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Introduction Increased salience of drug-related cues over nondrug reinforcers can drive drug use and contribute to tobacco use disorder (TUD). An important scientific and clinical goal is to effectively measure this elevated drug-seeking behavior in TUD. However, most TUD assessments rely on self-reported cravings and cigarette consumption, not providing an objective measure of the impact of drug cues on biasing behavior toward drugs. The probabilistic image choice (PIC) task investigates the choice of viewing drug-related pictures as compared to other salient pictures (eg, pleasant and unpleasant). This study aimed to develop and validate the PIC task for TUD and evaluate the associations between behavioral choice and tobacco craving, daily cigarette consumption, quit attempts and motivation to quit, and nicotine dependence (the Fagerström score). Methods We recruited 468 smokers and 121 nonsmokers using the Prolific online platform. Participants performed the PIC task twice (at a 1-month interval) and completed other measures relevant to TUD. Results Compared to nonsmokers, tobacco smokers selected to view significantly more tobacco images and less pleasant (nondrug reinforcer) images, a profile that remained stable at retest. Individual differences in choice of tobacco as compared to pleasant images on the PIC task were associated with craving but not with the other tobacco dependence measures, suggesting that the task may serve as a behavioral proxy measure of drug "wanting" rather than of cumulative nicotine exposure or physical dependence. Conclusions These results suggest that the PIC task can be a valuable tool for objectively assessing craving-associated tobacco seeking in TUD. Implications Most of the current measures of TUD rely on self-reports of consumption, dependence, and craving, and do not take into consideration the role of drug-related cues in driving tobacco seeking. This study shows that the PIC task provides an objective, reliable proxy measure of tobacco image-seeking behavior in people who smoke cigarettes that is linked to craving (desire) for smoking but not to other measures of TUD. Therefore, the PIC task may be a useful complementary tool for the classification, diagnosis, and prognosis of TUD. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the effect of nursing interventions applied to elderly individuals to improve rational use of medicines (RUM) and awareness through home visits. It was carried out in a prospective, randomized controlled experimental design with the pretest–post-test control group. The study was completed with 74 elderly individuals aged ≥65 years living in a rural area. The intervention group received education, counselling, brochures and pill boxes through home visits to increase RUM and awareness. The study data were collected between September and December 2022 using the face-to-face interview method, the elderly identification form, the Rational Use of Medicines Scale and the Rational Drug Use Awareness Scale. After nursing interventions were applied at home, it was determined that, the mean scores of RUM and Awareness of RUM of the intervention group increased compared to the control group and that, interventions to improve RUM and awareness were effective. In line with these results, training sessions on RUM should be organized periodically for elderly individuals and home visits should be planned by nurses at regular intervals to ensure the sustainability of RUM in the home environment. [ABSTRACT FROM AUTHOR]

Background: Application of the ABC-VEN method in evaluating drug planning can increase efficiency and ensure optimal medicine availability and stable access to medications. Objective: To analyze ABC-VEN combinations to examine the profile of medicine use in the internal medicine department. Methods: This was an observational study with retrospective prescription data from outpatients in the Internal Medicine Department from January to March 2020. Collected data included the type, number of medicines, and medicine prices. Patients undergoing chemotherapy and retroviral therapy for HIV were excluded from the study. Subsequently, an ABC-VEN analysis was performed. Results: Of4,242 prescription samples, 188 types of medicines were used. Based on the drug use evaluation with ABC analysis, category A contained 23 items (12.17%), category B contained 35 items (18.52%), and category C contained 130 items (69.31%). The ABC analysis for investment value found that category A contained eight items (4.23%), category B contained 22 items (11.64%), and 158 items (84.13%). Based on the VEN analysis, Group V had six medicine items, Group E had 152 medicine items, and Group N had 30 medicine items. The ABC-VEN investigation showed that there were eight, 151, and 29 items of medicines in Categories I, I, and III, respectively. Conclusion: Although there are medicines that are highly used, their investment value is quite low. The use of the ABC-VEN method to evaluate medicine use is crucial for organizing and controlling the medicine supply. [ABSTRACT FROM AUTHOR]

Introduction: Healthcare students are becoming increasingly concerned about self-medication (SM), which can have major health repercussions. It affects how future physicians make professional decisions about medications. Such a mindset has an indirect impact on providing their patients with appropriate counselling. The study was planned to investigate the attitude, determinants and different clinical aspects associated with SM of dental pain amongst medical students in Jeddah, Saudi Arabia. Materials and Methods: The present descriptive cross-sectional study was conducted exclusively on the 400 medical students from the 1st year and interns pursuing bachelor’s degrees from various medical colleges in Jeddah, Saudi Arabia. A convenient non-probability sampling technique was employed, and a pre-tested/pre-validated questionnaire was loaded on Google Forms and sent to the medical students of medicine, dentistry, pharmacy and nursing programmes. Qualitative characteristics were assessed using the Chi-square test. The significance level (P value) chosen for the various comparisons was P < 0.05. Results: The results of this study show that 65.5% of students self-medicate. It was significantly more common in women (74.9%), pharmacists (76.9%) and dental students (72.7%). Students who self-medicated less often were in the 1st and 2nd years (49.2% and 57.1%). Toothache was the most common cause for which they self-medicated (79.8%). Conclusion: The results of the present study have shed light on the fact that SM was high amongst medical students in Jeddah. The potential problems associated with self-medication should be highlighted to students to reduce the risk of inappropriate SM, which can seriously harm both students and others to whom they prescribe medication. [ABSTRACT FROM AUTHOR]

Background Increasing fruit and vegetable (FV) consumption is associated with reduced cardiovascular disease risk in observational studies but with little evidence from randomised controlled trials (RCTs). The impact of concurrent pharmacological therapy is unknown. Objective To pool data from six RCTs to examine the effect of increasing FV intake on blood pressure (BP) and lipid profile, also exploring whether effects differed by medication use. Design Across trials, dietary intake was assessed by diet diaries or histories, lipids by routine biochemical methods and BP by automated monitors. Linear regression provided an estimate of the change in lipid profile or BP associated with a one portion increase in self-reported daily FV intake, with interaction terms fitted for medication use. Results The pooled sample included a total of 554 participants (308 males and 246 females). Meta-analysis of regression coefficients revealed no significant change in either systolic or diastolic BP per portion FV increase, although there was significant heterogeneity across trials for systolic BP (I 2 = 73%). Neither adjusting for change in body mass index, nor analysis according to use of anti-hypertensive medication altered the relationship. There was no significant change in lipid profile per portion FV increase, although there was a significant reduction in total cholesterol among those not on lipid-lowering therapy (P  < 0.05 after Bonferroni correction). Conclusion Pooled analysis of six individual FV trials showed no impact of increasing intake on BP or lipids, but there was a total cholesterol-lowering effect in those not on lipid-lowering therapy. [ABSTRACT FROM AUTHOR]

Background and Objectives: This study aims to assess the health status and factors influencing healthy choices among children and young people in Romania, as well as the efficacy of related health education programs. Through understanding these dynamics, the study seeks to provide insights that can shape targeted interventions, policies, and educational strategies to improve this demographic's overall health and well-being. Materials and Methods: For this study, we performed a literature review of original published papers on the health status, healthy habits, health education, predisposition to making healthy choices in the future, and accessibility to the paediatric health system of Romanian children and young people, as well as the effects of different types of educational interventions on this demographic in Romania. Results: The prevalence of dental caries is high in Romania. In terms of eating habits and nutritional status, a worrying proportion of children are overweight or obese, which can lead to a variety of future physical and psychological problems. In terms of physical activity, few adolescents demonstrate regular fitness practices. Romania presents an increase in alcohol and tobacco consumption among adolescents. The mental health of students has become a pressing public health concern, exacerbated by the COVID-19 pandemic. The use of social networks is linked to mental health issues among young people. Romania still has one of the highest rates of sexually transmitted diseases and faces a high incidence of cervical cancer, with a mortality rate three times higher than the EU average. High rates of teenage pregnancies are linked to limited information about sexuality and a lack of access to family planning at a young age. There are large discrepancies in the accessibility of medical services between urban and rural areas. Conclusions: Romania faces significant obstacles to providing high-quality healthcare to children and young people. Improving nutrition, immunisation rates, and access to medical services represent essential areas for enhancing the health of children and young people in Romania. [ABSTRACT FROM AUTHOR]

(1) Background/Objectives: To investigate the nationwide screening practices and trends in tamoxifen retinal toxicity (tamoxifen retinopathy) in South Korea using national health insurance claims data. (2) Methods: A total of 43,848 patients who started tamoxifen therapy between 2015 and 2020 and had no prior ophthalmic diseases or other conditions requiring screening for retinopathy were included. The annual numbers of tamoxifen users and new initiators of tamoxifen therapy were assessed. The screening examinations were separated into baseline (first ophthalmic examination after tamoxifen administration) and subsequent monitoring examinations. The timing and modalities for the baseline and subsequent monitoring examinations performed between 2015 and 2021 were assessed in tamoxifen users. (3) Results: The annual number of tamoxifen users increased over the study period from 54,056 in 2015 to 81,720 in 2021. The number of patients who underwent ophthalmic examination after tamoxifen administration was 8961 (20.4%). Baseline screening was performed in 6.5% of patients within 1 year of use, and subsequent monitoring was performed in 27.8% of patients who underwent baseline screening. Funduscopy or fundus photography was performed most commonly for baseline screening and subsequent monitoring (99.0% and 98.6%, respectively), while optical coherence tomography was performed only in 21.9% and 29.6% of baseline and monitoring examinations, respectively. The average number of monitoring examinations per year was 0.68 ± 0.45. Although the annual percentage of patients receiving a baseline examination within 1 year gradually increased over time, the percentage of those with subsequent monitoring performed within 1 year was similar over the study period. (4) Conclusions: Our finding, appropriate screening in a small proportion of patients receiving tamoxifen, suggests the need to promote awareness among healthcare professionals and develop a standardized approach for screening for tamoxifen retinopathy. [ABSTRACT FROM AUTHOR]

Background Sleep problems following childhood cancer treatment may persist into adulthood, exacerbating cancer-related late effects and putting survivors at risk for poor physical and psychosocial functioning. This study examines sleep in long-term survivors and their siblings to identify risk factors and disease correlates. Methods Childhood cancer survivors (≥5 years from diagnosis; n = 12 340; 51.5% female; mean [SD] age = 39.4 [9.6] years) and siblings (n = 2395; 57.1% female; age = 44.6 [10.5] years) participating in the Childhood Cancer Survivor Study completed the Pittsburgh Sleep Quality Index (PSQI). Multivariable Poisson-error generalized estimating equation compared prevalence of binary sleep outcomes between survivors and siblings and evaluated cancer history and chronic health conditions (CHC) for associations with sleep outcomes, adjusting for age (at diagnosis and current), sex, race/ethnicity, and body mass index. Results Survivors were more likely to report clinically elevated composite PSQI scores (>5; 45.1% vs 40.0%, adjusted prevalence ratio [PR] = 1.20, 95% CI = 1.13 to 1.27), symptoms of insomnia (38.8% vs 32.0%, PR = 1.26, 95% CI = 1.18 to 1.35), snoring (18.0% vs 17.4%, PR = 1.11, 95% CI = 1.01 to 1.23), and sleep medication use (13.2% vs 11.5%, PR = 1.28, 95% CI = 1.12 to 1.45) compared with siblings. Within cancer survivors, PSQI scores were similar across diagnoses. Anthracycline exposure (PR = 1.13, 95% CI = 1.03 to 1.25), abdominal radiation (PR = 1.16, 95% CI = 1.04 to 1.29), and increasing CHC burden were associated with elevated PSQI scores (PRs = 1.21-1.48). Conclusions Among survivors, sleep problems were more closely related to CHC than diagnosis or treatment history, although longitudinal research is needed to determine the direction of this association. Frequent sleep-promoting medication use suggests interest in managing sleep problems; behavioral sleep intervention is advised for long-term management. [ABSTRACT FROM AUTHOR]

Background: The use of proton pump inhibitors (PPIs) has increased over the past decades. One potential gateway into new PPI use is following a hospital admission. The study aimed to examine the incidence of new PPI usage following admission to internal medicine services and the ratio of new persistent users. Methods: A retrospective descriptive study was conducted among all adults who had been admitted to internal medicine wards at the National University Hospital of Iceland from 2010–2020. Data was obtained from the Icelandic Internal Medicine Database. The proportion of patients who started treatment with PPI within 3 months of discharge (new users) and the proportion of patients who continued to use it after 3 months (persistent users) were examined. Results: Among 85.942 admissions during the study period, 7238 (15.6%) became new users, and of those 4942 (68%) were new persistent users. The incidence of new PPI use was highest for patients discharged from gastroenterology (32.2%), hematology (31.8%), and oncology (29.2%). Patients with new PPI use more commonly had a history of malignancy (19.5%) and liver disease (22.7%) and more commonly were admitted to the ICU during their hospitalization. The highest ratio of persistent usage was among patients discharged from geriatric medicine (84%). Conclusion: One in every six patients admitted to internal medicine wards filled out a prescription for PPI within 3 months from discharge, and a large proportion of them became persistent users. The high rate of new PPI users from oncology and hematology is noteworthy and requires further research. [ABSTRACT FROM AUTHOR]

Faced with this situation, a general awareness has led to the creation of an international day against drug abuse and trafficking on June 26. Several international and regional conventions are working together to develop strategies and policies to fight this scourge. The aim of this study is to look for the prevalence and associated factors of drug use in schools in the city of Ouagadougou in 2019. This study used a descriptive and analytical cross-sectional study using a self-administered questionnaire administered to students in schools in the city of Ouagadougou who were present during the survey in March 2019. The collection tool was a self-administered questionnaire inspired by the WHO guide on school health surveillance in the Burkinabe context, which had been previously tested. Kobocollect software was used to collect the data. Data processing and analysis were carried out using STATA version 15.1 software. The variable of interest was drug use. The data collected were analyzed with STATA version 15.1 software. The students in this study ranged in age from 12 to 25, with a mean age of 14.78 ± 2.26 years. The prevalence of drug use was 6.11%. It varied significantly according to gender, pocket money, and history of drug use. Strategies to combat drug use must be strengthened and adapted to our context in order to bring about a change in behavior, especially in schools. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted to determine the drug/non-drug product use status of parents for their children before admission to the hospital. Methods: The universe and sample of this descriptive and cross-sectional study consisted of 91 parents who applied to the pediatric emergency service of a training and research hospital for treating their children, were admitted to the infant service and agreed to participate in the study between June and December 2017. Data were collected using Information Form created by the researchers. Results: A statistically significant difference was found between the drug administration status of children before admission to the hospital according to age group (p

Limbic surgery is one of the most attractive and retaken fields of functional neurosurgery in the last two decades. Psychiatric surgery emerged from the incipient work of Moniz and Lima lesioning the prefrontal cortex in agitated patients. Since the onset of stereotactic and functional neurosurgery with Spiegel and Wycis, the treatment of mental diseases gave attention to refractory illnesses mainly with the use of thalamotomies. Neurosis and some psychotic symptoms were treated by them. Several indications when lesioning the brain were included: obsessive-compulsive disorder, depression, and aggressiveness among others with a diversity of targets. The indiscriminately use of anatomical sites without enough scientific evidence, and uncertainly defined criteria for selecting patients merged with a deficiency in ethical aspects, brought a lack of procedures for a long time: only select clinics allowed this surgery around the world from 1950 to the 1990s. In 1999, Nuttin et al. began a new chapter in limbic surgery with the use of Deep Brain Stimulation, based on the experience of pain, Parkinson’s disease, and epilepsy. The efforts were focused on different targets to treat depression and obsessive-compulsive disorders. Nevertheless, other diseases were added to use neuromodulation. The goal of this article is to show the new opportunities to treat neuropsychiatric diseases.

Youth are significant consumers of internet technologies. Sometimes, adolescents are directly involved in problematic internet usage, such as online gambling and pornography. They are indirectly exposed to some negative behavior, such as alcohol usage, drug usage, internet addiction, and social isolation. This study aims to identify the relationship between six factors of negative behavior and gratification in using the internet among 440 Malaysian youth by collecting data via survey. The theory applied is the uses and gratification theory (U&G). The results revealed no meaningful relationship between the gratification of using the internet and pornography, online gambling, alcohol, and drug usage. However, there was a significant positive relationship between the gratification of internet use, social isolation, and internet addiction. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease is one of the chronic diseases with an increasing prevalence from year to year. The results of Indonesia's basic health research (RISKESDAS 2018) showed that it was experienced by 2.9% of the population. Ensuring the continuity of drug availability is very important in pharmacy services for this patient group. The history of drug use is considered in the planning dan procurement of drug products. Objective: This study aims to analyze the drug use pattern and cost of drugs for cardiology outpatients in the National Health Insurance scheme (JKN). Methods: A retrospective observational study was conducted using the prescription of cardiology outpatients JKN for March-May 2021. The ABC method carried out the analysis of drug use patterns and cost. Results: From 2,986 prescriptions for cardiovascular disease, there were 94 types of drugs from 37 therapeutic classes. In the ABC analysis of drug use for class A, 68.82% contained seven types of drugs, class B, 20.55% contained nine types of drugs, and class C, 10.63% with 78 types of drugs. The results of ABC analysis for investment value (cost) of drugs class A 66.96% contained two types of drugs, class B 19.81% with four types of drugs, and class C 14.23% with 88 types of drugs. Conclusion: ABC analysis of the drug use pattern and cost/investment showed different patterns which had value to consider in procurement planning to maintain service continuity. [ABSTRACT FROM AUTHOR]

BackgroundAdolescent juvenile offenders are at high risk for problems associated with drug use, including polysubstance use (i.e., use of a variety of drugs). The combination of juvenile offending and polysubstance use presents a significant public and child health concern.ObjectiveThis study explored polysubstance use among a sample of youth incarcerated for serious offenses. We examined several risk factors for substance use and delinquency (i.e., early and frequent substance use, prior history of arrests, school expulsion, Black ethnicity), as well as the association between aggression and polysubstance use.MethodsData were collected via questionnaires from 373 serious male juvenile offenders upon intake into a secure locked facility. Youth were on average 16 years old, and minority youth were overrepresented (28.1% Black, 53.1% Latino). Poisson regressions were used to assess the associations between the risk factors, aggression, and polysubstance use.ResultsConsistent with the literature, Black youth reported less polysubstance use and later age of drug use onset than White and Latino youth. Findings suggest that Latino juvenile offenders and those with an early and problematic pattern of substance use are at heightened risk for polysubstance use. Aggression was not significantly related to polysubstance use, over and above the risk factors.ConclusionsGiven that Latino youth experience low rates of treatment for substance use, the development of culturally-sensitive interventions for these youth is needed. Interventions should also be multifaceted to address the multitude of risk factors associated with polysubstance use among juvenile offenders.

Drug Addiction is a very severe problem in the Indian region which is affecting all aspects of the society. It has received greater attention in recent times due to the proliferating magnitude of the problem and the changing trends in usage of drugs particularly in youth. Drugs have started breeding their own sub-culture, which has its own norms, values, behaviour and symbols. This problem deteriorates an individual's health and happiness of an individual, the family, the community and the society. Today, there is no part of the world that is free from the curse of drug trafficking and drug addiction. Drug Addiction is not confined to a single person or region. Its number could be varied and found in any age, gender, ethnicity, social class or religion. As a matter of fact, the tentacles of drug addiction have spread world widely covering every country in the world. There are various factors like peer pressure, masses high aspirations, unemployment and changing societal order are continuously enhancing this particular menace. The present study therefore aims to study the distinctive consequences behind the problem of drug addiction which impacts the masses physically, psychologically, economically and socially. It also manifests some possible solutions that could be taken by family, community, friends and society to eradicate this problem. [ABSTRACT FROM AUTHOR]

Abstract The consumption of alcohol and illicit substances has shown alarming levels among young university students, and its use may be associated with the coping strategy of academic burnout. This review aimed to synthesize the scientific evidence related to the consumption of alcohol and illicit substances associated with burnout syndrome in university students. Searches were carried out in: Biblioteca Virtual em Saúde, PubMed, Web of Science, PsycNet and Scopus databases, with no year limitation and based on the PRISMA guideline. Among the 2.269 articles identified, 16 met the inclusion criteria. All studies evaluated students in the health area, 12 studies found an association between the variables, with alcohol and illicit substances consumption strongly related to burnout syndrome. It was concluded that there is an association between the studied variables, indicating that the presence of burnout syndrome in university students can result in the use of negative strategies as a coping measure.

Presently, the operational strategies for the control of Soil-Transmitted Helminths (STHs) has been via Mass Drug Administration (MDA) which primarily targets school and pre-school age children, child-bearing age women, including adults with high-risk occupations. Therefore, this study was done to relate the frequency of drug usage by the host to the intensity and viability of STH ova in the faecal samples collected in 11 study areas (Alakia, Akanran, Molete, Aleshinloye, Iwo Road, Eleyele, Bodija, Moniya, Olodo, Omi Adio and Podo) within Ibadan methropolis. A total of 1100 faecal samples were collected from voluntary participants between January and December 2018 and a standard Kato-Katz techniques was used for diagnosis. Well-structured questionnaire to acquire data on the demographics and usage of drug against STH infections was administered to each of the consenting participants. SPSS version 21 was used to analyze the data; ANOVA at p< 0.05. Faecal samples (35.9%) had one species of parasite minimally. Ascaris had the highest prevalence of 41.6%, followed by 24.5%, 23.5% and 10.4% for Trichuris, hookworm and Strongyloides species respectively. The parasite specific prevalence varied significantly (p≤0.05). Bodija had the highest frequency of drug usage with the least viability (6.1%) and intensity (5.4%). There is a negative correlation between frequency of drug usage and intensity (r= -0.39) and viability (r= -0.35) across the sampling locations. The STH infection prevalence observed could be attributed to poor environmental sanitation, poor personal hygiene arising from several factors such as lack of adequate sanitary facilities and other associated risk in the study locations. The decrease in viability and intensity of STH with respect to level of MDA drug usage might be significant to anticipated effectiveness and eventual success of MDA programmes in Ibadan environs. [ABSTRACT FROM AUTHOR]

The development of methods for statistical analysis of large data volumes and availability of standard information processing packages to users shows signs of widespread their usage, including for medical forecasting. It is a scientifically sound prediction of possible future changes in public health in general or the health status of specific patients. In order to make medical decisions and obtain information about public health in general or the health of individual patients the prediction of possible future changes is important. Different statistical approaches should be applied to validate the projected risks. Comparatively two study groups tested for normality a number of criteria presented for analysis and concerning the incidence of human immunodeficiency virus/acquired immunodeficiency syndrome of residents of Odessa, Mykolaiv, Kherson regions and Ukraine as a whole, as well as injecting drug users, injecting drug users specified areas. Using the modern methods of a statistical analysis the authors come to the idea that these absolute and relative data allow to make a complex scheme of HIV/AIDS prediction on the Black Sea region of Ukraine. Therefore, it was shown that Odessa and Kherson regions of the Black Sea region demonstrated a steady increase in the HIV incidence; the increase of the incidence makes around 10-20% annually. In the Mykolaiv region, on the contrary, there is an annual reduction in incidence, although this trend weakened in recent years. The nature of fluctuations in the incidence of HIV in the period from 2006 to 2018 differs in Odesa, Mykolaiv, Kherson regions and in Ukraine in general. The correlation between Odesa and Mykolaiv region – is negative, between Odessa and Kherson - almost zero between Ukraine and Odessa region – weakly positive

Background: Proton pump inhibitors (PPIs) are the most potent antacids used in clinical practice with greater safety and efficacy. Limited data are available on the usage of PPIs in Indian health-care settings. Our aim was to understand the usage pattern and potential drug interactions with concurrently administered medications employing a single-day cross-sectional study design. Methods: A prospective observational cross-sectional study conducted on a single day, at two tertiary care teaching hospitals in South India. Inpatients of above 18 years of age were included. Case profiles were reviewed and data were collected in predesigned forms and analyzed. Drug interactions were identified using Micromedex and Medscape drug-interaction databases. Results: A total of 797 case profiles screened from both the centers; 714 were prescribed with PPIs. In intensive care units (ICUs), the use of PPIs was highest with 95% of cases getting these drugs. A PPI was seen in about 93% of patients, who had more than or equal to 4 drugs in their prescriptions. Pantoprazole was the mostly prescribed PPI in around 90% of the cases. Around 33% of the PPIs usage was through IV (intravenous) route, and 75% of that use was seen in wards. Around 134 drug interactions were identified, of which 10 were of major severity. Conclusions: Around 90% of inpatients were prescribed with PPIs. Pantoprazole is the most commonly prescribed PPI (90%). The IV administration was seen more in wards than ICUs, and 10 major drug interactions were observed in this single-day study. Careful monitoring is needed to avoid serious drug interactions involving PPIs, and training programs should sensitize the clinicians on the evidence-based use of PPIs. [ABSTRACT FROM AUTHOR]

Diabetes is a chronic disease that requires patient-centered treatment. The physician strategy for treatment of diabetes varies from one patient to another. Using the clinical parameters and the evidence of diabetes at various group of people are to be treated with the drugs that provide significant changes over period of time. In this work, safety and efficiency of drug that is used for diabetes and to provide justification using statistical approach is proposed. The benefits and harm of various drugs are represented as null hypothesis and alternate hypothesis using two-tailed t test (unpaired hypothesis testing). The drugs specified are given periodically at various weeks so that the effect of each drug is identified with clinical parameters and it is summarized. The various medications that are to be imposed on various groups of people and respected hypothesis values are calculated. The post hoc power, evaluation of p value that specify the significant change in the clinical parameters are observed. With the help of this p value and the hypothesis testing, it recommends the correct specification of drugs. The drug combination such as sulfonyl urea (glibenclamide 5 mg), sulfonyl urea + sitagliptin, sulfonyl urea + vildagliptin, metformin, metformin + sitagliptin, metformin + vildagliptin were used in this study. The above drugs are given to various groups to find out the effectiveness of drug usage in diabetes. The idea is implemented with both manual and automated approach of handling patient report and to find their significant approach and thereby to provide conclusion of the drug usage for diabetes.

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Background Ischaemic heart disease (IHD) and hypertension are leading causes of mortality and night work has been suspected as a risk factor. Meta-analyses and previous studies are often limited by power and various definitions of exposure and outcomes. This study aimed to investigate if night work increases the risk of IHD or anti-hypertensive drug usage in a large cohort of Danish employees. Methods Individual participant data on night work were drawn from the Danish Labour Force Survey (1999–2013). We included 145 861 participants (53% men) 21–59 years of age working 32 h or more per week. Participants with diagnosis or drug use in the year prior to baseline were excluded. Data on outcomes were obtained from nationwide health registers. Using Poisson regression we analyzed incidence rates of the outcomes as functions of night work adjusted for relevant covariates. Results We observed 3635 cases of IHD and 20 648 cases used anti-hypertensive drugs. When examining main effects the association of night work with drug use was estimated at rate ratio (RR): 1.05 (95% CI: 1.01–1.09). A sensitivity analysis suggested a dose-response association. The association of night work with IHD was estimated at RR: 1.08 (95% CI: 0.98–1.19). Overall likelihood ratio test showed no statistically significant associations between night work and IHD or drug use when including interactions with sex and socioeconomic status. Conclusions Night work was associated with an increased risk of anti-hypertensive drug use. Small estimates suggested a dose-response association. No statistically significant association between night work and IHD were found. [ABSTRACT FROM AUTHOR]

Background Our objective was to obtain estimates of the impact of the Dutch vaccination programme on medication use, outpatient visits, hospitalization and mortality at age 65. Methods We linked population-wide mortality, hospitalization and municipality registries to identify influenza-related deaths and hospitalizations, and used health interview surveys to identify medication use and outpatient visits during 1996–2008. We applied a regression discontinuity design to estimate the intention-to-treat effect of the personal invitation for a free influenza vaccination sent to every Dutch inhabitant at age 65 years on each of the outcomes, separately in influenza-epidemic and non-epidemic months. Results Invitation receipt for free influenza vaccination at age 65 led to a 9.8 percentage points [95% confidence interval (CI) = 3.5 to16.1; P < 0.01] rise in influenza vaccination. During influenza-epidemic months, it was associated with 1.5 fewer influenza/pneumonia deaths per 100 000 individuals (95% CI = −3.1 to −0.0; P = 0.05), a 15 percentage point lower probability to use prescribed medicines (95% CI = −28 to −3; P = 0.02) and 0.13 fewer General Practitioner (GP) visits per month (95% CI = −0.28 to 0.02; P = 0.09), while the association with hospitalizations due to influenza/pneumonia was small and imprecisely estimated (seven more hospitalizations per 100 000 individuals, 95% CI = −20 to 33; P = 0.63). No associations were found with any outcomes during non-epidemic months. Conclusions Personal invitations for a free influenza vaccination sent to every Dutch inhabitant at age 65 took pressure off primary health care but had small effects on hospitalizations and mortality. [ABSTRACT FROM AUTHOR]

Background: Recognition of drug usage patterns provides the basis for improving safety and plummeting risks associated with their use. Thus, this study was undertaken to explore the drug usage pattern in ophthalmology with an emphasis on antimicrobial use at a tertiary care teaching hospital. Materials and Methods: An observational study was conducted in the Department of Ophthalmology, Hakeem Abdul Hameed Centenary Hospital, Jamia Hamdard, New Delhi, India for 9 months. Newly registered patients visiting the Outpatient Department for curative complaints were included. All drugs prescribed were recorded, including dose, route, dosage form, frequency of administration, indications for prescription, and duration of therapy, and the data was audited using the indicators prescribed by the World Health Organization. Result: A total of 600 prescriptions were analyzed. The number of drugs prescribed was 1097 with an average drug per prescription being 1.8. The most common disorders diagnosed were infective conjunctivitis (21.5%) followed by stye (5.5%). Drugs were prescribed in different dosage forms with eye drops (72.6%) being the most common. Drugs were predominantly prescribed by brand name (100%). Antimicrobials (44.7%) were the most commonly prescribed drugs followed by lubricants (17.5%). Moxifloxacin (53.5%) was the most commonly prescribed antimicrobial agent. Of the antimicrobials prescribed, 89.6% were prescribed topically. Average total cost per prescription was 113 INR. Conclusion: The study concludes with an overall impression of rational prescription in terms of prescribing in consensus with the recommended treatment protocol of ocular diseases. Nevertheless, health-care professionals should be encouraged to prescribe by generic name. Creating awareness regarding selection of drugs from essential drug list to reduce the drug cost is the need of the hour. Last but not least, updating knowledge regarding appropriate antimicrobial use and the development of discreet strategies for their use should be implemented to steer clear of antimicrobial resistance.

Introduction: Calmare Scrambler Therapy (ST) interferes with pain signal transmission by using nerve fibers to convey a message of normality to the central nervous system. This prospective, double-blinded, randomized trial had three aims. First, we tried to determine ST's effectiveness in reducing chronic neuropathic pain symptoms and analgesic medication use in military service members, when compared to sham treatment. Next, we examined its effect on reported mental and physical health-related quality of life. Finally, we sought to describe participant perceptions of treatment effectiveness.Materials and Methods: Forty-seven subjects were randomized to receive ten 30-minute active ST or sham treatments. Data were collected at baseline, posttreatment, and 1-month follow-up.Results: The groups showed no statistically significant differences in pain scores, medication use, or mental or physical health-related quality of life with active versus sham treatment. However, both produced clinically meaningful reductions in pain and improvements in physical health-related quality posttreatment that was sustained at 1-month follow-up. Ninety percent of the blinded sample described the treatment intervention as a partial or complete success.Conclusion: ST is no better than sham treatment in decreasing pain. Yet, patient perceptions of treatment effectiveness are equally important in chronic pain treatment. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the predictive value of pre-fracture medication usage on 30-day mortality following a hip fracture. Methods: Information on age, sex, fracture type, time of death and Charlson co-morbidity index (CCI) was collected from the Danish National Patient Registry on all patients above 60 years, sustaining a hip fracture during the period January 1995 to December 2013. Information on drug usage was obtained from the Danish National Prescription Database. Hazard ratios were calculated with 30-day mortality as the outcome. A univariate and 3 multivariate analyses were conducted with increasing adjustments, starting with age, sex and fracture type, adding co-morbidity and dose in the latter. Results: 141,201 patients were included and a total of 12 drugs/drug groups were identified for analysis. Increased mortality was evident in all analyses for antiarrhythmics, beta blockers, proton pump inhibitors, loop diuretics, opioids, acetaminophen and for psycholeptics. For ACE-inhibitors, increased mortality was found in all analyses, except after adjustment for co-morbidity and dose. For thiazide diuretics, a significantly reduced mortality was evident in all but the univariate analyses while NSAIDs and statins were associated with a significantly reduced mortality in all analyses. For calcium channel blockers, an insignificant decrease was found after adjustment for dose. Further analysis showed a dose-response relationship for all drugs except ACE-inhibitors and calcium channel blockers. Conclusion: The study shows a correlation between pre-fracture usage of certain drugs and 30 day mortality after a hip fracture. [ABSTRACT FROM AUTHOR]

Introduction: Prior work suggests that the prevalence of cigarette smoking is persistently higher among people with mental health problems, relative to those without. Lower quit rates are one factor that could contribute to higher prevalence of smoking in this group. This study estimated trends in the cigarette quit rates among people with and without past-month serious psychological distress (SPD) from 2008 to 2016 in the United States.Methods: Data were drawn from 91 739 adult participants in the 2008-2016 National Survey on Drug Use and Health, a repeated, cross-sectional, national survey. Linear time trends of cigarette quit rates, stratified by past-month SPD, were assessed using logistic regression models with continuous year as the predictor.Results: Cigarette quit rates among individuals with past-month SPD were lower than among those without SPD every year from 2008 to 2016. Quit rates did not change appreciably among those with past-month SPD (odds ratio = 1.02 [0.99, 1.06]) from 2008 to 2016, whereas quit rates increased among those without past-month SPD (odds ratio = 1.02 [1.01, 1.02]).Conclusions: In the United States, quit rates among individuals with past-month SPD are approximately half than quit rates of those without SPD and have not increased over the past decade. This discrepancy in quit rates may be one factor driving increasing disparities in prevalence of smoking among those with versus without mental health problems. Tobacco control efforts require effective and targeted interventions for those with mental health problems.Implications: Cigarette smoking quit rates have not increased among persons with serious mental health problems over the past decade. This work extends prior findings showing that smoking prevalence is not declining as quickly among persons with serious mental health problems. Findings suggest that diverging trends in quit rates are one possible driver of the persistent disparity in smoking by mental health status. Innovation in both tobacco control and targeted interventions for smokers with mental health problems is urgently needed. [ABSTRACT FROM AUTHOR]

Introduction: Drug usage is a prevalent social and health problem in most countries. The highest prevalence of drug abuse has been reported among people aged 30-40 years old. The purpose of this study was to determination of the types of drugs and the methods of drug usage in Iran in a systematic and meta-analysis study. Methods: This study was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases ofSID, Iran Doc, ISI, Cochrane library, Science direct, PubMed/Medline, and Scopus were independently searched by two researchers using MeSH keywords. Articles published between 2004 and 2018 were recruited.Data was analyzed using random effectsmodel using STATA-SE12 software. Heterogeneity among studies was investigated using, T2 and I2statistical indices. Results: Initial search retrieved 90 articles from which 7 articles with desirable quality were finally analyzed. Opium was the most common in used narcotic50 %(95% CI: 35-66%) followed by opium extract44%(95% CI: 5-83%), and heroin 19%(95% CI: 12-26%). Using more than one narcotic was observed in 9% (95% CI: 4-15%). The inhalation was the most common method of usage72 %( 95% CI: 61-83%) followed by oral consumption 32%(95% CI: 9-54%) and injection 14%( 95% CI: 05-24%). Conclusion: Drug abuseis a common phenomenon in Iran. It is amenable to reduce the tendency to using drugs by providing appropriate training, informing the risks of drug abuse, and identifying and educating high-risk groups. [ABSTRACT FROM AUTHOR]

Background The relationship between gout medication use and cataract development is controversial. Moreover, limited clinical studies have evaluated this relationship. Aim To assess the effects of colchicine, allopurinol and benzbromarone on the risk of cataract in patients with gout. Design Population-based nested case–control study. Methods We enrolled 7900 patients who had received a new diagnosis of cataract >3 years after gout diagnosis into the study group and 33 475 patients who did not receive a diagnosis of cataract into the control group by matching for age, sex and the year of gout diagnosis at a ratio of 1:1. We used World Health Organization's defined daily dose (DDD) as a measure to assess the dosage of colchicine, allopurinol and benzbromarone exposure. Logistic regression was used to estimate crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the risk of cataract. Results The risk of cataract significantly increased in patients who received colchicine at a cumulative DDD of ≥66.5 (OR = 1.17, 95% CI = 1.01–1.36, P  = 0.041). In the age-stratified analysis, patients with gout aged >60 years had a higher risk of cataract (OR = 1.27, 95% CI = 1.06–1.53, P  = 0.011) than did patients aged <60 years. Allopurinol and benzbromarone had no association with cataract. Conclusions In this population-based nested case–control study, we observed that colchicine use increased the risk of cataract in patients with gout, especially in those aged >60 years who received colchicine at a cumulative DDD of >66.5. [ABSTRACT FROM AUTHOR]

Objective The present work is part of the ongoing project of examining the validation and standardization of the Executive Functions and Emotion Assessment for Adolescents with Risk Behaviors (EFEAA) test in the rural areas of Northwest Mexico. The objectives of the present study were (1) to examine the effects of age and risk behavior on emotionally interfered working memory ability, measured as performance on the Emotionally Interfered Working Memory Task (EIWMT) section of the EFEAA in a group of healthy adolescents from rural areas; and (2) to use these results to construct normative data that can be used in clinical practice. Participants and Method A total of 275 adolescents, 14.1 years old, geographically distributed among northwest Mexico were included in the sample. They were individually assessed using the Montreal Cognitive Assessment, Risk Behavior Questionnaire, including: sexual risk behavior, impulsiveness, drug, alcohol, and tobacco consumption, unhealthy food intake, and physical inactivity; for measuring emotion-cognition interaction we used the EIWMT. Results Results of this study present a database supported by factors of risk behavior and working memory, which includes: predictors for conduct disorders, drug use, and delinquency, in addition to correlations between the performance of emotionally interfered working memory and risk behaviors associated to health. Percentile and normal distribution tables were generated, demonstrating that there is a high prevalence of risk behavior in rural areas. Conclusions This study demonstrates data related to rural areas in northwest Mexico, a region where adolescents are frequently involved in risk behaviors. Additionally, protective factors are understudied in Mexico-US border cities. Further analyses are needed to find reward delay skills on the studied sample as well as urban area comparisons. [ABSTRACT FROM AUTHOR]

Objective The use of illicit drugs has increased dramatically over the past two decades among Hispanics. Neurocognitive impairments and morphological alterations have been linked to the use of drugs among the Hispanic population. However, even when increased attention is paid to the impact of drug consumption on neurocognitive functions among Hispanics, the majority of publications have been limited to male samples. This is relatively important, considering that women who consume illicit drugs appear to be more vulnerable in developing drug dependence and exhibit more neurocognitive impairment when compared to men. The present study aims to determine the impact of drug consumption in the visual-motor integration in a sample of Puerto Rican women. Our hypothesis was that Puerto Rican women who consume illicit drugs would perform poorly on visual-motor integration when compared to non-consumers. Participants and Method A total of 59 Puerto Rican women participated in this cross-sectional study. The participants were divided into three groups according to the criteria of: consumers, non-consumers, and abstinence. To evaluate the visual-motor integration, we administered the neuropsychological Bender-Gestalt-II test to all participants. Results A Kruskal-Wallis analysis revealed that there was a statically significant difference in the visual-motor integration between groups (H(2) = 12.69, p = 0.02), with a mean rank of 28 for consumers, 40 for non-consumers, and 21 for abstinence group. However, there was no significant difference between the abstinence and consumer groups in their visual-motor integration (p =.217). Conclusions These results suggest that the use of drugs can impact some neurocognitive functions, such as visual-motor integration in women, and can lead to a decline in such functions- even after sustained abstinence. [ABSTRACT FROM AUTHOR]

Objective To provide further convergent validity on the Personal Impact of Epilepsy Scale (PIES) Spanish version for use in Hispanics with epilepsy. Participants and Method This study included 90 patients (22 Hispanic and Spanish speaking - HSS, 30 Hispanic and English speaking – HES, and 38 non-Hispanic and English speaking – NHES) who were diagnosed with epilepsy and referred by their epileptologist for a comprehensive neuropsychological evaluation that, in addition to cognitive measures, also included the Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI), and PIES in English or Spanish- depending on the participant's primary language. The PIES was created with subscales to measure the effect of seizures, adverse effects of treatment, and comorbidities such as mood disorders on quality of life. We compared scores on the PIES subscales in English and Spanish to determine equivalence. We further examined if language of administration moderated the relationship between PIES subscale scores and depression/anxiety through nonparametric bootstrapping. Results There were no significant demographic or clinical differences between the 3 groups examined. ANOVA contrast of mean scores on all PIES subscales between HSS, HES and NHES groups did not reach significance (Seizures F [2,88] =.06 , p = -.93; Medication use F[2,88] = 1.95, p =.14, Comorbidity F[2,88] =.64, p =.52, and total PIES F[2,88] =.19, p =.83). The relationships between PIES and BDI-II/BAI scores were not significantly moderated by language of administration. Conclusions Our data suggest clinical equivalency between the English and Spanish versions of the PIES. Furthermore, the relationships between PIES subscales and the BDI-II/BAI were not significantly changed by language of administration. These findings indicate that the Spanish PIES appears to have good convergent validity with the original English version and can be useful in the assessment of quality of life in HSS patients. [ABSTRACT FROM AUTHOR]

Background Hip fractures are common in older adults and are associated with increased mortality and morbidity resulting in medical and socioeconomic burden for healthcare system and patient alike. Methods A retrospective study was conducted on patients admitted to a Dublin hospital for hip fracture repair between October 2018 and February 2019. Data on sociodemographic characteristics such as; gender; age; pre-admission residence; fracture history; bone protection medication use; pre-fracture mobility; discharge mobility and destination; length of stay and mortality rate was collected. Results 50 patients admitted between 01/10/19 and 31/01/2019. 2:1 female to male. Average age 78 ranging from 48-93. 88% admitted from home. 44% had previous fractures. Vertebral (36%), wrist (23%) and pelvic (23%) most common fractures. 27% of these were on bone protection medication on admission. 41% were taking Calcium and Vit D or Vitamin D only. 70% of participants were independently mobile pre-fracture. 94% required some form of mobility aid on discharge. The average length of stay was 32 days ranging from 2 to 160 days. 38% went home whilst 36% were discharged to rehabilitation. 88% were discharged on bone protection medication - 70% received IV Zoledronic acid as inpatients, 14% commenced Prolia 6 monthly injections and 4% on oral bisphosphonates. Mortality rate was 6% Conclusion Hip fractures have a negative effect on a person's mobility. Whilst many guidelines for the assessment and treatment of osteoporosis recommend intervention be considered in men and women who have sustained a fragility fracture, it is clear from this study that an osteoporosis care gap exists and further work is required to better identify, assess and treat patients following their first fracture in the hope of reducing further fractures, particularly hip and vertebral fractures. [ABSTRACT FROM AUTHOR]

Background Frailty is a multi-factorial, age-related syndrome, often defined in terms of accumulation of deficits. This approach uses the proportion of a list of age-associated items (signs, symptoms, diseases, impairments, etc.) available to identify frailty. Some frailty indexes (FI) include more functional aspects than others. This study examines whether functional components and diseases or risk factors predict the same phenomena. Methods Data were included from The Survey of Health, Ageing and Retirement in Europe (SHARE) wave seven for participants age ≥50 years. A 52-item FI was constructed from physical health data with 26 functional and 26 non-functional items. Functional items were obtained from activities of daily living questions (ph048 & ph049), and health-related activity limitation (gali question). Non-functional items were obtained from questions on BMI, self-perceived health, disease/risks (ph006), medication use (sleep, anxiety/depression, osteoporosis), and frailty related symptoms (ph048). Participants missing one or more of the 52 items were excluded. Data were analysed at individual and country-level to assess for significant differences. Results In total, 73,510 (97.3%) participants had complete frailty data available and were included. The mean score for the FI-52 was 0.12 (95% CI: 0.11-0.12). Mean FI scores for the functional and non-functional components were 0.12 (95% CI:0.12-0.12) and 0.11 (95% CI:0.11-0.11), respectively, representing a significant difference (p<0.001). For a cut-off of 0.25 for frailty this difference was 5.4% (95% CI:3.9%-6.2%). Spearman's correlation between these components was 0.66 for individual participants and 0.72 for country-level mean scores, indicating moderate to strong correlation. These were similar using a cut-off of 0.25, at 0.45 and 0.71, respectively. Conclusion Findings suggest that having more functional items in a frailty index results in significantly higher frailty estimates but this only amounted to an approximately 5% difference. Although moderate-strong correlation was observed, further research is needed to investigate if the proportion of functional components influences risk-prediction at population-level. [ABSTRACT FROM AUTHOR]

Background Aggregated claims data on medication are often used as a proxy for the prevalence of diseases, especially chronic diseases. However, linkage between medication and diagnosis tend to be theory based and not very precise. Modelling disease probability at an individual level using individual level data may yield more accurate results. Methods Individual probabilities of having a certain chronic disease were estimated using the Random Forest (RF) algorithm. A training set was created from a general practitioners database of 276 723 cases that included diagnosis and claims data on medication. Model performance for 29 chronic diseases was evaluated using Receiver-Operator Curves, by measuring the Area Under the Curve (AUC). Results The diseases for which model performance was best were Parkinson's disease (AUC =.89, 95% CI =.77–1.00), diabetes (AUC =.87, 95% CI =.85–.90), osteoporosis (AUC =.87, 95% CI =.81–.92) and heart failure (AUC =.81, 95% CI =.74–.88). Five other diseases had an AUC >.75: asthma, chronic enteritis, COPD, epilepsy and HIV/AIDS. For 16 of 17 diseases tested, the medication categories used in theory-based algorithms were also identified by our method, however the RF models included a broader range of medications as important predictors. Conclusion Data on medication use can be a useful predictor when estimating the prevalence of several chronic diseases. To improve the estimates, for a broader range of chronic diseases, research should use better training data, include more details concerning dosages and duration of prescriptions, and add related predictors like hospitalizations. [ABSTRACT FROM AUTHOR]

Background Adverse childhood experiences (ACEs) can increase risks of health-harming behaviours and poor health throughout life. While increases in risk may be affected by resilience resources such as supportive childhood relationships, to date few studies have explored these effects. Methods We combined data from cross-sectional ACE studies among young adults (n = 14 661) in educational institutions in 10 European countries. Nine ACE types, childhood relationships and six health outcomes (early alcohol initiation, problem alcohol use, smoking, drug use, therapy, suicide attempt) were explored. Multivariate modelling estimated relationships between ACE counts, supportive childhood relationships and health outcomes. Results Almost half (46.2%) of participants reported ≥1 ACE and 5.6% reported ≥4 ACEs. Risks of all outcomes increased with ACE count. In individuals with ≥4 ACEs (vs. 0 ACEs), adjusted odds ratios ranged from 2.01 (95% CIs: 1.70–2.38) for smoking to 17.68 (95% CIs: 12.93–24.17) for suicide attempt. Supportive childhood relationships were independently associated with moderating risks of smoking, problem alcohol use, therapy and suicide attempt. In those with ≥4 ACEs, adjusted proportions reporting suicide attempt reduced from 23% with low supportive childhood relationships to 13% with higher support. Equivalent reductions were 25% to 20% for therapy, 23% to 17% for problem drinking and 34% to 32% for smoking. Conclusions ACEs are strongly associated with substance use and mental illness. Harmful relationships are moderated by resilience factors such as supportive childhood relationships. Whilst ACEs continue to affect many children, better prevention measures and interventions that enhance resilience to the life-long impacts of toxic childhood stress are required. [ABSTRACT FROM AUTHOR]

The paper presents the study on identification and systematic description of typical behavioral patterns of drug usage. The dataset is based on the qualitative interviews with 70 drug users and the survey within 80 experts of federal drug control service in St.Petersburg obtained in the course of 2015. A behavioural pattern is considered as a sequence of typical states occurring during the deviation career of a drug user described by certain psycho-physiological characteristics. It is argued that the transitions between these states are not always linearly determined, but rather depend upon desires and motivations of the drug user, which in turn depend on a variety of personal, environmental, and social factors. Based on the empirical data we define basic states and probabilities of transitions between them. Then we build an information model of basic algorithms of narcotization process which can be used for forecasting drug addiction. [ABSTRACT FROM AUTHOR]

In this paper, we formulated a mathematical model of the dynamics of Ebola virus infection incorporating effectiveness of drug usage. The infection free and infection persistence equilibrium points were obtained. The control reproduction number was obtained which was used to analyse the local and global stability of the infectionfree equilibrium. Using the method of linearization, the infection-free equilibrium (IFE) state was found to be locally asymptotically stable if Rc < 1 and unstable if Rc > 1. By constructing lyapunov function, the infection-free equilibrium was found to be globally asymptotically unstable if Rc > 1. Numerical simulation of the model was done. It is observed that, as percentage of effectiveness of drug administration increases, the control reproduction number decreases. This suggests that with the help of drugs usage, the immunes system have the ability to suppress the increase of infected cells, as well as virus load which shown that the virus does not maintain an infection in the system. Keywords: Drug Usage; Ebola virus; Global stability; Immune response; Mathematical model

Background: Aspirin use is associated with reduced risk of several cancers. A pooled analysis of 12 case-control studies showed a 10% decrease in ovarian cancer risk with regular aspirin use, which was stronger for daily and low-dose users. To prospectively investigate associations of analgesic use with ovarian cancer, we analyzed data from 13 studies in the Ovarian Cancer Cohort Consortium (OC3).Methods: The current study included 758 829 women who at study enrollment self-reported analgesic use, among whom 3514 developed ovarian cancer. Using Cox regression, we assessed associations between frequent medication use and risk of ovarian cancer. Dose and duration were also evaluated. All statistical tests were two-sided.Results: Women who used aspirin almost daily (≥6 days/wk) vs infrequent/nonuse experienced a 10% reduction in ovarian cancer risk (rate ratio [RR] = 0.90, 95% confidence interval [CI] = 0.82 to 1.00, P = .05). Frequent use (≥4 days/wk) of aspirin (RR = 0.95, 95% CI = 0.88 to 1.03), nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs; RR = 1.00, 95% CI = 0.90 to 1.11), or acetaminophen (RR = 1.05, 95% CI = 0.88 to 1.24) was not associated with risk. Daily acetaminophen use (RR = 1.28, 95% CI = 1.00 to 1.65, P = .05) was associated with elevated ovarian cancer risk. Risk estimates for frequent, long-term (10+ years) use of aspirin (RR = 1.15, 95% CI = 0.98 to 1.34) or nonaspirin NSAIDs (RR = 1.19, 95% CI = 0.84 to 1.68) were modestly elevated, although not statistically significantly so.Conclusions: This large, prospective analysis suggests that women who use aspirin daily have a slightly lower risk of developing ovarian cancer (∼10% lower than infrequent/nonuse)-similar to the risk reduction observed in case-control analyses. The observed potential elevated risks for 10+ years of frequent aspirin and NSAID use require further study but could be due to confounding by medical indications for use or variation in drug dosing. [ABSTRACT FROM AUTHOR]

Introduction: Varenicline doubles cessation over nicotine replacement therapy (NRT) patch for "normal," but not "slow," nicotine metabolizers, as assessed by the nicotine metabolite ratio (NMR). Metabolism-informed care (MIC) could improve outcomes by matching normal metabolizers with non-nicotine medication (e.g., varenicline) and slow metabolizers with NRT patch.Methods: We conducted a feasibility randomized controlled trial of MIC versus guideline based care (GBC) among 81 outpatient adult daily smokers with medical comorbidity. Participants reported perceptions of MIC, underwent blood draw for NMR, and received expert cessation counseling. For MIC participants, medication selection was informed by NMR result (normal (≥0.31) vs. slow (< 0.31)). The primary outcome was MIC feasibility, reflected by attitudes toward MIC and by match rates between NMR and medication. Secondary endpoints (cessation confidence, medication use, smoking status) were assessed over 6 months to inform future studies.Results: Participants were median age 53 years, 46% female, 28% black, and ~90% endorsed MIC. Despite high varenicline prescription rates (~60%) in both arms, NMR-medication matching was higher in MIC (84%) versus GBC (58%) participants (p=0.02); unadjusted odds ratio (OR) 3.67, 95% confidence interval [1.33, 11.00; p-value=0.02]. Secondary endpoints were similar at 1, 3, and 6 months.Conclusions: MIC, an NMR-based precision approach to smoking cessation, was acceptable to 90% of smokers and improved NMR-medication match rates more than 3-fold compared to GBC, even with generally high use of varenicline. These data support the feasibility of MIC, which could maximize efficacy of smoking cessation medication while minimizing side effects and cost.Implications: Among treatment-seeking daily smokers with medical comorbidity, most viewed metabolism-informed care (MIC), guided by the nicotine metabolism ratio (NMR), favorably, and were willing to accept MIC-guided medication. Compared to GBC participants (58%), more MIC participants (84%) were prescribed NMR-matched medication (i.e., normal metabolizers received varenicline; slow metabolizers received NRT patch). MIC increased the odds of optimized matching between NMR and medication more than 3-fold over GBC. Because the number needed to treat (NNT) to help one normal metabolizer quit smoking is only 4.9 for varenicline versus 26 for patch, broad implementation of MIC will improve drug efficacy in normal metabolizers as well as minimize side effects in slow metabolizers. [ABSTRACT FROM AUTHOR]

Introduction: Three-quarters of homeless people smoke cigarettes. Financial incentives for smoking abstinence have appeared promising in nonexperimental studies of homeless smokers, but randomized controlled trial (RCT) data are lacking.Methods: We conducted a pilot RCT of financial incentives for homeless smokers. Incentive arm participants (N = 25) could earn escalating $15-$35 rewards for brief smoking abstinence (exhaled carbon monoxide <8 parts per million) assessed 14 times over 8 weeks. Control arm participants (N = 25) were given $10 at each assessment regardless of abstinence. All participants were offered nicotine patches and counseling. The primary outcome was a repeated measure of brief smoking abstinence across 14 assessments. The secondary outcome was brief abstinence at 8 weeks. Exploratory outcomes were self-reported 1-day and 7-day abstinence from (1) any cigarette and (2) any puff of a cigarette. Other outcomes included 24-hour quit attempts, nicotine patch use, counseling attendance, and changes in alcohol and drug use.Results: Compared to control, incentive arm participants were more likely to achieve brief abstinence overall (odds ratio 7.28, 95% confidence interval 2.89 to 18.3) and at 8 weeks (48% vs. 8%, p = .004). Similar effects were seen for 1-day abstinence, but 7-day puff abstinence was negligible in both arms. Incentive arm participants made more quit attempts (p = .03). Nicotine patch use and counseling attendance were not significantly different between the groups. Alcohol and drug use did not change significantly in either group.Conclusions: Among homeless smokers, financial incentives increased brief smoking abstinence and quit attempts without worsening substance use. This approach merits further development focused on promoting sustained abstinence.Registration: ClinicalTrials.gov (NCT02565381).Implications: Smoking is common among homeless people, and conventional tobacco treatment strategies have yielded modest results in this population. This pilot RCT suggests that financial incentives may be a safe way to promote brief smoking abstinence and quit attempts in this vulnerable group of smokers. However, further development is necessary to translate this approach into real-world settings and to promote sustained periods of smoking abstinence. [ABSTRACT FROM AUTHOR]

Background The pattern of alcohol and substance use is changing, with the introduction of novel psychoactive substances, the internet as a means of acquisition and variations in drug purity and price. Alcohol and substance use among adolescents is associated with behavioural, mental health, health and social difficulties; arising at a vulnerable period in their development. Little is known about adolescent substance use in the UK, especially in rural areas. Aim To investigate the prevalence of substance use amongst young people, aged 16–21 years, in Norfolk schools. Design Cross sectional questionnaire survey. Method Pupils from two, sixth form colleges in Norfolk answered a self-report questionnaire designed to measure prevalence, age of onset and frequency of use for alcohol, tobacco, illicit substances including new psychoactive substances as well as demographic data. Results A total of 482 students completed the survey (68% participation rate). Life-time use of alcohol was reported by 442 (91.7%) students and over half the pupils had tried tobacco (52.5%, n =253). About 40.7% reported cannabis use and nearly one-fifth (18.9%, n =91) reported using 3,4-methylenedioxymethamphetamine (MDMA); 41.1% (n =198) students reported using 'any drug' and 23.2% (n =112) 'using an illicit drug other than cannabis' and 8.7% (n =42) reported the use of a novel psychoactive substance. Conclusion The most widely used substances were alcohol, tobaccos and cannabis; in keeping with European trends. Over the past decade a decline in alcohol and drug use by adolescents has been seen in the UK. However, since 2010 this decline has slowed with an increase in substance use noted in the past 2 years. This study provides evidence to support this trend. The findings demonstrate differences between the use of substances by pupils in this Norfolk sample compared to national surveys and more urbanized areas. These regional differences can be used to assist the development of local interventions targeting substance use among adolescents. [ABSTRACT FROM AUTHOR]