Kansas journal of medicine最新文献

{"title":"Cranial Nerve III Palsy and Nothnagel Syndrome in a Patient with Vascular Risk Factors: A Case Report.","authors":"Ethan Scharf, Clifford Kissling","doi":"10.17161/kjm.vol19.24386","DOIUrl":"10.17161/kjm.vol19.24386","url":null,"abstract":"","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 3","pages":"72-73"},"PeriodicalIF":0.0,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440487","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":"Aggressive Plasmablastic Myeloma with Retroperitoneal Extramedullary Plasmacytoma.","authors":"Ty M Moore, Morgan B Heitt, Jeries Kort","doi":"10.17161/kjm.vol19.25065","DOIUrl":"10.17161/kjm.vol19.25065","url":null,"abstract":"","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 3","pages":"68-71"},"PeriodicalIF":0.0,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440430","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 Qualitative Evaluation of Infant Safe Sleep Following Free Crib Provision.","authors":"Kourtney Bettinger, Maheen Bangash, Danica Dodd, Carolyn R Ahlers-Schmidt, Christy Schunn, Ann Davis","doi":"10.17161/kjm.vol19.25004","DOIUrl":"10.17161/kjm.vol19.25004","url":null,"abstract":"<p><strong>Introduction: </strong>Unsafe sleep practices are a leading cause of infant mortality in the United States. Authors of this qualitative study examined parental perceptions and reported practices related to infant safe sleep among families who received a free portable crib after their infant's birth. Specifically, authors explored whether families used the portable crib to provide a safe sleep environment for their infants.</p><p><strong>Methods: </strong>Parents of infants aged 2 to 11 months who received a free portable crib were invited to participate in a structured 11-question interview assessing safe sleep perceptions and practices, including crib use. Eleven families participated in the study.</p><p><strong>Results: </strong>Six themes emerged from the interviews: (1) parents recalled receiving safe sleep counseling, often in considerable detail; (2) many parents initially planned to bed-share before receiving the crib; (3) reported sleep practices frequently differed from established safe sleep recommendations; (4) parents described multiple reasons for not consistently following recommendations; (5) participants supported the continued provision of free cribs and safe sleep counseling; and (6) parents generally found the crib helpful, although it often was used alongside other sleep arrangements.</p><p><strong>Conclusion: </strong>Although parents recalled receiving safe sleep counseling, reported sleep practices frequently did not align with recommended guidelines. Further research is needed to better understand this gap and to identify strategies that improve adherence to safe sleep recommendations.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 3","pages":"49-54"},"PeriodicalIF":0.0,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440332","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":"Pneumothorax Secondary to Lymphangioleiomyomatosis.","authors":"Allison M Coy","doi":"10.17161/kjm.vol19.24389","DOIUrl":"10.17161/kjm.vol19.24389","url":null,"abstract":"","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 3","pages":"64-67"},"PeriodicalIF":0.0,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440642","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":"Complementary Medicine in Oncology: A Dual-Perspective Examination of Patient Use and Clinician Attitudes.","authors":"Anthony Albayeh, Alexandre Khoury, Marcel Katrib, Laura El Halabi, Janane Nasr, Ammar Al-Obaidi","doi":"10.17161/kjm.vol19.25374","DOIUrl":"https://doi.org/10.17161/kjm.vol19.25374","url":null,"abstract":"<p><strong>Introduction: </strong>Use of complementary and alternative medicine (CAM) among cancer patients has increased, yet limited research has examined how patient behaviors, clinician perspectives, and communication patterns intersect within the same clinical environment. This scoping review examines the prevalence and types of CAM used by cancer patients, evaluates oncologists' knowledge and attitudes toward CAM, and identifies communication factors shaping disclosure and clinical decision-making in conventional oncology care.</p><p><strong>Methods: </strong>Following PRISMA-ScR guidelines, this review included peer-reviewed studies assessing CAM use among adult cancer patients, clinician perspectives, or patient-physician communication. Eligible studies included surveys, observational studies, systematic reviews, and clinical reports.</p><p><strong>Results: </strong>Included studies demonstrated that approximately 40% of cancer patients reported using CAM, with common modalities including herbal products, nutraceuticals, probiotics, and mind-body therapies. Non-disclosure rates varied considerably, with many patients refraining from discussing CAM use because of concerns about negative provider reactions or limited consultation time. On the clinician side, key barriers included limited formal training in CAM and uncertainty regarding the quality of supporting evidence. Evidence also demonstrated communication gaps and discordance between patient motivations and clinician concerns related to treatment safety and herb-drug interactions.</p><p><strong>Conclusions: </strong>CAM use remains prevalent in oncology and is shaped by patient beliefs, cultural factors, and clinical communication. Variability in study methods and definitions limits cross-study comparisons. Enhancing clinician education, fostering open communication, and conducting institutional assessments may improve the safe and informed integration of CAM into oncology practice.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 Suppl 1","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944282","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 Retrospective Cross-Sectional Study Investigating the Effect of Albumin Administration on the BDG (1,3-β-D-glucan) Serum Assay.","authors":"Chelsea Huerter, Emily Hughes, Monica Ahrens, Albert Eid","doi":"10.17161/kjm.vol19.25388","DOIUrl":"https://doi.org/10.17161/kjm.vol19.25388","url":null,"abstract":"<p><strong>Introduction: </strong>The β-D-glucan (BDG) serum assay is a screening tool used in the diagnosis and management of invasive fungal infections (IFI). False-positive results have been reported, including in patients who have recently received intravenous albumin prior to testing. Author of this study examined the association between timing of albumin administration and BDG assay results.</p><p><strong>Methods: </strong>We conducted a retrospective cross-sectional study of 4,599 electronic health records at The University of Kansas Health System (TUKHS). Patients were eligible if they were ≥18 years of age and had a BDG serum assay performed between 2010 and 2020. Demographic data, comorbidities, albumin administration, and IFI status were extracted and recorded in REDCap, a HIPAA-compliant database. The final analytic cohort included 2,061 patients. Logistic regression was used to assess the association between time from albumin administration to BDG testing and false-positive results. Statistical analyses were performed using R version 4.5.2.</p><p><strong>Results: </strong>A total of 255 patients received albumin within two weeks prior to BDG testing, of whom 109 (42.7%) had a positive BDG result. Among these positive results, 83 were classified as false positives (false-positive rate: 76.1%). Logistic regression demonstrated the highest odds of a false-positive result when albumin was administered 6-8 days prior to testing (OR 1.22; 95% CI 0.51-2.91).</p><p><strong>Conclusions: </strong>Albumin administration within days preceding BDG testing may be associated with an increased risk of false-positive results, potentially leading to unnecessary diagnostic evaluation and treatment.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 Suppl 1","pages":"19"},"PeriodicalIF":0.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944342","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":"Vitamins and Cancer Risk: A Comprehensive Review of Epidemiologic and Clinical Evidence.","authors":"Laura El Halabi, Anthony AlBayeh, Alexandre Khoury, Marcel Katrib, Janane Nasr, Ammar Al-Obaidi","doi":"10.17161/kjm.vol19.25377","DOIUrl":"https://doi.org/10.17161/kjm.vol19.25377","url":null,"abstract":"<p><strong>Introduction: </strong>Vitamin supplementation nearly is universal among patients with cancer, yet the scientific landscape is far more complex. Across decades of research, vitamins have demonstrated profound biological effects ranging from immune activation and ferroptosis modulation to paradoxical tumor promotion.</p><p><strong>Objective: </strong>This scoping review maps the breadth of compelling and controversial evidence surrounding vitamins A, D, E, K, C, and the B-complex in cancer prevention, treatment response, and toxicity.</p><p><strong>Methods: </strong>Guided by PRISMA-ScR domains, we synthesized mechanistic studies, epidemiologic cohorts, randomized trials, and therapeutic investigations addressing vitamins in the oncology context. Eligibility focused on sources examining cancer risk, progression, treatment interactions, or toxicity.</p><p><strong>Results: </strong>Several vitamins exhibit striking anticancer mechanisms: vitamin K2 triggers autophagy-driven leukemia cell death; pharmacologic vitamin C selectively kills KRAS- and BRAF-mutated colorectal cancer cells; niacin reshapes the tumor immune microenvironment; and vitamin D enhances microbiome-dependent antitumor immunity. Yet the review also identifies potential harms, including beta-carotene increasing lung cancer risk in smokers, vitamin E raising prostate cancer risk, and antioxidant supplementation potentially weakening the oxidative mechanisms essential for chemotherapy and radiotherapy efficacy. Dose-response patterns frequently are U-shaped, with both deficiency and excess linked to greater risk. High-dose intravenous vitamin C, vitamin D repletion during immunotherapy, and vitamin-targeted nanoparticles emerge as promising but unproven therapeutic strategies.</p><p><strong>Conclusions: </strong>Across vitamins, benefits appear highly context-dependent. Routine supplementation is unsupported, while targeted correction of true deficiencies remains essential. This rapidly evolving field demands individualized decision-making and rigorously designed trials to define when vitamins act as allies, and when they become adversaries, in cancer care.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 Suppl 1","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944394","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":"Understanding Practice Intentions and Barriers Following Pediatric Mental Health ECHO Participation.","authors":"McKenzie James, Sarah Krogman, Carolyn Ahlers-Schmidt, Kari Harris","doi":"10.17161/kjm.vol19.25365","DOIUrl":"https://doi.org/10.17161/kjm.vol19.25365","url":null,"abstract":"<p><strong>Introduction: </strong>A national shortage of mental health professionals has shifted much of youth mental and behavioral health care to primary care professionals (PCPs), who often feel underprepared, especially in Kansas, where most counties are designated mental health shortage areas. Project ECHO provides continuing medical education (CME) to strengthen PCPs' ability to manage pediatric mental health conditions.</p><p><strong>Methods: </strong>Authors administered a 10-item survey immediately after ECHO sessions from April 2020 to October 2024. A cross-sectional analysis of 512 CME surveys was conducted, and descriptive statistics were used to summarize responses across eight mental health topics.</p><p><strong>Results: </strong>Respondents included physicians (n = 346), APRNs (n = 114), nurses (n = 81), PAs (n = 18), and other professionals (n = 157). Survey counts varied by topic: ADHD (n = 92), Anxiety (n = 65), Autism (n = 28), Depression (n = 59), ID/DD (n = 56), Sleep (n = 86), Suicide (n = 41), and Trauma (n = 85). Across topics, 50-71% of PCPs strongly agreed they learned information that could improve patient outcomes. Many respondents (45-70%) reported no barriers to applying new strategies. When barriers were identified, lack of knowledge was the most common (19-30%), except in suicide sessions, where \"other\" barriers were cited most frequently (17%).</p><p><strong>Conclusions: </strong>Findings indicate that knowledge gaps remain the primary barrier to implementing pediatric mental health care, underscoring the value of programs such as KSKidsMAP ECHO in improving provider confidence and practice uptake. Participants also reported gaining information they could share with colleagues, suggesting a broader team-level impact.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 Suppl 1","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944371","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":"Tocilizumab: From Bench to Bedside - A Comprehensive Review.","authors":"Alexandre Khoury, Laura El Halabi, Anthony Al Bayeh, Marcel Katrib, Janane Nasr, Pavan Reddy","doi":"10.17161/kjm.vol19.25372","DOIUrl":"https://doi.org/10.17161/kjm.vol19.25372","url":null,"abstract":"<p><strong>Introduction: </strong>Interleukin-6 (IL-6) is a key mediator of inflammation and cancer biology. Tocilizumab, an IL-6 receptor blocker, is used to treat autoimmune diseases and has become essential in managing cytokine release syndrome (CRS) associated with CAR-T cell therapy and bispecific antibodies. However, global access to tocilizumab, as well as the cost and uptake of its biosimilars, remains uneven. This review summarizes evidence across three major areas: clinical uses and safety, oncologic and CRS-related applications, and global access and biosimilars.</p><p><strong>Methods: </strong>Using a PRISMA-ScR approach, we mapped published studies, clinical data, and economic reports. We included evidence on tocilizumab's approved and emerging indications; its role in CRS related to immunotherapies; and access, pricing, and biosimilar availability across regions.</p><p><strong>Results: </strong>Tocilizumab continues to demonstrate reliable anti-inflammatory effects in rheumatoid arthritis, giant cell arteritis, and COVID-19, with a consistent safety profile that includes infections, cytopenias, and elevated liver enzymes or lipid levels. In oncology, it is the standard treatment for moderate to severe CRS associated with CAR-T therapy and is increasingly used with bispecific antibodies. Early or prophylactic use may reduce hospitalization without compromising anticancer efficacy. Preclinical and early clinical data also suggest IL-6 blockade may improve responses to immunotherapy, although this remains exploratory. Global access varies widely: FDA- and EMA-approved biosimilars have lowered costs in high-income regions, while affordability and availability remain major barriers in low- and middle-income countries.</p><p><strong>Conclusions: </strong>Tocilizumab now spans autoimmune care, supportive oncology, and early investigational cancer applications. Improving biosimilar access, clarifying CRS management strategies, and expanding high-quality oncologic trials are important next steps.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 Suppl 1","pages":"8"},"PeriodicalIF":0.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944399","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":"Pediatric Residents' Intubation Competency Through Simulation-Based Training: A Quality Improvement Initiative.","authors":"Roy Ghanem, Lukas Hall, Harsh Nathani, Sara Powell, Anton Rogachov, Robert Steele, Michael Nelson, Jacob Hunter, William Krogman, Christopher Plymire","doi":"10.17161/kjm.vol19.25386","DOIUrl":"https://doi.org/10.17161/kjm.vol19.25386","url":null,"abstract":"<p><strong>Introduction: </strong>Intubation is a critical skill in pediatric emergency medicine, yet many residents report limited procedural exposure. Simulation-based training provides a safe and structured environment to address this gap. Authors of this ongoing quality improvement (QI) initiative aimed to enhance pediatric residents' intubation skills through simulation-based assessment in partnership with the Department of Anesthesiology.</p><p><strong>Methods: </strong>A total of 24 residents participated (Pediatrics = 17; Med-Peds = 5). Stage 1 of the QI initiative consisted of a didactic seminar led by anesthesiology residents, followed by a skills workshop with four stations: bag-mask ventilation (BMV), oropharyngeal/nasopharyngeal airway placement, laryngeal mask airway insertion, and endotracheal intubation. Outcomes included pre- and post-intervention multiple-choice examinations (MCQs), self-reported confidence surveys, and objective skills assessments evaluated by anesthesiology faculty. Primary outcomes were changes in knowledge, confidence, and intubation competency scores.</p><p><strong>Results: </strong>Mean pre-MCQ scores were 11.75 (±3.2) out of 20, increasing to 16.4 (±2.8) post-intervention (p < 0.001). Skills assessment identified lower performance in LEMON assessment, head positioning, and BMV technique. Self-reported confidence in airway management increased from 3.6 (±2.1) to 7.2 (±1.5) (p < 0.001). Confidence in BMV improved from 5.7 (±2.3) to 8.5 (±1.7) (p < 0.01), and confidence in intubation increased from 3.5 (±1.9) to 7.0 (±1.4) (p < 0.001).</p><p><strong>Conclusions: </strong>Stage 1 of this QI initiative improved both knowledge and self-reported confidence in pediatric airway management among residents. These findings suggest that simulation-based training may enhance short-term competency in pediatric intubation skills. Long-term skill retention will be evaluated in Stage 2 using a delayed post-intervention MCQ following a high-fidelity simulation session.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 Suppl 1","pages":"17"},"PeriodicalIF":0.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944259","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}