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

{"title":"The State of Palliative Care in South Dakota.","authors":"Amanda Kay Sedlacek, Sarah Mollman, Michele Snyders, Michelle Gierach","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>As numbers of patients living with chronic diseases are increasing, there is a growing demand for physicians who have knowledge to provide interventions that align with the goals of palliative care. The increasing number of patients living with chronic disease creates a challenge for the healthcare landscape of South Dakota. Even though South Dakota has a growing number of fellowship trained and board certified palliative and hospice physicians to help meet patient needs, there is a shortage of providers to meet the demand. This article provides an overview of the state of palliative care in South Dakota. A brief background of palliative care is provided along with information related to advanced training for physicians. An overview of legislation addressing palliative care for the 2024 session is provided. Through the collaboration of our healthcare teams, universities, and the South Dakota Association of Healthcare Organization, there is increasing exposure to palliative care principles, patient care, and a unified vision for palliative care in South Dakota is being created.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"77 11","pages":"505-509"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012964","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":"Taking Control of Your Health: Self-Measured Blood Pressure Program in Yankton, South Dakota.","authors":"Brittany Bamberg, Christopher Behrend, Jennifer Boleyn, Kyler Hardie, Ross Lanier, Christopher Rumrill, Susan Fanta","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Identification and management of hypertension is one of the most common problems for primary care providers. Rural settings have increased rates of hypertension due to a variety of factors including access to care, socioeconomic factors, and restricted strategies to identify hypertension outside of the clinic setting. To address this challenge, a self-measured blood pressure (SMBP) program was employed at a rural clinic in South Dakota with a goal of increasing the number of patients with well-controlled blood pressure.</p><p><strong>Methods: </strong>One-hundred seventy-two patients aged 18-85 years with a primary residence of South Dakota were enrolled during a nine-month period. Two sets of home blood pressure measurements were taken twice a day for seven consecutive days and recorded by the patient. Controlled blood pressure was defined as systolic blood pressure less than 140 mm Hg and diastolic blood pressure less than 90 mm Hg. The number of patients with controlled blood pressures were documented. Additionally, the number of patients with uncontrolled blood pressures requiring treatment plan or medication changes as a result of the program were recorded. Patient data was reviewed by the provider and utilized to make diagnosis and further recommendations.</p><p><strong>Results: </strong>Eighty-eight out of the 172 patients were considered to have controlled blood pressure by the end of the study period without the need for interventions. Eighty-four patients required new medication or treatment plan changes throughout the study period in response to uncontrolled blood pressure readings obtained from the patients' blood pressure logs. Overall, patients reported appreciation for taking ownership in their health management through home blood pressure monitoring.</p><p><strong>Conclusion: </strong>This work provides a framework to implement an SMBP program as a strategy to improve outpatient management of hypertension by empowering patients to take a greater, more active role in their health.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"77 11","pages":"486-490"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012793","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":"Immature Smooth Muscle Infiltration in Sporadic Lymphangioleiomyomatosis: A Case Study.","authors":"Conner Stearns, DesiRae Muirhead, Brandon Rosell","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Lymphangioleiomyomatosis (LAM) is a rare cystic lung disease that causes progressive pulmonary damage. It typically affects young reproductive-age females with tuberous sclerosis complex (TSC). The clinical manifestations of LAM result from the progressive invasion of abnormal smooth muscle cells into lung parenchyma, lymphatics, or pulmonary vasculature. A 43-year-old female presented to the emergency department with a 4-week history of radiating chest pain and shortness of breath. The workup revealed multiple bilateral, small, parenchymal cysts and a left spontaneous pneumothorax. A wedge biopsy confirmed the diagnosis of lymphangioleiomyomatosis. Although LAM is often associated with TSC, it can also be sporadic. Treatment often relies on the degree of lung function and extent of lung damage.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"77 11","pages":"511-515"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012790","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, Jason Wickersham, Susan M Anderson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>South Dakota's Emergency Medical Services (EMS) volunteer participation is declining, and projected to further decrease over the next decade. To minimize this deficit, South Dakota's Department of Health recommends that rural firefighters assist EMS in high-acuity calls to decrease the burden on EMS personnel in an effort to improve volunteer retention. Bridging the Gap from Rural Trauma to Rural Healthcare aimed to create educational training opportunities for firefighters when assisting EMS. A focus group including EMS personnel, firefighters, and the fire chief from communities surrounding and including Parkston, South Dakota, identified a list of skills where knowledge deficits existed; this list included backboard technique, tourniquets, field dressings, splints, Lund University Cardiopulmonary Assist System (LUCAS) device application, triage procedure, stair chair utilization, oxygen administration, familiarization with ambulance supplies, limb recovery in the field, EMS communication and report, extrication scenarios/problem-solving, cardiopulmonary resuscitation (CPR) re-familiarization, decontamination procedures, and a tour of Parkston's rural emergency department. These skills were divided into three nights of hands-on learning sessions. Pre- and post-session surveys were administered to measure the firefighters' confidence levels regarding each skill. Firefighters demonstrated a statistically significant change in confidence levels in nearly all skills that were taught, with LUCAS device application, decontamination location, and decontamination procedure demonstrating a mean increase in confidence levels of greater than 100%. Typically, firefighters are on location for many rural, high-acuity calls. If trained to assist EMS, firefighters may enhance the South Dakota Department of Health's goals to improve EMS volunteer retention over the next decade.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"77 11","pages":"492-499"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013698","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":"A Rare Case of Hypopharyngeal Hamartoma Causing Acute Airway Obstruction.","authors":"R Austin Cihak, William C Spanos","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A hamartoma is a benign tumor of tissue resembling the site of origin, despite exhibiting disorganized architecture. While benign, symptoms typically arise from mass effects. They are often found in the lower gastrointestinal tract and are a rare finding in the pharynx and larynx. Here we present a rare case of hamartoma of the hypopharynx in an 87-year-old male, which was dislodged and regurgitated during an episode of coughing, which resulted in syncope and airway obstruction. His wife was able to restore airway function by rolling the patient on his side until the ambulance arrived. The patient underwent microlaryngeal excision of the dislodged mass, and analysis of frozen sections showed hamartoma with no potential of malignancy. The patient's recovery was uncomplicated, and there has been no evidence of recurrence noted two years post-operatively.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"77 10","pages":"458-460"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013551","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":"Induced Resistance of Ocular Surface Flora in Patients Undergoing Cataract Surgery.","authors":"Elise Meide, Tanner Ferguson, Daniel Terveen","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated the effects of pre-operative topical moxifloxacin prior to cataract surgery on the growth of ocular surface bacteria and induced antibiotic resistance after a 3-day course of moxifloxacin.</p><p><strong>Methods: </strong>The study was a prospective, dual arm, randomized study. The study group of 17 patients used moxifloxacin four times daily, for three days prior to surgery. The control group of 11 patients used no topical antibiotics prior to surgery. Patients' surgical eye was swabbed within sixty days of surgery at the pre-operative appointment and again the morning of surgery prior to surgical prep.</p><p><strong>Results: </strong>The morning of surgery 100% of control patients and 52% of study patients (p=0.0097) had ocular surface bacterial growth. No patients had moxifloxacin resistant ocular surface bacteria prior to the start of the study. On the morning of surgery, 17% (3 patients) in the study group had moxifloxacin resistant ocular surface bacteria, compared to no patients in the control group (p=0.2579).</p><p><strong>Conclusions: </strong>Although short-course pre-operative antibiotics reduce ocular surface bacterial growth, they do not eradicate it in the majority of patients. This could explain why topical antibiotics are less effective than intracameral antibiotics. Further, pre-operative antibiotic use may induce antibiotic resistance and may negatively affect the capabilities of intracameral antibiotics in endophthalmitis prevention and treatment.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"77 10","pages":"462-464"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013559","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":"Orf Infection (Ecthyma Contagiosum) Transmitted from Sheep to Child: A Case Report.","authors":"Luke C Teigen, Jacob C Teigen, Hao Li, Andrew J Eide","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Orf is a parapoxvirus endemically found in sheep and goats. Orf can be transmitted to humans in close contact with infected animals, causing a self-limited viral skin infection known as ecythyma contagiosum. The diagnosis can be made clinically and treatment is usually conservative; however, unfamiliarity with orf may lead to an extended work-up. We present an 11-year-old male with orf infection of his index finger, to increase awareness of this diagnosis especially for healthcare providers serving rural communities.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"77 10","pages":"450-452"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013561","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":"A Case of Skin Limited IgA Vasculitis in an 84-Year-Old Female.","authors":"Nathan Stadem, Sara Ruter, Graison Sitenga","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>IgA vasculitis is a small vessel vasculitis and while it represents the most common form of vasculitis in pediatric populations, it is rare in adults. This manuscript describes a case of skin limited IgA vasculitis in an 84-yearold Caucasian female. The patient presented for bilateral lower extremity rash that occurred roughly one month following a viral upper respiratory illness. Her rash initially began as small petechial macules around her ankles and progressed to large confluent ecchymoses with scattered petechiae and necrosis over the course of a month. The patient underwent extensive clinical and laboratory analysis for suspected vasculitis which revealed elevated serum IgA, moderate hematuria, pyuria, and an asymptomatic urinary tract infection on urinalysis, but had otherwise normal results on autoimmune testing. The patient underwent tissues biopsies of her bilateral lower extremity rashes which revealed pathology suggestive of leukocytoclastic vasculitis of dermal vessels. Nephrology evaluation revealed no acute renal pathologies and thus biopsy was deferred. Given the result of skin biopsies, elevated serum IgA, and previous viral prodrome, the diagnosis of IgA vasculitis was confirmed. The patient was treated with 40 mg prednisone daily which was tapered over 6 weeks. Following completion of her steroid taper the rashes appeared to be healing well with only residual erythema and no signs of recurrent or worsening purpura. She continues to follow with her medical specialist for potential systemic involvement, which currently remains negative.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"77 10","pages":"454-457"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013548","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 Development of Immobilization Induced Hypercalcemia in the Outpatient Setting - A Case Report.","authors":"Andrew L Guymon, Jamie Schaeffer, Sonalika Khachikian","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Immobilization induced hypercalcemia is an uncommon and serious disorder that requires a thorough evaluation to exclude more common causes of an elevated calcium. Although the pathogenesis is not clearly illuminated, immobilization results in an uncoupling between osteogenic and osteoclastic factors that maintain bone homeostasis. When calcemic bone resorption overwhelms urinary calcium excretion, blood hypercalcemia ensues. Immediate management is similar to other hypercalcemic treatments, while definitive resolution may require bisphosphonates, denosumab, and mobilization. An asymptomatic presentation and other alterations of calcium homeostasis may complicate immobilization induced hypercalcemia. Because of the severe nature of the inciting events surrounding patient immobilization, immobilization induced hypercalcemia is rarely diagnosed in the outpatient setting. However, as seen in our case, outpatient diagnosis may still occur. We highlight the keen awareness and high index of suspicion that primary care providers should maintain to best serve our patients. We report a unique case of immobilization induced hypercalcemia, preceded by traumatic hypocalcemia, that developed and was first evaluated in the outpatient setting.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"77 10","pages":"446-448"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013711","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":"Advancement in the Treatment of Recurrent Pericarditis: Exploring Innovative Therapeutic Options.","authors":"Hammad S Chaudhry, Dawood Shehzad, Mustafa Shehzad, Wahab Jahangir Khan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Acute pericarditis, the predominant pericardial disease, often lacks a clear etiology, with 15-30% of patients experiencing recurrence, rising to 20-50% in those with prior relapses. Autoimmune mechanisms significantly contribute to recurrence, with interleukin-1 identified as a pivotal inflammatory mediator. While NSAIDs, colchicine, and steroids remain staples for acute cases, the spotlight in recurrent pericarditis management has shifted toward immunosuppressive medications. Pericardiectomy serves as the ultimate resort. Notably, rilonacept emerges as a key player, specifically addressing cases resistant to colchicine and dependent on corticosteroids in recurrent pericarditis.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"77 10","pages":"471-476"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013557","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}