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 10,2020

Early treatment with the antiviral drug remdesivir has been found to reduce viral load and prevent lung disease in macaques infected with SARS-CoV-2 that causes COVID-19, according to a study.

The findings, published in the journal Nature on Tuesday, support the early use of remdesivir treatment in patients with COVID-19 to prevent progression to pneumonia.

Researchers from the National Institutes of Health in the US noted that remdesivir has broad antiviral activity and has been shown to be effective against infections with SARS-CoV and MERS-CoV in animal models.

The drug is being tested in human clinical trials for the treatment of COVID-19, they said.

Researcher Emmie de Wit and colleagues investigated the effects of remdesivir treatment in rhesus macaques, a recently established model of SARS-CoV-2 infection.

Two sets of six macaques were inoculated with SARS-CoV-2.

One group was treated with remdesivir 12 hours later -- close to the peak of virus reproduction in the lungs -- and these macaques received treatment every 24 hours until six days after inoculation.

In contrast to the control group, the researchers found that macaques that received remdesivir did not show signs of respiratory disease, and had reduced damage to the lungs.

Viral loads in the lower respiratory tract were also reduced in the treated animals; viral levels were around 100 times lower in the lower-respiratory tract of remdesivir-treated macaques 12 hours after the first dose, they said.

The researchers said that infectious virus could no longer be detected in the treatment group three days after initial infection, but was still detectable in four out of six control animals.

Despite this virus reduction in the lower respiratory tract, no reduction in virus shedding was observed, which indicates that clinical improvement may not equate to a lack of infectiousness, they said.

Dosing of remdesivir in the rhesus macaques is equivalent to that used in humans, the researchers noted.

They cautioned that it is difficult to directly translate the timing of treatment used in corresponding disease stages in humans, because rhesus macaques normally develop only mild disease.

However, researchers said the results indicate that remdesivir treatment of COVID-19 should be initiated as early as possible to achieve the maximum treatment effect.

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Agencies
June 20,2020

The World Health Organisation has warned that the COVID-19 pandemic is entering a "new and dangerous" phase. Thursday saw the most cases in a single day reported to the WHO.

Tedros Adhanom Ghebreyesus said the day had seen 150,000 new cases with half of those coming from the Americas and large numbers also from the Middle East and South Asia, the BBC reported.

He said the virus was still spreading fast and the pandemic accelerating.

He acknowledged people might be fed up with self-isolating and countries were eager to open their economies but he said that now was a time for extreme vigilance.

Maria van Kerkhove, technical lead of the WHO's COVID-19 response, told a press conference the pandemic is "accelerating in many parts of the world".

"While we have seen countries have some success in suppressing transmission and bringing transition down to a low level, every country must remain ready," she said.

Mike Ryan, the head of the WHO's Health Emergencies Programme, said that some countries had managed to flatten the peak of infections without bringing them down to a very low level.

"You can see a situation in some countries where they could get a second peak now, because the disease has not been brought under control," he said.

"The disease will then go away and reduce to a low level, and they could then get a second wave again in the autumn or later in the year."

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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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