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

{"title":"Graves' Disease Complicated by Cardiac Tamponade in Pregnancy: A Case Report and Review of the Literature.","authors":"Haley S Jerman, Rachel L Rodel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Thyrotoxicosis and its associated complications pose a diagnostic and therapeutic challenge with heightened complexities in pregnant patients. Although Graves' disease is an established but infrequent cause of pericarditis, cardiac tamponade has been documented in association with hyperthyroidism only in case reports. We present the case of a 23-year-old patient with Graves' disease, leading to recurrent thyrotoxicosis and pericarditis. She presented in her second trimester of pregnancy with cardiac tamponade requiring emergent pericardiocentesis and interval thyroidectomy. This case highlights the rarity of cardiac tamponade and Graves' disease during pregnancy. Although medication management is first line in the treatment of hyperthyroidism in pregnancy, surgical management should not be delayed if the benefits to maternal and fetal health are deemed to outweigh the risks.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"78 7","pages":"311-315"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973137","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":"Pronounced Disparities in Amyloidosis Cardiovascular Mortality Among Elderly Adults in the United States from 1999-2020.","authors":"Mustafa Shehzad, Dawood Shehzad, Logan Johnke, Dawlat Khan, Hammad Shabir Chaudhry","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Amyloidosis is a group of protein-folding disorders marked by the accumulation of amyloid fibrils, leading to significant organ dysfunction. This study investigates trends in cardiovascular mortality linked to amyloidosis in the U.S. from 1999 to 2020, using data from the CDC WONDER database. We analyzed age-adjusted mortality rates (AAMR) among older adults (older than 65 years) across various demographic, racial, and geographic categories. Findings show a concerning increase in AAMR from 1.71 in 1999 to 4.23 in 2020, with a notable acceleration after 2018 (annual percentage change of +16.30). Males consistently demonstrated higher mortality rates than females, while non-Hispanic Black individuals had nearly double the AAMR compared to other racial groups. Regional analysis revealed the highest mortality rates in the Northeast and West, contrasting with lower rates in the South despite a larger Black population in that region. These disparities highlight potential influences from socioeconomic factors, healthcare access, and diagnostic practices. The increase in amyloidosis-related mortality may reflect enhanced recognition rather than an actual rise in disease prevalence. Our results underscore the urgent need for targeted public health interventions to address these disparities and improve diagnostic and treatment strategies. Continued investigation into the underlying causes of these trends is essential for enhancing patient outcomes and managing the growing burden of amyloidosis among the aging population.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"78 7","pages":"321-326"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973108","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":"To Take or Not to Take: A Case of Cholestyramine Induced Vitamin K Deficiency.","authors":"Tinotenda Me Sekeramayi, Christopher Sumey","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cholestyramine resin combines with bile acids preventing their reabsorption from the small bowel, leading to a reduction in the absorption of fat-soluble vitamins A, D, E, and K. While rarely clinically significant, in some cases this can lead to vitamin K related coagulopathy. We present a case of a 57-year-old female with a profound vitamin K deficiency refractory to concomitant oral vitamin K supplementation in the setting of ongoing cholestyramine administration.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"78 7","pages":"317-318"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973140","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":"First Use of Gamma Knife Radiosurgery for Glossopharyngeal Neuralgia in South Dakota: A Case Report.","authors":"Nathan Popp, Sydney Payne, Charles Murphy, Justin Persson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Glossopharyngeal neuralgia (GPN) is a rare and debilitating condition characterized by severe, episodic pain in the throat, ear, and tongue. This case report presents an 85-year-old woman with left-sided GPN whose condition proved resistant to medical therapies, necessitating an alternative approach. In May 2024, she underwent Gamma Knife radiosurgery (GKRS), marking the first documented use of this procedure for GPN in South Dakota. The treatment was well-tolerated, and the patient reported complete pain relief without complications at her one-month follow-up. This case demonstrates GKRS as a minimally invasive, safe, and effective alternative for managing refractory GPN, especially in elderly patients who are poor candidates for invasive surgery. It also underscores the potential to expand GKRS in rural healthcare settings to improve access to advanced treatments.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"78 6","pages":"276-279"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973129","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":"Dermatofibrosarcoma Protuberans Treatment in South Dakota.","authors":"Joseph H Kelly, Marcus L Frohm","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Dermatofibrosarcoma protuberans (DFSP) is a rare, locally aggressive dermal soft tissue sarcoma. Local recurrences, reported at rates between 2-19%, risk sarcomatous transformation and increasing risk for metastasis. Swift diagnosis and appropriate management mitigate the risk of advanced local disease, extensive surgical resection, and subsequent risk of metastasis. Clinically, DFSP resembles multiple, common subcutaneous growths. Misdiagnosis leads to incorrect or delayed treatment. This study investigates whether access to dermatology affects outcomes of DFSP treatment in South Dakota by characterizing the rates of appropriate workup, diagnosis, treatment, and recurrence rates among dermatology and non-dermatology providers.</p><p><strong>Methods: </strong>This study was a retrospective review for 24 adults with a histological DFSP diagnosis. The study evaluated three endpoints: rates of appropriate workup and diagnosis comparing dermatology and non-dermatology providers, rates of appropriate primary treatment between lesions with and without appropriate workup and diagnosis, and rates of positive margins or primary recurrence between lesions with and without appropriate primary treatment.</p><p><strong>Results: </strong>The results for the first endpoint were not statistically significant (OR = 0.13, 95% CI: 0.012 - 1.33, p = 0.0774). The data rejected the null hypothesis of the second and third endpoints, (OR = 0.065, 95% CI: 0.0062 - 0.674, p = 0.0272), respectively. Clinical tumor size did not independently impact the treatment course for DFSP (OR: 0.43, 95% CI: 0.066 - 2.80, p = 0.657). Finally, there were no metastases in any of the 24 patients.</p><p><strong>Conclusion: </strong>Patient outcomes are better when providers biopsy DFSPs on initial presentation. Without a biopsy and uncertain diagnosis prior to treatment, providers excise insufficient surgical margins. This increases overall morbidity before achieving clear surgical margins. Higher clinical suspicion for DFSP prompting appropriate biopsy prior to surgical treatment should improve patient outcomes.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"78 6","pages":"247-252"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973126","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":"Cerebellar Hemangioblastoma Masquerading as Recurrent Posterior Fossa Meningioma: A Case Report.","authors":"Joel C Stroman, Amity Peterson, Karan Topiwala","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Meningiomas and hemangioblastomas are two entities neurosurgeons may encounter in the posterior fossa. Each lesion has its own unique imaging findings, clinical presentation, and associated risks. Treatment for the two lesions may vary but surgical resection is typically considered definitive for both. While meningioma recurrence is common, hemangioblastoma recurrence is exceedingly rare and hemangioblastoma in the location of previous meningioma even more so, with zero reported cases until now.</p><p><strong>Case description: </strong>A 59-year-old female with a medical history significant only for a self-reported left cerebellar meningioma excision nearly forty years ago presented with posterior headache, dysmetria, and gait imbalance. Brain magnetic resonance imaging (MRI) revealed a T1 hypointense and T2 hyperintense mass in the left cerebellum that appeared to arise from the tentorium. Angiography and preoperative embolization of feeder vessels was performed in what was suspected to be a recurrent meningioma with exuberant vascularity. The patient underwent a paramedian suboccipital craniotomy and the mass was successfully removed. The mass was felt to be an arteriovenous malformation with coexisting aneurysm based on intraoperative findings and review of imaging. The histologic examination was consistent with hemangioblastoma.</p><p><strong>Conclusion: </strong>We present a case of hemangioblastoma that was discovered intraoperatively after being mistaken for recurrent posterior fossa meningioma in the preoperative assessment period.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"78 6","pages":"259-264"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973063","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":"Who Accompanies Breast Cancer Patients to Reconstructive Surgery Consultation Appointments? Characteristics and Influence of the Patient-Companion Relationship.","authors":"Tiffany Bender, Sydney Bormann, Molly Lien, Madysen Eddy, Kianna Thelen, Li Cao, Heather Karu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Due to the emotional and psychological weight a breast cancer diagnosis may carry, many patients find comfort in navigating treatment and reconstruction with a companion. The relationship of such a companion can vary, ranging from first-degree relatives to friends with no familial relationship. Similarly, the degree of influence a companion has on a patient's treatment and reconstruction journey may also vary.</p><p><strong>Methods: </strong>This study aimed to identify the relationships of companions who accompany patients to their breast cancer reconstruction appointments through a retrospective chart review of electronic medical records. Patients with both active breast cancer and those undergoing prophylactic mastectomy who had a breast cancer reconstruction surgery consultation from 2015 to 2020 were included in the study. Further characteristics such as age, relationship status, and distance traveled for the appointment were also assessed.</p><p><strong>Results: </strong>Results of the analysis showed that over half of patients were accompanied by a companion, emphasizing the important role companions may play in emotional support. Married or partnered patients were significantly more likely to have a companion compared to their single, widowed, or divorced counterparts. On average, patients traveled 92.77 miles to attend their consultations. Patients who traveled futher distances were more likely to be accompanied by a companion than those without, suggesting the presence of a companion may be critical for those facing geographical challenges or seeking additional emotional reassurance during the consultation process.</p><p><strong>Conclusion: </strong>This study aimed to explore the relationship between patients and their companions, based on patient demographics including age, relationship status, and relationship to their companion. Upon analysis of 421 patients with breast cancer, it was found patients who traveled further distances were more likely to be accompanied by a companion than those without, and those who were married were more likely to have a companion than those who were single. This analysis helps providers modify their approach to care, as well as better understand potential barriers to support in oncology patients. Future studies may aim to evaluate a more comprehensive picture of patientcompanion dynamics and their role in breast cancer consultations.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"78 6","pages":"254-257"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973132","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 Investigation of Historical Injustices in the South Dakota Medical Journal 1912-1930.","authors":"Madison Toll, Henry Travers","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Historians' recent exploration of the role of the New England Journal of Medicine in perpetuating historical biases and injustices in medicine prompted us to examine the journal of the South Dakota Medical Association for similar themes. Known as the Journal-Lancet in the years 1912-1930 covered by our study, the journal's content was searched using key words in four categories: Native American, Blacks, the feeble-minded and eugenics. Relevant articles containing key words were archived in databases (DEVONthink and Claris FileMaker) structured to permit systematic examination of the material. For eugenics, South Dakota newspapers were also searched. We found that Native Americans were frequently denigrated as savages and incapable of participating in efforts to change reservation environments to reduce the twin scourges of trachoma and tuberculosis. Blacks were incorrectly viewed as racially less susceptible to trachoma. There was widespread acceptance of the eugenic assertion that individuals regarded as defective, tubercular or feeble-minded, including many Native Americans, inherited their conditions and could pass them on. The belief in the greater fecundity of \"defectives\" fueled the fear that they would displace \"normal\" people in the population which led to their sterilization, removal to institutions, and attempts to restrict their right to marry. Public support for eugenics in South Dakota came largely from women's clubs. We concluded that physicians writing in the Journal-Lancet during this time perpetuated unjust views of Native Americans, blacks and the mentally impaired that significantly harmed these populations. Harms included restriction of their personhood, continued persistence of disease among them, social denigration, and racial bias.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"78 6","pages":"267-274"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973098","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":"Impact of Dermatology Access on Dermatofibrosarcoma Protuberans Outcomes: A Retrospective Study in a Larger Cohort.","authors":"Joseph H Kelly, Linze Christensen, Marcus L Frohm","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Dermatofibrosarcoma protuberans (DFSP) is an aggressive rare cutaneous tumor with a relatively high rate of local recurrence. Incidence in the United States has been reported around 4 occurrences per million people per year. Local recurrences have been reported between 2 to 19% of cases. These cases are at higher risk for sarcomatous transformation, increasing the risk for metastasis. Early and accurate diagnosis, coupled with appropriate management, is essential to minimize these risks. However, early on, DFSP is often misdiagnosed as a number of benign subcutaneous growths. Misdiagnosis often leads to incorrect or delayed treatment. This study extends previous research by evaluating whether access to dermatology care influences DFSP treatment outcomes in a larger cohort and larger geographical area.</p><p><strong>Methods: </strong>This study is a retrospective review currently including 68 adults with histologically confirmed DFSP. The study evaluated three endpoints: rates of appropriate workup and diagnosis comparing dermatology and non-dermatology providers, rates of appropriate primary treatment between lesions with and without appropriate workup and diagnosis, and rates of positive margins or primary recurrence between lesions without and with appropriate primary treatment.</p><p><strong>Results: </strong>For all three endpoints, the data rejected the null hypothesis.</p><p><strong>Conclusion: </strong>These findings further support that early biopsy and high clinical suspicion for DFSP improve surgical outcomes, particularly when diagnostic biopsy is performed prior to treatment. The larger sample size reinforces the importance of dermatology access in optimizing patient care and decreasing morbidity from DFSP treatment. Increased clinical awareness and stricter adherence to diagnostic and therapeutic guidelines are recommended for improved patient outcomes in the management of DFSP.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"78 suppl 5","pages":"s30"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477177","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":"Maximizing Long-Term Care Resident Satisfaction Using the Kano Model: A Quality Improvement Project Within a South Dakota Long-Term Care Facility.","authors":"Carly Haring, Dan Rath","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>With the growing demand for long-term care facilities, understanding residents' values is critical to delivering high-quality care and enhancing their quality of life. This project aimed to identify the quality-of-life features most valued by residents to optimize resource allocation and maximize satisfaction.</p><p><strong>Methods: </strong>A survey assessing 11 quality-of-life features was conducted with residents at a South Dakota nursing home. Participation was voluntary, excluding residents unable to communicate verbally or hear the interviewer. Survey responses were analyzed using the Kano Model, which categorizes features as \"mustbe,\" \"performance,\" \"attractive,\" or \"indifferent,\" reflecting their impact on satisfaction and prioritization. \"Must-be\" features represent expectations essential to satisfaction, while \"performance\" features influence satisfaction proportionally. \"Attractive\" features offer added value by improving satisfaction, without reducing it when absent. \"Indifferent\" features provide opportunities to reallocate resources toward higherpriority needs.</p><p><strong>Results: </strong>Thirty-three residents participated in the survey, and analysis of their responses revealed distinct categorizations for the quality-of-life features. Features identified as \"must-be\" included permission to leave, autonomy in sleep schedules, help when needed, shared decision-making, and security of possessions. Features categorized as \"performance\" were organized activities, religious activities, and comfortable room temperature. \"Attractive\" features consisted of enjoying food and staff taking personal interest, while private phone calls were classified as \"indifferent.\" To add prioritization within these categories, importance scores from the survey were incorporated. Based on these scores, the features were ranked in the following order to maximize satisfaction: help when needed, security of possessions, permission to leave, shared decision-making, autonomy in sleep schedules, room temperature, religious activities, organized activities, enjoying food, staff taking personal interest, and private phone calls.</p><p><strong>Conclusions: </strong>The findings highlight the importance residents assign to quality-of-life features and demonstrate which features residents value most. This allows administrators to make data-driven decisions to efficiently enhance resident satisfaction.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"78 suppl 5","pages":"s28"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477182","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}