Opioid Prescribing Habits of Emergency Department Providers in Response to an Educational Intervention.

Introduction: Prescription opioid misuse and dependency has been a rising cause for concern in the United States in recent years, and many of these cases began with an initial prescription in the Emergency Department (ED). Prior studies found that patients seen by "high intensity" prescribers, who prescribe greater quantities of opioids than 75% of other ED physicians within the same hospital, are significantly more likely to suffer from long-term opioid use. Other studies have shown that educational interventions on appropriate opioid prescription in surgical settings have resulted in fewer post-operative opioid prescriptions and less variance in prescribing habits by providers.

Brief Provider Education is Associated With Decreased ED Visits by Super-Utilizers.

Introduction: Prior studies have demonstrated that the use of opioids in an Emergency Department (ED) increases the chances of a 30-day return to the ED for similar diagnoses. Super-utilizers (SUs) of the EDs tax the ED resources, resulting in sub-optimal outcomes for these patients. Most physicians receive sub-optimal formal training on pain and opioid prescribing.

Higher Incidence of Pyogenic Liver Abscess in an Upper Midwest Hospital System: A 5-Year Study With Emphasis on Rural Impact.

Introduction: Incidences of hepatic abscesses are increasing nationally. Current estimates of national incidence range from 8 to 20 abscesses per 100,000 hospital admissions. Understanding risk factors is essential for efficient diagnosis and treatment of hepatic abscess.

Medical Students as Simulation Educators.

Introduction: Physicians are expected to educate patients, students, colleagues, as well as members of the interdisciplinary team. However, unlike in the United Kingdom and Canada, US medical schools do not require teaching as a competency for graduation. High-quality teaching and communication skills are necessary to ensure patient safety and trust.

Development and Implementation of Screen-Based Simulation Technology to Meet Medical Education Demands During the COVID-19 Pandemic.

Background: Simulation-based learning has been a valuable integrated part of simulation curricula. Simulation modalities include high-fidelity simulation (HFS), clinical skills (SK), standardized patients (SP), hybrid and combined simulation. HFS and SK are usually taught face-to-face and require specialized equipment.

Review of Retinopathy of Prematurity.

Retinopathy of prematurity (ROP) is a leading cause of blindness in pre-term infants and is caused by incomplete vascularization of the retina at birth. Early diagnosis and treatment of ROP is important to reduce the risk of vision loss. The risk factors, pathogenesis, screening, diagnosis, and treatment of this disease will be reviewed.

Anemia In Pregnancy: Examining Missed Diagnoses and Racial Disparities in the Upper Midwest.

Anemia in pregnancy (AIP) is associated with poor maternal/fetal outcomes. The prevalence of AIP globally ranges from 44-53% and varies drastically depending on maternal race/ethnicity and other factors. Screening and treatment of AIP is disputed.

Clinical Practice Update: Achilles Tendon Rupture.

Achilles tendon rupture is a common injury. It most often occurs in middle aged men who participate in recreational sports. The injury classically presents with a loud popping noise and immediate pain and weakness of the lower extremity during actions such as jumping or running.

A Case Presentation of Metastatic Hepatic Epithelioid Hemangioendothelioma: A Rare Vascular Tumor.

Epithelioid hemangioendothelioma (EHE) is an uncommon vascular tumor that can present in various organs, including the liver. Hepatic EHE (HEHE) may showcase with metastases at initial presentation, as patients have vague symptoms such as right upper quadrant pain leading to the risk of delayed diagnosis. There is no standard treatment.

A Case of Neurocysticercosis in Rural South Dakota.

Neurocysticercosis (NCC) is a rare, potentially life-threatening parasitic infection endemic in many developing countries where pig farming and pork consumption are popular. The rates of neurocysticercosis could increase in the U.S.

Colorectal Adenocarcinoma in a 35-year-old Female with No Germline Mutations.

Colorectal cancer (CRC) is the third most common cancer to cause death in the world. Despite the recent change in age from 50 to 45 in some societies' recommendations for CRC screening, its incidence is increasing in patients under 50 years. We present a case of a 35-year-old female with no family history of CRC who presented to the emergency department with abdominal pain, vomiting, and obstipation and was found to have sporadic obstructing transverse colon adenocarcinoma.

Mediastinal Presentation of Testicular Embryonal Carcinoma.

Testicular embryonal carcinoma is a type of nonseminomatous germ cell tumor (NSGCT) that commonly presents with scrotal swelling due to testicular mass. About half of patients with NSGCTs will present with metastases at initial diagnosis. Rarely, testicular embryonal carcinoma can present primarily in the mediastinum.

Educating Children Through the Art of Storytelling Using a Medically-Informed Children's Book.

Introduction: The purpose of this study is to demonstrate how children learn about a health topic from an interactive reading session. Due to the large number of children with allergies, the specific topic chosen for this research study was peanut allergies. The goal of the project was to assess how students learn from a children's book.

Transient Complete Atrioventricular Block Associated With Herbal Supplement Use.

Introduction: Increasing and easy availability of so-called natural/herbal supplements pose the unique challenge of identifying associated side effects, including arrhythmias in otherwise-healthy individuals.

Case Presentation: A 25-year-old female patient presented to the emergency department with fatigue and lightheadedness. The electrocardiogram showed complete AV block with a junctional escape rhythm at 55 beats per minute with QT prolongation (542ms).

CYP450 Genetic Polymorphisms: Generalized Tonic-Clonic Seizure after Intentional Fluoxetine and Melatonin Overdose.

Cytochrome P450 polymorphisms have gathered much attention regarding personalized psychopharmacological care. It is well documented that these drug metabolizing enzymes lead to interpatient variability in pharmacokinetic profiles. It appears that less functional genotype may increase of risk of higher side-effect burden.

A Description and Analysis of Injury and Exercise in Collegiate Rodeo Athletes.

Introduction: Rodeo constitutes an exciting sporting spectacle enjoyed worldwide by competitors of all ages. College rodeo encompasses nine core events: bull riding, saddle bronc riding, bareback riding, team roping, tie-down roping, breakaway roping, steer wrestling, goat tying, and barrel racing. There is little research on rodeo athletes regarding training habits, injuries during competition and/or practice, or effective injury prevention strategies.

Chronic Nerve Root Injury in Pediatric Patients With Chronic Lumbar Stress Fractures: A Retrospective Review.

Introduction: Many orthopedic providers currently treat chronic spondylolysis as self-limited fractures. While the condition has previously been associated with back pain in pediatrics, there has been little attention on the risk of neurologic harm. Electromyography (EMG) is a common study used to evaluate nerve injury, but it has not been previously reported for testing pediatric patients with stress fractures.

Burnout Among South Dakota-Licensed Physicians.

Introduction: Physician well-being is a topic of increasing attention nationwide. In collaboration with the South Dakota Board of Osteopathic and Medical Examiners and the South Dakota State Medical Association, we undertook an anonymous, web-based survey of all licensed physicians to assess the current baseline level of physician burnout.

Methods: The survey consisted of demographic questions and a single, validated burnout question that correlates with the lengthier Maslach Burnout Index.

Identifying the Use of Tanning Beds Among Undergraduate Students at South Dakota Universities and the Role of Providers: A Survey Analysis.

Introduction: Tanning bed use is common among young adults in the United States, and it contributes to over 400,000 cases of skin cancer annually. Many college students acknowledge the risk of skin cancer with tanning bed use, but this is not always a deterrent to the behavior. This study assesses the trends regarding tanning bed usage among university students and analyzes the role that primary care providers (PCPs) and dermatologists could play in reducing participation in this risky habit.

Healer's Perspective: A Course for Medical Students.

Introduction: Healer's Perspective was a course on Zoom developed from the Sanford Summer Leadership Academy. The five, one-hour sessions were held during the fall of 2022 and was student-led. Thirty-seven students from the Sanford School of Medicine class of 2025 participated in this course.