Stopping Epidemics At The Source: Applying Lessons From Cholera To The Opioid Crisis

On September 8, 1854, acting on the advice of Dr. John Snow, London municipal authorities removed the pump handle from the Broad Street well in an effort to halt a major outbreak of cholera. Although an anesthesiologist by profession, Snow had methodically mapped the homes of new cases of cholera. He found that many clustered around the Broad Street pump. Snow’s findings, still regarded as a classic example of epidemiology, established the principle: “that the most important information to have about any communicable disease is its mode of communication.” Dr. Snow did not establish the biologic mechanism of cholera or devise an effective treatment for those stricken with the disease; instead, his research indicated that the disease was transmitted through contaminated water. His methods demonstrated how the root cause of an emerging public health problem could be determined through epidemiological observation. It was later determined that a cholera-contaminated diaper had been washed near the pump. We Need to Change How We Manage Pain Today, our nation faces a different kind of epidemic — a rising toll of hospitalizations and deaths from opioid abuse. The Department of Defense (DoD) and Veterans Health Administration (VA) have been aware of problems with excessive use of opioids in patient management for more than a decade. This recognition, in part, was driven by the last 17 years of armed conflict and the health care challenges this has wrought on in...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Featured Public Health Quality Department of Veterans Affairs military health care Opioid Addiction opioid epidemic Source Type: blogs

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In conclusion, the authors underline that ECD was diagnosed at a second diagnostic attempt both clinically and by specific staining pathology specimens. PMID: 30006650 [PubMed - as supplied by publisher]
Source: Hellenic Journal of Nuclear Medicine - Category: Nuclear Medicine Tags: Hell J Nucl Med Source Type: research
Conclusions: Soldiers returning from deployment were more likely to receive an opioid prescription than the overall active duty population, and 1.1% initiated a long-term opioid episode. We report a declining rate of opioid receipt and long-term opioid utilization among Army members from fiscal years 2008-2014. This study demonstrates that the most important predictors of opioid receipt were not demographic factors, but generally clinical indicators of acute pain or physical trauma. PMID: 30007291 [PubMed - as supplied by publisher]
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research
This study aimed to investigate the efficacy and safety of drug eluting beads transarterial chemoembolization (DEB-TACE) treatment in Barcelona Clinic Liver Cancer (BCLC) stage C liver cancer patients. In 39 patients with BCLC stage C liver cancer, after the first cycle of DEB-TACE, 2 (5.1%) and 24 (61.5%) patients achieved complete response (CR) and partial response (PR) to give an overall objective response rate (ORR) of 66.7%. With respect to the second cycle of therapy, the ORR was higher in patients receiving DEB-TACE compared with cTACE (57.1% vs 11.1%). Post first cycle of DEB-TACE treatment, the percentages of abno...
Source: Oncology Research - Category: Cancer & Oncology Tags: Oncol Res Source Type: research
CONCLUSIONS: First pass intubation success rates were similar for the King Vision and the Macintosh (96.6% vs. 94.3%, respectively, p>0.05). King Vision resulted in a longer average time to glottic view (95% CI 0.5-1.4s, p
Source: Revista Brasileira de Anestesiologia - Category: Anesthesiology Tags: Rev Bras Anestesiol Source Type: research
Authors: Mabweazara SZ, Ley C, Leach LL Abstract Physical activity can be used for the effective and comprehensive management of HIV and AIDS. Social support and socio-economic status (SES) are two factors that shape physical activity behaviours. Individuals of low SES carry a disproportionate burden of the HIV and AIDS epidemic. In addition, limited resources constitute socio-ecological barriers predisposing such individuals to physical inactivity. The purpose of this narrative review is to examine the available literature on physical activity, social support and SES and to generate recommendations for designing a...
Source: African Journal of AIDS Research - Category: African Health Tags: Afr J AIDS Res Source Type: research
CONCLUSIONS: The perioperative period may be an important opportunity to identify undiagnosed hypertensive patients. The perioperative encounter may have a significant public health implication in facilitating appropriate referral and treatment of patients with hypertension to decrease long-term cardiovascular complications in SA. PMID: 30004348 [PubMed - in process]
Source: South African Medical Journal - Category: African Health Tags: S Afr Med J Source Type: research
We report a South African series of 5 patients who presented with trichobezoars. Each patient was retrospectively reviewed and analysed with regard to background, demographics, clinical presentation, diagnosis, surgical management and complications. Five female patients with a median age of 19 (range 12 - 27) years presented with clinical symptoms, including early satiety, intermittent vomiting with gastric outlet obstruction, abdominal pain and weight loss. The diagnosis was made by endoscopy, abdominal computed tomography (CT) imaging, barium meal examination or plain abdominal radiography. Two patients presented with se...
Source: South African Medical Journal - Category: African Health Tags: S Afr Med J Source Type: research
CONCLUSIONS: The procedure was easily mastered and technically simple, and represents savings in cost, time and human resources in our setting. PMID: 30004332 [PubMed - in process]
Source: South African Medical Journal - Category: African Health Tags: S Afr Med J Source Type: research
Authors: Chersich MF, Scorgie F, Rees H, Wright CY PMID: 30004323 [PubMed - in process]
Source: South African Medical Journal - Category: African Health Tags: S Afr Med J Source Type: research
“Summer lovin’ had me a blast. Summer lovin’ happened so fast”. — lyrics from “Summer Nights” in Grease. It’s a delicious fantasy, isn’t it? — falling in love while on vacation or on the summer job at the beach. Movies like Grease and Dirty Dancing make it seem so perfect, so possible, so without consequences so, I don’t know, so, so steamy and dreamy. When people think about having a “summer romance”, they are usually thinking about a fling, not a serious relationship. By definition, a summer romance is intended to last for only the summer. Oft...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Communication Marriage and Divorce Men's Issues Relationships Self-Help Sexuality Women's Issues Source Type: blogs
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