Indiana medicine : the journal of the Indiana State Medical Association
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During the past 25 years, the consumption of chewing tobacco and moist snuff has been increasing in frequency, especially among the youth. Smokeless tobacco (ST) use among Indiana youngsters is higher than its use among youngsters nationally. More than 10% of current Indiana high school junior and senior female students report some ST usage. ⋯ Early intervention in youth who are experimenting with ST or using "starter" products may prevent addiction and disease. Physicians should be alert to the intraoral physical signs of ST use. To strengthen their tobacco intervention skills, physicians should require continuing education training regarding ST.
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This study examined the trends and stability of public opinion related to tobacco use and raising tobacco taxes in Indiana. Using a structured questionnaire, a sample of 800 households was randomly selected, and the adults were interviewed by telephone in 1989, 1990 and 1992 by the Indiana University Center for Survey Research. The data were subjected to descriptive and chi-square statistical procedures. ⋯ Most respondents agreed that public places should be required to have nonsmoking areas. Further, most people favored a tax increase on cigarettes, and there was an upward trend toward more people favoring a tax increase in recent years. It was concluded that the tax on tobacco should be increased for public health reasons.
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With increasing survival rates from acute medical or surgical emergencies a new form of peripheral neuropathy, CIP, has been recognized. CIP can be seen only in patients who are considered to be critically ill; therefore, it invariably occurs in the ICU. Typically, initial symptoms begin with transient (hours to a few days) septic encephalopathy followed by generalized weakness, manifested in weaning failure, limb weakness and hyporeflexia. ⋯ Prognosis is poor in severe cases, in which the EMG also shows severe axonal degeneration. In milder forms, fair to good recovery is expected within weeks. Management includes treatment of sepsis, normalization of failing organ function, physical therapy and proper nutrition.