South Dakota Medicine : the Journal of the South Dakota State Medical Association

INTRODUCTION: Prior studies have demonstrated that the use of opioids in an Emergency Department (ED) increases the chances of a 30-day return to the ED for similar diagnoses. Super-utilizers (SUs) of the EDs tax the ED resources, resulting in sub-optimal outcomes for these patients. Most physicians receive sub-optimal formal training on pain and opioid prescribing. These facts provide an area of improvement for administering optimal patient care in the ED. Presenting a structured curriculum on how to treat patients with pain in the ED could result in a simple, cost-effective solution to decrease provider work-overload, decrease misuse of healthcare resources, and increase the well-being of opioid-addicted patients...

INTRODUCTION: Incidences of hepatic abscesses are increasing nationally. Current estimates of national incidence range from 8 to 20 abscesses per 100,000 hospital admissions. Understanding risk factors is essential for efficient diagnosis and treatment of hepatic abscess. This study aimed to assess if hepatic abscess incidence in a Midwest cohort was higher in rural areas compared to metropolitan areas. Water infrastructure factors were also considered. METHODS: A retrospective chart review was completed for all patients admitted with a diagnosis of hepatic abscess to an upper Midwest hospital system in South Dakota between Jan...

INTRODUCTION: Physicians are expected to educate patients, students, colleagues, as well as members of the interdisciplinary team. However, unlike in the United Kingdom and Canada, US medical schools do not require teaching as a competency for graduation. High-quality teaching and communication skills are necessary to ensure patient safety and trust. As the field of medicine becomes increasingly expansive and complex, it can no longer rely on empiric forms of knowledge exchange. Physician training must include pedagogy to create competent educators...

BACKGROUND: Simulation-based learning has been a valuable integrated part of simulation curricula. Simulation modalities include high-fidelity simulation (HFS), clinical skills (SK), standardized patients (SP), hybrid and combined simulation. HFS and SK are usually taught face-to-face and require specialized equipment. In response to the COVID-19 pandemic and lockdowns, efforts to develop distributed screen-based high-fidelity simulation accelerated to provide enhanced remote learning...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Retinopathy of prematurity (ROP) is a leading cause of blindness in pre-term infants and is caused by incomplete vascularization of the retina at birth. Early diagnosis and treatment of ROP is important to reduce the risk of vision loss. The risk factors, pathogenesis, screening, diagnosis, and treatment of this disease will be reviewed.

No abstract text is available yet for this article.

Anemia in pregnancy (AIP) is associated with poor maternal/fetal outcomes. The prevalence of AIP globally ranges from 44-53% and varies drastically depending on maternal race/ethnicity and other factors. Screening and treatment of AIP is disputed. This study is a retrospective review of electronic medical records (EMR) of pregnant adults over three years (2018-2020, inclusive) of Sanford Health, a large healthcare system in the upper Midwest. AIP was determined by either diagnosis or lab values (hemoglobin, hematocrit, and ferritin) overlapping with pregnancy...

Achilles tendon rupture is a common injury. It most often occurs in middle aged men who participate in recreational sports. The injury classically presents with a loud popping noise and immediate pain and weakness of the lower extremity during actions such as jumping or running. The diagnosis is made clinically, but an MRI is often obtained for confirmation of rupture and to aid in surgical planning. Treatment is either operative, with open or minimally invasive approaches, or non-operative, with functional bracing or plaster casting...

Epithelioid hemangioendothelioma (EHE) is an uncommon vascular tumor that can present in various organs, including the liver. Hepatic EHE (HEHE) may showcase with metastases at initial presentation, as patients have vague symptoms such as right upper quadrant pain leading to the risk of delayed diagnosis. There is no standard treatment. Fortunately, prognosis is good. This remains true for some patients with metastatic disease who are not being actively treated. In this report, we present a unique case of metastatic HEHE in a 65-year-old Caucasian male who has not received treatment and continues to remain in stable condition after his initial diagnosis three years ago...

Neurocysticercosis (NCC) is a rare, potentially life-threatening parasitic infection endemic in many developing countries where pig farming and pork consumption are popular. The rates of neurocysticercosis could increase in the U.S. due to the influx of immigration from Central and South America, sub-Saharan Africa, and parts of Asia. Careful evaluation, diagnosis, and treatment is needed to prevent complications from the disease. We present a case of neurocysticercosis which presented as an unresponsive adult female in a rural South Dakota healthcare facility...

Colorectal cancer (CRC) is the third most common cancer to cause death in the world. Despite the recent change in age from 50 to 45 in some societies' recommendations for CRC screening, its incidence is increasing in patients under 50 years. We present a case of a 35-year-old female with no family history of CRC who presented to the emergency department with abdominal pain, vomiting, and obstipation and was found to have sporadic obstructing transverse colon adenocarcinoma.

Testicular embryonal carcinoma is a type of nonseminomatous germ cell tumor (NSGCT) that commonly presents with scrotal swelling due to testicular mass. About half of patients with NSGCTs will present with metastases at initial diagnosis. Rarely, testicular embryonal carcinoma can present primarily in the mediastinum. Treatment is well-studied and effective: chemotherapy with bleomycin, etoposide, and cisplatin. Post-chemotherapy retroperitoneal lymph node dissection (RPLND) is common adjuvant therapy. In this report we present a case of testicular embryonal carcinoma in a 32-year-old Caucasian man...

No abstract text is available yet for this article.

The Stare decisis of Medicine is the Scientific Method and the Stare decisis of the Scientific Method is Debate over any knowledge claim involving the patient. COVID-19 has threatened the orthodoxy of the Scientific Method with a new orthodoxy - Medicine as political purpose. Among the many examples involve origins, immunity and lockdowns. In each of these the patient-as-judge may declare a mistrial. Only Medicine can restore trust through the legal doctrine of Completeness.

INTRODUCTION: The purpose of this study is to demonstrate how children learn about a health topic from an interactive reading session. Due to the large number of children with allergies, the specific topic chosen for this research study was peanut allergies. The goal of the project was to assess how students learn from a children's book. METHODS: For the purposes of the research project, Vollmer wrote, illustrated, and published the children's book "A Party Without Peanuts: How Food Allergies Affect Friends"...

INTRODUCTION: Increasing and easy availability of so-called natural/herbal supplements pose the unique challenge of identifying associated side effects, including arrhythmias in otherwise-healthy individuals. CASE PRESENTATION: A 25-year-old female patient presented to the emergency department with fatigue and lightheadedness. The electrocardiogram showed complete AV block with a junctional escape rhythm at 55 beats per minute with QT prolongation (542ms). One week ago, she started to use a herbal medication (Muscle Eze Advanced) for muscle cramps after workouts...

Cytochrome P450 polymorphisms have gathered much attention regarding personalized psychopharmacological care. It is well documented that these drug metabolizing enzymes lead to interpatient variability in pharmacokinetic profiles. It appears that less functional genotype may increase of risk of higher side-effect burden. Here we highlight the importance of genetic polymorphisms to potentially predict a toxicity related phenotype after an intentional overdose. Genotyping may have a role in predicting serious side effects to help clinicians educate patients and their families, and implement more intensive monitoring and institute prophylactic treatment as needed...