Mesenteric Solitary Fibrous Tumor with High Risk for Aggressive Behavior: A Case Report.

A 64-year-old female presented to the emergency department (ED) with complaints of two days of intermittent fever and chills, progressively worsening back pain, and hematochezia. Initial evaluation and computer tomography (CT) imaging work up revealed a hypervascular and necrotic appearing pelvic mass, measuring 11.7 x 7.

Presentation and Management of a Traumatic Right Sided Diaphragmatic Hernia: A Case Report.

Traumatic diaphragmatic injury (TDI) is a rare and dangerous sequela of trauma. Right sided TDI is even more uncommon due to the usual protection of the diaphragm by the liver. TDI can present in a delayed fashion, making diagnosis difficult to obtain.

How to Approach Direct-to-Consumer Genetic Testing With Your Patients.

Direct-to-consumer genetic testing (DTC-GT) is genetic testing initiated by a consumer through a commercial company without the direct involvement of a physician or genetics professional. DTC-GT companies have developed tests that provide information about one's ancestry, carrier status, and risk to develop certain conditions. As more consumers participate in DTC-GT, primary care providers (PCPs) are at a greater chance to encounter DTC-GT results and conversations in their practice.

Heart Failure with Preserved Ejection Fraction: Concise Review.

Heart failure with preserved ejection fraction (HFpEF) is a highly prevalent disease, causing a significant burden to the elderly population. Due to the inconsistencies in the standard definition and criteria for diagnosis, HFpEF is often underdiagnosed and left untreated. Although diastolic dysfunction is one of the key driving factors of the disease process, other factors like systolic limitations, endothelial dysfunction, arterial stiffness, and poor ventricular-arterial coupling are also contributing factors.

The State of Newborn Screening in South Dakota.

South Dakota's Newborn Screening (NBS) program has been in existence for nearly 50 years. What began as a screen for a single condition has now expanded to more than 50 conditions. From 2005-2019 alone, 315 infants were confirmed as positive for a condition detected by the newborn screen in South Dakota.

Travel Distance for Rural South Dakota Dermatology Care.

Background: Nearly 40 percent of dermatologists in the U.S. practice in the 100 most population dense areas, with less than 10 percent practicing in rural areas.

Cytochrome P450 2D6 Genotyping for Post-Operative Opioids.

Within most electronic medical records, automated decision support helps health care providers reduce the frequency of adverse drug reactions. Historically, this decision support has been used to prevent drug-drug interactions (DDIs). More recently, the clinical and scientific communities have been moving toward the use of this approach to predict and prevent drug-gene interactions (DGIs).

Statins and New Onset Diabetes Mellitus.

Statins have become one of the forefront medications in the prevention of cardiovascular morbidity and mortality in the 21st century. Apart from lowering low density lipoprotein-C (LDL-C), statins also play an important role in atherosclerotic plaque stabilization and regression. In the last two decades, there is growing evidence that statins have the potential to cause new onset diabetes mellitus (NODM).

Preimplantation Genetic Testing for Desired Pregnancy in Case of Parental Balanced Translocation.

There are two main types of chromosomal translocations known as reciprocal translocations and Robertsonian translocations. These chromosomal rearrangements are described as balanced when there is no significant loss of chromosomal material. Most carriers of balanced translocations are phenotypically normal and may not even know they are carriers of a balanced translocation.

A Case of Isolated Bone Marrow Sarcoidosis Presenting as Symptomatic Hypercalcemia.

Sarcoidosis is primarily a disease of the lungs, and extrapulmonary manifestations are rare. Herein we report a case of isolated bone marrow sarcoidosis presenting as symptomatic hypercalcemia. A 75-year-old female presented with complaints of confusion, dizziness, headaches, and tremulousness.

Guselkumab-Associated Pulmonary Disease and Diffuse Alveolar Hemorrhage with Drug Rash with Eosinophilia and Systemic Symptoms.

Psoriasis is a common skin condition worldwide. Moderate-to-severe disease is treated with biologic or non-biologic disease-modifying anti-rheumatic drugs. These include tumor necrosis factor (TNF)-a inhibitors, interleukin (IL)-17 inhibitors, and IL-23 inhibitors.

A Practical Guide to Trauma Resuscitation - Recommendations for Managing Hemorrhagic Shock in the Rural Healthcare Setting.

Traumatic injury is the leading cause of death in individuals under the age of 45 and hemorrhage is the leading cause of preventable death within hours of presentation. This review article on adult trauma resuscitation is intended to be a practical guide for critical access centers. This is accomplished by discussing the pathophysiology and management of hemorrhagic shock.

Antibiotic Prescribing Practices in Group B Streptococcus Positive Obstetric Patients with Penicillin Allergy.

Introduction: Group B Streptococcus (GBS) positive patients with penicillin allergies receive intrapartum antibiotics for neonatal sepsis prophylaxis based on recommendations from the American College of Obstetricians and Gynecologists (ACOG). The objective of this study was to determine which antibiotics are used in GBS positive patients with documented penicillin allergies and evaluate for antibiotic stewardship improvements at a tertiary hospital in the Midwestern U.S.

Kidney Transplant Outcomes in Indigenous People of the Northern Great Plains of the United States.

Introduction: Indigenous people experience higher rates of end-stage renal disease as well as negative predictive factors such as medical comorbidities, lower socioeconomic status, greater waitlist time, and fewer pre-emptive transplants that undermine kidney transplantation success. In addition, Indian tribal reservation-dwelling Indigenous people may also be disproportionately affected by poverty, geographical disadvantages, limited physician availability, lower health literacy and cultural beliefs that further reduce access to care. Historically, all racial minority groups have experienced higher rates of rejection events, graft failure and mortality relating to these inequalities.

Improvement of Medical Terminology Education With Interactive Learning Module.

Introduction: Early in their first year, medical students at USD Sanford School of Medicine (SSOM) must pass a short-course in medical terminology. Taught using simple PowerPoint presentation, learning has been very dependent on rote memorization. In reviewing the literature, a study examining the effects of teaching medical terminology using mnemonics and imagery showed higher test scores with increasing exposure to this experimental learning method.

A Cannabinoid Type 2 (CB2) Receptor Agonist Augments NOS-Dependent Responses of Cerebral Arterioles During Type 1 Diabetes.

Introduction: While activation of cannabinoid (CB2) receptors has been shown to be neuroprotective, no studies have examined whether this neuroprotection is directed at cerebral arterioles and no studies have examined whether activation of CB2 receptors can rescue cerebrovascular dysfunction during a chronic disease state such as type 1 diabetes (T1D). The goal was to test the hypothesis that administration of a CB2 agonist (JWH-133) would improve impaired endothelial (eNOS)- and neuronal (nNOS)- dependent dilation of cerebral arterioles during T1D.

Methods: In vivo diameter of cerebral arterioles in nondiabetic and diabetic rats was measured in response to an eNOS-dependent agonist (adenosine 5'-diphosphate; ADP), an nNOS-dependent agonist (N-methyl-Daspartate; NMDA), and an NOS-independent agonist (nitroglycerin) before and 1 hour following JWH-133 (1 mg/kg IP).

UBXN2A, a Ubiquitin-Like Protein, Alters Proteins in mTORC2 Pathway.

Introduction: Colorectal cancer (CRC) is the third leading cause of cancer death in the United States causing approximately 50,000 deaths annually. Metastasis is a characteristic feature of CRC tumors, and is dominantly responsible for the high mortality of CRC patients. Thus, an urgent need exists for new therapies for patients with metastatic CRC.

Retrospective Analysis of Vaccination Coverage Among Rural American Indian Children Admitted With Lower Respiratory Tract Infection.

Background: Lower respiratory tract infections (LRTIs) have shown the greatest rate disparity between US infants for hospitalizations, with rates for American Indian (AI) twice the rate for non-AI infants. Vaccination coverage disparity has been hypothesized as one cause for this disparity. Vaccination disparities between AI and non-AI pediatric patients hospitalized for LRTIs were investigated.

Breaking Bad News: Integrating the Spikes Model into Medical School Curriculum.

Introduction: Breaking bad news to patients is a daunting yet inevitable task for most physicians. When done poorly, physicians can cause further pain to the patients while creating great distress for themselves; therefore, it is important medical students learn effective and compassionate techniques. The SPIKES model was created as a guiding framework for providers to use when breaking bad news.

Training Standardized Patients to Provide Effective Feedback: Development, Implementation, and its Effect on the Efficacy of Medical Students' Education.

Introduction: Standardized patient (SP) encounters are a pivotal part of medical student training and provide essential feedback on student performance. Feedback has been shown to develop interpersonal skills and alter motivation levels, reducing anxiety and increasing students' confidence in skills. Therefore, optimizing the quality of SP feedback will allow educators to provide students with more focused comments on performance, leading to personal development and better patient care.