Kansas Journal of Medicine最新文献

The “Neglected aVR Lead”: Kounis Syndrome of MINOCA Type, Severe Left Main or 3-Vessel Disease and Type A Dissecting Ascending Aortic Aneurysm 被忽视的 aVR 导联"： MINOCA 型库尼综合征、严重左主干或三支血管疾病和 A 型夹层升主动脉瘤

Kansas Journal of Medicine Pub Date : 2024-07-24 DOI: 10.17161/kjm.vol17.22352

Nicholas Kounis

引用次数: 0

Evaluating the Long-Term Neurologic Sequelae Among Trauma Patients who Received Flexion-Extension Radiographs 评估接受屈伸射线照相术的创伤患者的长期神经系统后遗症

Kansas Journal of Medicine Pub Date : 2024-07-24 DOI: 10.17161/kjm.vol17.21379

Shelby Durler, Kelly L. Lightwine, Elizabeth Ablah, Thomas Cox, James M Haan

{"title":"Evaluating the Long-Term Neurologic Sequelae Among Trauma Patients who Received Flexion-Extension Radiographs","authors":"Shelby Durler, Kelly L. Lightwine, Elizabeth Ablah, Thomas Cox, James M Haan","doi":"10.17161/kjm.vol17.21379","DOIUrl":"https://doi.org/10.17161/kjm.vol17.21379","url":null,"abstract":"Introduction. This study evaluated the presence of neurologic sequelae among trauma patients after flexion-extension (F/E) radiographs. \u0000Methods. Authors of the study conducted a retrospective review of patients (age ≥ 14 years) with a Glasgow Coma Score of 15 who sustained a blunt traumatic injury and received F/E radiographs. Radiographic scans were defined as positive, negative, inconclusive, or incomplete. The neurologic status of each patient was assessed before and after the F/E radiographs, and at discharge and follow-up.\u0000Results. Of the 501 patients included in the analysis, 84.6% (n = 424) had negative F/E radiographs, and 3.2% (n = 16) had positive F/E radiographs. Ten percent (n = 51) of patients had incomplete F/E radiographs, and 2.0% (n = 10) were inconclusive due to the inability to rule out a ligamentous injury. Three patients (0.6%) had MRI-confirmed ligamentous injuries, all of which had initial incomplete F/E radiographs due to pain. No patient had a documented neurological deficit before or after the F/E exam. Three patients with an initial negative F/E radiograph returned to the clinic with symptoms of neurologic sequelae. Two of these patients had symptom resolution with no further issues at future follow-up appointments. The third patient was found to have chronic neurologic symptoms after further evaluation.\u0000Conclusions. The inclusion of F/E exams in cervical spine clearance protocols did not demonstrate any new long-term iatrogenic neurologic injuries. Consideration should be given to performing MRIs on patients with incomplete F/E radiographs that cannot rule out a ligamentous injury. ","PeriodicalId":17991,"journal":{"name":"Kansas Journal of Medicine","volume":"52 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141806900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Vaginal Cuff Dehiscence after Robotic Hysterectomy in Endometrial Cancer vs. Non-Cancer Patients 子宫内膜癌与非癌症患者机器人子宫切除术后的阴道袖带开裂问题

Kansas Journal of Medicine Pub Date : 2024-07-24 DOI: 10.17161/kjm.vol17.21651

Paige Nichols, Adrienne Esposito, Maria Kolojeski, Jennifer Keomany, Hayrettin Okut, Jacqueline Morgan, Kevin Miller

{"title":"Vaginal Cuff Dehiscence after Robotic Hysterectomy in Endometrial Cancer vs. Non-Cancer Patients","authors":"Paige Nichols, Adrienne Esposito, Maria Kolojeski, Jennifer Keomany, Hayrettin Okut, Jacqueline Morgan, Kevin Miller","doi":"10.17161/kjm.vol17.21651","DOIUrl":"https://doi.org/10.17161/kjm.vol17.21651","url":null,"abstract":"Introduction: Vaginal cuff dehiscence (CD) after hysterectomy is a relatively uncommon but potentially serious complication of robotic-assisted laparoscopic total hysterectomy (RLTH), which is performed for benign and malignant indications. This study aimed to determine if there is a difference in the incidence and risk factors of CD following RLTH among patients with endometrial cancer compared to patients without endometrial cancer.\u0000Methods: This retrospective study included women 18 years or older who underwent RLTH performed by one of two surgeons from a single institution from 2013 through 2018. Patients who underwent conversion to laparotomy, chemotherapy and/or radiation within a year before or after RLTH, and with malignancies other than uterine cancer were excluded. Data were abstracted from patient medical records.\u0000Results: Of 950 patients meeting inclusion criteria, 50.7% (n=482) had endometrial cancer. CD was reported in 2.5% (n=24) of all patients. While controlling for other variables, obese patients were 25.1% less likely than non-obese patients to experience CD (p=.011). Additionally, CD was 2.8 times more likely to occur when surgery was performed by surgeon A compared to surgeon B (p=0.027). No other variables (cancer status, age, sexual activity after surgery, distance from home to location of surgery, time interval from surgery to loss to follow-up) predicted CD.\u0000Conclusions: Endometrial cancer patients were not at greater risk of experiencing CD compared to non-cancer patients. Surgeon differences and BMI were associated with incidence of CD, and patients with a normal BMI were most likely to report experiencing CD.","PeriodicalId":17991,"journal":{"name":"Kansas Journal of Medicine","volume":"50 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141807667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Case of Extensive Cholangiocarcinoma Highlighting Challenges in Diagnosis and Treatment 一例广泛性胆管癌病例凸显诊断和治疗难题

Kansas Journal of Medicine Pub Date : 2024-07-24 DOI: 10.17161/kjm.vol17.21875

Wissam Karam, Timothy Nguyen, William Salyers

引用次数: 0

Ethical Obligation of Adequate Pain Management in Long Term Care Residents with Dementia 对患有痴呆症的长期护理住院患者进行适当疼痛管理的伦理义务

Kansas Journal of Medicine Pub Date : 2024-07-24 DOI: 10.17161/kjm.vol17.22135

Donna Ewy

引用次数: 0

A Case Report of Leclercia adecarboxylata Pyogenic Arthritis 一个关于十八烷基莱克菌化脓性关节炎的病例报告

Kansas Journal of Medicine Pub Date : 2024-07-24 DOI: 10.17161/kjm.vol17.20588

Hitanshu Dave, Lawrence Zhou, Deva Zamzow, Robert Wittler

引用次数: 0

Navigating Work-Life Integration, Legal Issues, Patient Safety: Lessons for Work-Life Wellness in Academic Medicine: Part 1 of 3. 引导工作与生活的融合，法律问题，患者安全:学术医学中工作与生活健康的教训(三集之一)。

Kansas Journal of Medicine Pub Date : 2023-06-20 eCollection Date: 2023-01-01 DOI: 10.17161/kjm.vol16.19952

Jennifer L Hartwell, Paul Barach, Tracy D Gunter, Kyra Reed, Heather Kelker, Julie Welch, Kristine Olson, Elizabeth Harry, Samantha Meltzer-Brody, Mariah Quinn, Jennifer Ferrand, Sharon C Kiely, Jane Hartsock, Emily Holmes, Kristin Schroeder, Rami Ahmed

引用次数: 0

Navigating Minority and Gender Discrimination, Substance Use Disorder, Financial Distress, and Workplace Politics: Lessons for Work-Life Wellness in Academic Medicine: Part 2 of 3. 引导少数民族和性别歧视，物质使用障碍，财务困境和工作场所政治:学术医学中工作与生活健康的教训(三集之二)。

Kansas Journal of Medicine Pub Date : 2023-06-20 eCollection Date: 2023-01-01 DOI: 10.17161/kjm.vol16.19953

Rami Ahmed, Jennifer L Hartwell, Heather Farley, Julia MacRae, David A Rogers, Elizabeth C Lawrence, Chantal Mlr Brazeau, Eliza M Park, Anna Cassidy, Jane Hartsock, Emily Holmes, Kristen Schroeder, Paul Barach

引用次数: 0

Clear Cell Renal Carcinoma Presents as a Solitary Pulmonary Nodule Fifteen Years After Nephrectomy. 透明细胞肾癌在肾切除术后15年表现为孤立的肺结节。

Kansas Journal of Medicine Pub Date : 2023-05-25 eCollection Date: 2023-01-01 DOI: 10.17161/kjm.vol16.18988

Ahmad Mahdi, Wissam Karam, Mahmoud Mahdi, Nassim Nabbout

引用次数: 0

Identifying Opportunities for Impact of Community-Based Pharmacist-Led Biometric Health Screenings on ASCVD Risk. 确定社区药剂师主导的生物计量健康筛查对急性心血管疾病风险影响的机会。

Kansas Journal of Medicine Pub Date : 2023-04-24 eCollection Date: 2023-01-01 DOI: 10.17161/kjm.vol16.18514

Bradley J Newell, Ashley M Kells, Amy D Robertson, Tasha M Braun, Kimberly S Ward, Brent J Rohling, Brittany L Melton

{"title":"Identifying Opportunities for Impact of Community-Based Pharmacist-Led Biometric Health Screenings on ASCVD Risk.","authors":"Bradley J Newell, Ashley M Kells, Amy D Robertson, Tasha M Braun, Kimberly S Ward, Brent J Rohling, Brittany L Melton","doi":"10.17161/kjm.vol16.18514","DOIUrl":"10.17161/kjm.vol16.18514","url":null,"abstract":"Introduction: Community-based pharmacists are positioned uniquely to assist in the early detection of underlying cardiovascular disease (CVD) which affects approximately 50% of adults in the United States. Organizations utilize community-based pharmacists to conduct annual biometric health screenings to help employees identify health risks previously undetected. The goal of this study was to evaluate how community-based pharmacists could impact lifetime atherosclerotic cardiovascular disease (ASCVD) risk for a large population.Methods: This study was a retrospective analysis of annual pharmacist-led 15-minute biometric health screening data from a large regional community-based pharmacy chain. Employees between the ages of 20 and 79 who had completed at least three biometric health screenings between July 1, 2015 and June 30, 2020 were included. Incomplete biometric health screening records were excluded. To calculate lifetime ASCVD risk and identify perceived gaps in care, prescription fill history of study participants was used. The pharmacists did not make clinical interventions; however, education was provided with the information found.Results: A total of 10,001 patients were included. Median baseline ASCVD risk was 1.5% and increased to 1.8% (p < 0.001). Additionally, 1,187 patients with an elevated ASCVD risk ≥ 7.5%, showed statistically significant improvements in blood pressure, body mass index, and cholesterol.Conclusions: Improvements for high-risk patients were seen in several biometric health screening parameters including blood pressure, body mass index, and cholesterol. Community-based pharmacists were well positioned to intervene clinically to support reduction of ASCVD life-time risk.","PeriodicalId":17991,"journal":{"name":"Kansas Journal of Medicine","volume":"16 ","pages":"88-93"},"PeriodicalIF":0.0,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a6/e7/16-88.PMC10136613.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9393696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0