Simulating the impact of Addiction Consult Services in the context of drug supply contamination, hospitalizations, and drug-related mortality

2022 ◽  
Vol 100 ◽  
pp. 103525
Author(s):  
Caroline A. King ◽  
Ryan Cook ◽  
Haven Wheelock ◽  
P. Todd Korthuis ◽  
Judith M Leahy ◽  
...  
Keyword(s):  
Drug Supply ◽  
The Impact ◽  
Related Mortality

scholarly journals Mortality Associated with Idiopathic Pulmonary Fibrosis in Northeastern Italy, 2008–2020: A Multiple Cause of Death Analysis

2021 ◽  
Vol 18 (14) ◽  
pp. 7249
Author(s):  
Alessandro Marcon ◽  
Elena Schievano ◽  
Ugo Fedeli
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Cause Of Death ◽  
Age Groups ◽  
Mortality Rates ◽  
Annual Percent Change ◽  
Northeastern Italy ◽  
Mortality Ratio ◽  
The Impact ◽  
Related Mortality

Mortality from idiopathic pulmonary fibrosis (IPF) is increasing in most European countries, but there are no data for Italy. We analysed the registry data from a region in northeastern Italy to assess the trends in IPF-related mortality during 2008–2019, to compare results of underlying vs. multiple cause of death analyses, and to describe the impact of the COVID-19 epidemic in 2020. We identified IPF (ICD-10 code J84.1) among the causes of death registered in 557,932 certificates in the Veneto region. We assessed time trends in annual age-standardized mortality rates by gender and age (40–74, 75–84, and ≥85 years). IPF was the underlying cause of 1310 deaths in the 2251 certificates mentioning IPF. For all age groups combined, the age-standardized mortality rate from IPF identified as the underlying cause of death was close to the European median (males and females: 3.1 and 1.3 per 100,000/year, respectively). During 2008–2019, mortality rates increased in men aged ≥85 years (annual percent change of 6.5%, 95% CI: 2.0, 11.2%), but not among women or for the younger age groups. A 72% excess of IPF-related deaths was registered in March–April 2020 (mortality ratio 1.72, 95% CI: 1.29, 2.24). IPF mortality was increasing among older men in northeastern Italy. The burden of IPF was heavier than assessed by routine statistics, since less than two out of three IPF-related deaths were directly attributed to this condition. COVID-19 was accompanied by a remarkable increase in IPF-related mortality.

Heat-related mortality under climate change and the impact of adaptation through air conditioning: A case study from Thessaloniki, Greece

2021 ◽  
pp. 111285
Author(s):  
Panayiotis Kouis ◽  
Kyriaki Psistaki ◽  
George Yiallouros ◽  
Antonis Michanikou ◽  
Maria G. Kakkoura ◽  
...  
Keyword(s):  
Climate Change ◽  
Air Conditioning ◽  
The Impact ◽  
Related Mortality

scholarly journals Cardiovascular-related deaths at the beginning of the COVID-19 outbreak: a prospective analysis based on the UK Biobank

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e046931
Author(s):  
Junren Wang ◽  
Jianwei Zhu ◽  
Huazhen Yang ◽  
Yao Hu ◽  
Yajing Sun ◽  
...  
Keyword(s):  
Primary Diagnosis ◽  
Secondary Outcome ◽  
Hospital Inpatient ◽  
Reference Period ◽  
Stress Reactions ◽  
Uk Biobank ◽  
The Uk ◽  
The Impact ◽  
Distinct Increase ◽  
Related Mortality

ObjectiveTo assess the impact of the COVID-19 outbreak on cardiovascular disease (CVD) related mortality and hospitalisation.DesignCommunity-based prospective cohort study.SettingThe UK Biobank.Participants421 372 UK Biobank participants who were registered in England and alive as of 1 January 2020.Primary and secondary outcome measuresThe primary outcome of interest was CVD-related death, which was defined as death with CVD as a cause in the death register. We retrieved information on hospitalisations with CVD as the primary diagnosis from the UK Biobank hospital inpatient data. The study period was 1 January 2020 to June 30 2020, and we used the same calendar period of the three preceding years as the reference period. In order to control for seasonal variations and ageing of the study population, standardised mortality/incidence ratios (SMRs/SIRs) with 95% CIs were used to estimate the relative risk of CVD outcomes during the study period, compared with the reference period.ResultsWe observed a distinct increase in CVD-related deaths in March and April 2020, compared with the corresponding months of the three preceding years. The observed number of CVD-related deaths (n=218) was almost double in April, compared with the expected number (n=120) (SMR=1.82, 95% CI 1.58 to 2.07). In addition, we observed a significant decline in CVD-related hospitalisations from March onwards, with the lowest SIR observed in April (0.45, 95% CI 0.41 to 0.49).ConclusionsThere was a distinct increase in the number of CVD-related deaths in the UK Biobank population at the beginning of the COVID-19 outbreak. The shortage of medical resources for hospital care and stress reactions to the pandemic might have partially contributed to the excess CVD-related mortality, underscoring the need of sufficient healthcare resources and improved instructions to the public about seeking healthcare in a timely way.

scholarly journals Heart-related mortality after postoperative breast irradiation in patients with ductal carcinoma in situ in the contemporary radiotherapy era

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yu Jin Lim ◽  
Jaemoon Koh
Keyword(s):  
Competing Risks ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Statistical Significance ◽  
Young Patients ◽  
Subdistribution Hazard ◽  
The Impact ◽  
Related Mortality

AbstractAlthough radiation-induced cardiotoxicity has been addressed, its prognostic relevance to modern radiotherapy (RT) techniques is unclear. This study assessed the impact of adjuvant RT on heart-related deaths in patients with ductal carcinoma in situ. Patients who underwent adjuvant RT after breast-conserving surgery between 1988 and 2008 were identified from the Surveillance, Epidemiology, and End Results database. Kaplan‒Meier and competing risks analyses were conducted after propensity score-matching according to tumor laterality. A total of 41,526 propensity-matched patients were identified (n = 20,763 for either left- or right-sided tumor). In the analysis of the cumulative incidence of heart-related mortality events, there was a greater risk increment in the left-sided group over the first to second decades after RT in patients aged ≤ 50 years (P = 0.048). Competing risks analysis of the young patients showed that left-sided RT was associated with higher heart-related mortality rates (Grey’s test, P = 0.049). The statistical significance remained after adjusting for other covariates (subdistribution hazard ratio 2.35; 95% confidence interval 1.09‒5.10). Regarding the intrinsic effect of modern RT techniques, further strategies to reduce heart-related risks are needed for young patients. Close surveillance within an earlier follow-up period should be considered for these patients in clinics.

scholarly journals Reaching Men: Addressing the Blind Spot in the HIV Response

2018 ◽  
Vol 1 (SP1) ◽  
pp. e57-e70 ◽  
Author(s):  
Laura Pascoe ◽  
Dean Peacock ◽  
Lara Stemple
Keyword(s):  
South African ◽  
Gender Inequality ◽  
Gender Norms ◽  
Blind Spot ◽  
International Policy ◽  
Hiv Services ◽  
Immunodeficiency Virus ◽  
Delivery Strategies ◽  
The Impact ◽  
Related Mortality

Globally, men are less likely than women to access human immunodeficiency virus (HIV) testing, treatment, and care, and consequently experience disproportionate HIV-related mortality. To address men's underutilization of HIV services, efforts are needed on two fronts: challenging the regressive gender norms that discourage men from seeking health services, and developing improved health system policies, programs, and service delivery strategies to ensure better provision of HIV services to men. It has long been understood that harmful gender norms make women vulnerable to HIV, and this understanding should expand to include the way these norms also put men at risk. This paper presents the data concerning men and HIV, explores the impact of gender norms, examines national and international policy developments, and chronicles the evolution of men’s place in the HIV response. It does so in part by tracing the efforts of Sonke Gender Justice, a South African NGO working across Africa, as it promotes the engagement of men in the fight against the dual epidemics of gender inequality and HIV.

AIDS-Related Malignancies: State of the Art and Therapeutic Challenges

2008 ◽  
Vol 26 (29) ◽  
pp. 4834-4842 ◽  
Author(s):  
Jean-Philippe Spano ◽  
Dominique Costagliola ◽  
Christine Katlama ◽  
Nicolas Mounier ◽  
Eric Oksenhendler ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Hodgkin’S Lymphoma ◽  
Advanced Disease ◽  
State Of The Art ◽  
Hodgkin's Lymphoma ◽  
Increased Risk ◽  
Therapeutic Recommendations ◽  
The Subject ◽  
The Impact ◽  
Related Mortality

Despite the impact of combination antiretroviral therapy (cART) on HIV-related mortality, malignancy remains an important cause of death in the current era. Although the advent of cART has resulted in reductions in the incidence of Kaposi's sarcoma and non-Hodgkin's lymphoma, non–AIDS-defining malignancies present an increased risk for HIV-infected patients, characterized by some common clinical features, generally with a more aggressive behavior and a more advanced disease at diagnosis, which is responsible for poorer patient outcomes. Specific therapeutic recommendations are lacking for these new nonopportunistic malignancies, such as Hodgkin's lymphoma, anal cancer, lung cancer, hepatocarcinoma, and many others. Antiretroviral agents have a propensity for causing drug interactions as a result of their ability to either inhibit or induce the cytochrome P450 (CYP) enzyme system. Because many antineoplastic drugs are also metabolized by the CYP system, coadministration with cART could result in either drug accumulation with increased toxicity, or decreased efficacy of one or both classes of drugs. Further research delineating the combined safety and pharmacokinetics of antiretrovirals and antineoplastic therapy is necessary. Special considerations of these AIDS-related and non–AIDS-related malignancies and their clinical and therapeutic aspects constitute the subject of this review.

Abstract 14499: Impact of Pre-existing and New Incident Atrial Fibrillation on Outcomes of Patients With Acute Pulmonary Embolism: Findings From an International Registry

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Behnood Bikdeli ◽  
David Jimenez ◽  
Jorg Del Toro ◽  
Gregory Piazza ◽  
Augussina Rivas ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Embolism ◽  
Ischemic Stroke ◽  
Acute Pulmonary Embolism ◽  
Adverse Outcomes ◽  
Risk Of Mortality ◽  
Patient Groups ◽  
The Impact ◽  
Related Mortality

Background: Atrial fibrillation (AF) may occur prior to or early in the course of acute pulmonary embolism (PE). The impact of AF on outcomes of patients with PE remains uncertain. Methods: Using the data from a large prospective multicenter registry of patients with objectively-confirmed PE (04/2014 to 01/2020), we identified three patient groups: 1) those with pre-existing AF 2) patients with newly identified AF within 2 days from the index PE (incident AF) and 3) patients without AF. We assessed the 90-day and 1-year risk of mortality and stroke in patients with AF, in unadjusted and multivariable adjusted models considering those without AF as referent. Results: Among 16,497 patients with PE, 792 had pre-existing AF. Compared with those without AF, patients with pre-existing AF, had increased odds of 90-day all-cause (Odds ratio [OR]: 2.81 (95% confidence interval [CI]: 2.33-3.38) and PE-related mortality (OR: 2.38, 95% CI: 1.37-4.14). After multivariable adjustment, pre-existing AF significantly increased the odds of all-cause mortality (OR: 1.91, 95% CI: 1.57-2.32) but not PE-related mortality (OR: 1.50; 95% CI: 0.85-2.66). Pre-existing AF was associated with increased hazard for ischemic stroke at 1-year follow-up (hazard ratio [HR]: 5.48; 95% CI: 3.10-9.69). Among 16,497 patients with PE, 445 developed incident AF within 2 days of acute PE. Incident AF was associated with increased odds of 90-day all-cause (OR: 2.28; 95% CI: 1.75-2.97) and PE-related (OR: 3.64; 95% CI: 2.01-6.59) mortality. Findings were similar in multivariable analyses and at 1-year follow-up (Figure). No patients with incident AF developed ischemic stroke. Conclusion: In patients with acute symptomatic PE, both pre-existing AF and incident AF predict an adverse clinical course, although the type of adverse outcomes may be different depending on the timing of AF onset.

scholarly journals The variable and evolving nature of ‘cuckooing’ as a form of criminal exploitation in street level drug markets

2019 ◽  
Vol 23 (4) ◽  
pp. 301-323 ◽  
Author(s):  
Jack Spicer ◽  
Leah Moyle ◽  
Ross Coomber
Keyword(s):  
Qualitative Data ◽  
Crack Cocaine ◽  
Drug Markets ◽  
Drug Supply ◽  
Academic Literature ◽  
Criminal Exploitation ◽  
Local Residents ◽  
The Uk ◽  
Dominant Narratives ◽  
The Impact

AbstractA form of criminal exploitation rarely mentioned in the academic literature has recently emerged, evolved and taken meaningful hold in the UK. Hundreds of cases of ‘cuckooing’ have been reported, where heroin and crack cocaine dealers associated with the so-called ‘County Lines’ supply methodology have taken over the homes of local residents and created outposts to facilitate their supply operations in satellite locations. Dominant narratives surrounding this practice have stressed its exploitative nature and the vulnerabilities of those involved. Combining qualitative data from two studies, this paper critically analyses the model of cuckooing and the experiences of those affected. In turn it explores the impact of County Lines on affected areas and local populations, a topic that has received little academic scrutiny. Four typologies of cuckooing are constructed, highlighting its variance and complexity. Findings also suggest it to be a growing method of criminal exploitation beyond drug supply with a possible burgeoning presence being realised internationally.

Allogeneic Hematopoietic Stem-Cell Transplantation After Nonmyeloablative Preparative Regimens: Impact of Pretransplantation and Posttransplantation Factors on Outcome

2001 ◽  
Vol 19 (14) ◽  
pp. 3340-3349 ◽  
Author(s):  
Mauricette Michallet ◽  
Karin Bilger ◽  
Frédéric Garban ◽  
Michel Attal ◽  
Anne Huyn ◽  
...  
Keyword(s):  
Disease Status ◽  
Allogeneic Transplantation ◽  
Initial Diagnosis ◽  
Myelogenous Leukemia ◽  
Hematopoietic Stem ◽  
Graft Versus Host ◽  
Peripheral Blood Progenitor Cells ◽  
Conditioning Regimens ◽  
The Impact ◽  
Related Mortality

PURPOSE: To analyze the impact of pre- and posttransplantation factors on the outcome of allogeneic transplantation after nonmyeloablative conditioning regimens. PATIENTS AND METHODS: Ninety-two allogeneic transplantations after nonmyeloablative preparative regimens were reported to the Société Française de Greffe de Moelle Registry registry. Initial diagnoses were lymphoid diseases (n = 22), myeloma (n = 14), acute leukemia and myelodysplasia (n = 41), chronic myelogenous leukemia (n = 12), and solid tumors (n = 3). Forty-six patients had previously received a transplant, and 49 had progressive disease before transplantation. Three types of conditioning regimens were used with fludarabine or antithymocyte globulins. Eighty-nine patients underwent transplantation, 60 from peripheral-blood progenitor cells. Eighty-six patients received graft-versus-host disease (GHVD) prophylaxis for a median duration of 53 days. RESULTS: Seventy-nine patients engrafted, with 40 complete and 21 mixed chimerisms. The acute GHVD rate at 3 months was 50% ± 11%. Fifty-two patients achieved complete remission and 12, partial remission. At 18 months after transplantation, the overall survival (OS) and the transplant-related mortality (TRM) were 32% ± 12% and 38% ± 14%, respectively. Initial diagnosis and disease status before transplantation significantly influenced survival. Age and GHVD prophylaxis type significantly influenced TRM. We also showed an impact of GHVD prophylaxis duration on OS and TRM. In multivariate analysis, three factors remained of prognostic value on OS: initial diagnosis, disease status at transplantation, and GHVD prophylaxis duration. CONCLUSION: This series shows encouraging results from nonmyeloablative conditioning regimens before allotransplantation and demonstrates the impact of some pre- and posttransplantation factors on outcome after transplantation.

Sign in / Sign up

Export Citation Format

Share Document