Expanding SSOM's Health Equity Curriculum: Offering the Social Identities Workshop in New Student Orientation.

Introduction: In an effort to expand the first- and second-year curriculum surrounding bias, health equity, social determinants of health, and diversity in medicine, a student-led Social Identities Workshop was created to engage SSOM students in activities to 1) introduce definitions of systemic structures and inequities addressed throughout the Clinical Foundations curriculum, 2) encourage discussion rooted in individual experiences, uplifting shared and diverse identities among classmates and peers, and 3) end the week of orientation with an engaging, approachable, and low-stakes activity to get to know classmates better.

Methods: Pre- (n=68) and post-workshop surveys (n=75) were answered by first-year medical students about their knowledge and familiarity about social identities. The post-workshop survey also included questions to reflect on how the workshop content can be applied to interactions with peers and patients, and their satisfaction with the workshop and ideas of how to improve.

Triple V-plasty: Novel Renovascular Reconstruction Technique in Live-Donor Transplantation.

Introduction: Donor renovascular anomalies, including multiplicity, length and caliber of blood vessels, could hinder renal transplantation, especially from live-donors. However, meticulous back-bench vascular reconstruction ascertaining orientation and patency of individual vessels can be effective in utilization of renal grafts with multiple renal arteries, helping to expand the pool of live-donors.

Surgical Technique: Sequential v-plasty of individual donor renal arteries using fine, non-absorbable, monofilament (7-0 or 8-0 Prolene) suture in an uninterrupted fashion enables creation of a single, wide ostium for anastomosis with the target, inflow recipient (usually external or common iliac) artery.

Case Study - Metastatic Basal Cell Carcinoma with Axillary Lymph Node Invasion in a 71-Year-Old Male, Treated with Left Axillary Node Dissection.

Introduction: Basal cell carcinoma (BCC) is the most common skin cancer, accounting for 50% of all cancer in the United States. Mortality is often considered negligible due to the rare rate of metastasis at 0.0028% or 1 in 1,000,000 BCC diagnoses.

A Modified Single Mercedes Incision Surgical Technique for Simultaneous Liver Kidney Transplant: A Case Series Report.

Background: The traditional approach in simultaneous liver-kidney transplantation (SLKT) involves two separate and sequential incisions. We describe modification of the classic Mercedes incision which limits the operation to a single incision yet provides and maintains adequate exposure enabling safe dual-allograft transplantation.

Methods: Modification of the standard Mercedes incision includes bilateral, subcostal, muscle splitting incision 4-finger-breadths below the rib-edge with a midline, cephalad incision, and inferior±medial, ipsilateral extension on the side of intended iliac fossa laterality for renovascular and ureteroneocystostomy anastomosis.

Use of Motivational Interviewing Techniques by Student Volunteers to Reduce Substance Use in Coyote Clinic Patients.

Introduction: Nationally, free clinics report 18.5% of clients have a substance use disorder but few clinics have treatment resources on site. In 2014, 63,000 people in South Dakota needed but did not receive treatment for substance abuse.

Laparoscopic Resection of a Congenital Gastric Diverticulum that was Found Incidentally on Imaging: A Case Report.

Gastric diverticula are quite rare and can be either acquired or congenital. Resection is recommended when the diverticula are large (>4 cm), PPI therapy does not relieve symptoms, and/or complications arise. We present a case of a patient with a long-standing history of symptoms related to a congenital gastric diverticulum that had been found incidentally on imaging during a workup for possible small bowel obstruction.

Gallstone Pancreatitis Post-Cesarean Section: A Case Report.

Acute gallstone pancreatitis is a rare occurrence in pregnancy and the postpartum period. However, gallstone pancreatitis should be considered in a differential diagnosis for right upper quadrant (RUQ) pain in this population, as the risk of biliary stasis and gallstone formation increases in pregnancy due to high levels of circulating estrogen causing increased cholesterol formation and delayed gallbladder emptying. Although gallstones are the most common cause of acute pancreatitis in pregnancy, alcohol use and hypertriglyceridemia may also be considered.

Vaccine Breakthrough Cases in South Dakota: Impact of SARS-CoV-2 Variants in a Rural State.

Background: Emergence of the SARS-CoV-2 Delta variant raised concern for greater transmissibility and severity of illness compared to the Alpha variant. Our objective was to compare SARS-CoV-2 vaccine breakthrough cases in South Dakota during the time periods where the Alpha and Delta variants of SARS-CoV-2 predominated.

Methods: Data were obtained from the South Dakota Department of Health's electronic disease surveillance system and South Dakota's Health Information Exchange.

Health Outcomes of American Indians and Non-American Indians Hospitalized with COVID-19 in Western South Dakota.

Introduction: The purpose of this project was to determine the presence of disproportionate health outcomes during COVID-19 hospitalizations between American Indian and non-American Indian populations in western South Dakota.

Methods: A retrospective chart review study was conducted from March 29, 2020-November 30, 2021 at a 400 bed community hospital in western South Dakota. Groups were categorized by American Indian status (AI) and Non-American Indian status (NAI) based on admission paperwork.

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

Introduction: 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.

Description and Evaluation of a Multilevel Intervention for Improving HPV Vaccination Rates in a Rural South Dakota Clinic.

Background: This study describes an education-based, multilevel intervention and its impact on human papilloma virus (HPV) vaccination rates in a rural South Dakota clinic.

Methods: At a clinic-level, nurses and clinicians were provided education on HPV vaccination guidelines and opt-out communication techniques. At a community-level, parents/guardians attended an educational session at the local middle school orientation.

Adherence Rate of Pediatric Lipid Screening at a Rural, Independently Owned Primary Care and Multispecialty Clinic.

Background: In 2011, the AAP endorsed the recommendation of National Heart Lung and Blood Institute (NHLBI) for universal lipid screening in children 9-11 and 17-21 years old given the increasing prevalence of pediatric obesity. In 2017, a study conducted by the AAP showed low adherence with universal pediatric lipid screening. The purpose of this retrospective chart review is to assess the adherence rate for pediatric lipid screening at a rural, independently owned primary care and multispecialty clinic.

Delayed Presentation of Inferior STEMI Complicated by Ventricular Septal Rupture: An Indirect Consequence of the COVID-19 Pandemic.

The COVID-19 pandemic has adversely impacted healthcare delivery. An indirect consequence of the rational fear of contracting the virus is delayed medical attention for life threatening conditions. We present the case of inferior ST elevation myocardial infarction leading to the rare complication of a ventricular septal rupture reflecting transmural infarction.

A Unique Case of Community Acquired Proteus mirabilis Meningitis.

Proteus mirabilis, a gram-negative bacterium commonly known for causing urinary tract infections (UTI) can rarely present with central nervous system (CNS) infections. Proteus mirabilis CNS infections are usually encountered in the neonatal and infantile period and occasionally cause brain abscesses. It is an uncommon cause of adult CNS infection.

Unusual Hand Deformity in Parkinson's Disease.

We describe two patients with prominent hand deformities attributable to Parkinson's disease. This uncommon condition, which mimics inflammatory arthritis, can be hard to diagnose and is disabling. As these two cases illustrate, hand deformities attributable to Parkinson's can be a late complication of the disease or present in the early stage as initial symptomatology.

Training of Physical Therapists in Pelvic Floor Techniques: Is Care Available in the Rural Midwest?

Introduction: The number of patients affected by pelvic floor disfunction is predicted to continue to grow in the future. Pelvic floor physical therapy (PFPT) is a benign, first-line treatment for a variety of pelvic disorders. There is currently a failure rate estimated at 19.

Impact of Emergency Medical Service Provider Training and Institutional Volume Experience on ST-Elevation Myocardial Infarction Patient Outcomes in Rural Setting.

Introduction: Rural sites provide management challenges for ST-elevation myocardial infarction (STEMI) patients. The impact of emergency medical service (EMS) training and institutional volume experience on STEMI outcomes was examined.

Methods: All STEMI patients transferred to Sanford from 32 sites in rural South Dakota from 2010-2019 were analyzed.

Accuracy of Blueprint software in predicting range of motion 1 year after reverse total shoulder arthroplasty.

Hypothesis And Background: Blueprint 3-dimensional computed tomography software has a functionality that predicts impingement-free range of motion (ROM) with determination of the limits of ROM at which bone and/or prosthetic impingement occurs. To our knowledge, only 1 previously published study has assessed the ability of Blueprint software to predict actual postoperative ROM after reverse total shoulder arthroplasty (RTSA). The hypotheses of this study were that (1) mean Blueprint-predicted impingement-free ROM would be statistically similar to the mean actual ROM 1 year after RTSA and (2) there would be a correlation between Blueprint-predicted impingement-free ROM and the actual ROM 1 year after RTSA.

Vasoconstrictor Therapy for Acute Kidney Injury Hepatorenal Syndrome: A Meta-Analysis of Randomized Studies.

Background And Aims: Type 1 hepatorenal syndrome (HRS) is a rapid deterioration in kidney function in patients with cirrhosis. Data on efficacy of vasoconstrictors for type 1 HRS have shown mixed results.

Methods: Literature searched for randomized controlled trials comparing pharmacological therapy for HRS vs placebo or another drug for HRS.

Interesting case of incidental diagnosis of pulmonary embolism by endobronchial ultrasonography.

Pulmonary embolism (PE) is the obstruction of the pulmonary artery or its branches, usually by a thrombus that originates in the lower extremity veins. PE is associated with high mortality risk. Here, we present the case of a patient who initially presented with dysphagia.