72 results
Search Results
2. Multimodal treatment for smoking cessation with varenicline in alcoholic, methadone-maintained, and psychotic patients: A one-year follow-up
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Raich, Antònia, Pinet, Cristina, Ballbè i Gibernau, Montse, Mondon, Silvia, Tejedor, Rosa, Arnau, Anna, Fernández Muñoz, Esteve, Tobacco Group of the Catalan Network for Addiction, and Universitat de Barcelona
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Methadone maintenance ,Pediatrics ,medicine.medical_specialty ,Health (social science) ,medicine.medical_treatment ,media_common.quotation_subject ,Population ,multimodal treatment ,Medicine (miscellaneous) ,Smoking cessation ,Mentally ill ,lcsh:RC254-282 ,addicted patients ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Alcohòlics ,Tractament del tabaquisme ,medicine ,Addictes ,030212 general & internal medicine ,Alcoholics ,Varenicline ,education ,media_common ,lcsh:RC705-779 ,education.field_of_study ,business.industry ,Addiction ,Public Health, Environmental and Occupational Health ,lcsh:Diseases of the respiratory system ,Abstinence ,psychotic ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,030227 psychiatry ,Addicts ,varenicline ,chemistry ,Malalts mentals ,business ,Methadone ,medicine.drug ,Psychopathology ,Research Paper - Abstract
Introduction: Numerous studies have evaluated the efficacy and safety of varenicline for smoking cessation in smokers in the general population and, to a lesser extent, among the psychiatric population. However, few studies have evaluated varenicline in patients with other addictions. The present study was conducted to assess outcomes of a multimodal treatment for smoking cessation intervention with varenicline in a sample of alcohol and substance use disorders and patients with psychotic disorders. Methods: This was a prospective, multicenter study. The patient sample comprised alcoholics in remission, methadone-maintained patients, and patients with psychotic disorders, all of whom wanted to stop smoking. All participants received multimodal treatment for smoking cessation therapy (psychological therapy plus varenicline). Smoking abstinence and changes in the psychopathological state of patients were assessed at predefined time points during a 12-month follow-up. The probability of tobacco abstinence after one year of treatment was computed using Kaplan-Meier life tables. Results: The probability of abstinence at one year was 0.225 (95% CI: 0.143- 0.319). By group, the probabilities were as follows: patients with psychotic disorders 0.254 (95% CI: 0.118-0.415); alcoholics 0.237 (95% CI: 0.098- 0.409); and methadone-maintained patients 0.177 (95% CI: 0.065-0.335). Patients with previous quit attempts had a higher probability of achieving abstinence at one year (p
- Published
- 2018
3. Social Capital Role in Managing High Risk Behavior: a Narrative Review
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Zeinab Hamzeghardeshi, Zohreh Shahhosseini, and Mansoure Afzali
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narrative review ,Professional Paper ,HIV ,Social environment ,social support ,Social learning ,Social engagement ,Social relation ,AIDS ,Social group ,addicts ,high risk behaviors ,Social transformation ,Political science ,social capital ,Social position ,Social competence ,Social psychology - Abstract
BACKGROUND: Social capital as a social context based concept is a new component in addition to the previous factors including the biologic-environmental, the genetic and the individual behavior factors that influence health and society. Social capital refers to the information that makes people believe being interesting & being paid attention to, & respected, valued, and belonging to a network of bilateral relations. Health issue is greatly affected by the existence of social capital. High risk behaviors refer to the ones enhancing the probability of negative and devastating physical, psychological and social consequences for an individual. Negative & overwhelming results mean keeping one's distance from social norms as a result rejection and labeling (social stigma) and finally, to distance oneself from the benefits of social life in the individuals with high risk behaviors. The present study reviews social capital in the groups having high risk behaviors. METHODS: The present study is a narrative review in which researchers conducted their computer search in public databases like Google Scholar, and more specifically in Pubmed, Magiran, SID, Springer, Science Direct, and ProQuest using the keywords: social capital, social support, risk behaviors, addicts, HIV, AIDS, and selected the articles related to the study subject from 2004 to 2014. Overall 96 articles have been searched. Researchers reviewed the summary of all articles searched, & ultimately, they applied the data from 20 full articles to compile this review paper. RESULTS: Article review results led to organizing the subjects into 6 general categories: Social capital and its role in health; Social capital in groups with high risk behaviors (Including: substance abusers, AIDS patients, the homeless and multi-partner women); Social capital in different social groups; measurement tools for social capital and risk behaviors; the role of health in helping people with risky behaviors with the focus on improving social capital and social support. The findings of this study indicate that social capital was significantly lower in the substance abusers than the non-addicts. Also, social participation, social trust and networks of social relationships were significantly lower than non-drug abusers. Social capital has interactive effects on risky behaviors and delinquency. On the one hand, high levels of social capital can be involved in preventing delinquency. On the other hand, creating negative social capital in high risk groups is also considered as the damaging effects of the negative aspects of social capital in these groups. CONCLUSIONS: From this review extracted findings, it can be concluded that to design risky behaviors programs and preventive interventions, social capital and social support should be considered more than before. To accept an addict or HIV sufferer is effective in reducing their psychological reactions. So with effective social interaction and social support, these people can improve their risky lifestyles. As a result, these changes are associated with higher levels of satisfaction with their lives. Finally, it is recommended to design and implement counseling programs in order to educate health-promoting behaviors in high risk groups focusing on social capital and social support. Language: en
- Published
- 2015
4. The Role of Social Phobia Disorder among Cigarette Addicts in Abstaining from Cessation Programs.
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Abd Aldaim, Anees M. Khalifa and Mohd Noor, Suliman Shkib Bin
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SMOKING statistics ,SOCIAL phobia ,SMOKING cessation ,CIGARETTES ,LOGISTIC regression analysis ,COGNITIVE structures - Abstract
The increasing reluctance of cessation programs by cigarette smoking addicts with social disorder necessitates a smoking curb strategy. This paper aims to investigate the reason for the reluctance of cigarette addicts with social phobia disorder to quit cessation programs by comparing affected and uninfected smokers, and verifies that negative thoughts, pain, and stress contribute to refraining from these programs. The quantitative method was followed, and the sample of participants consisted of 191 current smokers, and their ages ranged between 18-45 years, with an average of 22.7, and those with social phobia were diagnosed with the current smokers, whose numbers are 111, or 58.12%, and as for the non-infected, their numbers are 80 current smokers or 41.88%, and for the purpose of verifying the goal of the study, the cigarette smoking addiction scale, the cessation program reluctance scale, and the Rollin Wei scale of social phobia were used, t-test for comparison between independent groups, and using a logistic regression coefficient to determine the relative contribution and effect size. Test results indicated t-test to the outweighing of people infected over people with no social phobia disorder in the level of cigarette smoking addiction and its sub-dimensions, as the results of the logistic regression analysis showed in terms of standard ß value an increase in negative thoughts and expectation of pain is accompanied by an increase in reluctance to quit the cessation programs with a standard degree not exceeding 42%, while an increase in the psychological stress variable is accompanied by a reluctance to quit the cessation programs with a standard degree not exceeding 25%. The results indicate that one of the most important barriers to quitting smoking for people with social phobia is embodied in negative thoughts and stress, and thus it may be a source of changing the strategy of quitting the cessation programs by focusing on changing the distorted cognitive structure and promoting a positive self-concept as part of quit interventions. [ABSTRACT FROM AUTHOR]
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- 2021
5. Measuring Impatience in Intertemporal Choice.
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Cruz Rambaud, Salvador and Muñoz Torrecillas, María José
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INTERTEMPORAL choice ,PATIENCE ,DISCOUNT prices ,COGNITION ,COMPARATIVE studies - Abstract
In general terms, decreasing impatience means decreasing discount rates. This property has been usually referred to as hyperbolic discounting, although there are other discount functions which also exhibit decreasing discount rates. This paper focuses on the measurement of the impatience associated with a discount function with the aim of establishing a methodology to compare this characteristic for two different discount functions. In this way, first we define the patience associated with a discount function in an interval as its corresponding discount factor and consequently we deduce that the impatience at a given moment is the corresponding instantaneous discount rate. Second we compare the degree of impatience of discount functions belonging to the same or different families, by considering the cases in which the functions do or do not intersect. [ABSTRACT FROM AUTHOR]
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- 2016
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6. Examining the relation of personality factors to substance use disorder by explanatory item response modeling of DSM-5 symptoms.
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Chen, Fu, Yang, Hongmei, Bulut, Okan, Cui, Ying, and Xin, Tao
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SUBSTANCE-induced disorders ,SENSATION seeking ,PERSONALITY ,ALCOHOL drinking ,DRUG abuse - Abstract
This paper explores how personality factors affect substance use disorders (SUDs) using explanatory item response modeling (EIRM). A total of 606 Chinese illicit drug users participated in our study. After removing the cases with missing values on the covariate measures, a final sample of 573 participants was used for data analysis. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was used to measure the illicit drug users’ SUD level. Four personality factors–anxiety sensitivity, impulsivity, sensation seeking and hopelessness–along with gender and alcohol use were included in EIRM as person covariates. The results indicated that gender, alcohol use, and their interaction significantly predicted the SUD level. The only personality factor that strongly predicted the SUD level was sensation seeking. In addition, the interaction between gender and hopelessness was also found to be a significant predictor of the SUD level, indicating that the negative effect of hopelessness on SUD is stronger for women than for men. The findings suggest that sensation seeking plays an important role in influencing SUDs, and thus, it should be considered when designing intervention or screening procedures for potential illicit drug users. In addition, several DSM-5 SUD symptoms were found to exhibit differential effects by gender, alcohol use, and personality factors. The possible explanations were discussed. [ABSTRACT FROM AUTHOR]
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- 2019
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7. Assessing the health risks of consuming ‘sachet’ alcohol in Acoli, Uganda.
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Otim, Ochan, Juma, Tom, and Otunnu, Olara
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ACHOLI (African people) ,ALCOHOL drinking ,MORTALITY ,HEALTH risk assessment - Abstract
The increased mortality rate among the Acoli people of northern Uganda is anecdotally blamed on excessive consumption of cheap and widely available sachet-packaged alcohol in the region. In this paper, we quantify this perceived association by determining statistically the health risks associated with ingesting 20 heavy metals in 17 popular spirits products consumed in Acoli. Thirteen of these products were industrially packaged in sachets (locally known as ‘sachet,’ waragi, arege or moo lyec) and four were locally produced Lira-Lira spirits from Bolo, Awere and Teso Bar in the region and Nsambya in southern Uganda. A Scottish whisky purchased in San Diego (USA) was our reference. Risk assessment was performed according to standardized protocols developed by the United States Environmental Protection Agency (US EPA). Our results show that a strong correlation indeed exists between health risks and ingestion of spirits in Acoli. At >2.5 sachets/day for 240 day/year over a lifetime for example, the risk of developing cancer due to exposure to As, Pb and Cr alone is 1 in 102,041. This estimate excludes ethanol, a known carcinogen, and 17 heavy metals also studied due to lack of their cancer slope factors. The primary non-cancer related health risk factor in all samples tested is ethanol with unacceptably high health index of four. The Lira-Lira spirits, with 100–6000% copper above the US EPA limit for intake by oral ingestion in water, would be the ‘cleanest’ without copper and at par with the Scottish whisky. Collectively, we find that no amount of alcohol consumed in Acoli is safe. Preventive measures are therefore recommended to reduce mortality in Acoli in particular, and in Uganda in general. These measures should include public education, better public policies, creating productive economic activities other than brewing alcohol, and social activities that engage people away from drinking. [ABSTRACT FROM AUTHOR]
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- 2019
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8. Variability and validity of intimate partner violence reporting by couples in Tanzania.
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Halim, Nafisa, Steven, Ester, Reich, Naomi, Badi, Lilian, and Messersmith, Lisa
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INTIMATE partner violence ,HUMAN rights ,PREGNANCY ,CRIME victims ,SELF-evaluation - Abstract
In recent years, major global institutions have amplified their efforts to address intimate partner violence (IPV) against women—a global health and human rights violation affecting 15–71% of reproductive aged women over their lifetimes. Still, some scholars remain concerned about the validity of instruments used for IPV assessment in population-based studies. In this paper, we conducted two validation analyses using novel data from 450 women-men dyads across nine villages in Northern Tanzania. , we examined the level of inter-partner agreement in reporting of men’s physical, sexual, emotional and economic IPV against women in the last three and twelve months prior to the survey, ever in the relationship, and during pregnancy. , we conducted a convergent validity analysis to compare the relative efficacy of men’s self-reports of perpetration and women’s of victimization as a valid indicator of IPV against Tanzanian women using logistic regression models with village-level clustered errors. We found that, for every violence type across the recall periods of the last three months, the last twelve months and ever in the relationship, at least one in three couples disagreed about IPV occurrences in the relationship. Couples’ agreement about physical, sexual and economic IPV during pregnancy was high with 86–93% of couples reporting concordantly. Also, men’s self-reported perpetration had statistically significant associations with at least as many validated risk factors as had women’s self-reported victimization. This finding suggests that men’s self-reports are at least as valid as women’s as an indicator of IPV against women in Northern Tanzania. We recommend more validation studies are conducted in low-income countries, and that data on relationship factors affecting IPV reports and reporting are made available along with data on IPV occurrences. Keywords: Intimate partner violence; measurement; validity; survey research; Tanzania. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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9. Attitudes towards bystander cardiopulmonary resuscitation: Results from a cross-sectional general population survey.
- Author
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Dobbie, Fiona, MacKintosh, Anne Marie, Clegg, Gareth, Stirzaker, Rebecca, and Bauld, Linda
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BYSTANDER CPR ,PUBLIC health surveillance ,MULTIVARIATE analysis ,CROSS-sectional method ,SURVIVAL - Abstract
Survival from out-of-hospital cardiac arrest (OHCA) varies across the developed world. Although not all OHCA are recoverable, the survival rate in Scotland is lower than in comparable countries, with higher average survival rates of 7.9% in England and 9% across Europe. The purpose of this paper is to explore the barriers, facilitators and public attitudes to administering bystander cardiopulmonary resuscitation (CPR) which could inform future policy and initiatives to improve the rate of bystander CPR. Data was collected via a cross-sectional general population survey of 1027 adults in Scotland. 52% of respondents had been trained in CPR. Of those who were not trained, two fifths (42%) expressed a willingness to receive CPR training. Fewer than half (49%) felt confident administering CPR, rising to 82% if they were talked through it by a call handler. Multivariate analyses identified that people in social grade C2DE were less likely than those in social grade ABC1 to be CPR trained and less confident to administer CPR if talked through by a call handler. The older a person was, the less likely they were to be CPR trained, show willingness to be CPR trained or be confident to administer bystander CPR with or without instruction from an emergency call handler. These findings are particularly relevant considering that most OHCA happen in the homes of older people. In a developed country such as Scotland with widely available CPR training, only half of the adult population reported feeling confident about administering bystander CPR. Further efforts tailored specifically for people who are older, unemployed and have a lower social grade are required to increase knowledge, confidence and uptake of training in bystander CPR. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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10. The societal cost of heroin use disorder in the United States.
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Jiang, Ruixuan, Lee, Inyoung, Lee, Todd A., and Pickard, A. Simon
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TREATMENT of heroin abuse ,DRUG abuse ,MEDICAL care costs ,DRUG abstinence ,DRUG overdose - Abstract
Objective: Heroin use in the United States has reached epidemic proportions. The objective of this paper is to estimate the annual societal cost of heroin use disorder in the United States in 2015 US dollars. Methods: An analytic model was created that included incarceration and crime; treatment for heroin use disorder; chronic infectious diseases (HIV, Hepatitis B, Hepatitis C, and Tuberculosis) and their treatments; treatment of neonatal abstinence syndrome; lost productivity; and death by heroin overdose. Results: Using literature-based estimates to populate the model, the cost of heroin use disorder was estimated to be $51.2 billion in 2015 US dollars ($50,799 per heroin user). One-way sensitivity analyses showed that overall cost estimates were sensitive to the number of heroin users, cost of HCV treatment, and cost of incarcerating heroin users. Conclusion: The annual cost of heroin use disorder to society in the United States emphasizes the need for sustained investment in healthcare and non-healthcare related strategies that reduce the likelihood of abuse and provide care and support for users to overcome the disorder. [ABSTRACT FROM AUTHOR]
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- 2017
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11. The factors affecting substance abuse relapse based on theory of planned behavior in male addicts covered by addiction treatment centers in Southern Iran
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Sohrabpour, Mojtaba, Kamyab, Amirhossein, Yari, Asiyeh, Harsini, Pooyan Afzali, and Khani Jeihooni, Ali
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- 2024
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12. Optimal management of infected femoral pseudo aneurysm in drug addicts presenting to Benazir Bhutto Hospital, Rawalpindi.
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Siddique, Sehrish, Anwar, Muhammad Haroon, Khan, Tayyab Mumtaz, and Zia, Naeem
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PEOPLE with drug addiction ,ANEURYSMS ,FEMORAL artery ,SURGICAL emergencies ,SURGICAL excision - Abstract
Objective: To compare the outcomes of excision of pseudo aneurysm along with ligation and local debridement with the outcomes of excision of pseudo aneurysm along with ligation and revascularization in the management of infected femoral pseudo aneurysm among drug addicts. Study Design: Retrospective Analytic study. Setting: Surgical Unit-1, Benazir Bhutto Hospital, Rawalpindi. Period: July 2010 to July 2019. Material & Method: Among patients presented with pseudo aneurysm in Surgical Emergency and out patients department. Data was collected through medical record of the hospital. P-value less than 0.05 was set statistically significant. Results: Mean age and duration of addiction for study population were 36.50 years with SD of ±6 years and 2.80 years with SD of ±0.90 years respectively. All enrolled participants were males (100%). Heroine (76%) was the most common used by addicts while other drugs included benzodiazepine (12%), amphetamine (8%), and cocaine (4%). Left sided femoral artery (70%) was more involved in pseudo aneurysm as compare to right sided femoral artery (30%). Post operative adverse events percentage for ligation without revascularization was 22.72%, whereas, it was 100% for ligation with revascularization. Mortality was 0% for excision with ligation and local debridement while it was 50% for excision with ligation and revascularization. Conclusion: For the optimal management of infected femoral pseudo aneurysm, excision with ligation and local debridement is effective in comparison to excision with ligation and revascularization among addicts. [ABSTRACT FROM AUTHOR]
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- 2022
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13. Effects of opium inhalation on physical and biochemical parameters of stray dogs in Kabul city, Afghanistan.
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Tawfeeq, Mohammad Monir, Hamid, Asadullah, Zabuli, Jahid, Hashimi, Sayed Abdul Jalil, Formuli, Mohammad Khalid, Rahmati, Shahpoor, and Darmal, Mohammad Bayer
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FERAL dogs ,OPIUM ,PUBLIC spaces ,PEOPLE with drug addiction ,DOGS ,CONJUNCTIVA - Abstract
Background: Afghanistan is one of the biggest opium-producing countries in the world. There are more than a million drug addicts in the country, and most of them are living in public places. Stray dogs who live with drug addicts are at the highest risk of inhaling drugs Aim: The aim of this study is to evaluate changes in physical and biochemical parameters of stray dogs inhaling drugs. Methods: A total of 12 dogs were assigned into two groups healthy and infected (stray dogs who inhale drugs) dogs. The physical and biochemical parameters of both groups were evaluated. Results: Subjective evaluation showed clinical changes such as congestion of conjunctiva in the infected group. Biochemical examination showed a significantly higher level of glucose (p < 0.05) and total protein (TP) (p < 0.01) in the infected group compared to the healthy group. The ratio of other biochemical parameters was slightly decreased as compared to healthy dogs. Conclusion: Drug inhalation can alter biochemical parameters like glucose and TP in dogs. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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14. The Comparation of Institutional Drug Treatment Programs in Europe and North America
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Šaško, Lucija, Novak, Tihana, Jandrić Nišević, Anita, and Doležal, Dalibor
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institutional programs ,rehabilitation of prisoners ,addicts ,therapeutic communities ,drug treatment in prison ,penal institutions - Abstract
se može svrstati i ovisnost o drogama. Dostupni podaci upućuju na veliki broj ovisnika u europskim i američkim zatvorima zbog čega se velika pozornost u rehabilitaciji zatvorenika pridaje upravo programima tretmana ovisnika. Cilj je ovog diplomskog rada opisati institucionalne programe tretmana ovisnika u Europi i Sjevernoj Americi te ih usporediti sukladno opisima i dokazima učinkovitosti proizašlima iz evaluacija i meta-analiza učinkovitosti. Psihosocijalne intervencije za ovisnike u penalnim institucijama obuhvaćaju terapijske zajednice, kognitivno-bihevioralni tretman, programe 12 koraka i motivacijski intervju. Zbog širokog spektra intervencija, većina opisanih programa i studija učinkovitosti usmjerena je na programe koji koriste pristupe terapijskih zajednica. Od europskih programa u radu su opisani P-ASRO program, RAPt program, programi u Danskoj i Finskoj te hrvatski program PORTOs. Što se tiče američkih programa, predstavljeni su KEY/CREST program, Lifestyle Change Program, Amity In-Prison Therapeutic Community i Changing Course. Nadalje, u radu je opisano nekoliko evaluacija i meta-analiza učinkovitosti programa za ovisnike u penalnim institucijama prikazom podataka o njihovim karakteristikama, metodologiji, rezultatima i ograničenjima. Autorica rada ističe izazovnost usporedbe institucionalnih programa tretmana ovisnika u Europi i Sjevernoj Americi te naglašava da rezultati usporedbe nisu relevantni već proizlaze iz dostupnih i, temeljem opisanih kriterija, odabranih studija. Temeljem usporedbe, izdvojene su neke od sličnosti programa kao što je utemeljenost na kognitivno-bihevioralnim principima iz kojih proizlaze specifični ciljevi, dobrovoljan pristanak zatvorenika i aktivno sudjelovanje u programima te provođenje programa od strane educiranih stručnjaka. Na kraju, istaknute su i neke specifičnosti europskih programa u odnosu na američke programe kao što su varijacije u samom konceptu programa, neodvojenost ovisnika od ostalih zatvorenika u penalnoj instituciji te testiranje urina korisnika programa. Zaključno, ističe se napor država da adekvatno odgovore na tretmanske potrebe ovisnika u penalnim institucijama, kao i potreba za češćim provođenjem i objavljivanjem evaluacija programa kako bi se poboljšala njihova učinkovitost u smanjenju kriminalnog povrata., The prisoner population faces a number of physical and mental health problems, including drug addiction. The available data point to a large number of addicts in European and American prisons, which is why great attention in the rehabilitation of prisoners is paid to the drug treatment programs. The aim of this thesis is to describe the institutional treatment programs for addicts in Europe and North America and compare them in accordance with the descriptions and evidence of efficacy derived from evaluations and meta-analyzes of efficacy. Psychosocial interventions for addicts in penal institutions include therapeutic communities, cognitive-behavioral treatment, 12-step programs, and a motivational interview. Due to the wide range of interventions, most of the described programs and efficacy studies are focused on programs that use therapeutic community approaches. Among the European programs, the paper describes the P-ASRO program, the RAPt program, programs in Denmark and Finland, and the Croatian PORTOs program. As for U.S. programs, the KEY / CREST program, the Lifestyle Change Program, the Amity Prisoner Therapy Community, and Changing Course program were presented. Furthermore, the paper describes several evaluations and meta-analyzes of the effectiveness of programs for addicts in penitentiary institutions presented with data on their characteristics, methodologies, results, and limitations. The author emphasizes the challenge of comparing institutional treatment programs for addicts in Europe and North America and emphasizes that the results of the comparison are not relevant but arise from available and, based on the described criteria, selected studies. Based on the comparison, some of the similarities of the program were highlighted, such as being based on cognitive-behavioral principles from which specific goals derive, voluntary consent of prisoners and active participation in programs, and program implementation by trained professionals. Finally, some specifics of European programs in relation to American programs were highlighted, such as variations in the very concept of the program, the separation of addicts from other prisoners in the penal institution, and urine testing of program users. In conclusion, the effort of states to adequately respond to the treatment needs of addicts in penal institutions, as well as the need for more frequent implementation and publication of program evaluations to improve their effectiveness in reducing criminal recidivism, is highlighted.
- Published
- 2020
15. Substitution of marijuana for opioids in a national survey of US adults.
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Ishida, Julie H., Wong, Peggy O., Cohen, Beth E., Vali, Marzieh, Steigerwald, Stacey, and Keyhani, Salomeh
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MEDICAL laws ,MARIJUANA ,INTERNET surveys ,DRUG abuse ,ADULTS - Abstract
Opioid prescriptions for chronic pain and subsequent opioid-related complications have risen dramatically in the US. Recent data suggest that medical marijuana laws have been associated with lower state-level opioid overdose mortality. In a national survey, we examined the prevalence of substitution of marijuana for opioids among US adults taking opioids for pain.Using GfK’s KnowledgePanel, we conducted an Internet-based survey of a nationally representative sample of 16,280 adults in 2017 about individual perceptions and use of marijuana. We developed questions designed to assess the extent and reasons for substitution of marijuana for opioids. We examined opioid substitution among respondents with a history of ever using marijuana who used opioids in the past 12 months. There were 9,003 respondents, corresponding to a 55.3% response rate. The mean age was 48 years. Among the 5% (n = 486) who reported ever using marijuana and using opioids in the past year, 43% used opioids daily, and 23% reported current (past 30 day) marijuana use. Forty-one percent reported a decrease or cessation of opioid use due to marijuana use; 46% reported no change in opioid use; and 8% reported an increase in opioid use. We found that a substantial number of US adults reported that they substituted marijuana for opioids. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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16. Use of rapid Model for End-Stage Liver Disease (MELD) increases for liver transplant registrant prioritization after MELD-Na and Share 35, an evaluation using data from the United Network for Organ Sharing.
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Brock, Guy N., Washburn, Kenneth, and Marvin, Michael R.
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LIVER transplantation ,LIVER diseases ,PROPORTIONAL hazards models ,HEPATOCELLULAR carcinoma ,PATIENT dropouts - Abstract
The Model for End-Stage Liver Disease (MELD) score has been successfully used to prioritize patients on the United States liver transplant waiting list since its adoption in 2002. The United Network for Organ Sharing (UNOS)/Organ Procurement Transplantation Network (OPTN) allocation policy has evolved over the years, and notable recent changes include Share 35, inclusion of serum sodium in the MELD score, and a ‘delay and cap’ policy for hepatocellular carcinoma (HCC) patients. We explored the potential of a registrant’s change in 30-day MELD scores (ΔMELD
30 ) to improve allocation both before and after these policy changes. Current MELD and ΔMELD30 were evaluated using cause-specific hazards models for waitlist dropout based on US liver transplant registrants added to the waitlist between 06/30/2003 and 6/30/2013. Two composite scores were constructed and then evaluated on UNOS data spanning the current policy era (01/02/2016 to 09/07/2018). Predictive accuracy was evaluated using the C-index for model discrimination and by comparing observed and predicted waitlist dropout probabilities for model calibration. After the change to MELD-Na, increased dropout associated with ΔMELD30 jumps is no longer evident at MELD scores below 30. However, the adoption of Share 35 has potentially resulted in discrepancies in waitlist dropout for patients with sharp MELD increases at higher MELD scores. Use of the ΔMELD30 to add additional points or serve as a potential tiebreaker for patients with rapid deterioration may extend the benefit of Share 35 to better include those in most critical need. [ABSTRACT FROM AUTHOR]- Published
- 2019
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17. Satisfaction with life in a group of alcohol and drug addicts. The role of personal resources and health behaviors.
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Konaszewski, Karol and Muszyńska, Jolanta
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LIFE ,PEOPLE with drug addiction ,HEALTH behavior ,ATTRIBUTION (Social psychology) ,RESEARCH - Abstract
The article presents the results of research aimed at determining the role of personality resources and health behaviors as factors determining life satisfaction among alcohol and drug addicts. In the article, we present a holistic model of predictors that takes into account resilience, communality, causality, health behaviors and life satisfaction. Its suitability has been tested through the analysis of a number of variables that have so far been examined separately: resilience, communality, causality and health behaviors as explanatory variables and satisfaction of life as a variable to be explained. We assumed that causative and communal orientation, resilience and health behaviors as personal resources can be considered as factors influencing life satisfaction and, in consequence, the course of addiction therapy. Our research reveals that personal resources are determinants of life satisfaction, which can make a significant contribution to the fight against the disease, including addiction. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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18. The role of spirituality in feelings of suffering and quality of life in self-introduced addicts.
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Ali Akbar Pirasteh Motlagh, Nikmanesh, Zahra, Liaghat, Ehsan, and Hematian, Mojahed
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QUALITY of life ,SPIRITUALITY ,DRUG abuse ,EMOTIONS ,PEOPLE with addiction ,SEX addiction ,ADDICTIONS - Abstract
Many researches are seeking evidence and ways in which spirituality can improve the feeling of suffering and quality of life in drug abuse addicts. This study was aimed to investigate the role of spirituality in feelings of suffering and quality of life in self-introduced addicts referring to addiction treatment centers. The statistical population consisted all of self-introduced addicts referring to addiction treatment centers in Yasuj city. 120 participants were selected by convenience sampling. Following instruments were used for data collection; spirituality questionnaire, scale of experience and perception of suffering and the world health organization quality of life questionnaire. The results showed that there was a significant negative correlation between spirituality and feelings of suffering. There was a significant positive correlation between spirituality and quality of life. Stepwise regression results showed that the best predictors of spiritual/existential suffering were selfawareness and spiritual activities. Also, the component of selfawareness was the best predictor of physical health, psychological health, environmental health and quality of life and social relations. Therefore, reinforcement of spirituality in addicts and encouraging them to perform the related activities can reduce the feeling of pain among them and improve their quality of lives. [ABSTRACT FROM AUTHOR]
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- 2019
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19. Estimating the prevalence of hepatitis C among intravenous drug users in upper middle income countries: A systematic review and meta-analysis.
- Author
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Granados-García, Víctor, Flores, Yvonne N., Díaz-Trejo, Lizbeth I., Méndez-Sánchez, Lucia, Liu, Stephanie, Salinas-Escudero, Guillermo, Toledano-Toledano, Filiberto, and Salmerón, Jorge
- Subjects
HEPATITIS C ,MIDDLE-income countries ,DISEASE prevalence ,DATA extraction ,ACQUISITION of data ,META-analysis - Abstract
Aim: This systematic review and meta-analysis characterizes the prevalence of hepatitis C virus (HCV) infection among intravenous drug users (IDUs) in upper middle-income countries. Methods: Five databases were searched from 1990–2016 for studies that took place in countries with a GDP per capita of $7,000 to $13,000 USD. The data extraction was performed based on information regarding prevalence, sample size, age of participants, duration of intravenous drug use (IDU), recruitment location, dates of data collection, study design, sampling scheme, type of tests used in identifying antibody reactivity to HCV, and the use of confirmatory tests. The synthesis was performed with a random effects model. The Cochrane statistical Q-test was used to evaluate the statistical heterogeneity of the results. Results: The 33 studies included in the analysis correspond to a sample of seven countries and 23,342 observations. The point prevalence value estimates and confidence intervals of the random effects model were 0.729 and 0.644–0.800, respectively for all seven countries, and were greatest for China (0.633; 0.522–0.732) as compared to Brazil (0.396; 0.249–0.564). Prevalence for Montenegro (0.416; 0.237–0.621) and Malaysia (0.475; 0.177–0.792) appear to be intermediate. Mexico (0.960) and Mauritania (0.973) had only one study with the largest prevalence. A clear association was not observed between age or duration of IDU and prevalence of HCV, but the data from some groups may indicate a possible relationship. The measures of heterogeneity (Q and I2) suggest a high level of heterogeneity in studies conducted at the country level and by groups of countries. Conclusions: In this systematic review and meta-analysis, we found that the pooled prevalence of HCV was high (0.729) among a group of seven upper middle income countries. However, there was significant variation in the prevalence of HCV observed in China (0.633) and Brazil (0.396). [ABSTRACT FROM AUTHOR]
- Published
- 2019
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20. Evaluation of self-deception: Factorial structure, reliability and validity of the SDQ-12 (self-deception questionnaire).
- Author
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Sirvent, Carlos, Herrero, Juan, Moral, María de la Villa, and Rodríguez, Francisco Javier
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SELF-deception ,DRUG abusers ,PEOPLE with alcoholism ,PEOPLE with addiction ,CONFIRMATORY factor analysis ,EXPLORATORY factor analysis - Abstract
We all need to resort to deception, either with ourselves (denial, self-deception, mystification) or with others (with modalities, such as impression management, social desirability), to a greater or lesser extent. Lies, in their broader meaning, are interpreted as something rather adaptive, useful, and necessary in our socioaffective world. In particular, self-deception is a highly interesting psychological concept in the clinical population, namely, in drug dependents, as it serves as a mechanism for maintaining addiction. The objective of this study was to create and explore the validity and psychometric properties of a short self-deception scale (SDQ-12), derived from the IAM-40 and emphasizing the manipulation and mystification dimensions. Participants in this study included a group of drug dependents (alcoholics and drug abusers) under treatment (n = 417) as well as a group of adults from the general population (n = 124) (total N = 541), selected using simple random sampling. Across the sample, 63% of individuals were male, with a mean age of 38.65 years (S.D. = 10.61). Empirical exploration of the SDQ-12 items using exploratory and confirmatory factor analysis revealed that the instrument has a clear structure matching the theoretically relevant proposed dimensions of mystification and manipulation. Internal consistency was verified (Cronbach’s alpha coefficient = .85), and confirmatory factor analysis revealed that the two-dimensional model provided an appropriate fit to the data. In addition, manipulation was greater in young male individuals, with significant differences found in mystification and manipulation between the general population and alcoholics and drug abusers. Our study supports the clinical and research importance of the SDQ-12 scale, due not only to its diagnostic efficacy but also to its novel nature, its importance, and its relevance. It could be particularly useful for evaluating the substantial components of self-deception in the addict population, thus guiding therapists in their diagnostic and interventional role. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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21. Molecular epidemiology of HIV-1 infection among men who have sex with men in Taiwan from 2013 to 2015.
- Author
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Li, Wei-You, Chen, Marcelo, Huang, Szu-Wei, Jen, I-An, Wang, Sheng-Fan, Yang, Jyh-Yuan, Chen, Yen-Hsu, and Chen, Yi-Ming Arthur
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GAY people ,HIV infections ,LENTIVIRUS diseases ,AIDS-related complex ,AIDS - Abstract
Men who have sex with men (MSM) is the major risk population of HIV-1 infection in Taiwan, and its surveillance has become critical in HIV-1 prevention. We recruited MSM subjects from 17 high-risk venues and 4 community centers in northern and southern Taiwan for anonymous HIV-1 screening during 2013–2015. Blood samples were obtained for genotyping and phylogenetic analysis, and a questionnaire survey covering demographic variables and social behavior was conducted. In total, 4,675 subjects were enrolled, yielding a HIV-1 prevalence rate of 4.3% (201/4675). Eight risk factors including subjects who did not always use condoms (OR = 1.509, p = 0.0123), those who used oil-based lubricants (OR = 1.413, p = 0.0409), and those who used recreational drugs (OR = 2.182, p = < .0001) had a higher risk of HIV-1 infection. The annual prevalence and incidence of HIV-1 showed a downward trend from 2013 to 2015 (6.56%, 5.97 per 100 person-years in 2013; 4.53%, 3.97 per 100 person-years in 2014; 1.84%, 2.08 per 100 person-years in 2015). Factors such as always using condoms, water-based lubricant use, correct knowledge of lubricating substitutes, and recreational drug use were significantly associated with the trend of incidence. Phylogenetic tree analysis showed that the cross-regional and international interaction of the local MSM population may have facilitated transmission of HIV. This survey of high-risk venues showed decreased prevalence and incidence of HIV-1 infection in Taiwan from 2013 to 2015, and this may be related to changes in behavioral patterns. Moreover, cross-regional interaction and recreational drug use need to be considered in future surveillance. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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22. : An SAS macro for detecting adverse drug-drug interactions in spontaneous reporting systems.
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Gosho, Masahiko, Ohigashi, Tomohiro, and Maruo, Kazushi
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DRUG side effects ,DRUG interactions ,POLYPHARMACY ,SOCIAL problems ,HERBAL medicine - Abstract
Statistical methods for detecting adverse drug reactions (ADRs) resulting from drug-drug interactions (DDIs) have been used in recent years to analyze the datasets in spontaneous reporting systems. We provide the macro in SAS to calculate the criteria for detecting ADRs resulting from the concomitant use of two drugs. We outline two criteria for detecting DDIs with the combination of two drugs and illustrate the implementation of the macro by way of an example. To implement the macro, a user specifies the target ADR and the two drugs to be evaluated. The macro outputs a table showing the number of reports on ADRs, the values of the two criteria for detecting ADRs, and the presence of DDIs. This macro enables users to easily and automatically assess the clinical DDIs that result from ADRs. The macro is freely available in the Supporting Information. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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- View/download PDF
23. The common truncation variant in pancreatic lipase related protein 2 (PNLIPRP2) is expressed poorly and does not alter risk for chronic pancreatitis.
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Németh, Balázs Csaba, Pesei, Zsófia Gabriella, Hegyi, Eszter, Szücs, Ákos, Szentesi, Andrea, Hegyi, Péter, Lowe, Mark E., and Sahin-Tóth, Miklós
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LIPASES ,CELL culture ,ENDOPLASMIC reticulum ,MESSENGER RNA ,GENE expression ,MOLECULAR biology - Abstract
A nonsense variant (p.W358X) of human pancreatic lipase related protein 2 (PNLIPRP2) is present in different ethnic populations with a high allele frequency. In cell culture experiments, the truncated protein mainly accumulates inside the cells and causes endoplasmic reticulum stress. Here, we tested the hypothesis that variant p.W358X might increase risk for chronic pancreatitis through acinar cell stress. We sequenced exon 11 of PNLIPRP2 in a cohort of 256 subjects with chronic pancreatitis (152 alcoholic and 104 non-alcoholic) and 200 controls of Hungarian origin. We observed no significant difference in the distribution of the truncation variant between patients and controls. We analyzed mRNA expression in human pancreatic cDNA samples and found the variant allele markedly reduced. We conclude that the p.W358X truncation variant of PNLIPRP2 is expressed poorly and has no significant effect on the risk of chronic pancreatitis. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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- View/download PDF
24. Impact of glass shape on time taken to drink a soft drink: A laboratory-based experiment.
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Langfield, Tess, Pechey, Rachel, Pilling, Mark, and Marteau, Theresa M.
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GLASSWARE -- Design & construction ,SOFT drinks ,ALCOHOLIC beverages ,APPLE juice ,MATHEMATICAL models - Abstract
Background: Glassware design may affect drinking behaviour for alcoholic beverages, with glass shape and size influencing drinking speed and amount consumed. Uncertainty remains both about the extent to which these effects are restricted to alcohol and the underlying mechanisms. The primary aim of the current study was to examine the effect of differently shaped glasses on time taken to drink a soft drink. The secondary aim was to develop hypotheses about mechanisms concerning micro-drinking behaviours and perceptual effects. Method: In a single-session experiment, 162 participants were randomised to receive 330ml of carbonated apple juice in a glass that was either inward-sloped, straight-sided, or outward-sloped. The primary outcome measure was total drinking time. Secondary outcome measures included micro-drinking behaviours (sip size, sip duration, interval duration), and perceptual measures (midpoint bias, drink enjoyment). Results: Participants drank 21.4% faster from the outward-sloped glass than from the straight-sided glass [95%CI: 0.2%,38.0%] in adjusted models. They were also 18.2% faster from the inward-sloped glass than the straight-sided glass, but this did not reach statistical significance with wide confidence intervals also consistent with slower drinking [95%CI: -3.8%,35.6%]. Larger sips were associated with faster drinking times (Pearson’s r(162) = -.45, p < .001). The direction of effects suggested sips were larger from the outward-sloped and inward-sloped glasses, compared to the straight-sided glass (15.1%, 95%CI: -4.3%,38.0%; 19.4%, 95%CI: -0.5%,43.6%, respectively). There were no significant differences between glasses in mean sip or interval duration. Bias in midpoint estimation was greater for the outward-sloped glass (12.9ml, 95%CI: 6.6ml,19.2ml) than for the straight-sided glass, although the degree of bias was not associated with total drinking time (Pearson’s r(162) = 0.01, p = .87). Discussion: Individuals drank a soft drink more quickly from an outward-sloped glass, relative to a straight-sided glass. Micro-drinking behaviours, such as sip size, are promising candidates for underlying mechanisms. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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25. Use of flavored electronic cigarette refill liquids among adults and youth in the US—Results from Wave 2 of the Population Assessment of Tobacco and Health Study (2014–2015).
- Author
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Schneller, Liane M., Bansal-Travers, Maansi, Goniewicz, Maciej L., McIntosh, Scott, Ossip, Deborah, and O’Connor, Richard J.
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ELECTRONIC cigarettes ,YOUTH ,ELECTRONIC voting ,TOBACCO products ,ADULTS ,TOBACCO - Abstract
Introduction: Flavored e-cigarettes are enticing to new users and established cigarette smokers using e-cigarettes to quit smoking due to the wide variety of flavor options. However, specific flavor combinations that are popular among e-cigarette users are understudied. Recently, the Deeming rule extended the US Food and Drug Administration’s authority over all tobacco products, including e-cigarettes. Methods: The Population Assessment of Tobacco and Health Study Wave 2 data were analyzed to assess the prevalence of self-reported flavor categories that are used individually and in combination with other flavor categories among past 30-day youth and adult e-cigarette users in the US. Results: Most youth and adult participants reported using a flavored e-cigarette. Reporting an individual flavor category was more common than reporting a combination of flavor categories. Fruit flavor was the most common flavor category reported among youth, and ‘menthol/mint’ was most common among adults. Fruit and candy/other sweets were the most common flavor categories reported together among both youth and adult past 30-day e-cigarette users. Conclusions: The use of flavored e-cigarettes is very popular among youth and adults. Most consumers reported using a single flavor category, although some consumers did use a combination of flavor categories. Preference for menthol/mint among adults may represent a carryover from associations with tobacco cigarettes. Typically, sweeter flavors, such as fruit, were among the most popular flavor categories reported, both individually and in combination with other flavors, while more bitter flavors (i.e.: clove/spice) were less common. Implications: This study identified predominant flavor categories among past 30-day youth and adult e-cigarette users. Findings indicate that the wide variety of flavors available and the freedom to “mix-and-match” flavors may maintain use of e-cigarettes among youth and adults, and future research should focus on the composition of the ENDS liquid/vapor to disentangle the contributions of sweeteners and flavorants. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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26. Influence of social network on drug use among clients of methadone maintenance treatment centers in Kunming, China.
- Author
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Shen, Ling, Assanangkornchai, Sawitri, Liu, Wei, Cai, Le, Li, Fei, Tang, Songyuan, Shen, Jiucheng, McNeil, Edward B., and Chongsuvivatwong, Virasakdi
- Subjects
SOCIAL networks ,DRUG abuse treatment ,METHADONE treatment programs ,SOCIODEMOGRAPHIC factors - Abstract
Aims: To examine drug use behavior of clients attending Methadone Maintenance Treatment (MMT) programs and its relationship with the clients’ social network characteristics. Design: Cross-sectional study. Setting: Four MMT clinics in Kunming, Yunnan province, China. Participants: 324 consecutive MMT clients. Measurements: A structured, self-completed questionnaire on background characteristics and existing social network. Current drug use was assessed by urine test for opiate metabolites. Analysis: The association between client's social network characteristics and their own current drug use behavior is analysed using multiple logistic regression adjusting for socio-demographic characteristics. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) are obtained to give the strength of the associations. Findings: MMT clients were more likely to concurrently use heroin while attending MMT if their social network had any of the following characteristics: more than half of the members were older than them (AOR = 1.03, 95% CI = 1.00,1.06), any member had a high level of influence on them (AOR = 6.47, 95% CI = 2.86,14.65) and any member joined them in using drugs (AOR = 1.94, 95% CI = 1.04,3.63). Having a social network member who could provide emotional support (AOR = 0.11, 95% CI = 0.03,0.35), having a spouse and/or child in their social network (AOR = 0.44, 95% CI = 0.24,0.81) and having a social network member with a high level of closeness (AOR = 0.28, 95% CI = 0.09,0.90) were associated with a decreased odds of heroin use. Conclusion: Social networks who could provide MMT clients with emotional support and a close relationship were significant factors for reducing the risk of concurrent drug use among clients attending MMT clinics in Kunming, China. Behavioral interventions should address the role of family and social network members in providing support to these clients. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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27. Hormonal contraception increases the risk of psychotropic drug use in adolescent girls but not in adults: A pharmacoepidemiological study on 800 000 Swedish women.
- Author
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Zettermark, Sofia, Perez Vicente, Raquel, and Merlo, Juan
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PSYCHIATRIC drugs ,PHARMACOEPIDEMIOLOGY ,WOMEN'S health ,DEPRESSION in women ,ANXIETY in women ,CONTRACEPTION ,PSYCHOLOGY of women - Abstract
The burden of depression and anxiety disorders is greater in women, and female sex hormones have been shown to affect mood. Psychological side effects of hormonal contraception (HC) are also a common complaint in the clinic, but few previous studies have investigated this subject. We therefore wanted to investigate whether use of HC was associated with adverse psychological health outcomes, and whether this association was modified by age. All women aged 12–30 years on 31 December 2010, residing in Sweden for at least four years and with no previous psychiatric morbidity (n = 815 662), were included. We followed the women from their first HC use (or 31 December 2010, if they were non-users) at baseline, until a prescription fill of psychotropic drugs or the end of the one-year follow-up. We performed age-stratified logistic regression models and estimated odds ratios (OR) to measure the association between different HC methods and psychotropic drug use, as well as the area under the receiver operating curve to estimate discriminatory accuracy of HC in relation to psychotropic drugs. Overall, we found an association between HC and psychotropic drugs (adjusted OR 1.34, 95% confidence interval [CI] 1.30–1.37). In the age-stratified analysis, the strongest association was found in adolescent girls (adjusted OR 3.46, 95% CI 3.04–4.94 for age 12 to 14 years), while it was non-existent for adult women. We conclude that hormonal contraception is associated with psychotropic drug use among adolescent girls, suggesting an adverse effect of HC on psychological health in this population. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
28. Comparing psychological disorders in addicts treated under NA Association and TC Centers.
- Author
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Jamshidi, Safoura, Ebrahimabad, Mohammad Javad Asghari, and Fakhri, Maryam Sadat
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SUBSTANCE abuse ,PERSONALITY disorder treatment ,SOCIAL problems ,QUESTIONNAIRES ,DEMOGRAPHIC surveys - Abstract
Introduction: Substance abuse is a widespread issue in the present era turned into a social and sanitary problem as to its increasing variety and a multilateral and suitable consideration is required to prevent and solve this problem. Therefore, the present study attempts to compare psychological conditions of personality disorders in addicts treated under NA association and TC centers. Materials and Methods: Research method is causative-comparative and the sample includes 213 individuals (107 clients of NA association and 106 clients of TC centers) in Mashhad city selected by convenience sampling method during first second half of 2017. They fulfilled two demographic questionnaires and Millon Clinical Multiaxial Inventory. Results: Findings obtained from the analysis of comparing two independent groups showed that NA group had better conditions than TC clients group in terms of psychological and personality disorders and they had significant difference statistically (P<0.05). Conclusion: It seems that self-help and protective groups of NA association are more qualified in decreasing psychological disorders. [ABSTRACT FROM AUTHOR]
- Published
- 2018
29. Survival from alcoholic hepatitis has not improved over time.
- Author
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Hughes, Emily, Hopkins, Laurence J., and Parker, Richard
- Subjects
HEPATITIS treatment ,DRUG development ,RANDOMIZED controlled trials ,MORTALITY ,MEDICAL databases - Abstract
Purpose/Background: We aimed to describe changes in survival in alcoholic hepatitis (AH) over time by examining published data. Methods: A systematic literature search of Ovid Embase and PubMed was undertaken using the MESH terms ‘hepatitis, alcoholic’ to identify randomised controlled trials (RCT) and observational studies (OS) in alcoholic hepatitis. Data were extracted from included studies regarding 28-day, 90-day, 180-day mortality, as well as biochemical and clinical data. Results: After review of the literature search results, 77 studies published between 1971 and 2016 were analysed, which included data from a total of 8,184 patients. Overall mortality from AH was 26% at 28 days, 29% at 90 days and 44% at 180 days after admission. No changes in mortality over time were observed in univariable analysis at 28 days or 90 days after admission (Pearson correlation r -0.216, p = 0.098, and r 0.121 p = 0.503 respectively). A small but statistically significant increase in mortality was seen in 180-day mortality (r 0.461 p = 0.036). However, after meta-regression to adjust for other factors associated with mortality at each time point, no changes in mortality were seen. Sub-group analysis did not reveal any changes in mortality over time in different study types, or when only biopsy-proven or severe disease were considered. Conclusion: There has been no improvement in mortality from AH. This is not explained by changes in severity of disease. This emphasises the urgent need for effective treatments for this alcoholic hepatitis. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
30. The impact of cannabis use on patients enrolled in opioid agonist therapy in Ontario, Canada.
- Author
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Franklyn, Alexandra M., Eibl, Joseph K., Gauthier, Graham J., and Marsh, David C.
- Subjects
CANNABIS (Genus) ,PUBLIC health ,SMOKABLE plants ,SUBSTANCE abuse ,OPIOIDS ,PSYCHIATRIC drugs - Abstract
Background: With the Canadian government legalizing cannabis in the year 2018, the potential harms to certain populations—including those with opioid use disorder—must be investigated. Cannabis is one of the most commonly used substances by patients who are engaged in medication-assisted treatment for opioid use disorder, the effects of which are largely unknown. In this study, we examine the impact of baseline and ongoing cannabis use, and whether these are impacted differentially by gender. Methods: We conducted a retrospective cohort study using anonymized electronic medical records from 58 clinics offering opioid agonist therapy in Ontario, Canada. One-year treatment retention was the primary outcome of interest and was measured for patients who did and did not have a cannabis positive urine sample in their first month of treatment, and as a function of the proportion of cannabis-positive urine samples throughout treatment. Results: Our cohort consisted of 644 patients, 328 of which were considered baseline cannabis users and 256 considered heavy users. Patients with baseline cannabis use and heavy cannabis use were at increased risk of dropout (38.9% and 48.1%, respectively). When evaluating these trends by gender, only female baseline users and male heavy users are at increased risk of premature dropout. Interpretation: Both baseline and heavy cannabis use are predictive of decreased treatment retention, and differences do exist between genders. With cannabis being legalized in the near future, physicians should closely monitor cannabis-using patients and provide education surrounding the potential harms of using cannabis while receiving treatment for opioid use disorder. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
31. Inverse association of marijuana use with nonalcoholic fatty liver disease among adults in the United States.
- Author
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Kim, Donghee, Kim, Won, Kwak, Min-Sun, Chung, Goh Eun, Yim, Jeong Yoon, and Ahmed, Aijaz
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MEDICAL marijuana ,LIVER disease treatment ,LIVER diseases ,MEDICAL care ,ULTRASONIC imaging ,PATIENTS - Abstract
Background & aims: The impact of marijuana on nonalcoholic fatty liver disease (NAFLD) is largely unknown. We studied the association between marijuana and NAFLD utilizing cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) from 2005–2014 and NHANES III (1988–1994). Methods: Suspected NAFLD was diagnosed if serum alanine aminotransferase (ALT) was > 30 IU/L for men and > 19 IU/L for women in the absence of other liver diseases (NHANES 2005–2014). In NHANES III cohort, NAFLD was defined based on ultrasonography. Results: Of the 14,080 (NHANES 2005–2014) and 8,286 (NHANES III) participants, prevalence of suspected NAFLD and ultrasonographically-diagnosed NAFLD were inversely associated with marijuana use (p < 0.001). Compared to marijuana-naïve participants, marijuana users were less likely to have suspected NAFLD (odds ratio [OR]: 0.90, 95% confidence interval [CI]: 0.82–0.99 for past user; OR: 0.68, 95% CI: 0.58–0.80 for current user) and ultrasonographically-diagnosed NAFLD (OR: 0.75, 95% CI: 0.57–0.98 for current user) in the age, gender, ethnicity-adjusted model. On multivariate analysis, the ORs for suspected NAFLD comparing current light or heavy users to non-users were 0.76 (95% CI 0.58–0.98) and 0.70 (95% CI 0.56–0.89), respectively (P for trend = 0.001) with similar trends in ultrasonographically-diagnosed NAFLD (OR: 0.77, 95% CI: 0.59–1.00 for current user; OR: 0.71, 95% CI: 0.51–0.97 for current light user). In insulin resistance-adjusted model, marijuana use remained an independent predictor of lower risk of suspected NAFLD. Conclusions: In this nationally representative sample, active marijuana use provided a protective effect against NAFLD independent of known metabolic risk factors. The pathophysiology is unclear and warrants further investigation. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
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32. Prevalence of problematic cell phone use in an adult population in Spain as assessed by the Mobile Phone Problem Use Scale (MPPUS).
- Author
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de-Sola, José, Talledo, Hernán, Rodríguez de Fonseca, Fernando, and Rubio, Gabriel
- Subjects
CELL phone systems ,SOCIAL context ,DESIRE ,LOGISTIC regression analysis ,REGRESSION analysis - Abstract
Problematic cell phone use has alarmingly increased in industrialized countries in the past 10 years. For many perpetrators, it can turn into a behavioural addiction, although this is not a recognized medical condition. Although there are many tools for evaluating this use, one of the most widely used tools is the Mobile Phone Problematic Use Scale (MPPUS), which we test on a representative sample of the population in Spain to obtain an estimate of the prevalence of problematic cell phone use in our midst. The age range consists of 16–65 years, with 1,126 surveys conducted. In this population, we verify that the reliability and internal consistency of the MPPUS (α = 0.939) are maintained. Additionally, the construct validity, considering the derived factors (Abuse and Dependence, Craving and Loss of Control, and Dependence on the Social Environment) are aligned with other research and with diverse external criteria of addiction. We establish four categories of users (Casual, Regular, At Risk, and Problematic) and obtain a prevalence of 15.4% among At Risk Users and 5.1% among Problematic Users. This finding implies a total of 20.5% of Users with Problems. A binary logistic regression analysis shows that age, gender, level of education, and daily cell phone use predict problematic cell phone use. The results, based on multiple criteria, show that such problematic use shares features of recognized addictions, affecting large segments of the population and not only adolescents. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
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33. PrEP in Italy: The time may be ripe but who's paying the bill? A nationwide survey on physicians' attitudes towards using antiretrovirals to prevent HIV infection.
- Author
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Di Biagio, Antonio, Riccardi, Niccolò, Signori, Alessio, Maserati, Renato, Nozza, Silvia, Gori, Andrea, Bonora, Stefano, Borderi, Marco, Ripamonti, Diego, Rossi, Maria Cristina, Orofino, Giancarlo, Quirino, Tiziana, Nunnari, Giuseppe, Celesia, Benedetto Maurizio, Martini, Salvatore, Sagnelli, Caterina, Mazzola, Giovanni, Colletti, Pietro, Bartolozzi, Dario, and Bini, Teresa
- Subjects
HIV prevention ,DENTAL prophylaxis ,PHYSICIANS' attitudes ,TENOFOVIR ,THERAPEUTICS - Abstract
Several studies have demonstrated the efficacy of the oral pre-exposure prophylaxis (PrEP) with tenofovir (with or without emtricitabine) on preventing HIV-negative partners of HIV infected patients to become infected through sexual contacts. PrEP is already available in the United States and now is approved by European Medicine Agency. In this setting we would like to gauge physicians’ knowledge, acquaintance with and attitude to include PrEP in their clinical practice. A cross sectional survey was conducted among Italian physicians expert on antiretroviral therapy. Out of 146 physicians, 35% of participants declared to be familiar with PrEP but only 46% of them believed that, currently, there are not enough reasons to make it available in Italy. 51% of physicians have already been attracted to prescribe it and 63.4% have been openly asked about PrEP. The main concerns noticed were: the risk of acquire other sexual transmitted diseases (STDs) (70% of physicians feared that PrEP could favor STDs spread), the potential harmful of PrEP if not adequately implemented and, especially the risk of possible side effects if not properly used. Nevertheless, 55.9% of participants believed that Health Authorities face an ethical obligation to make PrEP available as part of the strategies to protect from HIV transmission and half of the respondents asked for further researches to better define the role for PrEP. Attitudes regarding PrEP impact on Italian National Health Organization were also very interesting: 57.5% of participants did not believe that investing in PrEP would be an appropriate use of healthcare resources, while 70.6% affirmed that PrEP’s financial coverage should not be funded by the Italian National System of Health (SSN). This survey showed a high awareness of PrEP potential among Italian physicians coupled with a great deal of skepticism about how and if implementing it in clinical practice. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
34. The effect of federal and state off-label marketing investigations on drug prescribing: The case of olanzapine.
- Author
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Wang, Bo, Studdert, David M., Sarpatwari, Ameet, Franklin, Jessica M., Landon, Joan, and Kesselheim, Aaron S.
- Subjects
OLANZAPINE ,DRUG marketing ,DRUG efficacy ,DRUG factories ,MANAGEMENT ,GOVERNMENT policy ,THERAPEUTICS - Abstract
In the past decade, the federal government has frequently investigated and prosecuted pharmaceutical manufacturers for illegal promotion of drugs for indications not approved by the Food and Drug Administration (FDA) (“off-label” uses). State governments can choose to coordinate with the federal investigation, or pursue their own independent state investigations. One of the largest-ever off-label prosecutions relates to the atypical antipsychotic drug olanzapine (Zyprexa). In a series of settlements between 2008 and 2010, Eli Lilly paid $1.4 billion to the federal government and over $290 million to state governments. We examined the effect of these settlements on off-label prescribing of this medication, taking advantage of geographical differences in states’ involvement in the investigations and the timing of the settlements. However, we did not find a reduction in off-label prescribing; rather, there were no prescribing changes among states that joined the federal investigation, those that pursued independent state investigations, and states that pursued no investigations at all. Since the settlements of state investigations of off-label prescribing do not appear to significantly impact prescribing rates, policymakers should consider alternate ways of reducing the prevalence of non-evidence-based off-label use to complement their ongoing investigations. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
35. Multidrug resistant tuberculosis in prisons located in former Soviet countries: A systematic review.
- Author
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Droznin, Maxwell, Johnson, Allen, and Johnson, Asal Mohamadi
- Subjects
TUBERCULOSIS treatment ,MULTIDRUG resistance ,DISEASE prevalence ,SYSTEMATIC reviews - Abstract
Background: A systematic literature review was performed to investigate the occurrence of multidrug-resistant tuberculosis (MDR TB) in prisons located in countries formerly part of the Soviet Union. Methods: A systematic search of published studies reporting MDR TB occurrence in prisons located in former Soviet countries was conducted by probing PubMed and Cumulative Index Nursing and Allied Health Literature for articles that met predetermined inclusion criteria. Results: Seventeen studies were identified for systematic review. Studies were conducted in six different countries. Overall, prevalence of MDR TB among prisoners varied greatly between studies. Our findings suggest a high prevalence of MDR TB in prisons of Post-Soviet states with percentages as high as 16 times more than the worldwide prevalence estimated by the WHO in 2014. Conclusion: All studies suggested a high prevalence of MDR TB in prison populations in Post-Soviet states. [ABSTRACT FROM AUTHOR]
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- 2017
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36. Stable self-serving personality traits in recreational and dependent cocaine users.
- Author
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Quednow, Boris B., Hulka, Lea M., Preller, Katrin H., Baumgartner, Markus R., Eisenegger, Christoph, and Vonmoos, Matthias
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PERSONALITY ,SOCIAL perception ,COCAINE abuse ,STATISTICAL reliability ,EMPATHY - Abstract
Chronic cocaine use has been associated with impairments in social cognition, self-serving and antisocial behavior, and socially relevant personality disorders (PD). Despite the apparent relationship between Machiavellianism and stimulant use, no study has explicitly examined this personality concept in cocaine users so far. In the frame of the longitudinal Zurich Cocaine Cognition Study, the Machiavellianism Questionnaire (MACH-IV) was assessed in 68 recreational and 30 dependent cocaine users as well as in 68 psychostimulant-naïve controls at baseline. Additionally, three closely related personality dimensions from the Temperament and Character Inventory (TCI)–cooperativeness, (social) reward dependence, and self-directedness–and the screening questionnaire of the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) were acquired. At the one-year follow-up, 57 cocaine users and 48 controls were reassessed with the MACH-IV. Finally, MACH-IV scores were correlated with measures of social cognition and interaction (cognitive/emotional empathy, Theory-of-Mind, prosocial behavior) and with SCID-II PD scores assessed at baseline. Both recreational and dependent cocaine users showed significantly higher Machiavellianism than controls, while dependent cocaine users additionally displayed significantly lower levels of TCI cooperativeness and self-directedness. During the one-year interval, MACH-IV scores showed high test-retest reliability and also the significant gap between cocaine users and controls remained. Moreover, in cocaine users, higher Machiavellianism correlated significantly with lower levels of cooperativeness and self-directedness, with less prosocial behavior, and with higher cluster B PD scores. However, Machiavellianism was not correlated with measures of cocaine use severity (r<-.15). Both recreational and dependent cocaine users display pronounced and stable Machiavellian personality traits. The lack of correlations with severity of cocaine use and its temporal stability indicates that a Machiavellian personality trait might represent a predisposition for cocaine use that potentially serves as a predictor for stimulant addiction. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
37. The SCottish Alcoholic Liver disease Evaluation: A Population-Level Matched Cohort Study of Hospital-Based Costs, 1991-2011.
- Author
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Bouttell, Janet, Lewsey, James, Geue, Claudia, Antony, Grace, Briggs, Andrew, McCartney, Gerry, Hutchinson, Sharon, Graham, Lesley, and Heydtmann, Mathis
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ALCOHOLIC liver diseases ,HOSPITAL costs ,BIRTH control ,COHORT analysis ,DIAGNOSIS - Abstract
Studies assessing the costs of alcoholic liver disease are lacking. We aimed to calculate the costs of hospitalisations before and after diagnosis compared to population controls matched by age, sex and socio-economic deprivation. We aimed to use population level data to identify a cohort of individuals hospitalised for the first time with alcoholic liver disease in Scotland between 1991 and 2011.Incident cases were classified by disease severity, sex, age group, socio-economic deprivation and year of index admission. 5 matched controls for every incident case were identified from the Scottish population level primary care database. Hospital costs were calculated for both cases and controls using length of stay from morbidity records and hospital-specific daily rates by specialty. Remaining lifetime costs were estimated using parametric survival models and predicted annual costs. 35,208 incident alcoholic liver disease hospitalisations were identified. Mean annual hospital costs for cases were 2.3 times that of controls pre diagnosis (£804 higher) and 10.2 times (£12,774 higher) post diagnosis. Mean incident admission cost was £6,663. Remaining lifetime cost for a male, 50–59 years old, living in the most deprived area diagnosed with acoholic liver disease was estimated to be £65,999 higher than the matched controls (£12,474 for 7.43 years remaining life compared to £1,224 for 21.8 years). In Scotland, alcoholic liver disease diagnosis is associated with significant increases in admissions to hospital both before and after diagnosis. Our results provide robust population level estimates of costs of alcoholic liver disease for the purposes of health-care delivery, planning and future cost-effectiveness analyses. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
38. BEST: Next-Generation Biomedical Entity Search Tool for Knowledge Discovery from Biomedical Literature.
- Author
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Lee, Sunwon, Kim, Donghyeon, Lee, Kyubum, Choi, Jaehoon, Kim, Seongsoon, Jeon, Minji, Lim, Sangrak, Choi, Donghee, Kim, Sunkyu, Tan, Aik-Choon, and Kang, Jaewoo
- Subjects
MEDICAL literature ,GENETIC mutation ,CORPORA ,TRANSCRIPTION factors ,MICRORNA - Abstract
As the volume of publications rapidly increases, searching for relevant information from the literature becomes more challenging. To complement standard search engines such as PubMed, it is desirable to have an advanced search tool that directly returns relevant biomedical entities such as targets, drugs, and mutations rather than a long list of articles. Some existing tools submit a query to PubMed and process retrieved abstracts to extract information at query time, resulting in a slow response time and limited coverage of only a fraction of the PubMed corpus. Other tools preprocess the PubMed corpus to speed up the response time; however, they are not constantly updated, and thus produce outdated results. Further, most existing tools cannot process sophisticated queries such as searches for mutations that co-occur with query terms in the literature. To address these problems, we introduce BEST, a biomedical entity search tool. BEST returns, as a result, a list of 10 different types of biomedical entities including genes, diseases, drugs, targets, transcription factors, miRNAs, and mutations that are relevant to a user’s query. To the best of our knowledge, BEST is the only system that processes free text queries and returns up-to-date results in real time including mutation information in the results. BEST is freely accessible at . [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
39. Harmful Effect of Beer on Bovine Enamel Microhardness – In Vitro Study.
- Author
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Zanatta, Rayssa Ferreira, Esper, Maria Ângela Lacerda Rangel, Valera, Marcia Carneiro, Melo, Renata Marques, and Bresciani, Eduardo
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BEER ,MICROHARDNESS ,DENTAL enamel ,INCISORS ,IMMERSION in liquids - Abstract
This study aimed to evaluate the effect of beers on the bovine enamel microhardness. Fifty rectangular (1 x 3 x 1 mm–height x width x thickness) enamel specimens were obtained from permanent bovine incisors, and divided into five groups (n = 10) according to the treatment employed: Saliva, Coke, Brahma, Heineken, and Budweiser. Microhardness (Knoop) were obtained before; after 5, 30 and 60 min of immersion in each solution. The data were analyzed using repeated two-way ANOVA and Tukey´s test (p<0.05). Coke decreased the microhardness in all immersion times, and Heineken, showed low values after 60 minutes. Beers tested have low potential to cause enamel erosion when compared to Coke. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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- View/download PDF
40. Coping Styles and Alcohol Dependence among Homeless People.
- Author
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Opalach, Cezary, Romaszko, Jerzy, Jaracz, Marcin, Kuchta, Robert, Borkowska, Alina, and Buciński, Adam
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DIAGNOSIS of alcoholism ,MEDICAL databases ,MICHIGAN Alcoholism Screening Test ,ALCOHOL drinking ,PEOPLE with alcoholism - Abstract
Background and Objectives: The ways in which homeless individuals cope with stress may differ from those relied upon by the members of the general population and these differences may either be the result or the cause of their living conditions. The aim of the study was to determine the preferred coping style among the homeless and its relationship with alcohol dependence. Methods: The study included 78 homeless individuals and involved the collection of demographic, sociological, psychological and medical data from each participant. Coping styles relied upon when dealing with stressful situations were assessed using a Polish adaptation of the Coping Inventory for Stressful Situations. Alcohol dependence was assessed using the Michigan Alcoholism Screening Test (MAST) and a quantitative analysis of alcohol consumption. Results: Men accounted for 91.93% of the study population. Nearly 75% of the subjects met the alcohol dependence criterion. Significant relationships were observed between the individual's age, preferred coping style and alcohol consumption level. As an individual’s age increased, the use of emotion-oriented coping styles decreased, while an increase in alcohol consumption was associated with a more frequent use of emotion- and avoidance-oriented strategies. Conclusions: The findings of this study, similarly to those of many other studies of homeless individuals but investigating other areas (e.g. epidemiology of tuberculosis and traumatic injuries), are an exaggerated representation of associations observed in the general population. The results describe a group of people living on the margins of the society, often suffering from extremely advanced alcoholism, with clear evident psychodegradation. The presence of specific ways of coping with stress related to excessive alcohol consumption in this group of individuals may interfere with active participation in support programmes provided for the homeless and may further exacerbate their problems. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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- View/download PDF
41. Can We Predict Individual Combined Benefit and Harm of Therapy? Warfarin Therapy for Atrial Fibrillation as a Test Case.
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Li, Guowei, Thabane, Lehana, Delate, Thomas, Witt, Daniel M., Levine, Mitchell A. H., Cheng, Ji, and Holbrook, Anne
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ATRIAL fibrillation treatment ,DRUG therapy ,WARFARIN ,HEALTH outcome assessment ,ATRIAL fibrillation ,ATRIAL fibrillation diagnosis ,PATIENTS - Abstract
Objectives: To construct and validate a prediction model for individual combined benefit and harm outcomes (stroke with no major bleeding, major bleeding with no stroke, neither event, or both) in patients with atrial fibrillation (AF) with and without warfarin therapy. Methods: Using the Kaiser Permanente Colorado databases, we included patients newly diagnosed with AF between January 1, 2005 and December 31, 2012 for model construction and validation. The primary outcome was a prediction model of composite of stroke or major bleeding using polytomous logistic regression (PLR) modelling. The secondary outcome was a prediction model of all-cause mortality using the Cox regression modelling. Results: We included 9074 patients with 4537 and 4537 warfarin users and non-users, respectively. In the derivation cohort (n = 4632), there were 136 strokes (2.94%), 280 major bleedings (6.04%) and 1194 deaths (25.78%) occurred. In the prediction models, warfarin use was not significantly associated with risk of stroke, but increased the risk of major bleeding and decreased the risk of death. Both the PLR and Cox models were robust, internally and externally validated, and with acceptable model performances. Conclusions: In this study, we introduce a new methodology for predicting individual combined benefit and harm outcomes associated with warfarin therapy for patients with AF. Should this approach be validated in other patient populations, it has potential advantages over existing risk stratification approaches as a patient-physician aid for shared decision-making [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
42. Differential Expression of FosB Proteins and Potential Target Genes in Select Brain Regions of Addiction and Depression Patients.
- Author
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Gajewski, Paula A., Turecki, Gustavo, and Robison, Alfred J.
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PROTEIN expression ,ADDICTIONS ,DRUGS of abuse ,MENTAL illness ,TRANSCRIPTION factors - Abstract
Chronic exposure to stress or drugs of abuse has been linked to altered gene expression throughout the body, and changes in gene expression in discrete brain regions are thought to underlie many psychiatric diseases, including major depressive disorder and drug addiction. Preclinical models of these disorders have provided evidence for mechanisms of this altered gene expression, including transcription factors, but evidence supporting a role for these factors in human patients has been slow to emerge. The transcription factor ΔFosB is induced in the prefrontal cortex (PFC) and hippocampus (HPC) of rodents in response to stress or cocaine, and its expression in these regions is thought to regulate their “top down” control of reward circuitry, including the nucleus accumbens (NAc). Here, we use biochemistry to examine the expression of the FosB family of transcription factors and their potential gene targets in PFC and HPC postmortem samples from depressed patients and cocaine addicts. We demonstrate that ΔFosB and other FosB isoforms are downregulated in the HPC but not the PFC in the brains of both depressed and addicted individuals. Further, we show that potential ΔFosB transcriptional targets, including GluA2, are also downregulated in the HPC but not PFC of cocaine addicts. Thus, we provide the first evidence of FosB gene expression in human HPC and PFC in these psychiatric disorders, and in light of recent findings demonstrating the critical role of HPC ΔFosB in rodent models of learning and memory, these data suggest that reduced ΔFosB in HPC could potentially underlie cognitive deficits accompanying chronic cocaine abuse or depression. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
43. Alcoholic Hepatitis Markedly Decreases the Capacity for Urea Synthesis.
- Author
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Glavind, Emilie, Aagaard, Niels Kristian, Grønbæk, Henning, Møller, Holger Jon, Orntoft, Nikolaj Worm, Vilstrup, Hendrik, and Thomsen, Karen Louise
- Subjects
UREA synthesis ,HEPATITIS ,LIVER physiology ,INFLAMMATION ,STATISTICAL correlation ,PATIENTS - Abstract
Background and Aim: Data on quantitative metabolic liver functions in the life-threatening disease alcoholic hepatitis are scarce. Urea synthesis is an essential metabolic liver function that plays a key regulatory role in nitrogen homeostasis. The urea synthesis capacity decreases in patients with compromised liver function, whereas it increases in patients with inflammation. Alcoholic hepatitis involves both mechanisms, but how these opposite effects are balanced remains unclear. Our aim was to investigate how alcoholic hepatitis affects the capacity for urea synthesis. We related these findings to another measure of metabolic liver function, the galactose elimination capacity (GEC), as well as to clinical disease severity. Methods: We included 20 patients with alcoholic hepatitis and 7 healthy controls. The urea synthesis capacity was quantified by the functional hepatic nitrogen clearance (FHNC), i.e., the slope of the linear relationship between the blood α-amino nitrogen concentration and urea nitrogen synthesis rate during alanine infusion. The GEC was determined using blood concentration decay curves after intravenous bolus injection of galactose. Clinical disease severity was assessed by the Glasgow Alcoholic Hepatitis Score and Model for End-Stage Liver Disease (MELD) score. Results: The FHNC was markedly decreased in the alcoholic hepatitis patients compared with the healthy controls (7.2±4.9 L/h vs. 37.4±6.8 L/h, P<0.01), and the largest decrease was observed in those with severe alcoholic hepatitis (4.9±3.6 L/h vs. 9.9±4.9 L/h, P<0.05). The GEC was less markedly reduced than the FHNC. A negative correlation was detected between the FHNC and MELD score (rho = -0.49, P<0.05). Conclusions: Alcoholic hepatitis markedly decreases the urea synthesis capacity. This decrease is associated with an increase in clinical disease severity. Thus, the metabolic failure in alcoholic hepatitis prevails such that the liver cannot adequately perform the metabolic up-regulation observed in other stressful states, including extrahepatic inflammation, which may contribute to the patients’ poor prognosis. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
44. Predictors of Increased Risk of Hepatocellular Carcinoma in Patients with Type 2 Diabetes.
- Author
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Si, Won Keun, Chung, Jung Wha, Cho, Junhyeon, Baeg, Joo Yeong, Jang, Eun Sun, Yoon, Hyuk, Kim, Jaihwan, Shin, Cheol Min, Park, Young Soo, Hwang, Jin-Hyeok, Jeong, Sook-Hyang, Kim, Nayoung, Lee, Dong Ho, Lim, Soo, and Kim, Jin-Wook
- Subjects
CANCER risk factors ,LIVER cancer ,TYPE 2 diabetes ,EPIDEMIOLOGY ,CIRRHOSIS of the liver ,PROPORTIONAL hazards models ,VIRAL hepatitis - Abstract
Epidemiological data indicate that type 2 diabetes is associated with increased risk of hepatocellular carcinoma (HCC). However, risk stratification for HCC has not been fully elucidated in diabetic population. The aim of this study was to identify potential predictors of HCC in diabetic patients without chronic viral hepatitis. A cohort of 3,544 diabetic patients without chronic viral hepatitis or alcoholic cirrhosis was established and subjects were randomly allocated into a derivation and a validation set. A scoring system was developed by using potential predictors of increased risk of HCC from the Cox proportional hazards model. The performance of the scoring system was tested for validation by using receiver operating characteristics analysis. During median follow-up of 55 months, 36 cases of HCC developed (190 per 100,000 person-years). The 5- and 10-year cumulative incidences of HCC were 1.0%, and 2.2%, respectively. Multivariate Cox regression analysis showed that age > 65 years, low triglyceride levels and high gamma-glutamyl transferase levels were independently associated with an increased risk of HCC. DM-HCC risk score, a weighted sum of scores from these 3 parameters, predicted 10-year development of HCC with area under the receiver operating characteristics curve of 0.86, and discriminated different risk categories for HCC in the derivation and validation cohort. In conclusion, old age, low triglyceride level and high gamma-glutamyl transferase level may help to identify individuals at high risk of developing HCC in diabetic patients without chronic viral hepatitis or alcoholic cirrhosis. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
45. OpenVigil FDA – Inspection of U.S. American Adverse Drug Events Pharmacovigilance Data and Novel Clinical Applications.
- Author
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Böhm, Ruwen, von Hehn, Leocadie, Herdegen, Thomas, Klein, Hans-Joachim, Bruhn, Oliver, Petri, Holger, and Höcker, Jan
- Subjects
DRUG side effects ,DRUG approval ,MEDICAL care ,PHYSICIANS ,PHARMACISTS ,LICENSES - Abstract
Pharmacovigilance contributes to health care. However, direct access to the underlying data for academic institutions and individual physicians or pharmacists is intricate, and easily employable analysis modes for everyday clinical situations are missing. This underlines the need for a tool to bring pharmacovigilance to the clinics. To address these issues, we have developed OpenVigil FDA, a novel web-based pharmacovigilance analysis tool which uses the openFDA online interface of the Food and Drug Administration (FDA) to access U.S. American and international pharmacovigilance data from the Adverse Event Reporting System (AERS). OpenVigil FDA provides disproportionality analyses to (i) identify the drug most likely evoking a new adverse event, (ii) compare two drugs concerning their safety profile, (iii) check arbitrary combinations of two drugs for unknown drug-drug interactions and (iv) enhance the relevance of results by identifying confounding factors and eliminating them using background correction. We present examples for these applications and discuss the promises and limits of pharmacovigilance, openFDA and OpenVigil FDA. OpenVigil FDA is the first public available tool to apply pharmacovigilance findings directly to real-life clinical problems. OpenVigil FDA does not require special licenses or statistical programs. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
46. Impaired Ethanol-Induced Sensitization and Decreased Cannabinoid Receptor-1 in a Model of Posttraumatic Stress Disorder.
- Author
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Matchynski-Franks, Jessica J., Susick, Laura L., Schneider, Brandy L., Perrine, Shane A., and Conti, Alana C.
- Subjects
CANNABINOID receptors ,ETHANOL ,POST-traumatic stress disorder ,NEUROPLASTICITY ,PROTEIN expression ,LABORATORY mice ,PHYSIOLOGY - Abstract
Background and Purpose: Impaired striatal neuroplasticity may underlie increased alcoholism documented in those with posttraumatic stress disorder (PTSD). Cannabinoid receptor-1 (CB1) is sensitive to the effects of ethanol (EtOH) and traumatic stress, and is a critical regulator of striatal plasticity. To investigate CB1 involvement in the PTSD-alcohol interaction, this study measured the effects of traumatic stress using a model of PTSD, mouse single-prolonged stress (mSPS), on EtOH-induced locomotor sensitization and striatal CB1 levels. Methods: Mice were exposed to mSPS, which includes: 2-h restraint, 10-min group forced swim, 15-min exposure to rat bedding odor, and diethyl ether exposure until unconsciousness or control conditions. Seven days following mSPS exposure, the locomotor sensitizing effects of EtOH were assessed. CB1, post-synaptic density-95 (PSD95), and dopamine-2 receptor (D2) protein levels were then quantified in the dorsal striatum using standard immunoblotting techniques. Results: Mice exposed to mSPS-EtOH demonstrated impaired EtOH-induced locomotor sensitization compared to Control-EtOH mice, which was accompanied by reduced striatal CB1 levels. EtOH increased striatal PSD95 in control and mSPS-exposed mice. Additionally, mSPS-Saline exposure increased striatal PSD95 and decreased D2 protein expression, with mSPS-EtOH exposure alleviating these changes. Conclusions: These data indicate that the mSPS model of PTSD blunts the behavioral sensitizing effects of EtOH, a response that suggests impaired striatal neuroplasticity. Additionally, this study demonstrates that mice exposed to mSPS and repeated EtOH exposure decreases CB1 in the striatum, providing a mechanism of interest for understanding the effects of EtOH following severe, multimodal stress exposure. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
47. Risk Factors for Extended Duration and Timing of Peak Severity of Hot Flashes.
- Author
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Smith, Rebecca Lee, Gallicchio, Lisa, Miller, Susan R., Zacur, Howard A., and Flaws, Jodi A.
- Subjects
HOT flashes ,DISEASE duration ,MIDDLE-aged women ,MENOPAUSE ,ALCOHOL drinking ,PROGESTERONE ,HEALTH - Abstract
Objective: To identify risk factors associated with the duration of hot flashes and the time of peak hot flash severity in mid-life women. Methods: A cohort of 647 women reporting hot flashes were followed for 1–7 years, with survey data and hormone measurements. Survival analysis determined the association of risk factors with the duration of hot flashes. Linear regression determined the association of risk factors with the time of peak severity. Final models were determined through stepwise model selection. Results: Average hot flash duration was 2.5 years (range: 1–33), with peak severity on average at 2.96 years (range: 1–20). Duration of hot flashes was associated with race, education, menopause status, smoking history, BMI, alcohol consumption, leisure activity levels, and levels of estradiol and progesterone. In the final model, only race, alcohol consumption, leisure activity, and menopause were retained. White women had significantly shorter hot flash durations than non-white women. Women consuming at least 12 alcoholic drinks in the previous year had a significantly shorter duration of hot flashes with a smaller effect of hot flash duration on increasing in time to peak severity compared to those who consumed less than 12 alcoholic drinks in that year. Higher serum progesterone levels were associated with later peak severity if the duration of the hot flashes was less than 2 years and an earlier peak severity otherwise. Conclusions: These results suggest that some behaviors (such as moderate alcohol consumption) are associated with shorter durations of hot flashes, and that progesterone was associated with the dynamics of hot flash severity. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
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48. Methadone Maintenance Treatment Promotes Referral and Uptake of HIV Testing and Counselling Services amongst Drug Users and Their Partners.
- Author
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Tran, Bach Xuan, Nguyen, Long Hoang, Nguyen, Lan Phuong, Nguyen, Cuong Tat, Phan, Huong Thi Thu, and Latkin, Carl A.
- Subjects
METHADONE treatment programs ,DIAGNOSIS of HIV infections ,HEALTH counseling ,WILLINGNESS to pay ,SEXUAL partners - Abstract
Background: Methadone maintenance treatment (MMT) reduces HIV risk behaviors and improves access to HIV-related services among drug users. In this study, we assessed the uptake and willingness of MMT patients to refer HIV testing and counseling (HTC) service to their sexual partners and relatives. Methods: Health status, HIV-related risk behaviors, and HTC uptake and referrals of 1,016 MMT patients in Hanoi and Nam Dinh were investigated. Willingness to pay (WTP) for HTC was elicited using a contingent valuation technique. Interval and logistic regression models were employed to determine associated factors. Results: Most of the patients (94.2%) had received HTC, 6.6 times on average. The proportion of respondents willing to refer their partners, their relatives and to be voluntary peer educators was 45.7%, 35.3%, and 33.3%, respectively. Attending MMT integrated with HTC was a facilitative factor for HTC uptake, greater WTP, and volunteering as peer educators. Older age, higher education and income, and HIV positive status were positively related to willingness to refer partners or relatives, while having health problems (mobility, usual care, pain/discomfort) was associated with lower likelihood of referring others or being a volunteer. Over 90% patients were willing to pay an average of US $17.9 for HTC service. Conclusion: The results highlighted the potential role of MMT patients as referrers to HTC and voluntary peer educators. Integrating HIV testing with MMT services and applying users’ fee are potential strategies to mobilize resources and encourage HIV testing among MMT patients and their partners. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
49. Elevated Hair Cortisol Levels among Heroin Addicts on Current Methadone Maintenance Compared to Controls.
- Author
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Yang, Jin, Li, Jifeng, Xu, Guanyi, Zhang, Jing, Chen, Zheng, Lu, Zuhong, and Deng, Huihua
- Subjects
PEOPLE with heroin addiction ,METHADONE hydrochloride ,HYDROCORTISONE ,HYPOTHALAMIC-pituitary-adrenal axis ,MENTAL depression ,BIOMARKERS - Abstract
Whether methadone maintenance treatment (MMT) can improve the basal function of the hypothalamic–pituitary–adrenal (HPA) axis, which is suppressed by long-term heroin consumption, is a matter of debate. The stress state and depression and anxiety symptoms may affect the basal activity of the HPA axis in MMT patients. However, the effect of psychological factors on HPA activity was not simultaneously controlled in previous studies. This study investigated differences in HPA basal activity between MMT patients and controls using psychological variables as covariates. The participants included 52 MMT patients and 41 age-matched, non-heroin-dependent controls. Psychological states were self-reported with the Perceived Stress Scale, Self-Rating Depression Scale and Self-Rating Anxiety Scale. The hair cortisol level was adopted as a biomarker of HPA basal activity and was determined with liquid chromatography tandem mass spectrometry. The results revealed that MMT patients had significantly higher hair cortisol levels than the controls (p<0.05), but the difference was not significant (p>0.05) when the perceived stress, depression and anxiety scores were used as covariates. We concluded that patients with long-term MMT showed higher basal activity of the HPA axis. The high chronic stress state and increase in depression and anxiety symptoms may mask the suppression effect of methadone on the HPA activity. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
50. Baseline HCV Antibody Prevalence and Risk Factors among Drug Users in China’s National Methadone Maintenance Treatment Program.
- Author
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Wang, Changhe, Shi, Cynthia X., Rou, Keming, Zhao, Yan, Cao, Xiaobin, Luo, Wei, Liu, Enwu, and Wu, Zunyou
- Subjects
HEPATITIS C virus ,VIRUS diseases ,CHINESE people ,METHADONE treatment programs ,MEDICAL screening ,DEMOGRAPHY ,DISEASE risk factors ,DISEASES - Abstract
Background: Hepatitis C virus (HCV) is the most common viral infection among injecting drug users worldwide. We aimed to assess HCV antibody prevalence and associated risk factors among clients in the Chinese national methadone maintenance treatment (MMT) program. Methods: Data from 296,209 clients who enrolled in the national MMT program between March 2004 and December 2012 were analyzed to assess HCV antibody prevalence, associated risk factors, and geographical distribution. Results: Anti-HCV screening was positive for 54.6% of clients upon MMT entry between 2004 and 2012. HCV antibody prevalence at entry declined from 66.8% in 2005 to 45.9% in 2012. The most significant predictors of HCV seropositivity were injecting drug use (adjusted odds ratio [AOR]: 8.34, 95% confidence interval [CI]: 8.17–8.52, p<0.0001) and a history of drug use ≥9 years (AOR: 2.01, 95% CI: 1.96–2.06, p<0.0001). Being female, of Uyghur or Zhuang ethnicity, and unmarried were identified as demographic risk factors (all p-values<0.0001). Of the 28 provincial-level divisions included in the study, we found that 5 divisions had HCV antibody prevalence above 70% and 20 divisions above 50%. The HCV screening rate within 6 months after MMT entry greatly increased from 30.4% in 2004 to 93.1% in 2012. Conclusions: The current HCV antibody prevalence remains alarmingly high among MMT clients throughout most provincial-level divisions in China, particularly among injecting drug users and females. A comprehensive prevention strategy is needed to control the HCV epidemic among MMT clients in China. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
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