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Chronic pain medication can cause doctor-patient conflict

As the American health care system faces public scrutiny for alleged over-prescription of opioids and other drugs for chronic pain, a recent study conducted by University researchers examined the impact of chronic opioid use on patients and their relationships with their physicians.

Chronic pain — which the researchers defined as pain lasting for three months or longer — costs the United States as much as $635 billion annually “in medical treatment and lost productivity,” the authors wrote in the study.

While patients describe pain in general physiological terms, doctors see pain as the result of biological, social and psychological factors. Doctors expressed frustration at the “subjective” explanations that made it hard to separate real pain from less legitimate complaints.

Many of the 21 patients interviewed in the study said they felt reliant on their doctors to prescribe medication that curbs physical pain, and they feel they have a right to take opioids or other pain killers. But doctors said pain medications could lead to addiction and do not cure health problems. They recounted difficulties in canceling opioid prescriptions, as the patients would often resist.

The study shows the importance of balanced relationships between patients and physicians, and examines the ways in which chronic opioid use can strain them.

The study, conducted by Jeffrey Borkan, professor and chair of family medicine at the Alpert Medical School, and Angela Esquibel GS, was published online this week in the journal Pain.

Chemical research sheds light on drug-resistant bacteria

Though University researchers discovered a new class of molecules called ADEPs that can destroy many drug-resistant bacteria earlier this year, the molecules were less effective in destroying the species of bacteria that causes tuberculosis. New information about the structure of essential proteins in tuberculosis-causing bacteria has provided insights into why these molecules have not been as potent.

Drug-resistant bacteria are more prevalent than ever and pose a health risk because traditional antibiotics are not toxic to these species and fail to cure infections. A team of University researchers, led by Associate Professor of Chemistry Jason Sello, previously showed that ADEPs can kill bacteria that cause pneumonia, food poisoning and respiratory problems.

ADEPs attack bacteria by targeting a bacterial protein that normally disposes of cellular waste. The ADEPs induce this protein to indiscriminately degrade other proteins, including those essential for the bacteria to live, The Herald previously reported.

The new research, published in the journal Proceedings of the Natural Academy of Sciences, showed that half of the “garbage disposal” protein in tuberculosis-causing bacteria has a different structure than it does in other bacterial species. Only half of the ADEP-binding domains are present, which could be why the molecule is less effective against the species.

“We have already generated many new ideas about how the ADEP structure can be rationally modified to improve … binding and thus killing of M. tuberculosis,” Sello said in a University press release. “We are very optimistic that some of our designs could ultimately be a new class of drugs for the treatment of tuberculosis.”


Professor recognized for atmospheric research

The American Meteorological Society included Director of the University’s Institute for the Study of Environment and Society Amanda Lynch in the ranks of their fellows this year, recognizing her work in atmospheric and planetary research, according to a University press release.

“It is an honor indeed to be recognized by my fellow atmospheric and oceanic scientists in the American Meteorological Society,” Lynch said in the release. Less than 1 percent of AMS members reach the level of fellow, according to the release.

Lynch, who has published more than 100 peer-reviewed journal articles, is interested in climate change and meteorology in polar regions, according to her biography page on the University’s website. In addition to writing papers and book chapters, she serves as chief editor of the journal Weather, Climate and Society.

The AMS will formally recognize Lynch’s appointment at its annual meeting in January.


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