WMJ : official publication of the State Medical Society of Wisconsin
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Platypnea-orthodeoxia syndrome is a rare clinical syndrome defined by worsening deoxygenation and dyspnea when changing to an upright sitting or standing position. It is seen in 3 different clinical scenarios: intracardiac shunts, pulmonary arteriovenous shunts, and ventilation/perfusion mismatch in the lungs. ⋯ Platypnea-orthodeoxia syndrome is a clinical condition that is being recognized more frequently due to more accurate diagnosis, and its treatment can alleviate symptomatic hypoxemia.
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The Wisconsin Prescription Drug Monitoring Program (PDMP) was implemented in 2013 to reduce the misuse, abuse, and diversion of controlled substance prescriptions. ⋯ This study can be useful for health care organizations, state PDMPs, and prevention organizations in tailoring messaging to clinicians around safe prescribing and PDMP use.
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Deer hunting is popular in much of the United States. In Wisconsin, use of tree stands for hunting is common. Spine surgeons at a Level 1 Trauma Center observed a high incidence of spine and spinal cord injury due to falls from tree stands while hunting. This study's purpose is to systematically characterize and classify those injuries. ⋯ The majority of spine fractures are treated nonoperatively. However, enough patients require surgical intervention that consultation with a neurosurgical or orthopedic spine surgeon is prudent. It is more common to have multiple spine fractures from a tree stand fall, therefore, it is recommended that if 1 fracture is identified the entire spine be evaluated for additional fractures. For safety, it is recommended that hunters wear and use safety harnesses appropriately. Additionally, keeping the height of the tree stand at 10 feet or less is associated with a lower likelihood of spinal cord injury. Further study is needed to determine additional interventions such as education that might reduce the injury frequency in this population.