calling for mandatory vaccination of all U.S. service members. By late 2001, roughly 2.1 million doses of AVA had been administered. Production of AVA was suspended in 1998 when the facility manufacturing the vaccine was closed for renovations, which were undertaken to meet regulatory requirements of the Food and Drug Administration (FDA).



Author Affiliations: This abstract from the book The Anthrax Vaccine: Is It Safe? Does It Work? is printed with permission from the National Academy of Sciences.


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

Editorials

Wisconsin physicians’ role in combatting bioterrorism

Thomas C. Meyer, Medical Editor, WMJ

The combination of commercial aircraft as missiles and the use of the US mail service as vehicles to transport anthrax spores in the fall of 2001 certainly brought the somber realization that North America is no longer isolated by large sea masses, and therefore relatively protected from the hazards of war, disease, and similar tragedies that have beset Europe and Asia for centuries. The global and national responses to these events have and are being trumpeted daily in the media and so it seems appropriate to review some of the past and current efforts by Wisconsin physicians and organizations in combatting bioterrorism.


Author Affiliations: Medical Editor, WMJ

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

Original Research

The USA Preparing for Bioterrorism: The Role of Fort Detrick Since 1970

Richard A. Proctor, MD

Even before the anti-biological warfare treaty was accepted by all signatories, President Richard Nixon directed that Fort Detrick decommission its biological warfare activities. By the summer of 1971, the facilities for the production and testing of biological weapons were shut down. Much of the base was turned over to the Cancer Institute of the National Institutes of Health. However, the non-weapons program remained. This was known as USAMRIID: US Army Medical Research Institute of Infectious Diseases. USAMRIID has been involved in several aspects of defense against biological weapons. The need for this is clear because we may need to send our soldiers into all points on the globe, and they may encounter natural or man-made biologic agents. Therefore, the military and civilian workers at USAMRIID have played a major role in the development of vaccines, the study of the pathogenic mechanisms of agents likely to be used for bioterrorism, and the production of rapid diagnostic tests for biological agents. In addition, a hospital facility is present where people suspected of being exposed to agents such as hemorrhagic fever viruses or other biologic agents could be treated and isolated. Finally, emergency response strategies and teams for bioterrorism threats were developed. The importance of these activities has been made abundantly clear following the Sept. 11, 2001 terrorist attacks on the United States and the anthrax letters that followed. While many federal facilities closed, USAMRIID remained open for accepting specimens on September 11. One disturbing question has been recently raised: Did the anthrax come from domestic rather than foreign sources and is it linked to Fort Detrick? Several physicians that served at USAMRIID have continued their career in Wisconsin. Ed Overholt, MD, (retired Gunderson Clinic Director, La Crosse, Wis.) spent time at Fort Detrick in the 1960s. In the 1970s, several Madison physicians worked at USAMRIID: Deane Mosher, MD, (Chief, Hematology Section, Dept of Medicine, University of Wisconsin Medical School), Richard Proctor, MD, (Infectious Diseases Section, Dept of Medicine and Medical Microbiology/Immunology University of Wisconsin Medical School), and Cyril Hetsko, MD, (Internal Medicine Department, Dean Medical Clinic, Madison, and Past-president, Wisconsin Chapter of the American Medical Association). Both Mosher and Proctor launched their research careers while serving their country. In this review, I will cover several of the aspects of the USAMRIID mission since 1970.



Author Affiliations: Doctor Proctor is Professor of Medicine and Medical Microbiology/Immunology, University of Wisconsin Medical School, Madison, WI.


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

Creatine Supplementation in Wisconsin High School Athletes

Timothy A. McGuine, MS, ATC; Jude C. Sullivan, MS; David A. Bernhardt, MD

Background: Creatine is a nutritional supplement used to enhance athletic performance in collegiate and professional athletes. There is increasing evidence that high school athletes are using creatine as well. The objective of this study was to describe patterns of creatine supplementation as well as the behaviors and beliefs associated with creatine use in high school athletes. Methods: 4011 high school student-athletes from 37 public high schools in Wisconsin took part in a cross-sectional, multi-site, anonymous, descriptive survey. Measurements included self-reported patterns of creatine use. Results: 16.7% of the athletes (25.3% males, 3.9% females) reported using creatine. Creatine use was lowest in the 9th grade (8.4%) and highest in the 12th grade (24.6%). The percentage of participants in each sport who used creatine varied considerably from 1.3% (female cross country) to 30.1% (football). Increased strength was the most likely perceived benefit of creatine supplementation, while dehydration was cited most often as a perceived risk of creatine use. Users were encouraged to take creatine most often by their friends while their parents discouraged its use. Conclusion: Despite the lack of research regarding the efficacy or safety of creatine supplementation in high school athletes, creatine was used by 25% of males and 4% of female high school athletes in Wisconsin. High school athletes who use creatine may not be aware of the risks and benefits associated with creatine supplementation. Primary care providers and sports medicine professionals need to educate athletes, coaches and parents about the creatine use as a performance enhancing supplement.



Author Affiliations: Mr. McGuine and Mr. Sullivan are from the University of Wisconsin Hospital Sports Medicine Center. Mr. Bernhardt is from the Department of Pediatrics, University of Wisconsin Hospital and Clinics.


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

CT Screening for Lung Cancer: Are We Ready Yet?

Jannette Collins, MD, MEd, FCCP

As a result of recent publications in the lay press, individuals have started to ask physicians and other medical personnel about the availability of screening CT for lung cancer. Many imaging centers, perhaps without full knowledge of the complex issues involved, have capitalized on this enthusiasm by instituting CT screening programs. Whether a health care provider offers screening CT or not, physicians and other medical personnel need to be informed about recent developments in CT screening for lung cancer in order to advise patients. This article reviews the significance of lung cancer as a cause of death, the causes of lung cancer and how it can be prevented, the types and frequencies of different lung cancers, the conditions of effective screening, the biases associated with screening, and past and present lung cancer screening trials.



Author Affiliations: Doctor Collins is Associate Professor of Radiology and Affiliate Associate Professor of Medicine, University of Wisconsin Medical School.


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

Your Practice

Preparing for bioterrorism

Philip M. Farrell, MD, PhD; and George Mejicano, MD, MS

Over the past two decades, many people have come to believe that the specter of biological agents as weapons of mass destruction has greatly diminished. But as recent history has shown, the United States is still vulnerable to threats from terrorists that are undeterred by the economic, military and political consequences that could follow. The threat of biological weapons is not simply a matter of foreign affairs. Indeed, the threat may just as well come from groups or individuals on the home front.



Author Affiliations: Doctor Farrell is Dean, University of Wisconsin Medical School, and Vice Chancellor for Medical Affairs at UW-Madison. Doctor Mejicano is Assistant Dean for Continuing Medical Education.


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