South Dakota medicine : the journal of the South Dakota State Medical Association
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Tobacco use is the leading cause of preventable deaths in the United States and in South Dakota. Reducing tobacco use among South Dakotans is critical to alleviate the heavy burden of preventable deaths, illnesses and excessive health care costs that result from using tobacco products. The South Dakota Department of Health's Tobacco Control Program has collaborated with various agencies and coalitions to discourage people from starting to smoke, to help current smokers quit and to protect all people from exposure to secondhand smoke. ⋯ Despite decreasing cigarette use among all adults in South Dakota, 18- to 24-year-olds still have the highest smoking rate, at 29.3 percent. Surveillance will continue to monitor tobacco use trends in South Dakota and assess the impact of tobacco control efforts. Some of the most important findings are summarized in the following report.
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Research indicates that breastfeeding provides a wide array of physical and psychological benefits to both mother and child. Breastfeeding is also a practical way for families, government and society to save money. ⋯ Economic benefits also can be measured to determine advantages to breastfeeding. The following article reviews the extensive benefits that breastfeeding can provide to American Indian women and their families.
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Case Reports
A case study in therapeutic hypothermia treatment post-cardiac arrest in a 56-year-old male.
Cellular damage related to reperfusion injury after successful resuscitation may lead to increased morbidity and mortality in survivors of cardiac arrest. Therapeutic hypothermia to decrease the effects of reperfusion injury has demonstrated improved neurologic outcomes for patients who have experienced out-of-hospital cardiac arrest due to ventricular fibrillation. ⋯ Twenty-four hours of therapeutic hypothermia for patients who remain unresponsive following successful resuscitation after experiencing out-of-hospital ventricular fibrillation is a viable option for preservation of neurological function. The National Registry of Cardiopulmonary Resuscitation (NRCPR), sponsored by the American Heart Association (AHA), was developed with a goal to enhance patient safety and reduce patient disability and death through "providing an evidence-based, quality improvement program of patient safety, medical emergency team response, effective resuscitation and post-emergency care" to patients that have experienced cardiopulmonary events. NRCPR reports from 2007 include data from 127 participating organizations with information submitted on 19,555 in-patients who experienced 22,919 cardiopulmonary arrest (CPA) events. Of all of the arrests that occurred, 78.3 percent of patients involved did not survive the event. For those who did survive the event, an additional 35.2 percent died afterward, either via removal of life-support or natural death in the presence of do-not-resuscitate (DNR) directives. The remaining survivors (21.3 percent) were discharged to a variety of environments with home being the most common (48.5 percent), followed by skilled nursing facilities (19.2 percent), rehabilitation centers (12.4 percent), other acute care hospitals (11.8 percent) and hospice care (4.7 percent). From this information, it is apparent that continued research and improvements are essential to provide patients successful resuscitation and to decrease the complications that occur afterward. We present the case of a patient who remained comatose after return of spontaneous circulation (ROSC) following out-of-hospital ventricular fibrillation (VF) cardiac arrest in whom therapeutic hypothermia treatment was utilized with a positive neurological outcome.