The Journal of the Kentucky Medical Association
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Secondhand smoke (SHS) is the third leading cause of preventable death in the United States. It is responsible for an estimated 3,000 lung cancer deaths annually in never-smokers in the US. It also accounts for over 35,000 deaths annually from coronary heart disease in never-smokers. It increases the number and severity of asthmatic attacks in over 300,000 asthmatic children each year, and is associated with Sudden Infant Death Syndrome and middle ear infections, in addition to other illnesses in children. The purpose of this study was to examine indoor air quality in a sample of hospitality venues in Paducah, Kentucky. The relation between indoor air pollution and the presence of on premises smoking was assessed. ⋯ The effects of secondhand smoke are substantial and rapid, explaining the relatively large health risks associated with secondhand smoke exposure that have been reported in epidemiological studies. This study shows that physically separating smokers and non-smokers is not an effective way to protect non-smoking patrons from tobacco smoke pollution. "No smoking" sections provided protection to nonsmokers that can be characterized as trivial at best. In fact, patrons in Paducah cannot be certain that their exposure will not be higher in the "no smoking" sections of certain venues when compared to the smoking sections of other venues. It is imperative that physicians and other healthcare providers actively and aggressively lobby local policymakers to pass regulatory and/or public health ordinances, which have been demonstrated to be effective in controlling exposure to secondhand smoke.
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We examined systemic inflammatory serum markers and pain responses to image-guided lumbar epidural steroid injections (LESI) both before and after LESI in patients with lumbar disc herniations with various pathological intervertebral disc changes. ⋯ The results of this study suggest that elevated hs-CRP levels may be useful for objectively evaluating and predicting responses to LESI in those patients with lumbar disc pathology with lower extremity radiculitis.
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Pepper spray is defined as a non-lethal agent used in riot control and personal self-defense. Oleoresin capsicum (OC), derived from the fruit of plants in the Capsicum genus, commonly referred to as hot peppers or chilies, is the active agent used in many of these defense sprays. ⋯ Nationwide there have been numerous reports of pepper spray-related injuries, including officers injured in pepper spray-related training exercises. This report details one officer's experience.
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Metastatic squamous cell carcinoma presenting in the neck from an unknown primary site represetns 2% to 6% of head and neck cancers. Optimal management of these cases remains controversial and continues to evolve with experience. We performed a retrospective analysis involving patients treated for unknown primary squamous cell carcinomas with metastases to cervical lymph nodes who presented to either the University of Kentucky or the Veterans Affairs Hospital of Lexington, Kentucky, from 1990 to 2000. ⋯ The presence of extracapsular spread, increased number of positive lymph nodes, and eventual discovery of a primary tumor did not significantly decrease survival in this series. The mean follow-up period for patients in this study was 54.8 months. We continue to refine our diagnostic and treatment strategies in this group of patients in an effort to improve long-term survival and reduce patient morbidity.