Rate of Endophthalmitis Following Cataract Surgery Using Intracameral Moxifloxacin without Postoperative Topical Antibiotics

Purpose To report the recent rate of acute postoperative endophthalmitis following cataract surgery at the University of Kansas Medical Center (KUMC) where postoperative topical antibiotics were excluded. Methods This was a retrospective chart review of patients who underwent phacoemulsification with or without intraocular lens insertion as standalone surgery from February 2018 through August 2020. Those undergoing combination surgeries were excluded. All patients received intracameral moxifloxacin at the conclusion of cataract surgery but were not prescribed postoperative topical antibiotics. Acute postoperative endophthalmitis was defined as occurring within six weeks after surgery. Results There were 2,218 standalone cataract surgeries performed on 1,418 patients. Zero cases of acute postoperative endophthalmitis were identified (0%). There were no systemic adverse reactions to intracameral moxifloxacin administration in the 41 patients with a preexisting fluoroquinolone allergy. Conclusion The recent rate of acute postoperative endophthalmitis following cataract surgery at KUMC using intracameral moxifloxacin without postoperative topical antibiotics is 0%.

Effectiveness of “I Can Do It, You Can Do It” Health Promotion Program for Individuals With Disabilities

Date Presented 04/13/21 University of Kansas Medical Center OT supports many community programs to reduce health disparity in our community. The COVID-19 pandemic created a need for alternative health promotion programs. This study aimed to determine the feasibility of implementing the I Can Do It (ICDI) program virtually. Once established, a pre–post descriptive study was completed to explore ICDI further. The results may have strong influence on OT practice for adapting and executing interventions virtually. Primary Author and Speaker: Kayla Hamner

Eyelid myotonia and face stiffness in skeletal muscle sodium channelopathy

Title Eyelid myotonia and face stiffness in skeletal muscle sodium channelopathy Video Legend Video 1. Notice the delayed relaxation of the eyelids after forced eye closure (eyelid myotonia). Also, notice the full facial hair to prevent facial muscle stiffening exacerbation with cold weather. AuthorsSrijan Adhikari, MBBS, Jeffrey Statland, MD, Constantine Farmakidis, MD Authors information: Srijan Adhikari, MBBS, ORCID ID: 0000-0001-9653-3079, University of Kansas Medical Center, Department of Neurology, Kansas City, Kansas, USAJeffrey Statland, MD, ORCID ID: 0000-0003-0790-5315 University of Kansas Medical Center, Department of Neurology, Kansas City, Kansas, USAConstantine Farmakidis, MD, ORCID ID: 0000-0002-4688-9224, University of Kansas Medical Center, Department of Neurology, Kansas City, Kansas, USA Corresponding Author Srijan Adhikari, MBBS,Department of Neurology,University of Kansas Medical Center,3901 Rainbow Boulevard., MS 2012,Kansas City, KS [email protected] Author Conflict of Interests Dr Adhikari has nothing to disclose.Dr. Statland reports grants from NIH, grants from MDA, grants from FSHD Society, grants from Friends of FSH Research, personal fees from Dyne, personal fees from Fulcrum, personal fees from Avidity, personal fees from MT Pharma, personal fees from Acceleron, personal fees from Sarepta, personal fees from Strongbridge, outside the submitted work. Dr. Farmakidis reports personal fees from Argnex, personal fees from Momenta, personal fees from Terumo BCT, outside the submitted work.

TeleHospice: A Community-Engaged Model for Utilizing Mobile Tablets to Enhance Rural Hospice Care

Background: In rural communities, providing hospice care can be a challenge. Hospice personnel sometimes travel great distances to reach patients, resulting in difficulty maintaining access, quality, cost-effectiveness, and safety. In 1998, the University of Kansas Medical Center piloted the country’s first TeleHospice (TH) service. At that time, challenges with broad adoption due to cost and attitudes regarding technology were noted. A second TH project was launched in early 2017 using newer technology; this article updates that ongoing implementation. Methods: The Organizational Change Manager was followed for the guided selection of the hospice partner. The University of Kansas Medical Center partnered with Hospice Services, Inc. (HSI), a leader in rural hospice care, providing services to 16 Kansas counties. Along with mobile tablets, a secure cloud-based videoconferencing solution was chosen for ease of use. Results: From August 2017 through January 2018, 218 TH videoconferencing encounters including 917 attendees occurred. Calls were made for direct patient care, family support, and administrative purposes. These TH calls have been shown to save HSI money, and initial reports suggest they may strengthen the communication and relationships between staff, patients, and the patient’s family. Conclusion: Finding innovative, cost-effective, and community-driven approaches such as TH are needed to continually advance hospice care. TeleHospice’s potential to supplement and improve hospice services while reducing costs is significant, but continued research is needed to understand best fit within frontier hospices, to inform future urban applications, and to address reimbursement.

Human Papillomavirus Vaccine Frequency for University of Kansas Medical Center Pediatric Patients

Background. Human papillomavirus (HPV) vaccination is recommendedfor all adolescents aged 11 to 12 years, but coveragein Kansas is exceptionally poor. To understand local coverage, receiptof the 3-dose HPV vaccine series among pediatric patients atthe University of Kansas Medical Center (KUMC) was evaluated. Methods. All patients aged 11 to 12 years who were seen by aKUMC primary care provider (family medicine and pediatrics)in 2013 were included in the retrospective chart review. Recordswere reviewed through December 31, 2014 to capture the numberof HPV doses received, and receipt of other recommendedvaccines (tetanus-diphtheria-pertussis and meningococcal conjugate).Pearson’s chi-squared tests were used to evaluate relationshipsbetween HPV vaccination and patient characteristics. Results. Of the 261 eligible females and 243 eligible males, 71.2%received ≥ 1 HPV vaccine dose, 55.2% received ≥ 2 doses, and39.3% completed the HPV vaccine series (3 doses). Although vaccineinitiation was slightly lower in males compared to females(67.1% vs. 75.1%, p = 0.047), no difference in vaccine completionwas seen between males and females (37.0% vs. 41.7%, p = 0.319).Over 80% of patients received other concurrently recommendedvaccines (Tdap: 81.7%, meningococcal: 81.3%). HPV series completionoccurred more often among Spanish-speaking femalescompared to English-speaking females (59.5% vs 37.7%; p < 0.01).Conclusions. The proportion of adolescents who received theHPV vaccination at KUMC is substantially higher than nationaland state estimates, but there is room for improvement forboth initiation and series completion. KS J Med 2016;9(1):1-5.

Identifying Awareness, Use, and Perceptions of text4baby among Family Medicine and Obstetrics and Gynecology Practitioners at the University of Kansas Medical Center

Background. Low income minority women who receive inadequate or no prenatal care have greater infant morbidity and mortality in the postnatal period. Mobile health or mHealth initiatives such as text4baby are presumed to be a means to reach underserved pregnant and postpartum women to increase their use of prenatal and postnatal care. Providers are an important referral source for mHealth initiatives. It is important, therefore, to assess the awareness, use, and perceptions of the text4baby program among Family Medicine and Obstetrics/Gynecology (Ob/Gyn) providers to determine the means to increase referrals and improve outcomes for pregnant mothers and infants. Methods. Family medicine and Ob/Gyn providers (attending physicians, residents, nurse practitioners, nurses, and medical assistants) at the University of Kansas Medical Center (KUMC) completed a survey assessing awareness of use and perceived utility of text4baby as well as experience with technology and reservations about mHealth in general. Results. Seventy-eight providers (38 in Family Medicine and 40 in Ob/Gyn) responded to the survey. Awareness of text4baby among all providers was 18%. Among the 14 providers who knew about text4baby, one individual stated he/she regularly refers patients to text4baby and 11 agreed that text4baby is a useful tool for the care of pregnant patients. Comparison of text4baby awareness by demographic factors showed no significant differences between any of the groups. Providers who knew of mHealth applications were more likely to know about text4baby (p = 0.04). Older providers were less likely to have reservations about using mHealth in their practice (p = 0.02). There was widespread agreement (87%) that providing evidence to clinicians that text4baby improves outcomes would increase use of the service in clinical practice. Conclusions. Awareness of text4baby among practitioners at KUMC is minimal; use is negligible. Our study identified lack of awareness of the text4baby service and of supporting evidence about its effectiveness as the primary barriers to referral.