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

{"title":"Abstract: National Trends of Cholangiocarcinoma Mortality in the United States with reference to South Dakota: A Negative Binomial Analysis.","authors":"Amna Gill, Ali Zubair, Muhammad Arham, Jyotroop Kaur, Eesha Gill","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Cholangiocarcinoma (CCA) has been noted to have increasing mortality globally. This study aims to evaluate the demographic, racial and geographic trends in CCA mortality across the United States.</p><p><strong>Methods: </strong>Data was extracted through Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research by using ICD-10 codes C22.1, C24.0, C24.8 and C24.9 for people over 65 years of age, for the years 1999-2023. Age-adjusted mortality rates (AAMR) per 1,000,000 individuals and annual percentage changes (APC), with 95% confidence intervals, were analyzed across various demographic groups and geographical regions through Joinpoint regression. Negative Binomial Regression was utilized to compute adjusted Incidence Rate Ratios (IRRs), with South Dakota (SD) as the reference.</p><p><strong>Results: </strong>Our analysis revealed a total of 131,125 deaths in the United States from 1999 to 2023 due to CCA. Overall, there was a consistent increasing trend in the AAMR from 90.8 to 163.1 per 1,000,000 (AAPC: 2.40, 95% CI: 2.15 to 2.65). Males had a consistently higher AAMR than females across all years. African American population showed the highest increase in AAMR over the study years (AAPC: 3.36). Highest CCA-related mortality was seen in Rhode Island, followed by Massachusetts. Highest increase in mortality over the period was seen in Louisiana (AAPC 3.38, 95% CI: 1.70-5.10). Based on negative binomial regression, each one-year increase was associated with approximately 1% increase in AAMR (IRR=1.021, 95% CI: 1.020-1.022). Alaska had a 66% higher (IRR 1.66) and Rhode Island had a 23% higher incidence of mortality (IRR 1.23) when compared to SD. Mississippi had the lowest incidence of mortality, 51% less when compared to SD (IRR 0.49).</p><p><strong>Conclusion: </strong>The upward trajectory of CCA mortality is disproportionately higher in some states and underscores the need for additional research aimed at understanding risk factors driving this increase.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"79 suppl 5","pages":"s30"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621729","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: Expanding Access to Vascular Care Using BlueDop Vascular Expert: A Prospective Cohort Study.","authors":"Ben Van Bockern, Mason Woldt, Jacob R Devine, Alexander D M Withrow, Cole D Tessendorf, Chelsy Bleeker, Melissa Ostrem, Geoffrey A Answini, Mo Al-Qaisi, Patrick W Kelly","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Peripheral artery disease (PAD) affects millions of individuals annually and can lead to severe morbidity and mortality. Risk factors for development of PAD include hypertension, obesity, diabetes mellitus, and smoking. Conventional methods to detect PAD include the Ankle-Brachial Index (ABI) with duplex ultrasound being the gold standard for diagnosis. Factors such as vessel compressibility, cuff placement, patient positioning, and sequence of measurements serve as limitations or sources of inaccuracy for ABI. BlueDop Vascular Expert (BVE) is an artificial intelligence (AI) powered device that offers a standardized, accurate, and reliable method to detect early PAD development regardless of comorbidities. The device is portable, user-friendly, easy to interpret and has the potential to expand early PAD detection.</p><p><strong>Method: </strong>Individuals at risk for PAD underwent both ABI and BVE testing. Full leg arterial duplex interpreted by an independent vascular surgeon served as the reference standard. Subgroup analysis compared BVE and ABI capabilities among those with underlying comorbidities such as diabetes mellitus, hypertension, tobacco use, and obesity. Data from two cohorts were used: this study and Tessendorf et al.</p><p><strong>Results: </strong>For all-comers overall accuracy was 91.2% and 80.6% for BVE and ABI respectively. Overall sensitivity for BVE was 82.5% and specificity was 93.9%. In contrast, ABI sensitivity was 58.3%, specificity was 87.4%. Increased accuracy, sensitivity, specificity, and κ constant was present in all analyzed subgroups when comparing BVE to ABI.</p><p><strong>Conclusion: </strong>Across diverse patient populations, BVE provides more accurate and reliable PAD screening than ABI, including those with comorbidities that reduce ABI accuracy. BVE's portability, usability, and minimal reliance on specialized interpretation support it as a first-line screening tool, particularly in rural and underserved settings. Broader implementation of BVE could help reduce diagnostic disparities and improve outcomes for patients at risk of PAD.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"79 suppl 5","pages":"s46-s48"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621762","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: Sinonasal Undifferentiated Carcinoma in an 81-Year-Old Male with Visual Changes: A Case Report.","authors":"Cole Knoblich, Brant Hannahs, Matthew Schmitz, William C Spanos","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Sinonasal undifferentiated carcinoma (SNUC) is a rare but aggressive malignancy of the sinonasal cavity that can present with nonspecific symptoms such as nasal congestion and epistaxis. These are common primary care complaints and resemble several benign diseases, often leading to delayed diagnosis. We present an advanced case of SNUC in a patient with progressive nasal obstruction and new-onset vision changes to highlight concerning features that warrant urgent evaluation.</p><p><strong>Case report: </strong>We present an 81-year-old male with a history of nasal polyps that presented with a two-year history of unilateral nasal congestion and intermittent left-side epistaxis. Symptoms progressively worsened and were accompanied by new-onset blurred vision in the left eye, headache, imbalance, and facial pressure. His physical exam was unremarkable on external inspection. CT and MRI were significant for an expansile mass in the left ethmoid air cells with erosion of the cribriform plate, extension into the anterior cranial fossa, and invasion of the extraconal orbital space. There were no concerns for distant metastases based on chest imaging. Endoscopic biopsy revealed poorly differentiated carcinoma consistent with SNUC. He was started on chemotherapy and follow up at one month showed significant clinical and radiographic response, including return of baseline vision.</p><p><strong>Conclusion: </strong>Patients with SNUC can present with vague symptoms mimicking sinusitis, often leading to delayed diagnosis. High risk symptoms such as persistent unilateral nasal obstruction, recurrent epistaxis, new-onset visual changes, or neurological symptoms warrant early imaging and specialist referral. Sinonasal malignancies should be included in the differential when high risk symptoms are present or not responding to medical management. Despite its rarity, SNUC is highly aggressive and tends to invade nearby structures at presentation. Primary care clinicians serve a critical role in early recognition of alarming features to promote timely diagnosis and multidisciplinary management, which may improve patient outcomes.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"79 suppl 5","pages":"s32-s33"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621718","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: Solitary Colonic Ganglioneuroma Identified on Screening Colonoscopy: A Case Report.","authors":"Grace Geffre, Brandon Rosell, Ashwyna Sunassee, Ahmed T Kurdi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Ganglioneuromas are rare benign tumors derived from neural crest cells of the enteric nervous system. Stemming from the sympathetic nervous system, they are mostly encountered in the abdomen and rarely in the gastrointestinal tract. Polypoid ganglioneuromas are usually solitary. Ganglioneuromatous polyposis can be associated with systemic and familial syndromes such as Neurofibromatosis type I, Cowden syndrome, and Multiple Endocrine Neoplasia type 2B.</p><p><strong>Case report: </strong>We report the case of an asymptomatic 60-year-old female who was incidentally found to have a 4 mm sessile sigmoid polypoid lesion on a routine screening colonoscopy. The lesion was resected with a cold snare. Other diminutive polyps were similarly resected and consistent with tubular adenomas. Histopathology of the lesion confirmed a colonic ganglioneuroma. Unique features included expansion of the lamina propria by edema and a poorly circumscribed population of eosinophilic spindle cells with curved and tapered nuclei without atypia (H&E x40). Higher magnification (H&E x200) showed larger ganglion cells admixed with abundant amphophilic cytoplasm, round nuclei, and prominent eosinophilic nucleoli. Immunohistochemical staining reveals the spindle schwannian cells and larger ganglion cells are positive for S100 and SOX10 and negative for smooth muscle actin (SMA), CD117 (KIT), and DOG-1 (x40).</p><p><strong>Conclusion: </strong>Solitary polypoid ganglioneuromas of the colon are rare benign tumors with unique histopathologic features that do not tend to recur with adequate resection. Notably for these tumors, polyposis can be associated with systemic and familial syndromes. Till present, there are no recommendations on surveillance colonoscopy for solitary ganglioneuromas. Given tubular adenomas were concurrently resected, a repeat evaluation in 5 years was recommended to this patient.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"79 suppl 5","pages":"s29"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621727","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: Empowering Collegiate Female Athletes Through a Brief Educational Intervention on the Female Athlete Triad: A Quasi-Experimental Pre-Post Study.","authors":"Carly Haring, Jon Olson","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The Female Athlete Triad, characterized by low energy availability, menstrual dysfunction, and impaired bone health, poses short- and long-term health risks for female athletes. Despite its prevalence, awareness and education surrounding the Triad remain limited, contributing to delayed recognition and care. This project assessed baseline knowledge and comfort discussing Female Athlete Triad-related topics among collegiate female athletes and evaluated the impact of a brief educational intervention on knowledge, attitudes, and help-seeking intentions.</p><p><strong>Methods: </strong>A community-based educational initiative was conducted among collegiate female athletes at a South Dakota university. Participants completed anonymous pre- and post-surveys surrounding a 30-minute educational session on the Female Athlete Triad. Surveys assessed prior education, knowledge of the Triad and its components, likelihood of seeking medical care for menstrual irregularities, and comfort discussing related concerns. Paired t-tests analyzed changes in Likert-scale items, and a chi-square test evaluated changes in comfort discussing health concerns.</p><p><strong>Results: </strong>A total of 79 female athletes completed both surveys. While most participants reported prior education on nutrition (72), fewer had received education on bone (31) or menstrual health (37). Following the intervention, mean knowledge scores improved for understanding of the Female Athlete Triad (3.00 to 4.27), the role of nutrition (3.95 to 4.35), and factors affecting bone health (2.46 to 4.22) (all p < 0.001). The likelihood of seeking care for irregular menses increased (3.19 to 4.10, p < 0.001). Comfort discussing Triad-related concerns also improved, with more participants selecting \"yes\" and fewer selecting \"unsure\" (p = 0.002).</p><p><strong>Conclusions: </strong>A brief educational session significantly improved collegiate female athletes' knowledge of the Female Athlete Triad and enhanced comfort with help-seeking behaviors. These findings support the feasibility and impact of concise educational interventions as a preventive strategy and highlight opportunities to integrate Triad education into athletic programs and pre-participation sports physicals.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"79 suppl 5","pages":"s33"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621942","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 Purtscher-like Retinopathy Secondary to Anti-Synthetase Syndrome: A Case Report and Literature Review.","authors":"Sam Diemer, Elizabeth Atchison, Mark Vercel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Anti-Synthetase syndrome is a rare and potentially life-threatening subtype of dermatomyositis as part of the spectrum of idiopathic inflammatory myopathy (IIM) that can affect multiple organ systems. Here, we review many of the possible ocular manifestations of this inflammatory myopathy and highlight a case with retinal involvement. A man in his 30's with a history of anti-synthetase syndrome complained of blurred vision of both eyes ongoing for two weeks. A fundoscopic examination revealed numerous cotton wool spots in both eyes without any signs of hemorrhage or Purtscher flecken. Optical coherence tomography showed no evidence of macular edema. A month prior to presentation, the patient was prescribed oral prednisone and IV methylprednisolone in adjunct to mycophenolate mofetil with a recent infusion of rituximab; the drug course was continued. Best corrected visual acuity returned to 20/20 in both eyes with accompanied improvement of cotton wool spots correlating with his course of immunosuppression.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"79 5","pages":"202-204"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621715","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: Diagnostic Delays and Impediments in Managing CRAO for Better Outcomes: A Retrospective Cohort Study of Barriers to Thrombolysis Across a Regional Health System from 2018-2025.","authors":"Mason Woldt, Brendan Rezich, Srinivas Bandi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Central retinal artery occlusion (CRAO) is an ophthalmic emergency analogous to acute ischemic stroke, presenting with sudden painless vision loss and carrying a poor visual prognosis. The use of thrombolysis in managing CRAO remains controversial; recent randomized trials have not demonstrated statistically significant improvement in visual outcomes, though authors acknowledge potential underpowering to detect a clinically meaningful effect, with larger trials ongoing. Observational data suggest time-dependent treatment effects within a 4.5-hour window. Regardless of treatment efficacy, rapid recognition and evaluation within this narrow therapeutic window are essential for time-sensitive intervention. This study evaluated CRAO incidence and barriers to timely diagnosis within a regional healthcare system.</p><p><strong>Methods: </strong>Retrospective chart review of patients diagnosed with CRAO across Avera Health facilities (June 2018-September 2025). Cases were identified using ICD-10 codes and confirmed through medical record review. Thrombolysis rates were used as a process measure to identify workflow inefficiencies. Data included presentation site, referral pathways, time from symptom onset to presentation, and thrombolysis eligibility and administration.</p><p><strong>Results: </strong>Of 107 patients identified, 67 had complete documentation. Initial presentation occurred across multiple settings: 36 (53.7%) to the emergency department, 31 (46.3%) to ophthalmology/optometry/outpatient settings. Forty-three patients (64.2%) presented >4.5 hours after symptom onset. Among 24 presenting within the window, 7 (29%) received thrombolysis, 4 (16.7%) had contraindications to thrombolysis, and 13 (54.2%) either presented to or were referred to ophthalmology for evaluation, all of whom were diagnosed outside the treatment window.</p><p><strong>Conclusion: </strong>Timely CRAO evaluation remains uncommon due to delayed presentation and diagnostic delays awaiting ophthalmologic consultation. Among patients presenting within the treatment window, just 45.8% received time-sensitive treatment options. Referral for ophthalmologic evaluation prior to emergency department diagnosis was the most common barrier (54.2%). Streamlined triage pathways, emergency department education, and remote retinal imaging may facilitate earlier diagnosis and preserve treatment opportunities.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"79 suppl 5","pages":"s48-s49"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621952","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: Normal Serum IgG4 in Biopsy Proven IgG4 Related Hypophysitis: A Case Report.","authors":"Areeba Minhaj, Anna Sunny, Mina Al-Sammarraie, Maheera Farooqi, Seba Issa, Nour Alijriri Alhesan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>IgG4-related disease (IgG4-RD) is a systemic fibroinflammatory disorder that can affect multiple organ systems. Pituitary involvement, referred to as IgG4-related hypophysitis (IgG4-RH), is uncommon but is increasingly recognized as a cause of hypopituitarism and central diabetes insipidus.</p><p><strong>Case presentation: </strong>A 61-year-old man with type 1 diabetes presented with headaches, fatigue, and decreased libido. Laboratory evaluation revealed hypogonadism, secondary hypothyroidism, and secondary adrenal insufficiency. Brain MRI demonstrated a 9×7 mm hypoenhancing pituitary lesion with suprasellar extension. The patient was initially treated conservatively with hormone replacement therapy for presumed pituitary apoplexy. Three years later he developed polyuria and polydipsia and was diagnosed with central diabetes insipidus requiring desmopressin. He also reported progressive visual changes with bitemporal visual field loss. Repeat MRI showed interval extension of the lesion into the infundibulum. Transsphenoidal resection revealed dense lymphoplasmacytic infiltration with approximately 40 IgG4-positive plasma cells per high-power field and an IgG4: IgG ratio of 30%, consistent with IgG4-related hypophysitis. Notably, serum IgG4 level was normal (29.4 mg/dL), a finding observed in 30% of patients with IgG4-RD. Systemic evaluation did not reveal pancreatic disease. Chest CT showed features suggestive of IgG4-related lung involvement, which occurs in up to 30% of IgG4 related disease cases. PET/CT did not identify additional sites of hypermetabolic disease.</p><p><strong>Conclusion: </strong>IgG4-RH accounts for less than 5% of all hypophysitis cases. Panhypopituitarism is the most common presentation of IgG4-related hypophysitis. This case highlights a diagnostically challenging presentation of IgG4-related hypophysitis with normal serum IgG4 levels. Clinicians should maintain suspicion for IgG4-RD in patients with unexplained hypophysitis even when serum IgG4 is normal.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"79 suppl 5","pages":"s40"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621664","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: MRSA-Associated Acute Purulent Pericarditis: A Case Report.","authors":"Rilie B Curd, Muhammad Hasan, Mishka Ahmed","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Purulent pericarditis is a rare, but life-threatening condition occurring in roughly 27.7 cases of pericarditis per 100,000 population per year in developed countries. Gram positive cocci are the predominant causative pathogens with Staphylococcus aureus and Streptococcus species being the most common. Early recognition is essential in preventing complications such as cardiac tamponade, constrictive pericarditis, and effusive-constitutive pericarditis. Despite appropriate medical management including both drainage and antibiotics, mortality rates remain elevated and approximately 50% of cases are diagnosed postmortem.</p><p><strong>Case presentation: </strong>An 84-year-old male with a history of myelodysplastic syndrome, permanent atrial fibrillation and heart failure with preserved ejection fraction presented to the emergency department with sharp, left-sided chest pain radiating to the right shoulder, worsened by inspiration. A computed tomography angiogram performed to evaluate for pulmonary embolisms revealed a large pericardial effusion. Electrocardiogram (EKG) demonstrated low-voltage tachycardia. Transthoracic echocardiography showed a large circumferential pericardial effusion with fibrinous strands. The patient underwent pericardiocentesis with drainage of 450 cc of purulent fluid, followed by placement of a pericardial drain. Fluid analysis revealed a pH of 6.9 and 15,095 nucleated cells/μL with 89% neutrophils. Pericardial fluid and blood cultures were positive for MRSA. The patient was initiated on intravenous vancomycin and transesophageal echocardiography was negative for infective endocarditis. He was subsequently transitioned to daptomycin to complete a four-week course of antibiotics. Repeat blood cultures were negative.</p><p><strong>Conclusion: </strong>This case illustrates the diagnostic challenges and management considerations for MRSA-associated purulent pericarditis in a frail host. Early echocardiography and pericardiocentesis are critical in management. Despite source control and target antibiotics, mortality remains high in frail hosts.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"79 suppl 5","pages":"s26"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621752","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":"Receiving the Critique: What Medical Educators and Learners Both Need to Practice.","authors":"Jason J Kemnitz","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"79 5","pages":"195-196"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621763","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}