INSIDE WVSMA
Editor ’ s Letter
One Common and Two Uncommon Medical Conditions in West Virginia
Linda S . Nield , MD
The original research articles in this issue of the West Virginia Medical Journal focus on the treatment of opioid use disorder ( OUD ). Both articles include informative introductions that list facts about the incredulous number of individuals who suffer from OUD and the deleterious effects of this medical condition in the state and the nation .
When I was a pediatric resident in West Virginia ( WV ) from 1990-1993 , I did not receive much , if any , education about neonatal abstinence syndrome ( NAS ). Over the past three decades , there has been a great deal of on-the-job training as the cases of NAS continued to increase . As an attending physician currently working in the ambulatory setting for only one half day per week , it is not atypical to be involved in the outpatient care of multiple affected neonates on a routine basis . In 2022 , the training of pediatric residents now includes extensive learning experiences about the diagnosis and treatment of NAS .
Readers can become familiar with the West Virginia Perinatal Partnership , funded by the Claude W . Benedum Foundation , which tackles OUD through collaboration with experts from the major healthcare systems in the state . More information about the partnership is available at wvperinatal . org .
In this issue ’ s McCann et al article , an intentional structured opioid monitoring protocol is studied . 1 Their findings indicate that the protocol was associated with better compliance and decreased no-show rates . Hereford et al report the results of their survey about prescribing physicians ’ attitudes about buprenorphine-based medication-assisted treatment . 2 Although the survey response rate was low , the authors were still able to provide a glimpse into the attitudes of prescribing physicians who yearn for strategies to overcome barriers that hinder optimal care of patients with OUD .
miliary tuberculosis ( TB ). 4 Although the Centers for Disease Control and Prevention reported that WV had the fourth lowest incidence of TB in the United States in 2021 , 5 the patient with miliary TB from our state reminds our clinicians to still keep this potential diagnosis in mind .
REFERENCES
1 . McCann KS , Velthouse K , Sutphin R , Davies T , Petrany SM , Franks AM . Intentional Structured Opioid Monitoring Protocol : responsible and viable deprescribing . WVMJ . 2022 ; 118 ( 3 ): 18-24 .
2 . Hereford C , Lyon J , Montalto N , Becker J , Davies TH . Prescriber attitudes and medication assisted treatment . WVMJ . 2022 ; 118 ( 3 ): 26-33 .
3 . Addicott , Cottrell J . Delayed complete chorioamionotic membrane separation in the third trimester following a motor vehicle collision . WVMJ . 2022 ; 118 ( 3 ): 34-36 .
4 . Tuberculosis presenting as intestinal granulomas in patient from West Virginia . WVMJ . 2022 ; 118 ( 3 ): 38-40 .
5 . Filardo TD , Feng P , Pratt RH , Price SF , Self JL . Tuberculosis- United States , 2021 . MMWR . March 25 , 2022 ; 71 ( 12 ): 441-446 .
ACKNOWLEDGEMENT
The Publications Committee would like to thank Dr . TaraChandra “ TC ” Narumanchi . Dr . Narumanchi has served as the behind-thescenes proofreader for most of the features in each issue of the journal over the last two years . He has also served the people of West Virginia as a medical geneticist . Dr . Narumanchi is wished well as he moves on to his new position in Memphis , TN .
In contrast to the topic of OUD in the original research articles , the medical conditions in the two case reports represent rarer conditions reported to occur in WV . Addicott and Cottrell describe a 20-year-old patient who experienced a chorioamnionotic separation following a motor vehicle collision . 3 Catherman and colleagues authored their case report about a 73-year-old from WV presenting with granulomatous colitis who was ultimately diagnosed with
6 • www . wvsma . org