Demographics and Incident Location of Traumatic Injuries at a Single Level I Trauma Center.

Introduction: Traumatic injuries are preventable and understanding determinants of injury, such as socio-economic and environmental factors, is vital. This study evaluated traumatic injuries and identified areas of high trauma incidence.

Methods: A retrospective review was conducted of all patients 14 years or older who were admitted with a traumatic injury to a Level I trauma center between 2016 and 2017.

Administration and Prescription of Opioids in Emergency Departments: A Retrospective Study.

Introduction: Opioid overdose caused 47,600 deaths in 2017 in the United States. Emergency departments (EDs) are one source of opioids that could be abused or diverted for non-medical use. Bills to reduce opioid use in EDs have been passed in multiple states; however, Kansas does not have a bill regulating opioid administration.

The AAST prospective observational multicenter study of the initial experience with reversal of direct oral anticoagulants in trauma patients.

Background: Drug-specific agents for the reversal of direct oral anticoagulants (DOACs) were recently approved. We hypothesized that the approval of these reversal agents would lead improved outcomes for trauma patients taking DOACs.

Methods: A multicenter, prospective (2015-2018), observational study of all adult trauma patients taking DOACs who were admitted to one of fifteen participating trauma centers was performed.

Bivalirudin and thrombolytic therapy: a novel successful treatment of severe aortic arch thrombosis in a term neonate.

An early-term infant with uncomplicated perinatal history was found to have a large thrombus in the aortic arch after he failed regular newborn critical congenital heart defect screen. He responded well to bivalirudin thrombolytic and tissue-plasminogen activator (tPA) combination therapy, with a significant resolution of the thrombus. The infant tolerated hospital admission well with no significant complications.

Changes in Family Physicians' Perceptions of Electronic Cigarettes in Tobacco Use Counseling Between 2016 and 2019.

Introduction: Given the recent reports of e-cigarette, or vaping, product use-associated lung injury (EVALI) and harm of e-cigarettes, the authors evaluated changes in the use and perception of e-cigarettes as tobacco use cessation tools in 2019 relative to 2016. The authors also evaluated the sources family physicians most commonly use to receive information regarding e-cigarettes.

Methods: A cross-sectional online survey of 248 community family physicians in Kansas was conducted from October 2019 to December 2019.

Guideline Adherence in Dyspepsia Investigation and Treatment.

Introduction: The impact of dyspepsia guidelines on clinical practice may be poor. Provider adherence with dyspepsia guidelines was examined to determine their impact on clinical practice.

Methods: Provider adherence with the 2005 American College of Gastroenterology Guidelines for the Management of Dyspepsia and the 2017 American College of Gastroenterology and Canadian Association of Gastroenterology joint Dyspepsia Management Guidelines was assessed on a national level using data from the National Ambulatory Medical Care Survey (NAMCS).

Second Survey of County Health Departments of Kansas and COVID-19: Time for Change in Model for Pandemic Response.

Introduction: SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) causing COVID-19 (Coronavirus Disease 2019) continues to be widespread in Kansas. County health departments are trying to contain this pandemic.

Methods: This second survey of Kansas county health department directors occurred from August 7 to September 7, 2020.

Effectiveness of Flow Sheet Implementation on Diabetes Progression Screening at a Student-Run Free Clinic.

Introduction: Diabetes mellitus (DM) disproportionately affects people with low socioeconomic status (SES). Student-run free clinics (SRFC) aim to care for low SES populations and experience high clinician turnover. Flow sheets have been used to improve care for those with diabetes, yet no research has assessed the use of such a flow sheet in a SRFC.

How Should Risk Managers Respond to Cases for Which No Risk Profile Exists?

Rapid innovation makes some devices available for patient implantation prior to extensive preclinical trials. This article reviews information that risk managers can utilize to help patient-subjects and clinician-researchers make informed decisions about new device implantation in the absence of preclinical trial data. Novel devices should be regarded by risk managers as sources of unknowns with potential for procedural complications and other harms.

The impact of adjunctive tomosynthesis on screening mammography outcomes in two widely diverse radiology practices.

To determine the effect of adjunctive digital breast tomosynthesis screening on dissimilar mammography practices. We compared the outcomes of breast cancer screening with digital mammography versus digital mammography combined with tomosynthesis in two independent breast imaging practices from June 1, 2015, to May 31, 2016. Institution one was a hospital-based academic practice of breast imaging specialists and institution two was a community-based practice with academic affiliation served by general radiologists.

From Radical to Partial Nephrectomy in the Setting of Solitary Functioning Kidney: Neoadjuvant Treatment of Renal Cell Carcinoma.

Immunotherapy has revolutionized the treatment of metastatic renal cell carcinoma (RCC). This case evaluates the use of neoadjuvant immunotherapy for localized RCC in a patient with solitary functioning kidney. A retrospective chart review was conducted between September 2019 and January 2020 on a single patient.

The Effect of a Clinical Pathway on Reducing the Rate of Healthcare-Onset .

Introduction: Stool assays used to diagnose infection (CDI) do not differentiate acute CDI from asymptomatic carriers, which contributes to a falsely elevated rate of healthcare-facility onset (HO) CDI when CD stool assays are inappropriately ordered. The aim of this study was to investigate the rate of HO-CDI before and after implementing a mandatory clinical pathway prior to ordering stool tests when suspecting CDI.

Methods: A single-center retrospective observational study was conducted that spanned 12 months.

Kansas Family Physicians Perceptions of Parental Vaccination Hesitancy.

Introduction: In the past few decades, patients expressing the idea that vaccines are unsafe or unneeded have been experienced increasingly by physicians and other healthcare providers. Discussions with patients regarding their reasons for vaccine refusals are important, as it may provide information that can be utilized in an intervention to increase vaccination rates and combat the spread of diseases that are making a resurgence in the United States. The main objective of this study was to explore the perceptions of family physicians as to why parents in Kansas may be vaccine hesitant.

Surgery and Resource Utilization Trends for Pediatric Intussusception From 2005 Through 2014.

Background: Air or barium enema reduction is becoming increasingly common and safer for pediatric intussusception. However, little is known about trends of pediatric intussusception requiring surgical intervention in the United States.  Methods: National Inpatient Sample database was analyzed from 2005-2014 to identify pediatric (≤18 years) intussusceptions along with procedures such as enema and/or surgical intervention.

Could lymph node evaluation be eliminated in nearly 50% of women with early stage ER/PR positive breast cancer?

Background: The Society of Surgical Oncology introduced guidance discouraging routine axillary staging in women 70 years or older with invasive, clinically node negative, hormone-receptor positive breast cancer. Due to concerns this could result in patients missing necessary treatment, researchers from the Mayo Clinic developed a rule to distinguish between those at low/high-risk of having positive nodes. The purpose of this study was to validate the Mayo Clinic rule in women of all ages.

Hospital Workforce Engagement and Inpatient Mortality Rate: Findings from the English National Health Service Staff Surveys.

Background: Healthcare workforce engagement may represent a proactive approach against provider burnout, a widely prevalent condition that is associated with poor patient outcomes.

Objective: We examine whether workforce engagement is associated with better hospital performance, measured as lower inpatient mortality, in English National Health Services (NHS) acute Trusts.

Design: Panel study using cross-lagged regression, applying an optimally time-lagged value of the dependent variable as covariate to account for unmeasured Trust characteristics.

Concerns of women regarding pregnancy and childbirth during the COVID-19 pandemic.

Objective: Better understand knowledge, attitudes and practices of pregnant women and mothers of infants around coronavirus disease 2019 (COVID-19).

Methods: A 58-item electronic survey was distributed to pregnant and postpartum women (infants <12 months) who were >15 years, English-speaking and enrolled in prenatal programs. Data is summarized using central tendency, frequencies and nonparametric statistics.

Resident Experience Associated with Lung Biopsy Outcomes: A Cross-Sectional Study of Diagnostic Radiology Residents. Does the Level of Training Matter?

Introduction: Efficient execution of image-guided percutaneous biopsy is a procedural competency milestone in radiology training. Despite the importance of achieving such mastery, literature on successful execution by residents is limited. The purpose of this study was to evaluate resident performance as measured by nondiagnostic biopsy and major complication percentages, on CT-guided transthoracic core needle biopsies (TTNB) of lung and mediastinal lesions.