Descriptive Evaluation in Outpatient Follow-Up of Direct LDL-C in Patients with Elevated Triglycerides and Diabetes.

Introduction: An annual fasting lipid panel (FLP) is recommended for patients with diabetes, with more frequent testing advised during the escalation of cholesterol-lowering therapy. However, the calculated low-density lipoprotein cholesterol (LDL-C) using the Friedewald equation becomes unreliable when triglycerides are ≥400 mg/dL. In such cases, providers must order a separate direct LDL-C assay to obtain accurate results.

Assessment of clinician agreement with and knowledge of evidence-based obesity treatment in the primary care setting.

Introduction: Effective, evidence-based obesity treatment is needed, which often involves use of anti-obesity medications (AOMs). Data on the breadth and quality of guideline-directed obesity treatment implementation in primary care remain limited. This study aimed to assess primary care clinicians' agreement with and knowledge of guideline-directed obesity treatment, as well as to assess the health status of persons with obesity and their use of AOMs.

Carpal Tunnel Syndrome: Rapid Evidence Review.

Carpal tunnel syndrome (CTS) is caused by compression of the median nerve as it travels through the carpal tunnel. Patients commonly experience pain, paresthesia, and, less often, weakness in the distribution of the median nerve. Provocative maneuvers, such as the Phalen test and Tinel sign, have varying sensitivity and specificity for the diagnosis of CTS.

Factors Affecting Parental Intent to Vaccinate Against COVID-19 in the United States.

Introduction: The topic of childhood vaccinations has become increasingly contentious, sparking debate, and creating challenging decisions for parents. This study aimed to explore the factors influencing COVID-19 vaccination decisions for parents of unvaccinated children and identify the most common reasons for not vaccinating children against COVID-19 in the U.S.

Thoracic irrigation for prevention of secondary intervention after thoracostomy tube drainage for hemothorax: A Western Trauma Association multicenter study.

Background: Retained hemothorax (rHTX) requiring intervention occurs in up to 20% of patients who undergo chest tube (TT) placement for a hemothorax (HTX). Thoracic irrigation at the time of TT placement decreases the need for secondary intervention in this patient group but those findings are limited because of the single-center design. A multicenter study was conducted to evaluate the effectiveness of thoracic irrigation.

Evaluation of 340B prescription assistance program on healthcare use in chronic obstructive pulmonary disease.

Background: The federal 340B drug program was designed to stretch scarce federal resources to provide more comprehensive services for more eligible patients. To help satisfy community needs, 340B Prescription Assistance Programs (PAPs) allow eligible patients to access medications at significantly reduced costs.

Objectives: To measure the impact of reduced-cost medications for chronic obstructive pulmonary disease (COPD) through a 340B PAP on all-cause hospitalizations and emergency department visits.

Electronic Monitoring Of Mom's Schedule (eMOMS): Recruitment of pregnant populations with elevated BMI in a feasibility randomized controlled trial.

Underrepresentation of pregnant populations in randomized controlled trials of lifestyle change interventions is concerning due to high attrition and providers' limited clinical time. The purpose of this evaluative study was to assess intervention uptake of pregnant individuals enrolled in a three-arm feasibility randomized controlled trial, electronic Monitoring Of Mom's Schedule (eMOMS), examining lifestyle changes and lactation support alone, and in combination. Measures included: (1) participation and completion rates, and characteristics of intervention completers versus other eligible participants; and (2) provider experiences with screening and enrolling pregnant participants.

Utilizing clinical pharmacists and a medication assistance program to improve medication access for indigent and underserved patients in primary care.

Background: Medication Assistance Programs (MAP) provide needed medications to uninsured and underinsured patients. In 2019, 24% of adults had difficulty affording their medications. Literature has shown enrollment in MAP decreased emergency department (ED) visits, hospital admission, and total hospital cost.

Burnout, Depression, Anxiety, and Stress Among Resident Physicians 18 Months Into the COVID-19 Pandemic: A Cross-Sectional Study.

Introduction: Burnout among resident physicians has been an area of concern that predates the COVID-19 pandemic. With the significant turmoil during the pandemic, this study examined resident physicians' burnout, depression, anxiety, and stress as well as the benefits of engaging in activities related to wellness, mindfulness, or mental wellbeing.

Methods: A cross-sectional survey of 298 residents from 13 residency programs sponsored by the University of Kansas School of Medicine-Wichita was conducted in October and November 2021.

Improving Stewardship of Testing with EMR and Provider Phone Calls.

Introduction: Modern laboratory techniques cannot differentiate between colonization and infection; therefore, testing must be indicated clinically. To reduce hospital-onset of infections (HO-CDI), Ascension Via Christi Hospitals (AVCH) in Wichita intervened in three stages by introducing: 1) a testing algorithm; 2) an electronic medical record (EMR)-based decision support system to enforce said algorithm; and 3) phone calls from the infection prevention department to providers to discontinue tests not collected within 24 hours of the order. The goal of this study was to determine if these interventions improved the HO-CDI rate.

Current Testing Guidelines: A Retrospective Analysis of a Community-Based Hereditary Cancer Program.

It is estimated that 5% to 10% of all cancers are related to a hereditary cancer syndrome. However, specific cancers, such as pancreatic and ovarian cancers, are related to hereditary cancer syndromes 15% to 20% of the time. Genetic testing guidelines for hereditary cancer syndromes are frequently reviewed and updated by the National Comprehensive Cancer Network (NCCN).

Eastern Association for the Surgery of Trauma Multicenter Trial: Comparison of pre-injury antithrombotic use and reversal strategies among severe traumatic brain injury patients.

Background: Trauma teams are often faced with patients on antithrombotic (AT) drugs, which is challenging when bleeding occurs. We sought to compare the effects of different AT medications on head injury severity and hypothesized that AT reversal would not improve mortality in severe traumatic brain injury (TBI) patients.

Methods: An Eastern Association for the Surgery of Trauma-sponsored prospective, multicentered, observational study of 15 trauma centers was performed.

Family Physicians' Perception of the New mRNA COVID-19 Vaccines.

Introduction: This study was conducted to assess family physicians' perception of the US Food and Drug Administration-approved mRNA Coronavirus disease 2019 (COVID-19) vaccines, their plans to be vaccinated with an approved mRNA COVID-19 vaccine, and their support for vaccination of patients and family members.

Methods: The authors conducted a cross-sectional survey of 307 practicing family physicians, full-time faculty physicians, and resident physicians in Kansas from December 14, 2020, to December 31, 2020. The study participants completed an anonymous, 20-item survey assessing family physicians' concerns about exposure to COVID-19 and their perceptions of the mRNA COVID-19 vaccines to control SARS-CoV-2.

Autologous and allogeneic hematopoietic cell transplantation for diffuse large B-cell lymphoma-type Richter syndrome.

Richter syndrome (RS) represents a transformation from chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) to aggressive lymphoma, most commonly diffuse large B-cell lymphoma (DLBCL), which is associated with a dismal prognosis. Patients with DLBCL-RS have poor outcomes with DLBCL-directed therapy; thus, consolidation with hematopoietic cell transplantation (HCT) has been used, with durable remissions observed. Studies reporting HCT outcomes in patients with DLBCL-RS have been small, have not evaluated the prognostic impact of cytogenetic risk factors, and were conducted prior to the era of novel targeted therapy of CLL/SLL.

Outcomes after ultramassive transfusion in the modern era: An Eastern Association for the Surgery of Trauma multicenter study.

Background: Despite the widespread institution of modern massive transfusion protocols with balanced blood product ratios, survival for patients with traumatic hemorrhage receiving ultramassive transfusion (UMT) (defined as ≥20 U of packed red blood cells [RBCs]) in 24 hours) remains low and resource consumption remains high. Therefore, we aimed to identify factors associated with mortality in trauma patients receiving UMT in the modern resuscitation era.

Methods: An Eastern Association for the Surgery of Trauma multicenter retrospective study of 461 trauma patients from 17 trauma centers who received ≥20 U of RBCs in 24 hours was performed (2014-2019).

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.

Predictors of retained hemothorax in trauma: Results of an Eastern Association for the Surgery of Trauma multi-institutional trial.

Background: The natural history of traumatic hemothorax (HTX) remains unclear. We aimed to describe outcomes of HTX following tube thoracostomy drainage and to delineate factors that predict progression to a retained hemothorax (RH). We hypothesized that initial large-volume HTX predicts the development of an RH.

Impact of a Community-Based Weight Loss Program on Renal Function.

Introduction Obesity is associated with increased morbidity and mortality and is an independent risk factor for the development and progression of chronic kidney disease (CKD). This study investigated the effect of a community-based, lifestyle-focused, weight-loss intervention on renal function among participants at baseline following 12 weeks of therapy.  Methods A retrospective analysis of adults enrolled in a weight management program from 2009 to 2014 was conducted.

Electronic Monitoring Of Mom's Schedule (eMOMS™): Protocol for a feasibility randomized controlled trial to improve postpartum weight, blood sugars, and breastfeeding among high BMI women.

Background: Overweight and obesity are major risk factors for gestational diabetes among U.S. women.

Burnout and Other Types of Emotional Distress Among Medical Students.

Background: The medical literature reports that many medical trainees experience burnout. The primary goal of this study was to determine how the prevalence of burnout and other forms of emotional distress among the University of Kansas School of Medicine (KUSM) medical students compared to the previously published data.

Methods: We conducted a cross-sectional survey of 379 medical students.

Implementation and evaluation of a team-based pharmacy practice model in a community health system.

Purpose: The development and implementation of a team-based pharmacy practice model is described.

Methods: In January 2016 a transition from a staff-specialist to a team-based pharmacy practice model was implemented. The overall goal of the model change was to enhance the pharmacist's clinical roles and further integrate pharmacists into the healthcare team.

Evaluation of Unit Equivalency of Insulin Glargine to Insulin Detemir in an Acute Care Setting.

Insulin glargine and insulin detemir are the most commonly prescribed basal insulins in the United States. While these analogs chemically differ, clinical trials have established no significant difference in efficacy. However, controversy remains as to whether the 2 agents are comparable with regard to unit equivalency.