Dam­age from one cannabis smoke equals five cig­a­rettes

The Weekend Australian - Travel - - Health - Com­piled by Dr Chris­tine White

PIC­TURES on the pack show in graphic de­tail the dam­age that cig­a­rettes can do to your lungs. Now re­searchers have found that a sin­gle cannabis joint can have the same ef­fect on the lungs as smok­ing five cig­a­rettes at once. Their find­ings, pub­lished on­line this week in the jour­nal Tho­rax , are based on 339 adults aged 25 to 75. Par­tic­i­pants were di­vided into four groups — those who smoked only cannabis (at least one joint a day for five years), those who smoked only to­bacco (one pack of cig­a­rettes a day for at least a year), those who smoked both, and those who smoked nei­ther. Their lungs were ex­am­ined by CT (com­puted to­mog­ra­phy) scan and breath­ing tests were used to as­sess how well their lungs worked. While the lung dis­ease em­phy­sema was only seen in to­bacco smok­ers, cannabis smok­ers had sig­nif­i­cantly more lung dam­age and worse lung func­tion than ei­ther non-smok­ers or to­bacco smok­ers. And the more cannabis a per­son smoked, the greater their level of lung dam­age. Tho­rax - 2007;doi:10.1136/thx.2006.077081 (Ald­ing­ton S, et al) DRUGS com­monly used to treat type 2 di­a­betes may dou­ble the risk of heart fail­ure, even among those with no his­tory of heart dis­ease, ac­cord­ing to a new re­port in Di­a­betes Care . The au­thors an­a­lysed the re­sults of 249 stud­ies look­ing at the ef­fect of drugs called TZDs (thi­a­zo­lidine­diones, in­clud­ing rosigli­ta­zone and pi­ogli­ta­zone). Over­all, the stud­ies in­volved more than 78,000 pa­tients. In the stud­ies that com­pared TZDs to a placebo, the risk of heart fail­ure was more than twice as high in those tak­ing the drugs. The au­thors es­ti­mate that one in ev­ery 50 di­a­betic pa­tients tak­ing TZDs over a 26-month pe­riod will de­velop heart fail­ure. Th­ese drugs al­ready carry warn­ings that they should not be used in pa­tients with more se­vere cases of heart fail­ure, or in com­bi­na­tion with in­sulin. But the au­thors sug­gest that the warn­ings should now in­clude pa­tients with­out any other risk fac­tors for heart fail­ure. Di­a­betesCare 2007;30:2148-2153 (Singh S, et al) EVEN low lev­els of air pol­lu­tion can boost the chances of an early death, ac­cord­ing to new re­search pub­lished on­line in Tho­rax . Re­searchers ex­am­ined long-term records of air qual­ity from dif­fer­ent re­gions across the UK. For each re­gion, they cal­cu­lated the av­er­age black smoke and sul­fur diox­ide lev­els each year be­tween 1966 and 1998, and com­pared this to na­tional data on causes of death. More than 5000 adults aged 30 and over were in­cluded in the study. There was a strong as­so­ci­a­tion be­tween black smoke and sul­phur diox­ide lev­els and ear­lier death, par­tic­u­larly from res­pi­ra­tory dis­ease. Pol­lu­tion lev­els dropped over the study pe­riod, but the in­creased risk of early death re­mained, even at the rel­a­tively low lev­els of air pol­lu­tion in re­cent times. In 1994-1998, the risk of an early death from res­pi­ra­tory dis­ease rose by 19 per cent for ev­ery 10 mi­cro­grams per cu­bic me­tre in­crease in black smoke, and by 22 per cent for ev­ery 10 parts per bil­lion in­crease in sul­phur diox­ide. Tho­rax 2007;doi:10.1136/thx.2006.076851 (El­liott P, et al) AN­TIBI­OTIC use in chil­dren is still high enough to cause re­sis­tance to th­ese drugs in the gen­eral com­mu­nity, claim re­searchers in the Bri­tishMed­i­calJour­nal this week, and they en­cour­age doc­tors to fur­ther re­duce an­tibi­otic pre­scrip­tions. Their study in­cluded 119 chil­dren at­tend­ing gen­eral prac­tices in Ox­ford­shire, UK, with a se­vere res­pi­ra­tory in­fec­tion. An an­tibi­otic called amox­i­cillin was given to 71 of the chil­dren, and 48 re­ceived no an­tibi­otics. Their med­i­cal in­for­ma­tion was recorded and throat swabs were taken at the start of the study and again at two and 12 weeks to mea­sure the lev­els of an­tibi­oti­cre­sis­tant bac­te­ria. In the chil­dren who did not re­ceive an an­tibi­otic, there was no in­crease over time in the pro­por­tion car­ry­ing re­sis­tant bac­te­ria. But in chil­dren who re­ceived amox­i­cillin, the pro­por­tion car­ry­ing re­sis­tant bac­te­ria more than dou­bled at the two-week fol­low-up. Al­though the ef­fect was tem­po­rary in the in­di­vid­ual chil­dren, the in­crease in re­sis­tant bac­te­ria may be enough to main­tain a high level of an­tibi­otic re­sis­tance in the pop­u­la­tion, warn the au­thors. BMJ 2007;doi:10.1136/bmj.39274.647465.BE (Chung A, et al) CHIL­DREN of sol­diers ex­pe­ri­ence more ne­glect and mal­treat­ment when their par­ent is de­ployed to a com­bat zone, claims a new re­port in the Jour­naloftheAmer­i­canMed­i­cal As­so­ci­a­tion . Parental stress is thought to play an im­por­tant role in child mal­treat­ment, which in­cludes ne­glect as well as phys­i­cal, emo­tional and sex­ual abuse. Pre­vi­ous stud­ies have shown an as­so­ci­a­tion be­tween com­bat-re­lated de­ploy­ment and in­creased stress for the par­ent left at home. Re­searchers stud­ied the im­pact of com­bat-re­lated de­ploy­ment be­tween Septem­ber 2001 and De­cem­ber 2004 on 1771 fam­i­lies of en­listed sol­diers in the US Army. Each of th­ese fam­i­lies had been in­volved in one or more sub­stan­ti­ated claims of child mal­treat­ment. Within this group, 1858 par­ents mal­treated their chil­dren. The rate of child mal­treat­ment dur­ing de­ploy­ments was 42 per cent higher than dur­ing times when the en­listed par­ent was at home. JAMA 2007;298:528-535 (Gibbs DA, et al) FI­BROIDS— non-can­cer­ous growths in the uterus that af­fect one in four women— can be ef­fec­tively treated us­ing a non-in­va­sive ul­tra­sound method, as de­scribed in the jour­nal Ob­stet­ric­sandG­y­ne­col­ogy this week. Fi­broids com­monly strike women dur­ing their re­pro­duc­tive years, with symp­toms in­clud­ing se­vere ab­dom­i­nal and leg pain, ex­ces­sive men­strual bleed­ing and ab­dom­i­nal bloat­ing. The new treat­ment approach, called mag­netic res­o­nance imag­ing guided fo­cused ul­tra­sound surgery, de­stroys the fi­broids by di­rect­ing high-en­ergy sound waves across the ab­dom­i­nal wall. The treat­ment was tested in 359 women aged in their mid-to-late 40s, with fol­low-up at six, 12 and 24 months af­ter treat­ment. Com­pared to be­fore treat­ment, symp­tom sever­ity was sig­nif­i­cantly less at 24 months. The more com­pletely the fi­broids were de­stroyed, the longer the symp­tom re­lief, and the in­ci­dence of se­vere side ef­fects was low. Ob­stetGynecol 2007;110:279-287 (Ste­wart EA, et al) Want to know more? Items are ref­er­enced where pos­si­ble. A ref­er­ence such as ‘‘ 2007;35:18-25’’ means the source ar­ti­cle was pub­lished on pages 18-25 in vol­ume num­ber 35 of the pub­li­ca­tion, in 2007. A doi num­ber or web­site ad­dress is used for re­search pub­lished on a jour­nal’s web­site.

War zone: Ac­tive ser­vice has a knock-on ef­fect within fam­i­lies

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