Fool's gold: legalized gambling.
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Biomedical subjects
Publications and source records attributed to H N Blansfield.
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Osteoporosis may be a significant factor in unfavorable results following open cardiac surgery. This brief case report describes the fatal outcome of mitral valve replacement in an elderly woman with congestive heart failure complicated by severe osteoporosis. Profound collapse of the thoracic spine resulted in pulmonary insufficiency. The discussion includes substantiation that this phenomenon is not unusual but rather can be expected to occur in postmenopausal women who are inactive, not receiving calcium and vitamin D supplements, and are suffering from congestive heart failure for which loop diuretics are administered. Bone mineral density testing is essential to determine and track the efficacy of treatment.
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It is necessary that society accept the medical, neurological basis of compulsive drug/alcohol use in order for it to get on with finding and using pragmatic approaches to treatment, rather than punishment, as the rational way to deal with these issues. The increased availability of oral methadone must be promoted, not only because it eliminates the need for drug injection, but because it allows the opioid dependent to lead comfortable and functional lives. The emphasis on punishment and incarceration for illicit-drug users or purveyors must give way to alternatives bent on treatment and rehabilitation. More states should follow the example of Connecticut in dealing wisely with drug/AIDS issues.
The attitudes and beliefs held by society, including health professionals, are detrimental to the health and welfare of the chemically dependent. Dependency on psychoactive agents bears the hallmarks of a bona fide neurological illness due to alterations in neurons affected by exogenous neuroactive agents. Emphasis on abstinence as the only acceptable goal of treatment may be harmful to those incapable of attaining a drug-free state. Other alternatives for treatment must be offered without stigmatization and bias against the drug dependent. Methadone treatment for opioid dependence needs to be promoted and liberalized, especially because the oral route of administration eliminates the risks accompanying drug injection. Patients receiving methadone must be retained in treatment rather than terminated for rules infractions that are not harmful to others. This is an urgent matter in light of the current HIV epidemic among drug injectors.
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