Uncovering an Uncommon Diagnosis: Relapsing Adolescent Catatonia.

Catatonia in the pediatric population is a historically overlooked syndrome. Accurate recognition is complicated by a broad differential diagnosis and co-morbid substance use, particularly in adolescent patients. Prompt treatment is vital to avoid life-threatening complications such as malignant catatonia. This article summarizes a case of relapsing adolescent catatonia and discusses the pathway of diagnosis and treatment.

Empirically Validated Screening Tools for Adolescent Substance Use Disorders.

Substance use is a major cause of morbidity and mortality in the U.S., and data from treatment centers shows that 75 percent of patients initiated their use prior to the age of 17 years. Substance use in the adolescent years affects brain development and leads to poor physical and psychiatric health, decreased academic performance, and forensic outcomes. Screening at both primary care and specialty visits allows for early intervention and treatment. This article reviews the available screening tools for substance use disorders in children and adolescents for use in a variety of clinical settings.

The evolution of clinical outcomes in metastatic pancreatic adenocarcinoma: a 10-year experience at a tertiary referral center.

BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer mortality in the US. Recent studies have demonstrated survival benefits for FOLFIRINOX (5-FU, leucovorin, irinotecan, and oxaliplatin) and Gem/nab-P (gemcitabine/nab-paclitaxel) over gemcitabine. We aimed to evaluate the clinical outcomes of mPDAC before and after incorporating these newer regimens into the clinical practice. METHODS: A retrospective study of patients with mPDAC at our institution between 2009 and 2018, who were followed up until December 2019. Overall survival (OS) and progression-free survival (PFS) were calculated using Kaplan-Meier survival analysis. Univariate and multivariable Cox regression analyses were used to explore predictors of survival. RESULTS: A total of 394 patients with mPDAC were included: 122 (31%) were diagnosed 2009-2013 and 272 (69%) 2014-2018. In 2009-2013 cohort vs. 2014-2018 cohort, the median OS and PFS were similar (4 vs. 3.6 months, P = 0.5) and (2.3 vs. 2.5 months, P = 0.41), respectively. Age, ECOG-PS >1, serum albumin, neutrophil-to-lymphocyte ratio, and platelets-to-lymphocyte ratio were independent predictors of better OS. CONCLUSIONS: In this study of real-world data, the median OS and PFS for all patients with mPDAC were equivalent before and after incorporating newer treatment regimens into the clinical practice.

Adolescent Vaping and COVID-19: When an Epidemic Meets a Pandemic.

National epidemiological studies indicate that vaping or e-cigarette use has increased in alarming proportions among American adolescents. In vaping, a battery-powered device heats up a liquid into an aerosol which is inhaled by the user. The aerosol, commonly referred to as vapor, usually contains nicotine, flavoring, marijuana along with other chemicals and substances. This article highlights serious yet avoidable health risks from vaping amidst the coronavirus disease 2019 (COVID-19) pandemic. Vaping may mediate transmission, infections, disease progression and risk of succumbing to COVID-19. An overview of possible solutions and resources for South Dakota physicians is also discussed.

Incorporation of Women's Health Maintenance Screening in the USD Coyote Clinic.

INTRODUCTION: The Coyote Clinic is a student-run clinic that provides free services to Sioux Falls residents without insurance. It has not historically provided routine women's health screenings. The project addressed this lack of preventative care. We aimed to increase the percentage of female patients that are up to date on Papanicolaou (Pap) smears, mammograms, and human papillomavirus (HPV) vaccines through the implementation of screening questions. METHODS: A screening questionnaire was created and asked to female patients between the ages of 18-65 about the dates and results of their last Pap smear, mammogram, and the administration of any HPV vaccine. RESULTS: 27 patients answered the questions. Fifty-two percent were Caucasian, 26 percent Hispanic, 15 percent African American, and 7 percent Middle Eastern. Two patients were eligible for HPV vaccination: one had not received the vaccination and the other was unknown. All 27 women were eligible for Pap smears. Seventy-six percent had normal results, 19 percent were unsure of their results, and 5 percent had abnormal results. Eight patients were eligible for mammograms: five were up to date, two were tested in the last three years, and one had an unknown test date. CONCLUSIONS: The majority of eligible female patients were up to date on Pap smears and mammograms. The health maintenance questionnaire was a valuable resource for patient care, patient health literacy, and medical student education.