Smokeless tobacco use and health effects among baseball players

Article Abstract:

Use of smokeless tobacco (ST, including snuff and chewing tobacco) is increasing in the United States. Unfortunately, it is associated with increased risks of oral cancer and leukoplakia (white spots, potentially malignant, on the mucous membranes of the tongue or cheek). The effects of ST on several health-related factors, including oral leukoplakia and dysplasia (abnormal cells), periodontal (gums and supporting tissues of the teeth) and dental disease, blood pressure, pulse, and cholesterol, were studied in professional baseball players, a group with a high rate of ST use. Participants were classified as nonusers, former users, or current users (current-week or current-month, depending on the most recent ST use). Users identified ST brand, quantity, and pattern of use. Subjects completed a questionnaire about demographic data, alcohol and cigarette use, and dental hygiene, and underwent a complete dental examination and blood testing. Results from 1,109 players in the seven major and seven minor league baseball teams indicated that most participants (77 percent) were between 20 and 29 years of age, and (68 percent) were white. Forty-five percent were ST nonusers, 13 percent were former users, and 42 percent were current users, most within the previous week. Oral leukoplakia was markedly increased among current-week ST users: 196 (of 423) players had the condition (46 percent), while it was present in only seven (of 493) nonusers (1.4 percent). The prevalence increased with the amount of ST used and the hours of use per day. Snuff was more highly associated with oral leukoplakia than chewing tobacco. All lesions that were biopsied (in 92 men) were benign. Users and nonusers did not differ with respect to periodontal or dental findings, with the exception of higher rates of attachment loss (where the tooth is 'attached' to the gum) of four millimeters or more among users. Nor did results from blood tests differ between the groups, except that an inverse relationship between levels of HDL cholesterol (a type of cholesterol associated with reduced risk of heart disease) and cotinine (the main metabolite of nicotine) was found among the ST users. In summary, it appears that ST use is not desirable because it leads to an increased risk of oral leukoplakia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Causes of, Physiological aspects, Surveys, Baseball players, Smokeless tobacco, Tobacco habit, Leukoplakia

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The impact of a regulation restricting medical house staff working hours on the quality of patient care

Article Abstract:

A New York State regulation restricting the number of hours medical residents can work may result in delayed diagnostic testing and increased complications while in the hospital. Health Code 405, enacted in 1989, ruled that residents could not work more than 80 hours per week and that they must have at least eight hours off between shifts. Direct patient care was limited to 24 consecutive hours. A study compared the quality of patient care among 263 patients discharged in Oct 1988, prior to the enactment of Code 405, with that of 263 patients discharged from the same hospital in Oct 1989. Patients from both groups had similarly severe illnesses, but 35% of the patients treated in 1989 suffered at least one medical complication compared with 22% of patients treated in 1988. Also, 17% of patients discharged in 1989 experienced at least one delayed diagnostic test compared with 2% of those discharged in 1988. There were no significant differences in patient outcomes such as in-hospital deaths, transfers to the intensive care unit or lengths of stay.

Laws, regulations and rules, Medical care, Quality management, Medical care quality, Residents (Medicine), Interns (Medicine), Medical interns

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Regular Outpatient Medical and Drug Abuse Care and Subsequent Hospitalization OF Persons Who Use Illicit Drugs

Article Abstract:

Outpatient drug treatment and medical care can lower the rate of hospitalization in both HIV-positive and HIV-negative drug addicts. This was the conclusion of a study of 11,556 HIV-infected drug addicts and 46,687 HIV-negative drug addicts.

Care and treatment, Evaluation, Prevention, Hospitalization, Drug addicts, Drug abusers, Ambulatory medical care, Ambulatory care, Hospital care

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