Smokers more likely to need spinal surgery, says study

Agencies
January 6, 2018

Smoking increases the risk of lower back pain that needs to be fixed by spinal surgery, a Swedish study suggests.

Researchers focused on a common cause of lower back pain known as lumbar spinal stenosis, which occurs when the spinal canal narrows, putting pressure on the spinal cord and nerves. The condition often develops as people age, but nicotine’s constriction of blood flow and promotion of inflammation are believed to contribute to the process, the study authors write.

The researchers examined data on 331,941 construction workers who were part of a nationwide occupational health registry in Sweden. Workers were followed for an average of more than three decades, starting when they were typically in their 30s, and 1,623 of them eventually had surgery for lumbar spinal stenosis.

Compared to people who never smoked, heavy smokers who went through at least 15 cigarettes a day were 46 per cent more likely to have this spinal surgery, the study found. For moderate smokers who had up to 14 cigarettes a day, the increased risk was 31 per cent, while ex-smokers had 13 per cent higher odds of surgery.

“Smoking appears to be a risk factor for developing lower spine space narrowing that can lead to surgical treatment,” said senior study author Dr. Arkan Sayed-Noor, a researcher at Umea University.

“Quitting smoking can reduce the risk,” Sayed-Noor said by email.

While some previous research has linked smoking to worse outcomes from spinal surgery, the current study offers fresh evidence that it can also increase the odds that back pain will require surgery, Sayed-Noor added.

Overall, 44 per cent of the study participants were non-smokers. Another 16 per cent were former smokers, while 26 per cent were moderate smokers and 14 per cent were heavy smokers.

The connection between smoking and spinal surgery persisted even after researchers accounted for other factors that can increase the odds of lower back pain such as aging and obesity.

Smoking damages the spine in several ways, researchers note in The Spine Journal. Nicotine can damage spinal tissue, weaken bones and make back pain worse.

Heavy smoking is also often accompanied by a sedentary lifestyle that may lead to muscle weakness and increase strain on the lower back.

One limitation of the study is that researchers lacked data on exercise habits, the authors note. Most of the construction workers in the study were men, and the results might be different for women.

Still, the findings add to evidence linking cigarettes to disc damage and back pain, said Dr. Jean Wong, a researcher at the University of Toronto who wasn’t involved in the study.

“There are multiple short and long-term health reasons for smokers to quit, and by quitting smoking, smokers can reduce their risk of back pain due to disc degeneration and spinal stenosis - which can be a debilitating problem in smokers,” Wong said by email. “Although it may take multiple attempts, quitting smoking is the best thing a smoker can do to minimize the risk of spinal stenosis and other health problems.”

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Agencies
June 4,2020

The World Health Organisation on Wednesday said that anti-malarial drug hydroxychloroquine (HCQ) will return to the solidarity trial for the potential treatment of coronavirus disease.

At a press conference in the WHO headquarters in Geneva, Director General Tedros Adhanom Ghebreyesus said: "On the basis of the available mortality data, the members of the committee recommended that there are no reasons to modify the trial protocol. The Executive Group received this recommendation and endorsed continuation of all arms of the solidarity trial, including hydroxychloroquine."

The world health body had temporarily suspended the usage of HCQ from the solidarity trial for coronavirus treatment on May 25 soon after a study published in one of the most reliable medical journals, which had suggested that the drug could cause more fatalities among COVID-19 patients.

However, the WHO chief said that the decision was taken as a precaution while the safety data was reviewed.

Ghebreyesus also said that the Data Safety and Monitoring Committee will continue to closely monitor the safety of all therapeutics being tested in the solidarity trial.

"So far, more than 3,500 patients have been recruited in 35 countries. WHO is committed to accelerating the development of effective therapeutics, vaccines and diagnostics as part of our commitment to serving the world with science, solutions and solidarity," he said.

Soon after HCQ was suspended from the trial, the Indian government had said that the antimalarial drug has been known for its benefits for a long time and its usage will be continued on the frontline workers, including police and healthcare professionals, as prophylaxis. The government had also said that studies were being conducted and the drug would be included in the clinical trial also for the treatment of coronavirus disease.

US President Donald Trump also had strongly advocated the use of HCQ and called it a "game-changer". He went to the extent of saying that he had taken the medicine.

Launched by WHO and partners, solidarity trial is an international clinical trial to find an effective treatment for COVID-19, including drugs to slow the progression of the disease or improve survival. The trial, which enrols patients from different countries, "will compare four treatment options against standard of care to assess their relative effectiveness against COVID-19", said WHO. 

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Agencies
June 23,2020

The record levels of new daily COVID-19 cases are due to the fact that the pandemic is peaking in a number of big countries at the same time and reflect a change in the virus' global activity, the World Health Organisation said.

At a media briefing on Monday, WHO's emergencies chief Dr Michael Ryan said that the numbers are increasing because the epidemic is developing in a number of populous countries at the same time.

Some countries have attributed their increased caseload to more testing, including India and the US But Ryan dismissed that explanation.

We do not believe this is a testing phenomenon, he said, noting that numerous countries have also noted marked increases in hospital admissions and deaths neither of which cannot be explained by increased testing.

There definitely is a shift in that the virus is now very well established, Ryan said. The epidemic is now peaking or moving towards a peak in a number of large countries.

He added the situation was definitely accelerating in a number of countries, including the US and others in South Asia, the Middle East and Africa.

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Agencies
June 19,2020

While coughing, fever and difficulty in breathing are common symptoms of COVID-19, a new case study has found that pink eye is also a reason to be tested for the disease.

The study, published in the Canadian Journal of Ophthalmology, determined that conjunctivitis and keratoconjunctivitis can also be primary symptoms of COVID-19.

The researchers noted that in March, a 29-year-old woman arrived at the Royal Alexandra Hospital's Eye Institute of Alberta with a severe case of conjunctivitis and minimal respiratory symptoms.

After the patient had undergone several days of treatment with little improvement -- and after it had been determined that the woman had recently returned home from Asia -- a resident ordered a COVID-19 test.

The test came back positive, according to the researchers.

"What is interesting in this case, and perhaps very different to how it had been recognised at that specific time, was that the main presentation of the illness was not a respiratory symptom. It was the eye," said Carlos Solarte, an assistant professor at the University of Alberta in Canada.

"There was no fever and no cough, so we weren't led to suspect COVID-19 at the beginning. We didn't know it could present primarily with the eye and not with the lungs," Solarte said.

Academic studies at the outset of the pandemic identified conjunctivitis as a secondary symptoms in about 10 to 15 per cent of COVID-19 cases, he said.

Since then, scientists have gained greater knowledge of how the virus can transmit through and affect the body's mucous membrane system, of which the conjunctiva -- the clear, thin membrane that covers the front surface of the eye -- is an extension.

While the finding provides important new health information for the public, it also makes eye exams more complicated for ophthalmologists and staff, the researchers noted.

"The patient in this case eventually recovered well without any issues. But several of the residents and staff who were in close contact with the patient had to be under quarantine," said Solarte.

"Fortunately, none who were involved in her care also tested positive," he said.

Patients coming into an eye clinic with conjunctivitis and keratoconjunctivitis are now treated as potential cases of COVID-19 and extra precautions are taken by staff, according to the researchers.

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