Kansas Journal of Medicine最新文献

{"title":"2021 Annual Report of the Kansas Poison Control Center at The University of Kansas Health System.","authors":"Stephen L Thornton,&nbsp;Lisa K Oller,&nbsp;Kathy White,&nbsp;Robert Stockdale,&nbsp;Elizabeth Silver","doi":"10.17161/kjm.vol16.19525","DOIUrl":"https://doi.org/10.17161/kjm.vol16.19525","url":null,"abstract":"<p><strong>Introduction: </strong>This is the 2021 Annual Report of the Kansas Poison Control Center (KSPCC) at The University of Kansas Health System. The KSPCC serves the state of Kansas 24-hours a day, 365 days a year with certified specialists in poison information and clinical and medical toxicologists.</p><p><strong>Methods: </strong>Encounters reported to the KSPCC from January 1, 2021 through December 31, 2021 were analyzed. Data recorded includes caller demographics, exposure substance, nature and route of exposure, interventions, medical outcome, disposition, and location of care.</p><p><strong>Results: </strong>The KSPCC logged 18,253 total encounters in 2021, including calls from every county in Kansas. A majority of human exposure cases (53.6%) were female. Approximately 59.8% were pediatric exposures (defined as 19 years of age or less). Most encounters occurred at a residence (91.7%) and most were managed there (70.5%). Unintentional exposures were the most common reason for exposures (70.5%). The most common reported substance in pediatric encounters was household cleaning products (n = 815) and cosmetics/personal care products (n = 735). For adult encounters, analgesics (n = 1,241) and sedative/ hypnotics/antipsychotics (n = 1,013) were the most frequently reported. Medical outcomes were 26.0% no effect, 22.4% minor effect, 10.7% moderate effect, and 2.7% major effects. There were 22 deaths.</p><p><strong>Conclusions: </strong>The 2021 KSPCC annual report demonstrated that cases were received from the entire state of Kansas. Pediatric exposures remained most common but cases with serious outcomes continued to increase. This report supported the continued value of the KSPCC to both public and health care providers in the state of Kansas.</p>","PeriodicalId":17991,"journal":{"name":"Kansas Journal of Medicine","volume":"16 ","pages":"121-130"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9c/62/16-121.PMC10241204.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9963431","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}

{"title":"New-Onset Amyotrophic Lateral Sclerosis in a Patient who Received the J&J/Janssen COVID-19 Vaccine.","authors":"Elio Junior Feghali,&nbsp;Abhiram Challa,&nbsp;Mahmoud Mahdi,&nbsp;Eric Acosta,&nbsp;Jennifer Jackson","doi":"10.17161/kjm.vol16.18969","DOIUrl":"https://doi.org/10.17161/kjm.vol16.18969","url":null,"abstract":"New-Onset Amyotrophic Lateral Sclerosis in a Patient who Received the J&J/Janssen COVID-19 Vaccine Elio Junior Feghali, M.D., Abhiram Challa, M.D., Mahmoud Mahdi, M.D., Eric Acosta, M.D., Jennifer Jackson, M.D., FACP University of Kansas School of Medicine-Wichita, Wichita, KS Department of Internal Medicine Received Jan. 5, 2023; Accepted for publication Feb. 7, 2023; Published online March 15, 2023 https://doi.org/10.17161/kjm.vol16.18969","PeriodicalId":17991,"journal":{"name":"Kansas Journal of Medicine","volume":"16 ","pages":"69-70"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/84/6c/16-69.PMC10035647.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9192179","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}

{"title":"Infection and Recurrence Rates in Rural Inguinal Hernia Repair.","authors":"Brooke Fowler,&nbsp;Dorothy Hughes","doi":"10.17161/kjm.vol16.18552","DOIUrl":"https://doi.org/10.17161/kjm.vol16.18552","url":null,"abstract":"<p><strong>Introduction: </strong>Inguinal hernia repair (IHR) is a common procedure performed by general surgeons in rural community hospitals. Infection and recurrence rates for three types of IHR over two years at a rural Kansas hospital were analyzed. Previous research has shown outcomes regarding pain at six weeks were typically no different, and neither were long-term results, between open and laparoscopic techniques. However, there were fewer data showing the outcomes of these three hernia repair approaches in rural settings.</p><p><strong>Methods: </strong>This was a retrospective, cross-sectional study using data collected from the electronic medical record (EMR) of a small hospital in central Kansas. Data from adult patients who had undergone IHRs over a two-year period (2018-2019) were deidentified and described using frequencies and percentages. This study used multi-variate logistic regression to examine the association of patient, surgeon, and surgical procedure characteristics on the occurrence of post-operative complications.</p><p><strong>Results: </strong>Of the patients who received IHR, 46 were male and 5 were female. Mean age was 66 years, with a minimum of 34 and maximum ≥ 89 years. There were 14 total post-operative complications; two were superficial infections. There were no recurrences.</p><p><strong>Conclusions: </strong>The sample size for each procedure type was too small to allow for statistical testing. However, the hospital had no recurrences. Future research should follow-up with this and other rural hospitals and perform a direct comparison of hernia surgery outcomes with those at a larger, more urban hospital, to understand potential differences by hospital size.</p>","PeriodicalId":17991,"journal":{"name":"Kansas Journal of Medicine","volume":"16 ","pages":"65-68"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/45/3f/16-65.PMC10035649.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9192180","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}

{"title":"Evaluation of Outcomes and Treatment Options Among Trauma Patients with Abdominal Vascular Injuries.","authors":"David Kurt,&nbsp;Chad Ammar,&nbsp;Elizabeth Ablah,&nbsp;Kelly Lightwine,&nbsp;Hayrettin Okut,&nbsp;Liuqiang Lu,&nbsp;James M Haan","doi":"10.17161/kjm.vol16.18711","DOIUrl":"https://doi.org/10.17161/kjm.vol16.18711","url":null,"abstract":"<p><strong>Introduction: </strong>Abdominal vascular injuries are associated with significant morbidity and mortality. Treatment options include non-operative management, open repair, and endovascular procedures. This study aimed to characterize patients and detail treatment modalities among those who sustained a traumatic abdominal vascular injury.</p><p><strong>Methods: </strong>A six-year descriptive retrospective study was conducted at a level 1 trauma center and included all adult patients who sustained an abdominal vascular injury. Data abstracted included demographics, admitting characteristics, mechanism of injury, admitting vitals, injury details, diagnostic and treatment information, hospital course, and follow-up data.</p><p><strong>Results: </strong>Fifty-seven patients were admitted with abdominal vascular injuries, however, 14 patients sustained injuries to smaller vascular branches and were excluded. Most vascular injuries involved the iliac artery (27.9%, n = 12), abdominal aorta (25.6%, n = 11), and inferior vena cava (25.6%, n = 11). Twenty-seven percent (n = 12) of patients sustained an injury to more than one vascular structure. Thirty-four percent of patients (n = 15) died before treatment of the abdominal vascular injury. Among the 28 patients (65.1%) treated for their vascular injuries, 46.4% (n = 13) were treated with open surgery, 32.1% (n = 9) were treated non-operatively, and 21.4% (n = 6) with coil embolization. Sixty-four percent of the patients (n = 18) who survived to discharge presented for follow-up care with a mean follow-up period of 3 ± 4.1 months. There were no vascular reinterventions after discharge for patients who followed up with our hospital.</p><p><strong>Conclusions: </strong>Study findings suggested that appropriately selected cases of traumatic vascular injuries may be managed non-operatively and safely, as there were no mortalities, complications, or reinterventions among these patients.</p>","PeriodicalId":17991,"journal":{"name":"Kansas Journal of Medicine","volume":"16 ","pages":"11-16"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ba/5e/16-11.PMC9872503.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10632361","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}

{"title":"Colonic Ganglioneuroma: A Rare Incidental Finding.","authors":"Mahmoud Mahdi,&nbsp;Khalid Afaneh,&nbsp;Ahmad Mahdi,&nbsp;Obada Tayyem","doi":"10.17161/kjm.vol16.18859","DOIUrl":"https://doi.org/10.17161/kjm.vol16.18859","url":null,"abstract":"112 Colonic Ganglioneuroma: A Rare Incidental Finding Mahmoud Mahdi, M.D.1, Khalid Afaneh, M.D.2, Ahmad Mahdi, M.D.2, Obada Tayyem, M.D.3 1University of Kansas School of Medicine-Wichita, Wichita, KS Department of Internal Medicine 2Heartland Pathology, Wichita, KS 3Kansas Gastroenterology, Wichita, KS Received Dec. 12, 2022; Accepted for publication March 1, 2023; Published online April 24, 2023 https://doi.org/10.17161/kjm.vol16.18859","PeriodicalId":17991,"journal":{"name":"Kansas Journal of Medicine","volume":"16 ","pages":"112-113"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/50/cb/16-112.PMC10136615.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9393693","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}

{"title":"Acral Nodular Melanoma at a Site of Trauma.","authors":"Sandra Jaroonwanichkul,&nbsp;Emily Fan,&nbsp;Stephanie Matthews,&nbsp;Bao Vincent Ho,&nbsp;John C Hall","doi":"10.17161/kjm.vol16.19501","DOIUrl":"https://doi.org/10.17161/kjm.vol16.19501","url":null,"abstract":"Melanoma is a malignant cutaneous tumor accounting for approximately 2% of cancer deaths worldwide. Acral nodular melanomas are found on the hands and feet while nodular melanomas are characterized by prominent vertical invasion.","PeriodicalId":17991,"journal":{"name":"Kansas Journal of Medicine","volume":"16 ","pages":"187-188"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6d/9b/16-187.PMC10395766.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9939504","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}

{"title":"Recurrent Aseptic (Mollaret's) Meningitis in a Patient with HIV.","authors":"Craig Beavers,&nbsp;Nicholas Tuck,&nbsp;Richard Muraga","doi":"10.17161/kjm.vol16.18612","DOIUrl":"https://doi.org/10.17161/kjm.vol16.18612","url":null,"abstract":"INTRODUCTION Pierre Mollaret first described recurrent episodes of aseptic meningitis in 1944.1 Since it was first noted, several etiologies have been suggested, however, with the development of polymerase chain reaction (PCR), it is now known that patients with Mollaret’s meningitis contain Herpes Simplex Virus type 2 (HSV-2) in their cerebrospinal fluid (CSF) and the recurrent symptoms are due to reactivation of the virus.2 The CSF analysis often reveals a polymorphonuclear pleocytosis with large (Mollaret) cells early in the course of illness, followed by a lymphocytic predominance found later.3 Patients commonly present with meningeal symptoms, including fever, headache, and neck stiffness, and signs including positive Kernig and Brudzinski signs.4 They also often present with a recurrence of these symptoms, but the recurrence rate and previous medical history is extremely variable.5,6 In patients with human immunodeficiency virus (HIV), given their immunosuppressive state, meningitis can be caused by various etiologies, including bacterial, fungal, and viral pathogens, including HIV itself. While cryptococcal meningitis is the most common cause of meningitis, opportunistic infections such as cryptococcus primarily infect individuals with a CD4 count less than 350.7 In this case, a patient with HIV and aseptic meningitis is presented.","PeriodicalId":17991,"journal":{"name":"Kansas Journal of Medicine","volume":"16 ","pages":"19-20"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/03/65/16-19.PMC9872499.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10632359","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}

{"title":"Return to Sport After Primary Anterior Cruciate Ligament (ACL) Reconstruction: A Survey of The American Orthopaedic Society for Sports Medicine.","authors":"Shin Xu,&nbsp;Sana G Cheema,&nbsp;Armin Tarakemeh,&nbsp;Jeffrey Randall,&nbsp;Megan Bechtold,&nbsp;Scott Mullen,&nbsp;Paul Schroeppel,&nbsp;Mary K Mulcahey,&nbsp;Bryan G Vopat","doi":"10.17161/kjm.vol16.18617","DOIUrl":"https://doi.org/10.17161/kjm.vol16.18617","url":null,"abstract":"<p><strong>Introduction: </strong>Anterior cruciate ligament (ACL) tears are a common sports injury, and typically require a prolonged post-operative rehabilitation. The purpose of this study was to survey members of the American Orthopaedic Society for Sports Medicine (AOSSM) to determine their return to sport (RTS) criteria after primary ACL reconstruction (ACLR).</p><p><strong>Methods: </strong>A 23-question, anonymous survey hosted through Google^® Docs was distributed electronically to AOSSM members. This survey included questions regarding the timing, as well as any functional tests or other metrics used to determine when an athlete is ready to RTS.</p><p><strong>Results: </strong>A total of 863 surgeons responded over four months. The most popular graft choice was bone patellar tendon bone autograft (63%). For non-pivoting sports, 43% of respondents allowed RTS at five to six months, while 31% allowed RTS at seven to eight months. For pivoting sports, 34% of respondents allowed RTS at seven to eight months, while 36% allowed RTS at nine to ten months. The most common criteria for return to non-pivoting sports include full knee motion (89%) and time after ACLR (76%). The most common criteria for return to pivoting sports include full knee motion (87%) and passing a hop test (80%). Only 21% of respondents assessed for psychological readiness to RTS.</p><p><strong>Conclusions: </strong>RTS occurred sooner in non-pivoting than pivoting sports, with similar RTS criteria in both groups. Most respondents did not assess for psychological readiness to RTS.</p>","PeriodicalId":17991,"journal":{"name":"Kansas Journal of Medicine","volume":"16 ","pages":"105-109"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/03/9d/16-105.PMC10136672.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9393689","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}

{"title":"Navigating Work-Life Integration, Legal Issues, Patient Safety: Lessons for Work-Life Wellness in Academic Medicine: Part 1 of 3.","authors":"Jennifer L Hartwell,&nbsp;Paul Barach,&nbsp;Tracy D Gunter,&nbsp;Kyra Reed,&nbsp;Heather Kelker,&nbsp;Julie Welch,&nbsp;Kristine Olson,&nbsp;Elizabeth Harry,&nbsp;Samantha Meltzer-Brody,&nbsp;Mariah Quinn,&nbsp;Jennifer Ferrand,&nbsp;Sharon C Kiely,&nbsp;Jane Hartsock,&nbsp;Emily Holmes,&nbsp;Kristin Schroeder,&nbsp;Rami Ahmed","doi":"10.17161/kjm.vol16.19952","DOIUrl":"https://doi.org/10.17161/kjm.vol16.19952","url":null,"abstract":"In this series of three manuscripts, we will explore real-life scenarios encountered by clinicians, learners, and researchers in healthcare, which challenge our assumptions and our understanding of how to navigate issues as diverse as mental health, racial diversity, gender discrimination, imposter syndrome, and substance use disorder.","PeriodicalId":17991,"journal":{"name":"Kansas Journal of Medicine","volume":"16 ","pages":"153-158"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/14/3c/16-153.PMC10291991.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9781800","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}

{"title":"Unique Etiology of Trigeminal Neuralgia After Acute Ischemic Stroke.","authors":"James L Walker,&nbsp;Jared McLaughlin,&nbsp;John Dickerson,&nbsp;Sukruta S Pradhan,&nbsp;Felecia A Newton","doi":"10.17161/kjm.vol16.19500","DOIUrl":"https://doi.org/10.17161/kjm.vol16.19500","url":null,"abstract":"Unique Etiology of Trigeminal Neuralgia After Acute Ischemic Stroke James L. Walker, M.D.1, Jared McLaughlin, D.O.1, John Dickerson, M.D.2, Sukruta S. Pradhan, M.D.1, Felecia A. Newton, Ph.D.1 1University of Kansas School of Medicine-Wichita, Wichita, KS Department of Anesthesiology 2Kansas Spine and Specialty Hospital, Wichita, KS Received Feb. 3, 2023; Accepted for publication May 23, 2023; Published online July 25, 2023 https://doi.org/10.17161/kjm.vol16.19500","PeriodicalId":17991,"journal":{"name":"Kansas Journal of Medicine","volume":"16 ","pages":"185-186"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/23/f4/16-185.PMC10395765.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9930312","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}