Kansas journal of medicine最新文献

{"title":"Artificial Intelligence Templating for Total Knee Arthroplasty: Using Standard Preoperative Knee Radiographs.","authors":"Nathan Whitsell, Rosalee Zackula, Tarun Bhargava","doi":"10.17161/kjm.vol19.25384","DOIUrl":"https://doi.org/10.17161/kjm.vol19.25384","url":null,"abstract":"<p><strong>Introduction: </strong>This study investigated the accuracy and learning capabilities of an artificial intelligence (AI) templating algorithm that converts two-dimensional (2D) knee radiographs to three-dimensional (3D) bone models to facilitate preoperative planning in total knee arthroplasty (TKA).</p><p><strong>Methods: </strong>108 consecutive patients who underwent primary TKA by a single surgeon during a seven-month period were identified retrospectively. De-identified preoperative anteroposterior and lateral radiographs were uploaded to a novel AI algorithm (PeekMed, Braga, Portugal). The accuracy of the AI algorithm was evaluated by comparing implanted tibial and femoral sizes to the AI-predicted implant sizes. Novel machine learning with improved accuracy over time was evaluated by comparing the percentage of implanted components that were within one size (±1) of the predicted size between the initial 50 patients, and last 51 patients.</p><p><strong>Results: </strong>The AI algorithm accurately predicted the exact femoral and tibial implant sizes in 40% and 41.5% of cases, respectively. When allowing for (±1) size difference, the accuracy of the predicted femoral and tibial sizes improved to 90% and 87%, respectively. The AI algorithm significantly increased in accuracy over time for the tibial component (80% vs 94%, p = 0.0342) and trended towards significantly improved accuracy for the femoral component (87% vs 94%, p = 0.1719).</p><p><strong>Conclusions: </strong>2D radiographs converted to 3D models by this AI-based algorithm demonstrated high levels of accuracy when predicted TKA implant sizes were compared with the component sizes actually implanted during Department of Surgery. Moreover, prediction accuracy improved over time suggesting the algorithm may be a valuable preoperative planning tool for TKA.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 Suppl 1","pages":"15"},"PeriodicalIF":0.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944237","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":"When Inflammation Mimics Malignancy: Recognizing VEXAS Syndrome in Oncology Practice.","authors":"Laura El Halabi, Marcel Katrib, Anthony Albayeh, Alexandre Khoury, Nadia Katrib, Giovanni Yanni, Jannane Nasr, Ammar Al-Obaidi","doi":"10.17161/kjm.vol19.25390","DOIUrl":"https://doi.org/10.17161/kjm.vol19.25390","url":null,"abstract":"<p><strong>Introduction: </strong>VEXAS syndrome is a recently identified clonal hematoinflammatory disorder caused by acquired somatic mutations in the <i>UBA1</i> gene in hematopoietic stem and progenitor cells. Its discovery established a paradigm linking clonal hematopoiesis with systemic inflammation and progressive bone marrow dysfunction. Patients commonly present with persistent cytopenias and multisystem inflammatory manifestations that overlap with myelodysplastic syndromes, other clonal hematologic disorders, and complications encountered in oncology practice. As a result, affected individuals often are evaluated within hematology and oncology pathways, where findings may initially be attributed to malignancy, paraneoplastic inflammation, or treatment-related toxicity, contributing to delayed diagnosis.</p><p><strong>Methods: </strong>We conducted a narrative synthesis of published clinical studies, cohort analyses, and molecular investigations describing the pathogenesis, hematologic manifestations, and diagnostic features of VEXAS syndrome, with emphasis on findings relevant to hematology and oncology practice.</p><p><strong>Results: </strong>VEXAS syndrome predominantly affects men older than 50 years and is defined by somatic <i>UBA1</i> mutations that drive myeloid inflammation and bone marrow dysfunction. Hematologic manifestations include persistent macrocytic anemia, thrombocytopenia, and other cytopenias, frequently occurring in association with clonal hematologic disorders such as myelodysplastic syndromes and plasma cell dyscrasias. Bone marrow examination characteristically demonstrates cytoplasmic vacuolization of myeloid and erythroid precursor cells. Patients also may develop systemic inflammatory manifestations involving the skin, lungs, cartilage, joints, and vasculature, with recurrent fever and venous thromboembolism commonly reported.</p><p><strong>Conclusions: </strong>VEXAS syndrome represents a clonal hematoinflammatory disorder at the intersection of hematology, oncology, and immunology. Recognition of unexplained cytopenias accompanied by systemic inflammation should prompt consideration of <i>UBA1</i> testing to facilitate earlier diagnosis and multidisciplinary management.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 Suppl 1","pages":"21"},"PeriodicalIF":0.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944416","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":"EMS Perspectives of Community Paramedicine in Rural Kansas: A Cross-Sectional Survey.","authors":"Tyler Boone, Nicole Freund","doi":"10.17161/kjm.vol19.25363","DOIUrl":"https://doi.org/10.17161/kjm.vol19.25363","url":null,"abstract":"<p><strong>Introduction: </strong>Community Paramedicine (CP) is an evolving model of care designed to improve access to healthcare, particularly in rural communities where disparities are pronounced. However, the perspectives of Kansas Emergency Medical Services (EMS) professionals regarding CP have not been previously studied. Authors of this study aimed to inform CP implementation in Kansas.</p><p><strong>Methods: </strong>A cross-sectional survey was administered to EMS professionals in rural Kansas communities with clinical sites affiliated with the Summer Training Option in Rural Medicine (STORM), including EMS and fire departments across 19 communities. The survey included Likert-scale and open-ended questions assessing EMS professionals' understanding and perceptions of CP.</p><p><strong>Results: </strong>The study yielded 59 completed surveys and 9 incomplete surveys. Across all certification levels, respondents reported the highest confidence in assessment skills and the lowest confidence in referral activities. Paramedics and Advanced EMTs reported at least moderate confidence across more skill areas than EMTs. Reported concerns that may discourage CP certification included training and certification requirements, limited interest, funding and staffing constraints, perceived mismatch with the EMS mission, workload and age, liability, compensation, patient education, and organizational culture and morale. Most respondents (86%) believed that implementing CP would at least moderately improve healthcare access in their communities.</p><p><strong>Conclusions: </strong>EMS professionals reported confidence in many skills relevant to CP, suggesting that a CP scope of practice may align with existing EMS competencies, potentially minimizing the need for substantial additional training. Targeted education in prevention, public health, and referral skills may strengthen CP programs. Ensuring fair compensation, accessible training opportunities, and financial support for CP program development will be critical to successful implementation.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 Suppl 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944287","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":"Heterotopic Ossification Following Total Elbow Arthroplasty in Geriatric Distal Humerus Fractures: A Retrospective Cohort Study.","authors":"Christopher Merritt, Rosalee Zackula, Alex Bollinger","doi":"10.17161/kjm.vol19.25385","DOIUrl":"https://doi.org/10.17161/kjm.vol19.25385","url":null,"abstract":"<p><strong>Introduction: </strong>The purposes of this study were to determine (1) whether delay to total elbow arthroplasty (TEA) after traumatic distal humerus fracture affects heterotopic ossification (HO) formation and (2) whether HO is associated with postoperative elbow range of motion (ROM).</p><p><strong>Methods: </strong>This retrospective cohort study included patients with distal humerus fractures who underwent TEA at a single institution by a single orthopaedic surgeon from 2017 to 2021. All procedures were performed using a triceps fascial tongue approach. Patients did not receive HO prophylaxis and followed a standardized postoperative rehabilitation protocol. Demographic and clinical data were extracted from medical records and entered into an electronic database. Postoperative radiographs were reviewed for evidence of periarticular HO. HO volume was estimated using three-dimensional linear measurements derived from orthogonal radiographic views. Pearson bivariate correlation analyses were performed to assess associations between HO volume, time to surgery, and patient characteristics.</p><p><strong>Results: </strong>Sixteen female patients were included, with a mean age of 78.9 (±9.8) years. Median time to surgery was 14.5 days (IQR, 11-27.5). There was no significant correlation between delay to surgery and HO volume, which averaged 5.5 (±4.5) cm³. Among five of fifteen patients with a postoperative total elbow arc of motion <100°, the mean time to surgery was 17.6 days and mean HO volume was 9.2 cm³.</p><p><strong>Conclusion: </strong>Delay to TEA was not associated with HO volume in geriatric patients treated for distal humerus fractures. However, increased HO volume was associated with reduced postoperative elbow ROM.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 Suppl 1","pages":"16"},"PeriodicalIF":0.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944293","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":"Assessing Resident Knowledge Regarding Menopause, Treatment, and Patient Care.","authors":"Paige Nichols, Annie Carlson, Jennifer Keomany, Ashley Robbins","doi":"10.17161/kjm.vol19.25369","DOIUrl":"https://doi.org/10.17161/kjm.vol19.25369","url":null,"abstract":"<p><strong>Introduction: </strong>Current literature demonstrates significant deficiencies in menopause education among Department of Obstetrics and Gynecology (OB-GYN) residents, with limited formal curricula reported across residency programs. Reported gaps in resident knowledge and comfort with menopause management pose a concern for the growing aging population in the United States. The aim of this project was to assess resident knowledge of menopause, treatment options, and patient care.</p><p><strong>Methods: </strong>This cross-sectional, survey-based study involved OB-GYN residents affiliated with The University of Kansas School of Medicine-Wichita, Wichita, Kansas. The survey included questions assessing knowledge and comfort related to menopause topics. The primary outcome was resident knowledge regarding menopause. This study was conducted at a community-based OB-GYN residency program and was designed to be reproducible across residency programs.</p><p><strong>Results: </strong>Of 20 residents, 14 responses were received and analyzed (70% response rate). Most respondents reported fewer than 5 hours of exposure to menopause education (56.3%, n = 9). Of five knowledge questions, two had fewer than 25% correct responses. Most residents reported being only somewhat comfortable and needing additional experience explaining the etiology and physiology of menopause symptoms (56.3%, n = 9). When asked whether the program prepares them to confidently treat menopausal patients after graduation, the largest proportion neither agreed nor disagreed (43.8%, n = 7).</p><p><strong>Conclusions: </strong>Residents demonstrated limited knowledge of menopause and low comfort with menopause management. Although this study was limited to a single program, the findings are consistent with current literature. Increased exposure to menopausal patients and topics, along with standardized menopause curricula, may improve resident knowledge and comfort in menopause management.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 Suppl 1","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944318","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":"Preparing Sedgwick County Physicians to Treat Addiction: A Mixed-Methods Study.","authors":"Jason Nayar, Melinda Chenault, Elizabeth Ablah","doi":"10.17161/kjm.vol19.25391","DOIUrl":"https://doi.org/10.17161/kjm.vol19.25391","url":null,"abstract":"<p><strong>Introduction: </strong>Substance use disorders (SUDs) remain a major public health challenge in the United States, yet many affected individuals do not receive treatment. Physicians play a critical role in identifying and addressing SUD through screening, brief intervention, referral, and treatment; however, barriers such as limited training, stigma, and lack of awareness of treatment resources may limit physician engagement. The purpose of this study was to examine physician practices related to screening, brief intervention, referral, and treatment of SUD in Sedgwick County, Kansas, and to identify barriers and facilitators to providing care.</p><p><strong>Methods: </strong>We conducted a mixed-methods study using structured qualitative interviews and an electronic survey. Twenty-six attending physicians, residents, and medical students participated in interviews. In addition, an electronic survey distributed to physicians, residents, and medical students in Sedgwick County received 253 responses (17% response rate). Quantitative data were analyzed using descriptive statistics, and qualitative responses were coded to identify common themes.</p><p><strong>Results: </strong>Respondents most commonly reported screening for substance use (49%), referring patients to treatment (47%), and providing brief interventions (38%), whereas only 17% reported directly treating SUD. Frequently reported barriers included limited knowledge of local treatment resources, patient resistance or lack of follow-through, and time constraints during clinical encounters.</p><p><strong>Conclusions: </strong>Nearly half of respondents reported screening and referring patients with suspected SUD, but fewer reported comfort or engagement in direct treatment. Expanding physician training, improving awareness of local treatment resources, and implementing system-level supports may increase physician participation in SUD care and improve access to treatment.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 Suppl 1","pages":"22"},"PeriodicalIF":0.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944350","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":"Comparative Analysis of Reported Adverse Events with Nirsevimab and Palivizumab: A FAERS Observational Study.","authors":"Ibrahim Touffaha, Elizabeth Ablah, Hayrettin Okut, Gretchen Homan","doi":"10.17161/kjm.vol19.25389","DOIUrl":"https://doi.org/10.17161/kjm.vol19.25389","url":null,"abstract":"<p><strong>Introduction: </strong>Respiratory syncytial virus (RSV) is a leading cause of hospitalization among infants worldwide. Passive immunization remains central to prevention. Palivizumab has been used for over two decades, whereas nirsevimab, approved in 2023, provides extended protection with a single dose. However, comparative post-marketing safety data between these agents remain limited. Authors compared post-marketing adverse event profiles of nirsevimab and palivizumab using the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS).</p><p><strong>Methods: </strong>FAERS reports from July 2023 to March 2025 were analyzed. Reports were included if patients were ≤2 years of age and either nirsevimab or palivizumab was listed as the primary suspect drug. Duplicate and incomplete records were excluded. Adverse events were classified using Medical Dictionary for Regulatory Activities (MedDRA) System Organ Class (SOC) categories. Group comparisons were performed using chi-square or Fisher's exact tests as appropriate. Logistic regression was used to identify SOCs disproportionately associated with each drug.</p><p><strong>Results: </strong>A total of 2,021 reports met inclusion criteria (nirsevimab = 641; palivizumab = 1,380). Hospitalization was reported in 50% of nirsevimab cases and 70% of palivizumab cases, while deaths were reported in 5.9% and 9.8% of cases, respectively. Logistic regression identified three SOCs reported more frequently with nirsevimab: injury, poisoning, and procedural complications (OR 11.9, p < 0.0001), nervous system disorders (OR 2.9, p = 0.029), and skin and subcutaneous tissue disorders (OR 4.5, p = 0.002). No SOCs were reported more frequently with palivizumab.</p><p><strong>Conclusions: </strong>Nirsevimab and palivizumab demonstrated broadly comparable post-marketing safety profiles. Higher reporting of administration-related adverse events for nirsevimab likely reflects its recent introduction and reporting patterns rather than inherent differences in safety.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 Suppl 1","pages":"20"},"PeriodicalIF":0.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944331","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":"Gender and Burnout in Health Care Delivery - It's Complicated Cross-Sectional Study.","authors":"Bao Nhu To, Pravina Rodrigues, Hayrettin Okut, Robert Badgett","doi":"10.17161/kjm.vol19.25387","DOIUrl":"https://doi.org/10.17161/kjm.vol19.25387","url":null,"abstract":"<p><strong>Introduction: </strong>Multiple studies have demonstrated that women have a higher individual risk of reporting workplace burnout. In a prior analysis examining religion and burnout, we observed that a higher proportion of women within a healthcare organization was associated with lower aggregate burnout prevalence. Authors of the present study examined the association between gender composition and burnout among health care staff.</p><p><strong>Methods: </strong>We conducted a cross-sectional study using data from the 2021-2024 English National Health Service Staff Survey and followed STROBE guidelines for observational reporting. Random forest regression was used to identify key predictors of burnout. Mediation analyses were then performed to evaluate indirect pathways through which organizational gender composition may be associated with burnout.</p><p><strong>Results: </strong>The analysis included 942 organizational reports comprising 2,681,573 survey responses. In unadjusted analyses, a higher proportion of female staff was associated with lower reported burnout at the organizational level. However, after adjustment for workplace stressors and resources, this association reversed, with higher female representation associated with increased burnout. Mediation analyses suggested that higher proportions of female staff were associated with more favorable workplace characteristics, including increased perceived membership and autonomy, as well as reduced harassment and discrimination.</p><p><strong>Conclusions: </strong>Consistent with prior literature, adjusted analyses support an association between female gender and higher individual-level burnout. However, at the organizational level, unadjusted analyses demonstrated an inverse association, which reversed after adjustment for workplace factors. Mediation findings suggest that gender composition may influence burnout through improvements in workplace culture, particularly increased sense of membership. If replicated, these findings warrant further investigation into mechanisms by which organizational composition shapes burnout and how these pathways may be leveraged for intervention.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 Suppl 1","pages":"18"},"PeriodicalIF":0.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944337","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":"Resident Pediatricians' Reflections on Mental Health Care in Kansas: Findings from a Focus Group.","authors":"McKenzie James, Sarah Krogman, Carolyn Ahlers-Schmidt, Kari Harris","doi":"10.17161/kjm.vol19.25376","DOIUrl":"https://doi.org/10.17161/kjm.vol19.25376","url":null,"abstract":"<p><strong>Introduction: </strong>Kansas faces a critical pediatric mental health (MH) workforce shortage, leaving many children without timely access to specialty care. As a result, pediatric primary care physicians (PCPs) are increasingly responsible for MH care despite limited training, time, and system support. Understanding PCP perspectives is essential to developing interventions that expand pediatric MH capacity.</p><p><strong>Methods: </strong>A qualitative focus group was conducted at the Kansas Chapter of the American Academy of Pediatrics' 2025 Progress in Pediatrics Conference in Wichita, Kansas. Practicing physicians participated in guided discussions exploring experiences with pediatric MH, confidence, barriers, and recommendations. Sessions were recorded, transcribed, and analyzed using thematic analysis informed by grounded theory, with independent coding and consensus-based theme development.</p><p><strong>Results: </strong>Nine resident physicians participated. They described growing awareness and acceptance of pediatric MH needs. Helpful supports included co-located MH professionals, electronic health record prompts, required training, and programs such as KAAP and KSKidsMAP. Persistent barriers included limited time, referral challenges, poor continuity, and limited knowledge of community resources. Parents were viewed as essential partners, though they sometimes hindered care because of stigma or communication difficulties. Residents felt confident managing anxiety and depression but preferred referral for more complex conditions. Participants emphasized the need for streamlined referrals, expanded training, and stronger collaborative care models.</p><p><strong>Conclusions: </strong>Findings highlight ongoing system- and knowledge-related barriers and reinforce the need for programs that support PCPs in addressing pediatric MH gaps in Kansas.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 Suppl 1","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944388","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":"Anesthetic Modulation of Cancer Cell Biology: Convergent Roles of Lipid Rafts and Voltage-Gated Sodium Channels (A Narrative Review).","authors":"Yousaf Khan, Will Krogman, Tyler Jonas","doi":"10.17161/kjm.vol19.25364","DOIUrl":"https://doi.org/10.17161/kjm.vol19.25364","url":null,"abstract":"<p><strong>Introduction: </strong>Anesthetic agents traditionally are recognized for reversibly suppressing neuronal excitability through ion channel modulation and membrane interactions. Emerging evidence suggests these agents also may influence cancer cell biology. Malignant cells exhibit increased cholesterol-rich lipid rafts and aberrant expression of voltage-gated sodium (NaV) channels, particularly neonatal splice variants, which together promote oncogenic signaling, invasion, metabolic reprogramming, and metastasis. Because anesthetics directly interact with both lipid membranes and NaV channels, they may modulate cancer-specific vulnerabilities.</p><p><strong>Methods: </strong>Authors conducted a narrative using PubMed to identify experimental and clinical studies evaluating the effects of local, volatile, and intravenous anesthetics on lipid raft organization, NaV function, and cancer biology. Key search terms included \"anesthetics,\" \"lipid rafts,\" \"voltage-gated sodium channels,\" and \"cancer.\" Relevant mechanistic and preclinical data were synthesized.</p><p><strong>Results: </strong>Preclinical evidence demonstrates that local anesthetics inhibit NaV activity, reduce persistent sodium influx, impair cytoskeletal remodeling, suppress extracellular acidification, and decrease cancer cell migration and invasion. They also induce mitochondrial dysfunction, apoptosis, autophagy, and immunogenic cell death. In contrast, volatile anesthetics often activate PI3K/Akt/mTOR and hypoxia-inducible factor pathways while suppressing anti-tumor immunity. Intravenous agents such as propofol exhibit context-dependent effects, with studies demonstrating both anti-proliferative and pro-migratory outcomes.</p><p><strong>Conclusions: </strong>Anesthetics exert convergent effects on membrane lipid organization and NaV signaling, two interconnected regulators of malignant behavior. Local anesthetics demonstrate the most consistent anti-tumor profile, whereas volatile agents may promote survival signaling under certain conditions. Although clinical data remain largely neutral, these mechanistic insights provide a biologically grounded framework for interpreting perioperative oncologic outcomes and for designing anesthetic strategies that minimize tumor-promoting effects.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"19 Suppl 1","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944043","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}