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

{"title":"High BMI in Pregnancy: A Case for Referral.","authors":"Shelley Feng, Elizabeth Hultgren, Rachel Rodel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Obesity leads to higher risks of complications in pregnancy and at the time of labor and delivery, including preterm delivery, shoulder dystocia, operative vaginal delivery, and cesarean delivery. In addition, there is a dose-response relationship between increasing obesity class and risk of severe maternal morbidity at the time of delivery to include acute renal failure, heart failure, mechanically assisted ventilation, anesthesia complications, postpartum hemorrhage, and blood transfusion. In this brief review, we highlight the importance of referral specifically for delivery due to higher risk of complications for pregnant patients with elevated BMI, although certainly referring to a tertiary care center early in pregnancy would be preferred for medical optimization, detailed fetal anatomic evaluation, and delivery preparation.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"78 1","pages":"39-42"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259090","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":"Updates in Advance Care Planning in South Dakota.","authors":"Amanda Kay Sedlacek, Michele Snyders, Sarah Mollman, Michelle Gierach","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Advance care planning (ACP) is important to be outlined for patients, their family and healthcare team. Defining the difference between advance care planning vs goals of care planning and the appropriate documentation in records is essential and can at times be confusing. South Dakota has several advance care planning documents including SD Medical Order for Scope of Treatment and SD Comfort One that can be utilized along with their medical living will to help define patient's wishes. In this article, we will describe the resources for South Dakota ACP, documentation challenges, and provide examples of forms.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"78 1","pages":"28-32"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259095","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":"State of South Dakota's Child: 2024.","authors":"Ann L Wilson, Tyler A Hemmingson, Brad Randall","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>There was a slight decrease (n=23) in the 11,170 live births in South Dakota between 2022 and 2023 with the state's birth rate falling to its lowest rate (12.2 per 1,000 population) in its recorded history. The state's percentage of American Indian, Black and Other (AIBO) live born infants is declining and currently comprises 21% (down from 25% in 2017) of the 2023 birth cohort with American Indians decreasing in their respective contribution to it as diversity of newborns is increasing. Though lower than observed nationally, the state's newborns with birth weights of 1,500 to 2,499 grams are also increasing. In 2023, AIBO, compared to White newborns, have a higher percent of very low birth weight (2% vs 1%) and mid low birth weight (7% vs 6%). First trimester prenatal care is used by over 80% of White pregnant women but only 53% of AIBO pregnant women for whom 8% received no prenatal care. In 2023, there was a decrease in the state's infant mortality rate from 7.8 to 6.4 (deaths per 1,000 live births 0 to 364 days of life) with declines noted in both the neonatal (0 to 27days of life) and the post neonatal (28-364 days of life) period. Between the years 2019-2023, the state's rates of death for AIBO infants in the neonatal and post neonatal periods were significantly higher than these rates for White infants. Contributing to this observation are higher AIBO than White rates of infant deaths for perinatal causes, congenital anomalies, sudden unexpected infant death (SUID). The racial disparity in infant mortality has recently become more apparent, especially in the post neonatal period when SUIDs are the leading cause of death.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"78 1","pages":"6-19"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259094","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 Clinically Isolated Aortitis in a 51-Year-Old Male with Infrarenal Aorta Involvement.","authors":"Muhammad Hasan, J Austin Simonson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Aortitis can be broadly classified into infectious and non-infectious. Infectious causes include tuberculosis, salmonella and syphilis where as noninfectious causes include rheumatological diseases such as giant cell arteritis, Takayasu arteritis and antineutrophil cytoplasmic antibodies (ANCA) vasculitides. Clinically isolated aortitis refers to inflammation of the aorta without infectious or systemic causes. Most cases of aortitis involve the aortic root, thoracic aorta and ascending aorta. We present a rare case of clinically isolated aortitis in a 51-year-old male with infrarenal aortic involvement.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"78 1","pages":"24-26"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259089","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":"Is a Switch to Nurse Administered Nitrous Oxide Sedation Feasible and Effective? A Quality Improvement Project.","authors":"Alexandra Kracht, Matthew Billion, Kevin Feldhaus, Mir Ali","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Nitrous oxide (N2O) is used for minimal and moderate sedation procedures. It has an advantage against other sedative drugs due to its quick onset of action and resolution of effects making it effective for various pediatric procedures. Currently, pediatric intensivists at Sanford Children's Hospital administer N2O.</p><p><strong>Methods: </strong>A survey was completed by nurses on the Pediatric Outpatient Sedation Unit after they administered N2O that determined the nursing comfort level with administering N2O while transitioning from physician administration to nursing at Sanford Children's Hospital. This questionnaire aimed to identify the perspectives of the nursing team while progressing through the switch.</p><p><strong>Results: </strong>A total of 46 surveys were collected from May 2023 to May 2024. Nursing ratings of their comfort with administering N2O increased over the data collection period. Their knowledge of the mechanism of action of N2O and adverse effects of N2O increased. The patients' comfort during their sedation did not significantly change.</p><p><strong>Conclusion: </strong>Over the course of one year, the survey showed improvements in nursing comfort levels with administering N2O, while maintaining patient satisfaction. As time went on, the nurses' knowledge of the mechanism of action and adverse effects increased significantly. Concerns for patient safety showed a significant decrease. These correlated trends suggest applicability for a nurse-administered N2O program at Sanford Children's Hospital.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"78 1","pages":"20-23"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259091","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":"New Year, New Attitude.","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":"78 1","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259092","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":"Expanding the Genetic Etiology of Multiple Morphological Abnormalities of the Sperm Flagella: A Case Report of Two Novel DNAH1 Variants.","authors":"Emily Anderson, Megan Bell, Katherine Hornberger, Jason Flanagan, Kayleigh Avello, Fang Xu, Steffen Christensen, Ellen Johnson","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The following case report details the genetic evaluation and treatment of a 30-year-old male with a history of asthenoteratospermia and notable abnormalities of the sperm flagella.</p><p><strong>Methods: </strong>Genetic evaluation was performed via a multi-gene panel of genes associated with primary ciliary dyskinesia and multiple morphological abnormalities of the sperm flagella (MMAF) prior to the couple's in vitro fertilization (IVF) cycle.</p><p><strong>Results: </strong>Genetic evaluation was performed via a multi-gene panel of genes associated with primary ciliary dyskinesia and multiple morphological abnormalities of the sperm flagella (MMAF) prior to the couple's in vitro fertilization (IVF) cycle.</p><p><strong>Conclusions: </strong>The two novel DNAH1 variants add to the growing body of evidence of the relationship between DNAH1 and multiple morphological abnormalities of the sperm flagella. DNAH1 variants and abnormal sperm morphology appear to negatively impact embryo development. Genetic counseling can aid in genetic testing and counseling related to male infertility.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"77 12","pages":"540-544"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060806","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":"Tularemia in a Psoriasis Patient on Biologic Therapy After Relocation to Western South Dakota.","authors":"Alek Keegan, Luke Fritsch, James Engelbrecht","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Francisella tularensis is an aerobic, gram negative coccobacillus bacterium that causes tularemia. F. tularensis spreads primarily through ticks, biting flies, droplet inhalation, contaminated mud or water, or infected animal bites, and it can survive in animal carcasses with the most common mode of transmission occurring via inoculation into the skin and inhalation/ingestion. Individuals on biologics or immunosuppressive medications are at an increased risk for infections such as tularemia, particularly when moving geographically to regions where it is endemic.</p><p><strong>Case description: </strong>We describe a case of tularemia presenting in a South Dakota resident. The patient, who was on long term adalimumab, presented with persistent fever, chills, fatigue, night sweats and anorexia for 6 days. The patient had recently moved from eastern South Dakota to western South Dakota onto a farm that is mostly pasture land. Chest imaging showed bilateral nodular densities, and lymph node biopsy was diagnostic for F. tularensis. A diagnosis of tularemia was made based on her biopsy results and exposure to rabbit carcasses while mowing grass on her ranch. She was started on antibiotic therapy, and her symptoms and imaging improved. She followed up with internal medicine and infectious disease clinic, and her symptoms resolved and imaging cleared with transition to ciprofloxacin in the outpatient setting; additionally, she continues to do well with no evidence of recurrence of active infection.</p><p><strong>Conclusions: </strong>It is important that clinicians recognize the geographical dimension in infectious disease risk for immunosuppressed individuals. The patient's experience with tularemia following her relocation from eastern to western South Dakota highlights how geographic transitions can introduce new infectious exposures and risks. For patients on immunosuppressive therapies, healthcare providers must consider potential infections endemic to the new region and adopt proactive management strategies. Early recognition, targeted therapy, and adjustments in immunosuppression are critical in managing such cases effectively. This case illustrates the importance of detailed travel histories, patient education, and coordination between specialists to ensure comprehensive care and optimal outcomes for immunocompromised patients in new environments.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"77 12","pages":"550-555"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025081","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":"Do We Need a Fluid Bolus? The Necessary Refinement of Pediatric Propofol Sedation - a Quality Improvement Project.","authors":"Andrew L Guymon, Madigan M Moore, Laura E Nelson, Mir Ali","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Propofol is commonly used for pediatric MRIs to minimize patient movement. At our institution, intensivists typically administer a prophylactic 20 ml/kg saline bolus to maintain blood pressure (BP) during propofol sedation. This quality improvement project assessed whether a 10 ml/kg and a completely eliminated saline bolus are as effective as the standard 20 ml/kg bolus in completing pediatric propofol sedation and maintaining Mean Arterial Pressure (MAP).</p><p><strong>Methods: </strong>We reviewed pediatric propofol sedations over an 18 month period in which pediatric intensivists administered the standard 20 ml/kg saline bolus, a reduced 10 ml/kg bolus, and no saline bolus. Successful sedation meant completing the MRI without complications.</p><p><strong>Results: </strong>172 patients aged 19 months to 16 years were assessed. The percentage of successful sedations with a 20 ml/kg bolus, 10 ml/kg bolus, and no saline bolus was 92%, 100%, and 91%, respectively. There was a statistically significant higher average MAP in the 0 ml/kg group than in the 10 and 20 ml/kg cohorts (p = 0.002). No patients required an additional bolus to maintain blood pressure.</p><p><strong>Conclusions: </strong>The preservation of hemodynamic stability without a saline bolus supports the literature that the saline bolus can be safely reduced during pediatric propofol sedation for MRI.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"77 12","pages":"557-560"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025022","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":"Improving Access to Palliative Care through Education and Training.","authors":"Amanda Kay Sedlacek, Michelle Gierach, Michele Snyders, Sarah Mollman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The population is aging, especially in rural areas where people experience higher rates of mortality and chronic illness as well as greater distances to care, including specialty care. Since there is a lack of access to specialty palliative care, all clinicians must be trained to provide the fundamentals of palliative care to improve quality of life and limit suffering. Numerous options are available for clinicians to be trained in palliative care. A long-standing palliative care training option in South Dakota is the Interdisciplinary Palliative Care (IPC) Seminar which trains students from multiple disciplines in the foundation of palliative care. It has demonstrated significant student learning outcomes for 22 years. The IPC Seminar transitioned to virtual delivery in 2020 allowing additional students to participate across the state. It is currently hosted within the University of South Dakota Interprofessional Health Education Center which fostered additional disciplines to participate. As the need for palliative care grows in our state, so too, does the need for palliative care education whether it is acquired through national organizations or local education providers.</p>","PeriodicalId":39219,"journal":{"name":"South Dakota medicine : the journal of the South Dakota State Medical Association","volume":"77 12","pages":"546-548"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025079","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}