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

{"title":"Whole Blood Transfusion in Air Medical Transport: The First Five Years.","authors":"Abigail Polzin, Rylee Honomichl, Tanner A Smith","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Prehospital blood transfusion is increasingly used in emergency medical transport, particularly for trauma-related hemorrhage. Whole blood (WB) has shown advantages over component therapy, i.e., packed red blood cells (PRBC), but data on its use for civilian indications remains limited.</p><p><strong>Study objective: </strong>This retrospective analysis reviewed air medical transport cases over a five-year period from 2019 to 2024 in which blood products were administered.</p><p><strong>Methods: </strong>Data were compared between patients who received WB versus PRBCs, including patient demographics, transfusion indications, Rh status, and outcomes. Statistical analyses included chi-squared tests for categorical variables and Mann-Whitney U tests for continuous variables, with significance set at p<0.05.</p><p><strong>Results: </strong>The groups were demographically similar, and no transfusion-related complications were recorded. WB was significantly more likely to be used in trauma indications, while PRBC predominated in gastrointestinal (GI) bleeds and anemia. Of six Rh-negative women of child-bearing potential (under the age of 50) who received transfusions, two received WB, with one subsequently receiving Rh immunoglobulin. Mortality was higher in the WB group, most likely due to the severe nature of trauma cases.</p><p><strong>Conclusion: </strong>The findings suggest that WB transfusion is an appropriate and effective option in air medical transport, particularly in trauma scenarios. The risk of alloimmunization appeared minimal, supporting the use of WB when Rh matching is not feasible. Further research is needed to assess the role of WB transfusion in non-trauma scenarios.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"79 6","pages":"266-270"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621822","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":"Clostridium innocuum Bacteremia: Case Report and Systematic Review.","authors":"Carla de Matos-Konrad, Nneka Chima, Mark K Huntington","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Clostridium innocuum is an anaerobic gram-positive spore-forming bacteria, a commensal member of the human gut microbiome. We encountered a case of bacteremia with this organism as a complication of a foot ulcer in a middle-aged patient with diabetes, end-stage renal disease, and malnutrition. A systematic review of the limited number of previously reported cases of C. innocuum bacteremia is presented, along with a brief narrative review the organism's association with other diseases, ranging from diarrhea and local infections to modulating inflammatory bowel disease and kidney disease.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"79 6","pages":"271-273"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621851","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":"Adenoid Cystic Carcinoma of the Lip: A Case Report.","authors":"Sarah J Lane, Skye K Lawlor","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Adenoid cystic carcinoma (ACC) is an uncommon malignancy arising from secretory glands. While most commonly involving the parotid and submandibular glands, it can arise from any of the minor salivary gland tissue in the upper aerodigestive tract. This report features a more uncommon presentation of ACC in a 69 y.o. gentleman with a mass in his upper lip. Initial CT scan with contrast was concerning for an invasive lesion which subsequently led to a guideline-driven workup including fine-needle aspiration that was concerning for suspected salivary gland malignancy, most likely ACC. Pre-treatment chest CT was negative for metastatic disease. The patient underwent surgical excision followed by radiation therapy for definitive treatment. Surgical pathology confirmed a diagnosis of ACC with perineural invasion. The patient was treated with radiation therapy to minimize risk of tumor recurrence. Due to high prevalence for late recurrence and lung metastasis in patients with adenoid cystic carcinoma, the patient will be seen for ongoing surveillance including imaging. This case report looks to describe a more uncommon presentation of ACC and reviews the literature for management of ACC involving the minor salivary glands.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"79 6","pages":"258-260"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621826","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":"An Evaluation of Emily's Hope Substance Use Prevention Curriculum Among Early Elementary School Students: Preliminary Indications of Effectiveness - a Cross-Sectional Study.","authors":"Maria Villarroel Pinell, Phil Dohn, Minga C Vargas, Vivek Anand","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Substance use is a major cause of preventable morbidity and mortality, and national data show that many adolescents initiate use by middle school. Earlier prevention is critical, yet traditional approaches. There is growing recognition of the need for school-based strategies that are interactive, developmentally appropriate, and culturally relevant to promote healthy decision-making from an early age.</p><p><strong>Methods: </strong>An age-appropriate substance use prevention curriculum targeted at early elementary school students (KG, 1st and 2nd grades) was developed by a multidisciplinary educational committee. The curriculum was administered to 662 early elementary students in 16 school districts in South Dakota, North Dakota, Minnesota, and Iowa over the 2023-2024 school year.</p><p><strong>Results: </strong>All grades displayed statistically significant gains in awareness about body systems as measured by postcurriculum survey responses. Early elementary school students demonstrated an increased understanding of brain function, physical health, emotional regulation, and medication safety.</p><p><strong>Conclusion: </strong>This study highlights that a well-structured substance use prevention curriculum can promote early elementary school students' understanding about personal health, brain function, and safe medication use.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"79 6","pages":"252-256"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621788","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 Squamous Cell Carcinoma of the Colon.","authors":"Michael Roberts, Tate Blankespoor, Hareem Tahir, Rafia Irfan Waheed, Mamoon Ahmed","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Squamous cell carcinoma (SCC) of the colon is a rare malignancy. Unlike colonic adenocarcinomas, it lacks defined risk factors or established treatment guidelines. We describe a case of metastatic squamous cell carcinoma of the colon in a 77-year-old male with ulcerative colitis. The patient presented with abdominal pain and had labs that revealed transaminitis with conjugated hyperbilirubinemia. Imaging showed a large irregular mixed hyperechoic mass with fluid collection in the liver along with retroperitoneal lymphadenopathy concerning infection/abscess or malignancy. This was initially treated as an infection with broad-spectrum antibiotics and drain placement, but it failed to improve. Biopsy of the liver revealed carcinoma with squamous cell differentiation. In order to look for the primary site, the patient underwent a colonoscopy and esophagogastroduodenoscopy (EGD). EGD was negative, and colonoscopy revealed a mass at the hepatic flexure of the colon with pathology consistent with SCC. PET scan did not reveal any other sites suspicious for primary malignancy. Tempus tumor of origin testing was inconclusive. Hence, colon was thought to be the primary site for SCC with direct extension to the liver. Unlike colonic adenocarcinoma, colonic SCC lacks standardized treatment guidelines. Prognosis is also worse, especially in advanced stages. Surgical resection is preferred for localized disease, but evidence supporting systemic therapy is limited to case reports. The patient was not a surgical candidate and was initiated on FOLFOX (folinic acid, fluorouracil, and oxaliplatin) chemotherapy. This case overall highlights a rare case of colonic SCC and the need for more evidence to guide treatment.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"79 6","pages":"278-281"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621799","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":"Concordance Between Radiologist and AI-based Volumetric Breast Density Assessments: Clinical and Economic Implications - A Retrospective Cohort Study.","authors":"Jacob R Devine, Alexander D M Withrow, Sabina Choudhry","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Radiologists classify breast density using the Breast Imaging Reporting and Data System (BI-RADS) as required by the 2024 Mammography Quality Standards Act (MQSA), which mandates disclosure of breast density in all mammography reports. FDA-approved AI software now provides objective, reproducible breast density assessments to improve workflow and guide supplemental screening. This study examines concordance between AI-based systems (Volumetric density measurement by Volpara/Lunit) and radiologist assessments and explores potential clinical and economic implications.</p><p><strong>Materials and methods: </strong>A retrospective cohort study with IRB approval was conducted at Avera Health using 54,819 mammograms between February 2024 and June 2025. Radiologists assessed breast density with the option to override AI-generated assessments. Density classifications were compared and categorized as \"agreement\" or \"substantial change.\" Effects on Tyrer-Cuzick (TC) lifetime risk scores, patient referrals, and prospective healthcare costs were analyzed.</p><p><strong>Results: </strong>Overall, AI and radiologist assessments had agreement rates of 92-97% for BI-RADS B and C and 85-90% for A and D. Most discrepancies involved BI-RADS B and C categories, leading to misclassification of breast density and potential repercussions for patient care. Overestimation resulted in unnecessary procedures, radiation, costs, and anxiety, while underestimation risked delayed detection of aggressive cancers.</p><p><strong>Conclusion: </strong>Current AI software demonstrates concordance with radiologist assessments, though notable variability persists at critical diagnostic thresholds. Utilizing standardized protocols, periodic AI model updates, and radiologist oversight are crucial to minimizing misclassification, enhancing workflow efficiency, optimizing patient outcomes, and fostering trust in AI-assisted breast imaging.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"79 6","pages":"274-276"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621843","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":"Beyond the CHA2DS2VASc: Hypercoagulable States in Anticoagulated AF Patients.","authors":"Michael Roberts, Dawood Shehzad, Tate Blankespoor, Joe Reynen, Mahmoud Alsaiqali, Tehreem Fatima, Dawlat Khan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Despite the proven efficacy of direct oral anticoagulants (DOACs) in preventing thrombus formation in atrial fibrillation (AF), thrombus formation may rarely occur even with appropriate anticoagulation. We report the case of a 70-year-old woman with a history of AF, initially on warfarin, who underwent percutaneous left atrial appendage closure with a Watchman FLX 27 mm device due to recurrent gastrointestinal bleeding. She subsequently developed multiple unprovoked deep venous thromboses, necessitating the reinitiation of rivaroxaban therapy. She presented to the hospital with complaints of lower abdominal pain. Although the CT abdomen and pelvis was not a dedicated cardiac study, the superior slices incidentally captured the inferior and posterior left atrium, revealing a lobulated soft-tissue density suspicious for thrombus. Labs included INR 1.8, APTT of 40, and D-dimer of 0.62. Transthoracic echocardiography could not visualize thrombus. Transesophageal echocardiography revealed a large mobile thrombus in the superior cavity of LA. The watchman device was well seated with no flow noted across the device. A hypercoagulability workup showed low levels of Protein S antigen at 21. She was placed on warfarin. Follow-up TEE in 3 months showed a decrease in the thrombus size. This case highlights the importance of evaluating an underlying hypercoagulable state when thrombus develops despite DOAC therapy. While DOACs prevent thrombus formation in atrial fibrillation, their failure should not be dismissed as incidental. Clinicians should pursue a hypercoagulability workup, especially when thromboembolic events appear disproportionate to the CHA₂DS₂-VASc score. Early identification of inherited or acquired thrombophilies can guide tailored and effective long-term management.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"79 5","pages":"224-226"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621703","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":"Rickets in the New Age of Food Allergies: A Case Report and Comprehensive Review.","authors":"Ryan Peldo, Henry Mullaney, Emily Wilde, Cole Tessendorf, Drew Erie, Jared Daniel, Robert E Van Demark","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Nutritional rickets, once a historical disease, has reemerged in select pediatric populations despite modern food fortification efforts. While vitamin D deficiency remains the leading cause, dietary restrictions due to food allergies present a unique and underrecognized risk factor. This case report describes a 2-year-old male with multiple severe food allergies who developed vitamin D-deficient rickets due to a highly restrictive diet. His presentation, laboratory findings, radiographic abnormalities, and clinical management are discussed. Additionally, we provide a comprehensive review of the evolving epidemiology of rickets, its resurgence in high-risk populations, and the association between food allergies and nutrient deficiencies. Given the increasing prevalence of pediatric food allergies, this report underscores the need for proactive screening, early intervention, and interdisciplinary collaboration to prevent nutritional deficiencies in at-risk children.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"79 5","pages":"218-222"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621801","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":"Helicobacter Pylori Infection in the Primary Care Setting: Recognition, Diagnosis, and Updated Treatment Regimens.","authors":"Kennedy Forest, Melissa Pham, Sydney Lovrien, Deepan Panneerselvam","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Helicobacter pylori (H. pylori) is recognized as one of the most widespread infections globally and is associated with damaging gastric sequelae, including dyspepsia, peptic ulcers, and even malignancy. It is crucial for primary care physicians, in addition to gastroenterology specialists, to be well-informed about the typical clinical presentation, diagnostic modalities, and treatment protocols for H. pylori infections. The updated treatment guidelines from the American College of Gastroenterology (ACG), which address the nuances of antibiotic resistance trends, provide valuable direction for healthcare providers in managing patient infections effectively and mitigating the risk of complications related to chronic H. pylori infection.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"79 5","pages":"233-235"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621842","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":"Abstract: Talk the Talk or Walk the Walk? A Comparative Study of Educational Strategies to Increase High School Students' Interest in Healthcare Careers.","authors":"Tiffany Knecht, Parker Owen, Alan Sazama","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The healthcare industry is the largest private employer in the United States, yet workforce shortages persist. The Health Resources and Services Administration (HRSA) estimates that 92 million people live in primary care health professional shortage areas (HPSAs), 64 million in dental HPSAs, and 137 million in mental health HPSAs. An aging population and rising chronic illness rates place a growing burden on the healthcare system, with projected shortages exceeding 140,000 physicians and 100,000 registered nurses by 2038. Recruiting younger learners into healthcare careers is therefore critical. This study evaluated whether a traditional informational presentation or a presentation combined with hands-on activities was more effective at increasing high school students' interest in healthcare careers.</p><p><strong>Methods: </strong>Two medical students visited eight high school chemistry classes, providing either a 30-minute informational presentation with time for questions, or a 10-minute presentation followed by 30 minutes of hands-on healthcare activities, including practicing vital signs and learning intubation techniques. Both presentations discussed motivations for working in healthcare and potential career paths. Students completed anonymous pre- and post-surveys assessing healthcare career interest. Surveys were paired using anonymous identifiers. Parental consent and student assent were obtained per institutional review board requirements.</p><p><strong>Results: </strong>The study included 129 consented participants, primarily 10th-grade students (n=124). Prior healthcare exposure was reported by 54%, and 62% had previously considered a healthcare career. On a scale of 1-10, baseline interest averaged 4.29. Interest increased by 0.64 (±1.16) in the presentation-only group and by 0.68 (±1.27) in the presentation plus hands-on group. These changes were statistically significant (p<0.001), with no significant difference between groups. Overall, 44% of students reported increased interest, 43% no change, and 12% decreased interest.</p><p><strong>Conclusion: </strong>Both approaches were influential in reaffirming students' interest or disinterest in a healthcare career. However, they did not differ significantly in their effect on interest. Future studies including broader student populations and expanded hands-on activities may better clarify effective strategies for engaging undecided students.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"79 suppl 5","pages":"s36"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621680","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}