What do environmental concerns, pressure ulcers, C-sections, the value of a human life, and opioids have in common?
They are the themes in the articles we have been reading the past two weeks of May 14 and 21, 2018.
Your Environment May Increase Your Risk of COPD
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Although cigarette smoking is often the cause of COPD, a recent study led by researchers from the Barcelona Institute for Global Health (ISGlobal) reminds us that COPD may be caused by other factors.
The study involved more than 3,300 patients. Researchers found that 21% of COPD cases were associated with these occupational exposures such as biological dust, pesticides, gases, and fumes. Explained Jan-Paul Zock, ISGlobal researcher and lead author of the study:
“Previous studies had estimated that about 15% of COPD cases are attributable to workplace exposures. Our results strengthen this evidence base substantially. To our knowledge, this is the first study to demonstrate an effect of biological dust exposure on the incidence of COPD in a prospective fashion in a general population cohort.”
How Opioids are Delivered May Decrease Usage
Researchers at Yale School of Medicine and Yale New Haven Hospital found that “delivering the opioids with a shot under the skin or with a pill instead of an IV … could decrease patient exposure to the medications while also maintaining or improving pain relief.” Robert Fogerty, M.D., associate professor of medicine at YSM and co-author on the study, said:
“The data shows that the non-IV use of opioids can reduce overall opioid use in adult inpatients with no change in pain control, and potentially an improvement. It’s an example of less is more.”
What Pain Relief is Delivered May Decrease Usage
Researchers at Washington University in St. Louis have found that a single intraoperative dose of methadone “decreased opioid requirements and provided better analgesia than short-duration opioids in people undergoing ambulatory procedures.”
Non-opioid Pain Relievers are Being Underutilized
Johns Hopkins researchers found that patients are underutilizing over-the-counter medications. Patients involved were inpatient adult spine and joint surgery patients at The Johns Hopkins Hospital from August to November 2016.
Mark Bicket, M.D., assistant professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine and the paper’s first author, said:
“Many people are not aware of how well some over-the-counter medications relieve pain. Compared to prescription opioids, pain relievers like ibuprofen relieve pain just as well or better than opioids, and with fewer side effects. Adding acetaminophen (Tylenol) to the mix provides an extra boost in pain relief greater than each drug by itself. Despite being available over-the-counter, these drugs often receive less attention that prescription opioids.”
How Much is Human Life Worth?
A paper on the use of naloxone is raising the question – “how much is a human life worth?”
Economists Jennifer L. Doleac, PhD, an associate professor of economics at the University of Virginia, in Charlottesville, and Anita Mukherjee, PhD, an associate professor of risk and insurance at the University of Wisconsin–Madison, looked at analyzed law enforcement and public health data from communities that had recently passed and implemented naloxone access laws. Their conclusion seems to take the stand that “Naloxone does not truly save lives; it merely extends them until the next overdose.”
Do you agree?
Is that C-Section Necessary?
Although a C-section may be necessary (positioning of the baby inside the womb, delayed pregnancy, etc), doctors are often recommending C-sections without the presence of such complications.
Public health experts in a recent meeting, “Stakeholders’ Consultation on Prevention of Unnecessary Caesarean Section” came together to discuss how to prevent unnecessary C-sections because C-sections pose dangers to both the mother and her child:
“Mothers who undergo C-sections can face post-operative wound infections, complications from anaesthesia, injury to organs, blood clots and infertility and placental complications in future pregnancies. Moreover, the babies are at risk of accidental surgical cuts, need for intensive care, being delivered prematurely and breathing difficulties at birth and beyond.”