Implementation of a Multidisciplinary Medication Refill Protocol.

Introduction: Primary care clinicians spend significant time managing nonvisit activities, including processing of requests for prescription renewal. Delays in processing refills may lead to patient dissatisfaction and impact provider productivity. Having nonclinicians process refills can be more efficient and time-saving.

Association of Natural Waterways and Infection in Eastern Wisconsin: A Case-Control Study.

Preliminary research has suggested possible associations between natural waterways and infection, and we previously explored these associations in eastern Wisconsin using positive serogroup 1 urine antigen tests (LUAT) as diagnostic. This case-control study was a secondary analysis of home address data from patients who underwent LUAT at a single eastern Wisconsin health system from 2013 to 2017. Only zip codes within the health system's catchment area that registered ≥3 positive cases and ≥50 completed tests, as well as geographically adjacent zip codes with ≥2 positive cases and ≥50 tests, were included.

Seroprevalence of COVID-19 IgG Antibody in Resident and Fellow Physicians in Milwaukee, Wisconsin: Analysis of a Cross-Sectional Survey.

Purpose: Medical trainees are likely at differential risk of exposure to COVID-19 per respective clinical activity. We sought to determine the seroprevalence of COVID-19 antibody (Ab) among resident and fellow physicians with varying degrees of exposure to COVID-19.

Methods: A cross-sectional study of Milwaukee-based resident and fellow physicians, encompassing December 2019-June 2020, was conducted.

Attempted Isolation of Cryptococcus Species and Incidental Isolation of Exophiala dermatitidis from Human Oral Cavities.

Recent molecular studies suggest that Cryptococcus may inhabit the normal human mouth. We attempted to isolate Cryptococcus from 21 adult non-acutely ill patients and 40 volunteer medical and non-medical staff in Southeastern Wisconsin, USA. An upper lip sulcus culture and an oral rinse specimen were inoculated separately onto Staib (birdseed) agar containing chloramphenicol and incubated in gas impermeable zip lock bags at 35 °C.

Epidemiologic Survey of Legionella Urine Antigen Testing Within a Large Wisconsin-Based Health Care System.

Purpose: Legionella pneumophila pneumonia is a life-threatening, environmentally acquired infection identifiable via Legionella urine antigen tests (LUAT). We aimed to identify cumulative incidence, demographic distribution, and undetected disease outbreaks of Legionella pneumonia via positive LUAT in a single eastern Wisconsin health system, with a focus on urban Milwaukee County.

Methods: A multilevel descriptive ecologic study was conducted utilizing electronic medical record data from a large integrated health care system of patients who underwent LUAT from 2013 to 2017.

Cryptococcal Antigen Testing in an Integrated Medical System: Eastern Wisconsin.

Cryptococcosis is a serious environmentally acquired endemic fungal infection commonly associated with immunocompromised hosts. Little is known regarding frequency or distribution in Wisconsin. We explored the geodemographic and clinical features of patients tested with cryptococcal antigen tests (CrAg) - previously shown to be >90% sensitive and >90% specific - within a large health care system located in eastern Wisconsin.

Enhancing Immunization Rates in Two Urban Academic Primary Care Clinics: A Before and After Assessment.

Purpose: Immunization rates in many cities in the United States remain suboptimal compared to Healthy People 2020 Goals and are lower than national averages. This study aimed to determine whether a lecture-based educational intervention targeted at nurses and medical assistants would improve vaccination rates.

Methods: We conducted a quality improvement study in two urban academic family medicine clinics serving a predominantly Medicaid patient population as well as a sizable proportion of refugees.

Oral Fungal Microbiota: To Thrush and Beyond.

The oral microbiota is complex, multikingdom, interactive, and involves extensive biofilm formation. While dominated by bacteria, is a frequent member of this microbiota; however, several other potentially pathogenic fungi (among around 100 identified species) appear to reside in some individuals, including , and . Oral candidiasis may manifest as a variety of disease entities in normal hosts and in the immunocompromised.

Utilization of Acupuncture Services in the Emergency Department Setting: A Quality Improvement Study.

Purpose: Patients often present to the emergency department (ED) for pain. As opioid fatalities rise, alternative treatments are warranted for pain management. Acupuncture, a nonpharmacological treatment involving the insertion of needles into skin or tissue at specific points within the body, may help to decrease acute pain.

Multimodal Local Opioid Prescribing Intervention Outcomes in Chronic Noncancer Pain Management.

Background: Opioid misuse in the United States has made it challenging for physicians to treat chronic noncancer pain (CNCP). We implemented an educational program aimed at promoting safe opioid prescribing practices in hopes of increasing the level of appropriateness associated with prescribing opioids for CNCP.

Methods: We conducted a quality-improvement study with a retrospective chart review of adult patients who were prescribed opioids for CNCP for at least 90 consecutive days at 2 academic primary care clinics.

Potential clinical utility of ERC-2 yeast phase lysate antigen for antibody detection in dogs with blastomycosis.

Four Blastomyces antigens ERC-2 (B. gilchristii, dog, Wisconsin), B5929 (human, Minnesota), 597 (human, Wisconsin), and T-27 (polar bear, Tennessee) were tested against 31 serum specimens from dogs with blastomycosis and 19 from healthy dogs. All antigens detected antibody; efficacy varied.

Use of Urine Antigen Testing for in an Integrated Health System.

Purpose: Blastomycosis, an endemic fungal infection, mimics many other diseases. We explored the use of urine antigen (BuAg), reportedly the most sensitive noninvasive test, in clinical practice and compared it to other noninvasive tests.

Methods: A total of 836 BuAg tests performed on unique patients (first test only) at one large integrated health system from June 2013 to May 2016 were retrospectively reviewed to examine test characteristics and demographic features.