Kansas Journal of Medicine最新文献

{"title":"Management of Labile Blood Pressure due to COVID-19 Infection and Radiation Induced Baroreceptor Dysfunction.","authors":"Timothy Nguyen, Stephen S Wanjala, Mona B Brake","doi":"10.17161/kjm.vol16.19691","DOIUrl":"https://doi.org/10.17161/kjm.vol16.19691","url":null,"abstract":"Management of Labile Blood Pressure due to COVID-19 Infection and Radiation Induced Baroreceptor Dysfunction Timothy Nguyen, D.O.1, Stephen S. Wanjala, M.D.1, Mona B. Brake, M.D., FACN1,2 1University of Kansas School of Medicine-Wichita, Wichita, KS Department of Internal Medicine 2Robert J. Dole Veterans Affairs Medical Center, Wichita, KS Received March 10, 2023; Accepted for publication May 22, 2023; Published online July 25, 2023 https://doi.org/10.17161/kjm.vol16.19691","PeriodicalId":17991,"journal":{"name":"Kansas Journal of Medicine","volume":"16 ","pages":"182-184"},"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/22/86/16-182.PMC10395768.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9939505","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":"Assessment of Emergency Medical Services Personnel Compliance with Escalating Airway Algorithm Protocol.","authors":"Leah Duncan,&nbsp;Michael Falahat,&nbsp;Connor Hartpence,&nbsp;Deryk S Ruddle,&nbsp;Samuel Ofei-Dodoo","doi":"10.17161/kjm.vol16.18938","DOIUrl":"https://doi.org/10.17161/kjm.vol16.18938","url":null,"abstract":"<p><strong>Introduction: </strong>When emergency medical services (EMS) personnel respond to emergencies, the decisions they make often can mean life or death for the patient. This is especially true in the case of advanced airway management. Protocols are set in place to ensure that the least invasive airway management techniques are used initially before more invasive techniques. The purpose of this study was to determine how often EMS personnel followed this protocol, while adequately achieving the goals of appropriate oxygenation and ventilation.</p><p><strong>Methods: </strong>This retrospective chart review was approved by the Institutional Review Board of the University of Kansas Medical Center. The authors reviewed the Wichita/Sedgewick County EMS system for cases during 2017 in which patients required airway support. We examined de-identified data to determine if invasive methods were applied in sequence. Cohen's kappa coefficient (κ) and immersion-crystallization approach were used to analyze the data.</p><p><strong>Results: </strong>A total of 279 cases were identified in which EMS personnel used advanced airway management techniques. In 90% (n = 251) of cases, less invasive techniques were not used prior to more invasive techniques and in 80% (n = 222) of cases, the more invasive technique was used alone. A dirty airway was the most common reason for the EMS personnel's choice of using more invasive approaches in achieving the goals of appropriate oxygenation and ventilation.</p><p><strong>Conclusions: </strong>Our data showed that EMS personnel in Sedgwick County/Wichita, Kansas often deviated from the advanced airway management protocols when caring for patients in need of respiratory intervention. Dirty airway was the main reason for using a more invasive approach in achieving the goals of appropriate oxygenation and ventilation. It is important to understand reasons why deviations in protocol were occurring to ensure that current protocols, documentation, and training practices are effective in producing the best possible patient outcomes.</p>","PeriodicalId":17991,"journal":{"name":"Kansas Journal of Medicine","volume":"16 ","pages":"53-55"},"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/ec/c3/16-53.PMC9957594.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9356976","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":"Injury Care: A Missing Piece in the December 15, 2022 U.S.-Africa Leaders' Summit.","authors":"Terrence B Epie,&nbsp;Ojas Patel,&nbsp;Jack Ayres,&nbsp;Albers Haley,&nbsp;Ravali Reddy,&nbsp;Wendy Metumah,&nbsp;Austin Gartner,&nbsp;Johnathan Dallman,&nbsp;Archie Heddings","doi":"10.17161/kjm.vol16.19222","DOIUrl":"https://doi.org/10.17161/kjm.vol16.19222","url":null,"abstract":"61 Injury Care: A Missing Piece in the December 15, 2022 U.S.-Africa Leaders' Summit Terrence B. Epie, M.D., M.Sc., MBA1,2, Ojas Patel1,3, Jack Ayres1,3, Albers Haley1,3, Ravali Reddy1,3, Wendy Metumah4, Austin Gartner1,3, Johnathan Dallman1,3, Archie Heddings, M.D.1,3 1African Trauma Initiative (ATI), Kansas City, KS 2University of Kansas, Lawrence, KS School of Business 3University of Kansas Medical Center, Kansas City, KS 4University of Ngaoundéré, Ngaoundéré, Cameroon Received Jan. 20, 2023; Accepted for publication Jan. 24, 2023; Published online Feb. 21, 2023 https://doi.org/10.17161/kjm.vol16.19222","PeriodicalId":17991,"journal":{"name":"Kansas Journal of Medicine","volume":"16 ","pages":"61"},"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/d5/0a/16-61.PMC9957596.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9356981","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":"Splenic Artery Pseudoaneurysm in a Septic Patient with Acute Pancreatitis.","authors":"Mahmoud Mahdi,&nbsp;Aastha Bharwad,&nbsp;Rajeev Seecheran,&nbsp;Joud Zakhour,&nbsp;Majd Kayali,&nbsp;Ahmad Mahdi","doi":"10.17161/kjm.vol16.18696","DOIUrl":"https://doi.org/10.17161/kjm.vol16.18696","url":null,"abstract":"Splenic Artery Pseudoaneurysm in a Septic Patient with Acute Pancreatitis Mahmoud Mahdi, M.D., Aastha Bharwad, M.D., Rajeev Seecheran, M.D., Joud Zakhour, M.D., Majd Kayali, M.D., Ahmad Mahdi, M.D. University of Kansas School of Medicine-Wichita, Wichita, KS Department of Internal Medicine Received Nov. 16, 2022; Accepted for publication Dec. 20, 2022; Published online Jan. 18, 2023 https://doi.org/10.17161/kjm.vol16.18696","PeriodicalId":17991,"journal":{"name":"Kansas Journal of Medicine","volume":"16 ","pages":"17-18"},"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/c6/89/16-17.PMC9872497.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10632358","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":"On the Relationship Between Stakeholder Affiliation and Attitudes Toward Behavioral Health Reform in Kansas.","authors":"Ngoc X Vuong,&nbsp;Nikki K Woods","doi":"10.17161/kjm.vol16.18542","DOIUrl":"https://doi.org/10.17161/kjm.vol16.18542","url":null,"abstract":"<p><strong>Introduction: </strong>The lack of access to behavioral health care, trends in behavioral health issues, and the impact of social determinants of health underlie the need for behavioral health reform in Kansas. However, stakeholders may affect progress toward behavioral health reform. This study examined stakeholders' attitudes toward behavioral health reform.</p><p><strong>Methods: </strong>The authors analyzed data from a survey administered to elected officials, members of health advocacy groups, state employees, and payers in Kansas. Main outcome measures included attitudes toward the perceived benefit of certain behavioral health and social determinants of health policies and the perceived performance of the primary care and behavioral health care systems in Kansas.</p><p><strong>Results: </strong>Payers perceived legislation to improve insurance coverage for behavioral health issues as less beneficial than state employees and members of health advocacy groups. Elected officials perceived legislation to address various social determinants of health as less beneficial than health advocates. Members of health advocacy groups rated the behavioral health care system more poorly than elected officials did.</p><p><strong>Conclusions: </strong>Preliminary findings reflected both the barriers and facilitators to behavioral health reform in Kansas. However, several limitations undermined the generalizability of these findings. Future studies should consider more representative sample sizes, additional variables in behavioral health and social determinants of health policies, and more comprehensive, validated measures.</p>","PeriodicalId":17991,"journal":{"name":"Kansas Journal of Medicine","volume":"16 ","pages":"28-34"},"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/e3/a0/16-28.PMC9957591.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9341346","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":"Risk of Occupational HPV Exposure Among Medical Trainees: A Call for HPV Vaccination.","authors":"William M Webb,&nbsp;Andrea E Covey","doi":"10.17161/kjm.vol16.19567","DOIUrl":"https://doi.org/10.17161/kjm.vol16.19567","url":null,"abstract":"The global COVID-19 pandemic has brought new scrutiny to aero-sol-generating medical procedures (AGMPs) and the risk that they pose to healthcare workers, namely through the transmission of aerosolized viral particles and viral DNA. As a result, there is now widespread knowl-edge of the risks posed by the SARS-CoV-2 virus and the measures that protect against it, including personal protective equipment and vaccination. However, healthcare workers regularly encounter another virus that is known to be highly contagious in multiple contexts and leads to significant morbidity and mortality. This is the human papillomavirus (HPV), which accounts for up to 79% of all oropharyngeal cancers in the U.S. and is a known cause of respiratory conditions such as recurrent laryngeal papillomatosis. 1-2 While studies into the respiratory transmission of HPV mainly have examined the risk posed by exposure to and inhalation of surgical smoke during procedures such as loop electrosurgical excision pro-cedure and CO2-laser ablation, 3 many non-surgical AGMPs, such as mechanical ventilation and even endotracheal suctioning, have been shown to result in the airborne transmission of other virus-contain-ing aerosols. 4 Although more research is needed to determine the risk of HPV transmission specifically in procedures that are common to general and critical care medicine, the list of known AGMPs includes sputum induction, nebulized or aerosol therapy, high-flow oxygen therapy, non-invasive and manual ventilation, endotracheal intuba-tion and","PeriodicalId":17991,"journal":{"name":"Kansas Journal of Medicine","volume":"16 ","pages":"143"},"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/15/6a/16-143.PMC10241205.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9963433","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":"Should Infants with Blunt Traumatic Brain Injuries and Intracranial Hemorrhage Have Routine Repeat Imaging?","authors":"E Patricia Engel,&nbsp;Bradon Bitter,&nbsp;Jared Reyes,&nbsp;Raymond Grundmeyer,&nbsp;Stephen D Helmer,&nbsp;James M Haan","doi":"10.17161/kjm.vol16.19209","DOIUrl":"https://doi.org/10.17161/kjm.vol16.19209","url":null,"abstract":"<p><strong>Introduction: </strong>The practice of repeat head CT imaging in infants as a distinct population is poorly studied. The purpose of this study was to evaluate the incidence and utility of repeat head CT in the infant population.</p><p><strong>Methods: </strong>A 10-year retrospective review was conducted of infants with blunt traumatic head injuries (N = 50) that presented to a trauma center. Information from the hospital trauma registry and patient medical records were extracted regarding the size and type of injury, number and results of computed tomography (CT) imaging, changes in neurological exams, and any interventions that were required.</p><p><strong>Results: </strong>Most patients (68%) had at least one repeat CT, with 26% showing progression of hemorrhage. Decreased Glasgow Coma Scale was associated with having repeat CT scans. Nearly one in four infants had a change in management associated with repeat imaging. Repeat CT scans resulted in operative interventions in 11.8% of cases and longer intensive care unit (ICU) stays in 8.8% of cases. Repeat CT scans were associated with increased hospital length of stay, but not with increased ventilator days, ICU length of stay, or mortality. Worsening bleeds were associated with mortality, but not with other hospital outcomes.</p><p><strong>Conclusions: </strong>Changes in management following repeat CT appeared to be more common in this population than in older children or adults. Findings from this study supported repeat CT imaging in infants, however, further research is needed to validate results of this study.</p>","PeriodicalId":17991,"journal":{"name":"Kansas Journal of Medicine","volume":"16 ","pages":"117-120"},"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/b8/97/16-117.PMC10241199.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9963435","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":"Illicit Non-Pharmaceutical Fentanyl and Its Analogs: A Short Review of Literature.","authors":"Vivek Velagapudi,&nbsp;Roopa Sethi","doi":"10.17161/kjm.vol16.18555","DOIUrl":"https://doi.org/10.17161/kjm.vol16.18555","url":null,"abstract":"Illicit Non-Pharmaceutical Fentanyl and Its Analogs: A Short Review of Literature Vivek Velagapudi, B.S.1, Roopa Sethi, M.D.2 1University of Kansas School of Medicine, Kansas City, KS 2University of Kansas Health System, Kansas City, KS Department of Psychiatry and Behavioral Sciences Received Sept. 29, 2022; Accepted for publication Jan. 5, 2023; Published online Jan. 18, 2023 https://doi.org/10.17161/kjm.vol16.18555","PeriodicalId":17991,"journal":{"name":"Kansas Journal of Medicine","volume":"16 ","pages":"25-27"},"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/15/52/16-25.PMC9872502.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10632355","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":"Civil Commitment Law with a Focus on Hospitalized Patients History and Practice in Kansas: Part I and Part II.","authors":"David D Masolak,&nbsp;Pamela Parker,&nbsp;Jana Lincoln","doi":"10.17161/kjm.vol16.18707","DOIUrl":"https://doi.org/10.17161/kjm.vol16.18707","url":null,"abstract":"","PeriodicalId":17991,"journal":{"name":"Kansas Journal of Medicine","volume":"16 ","pages":"21-24"},"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/9b/7d/16-21.PMC9872501.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10632360","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":"Nicotine Dependence from Electronic Cigarettes Use and Depressive Symptoms Among Adolescents.","authors":"Christopher Winburn,&nbsp;Samuel Ofei-Dodoo","doi":"10.17161/kjm.vol16.18723","DOIUrl":"https://doi.org/10.17161/kjm.vol16.18723","url":null,"abstract":"<p><strong>Introduction: </strong>The use of electronic cigarettes (e-cigarettes) has been increasing among adolescents in the United States since they were first introduced to the U.S. market in 2007. With depression as a major risk factor for suicide in adolescents, this study examined nicotine dependence from the use of e-cigarettes and depressive symptoms among adolescents.</p><p><strong>Methods: </strong>The authors conducted a retrospective patient chart review at a pediatric clinic in the Midwestern United States, from May 2021 to September 2021. As a standard practice, the clinic uses the adapted Penn State Nicotine Dependency Index to evaluate its patients' nicotine dependence from the use of e-cigarettes, and the PHQ-9 modified for teens to screen for depressive symptoms of its patients. Data on 69 patients were included in the study. The authors used standard descriptive statistics and an adjusted odds ratio (aOR) to analyze the data on the 69 adolescents.</p><p><strong>Results: </strong>The mean age of the adolescents was 17.6 (SD = 2.3), 46.4% (n = 32) were female, and 53.6% (n = 37) were male. More than 88% (n = 61) of the adolescents met criteria for high nicotine dependence from e-cigarette use and 30.4% (21 of 69) of them screened positive for depression. Findings of the analyses indicated that there was not a statistically significant association between nicotine dependence from e-cigarette use and depressive symptoms (aOR = 1.07; 95% confidence interval, 0.93-1.23; p = 0.297).</p><p><strong>Conclusions: </strong>The results showed that while a third of the adolescents screened positive for depression and the majority (88%) depended on nicotine from e-cigarettes, there was no association between the outcomes. Future larger multicenter studies are needed to better understand the association between nicotine dependence from e-cigarettes and depressive symptoms as reported in the literature.</p>","PeriodicalId":17991,"journal":{"name":"Kansas Journal of Medicine","volume":"16 ","pages":"1-4"},"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/13/30/16-1.PMC9872498.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10625086","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}