WMJ : official publication of the State Medical Society of Wisconsin
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To evaluate the clinical effects of subthalamic nucleus deep brain stimulation in patients with Parkinson's disease within the first 12 months after surgery. ⋯ Bilateral stimulation of the subthalamic nucleus is associated with significant improvement in motor function and reduction of antiparkinsonian medications in patients with Parkinson's disease in the first 12 months after surgery. On-state dyskinesias were greatly reduced, probably due to the reduction of total antiparkinsonian medications. The procedure is well tolerated.
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Sickle cell trait is a relatively common condition in the African-American population. Individuals with this condition may have any of several complications under rare circumstances. We report a patient who presented with extensive compartment syndrome leading to death. ⋯ Although the patient underwent multiple fasciotomies for extensive compartment syndrome and received aggressive resuscitation with massive transfusions of blood, blood products and intravenous fluids, he died. Multiple compartment syndromes in patients with sickle cell trait represent a very unusual complication and can cause significant morbidity and mortality. Avoidance of strenuous exercise, especially in hot climates, early diagnosis, and aggressive therapy are very important to prevent this catastrophic complication.
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To evaluate outcomes of intradiscal electrothermal annuloplasty (IDEA) therapy in the treatment of chronic discogenic low back pain in consecutive IDEA patients treated at a rural pain management clinic. ⋯ These data show favorable outcomes after IDEA therapy, and suggest that women may experience more improvement than men, particularly with regard to perceived disability improvements. Data suggest that greater improvement in IDEA outcomes may be achieved by profiling the characteristics of patients who achieve the optimal long-term outcomes following treatment and should be considered during evaluation of patient eligibility for IDEA.
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Research has shown that proactive tobacco cessation quitlines are effective in increasing quit rates 4-fold, compared to quitting with no counseling support. In Wisconsin, the state-funded Wisconsin Tobacco Quit Line has documented a quit rate of 22%, with an estimated 6700 individuals quitting as a result of receiving Quit Line services. Since its launch in 2001, the Wisconsin Tobacco Quit Line has assisted more than 36,000 callers. ⋯ The model involves close collaboration between UW-CTRI and health care delivery systems who train their staff and integrate a quitline referral system into their regular delivery of health care for smokers who are interested in having the quitline contact them. This paper examines the extent to which this approach has been adopted by health care providers in Wisconsin. The potential is for this to become a key component of an integrated tobacco dependence treatment.
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Atrial septal defects are among the most common congenital heart defects seen in the adult population. The diagnosis is usually made in children and closure is attempted before they are school age. In other cases, where the diagnosis is missed until adulthood, atrial arrhythmias and congestive heart failure are commonly seen. ⋯ The patient was referred for closure of the atrial septal defect. Presently, the options for septal defect closure are direct suture repair, Dacron patch repair depending on the size of the defect, and percutaneous transcatheter closure. Transcatheter closure is also available in treating selected patients with patent foramen ovale.