Kansas journal of medicine最新文献

{"title":"Critical Appraisal of a Systematic Review Comparing Surgical and Conservative Therapies in Treating Meniscus Root Tears.","authors":"Alexandria Watkins, Shang-You Yang","doi":"10.17161/kjm.vol19.24720","DOIUrl":"https://doi.org/10.17161/kjm.vol19.24720","url":null,"abstract":"","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 2","pages":"43-46"},"PeriodicalIF":0.0,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793374","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":"Lower Abdominal Juvenile Xanthogranuloma in an Infant: A Rare Site of Presentation.","authors":"Jack R Thomas, Brandon R Litzner","doi":"10.17161/kjm.vol19.24768","DOIUrl":"https://doi.org/10.17161/kjm.vol19.24768","url":null,"abstract":"","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 2","pages":"40-42"},"PeriodicalIF":0.0,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793487","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":"A Cross-Sectional Analysis of Expanding Maternity Care Deserts in Rural Kansas Counties, 2016-2023.","authors":"Anna Carlson, Brenda Aguirre, Joshua Young, Ryan Hoefferle, Michael Kennedy, Laurel B Witt","doi":"10.17161/kjm.vol19.24265","DOIUrl":"https://doi.org/10.17161/kjm.vol19.24265","url":null,"abstract":"<p><strong>Introduction: </strong>Rural Kansas accounts for one-quarter of the state's population and births. Living in rural areas is associated with delayed prenatal care, adverse birth outcomes, and higher infant mortality. Limited access to obstetric services, particularly in maternity care deserts (MCDs), defined as counties without hospitals or clinicians offering obstetric care, contributes to these disparities. Authors of this study assessed obstetric care availability in rural Kansas and compared findings with 2016 data.</p><p><strong>Methods: </strong>In this cross-sectional study, rural hospitals were defined as those located in counties with <39.9 people per square mile using Kansas Department of Health and Environment (KDHE) data. Ninety-three hospitals were contacted by phone between August and October 2023. A survey, replicated from a 2016 study, assessed obstetric clinicians' availability, attrition, and anticipated retirements. Data were analyzed using descriptive statistics and Wilcoxon signed-rank tests.</p><p><strong>Results: </strong>Of 93 hospitals, 66 (71.0%) responded. Among these, 38 (57.6%) reported no obstetric services and 28 (42.4%) offered services. Nine hospitals (32.1%) anticipated losing clinicians within five years, including one (3.5%) expecting complete loss. Among 28 hospitals with data from both years, 50.0% lost ≥1 provider and 21.4% lost all. Median provider counts declined from 5 (IQR 3-6.5) to 4 (IQR 2-5; p = 0.038). MCDs have continued to expand.</p><p><strong>Conclusions: </strong>Obstetric care access in rural Kansas has declined, with expanding MCDs. These trends threaten maternal and neonatal outcomes and underscore the need for targeted strategies to sustain rural obstetric services.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 2","pages":"33-36"},"PeriodicalIF":0.0,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793440","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":"Access to Health Care for Children and Youth with Special Health Care Needs in Kansas: A Retrospective Analysis.","authors":"Trinity Bogle, Dulcinea Rakestraw, Hayrettin Okut, Kari Nilsen","doi":"10.17161/kjm.vol19.24287","DOIUrl":"https://doi.org/10.17161/kjm.vol19.24287","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the high prevalence of Children and Youth with Special Health Care Needs (CYSHCN) in the United States, health care services for this population remain insufficient. Prior studies have documented disparities in both access to and quality of care. We aimed to evaluate health care access and barriers among CYSHCN in Kansas.</p><p><strong>Methods: </strong>Using data from the 2021 National Survey of Children's Health (NSCH), we conducted a retrospective, quasi-experimental analysis of health care access and barriers among 1,696 Kansas households. Children were classified as having special health care needs based on diagnoses across 24 specified conditions.</p><p><strong>Results: </strong>Although most CYSHCN in Kansas reported adequate access to health care (97.2%), significant barriers persist, particularly among those with lifelong conditions. These children were more likely to report needing care but not receiving it (χ² _Rao-Scott (1, n = 1696) = 11.64; p <0.001; OR 0.29; 95% CI, 0.14-0.61), primarily due to appointment or service unavailability and cost. They also were more likely to report difficulty paying medical bills (χ² _Rao-Scott (1, n = 1291) = 10.21; p <0.001; OR 0.49; 95% CI, 0.31-0.77), and a greater proportion lived in poverty (χ² _Rao-Scott (1, n = 1696) = 5.29; p = 0.021; OR 0.74; 95% CI, 0.57-0.96).</p><p><strong>Conclusions: </strong>While CYSHCN in Kansas generally reports adequate health care access, important barriers remain. Efforts to improve access to specialty care, reduce costs, and enhance insurance coverage are essential to improving care for this vulnerable population.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 2","pages":"24-28"},"PeriodicalIF":0.0,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793451","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":"Emerging Concern: Lidocaine Adulterated \"Purple Fentanyl\" in the Midwest.","authors":"Satneet Singh, Melissa Perchellet, Sophie Troupe, Roopa Sethi","doi":"10.17161/kjm.vol19.24641","DOIUrl":"https://doi.org/10.17161/kjm.vol19.24641","url":null,"abstract":"","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 2","pages":"47-48"},"PeriodicalIF":0.0,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793513","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":"Is Embolization a Safe Treatment Option for Certain Traumatic Subdural Hematomas?","authors":"Cody Neuburger, Siman Antar, Mohamad Halloum, Jared Reyes, James M Haan","doi":"10.17161/kjm.vol19.24163","DOIUrl":"https://doi.org/10.17161/kjm.vol19.24163","url":null,"abstract":"<p><strong>Introduction: </strong>Middle meningeal artery (MMA) embolization is effective in chronic subdural hematoma (SDH), but its safety in acute SDH remains unclear. Authors of this study evaluated the safety of MMA embolization in acute SDH management.</p><p><strong>Methods: </strong>We conducted a retrospective review of adult acute SDH patients treated between July 2021 and July 2023 at a community-based Level I Trauma Center. Demographics, injury characteristics, treatments, and outcomes were compared between patients who did and did not undergo MMA embolization.</p><p><strong>Results: </strong>Records from 33 patients with acute SDH were reviewed: 17 underwent MMA embolization and 16 did not. Patients in the embolization group were older (median age 71.0 vs. 37.5 years). Minimal differences were observed between groups with respect to sex, race, or injury severity score. Non-embolized patients presented with a lower median Glasgow Coma Scale (GCS) score (11.5 vs. 14.0). Among the 17 embolized patients, 11 presented with acute bleeding and 6 with acute-on-chronic bleeding. Two patients in each subgroup required craniotomy prior to embolization. Of the remaining non-operatively managed patients, one underwent burr hole evacuation one day after embolization and was subsequently discharged to hospice. No patients required craniotomy after MMA embolization.</p><p><strong>Conclusions: </strong>MMA embolization appears to be a safe and potentially effective adjunct in the management of acute SDH, particularly in less severe cases. Larger, controlled studies are needed to better define its role and to determine whether it should be incorporated into standard treatment paradigms.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 2","pages":"29-32"},"PeriodicalIF":0.0,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793543","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":"Multifocal Cardiac Fibroma Discovered During Pregnancy: A Case Report.","authors":"Reuben L Odai, Emmanuel Oundo, Abdul-Rahman Akkawi, Laiba Sajjad, Anthony Alchaer, Hope Smelser, Wassim H Shaheen","doi":"10.17161/kjm.vol19.24909","DOIUrl":"https://doi.org/10.17161/kjm.vol19.24909","url":null,"abstract":"","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 2","pages":"37-39"},"PeriodicalIF":0.0,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793538","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":"Disparities in Patient Portal Access and Their Association with Perceived Health Care Quality Among U.S. Adults: A Population-Based Cross-Sectional Study.","authors":"Samuel Ofei-Dodoo, Hailey Rounsley, Yessin Wael, Hayrettin Okut, Tiffany Huynh, Kaidyn Smith, Katelyn Cunningham, Fernanda Reyes","doi":"10.17161/kjm.vol19.24775","DOIUrl":"https://doi.org/10.17161/kjm.vol19.24775","url":null,"abstract":"<p><strong>Introduction: </strong>Patient portals are designed to improve transparency, engagement, and satisfaction with health care. However, disparities in access and encouragement to use portals persist, and their relationship with perceived care quality is not well understood. Authors of this study examined whether being offered access to a patient portal, and being encouraged to use it, were associated with higher perceived quality of care among United States adults.</p><p><strong>Methods: </strong>The authors analyzed data from the 2024 Health Information National Trends Survey 7 (HINT 7), a nationally representative cross-section of United States adults aged ≥18 years. Weighted analyses assessed associations between portal access offers, encouragement, and self-rated care quality in the past 12 months, adjusting for sociodemographic characteristics.</p><p><strong>Results: </strong>Among 7,278 respondents (mean [SD] age, 49.0 [18.0] years), 78.6% rated their care as good, very good, or excellent. Overall, 73% had portal access and 69.0% were encouraged to use a portal. The number of respondents offered access to patient portal was significantly lower among older adults ≥75 years (10.6%; χ² ₈=108.2, p <0.0001), women (27.9%; χ² ₄=31.7, p <0.0001), those with lower income (8.3%; χ² ₁₀=158.0, p <0.0001) or education (13.6%; χ² ₆=107.9, p <0.0001), and rural residents (10.0%; χ² ₂=12.1, p = 0.0024). In adjusted analyses, being offered portal access was associated with higher odds of rating care as excellent (aOR 2.47, 95% CI 1.21-5.07).</p><p><strong>Conclusions: </strong>Being offered portal access independently was associated with higher perceived care quality. Addressing disparities in portal access; especially among older, lower-income, and rural populations; may improve equity in patient experience.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147350096","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":"Does Mortality Risk Increase with Active Treatment of Patent Ductus Arteriosus in Preterm Infants? A Critical Appraisal Skills Programme (CASP) Assessment of a Meta-Analysis.","authors":"Caitlynn B Bohanon Franco, Rosey E Zackula, Talkad S Raghuveer","doi":"10.17161/kjm.vol19.24634","DOIUrl":"https://doi.org/10.17161/kjm.vol19.24634","url":null,"abstract":"","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 1","pages":"20-23"},"PeriodicalIF":0.0,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147350100","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":"The Meaning of Community Characteristics in the Recruitment and Retention of Rural Health Care Professionals.","authors":"Brynn Niblock, Dorothy Hughes","doi":"10.17161/kjm.vol19.24260","DOIUrl":"https://doi.org/10.17161/kjm.vol19.24260","url":null,"abstract":"<p><strong>Introduction: </strong>Rural communities face shortages of health care professionals, leading to reduced access to care and increased patient mortality. While prior studies have identified factors that positively influence recruitment and retention, limited research has examined how community characteristics shape these experiences. Authors of this study aimed to better understand the role of community characteristics in recruiting and retaining rural health care professionals in Kansas.</p><p><strong>Methods: </strong>In-depth interviews were conducted with physicians, advanced practice providers (APPs), and nurses working at University of Kansas School of Medicine Summer Training Option in Rural Medicine (STORM) sites. Interviews explored the meaning of community characteristics and their influence on recruitment and retention experiences. Participants were recruited via email. Interviews were digitally recorded, transcribed, and coded inductively. Thematic network analysis was used to develop global themes and inform conclusions.</p><p><strong>Results: </strong>Seventeen rural health care professionals (6 physicians, 5 APPs, and 6 nurses) participated. The average interview length was 18.6 minutes. Five global themes emerged: (1) predisposing factors, (2) community ability to meet basic needs, (3) workplace satisfaction and sense of purpose, (4) fulfillment through social connections and environment, and (5) challenges in rural health care. Although these themes were consistent across professions, each profession described their impact differently.</p><p><strong>Conclusions: </strong>Factors influencing recruitment and retention of rural health care professionals in Kansas were similar across professions; however, their meaning and impact varied by profession. Recognizing these differences is important for developing strategies to improve recruitment and retention in rural communities.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 1","pages":"9-14"},"PeriodicalIF":0.0,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147350158","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}