South Dakota medicine : the journal of the South Dakota State Medical Association最新文献

{"title":"When Anticoagulation Matters: A Case of Large Left Atrial Thrombus After Left Atrial Appendage Ligation.","authors":"Emmanuel Fohle, Natale Wasef, Filip Oleszak, Maria Stys","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is the most frequently encountered arrhythmia in the clinical practice and is associated with stroke. In clinical practice, CHAD2DS2-VASc score is used as a tool to decide whether anticoagulation is needed. In those patients with high bleeding risk or falls, surgical ligation of the left atrial appendage (LAA) or percutaneous closure devices are strategies used to mitigate these challenges. However, there is no guideline advising on what patient's specific factors should be considered in determining initiation or continuation of anticoagulation post LAA ligation. Herein, we report the case of a patient with surgical ligation who developed large atrial thrombus requiring emergent median sternotomy.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"77 8","pages":"358-360"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Crossing Bridges Before You Come to Them: Anticipating the Uneven Path Toward Clinical Kindness.","authors":"Ann Cook, Jerome W Freeman","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"77 8","pages":"338-339"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Pharmaceutical Future of Remimazolam as Compared to Propofol and Midazolam: A Literature Review.","authors":"Hannah Meyer, Sean McCann, Joel Farmer","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Remimazolam is an ultra-short-acting benzodiazepine with a predictable and quick recovery that was FDA approved in 2020. As a relatively new medication, it is not as mainstream as other sedatives such as propofol or midazolam. This research aims to highlight the differences, benefits, and drawbacks of remimazolam in comparison to other short-term sedatives in order to bring greater awareness, and to consolidate the current knowledge of the effects of remimazolam.</p><p><strong>Methods: </strong>The PubMed database was used to search for current relevant research to review. The search terms used were: \"remimazolam\", \"midazolam\", \"propofol\", and procedural sedation. The search also used qualifiers using only publications in English and published within the last five years. This query yielded 26 articles which were reviewed for content and relevance.</p><p><strong>Results: </strong>Sixteen of the reviewed studies resulted in common themes suggesting remimazolam to be an effective alternative for procedural sedation with fewer adverse effects. Primarily, remimazolam is observed to have decreased procedural hypotension, bradycardia, and injection site pain. With no studies demonstrating an increased frequency of bradycardia, remimazolam is theorized to be superior to propofol in respect to sedation-associated bradycardia. One specific study notes a 14% decrease in frequency of bradycardia compared to propofol. Further benefits of remimazolam over propofol include the availability of an effective and reliable antidote, flumazenil.</p><p><strong>Conclusion: </strong>In being that remimazolam has primarily been used and studied in short-term sedation, we can only confidently conclude remimazolam's safety in these settings. There is little research being done in the way of ICU sedation or general anesthesia, but with the relatively similar, or decreased rates of adverse events with remimazolam, we suspect an increase in clinical research of remimazolam in these settings. With continued robust research, remimazolam could become more widely accepted as a safe alternative to current sedatives.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"77 suppl 8","pages":"s20-s21"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Posterior Triangle and Posterior Muscles of the Neck in 3-Dimensions: Creating a Digital Anatomic Model Using Peer-Reviewed Literature, Radiographic Imaging, and an Experienced Medical Illustrator.","authors":"Mason Blue, Gabriela A Calcano, Dan C Schmidtman, Gabriel A Hernandez-Herrera, Emilyn P Frohn, Caitlin J Vander Wert, Kathryn M Van Abel, Jonathan M Morris, Linda X Yin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The posterior cervical triangle houses an important nodal basin in the spread of several cancers in the head and neck, particularly cutaneous malignancies of the scalp. A safe and effective Level V neck dissection necessitates thorough understanding of the neurovascular structures housed within the region. Conventional 2D anatomical representations offer insights into the named structures, but fall short in illustrating the spatial relationships crucial in surgery. Here, we aim to develop an anatomically-precise 3D virtual model of the posterior cervical triangle and its constituent structures.</p><p><strong>Methods: </strong>Musculature and neurovasculature were segmented from the computerized tomography (CT) angiogram of a healthy 29-year-old female. Literature review of cadaveric studies was performed to identify the most common variants, relevant surgical relationships, and usual dimensions of structures contained in the model. Structures unable to be visualized on imaging were created de novo using data obtained in the literature review. A medical illustrator then used this data to develop a 3D anatomical model using ZBrush.</p><p><strong>Results: </strong>The musculature (sternocleidomastoid, trapezius, omohyoid, scalenes, erector spinae, and transversospinalis muscles) and neurovasculature (spinal accessory nerve, phrenic nerve, vertebral artery, subclavian artery, and brachial plexus) were characterized through literature review. Musculature and vasculature were segmented from CT angiography while neural structures were created de novo. Both radiographic and anatomic data were used to inform the creation of a 3D model, which will be uploaded to an online database for open access viewing.</p><p><strong>Conclusions: </strong>A dynamic understanding of the spatial relationships existing among structures housed within the posterior triangle of the neck is imperative when operating in the region. The development of an accurate 3D anatomical model of such structures based upon predominant variants found in the literature will supplement the education of practicing and aspiring head and neck surgeons.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"77 suppl 8","pages":"s17-s18"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity: A Profoundly Under Recognized Chronic Disease; And Its Impacts on Cardiovascular Disease.","authors":"Muhammad Asif","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Obesity is a treatable chronic disease of high prevalence in the U.S. It has various direct and indirect adverse health effects in terms of morbidity and mortality. It not only increases cardiovascular mortality but is also associated with an increased risk of multiple cancers. However, unlike other chronic diseases, obesity diagnosis often misses patients' and providers' attention and historically has been undertreated. This article is written to highlight the impact of obesity on health with special reference to cardiovascular disease, stimulate the quest among the masses and primary care providers for the diagnosis and treatment of obesity, its complications, and benefits obtained from its treatment.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"77 8","pages":"378-379"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Evolution of Renal Denervation for the Treatment of Hypertension: Insights from Trials and Prospects for Clinical Practice.","authors":"Hammad Shabir Chaudhry, Dawood Shehzad, Mustafa Shehzad, Logan Johnke, Muhammad Asif, Dawlat Khan, Wahab Jahangir Khan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Hypertension affects 1.3 billion adults globally, with severe health implications if left untreated. Despite efforts, research suggests only a fraction achieve adequate control. Renal denervation (RDN) therapy has emerged as a potential solution, particularly for treatment-resistant cases. RDN targets the dysregulated sympathetic nervous system activity frequently encountered in resistant hypertension. Recent FDA approval of advanced RDN catheter systems in 2023 signifies a pivotal advancement in hypertension management. As an adjunctive to pharmacotherapy, RDN holds promise as a therapeutic modality in achieving optimal blood pressure control and attenuating hypertension-related morbidity and mortality. Further research elucidating the nuances of patient selection, procedural standardization, and long-term outcomes is warranted to optimize the clinical utility of RDN in the management of hypertension. This manuscript compiles evidence for the use of RDN and reviews the long-term safety data from recent trials.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"77 8","pages":"365-371"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Head Impacts in Collegiate Rodeo Athletes: An Observational Study.","authors":"Colton D Carlson, Thayne Munce, Jake Miller, Jason C Dorman, Verle D Valentine","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Brain health has been a growing concern across a wide range of contact sports in the last three decades. While most of the early brain health research was focused on identifying and preventing concussions, newer research has found that an accumulation of repetitive head impacts (RHI) are more predictive of long-term brain health than the number of concussions sustained. Consequently, being able to assess RHI in sports despite the lack of outward symptoms has become paramount in promoting the long-term health of athletes. The sport of rodeo has long been regarded as one of the most dangerous contact sports. While some epidemiological research has been done on injury rates in rodeo that has largely backed up its dangerous reputation, no research has been done into RHI in rodeo athletes.</p><p><strong>Methods: </strong>Head acceleration events (HAE) were measured in collegiate athletes competing in the \"Roughstock\" events of Bareback Riding, Saddle Bronc Riding and Bull Riding. HAE were recorded using impact monitoring mouthgaurds (iMG) and subsequently confirmed using video verification and submitted to statistical analysis.</p><p><strong>Results: </strong>Rodeo has a high rate of HAE across all the Roughstock events. The Bull Riding experiences the highest magnitude HAE based on both linear and rotational acceleration. These events are primarily the result of the head impacting either the ground or the animal during the dismount phase of the ride. Bareback riding experiences the highest quantity of lower magnitude HAE which mainly result from whiplash-like movement of the head during the ride.</p><p><strong>Conclusions: </strong>Rodeo athletes experience a high volume of HAE that often reach concerning magnitude. A surprising amount of the HAE are the result not of impacts, but of the whiplash-like movement that is experienced during the rides.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"77 suppl 8","pages":"s19"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the Gap From Rural Trauma to Rural Healthcare: Fire Department Education Sessions.","authors":"Kaihlen Smith, Gaven Bowman, Susan Anderson","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Many rural communities within the United States rely upon volunteer firefighters and EMS personnel in emergency response scenarios. However, it has been found that \"medical direction in rural EMS was identified as a major issue for a majority of states\" within America. With the consideration that some firemen can arrive on the scene ~15 minutes before an ambulance, a gap exists in time and skills where knowledge of basic emergency response techniques could equip firefighters to assist EMS personnel in life-sensitive scenarios.</p><p><strong>Methods: </strong>Our study took place in Parkston, South Dakota with a volunteer crew of ~ 30 firefighters and EMS personnel. Outside of their pre-scheduled bi-weekly meetings, our study provided further training for firefighters with various emergency response skills. Three nights of training were provided with pre-and post-surveys administered for each training station, analyzing confidence levels on a five-point system. Mean pre- and post-training confidence levels were obtained. Standard deviation, standard error, 95% confidence interval, and percent increase in mean confidence levels where calculated. Grouped bar graphs were plotted and analyzed for statistical significance.</p><p><strong>Results: </strong>With the exception of two stations in night 2, all remaining training stations in nights 1, 2, and 3 demonstrated a statistically significant increase in mean confidence levels for each skill being taught.</p><p><strong>Conclusions: </strong>Based on the data obtained from this study, a statistically significant increase in mean confidence levels per training station demonstrates value in continued delivery of rural training sessions to firefighter personnel. As firefighter and EMS numbers across the United States continue to decline, timing is becoming increasingly more important in emergency response scenarios within our country's rural communities. Creating confident firefighters that are trained in skills beyond basic first aid and CPR may provide immense value for the continued evolution of rural emergency healthcare.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"77 suppl 8","pages":"s23"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Substance Use Disorder in Adults with ADHD in South Dakota.","authors":"Connor McMahon, William Schweinle, Vivek Anand","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Attention-deficit hyperactivity disorder (ADHD) increases the risk for comorbid psychiatric and substance use disorders. This study examined the prevalence of ADHD in residential addiction treatment and the prevalence of monosubstance, comorbid substance, and polysubstance use disorders (PUD) as a function of ADHD status.</p><p><strong>Method: </strong>All adults admitted to residential substance use disorder treatment center in South Dakota during November 2021 to June 2022 were included (N= 55). The participants underwent a clinical interview and objective assessment to determine ADHD status. The participants were also administered ADHD questionnaire developed by investigators to assess ADHD history and treatment. SAS statistical software using an α level of 0.05 was used for all analyses.</p><p><strong>Results: </strong>Almost half, 25 of the total 55 participants, had ADHD (45%). A quarter (n=14) of participants were diagnosed with ADHD during childhood. A fifth (n=11) of participants were diagnosed with ADHD during this study. Thirty participants (54%) were not found to have ADHD. A majority of ADHD patients (n=21; 84%) were diagnosed with PUD. Participants with ADHD had a higher prevalence of PUD (p=0.054) compared to participants without ADHD. Approximately a quarter of patients with alcohol use disorder and three-quarters of patients with methamphetamine use disorder had ADHD.</p><p><strong>Conclusions: </strong>ADHD and substance use disorders have notable comorbidity. This study demonstrates a high prevalence of ADHD in populations with substance use disorder. The presence of ADHD may be a risk factor for PUD.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"77 8","pages":"342-348"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Students Wellness Habits and Perceived Stress Levels, a Cross-Sectional Study of USD SSOM Students.","authors":"Tayler Modlin, John Richter, Bhaskar T Ulichi, Alan Sazama","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Burnout is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It includes feelings of energy depletion and cynicism and reduced professional efficacy. Psychological distress among U.S. and Canadian medical students is higher overall relative to both the general population and age-matched peers. Physical activity has been shown to decrease burnout and improve quality of life. In addition, unhealthy eating patterns and poor sleep quality have been linked to elevated levels of stress.</p><p><strong>Methods: </strong>This is a cross-sectional, survey-based study of medical students currently enrolled at the USD SSOM. All students received an email with the survey. Participation was anonymous and voluntary. We used the Perceived Stress Scale6 and compared it to exercise, dietary, sleep, and mindfulness habits.</p><p><strong>Results: </strong>147 students responded. The average perceived stress scale score was 16, indicating moderate stress. Most students reported engaging in light exercise either every day (37%) or a few times per week (42%). Fifty percent reported moderate exercise a few times per week. For vigorous exercise, 29% reported a few times per week. Only 63% of students reported eating breakfast compared to 90% for lunch and 99% for dinner. Eating a home cooked meal every day was reported by 52% of students. Twenty five percent of students reported eating out a few times a week. Caffeine intake varied amongst students, with 15% of students having 0 servings of caffeine daily, 23% having 1, 33% having 2, 15% having 3, 7% having 4, and 7% reported more than 4. The average amount of sleep reported was 7.3 hours nightly and the average amount of mindfulness activities per week was 2.4.</p><p><strong>Conclusions: </strong>The average USD SSOM student reports moderate stress levels. Addressing lifestyle habits can lead to a reduction of stress and burnout.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"77 suppl 8","pages":"s21-s22"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}