A Digital Initiative to Improve Patient Health Literacy.

Background: The U.S. is in the midst of a health literacy crisis.

Integrating Standardized Multimedia to Supplement Physical Examination Curriculum: An Assessment of Medical Student and Evaluator Perspective.

Introduction: As a new generation enters the realm of medical education, so do their preferences for technology integration into didactic curricula. An analysis of 106 LCME-accredited medical schools found that 97 percent of programs utilize supplemental e-learning to enhance traditional, face-to-face education in their physical examination curricula. Of these programs, 71 percent produced their multimedia internally.

The Effects of Regular Light Strength Training and Flexibility Training on Physical and Mental Health in Senior Citizens.

Introduction: Frequent exercise is known to be associated with better physical and mental health outcomes in all age groups. Vermillion, South Dakota, has no easily accessible way for senior citizens to exercise in groups safely. Clinical observations suggested the hypothesis that senior citizens living independently would benefit both physically and mentally from a tri-weekly chair-based exercise program.

Simulation-Based Interprofessional ICU Bedside Rounding Course.

Introduction: Medical schools are beginning to implement courses in interprofessional education (IPE) to prepare students for the interprofessional team-based patient care model which is becoming the standard of practice in many healthcare facilities. Students often have little exposure to multidisciplinary rounds prior to residency, and fast-paced low-capacity healthcare environments such as operating rooms and intensive care units (ICUs) necessitate providers be competent and efficient in working within interprofessional teams.

Methods: The University of South Dakota Sanford School of Medicine has developed an innovative, simulationbased ICU bedside rounding course that uses a custom-designed simulated electronic health record system that is a hybrid desktop/web-based application.

Vitamin D Levels and Sperm DNA Fragmentation.

Introduction: Intracytoplasmic sperm injection (ICSI) has revolutionized the treatment of couples with male factor infertility but results remain suboptimal, suggesting the need for further investigation into the molecular biology of spermatozoa. Limitations to traditional semen analysis have brought new methods to the forefront like Sperm Chromatin Structure Assay (SCSA), which uses flow cytometry to measure sperm DNA fragmentation. Increased DNA damage in semen has been correlated with failed IVF cycles and decreased fertilization.

Complex Coronary Intervention - When Time Is of Essence: Ping Pong Technique.

Coronary artery disease (CAD) continues to be a significant cause of morbidity and mortality in the U.S. The prognosis and treatment of which is dependent on various factors including type, size, localization and extent of the coronary plaque and severity of the stenosis.

A Survey of Eye Care Needs Among Community Health Center Patients in Western South Dakota.

Background: Community health centers (CHCs) provide healthcare to underserved communities, including the uninsured and underinsured. Ocular disease and visual impairment affect individuals of all ages, race, and socioeconomic standing, but are disproportionately detrimental to individuals with limited access to care. The purpose of this study is to assess the need for and potential utilization of an on-site eye care clinic at a CHC in Rapid City, South Dakota.

A Concise Review of Neonatal Dermatology.

Skin findings in neonates carry a wide differential diagnosis, ranging from self-limiting rashes to something more sinister, as cutaneous changes can be an indicator of a serious underlying infectious process. Even benign rashes can cause great concern for families and providers. Pathologic rashes pose a potential risk to the neonate's health.

Nonalcoholic Fatty Liver Disease in Women with Polycystic Ovarian Syndrome: A Narrative Review.

Polycystic ovarian syndrome (PCOS) has been estimated to affect 10-15 percent of women in the U.S. Emerging research has found higher rates of nonalcoholic fatty liver disease (NAFLD) among PCOS individuals.

A Case-Based Review of Cutaneous CD30-Positive Lymphoproliferative Disorders.

CD30-positive lymphoproliferative disorders are a group of diseases which represent the second most common (30 percent) subgroup of cutaneous T-cell lymphomas. They present a challenging diagnosis given their similar findings histologically and clinically in comparison to other cutaneous pathologies. Use of immunohistochemical staining to identify CD30 positivity facilitates a more rapid development of the appropriate management plan.

Diffuse Ganglioneuromatosis of the Colon in a Patient with Neurofibromatosis 1.

Ganglioneuromas are rare, benign neurogenic tumors characterized by a proliferation of ganglion cells, nerve fibers, and support cells of the nervous system. They have been classified into three groups: solitary, polyposis, and diffuse. The diffuse type has several syndromic associations including multiple endocrine neoplasia syndrome type 2B and, less commonly, neurofibromatosis type 1.

A Case of Neonatal Myeloid Sarcoma.

Here we describe a cutaneous neonatal myeloid sarcoma (MS) case with a subsequent diagnosis of acute myeloid leukemia (AML) seven days later. Cytogenetic studies were unusual demonstrating a triple copy of KAT6A abnormality and complex 8;14;22 translocation involving the 8p11.2 region.

Bridging the gap: The critical role of laboratory developed tests in clinical toxicology.

•Toxicology testing provides valuable information for patient management.•Current in vitro diagnostics (IVDs) are unable to meet all clinical needs.•Lab-developed tests (LDTs) in toxicology can be used to close clinical care gaps.

Patients who have intraoperative deviations in their preoperative plan have inferior clinical and radiographic outcomes after anatomic total shoulder arthroplasty.

Background: Three-dimensional computed tomography preoperative planning has become adopted among shoulder arthroplasty surgeons. Prior studies have not examined outcomes in patients in whom the surgeon implanted prostheses that deviated from the preoperative plan compared with patients in whom the surgeon followed the preoperative plan. The hypothesis of this study was that clinical and radiographic outcomes would be equivalent between patients undergoing anatomic total shoulder arthroplasty that had a deviation in the components predicted in the preoperative plan and patients who did not have a change in the components predicted in the preoperative plan.

Fetal alcohol spectrum disorders.

Alcohol readily crosses the placenta and may disrupt fetal development. Harm from prenatal alcohol exposure (PAE) is determined by the dose, pattern, timing and duration of exposure, fetal and maternal genetics, maternal nutrition, concurrent substance use, and epigenetic responses. A safe dose of alcohol use during pregnancy has not been established.

Bedside Carotid Sinus Massage for Syncope Evaluation With Bifascicular Block and First-Degree Atrioventricular Block.

Symptomatic bifascicular block (BFB) with a reversible high-grade atrioventricular block (AVB) is an overlooked cause of syncope with differing diagnostic and therapeutic approaches. We present a case of a 79-year-old gentleman with multiple episodes of cardiac syncope. Initial electrocardiogram revealed a left bundle branch block and first-degree AVB worsened by bedside carotid sinus massage (CSM) obviating the need for electrophysiologic (EP) studies or continuous electrocardiographic monitoring for further evaluation.

Bradycardia, Renal Failure, Atrioventricular Nodal Blockade, Shock and Hyperkalemia (BRASH) Syndrome: A Clinical Case Study.

BRASH syndrome, which stands for Bradycardia, Renal failure, Atrioventricular (AV) Nodal blockade, and shock, is a relatively new clinical condition. Bradycardia develops because of the synergistic effect of AV-nodal blockers and hyperkalemia in a renal failure resulting in a vicious cycle of progressive bradycardia, renal hypoperfusion, and hyperkalemia. We present a case of an 88-year-old man with chronic systolic heart failure, atrial fibrillation, stage 3 chronic kidney disease, and dementia who presented to our emergency department with poor oral intake and weakness.

Propofol Use in Pediatric Sedations: Will a Lesser Dose be Effective? A Quality Improvement Project.

Background: Propofol provides sedation in the pediatric setting for imaging interventions, ensuring minimal movement from patients and high-quality pictures. Sanford Children's outpatient sedation clinic currently does not have a standard protocol for using propofol for sedation.

Methods: The study had three phases.