South Dakota medicine : the journal of the South Dakota State Medical Association
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Comparative Study
Comparison of Content and Format for Upper Respiratory Illness Antibiotic Prescribing Guideline Developed by Two Midwestern Organizations.
Antimicrobial resistance is a rapidly emerging public health problem, largely due to antibiotic prescribing which lacks an evidence base. We previously reported the results of local efforts within a single healthcare system at devising clinical guidelines to reduce unnecessary and even inappropriate antibiotic prescribing. This paper presents a comparison of the antibiotic guidelines developed by that process with those released by Institute for Clinical Systems Improvement, a national clinical quality organization. We found that the content of the guidelines are comparable, but not identical, while the formats differed, fitting separate but overlapping niches.
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Hook of the hamate fractures are uncommon. This fracture is usually seen in sports involving a club or a racquet (i.e., baseball or golf) and is caused by blunt trauma. Stress fractures of the hamate are exceedingly rare. ⋯ When the diagnosis is delayed, nonunion of the fracture is common and is usually treated with surgery. This case represents a hook of the hamate stress fracture that healed with casting in spite of being seen two months from the onset of symptoms. Hamate fractures are reviewed, including the anatomy and treatment options for hook of the hamate fractures.
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South Dakota is one of eight states that do not require any vision screening for children. This study describes the results of the first children's vision screening program in the state. ⋯ The SPOT photoscreener yielded an acceptable referral rate of 11.9 percent. This study represents an effective model for pediatric vision screening in South Dakota.
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With the recent legalization of recreational marijuana in Colorado, Washington, Alaska, the District of Columbia and legislation pending for both medical and recreational marijuana in several other states, it is important for the facts regarding its potential for serious mental health consequences to be known. Little has been said about the psychiatric risks of this substance, particularly in youth. ⋯ In addition, permanent loss of IQ and structural changes in the brain have been demonstrated with habitual use. Legalization of marijuana for recreational use can influence an adolescent's perception of this substance as "safe." In states that have legalized marijuana for medical purposes, there is the very real problem of "diversion." As many as 34 percent of 12th-graders who use marijuana in states with legalized marijuana had obtained it from a person who had received it through a prescription.
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The "Golden Hour," the first 60 minutes following the birth of an extremely premature infant, are perhaps the most important of his or her life. Specific attention to respiratory management, temperature regulation, and vascular access, undertaken via a standardized approach may have immeasurable long-term benefits, and make the difference between life and death. ⋯ We were not able to detect differences in temperature management, bronchopulmonary dysplasia or average length of hospital stay following implementation of the Golden Hour protocol. However, we observed a marked decrease in intraventricular hemorrhage and faster time for umbilical catheter insertion than prior to the protocol. Long-term follow-up of these infants is critical to assess neurodevelopmental benefits gained from use of the protocol.