Kansas journal of medicine最新文献

{"title":"Physician Workforce in Kansas: Where are the Orthopedic Surgeons?","authors":"Dorothy Hughes, Derek Reese, Kim Templeton","doi":"10.17161/kjm.vol17.21124","DOIUrl":"https://doi.org/10.17161/kjm.vol17.21124","url":null,"abstract":"Introduction. Rural patients have greater need but less access to orthopedic surgical care than their urban counterparts. Previous studies have investigated rural surgical care, but this is the first to assess the Kansas orthopedic surgery workforce to identify changes over time and rurality and inform thinking about future workforce composition.      \u0000Methods. The authors analyzed 2009 and 2019 AMA MasterFile and Area Health Resource File (AHRF) data. Using frequencies, percentages, and calculations of orthopedic surgeons per capita, we assessed workforce changes by rurality (Rural Urban Continuum Codes).  \u0000Results. The dataset included 307 orthopedic surgeons; 197 were in both 2009 and 2019. Of these, 165 were in active practice in 2009 and 244 in 2019, an increase of 79 (47.9%). Kansas had smaller proportions of surgeons in rural (non-metro) versus urban (metro) counties in both years. Orthopedic surgeons per capita grew throughout the state, but the increase was smaller in rural counties. There were 11 women orthopedic surgeons in both years, 3.6% of the total 307. Among the 197 surgeons in both years, four (2.0%) were women. No women orthopedic surgeons were in non-metro counties either year.  \u0000Conclusions. Although the Kansas orthopedic surgery workforce grew from 2009 to 2019, rural Kansas remains a surgery desert based on orthopedic surgeons per capita. Further studies could determine whether this trend is similar to that in other rural states and how to attract orthopedic surgeons to rural practice.","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"12 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140239277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lemierre's Syndrome Caused by Streptococcus pneumoniae in a Patient with Carbimazole-Induced Severe Neutropenia","authors":"Naman Lodha, Nakka Vihari, N. Midha, Tashmeen Kaur Sethi, Pawan Garg, Vibhor Tak","doi":"10.17161/kjm.vol17.21217","DOIUrl":"https://doi.org/10.17161/kjm.vol17.21217","url":null,"abstract":"","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"26 35","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140240170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gallbladder Torsion: A Rare but Critical Diagnosis","authors":"Jessica Keller, Shaun Best, Christine Boatright","doi":"10.17161/kjm.vol17.21594","DOIUrl":"https://doi.org/10.17161/kjm.vol17.21594","url":null,"abstract":"","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"61 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140237265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is it Worsening ADHD or Graves' Disease? A Case Report of Undiagnosed Graves' Disease in a Patient with ADHD","authors":"Htet Htet Lin, Nazeen Morelli, Susanna Ciccolari Micaldi","doi":"10.17161/kjm.vol17.21368","DOIUrl":"https://doi.org/10.17161/kjm.vol17.21368","url":null,"abstract":"","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"17 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140239203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Telemedicine in Rural Specialty Care: Priorities and Recommendations from Rural Primary Care Physicians","authors":"Faith Hampton, Jeremy Larson, Alyssa Hobson, Ph.D Dorothy Hughes","doi":"10.17161/kjm.vol17.21290","DOIUrl":"https://doi.org/10.17161/kjm.vol17.21290","url":null,"abstract":"Introduction. The study goal was to understand telemedicine’s role in improving access to rural specialty care. Other outcomes included assessing specialty availability and frequency of referrals at rural sites.      \u0000Methods. This mixed methods study included surveys and semi-structured interviews of rural primary care physicians (PCPs). Survey data were analyzed with summary statistics and cross-tabulations. Interview transcripts were inductively thematically analyzed.  \u0000Results. Of the 19 PCPs who completed the survey, 37% agreed/strongly agreed current telemedicine practices connected patients to better specialty care; 90% agreed/strongly agreed it had such potential. Interviews revealed telemedicine could improve care when local specialists were unavailable and provided the most benefit in acute care settings or specialist follow-ups. Most survey respondents reported outreach specialists were highly effective in addressing rural specialty care needs. Respondents reported cardiology, general surgery, orthopedic surgery, ENT/otolaryngology, and dermatology as the most frequently referred-to specialties. In-person neurology, gastroenterology, and dermatology were unavailable in many communities. Respondents identified psychiatry as a high priority for telemedicine and discussed clinic-to-clinic visits to optimize telemedicine use.  \u0000Conclusions. The perceived discrepancy between the current and potential roles of telemedicine in rural specialty care suggests that telemedicine may not fully align with the needs of rural patients and could be optimized for rural practice settings. While local, in-person access to specialists remains a priority, telemedicine can reduce patient burdens and improve care when in-person specialists are unavailable. ","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"7 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140239380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal Decision-Making in Patients with Limited English Proficiency: What Factors are Involved?","authors":"Natalie Schelbar, Olivia Pruss, Maria Alonso-Luaces, Faith Butler","doi":"10.17161/kjm.vol17.21375","DOIUrl":"https://doi.org/10.17161/kjm.vol17.21375","url":null,"abstract":"Introduction. A comprehensive definition of culture encompasses shared norms, beliefs, expectations, language, and customs, all of which are crucial considerations when working with patients with limited English proficiency (LEP). In this study, the authors examined how language, external influences, and patient-provider relational factors associated with decisional conflict in prenatal care patients.      \u0000Methods. The authors conducted a cross-sectional study to assess decisional conflict related to postpartum contraception, elective induction, and newborn feeding methods. The survey included questions about demographics, communication methods, external influences, and provider trust, and was distributed to prenatal care patients who spoke either English or Spanish. Data analysis involved using descriptive statistics and chi-square analyses.  \u0000Results. Out of the 23 respondents, 12 were Spanish-speaking and 11 were English-speaking. Spanish-speaking participants were less likely to have health insurance compared to English-speaking participants (χ2(1, N = 23) = 3.67, p = 0.016). There was no statistically significant difference in decisional conflict between English- and Spanish-speaking participants. Religion affected 11 of 23 participants' decisions, while partner expectations influenced 10 of 23 participants. Working with an interpreter and the quality of interpretation were crucial for Spanish-speaking individuals. Most participants (59%) felt that the provider's understanding of the patient’s cultural background was important for decision-making.  \u0000Conclusions. While there was no association between language discordance and decisional conflict, several factors influencing prenatal decision-making were identified. The use and quality of interpretation significantly affected decision-making and should be prioritized for patients with LEP. Religion and partner expectations were found to be highly influential in decision-making. Respondents also emphasized the importance of the provider's understanding of the patient’s cultural background.","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"10 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140239420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effectiveness of Buprenorphine Transdermal Patch and Low Dose Sublingual Buprenorphine Induction to Transition to Long-Acting Subcutaneous Buprenorphine Injection in Opioid Use Disorder in Inpatient Setting","authors":"Jack Gorham, Faisal Ansari, Roopa Sethi","doi":"10.17161/kjm.vol17.21229","DOIUrl":"https://doi.org/10.17161/kjm.vol17.21229","url":null,"abstract":"","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"49 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140239801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Electrocautery to Facilitate Suture Passage Through the Greater Trochanter of the Femur: A Biomechanical Study.","authors":"Jackson R Staggers, Alexander C M Chong, Kevin A Dahl, Bruce E Piatt","doi":"10.17161/kjm.vol16.21132","DOIUrl":"10.17161/kjm.vol16.21132","url":null,"abstract":"<p><strong>Introduction: </strong>The specific aims of this study were to evaluate (1) the axial force reduction of suture passage utilizing electrocautery when applied to the greater trochanter of the femur, (2) the temperature change caused while using electrocautery for suture passage, and (3) the failure loads and failure modes utilizing this technique.</p><p><strong>Methods: </strong>Five matched pairs of fresh-frozen femurs were used and classified into two groups: with electrocautery on needle (study group) and without electrocautery on needle (control group). Two bicortical, osseous tunnels were made around the insertion of the gluteus medius tendon. Each specimen was sequentially tested in a needle penetration test and a single load-to-failure test. A #5 Ethibond suture with a straight needle was used.</p><p><strong>Results: </strong>Electrocautery reduced the peak axial force for bone penetration in 40% (near cortex) and 70% (far cortex) of the trials, and no significant difference was detected between groups or between two osseous tunnels. The average peak force was significantly higher for the far cortex for both groups and for both osseous tunnels compared to the near cortex. There was no significant change in temperature of the tunnel site with electrocautery. Ninety percent of the samples experienced bone tunnel failure for the study group compared to 70% in the control group. The average ultimate failure load for the study group was lower compared with the control group, but this finding was not statistically significant (range: 6%-15%).</p><p><strong>Conclusions: </strong>Suture passage using electrocautery may not significantly decrease the peak force needed to pass a needle directly through the greater trochanter.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"16 ","pages":"316-320"},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10829854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652424","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":"Health Literacy Analytics of Accessible Patient Resources in Cardiovascular Medicine: What are Patients Wanting to Know?","authors":"Som P Singh, Aarya Ramprasad, Anh Luu, Rohma Zaidi, Zoya Siddiqui, Trung Pham","doi":"10.17161/kjm.vol16.20554","DOIUrl":"10.17161/kjm.vol16.20554","url":null,"abstract":"<p><strong>Introduction: </strong>There remains an increasing utilization of internet-based resources as a first line of medical knowledge. Among patients with cardiovascular disease, these resources often are relied upon for numerous diagnostic and therapeutic modalities. However, the reliability of this information is not fully understood. The aim of this study was to provide a descriptive profile on the literacy quality, readability, and transparency of publicly available educational resources in cardiology.</p><p><strong>Methods: </strong>The frequently asked questions and associated online educational articles on common cardiovascular diagnostic and therapeutic interventions were investigated using publicly available data from the Google RankBrain machine learning algorithm after applying inclusion and exclusion criteria. Independent raters evaluated questions for Rothwell's Classification and readability calculations.</p><p><strong>Results: </strong>Collectively, 520 questions and articles were evaluated across 13 cardiac interventions, resulting in 3,120 readability scores. The sources of articles were most frequently from academic institutions followed by commercial sources. Most questions were classified as \"Fact\" at 76.0% (n = 395), and questions regarding \"Technical Details\" of each intervention were the most common subclassification at 56.3% (n = 293).</p><p><strong>Conclusions: </strong>Our data show that patients most often are using online search query programs to seek information regarding specific knowledge of each cardiovascular intervention rather than form an evaluation of the intervention. Additionally, these online patient educational resources continue to not meet grade-level reading recommendations.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"16 ","pages":"309-315"},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10829858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652468","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":"Short and Long-Term Success of a Surgery Residency Prep Course.","authors":"Grace M Crouch, Kelly A Winter, Karson R Quinn, Stephen D Helmer, Marilee F McBoyle","doi":"10.17161/kjm.vol16.20090","DOIUrl":"10.17161/kjm.vol16.20090","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to assess the feasibility of evaluating the short-term and long-term effectiveness of a surgery residency prep course throughout the intern year.</p><p><strong>Methods: </strong>The authors offered a surgery residency prep course to graduating medical students. We used an anonymous survey to assess the perceived confidence in medical knowledge, clinical skills and surgical skills pre-course, post-course, and at six months into residency. Participants also completed a pre- and post-course quiz.</p><p><strong>Results: </strong>Eleven students completed the course and participated in a pre-course survey, seven completed the post-course survey, and four completed the six month survey. Students felt significantly more confident for intern year following the course compared to before the course (4.0 vs. 2.7, p = 0.018). There was no significant change in perceived confidence at six months compared to post-course results (4.0 vs. 3.9, p = 0.197). Objectively, there was a significant improvement in postcourse quiz results compared to pre-course quiz results (12.9 vs. 10.6, p = 0.004).</p><p><strong>Conclusions: </strong>This study demonstrates that a surgery prep course may have long-term positive effects on resident confidence when entering a surgery residency.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"16 ","pages":"321-323"},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10829851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652422","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}