Calcified Chondroid Mesenchymal Neoplasm: Exploring the Morphologic and Clinical Features of an Emergent Entity With a Series of 33 Cases.

Calcified chondroid mesenchymal neoplasm is a term proposed for tumors with a spectrum of morphologic features, including cartilage/chondroid matrix formation, that frequently harbor FN1 gene fusions. We report a series of 33 cases of putative calcified chondroid mesenchymal neoplasms, mostly referred for expert consultation out of concern for malignancy. Patients included 17 males and 16 females, with a mean age of 51.

U2AF2 variant in a patient with developmental delay, dysmorphic features, and epilepsy.

Variants in the RNA binding protein (RBP) U2AF2 are hypothesized to cause a novel neurodevelopmental disorder. Here, we report a patient with a de novo missense variant in U2AF2, the second case report of the same variant, and third case report overall. The patient in this report has a history of global developmental delay, dysmorphic features, and epilepsy.

Diagnostic and Therapeutic Challenges Associated With Left Ventricular Tumors.

Cardiac tumors are uncommon. Sometimes it is challenging to differentiate non-invasively between different kinds of cardiac tumors and thrombi, which is critical to dictate the subsequent treatment. In addition, not all high-risk cardiac tumors are amenable to surgical resection posing a therapeutic challenge.

Ceftriaxone-Associated Severe Acute Hepatitis.

Drug-induced liver injury (DILI) is a common entity. Ceftriaxone is a well-tolerated parenteral antibiotic widely used for various bacterial infections. We report a patient who developed severe acute hepatitis following a single dose of 2 g ceftriaxone within one day.

Impact of Acute Coronary Syndrome on Clinical Outcomes in Patients With Thrombotic Thrombocytopenic Purpura.

Thrombotic thrombocytopenic purpura (TTP) is a life-threatening clinical syndrome characterized by microangiopathy and a variable degree of end-organ ischemic damage. Cardiac involvement has been recognized as a major cause of mortality in these patients. In this study, we queried the National Inpatient Sample (NIS) for all patients hospitalized with thrombotic microangiopathy from 2002 to 2017, who also received plasma exchange (PLEX) during the same admission.

Thyroid Cancer Presenting as Aspiration Pneumonia: A Tale of Retrosternal Goiters.

Abnormal enlargement of the thyroid gland is called goiter. Structurally, it can be nodular or diffuse. Usually, it presents as an anterior cervical mass; however, less commonly, it presents as a retrosternal mass causing symptoms of compression on the surrounding structures.

The Role Bariatric Surgery and Endobariatric Therapies in Nonalcoholic Steatohepatitis.

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide. Disease spectrum varies from steatosis, steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma. Currently, there are no approved medical therapies, and weight loss through lifestyle modifications remains a mainstay of therapy.

Evaluation of heterogeneity in effect of therapeutic hypothermia by sex among infants with neonatal encephalopathy.

Background: Our objective was to examine heterogeneity in the effect of therapeutic hypothermia by sex in infants with moderate or severe neonatal encephalopathy.

Methods: We conducted a post hoc analysis of the Induced Hypothermia trial, which included infants born at gestational ages ≥36 weeks, admitted at ≤6 postnatal hours with evidence of severe acidosis or perinatal complications and moderate or severe neonatal encephalopathy. Multivariate modified Poisson regression models were used to compare the treatment effect of whole-body hypothermia versus control, with an evaluation of interaction by sex, on the primary outcome of death or moderate or severe disability at 18-22 months of corrected age.

Alcoholic Hepatitis: The Rising Epidemic.

Alcoholic hepatitis (AH) is a unique clinical syndrome on the spectrum of alcohol-associated liver disease (ALD). It constitutes a rising epidemic with increasing incidence and major public health implications. In severe AH, 30-day mortality approaches 30%, yet therapeutic options remain limited.

Clinical Outcomes of a Non-Diffractive Extended Depth-of-Focus IOL in Eyes with Mild Glaucoma.

Purpose: To evaluate the clinical outcomes of a non-diffractive, wavefront-shaping extended depth-of-focus (EDOF) intraocular lens (IOL) in eyes with mild open-angle glaucoma (OAG).

Setting: Private practice; Sioux Falls, South Dakota.

Design: Prospective, open-label, interventional study.

Asymptomatic Pulmonic Valve Mass: A Diagnostic and Therapeutic Dilemma.

Cardiac masses are not common but remain important in cardiology practice as they can cause havoc to a patient's life through obstructive and arrhythmogenic symptoms. These lesions mostly include vegetation, thrombi, and tumors. Myxomas are the most common primary cardiac tumor, primarily arising from the left heart chambers.

Health challenges in South Dakota: Creation of healthcare provider referral list for Special Olympic athletes.

Special Olympics promotes the health of their athletes year-round and offers their athletes options to obtain free health screenings. Following screening events, athletes often have difficulties finding needed referral care. Obstacles to finding a healthcare provider (HCP) for a referral is what necessitates the need for a state-wide HCP referral list in South Dakota.

Virtual Partnership Addressing Mental Health Crises: Mixed Methods Study of a Coresponder Program in Rural Law Enforcement.

Background: A mental health crisis can create challenges for individuals, families, and communities. This multifaceted issue often involves different professionals from law enforcement and health care systems, which may lead to siloed and suboptimal care. The virtual crisis care (VCC) program was developed to provide rural law enforcement with access to behavioral health professionals and facilitated collaborative care via telehealth technology.

Emerging targets for therapy in ALD: Lessons from NASH.

Alcohol-associated liver disease due to harmful alcohol use and NAFLD associated with metabolic syndrome are the 2 most common liver diseases worldwide. Control of respective risk factors is the cornerstone in the long-term management of these diseases. Furthermore, there are no effective therapies.

Consistency is Key: Additional Education and Outreach in a Rural Trauma System Reduces Excess Imaging Studies.

Background: Repeat imaging for trauma patients is common in rural health care systems after transfer to a tertiary trauma center which subjects patients to increased radiation, excess costs, and delays to definitive care. A previous retrospective review at our regional trauma center found that pre-transfer CT scans were frequently performed with little change in management. To improve this rate, additional emphasis was placed on (1) best imaging practices during Rural Trauma Team Development Courses (RTTDC), (2) management feedback during regional trauma case reviews, and (3) implementation of practice management guidelines for an inter-provider telehealth system.

Preventing Unintended Pregnancies: A Review of Long-Acting Reversible Contraception.

With increasing uncertainty surrounding female reproductive rights, patient education about contraceptive options is of paramount importance. Although traditional oral contraceptive pills (OCP) are often used to prevent pregnancy, they require precise, daily effort and have continual monetary maintenance costs for patients. Long-acting reversible contraceptives (LARCs) - intrauterine devices and the contraceptive implant - are effective and reliable alternatives to OCPs that are gaining popularity in the U.

Disseminated Mucormycosis from Marijuana Use in a Renal Transplant Patient.

Mucormycosis is a serious fungal infection that typically affects immunocompromised patients. We present a case of disseminated mucormycosis infection in a 34-year-old male with a history of marijuana use and focal segmental glomerulosclerosis who underwent living unrelated kidney transplant. After his transplant, he developed recurrent focal segmental glomerulosclerosis.

Polypharmacy in Older Adults: A Case Study.

Polypharmacy is defined as concurrent use of multiple drugs for one or more conditions. The occurrence of polypharmacy in vulnerable populations, particularly the elderly, is frequent. Increased incidents of adverse drug reactions and drug-drug interactions plus high costs are not offset by a noticeable improvement in outcome.

A Case of Metastatic Uveal Melanoma: From Diagnosis to Survival Four Years Later.

Uveal melanoma includes melanoma of the choroid, ciliary body or the iris of the eye and is a rare malignancy that accounts for about 1,500 new cases in the U.S. every year.

Novel Innovations in Ascites Management.

Ascites in patients with end-stage liver disease and resultant portal hypertension worsens prognosis and accelerates mortality of up to 40% within one year and 50% within two years. In case of refractory ascites, median survival often does not exceed six months due to the development of complications including spontaneous bacterial peritonitis, hyponatremia and renal failure. Additionally, ascites hinders quality of life (QOL) and its management poses a challenge.

Angioinvasive Fungal Thyroidits.

Fungal thyroiditis is an uncommon cause of thyroid inflammation and infection. This condition is typically observed within immunosuppressed patients, such as those with a hematologic malignancy or those receiving corticosteroids or chemo-radiation therapies. This report describes a case of a 66-year-old male with underlying high-risk myelodysplastic syndrome who presents with complaints of fever, right anterior neck pain, severe dysphagia, dysphonia, and difficulty managing upper airway secretions.

Rural Land Management and Kidney Health.

There is wide geographic variability in the prevalence of chronic kidney disease, and much of this variability is unexplained by known clinical risk determinants such as diabetes and hypertension. Additional factors contributing to this geographic variability include social determinants of kidney health, as well as genetic factors (ancestry) and non-genetic factors (the environment). Environmental nephrotoxins can accelerate the progression of kidney disease in some patients at risk.