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March 2026 Vol. 126, No. 3

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Latest Articles
Cardiopulmonary Medicine

Estimating ejection fraction and heart failure severity using cardiac apex angles: a multiphase pilot study

Schafer Paladichuk, BS; Graydon Dietrich, BS; Austin Evanovich, BS; Dane Warp, DO; Ronald F. Walser, DPT; Dan Selski, PhD; and Jesse Cone, MD
Heart failure affects 6.7 million American adults. The gold standard for heart failure assessment is echocardiography to determine the ejection fraction (EF). Evaluating the cardiac apex angle may be a possible way to estimate EF; however, there is a lack of investigation into this relationship. This study aimed to evaluate whether a correlation exists between the cardiac apex angle and EF.
Medical Education

Addressing physician shortage in medically underserved rural and tribal communities through residency program collaboration

Natasha N. Bray, DO; Michael Raischel, DO; Derek McGuire, DO; Ryan Newhardt, DO; Douglas Nolan, DO; Tyler Snyder, DO; Mousumi Som, DO; Lesley VanVolkinburg, EdD; Chad Landgraf, MS; and Denna Wheeler, PhD
The United States is facing a persistent physician shortage, particularly in rural and tribal regions. Oklahoma ranks 43rd nationally for primary care provider availability, with rural and tribal communities experiencing some of the most severe health workforce shortages. This study aimed to evaluate the geographic distribution and practice outcomes of graduates from three family medicine residency programs located in tribal healthcare systems in Oklahoma and to assess their contributions to addressing physician shortages in rural and underserved areas.
Clinical Image

Clinical evolution of atypical pyoderma gangrenosum in a patient with hemochromatosis

Nicholas Lo, BS; and Robert Dazé, DO, FAAD

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Clinical Image

Rotator cuff injuries: improving identification with bedside ultrasound

A 53-year-old woman reported falling off her sofa and injuring her right shoulder 4 hours before arrival in the emergency department. After her injury, she was unable to utilize or raise her right arm. Physical examination demonstrated that the patient was holding her shoulder in an internally rotated position, with limited active and passive range of motion of the shoulder due to pain. Read more