WMJ : official publication of the State Medical Society of Wisconsin
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Changes in physician behavior are difficult to accomplish. We hypothesized measuring physicians' vitamin D levels would increase measurement of their patients' levels. ⋯ Physicians with low vitamin D testing rates were receptive to a personal intervention involving measurement of their own vitamin D levels. High workload appeared to attenuate this effect. These novel but preliminary observations require confirmation in future studies.
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It has been estimated that 10%-35% of patients who undergo total hip arthroplasty (THA) have chronic postoperative pain, most often located at the greater trochanter. After greater trochanteric bursectomy (GTB), patients also may continue to experience chronic surgical site pain. Chronic pain has a neuropathic component, which often responds poorly to opioids. In an attempt to provide increased pain relief for patients with intractable chronic pain, unconventional agents and interventional management approaches have received considerable attention. Peripheral nerve field stimulation (PNFS) has been used with increased frequency as a minimally invasive and safe intervention for the management of intractable neuropathic postoperative pain. The objective of this retrospective study was to evaluate the efficacy of PNFS for treatment of chronic hip pain after THA and GTB. ⋯ PNFS provides an effective alternative treatment option for select patients with chronic postoperative pain after THA and GTB who have failed conservative treatment.
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Löfgren's syndrome is a rare variant of sarcoidosis characterized by the triad of hilar adenopathy, acute polyarthritis, and erythema nodosum. It can be the first presentation of underlying sarcoidosis. ⋯ This is a self-limiting disease with a very good prognosis. Non steroidal anti-inflammatory drugs (NSAIDs), along with supportive care and close monitoring, are the mainstay for treatment.
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A previous cost-benefit analysis found Screening, Brief Intervention, and Referral to Treatment (SBIRT) to be cost-beneficial from a societal perspective. This paper develops a cost-benefit model that includes the employer's perspective by considering the costs of absenteeism and impaired presenteeism due to problem drinking. ⋯ We concluded that implementing SBIRT is cost-beneficial from the employer's perspective and recommend that Wisconsin employers consider covering SBIRT services for their employees.