Myelofibrosis (MF), polycythemia vera (PV) and essential thrombocythemia (ET) are three classic BCR ABL fusion gene-negative chronic myeloproliferative neoplasms (MPNs). Though rare, it is important to understand the burden of illness of these disorders for public health planning, healthcare insurers and pharmaceutical manufacturers. Therefore, we have described the incidence of MF and prevalence of MF, ET and PV in the United States between 2008 and 2010 based on data from two large health plans. The incidence of primary MF was about 1 per 100 000 per year and did not vary over the study years. The prevalence of PV (44-57 per 100 000) and ET (38-57 per 100 000) was much higher than that of MF (4-6 per 100 000) or subgroups containing MF (post-PV MF = 0.3-0.7 per 100 000; post-ET MF = 0.5-1.1 per 100 000). Additional research using other national databases and/or study designs is needed to substantiate these findings.

Poor medication adherence is associated with a significantly increased risk of fracture versus optimal adherence. Improving medication adherence in patients with osteoporosis may lead to a greater reduction in fracture.

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Respiratory depression is common in patients recovering from surgery and anaesthesia. Failure to recognise and lack of timely institution of intervention can lead to catastrophic cardiorespiratory arrest, anoxic brain injury, and mortality. Opioid-induced respiratory depression (OIRD) is a common and often under-diagnosed cause of postoperative respiratory depression. Other causes include residual anaesthesia, residual muscle paralysis, concurrent use of other sedatives, splinting from inadequate pain control, and obstructive sleep apnoea. Currently used methods to identify and monitor respiratory safety events in the post-surgical setting have serious limitations leading to lack of universal adoption. New tools and technologies currently under development are expected to improve the prediction of respiratory depression especially in patients requiring opioids to alleviate acute postoperative pain. In this narrative review, we discuss the various causes of postoperative respiratory depression, and highlight the advances in monitoring and early recognition of patients who develop this condition with an emphasis on OIRD.