South Dakota medicine : the journal of the South Dakota State Medical Association
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Case Reports
Bilateral Chronic Exertional Compartment Syndrome of the Leg: A Rare but often Debilitating Condition in Athletes.
This report discusses an unusual case of bilateral chronic exertional compartment syndrome (CECS) of the lower leg, a syndrome found mainly in young athletes. Pathophysiology includes exercise-induced muscle expansion against noncompliant fibro-osseous membranes separating compartments of the lower leg. A 24-year-old female distance runner with a history significant for misdiagnosed shin splints and tibial stress fracture presented with acute-on-chronic right lower leg pain. ⋯ Two months after return to running, symptoms were improved in the right leg, but appeared in the left leg. Subsequent pressure testing on the left revealed CESC, and four compartment fasciotomy was performed. Her symptoms significantly improved and she returned to running at six weeks without pain bilaterally.
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Amblyopia is a preventable, sight stealing disorder with a prevalence of approximately 2-4 percent in the U.S. pediatric population. Identifying efficacious, early stage screening modalities is of critical importance to sustain quality of vision and quality of life. This project assessed the quality of screening methods used in the Children's Vision Screening Initiative (CVSI), administered by Northern Plains Eye Foundation in collaboration with Western South Dakota Lions Clubs, by comparing to data collected in follow-up appointments at professional eye care clinics. ⋯ Vision screening performed using the SPOT device represents a valuable modality that is easily employable and can provide tremendous benefit to children in the state of South Dakota.
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The application process for residency positions is a costly endeavor. This study aims to quantify the financial expenses incurred by University of South Dakota Sanford School of Medicine (USD SSOM) class of 2016. Our hope is that this study will prepare future students of USD and other smaller programs for the financial burdens associated with the match. This data should be used to guide financial decision making by medical students from USD or by regional students from medical programs that desire to apply to residency programs not offered at their home institution. ⋯ The process of applying to residencies among the graduating MD class of 2016 is a costly endeavor. Attendance of interviews for residency positions is the most costly part of the residency application process. Although the financial burden associated with applying to residency programs is high, increasing competition for graduate medical education positions may only drive the cost further.
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With the emphasis on pain control (i.e., pain as the fifth vital sign) starting in the late 1990s and the increased prescribing of opioids, the opioid epidemic began. With the expanding misuse of opioids a new emphasis has been given for more responsible management of opioid prescribing by health care providers in all specialties. Since the pain experienced by patients with chronic musculoskeletal pain and acute postoperative pain can be severe, specific attention must be given to these patients who may be at increased risk for opioid abuse. ⋯ As a result of this epidemic, several intraoperative techniques have been developed to decrease the need for postoperative pain medication. In addition, we identify several key features of a patient's background and their behavior that can indicate a potential for opioid abuse or misuse. Treatment strategies for providers including opioid prescribing guidelines are also discussed.
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Case Reports
Atrial Fibrillation Induced by Carbon Monoxide Poisoning and Successful Treatment with Hyperbaric Oxygen.
Carbon monoxide (CO) intoxication is one of the major public health hazards which may go unnoticed as this is a colorless, odorless and tasteless gas. The manifestations of the CO poisoning are far-reaching. ⋯ In the literature, there have been few cases of CO poisoning-induced atrial fibrillation (AF) reported. We hereby report an AF caused by CO toxicity in a young male patient and successful conversion to sinus rhythm with the hyperbaric therapy.