South Dakota medicine : the journal of the South Dakota State Medical Association
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Maternal obesity, high gestational weight gain and diabetes mellitus during pregnancy are known risk factors that correlate with high infant birth weight and the mother's race. Previous studies have focused on low birth weight, prematurity and infant mortality. This study examined the interaction between race, maternal risk factors and high infant birth weights at the population level in South Dakota to identify factors contributing to the high Native American infant birth weights. We hypothesized that high infant birth weights were associated with maternal diabetes, obesity and high gestational weight gain, and that Native American infants' higher birth weights were related to the prevalence of diabetes and obesity. ⋯ Native American race, gestational diabetes mellitus, overweight and obese BMI, and excessive gestational weight gain for BMI were the most significant maternal factors associated with high infant birth weight. Mothers with any one risk factor gave birth to heavier infants. Mothers with all risk factors had infants with the highest mean birth weights in South Dakota. This large population-based study provides evidence that Native American mothers in South Dakota with GDM, overweight or obese BMI and excessive GWG are more likely to give birth to high birth weight infants. At-risk mothers should be educated regarding the risks and potential complications of high birth weight infants.
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Poor follow-up after post-screening referral is a challenge faced by vision screening organizations. This study examines barriers to follow-up eye care in children who were referred for a comprehensive eye exam following a vision screening event in western South Dakota. ⋯ The majority of surveyed parents/guardians reported their children having seen an eye care provider. Appropriate documentation has been limited due to reliance on parents/guardians to give referral forms to eye care providers and subsequent dependence on providers to forward completed referral forms to CVSI. Improved documentation is needed to assess the accuracy of the screening, support screening prevalence data, and evaluate the impact of CVSI.
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Case Reports
A Case of Acute Compartment Syndrome of the Thigh Associated with Repetitive Athletic Trauma.
We present a case of acute compartment syndrome (ACS) in an athlete who sustained minimal but repetitive trauma to the thigh during a sporting event. During his evaluation, concern was raised regarding the diagnosis of ACS as a cause of his symptoms. ⋯ ACS is a potential complication of muscular-skeletal injuries from various causes, and our case is unusual as the cause was mild but repetitive trauma in an otherwise healthy athlete. It is important to recognize the signs and symptoms of ACS to avoid the potentially significant complications should the diagnosis be missed.
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We report a case of spontaneous pneumomediastinum with unusual clinical presentation. The most common symptoms of spontaneous mediastinum are chest pain and shortness of breath. Our patient presented with neck swelling and change in voice, an unusual presentation for spontaneous pneumothorax. ⋯ Our patient developed the condition after an intense coughing spell following smoking cessation. CT scan is considered gold standard for the diagnosis. Spontaneous pneumomediastinum is characterized by spontaneous recovery and can be treated with short period of observation and symptomatic management.
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Papillary muscle rupture is a rare, life-threatening post myocardial infarction mechanical complication. Without surgical intervention, prognosis is very poor. Clinicians need to recognize this complication early, as prompt therapy is crucial. ⋯ In our patient, a new mitral regurgitation murmur suggested this mechanical complication. Complete disruption of papillary muscle was visualized by transesophageal echocardiography. This case illustrates the importance of good physical examination for early diagnosis of papillary muscle rupture, so that life-saving treatment can be administered without delay.