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
July 3,2020

Apart from the many benefits of doing exercise, new research has now found that exercise can slow down or prevent the development of macular degeneration and may benefit other common causes of vision loss, such as glaucoma and diabetic retinopathy.

The new study from the University of Virginia School of Medicine found that exercise reduced the harmful overgrowth of blood vessels in the eyes of lab mice by up to 45 per cent. This tangle of blood vessels is a key contributor to macular degeneration and several other eye diseases.

The study represents the first experimental evidence showing that exercise can reduce the severity of macular degeneration, a leading cause of vision loss, the scientists report. Ten million Americans are estimated to have the condition.

"There has long been a question about whether maintaining a healthy lifestyle can delay or prevent the development of macular degeneration. The way that question has historically been answered has been by taking surveys of people, asking them what they are eating and how much exercise they are performing," said researcher Bradley Gelfand, PhD, of UVA's Center for Advanced Vision Science.

"That is basically the most sophisticated study that has been done. The problem with that is that people are notoriously bad self-reporters ... and that can lead to conclusions that may or not be true. This [study] offers hard evidence from the lab for the very first time," Gelfand added.

Enticingly, the research found that the bar for receiving the benefits from exercise was relatively low - more exercise didn't mean more benefit.

"Mice are kind of like people in that they will do a spectrum of exercise. As long as they had a wheel and ran on it, there was a benefit. The benefit that they obtained is saturated at low levels of exercise," Gelfand said.

An initial test comparing mice that voluntarily exercised versus those that did not found that exercise reduced the blood vessel overgrowth by 45%. A second test, to confirm the findings, found a reduction of 32 per cent.

The scientists aren't certain exactly how exercise is preventing the blood vessel overgrowth. There could be a variety of factors at play, they say, including increased blood flow to the eyes.

Gelfand, of UVA's Department of Ophthalmology and Department of Biomedical Engineering, noted that the onset of vision loss is often associated with a decrease in exercise.

"It is fairly well known that as people's eyes and vision deteriorate, their tendency to engage in physical activity also goes down. It can be a challenging thing to study with older people. ... How much of that is one causing the other?" he said.
The researchers already have submitted grant proposals in hopes of obtaining funding to pursue their findings further.

"The next step is to look at how and why this happens, and to see if we can develop a pill or method that will give you the benefits of exercise without having to exercise," Gelfand said.

He explained, "We're talking about a fairly elderly population [of people with macular degeneration], many of whom may not be capable of conducting the type of exercise regimen that may be required to see some kind of benefit." (He urged people to consult their doctors before beginning any aggressive exercise program.)
Gelfand, a self-described couch potato, disclosed a secret motivation for the research: "One reason I wanted to do this study was sort of selfish. I was hoping to find some reason not to exercise," he joked. "It turned out exercise really is good for you."

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