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INTRODUCTION. This is the 2019 Annual Report of the Kansas Poison Control Center at The University of Kansas Health System (KSPCC). The KSPCC is one of 55 certified poison control centers in the United States and serves the state of Kansas 24-hours a day, 365 days a year with certified specialists in poison information and clinical and medical toxicologists. The KSPCC receives calls from the public, law enforcement, health care professionals, and public health agencies. All calls to the KSPCC are recorded electronically in the Toxicall® data management system and uploaded in near real-time to the National Poison Data System (NPDS) which is the data repository for all poison control centers in the United States. METHODS. All encounters reported to the KSPCC from 01/01/2019 through 12/31/2019 were analyzed. Data recorded for each exposure includes caller location, age, weight, gender, exposure substance, nature of exposure, route of exposure, interventions, medical outcome, disposition and location of care. Encounters were further classified as human exposure, animal exposure, confirmed non-exposure or information call (no exposure reported). RESULTS. The KSPCC logged 20,589 total encounters in 2019, including 19,406 human exposure cases. The KSPCC received calls from every county in Kansas. A slim majority of human exposure cases (50.5%, n=9,790) were female. Approximately 61% (n=11,876) of human exposures involved a child (defined as 19 years of age or less). Most encounters occurred at a residence (91.6%, n=17,780) and most cases (64.9%, n=12,599) originated from a residence. The majority of human exposures (85.5%, n=16,589) were acute cases (exposures occurring over 8 hours or less). Ingestion was the most common route of exposure documented (85.3%, n=16,548). The most common reported substance in pediatric (children ≤5) encounters was cosmetics/personal care products (n=959) followed closely by household cleaning product (n=943). For adult encounters, analgesics (n=1,296) and sedative/hypnotics/antipsychotics (n=1,084) were the most frequently involved substances. Unintentional exposures were the most common reason for exposures (75.4%, n=14,634). Most encounters (65.9%, n=12,780) were managed in a non-healthcare facility (i.e. a residence). Among human exposures, 14,591 involved exposures to pharmaceutical agents while 9,439 involved exposure to non-pharmaceuticals. Medical outcomes were 26.4% (n=5,116) no effect, 18.8% (n=3,652) minor effect, 9.3% (n=1,813) moderate effect, and 3.1% (n=603) major effects. There were 14 deaths in 2019 reported to the KSPCC. Cases from healthcare facilities, and cases with moderate or major medical outcomes and increased in 2019 compared to 2018. The number of deaths reported to the KSPCC increased in 2019 to 14 from 7 in 2018. CONCLUSIONS. The results of the 2019 Kansas Poison Control Center’s annual report demonstrate that cases are received from the entire state of Kansas totaling over 19,400 human exposures per year. While pediatric exposures remain the most common encounter, there continues an trend of increasing number of cases from healthcare facilities and for cases with serious outcomes. The experience of the KSPCC is comparable to national data. This report supports the continued value of the KSPCC to both public and acute health care in the state of Kansas.

Background. This is the 2018 Annual Report of the Kansas Poison Control Center at The University of Kansas Health System (KSPCC). The KSPCC serves the state of Kansas 24-hours per day, 365 days a year with certified specialists in poison information and clinical and medical toxicologists. Methods. All encounters reported to the KSPCC from 01/01/2018 through 12/31/2018 were analyzed. Data recorded for each exposure included caller location, age, weight, gender, exposure substance, nature of exposure, route of exposure, interventions, medical outcome, disposition, and location of care. Results. There were 21,072 total encounters, including 20,031 human exposure cases. Calls were received from every county and hospital in Kansas. Most of the exposures involved females (51.5%, n = 10,320) and a child less than 19 year of age (64%, n = 12,865). Medical outcomes were 24.5% (n = 4,912) no effect, 17.7% (n = 3,542) minor effect, 9.1% (n = 1,830) moderate effect, and 2.4% (n = 476) major effect. Seven deaths were reported in 2018. The number of exposure calls from healthcare facilities and severity of medical outcomes increased in 2018 compared to 2017. Conclusions. The 2018 KSPCC annual report demonstrated that the center receives calls from the entire state of Kansas totaling over 20,000 human exposures. While pediatric exposures remain the most common encounter, a trend continued of an increasing number of calls from healthcare facilities and for cases with serious outcomes. This report supported the continued value of the KSPCC to both public and acute health care in the state of Kansas.

Dear Editor, Diphacinone (2-Diphenylacetyl-1,3-Indandione) is an inandione vitamin-K antagonist. Like coumarins, diphacinone inhibits the enzyme vitamin K epoxide reductase resulting in a deficienc...

Background: Cancer-associated pulmonary embolism (PE) is a common condition that increases morbidity and mortality among cancer patients. Lymphoma has one of the highest rates of venous thromboembolism in cancer patients. The National Inpatient Sample (NIS) Healthcare Cost and Utilization Project (HCUP) includes the largest all-payer inpatient hospital care data in the United States and therefore may represent a significant sample of clinically relevant pulmonary embolism in lymphoma patients. Methods: We utilized the NIS-HCUP database to extract the following data on hospitalizations from 2002 to 2014. We included in our analysis ICD-9 codes for acute PE as a primary or secondary diagnosis of admission and excluded iatrogenic, septic, chronic PE and PE related to obstetrical conditions. We divided our primary population of yielded weighted frequencies i.e. acute PE admissions into two groups: a group with lymphoma as a comorbid condition using Elixhauser comorbidity measures and a group without lymphoma. We identified baseline characteristics of each group including median age on admission, gender and race breakdown as well as common comorbidities' prevalence using Elixhauser comorbidity measures. We ran the analysis for the median length of stay, total charges, mortality scores, readmit scores and inpatient mortality using SAS software, version 9.4 (SAS Institute, Cary, North Carolina). Continuous variables were tested using Wilcoxon two-sample test. Results: We identified a total of 3,293,040 admissions of acute PE in the database from 2002 to 2014, with 98.5% (3,242,571) of the admissions in patients without lymphoma vs. 1.5% (50,469) in patients with lymphoma as a comorbidity. The breakdown of race was comparable across the two groups with the Caucasian race being predominant in lymphoma and non-lymphoma groups at 77.3% vs. 74.2% respectively [Table 1]. Male gender constituted the majority in the lymphoma group at 53.6% in contrast to the non-lymphoma group where female gender was the majority at 53.6%. [Table 2]. While median age on admission was higher in the lymphoma group compared with the non-lymphoma group (68.7 vs. 65 years respectively) , the prevalence of common comorbidities such as hypertension, paralysis, renal failure, heart failure, diabetes mellitus with and without complications were comparable across the two groups except for obesity prevalence which was higher in the non-lymphoma group. [Table 2] Median length of stay was marginally but significantly higher in the lymphoma group at 5.4 days (95% CI 5.33-5.53) vs. 4.96 (95% CI 4.95-4.97) days in the non-lymphoma group (p Conclusion: Lymphoma was a comorbid diagnosis in 1.5% of patients admitted to the hospital with acute PE between 2002 and 2014 in the NIS-HCUP database. While the median age in the lymphoma group was higher, the prevalence of clinically significant comorbidities was comparable or higher in the non-lymphoma group. Lymphoma was associated with increased all-cause inpatient mortality in patients admitted with acute PE despite the study's limitation of not excluding other cancer patients from the control non-lymphoma group. Patients in the lymphoma group also had a higher risk of readmission in addition to having higher total charges per hospitalization and increased the length of stay. Efforts should continue to better prevent and treat pulmonary embolism in the lymphoma population. Disclosures No relevant conflicts of interest to declare.

To collect qualitative information about personal experiences with stroke rehabilitation from members of a community based stroke club.In this focused ethnographic study, four data collectors observed and videotaped two sessions of a community based stroke club. The videotape and written notes were reviewed and analysed according to standard qualitative research procedures.Two themes emerged from analysis of the qualitative data: concerns that individualized needs were not addressed during the rehabilitation process and that services were insufficient to ease the transition to community living.Rehabilitation professionals can benefit from soliciting reflections and suggestions from individuals who have returned to community living after completing post-stroke rehabilitation programmes. Specific recommendations are provided for tailoring interventions to meet individual goals, for enhancing follow up services provided after inpatient rehabilitation, and for providing early access to available resources in stroke survivors' communities.