Kansas journal of medicine最新文献_第8页

Contraceptive Knowledge and Counseling among OB-GYN and Family Medicine Physicians. 妇产科和家庭医生的避孕知识与咨询。

Kansas journal of medicine Pub Date : 2025-10-15 eCollection Date: 2025-09-01 DOI: 10.17161/kjm.vol18.23954

Nicole Thurman, Rachna Gulati, Jennifer Keomany, Mallory Lehr, Hayrettin Okut, Ashley Robbins

{"title":"Contraceptive Knowledge and Counseling among OB-GYN and Family Medicine Physicians.","authors":"Nicole Thurman, Rachna Gulati, Jennifer Keomany, Mallory Lehr, Hayrettin Okut, Ashley Robbins","doi":"10.17161/kjm.vol18.23954","DOIUrl":"10.17161/kjm.vol18.23954","url":null,"abstract":"Introduction: Few studies have examined contraceptive knowledge and counseling confidence among primary care residents and physicians. Authors of this study evaluated education, knowledge, and counseling practices related to contraception among physicians in obstetrics and gynecology (OB-GYN) and family medicine (FM).Methods: In this prospective, cross-sectional study, current OB-GYN and FM residents, as well as program graduates from the past five years at a single institution, were surveyed. The survey assessed demographics, contraception knowledge, provider confidence, counseling practices, and procedural experience. Responses were included in the analysis if at least one knowledge question was completed.Results: The final analysis included 45 respondents (8% response rate): 33.3% (n = 15) from FM and 66.7% (n = 30) from OB-GYN. Average knowledge scores did not differ significantly between FM (60%, 12/20) and OB-GYN physicians (70%, 14/20). Attending physicians' average scores were significantly higher (85%, 17/20) than residents (60%, 12/20; p = 0.0014). Most respondents (97.8%, n = 44) reported feeling comfortable counseling patients, and 93.3% (n = 42) felt comfortable performing procedures and prescribing contraceptives. OB-GYN physicians reported greater comfort placing levonorgestrel and Paragard® intrauterine devices (IUDs) than FM physicians (93%, n = 14 vs. 61%, n = 11; p = 0.040). More OB-GYN physicians (6.7%, n = 3) reported performing over 80 Nexplanon® insertions compared to FM physicians (0.0%, n = 0; p <0.0001).Conclusions: Contraceptive knowledge did not differ significantly between OB-GYN and FM physicians. However, advanced training was associated with greater comfort in both prescribing and performing contraceptive procedures.","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"18 5","pages":"115-118"},"PeriodicalIF":0.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350876","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}

引用次数: 0

Chronic Suicidality in Youth Admitted for Mental Health Emergencies: A Retrospective Chart Review. 因精神卫生紧急情况入院的青少年慢性自杀：回顾性图表回顾。

Kansas journal of medicine Pub Date : 2025-10-15 eCollection Date: 2025-09-01 DOI: 10.17161/kjm.vol18.23589

Nazeen Morelli, David Matuszewski, Coral Walker, Saba Fatima, Alisa Bridge, Nicole Klaus, Kari Harris, Paul Teran

{"title":"Chronic Suicidality in Youth Admitted for Mental Health Emergencies: A Retrospective Chart Review.","authors":"Nazeen Morelli, David Matuszewski, Coral Walker, Saba Fatima, Alisa Bridge, Nicole Klaus, Kari Harris, Paul Teran","doi":"10.17161/kjm.vol18.23589","DOIUrl":"10.17161/kjm.vol18.23589","url":null,"abstract":"Introduction: Suicide is a leading cause of death among youth in the United States. Most youth who attempt suicide have underlying mental health disorders, which account for approximately 10% of pediatric hospitalizations. Researchers hypothesized that children with chronic suicidality (CS) have more suicide-related risk factors, attempt suicide with greater lethality, and have more pre-existing mental health diagnoses compared to those without chronic suicidality (Non-CS).Methods: The study team reviewed pediatric hospitalizations related to suicide at Wesley Medical Center from 2016 to 2021. CS was defined as a reported history of, or prior hospitalization for, suicide-related behavior. The severity of suicidal ideation/behavior and actual lethality or medical damage was measured using the Columbia-Suicide Severity Rating Scale (C-SSRS).Results: Of 375 patients, 253 were classified as CS and 122 as Non-CS. Age and race distributions were similar between groups. Females were more likely to have CS (p = 0.0006). Patients with CS were more often admitted for suicide attempts rather than non-suicidal self-injury (p = 0.0171). No significant differences were found in method or lethality of attempts.Patients with CS experienced more peer stress, abuse, legal problems, and job-related issues (all p <0.05). No differences were observed in other stressors. CS patients had more prior mental health treatment (p <0.0001) and were more frequently discharged to inpatient mental health care (p <0.0001).Conclusions: Female gender and psychosocial stressors were associated with increased risk of chronic suicidality in youth. Early identification of these factors may enable earlier interventions to prevent suicide-related behaviors.","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"18 5","pages":"111-114"},"PeriodicalIF":0.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350936","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}

引用次数: 0

Laying it all out on the Table: A Case Report. 把一切都摆在桌面上：一份病例报告。

Kansas journal of medicine Pub Date : 2025-08-15 eCollection Date: 2025-07-01 DOI: 10.17161/kjm.vol18.24069

Chelsey M Schartz, Megan L Folsom

引用次数: 0

A Single-Center, Retrospective Comparison of Non-Pre-emptive with Pre-emptive Renal Transplantations. 单中心回顾性比较非抢先性与抢先性肾移植。

Kansas journal of medicine Pub Date : 2025-08-15 eCollection Date: 2025-07-01 DOI: 10.17161/kjm.vol18.23625

Terra M Hill, Lauren T Kerivan, Diego R Mazzotti

{"title":"A Single-Center, Retrospective Comparison of Non-Pre-emptive with Pre-emptive Renal Transplantations.","authors":"Terra M Hill, Lauren T Kerivan, Diego R Mazzotti","doi":"10.17161/kjm.vol18.23625","DOIUrl":"10.17161/kjm.vol18.23625","url":null,"abstract":"Introduction: End-stage renal disease (ESRD) requires renal replacement therapy, either through pre-emptive transplantation (PET) or non-pre-emptive transplantation (non-PET). PET is associated with improved patient and allograft survival compared to non-PET; however, only 2.5% of patients in the United States undergo PET. The authors of this study report on mortality and allograft rejection rates in patients undergoing PET versus non-PET.Methods: This single-center, retrospective study compared posttransplant complications between PET and non-PET in adults with ESRD. De-identified electronic health record data from 2017 to 2022 were analyzed. Odds ratios (ORs) for one-year post-transplant mortality and allograft rejection were calculated using unadjusted multivariate logistic regression (Model 1), adjusted for age and sex (Model 2), and further adjusted for comorbidities (Model 3).Results: A total of 787 patients with ESRD underwent kidney transplantation: 14% underwent non-PET and 86% underwent PET. Compared to PET, the ORs for one-year post-transplant mortality with non-PET were:Model 1: OR 1.76 (95% CI, 0.64-4.85; p = 0.27)Model 2: OR 2.02 (95% CI, 0.71-5.71; p = 0.19)Model 3: OR 1.86 (95% CI, 0.64-5.39; p = 0.24)For one-year allograft rejection, the ORs for non-PET versus PET were:Model 1: OR 1.63 (95% CI, 0.85-3.10; p = 0.13)Model 2: OR 1.61 (95% CI, 0.84-3.06; p = 0.15)Model 3: OR 1.60 (95% CI, 0.82-3.10; p = 0.16).Conclusions: This single-center study found no statistically significant differences in one-year mortality or allograft rejection between patients undergoing PET and non-PET.","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"18 4","pages":"86-88"},"PeriodicalIF":0.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984111","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}

引用次数: 0

Comparison of Polyethylene Thickness and Constraint in Traditional and Robotic-Assisted Total Knee Arthroplasty. 传统和机器人辅助全膝关节置换术中聚乙烯厚度和约束的比较。

Kansas journal of medicine Pub Date : 2025-08-15 eCollection Date: 2025-07-01 DOI: 10.17161/kjm.vol18.23669

Levi W Kindel, Rosalee E Zackula, Audrey L Schotte, Shang-You Yang, Paul C Pappademos

{"title":"Comparison of Polyethylene Thickness and Constraint in Traditional and Robotic-Assisted Total Knee Arthroplasty.","authors":"Levi W Kindel, Rosalee E Zackula, Audrey L Schotte, Shang-You Yang, Paul C Pappademos","doi":"10.17161/kjm.vol18.23669","DOIUrl":"10.17161/kjm.vol18.23669","url":null,"abstract":"Introduction: Thicker polyethylene inserts in total knee arthroplasty (TKA) may be associated with increased wear rates, a higher risk of implant failure, and the need for revision surgery. The authors of this study aimed to compare polyethylene insert thickness in robotic-assisted TKA versus conventional manual TKA.Methods: The authors conducted a cross-sectional study on patients with end-stage primary knee osteoarthritis who underwent TKA by a single fellowship-trained orthopedic surgeon over a two-year period. Patients with post-traumatic or inflammatory arthropathy or those undergoing revision arthroplasty were excluded. Demographics, implant manufacturer and type, and polyethylene insert thickness were recorded in an electronic database. Bivariate analyses, including t-tests, Mann-Whitney U tests, and Fisher's exact tests were used to compare robotic-assisted and manual TKA procedures.Results: Data from 222 patients were analyzed, with 111 in each group. The mean (standard deviation [SD]) age at surgery was similar between groups: 64.3 (8.2) years for robotic-assisted and 62.3 (8.8) years for the manual group (p = 0.398). Polyethylene insert thickness differed significantly: the median was 9 mm (range 9-13 mm) in the robotic-assisted group versus 11 mm (range 9-16 mm) in the manual group (p <0.001). The most frequently used thickness was 9 mm, used in 70.3% (78/111) of robotic-assisted cases compared to 34.2% (38/111) of manual cases (p <0.001).Conclusions: Robotic-assisted TKA was associated with significantly thinner polyethylene inserts compared to manual TKA, suggesting more precise, bone-sparing femoral and tibial cuts. These findings may support the use of robotic-assisted techniques by orthopedic surgeons seeking to optimize implant positioning and longevity.","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"18 4","pages":"83-85"},"PeriodicalIF":0.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984193","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}

引用次数: 0

The Impact of the Dobbs Decision on Access to Gender Diverse Care at a Midwest Academic Health Center. 多布斯决定对中西部学术健康中心获得性别多样化护理的影响。

Kansas journal of medicine Pub Date : 2025-08-15 eCollection Date: 2025-07-01 DOI: 10.17161/kjm.vol18.23425

Sarah Dreibelbis, Valerie French, Quinn Jackson, Sharon Fitzgerald Wolff, Meredith Gray

{"title":"The Impact of the Dobbs Decision on Access to Gender Diverse Care at a Midwest Academic Health Center.","authors":"Sarah Dreibelbis, Valerie French, Quinn Jackson, Sharon Fitzgerald Wolff, Meredith Gray","doi":"10.17161/kjm.vol18.23425","DOIUrl":"10.17161/kjm.vol18.23425","url":null,"abstract":"Introduction: The Dobbs decision returned the regulation of abortion to individual states. In the Midwest, several legislative efforts have included restrictions on both abortion and gender-affirming care. Clinics that provide abortion services sometimes offer gender-affirming care. Given this intersection, recent laws restricting abortion may have unintended consequences for access to gender-affirming care in the Midwest.Methods: Authors of this retrospective study analyzed medical records of patients seen at a Midwestern health center. We included patients aged 18 or older who attended a new patient visit at either the gender diversity clinic (GDC) or the general gynecology (GYN) clinic between July 1, 2021 and June 30, 2023. We used generalized estimating equations to assess changes in wait times and distance traveled pre- vs. post-Dobbs. Differences in new patient volume were analyzed using Poisson regression.Results: We reviewed 5,260 charts, 4,552 from the GYN clinic and 708 from the GDC. Following Dobbs, the GYN clinic experienced a 6% increase in new patients, while the GDC saw a 21% increase (p <0.001). The average wait time for a GYN appointment increased by two days, whereas the wait time for GDC appointments decreased by 21 days. The average distance traveled by new GYN patients decreased by 6.3 miles (p <0.001), while distance for GDC patients increased by 2.5 miles (p = 0.738).Conclusions: Patients continue to seek gender-affirming care in the post-Dobbs landscape. Despite an increase in patient volume, wait times for gender diversity appointments decreased, likely reflecting expanded appointment availability around the time of the Dobbs decision.","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"18 4","pages":"70-74"},"PeriodicalIF":0.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984237","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}

引用次数: 0

Knowledge Gaps of Professionals Regarding Infant Safe Sleep Recommendations: Qualitative Evaluation of Topics Learned. 专业人员关于婴儿安全睡眠建议的知识差距：所学主题的定性评估。

Kansas journal of medicine Pub Date : 2025-08-15 eCollection Date: 2025-07-01 DOI: 10.17161/kjm.vol18.22753

Katherine Hess, Ashley Hervey, Alicia Smith, Christy Schunn, Maria Torres, Carolyn R Ahlers-Schmidt

{"title":"Knowledge Gaps of Professionals Regarding Infant Safe Sleep Recommendations: Qualitative Evaluation of Topics Learned.","authors":"Katherine Hess, Ashley Hervey, Alicia Smith, Christy Schunn, Maria Torres, Carolyn R Ahlers-Schmidt","doi":"10.17161/kjm.vol18.22753","DOIUrl":"10.17161/kjm.vol18.22753","url":null,"abstract":"Introduction: To reduce Sudden Unexpected Infant Death (SUID), the Kansas Infant Death and SIDS Network offered a series of two-day Safe Sleep Instructor (SSI) certification trainings. These sessions aimed to educate health care and related professionals on the American Academy of Pediatrics (AAP) evidence-based safe sleep recommendations.Methods: A secondary analysis of qualitative data was conducted using responses to a single open-ended question on the post-training assessment. Participants were asked to list three specific things they learned during the training. All Fiscal Year 2023 participants (N = 67) responded. Two trained coders independently analyzed responses using a priori codes derived from the 2022 AAP Safe Sleep Recommendations and key concepts from the Safe Sleep Instructor training. Inter-rater reliability was assessed using Cohen's kappa.Results: A total of 205 comments were collected from 67 participants, who self-identified as nurses, social workers, home visitors, early childhood professionals, parent educators, and others. Cohen's kappa indicated substantial agreement (κ = 0.87; 95% CI, 0.77-0.87; p <0.001). The most frequently cited AAP-related topics were temperature regulation (13%, n = 27) and the recommendation for a separate sleep surface (10%, n = 21). Additionally, 12% (n = 24) of responses aligned with key training concepts, while 11% (n = 23) were categorized as \"other.\" No clear patterns in knowledge acquisition emerged within specific professional groups (e.g., nurses).Conclusions: The presence of pre-training knowledge gaps related to safe sleep practices highlights the importance of comprehensive, evidence-based educational programs for professionals involved in perinatal and infant care.","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"18 4","pages":"75-77"},"PeriodicalIF":0.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984212","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}

引用次数: 0

Premature Ventricular Contractions as an Underrecognized Cause of Chronic Cough: A Case of Misdiagnosis in a Patient with Bronchiectasis. 室性早搏是慢性咳嗽的一个未被充分认识的原因：一例支气管扩张患者的误诊。

Kansas journal of medicine Pub Date : 2025-08-15 eCollection Date: 2025-07-01 DOI: 10.17161/kjm.vol18.23911

Joseph O Odeyemi, Reem Mumtaz, Abdel-Ghanie Abu-Samra

引用次数: 0

Bridging the Gap from Classroom to Clerkship to Career: Informal Surgical Mentorship for Pre-Clerkship Medical Students. 弥合从课堂到见习再到职业的差距：见习前医学院学生的非正式外科指导。

Kansas journal of medicine Pub Date : 2025-08-15 eCollection Date: 2025-07-01 DOI: 10.17161/kjm.vol18.23769

Joshua Lawton, Dylan Wentzel, Cooper Root, Meeli Patel, Jordan Baker, Lyndsey Kilgore

{"title":"Bridging the Gap from Classroom to Clerkship to Career: Informal Surgical Mentorship for Pre-Clerkship Medical Students.","authors":"Joshua Lawton, Dylan Wentzel, Cooper Root, Meeli Patel, Jordan Baker, Lyndsey Kilgore","doi":"10.17161/kjm.vol18.23769","DOIUrl":"10.17161/kjm.vol18.23769","url":null,"abstract":"Introduction: Mentorship is important in medical education, yet its specific impact on pre-clerkship medical students interested in surgery remains underexplored. We hypothesized that a formal but unstructured surgical mentorship program would increase students' interest in surgery and improve their self-perceived readiness for the third-year surgical clerkship.Methods: In this before-after study, pre-clerkship students at The University of Kansas School of Medicine were paired with volunteer surgical faculty mentors. An initial one-on-one meeting was required, while the frequency and structure of subsequent meetings were left to the participants. Surveys assessing student confidence and perceptions of the program were administered via Research Electronic Data Capture® (REDCap®) before the program and again six months later. Changes were analyzed using the Wilcoxon rank sum test for independent groups (p <0.05).Results: Of the 47 students enrolled, 31 (66.0%) completed the preprogram survey, and 24 (51.1%) of these completed the post-program survey. After six months, students reported significantly greater confidence in their preparation and knowledge for the third-year surgical clerkship, surgical skills, and understanding of surgical career pathways. More students also identified potential residency letter writers. However, 87.5% of respondents reported inconsistent mentor-mentee meetings.Conclusions: A formal yet unstructured surgical mentorship program significantly improved pre-clerkship students' confidence in pursuing a surgical career and preparing for the surgical clerkship. Despite inconsistent meeting frequency, the program enabled meaningful mentorship without requiring rigid scheduling or extensive time commitments from participants.","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"18 4","pages":"78-82"},"PeriodicalIF":0.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984025","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}

引用次数: 0

Disseminated Melanoma with Extensive Gastrointestinal Tract Involvement: Incidental Detection of Metastases on Upper Endoscopy. 广泛累及胃肠道的播散性黑色素瘤：上内镜偶然发现转移瘤。

Kansas journal of medicine Pub Date : 2025-08-15 eCollection Date: 2025-07-01 DOI: 10.17161/kjm.vol18.23693

Hasan Jaber, Fawzi Elias, Nader Al Souky, Obada Tayyem

引用次数: 0