scholarly journals Influence of long-term intravenous drug use on physiological indicators and morphological changes of internal organs in piglets

2021 ◽  
Vol 282 ◽  
pp. 04006
Author(s):  
M.I. Barashkin ◽  
I.М. Milshtein ◽  
М.М. Sibiryakov ◽  
А.S. Barkova ◽  
E.S. Eroshenko

The article considers the state of physiological indicators and morphological changes of internal organs during the application of long-term non-inhalation narcosis in pigs of two groups while providing artificial lung ventilation.

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
I Khan ◽  
E Brookes ◽  
J Santamaria ◽  
A Wilson ◽  
J Darby ◽  
...  

Abstract Introduction Intravenous drug use (IVDU) associated infective endocarditis (IE) is a clinically challenging case. Not only can the natural history of IE in the IVDU population be significantly different, making detection a diagnostic dilemma, additional social factors associated with this population can drastically change management, including suitability for surgery or long-term intravenous access for antibiotics Furthermore, the rates of IVDU are increasing globally, leading to increasing incidence of IVDU associated IE. Purpose With a lack of clear mangement guidelines for IVDU associated IE, our study assesses the differences in presentation, management and long-term prognosis of IE between the IVDU population and the non-IVDU population to help guide future care. Methods This is an observational cohort study on a prospectively collected database of 350 patients treated for IE at our centre between 1999 and 2015. Patients were followed-up until death or January 2021. The primary outcome was all-cause mortality. Continuous variables were compared using unpaired t-test. Categorical variables were compared using Chi-square test when sample size was >5 or Fisher's exact test when sample size was ≤5. Long-term survival data was analysed using Kaplan-Meier survival curves. Results The IVDU population was younger, more likely to have concurrent infections and other substance use, while the non-IVDU population was older with a higher level of overall comorbidity. IVDU patients were more likely to become reinfected (p-value=0.034) but had better long-term survival compared to the non-IVDU population (p<0.001). Survival estimates at 15-years were 64.98% (95% CI: 50.94–75.92%) for the IVDU population compared to 26.67% (95% CI: 19.76–34.05%) for the non-IVDU population (p-value<0.0001). Conclusion Despite having higher levels of reinfection, IVDU patients have better long-term outcomes of IE compared to non-IVDU patients. Therefore, IVDU patients should not have blanket restrictions on the management they are offered unless the individual has clear contraindications to a particular therapy. FUNDunding Acknowledgement Type of funding sources: None.


1993 ◽  
Vol 38 (6) ◽  
pp. 655-656
Author(s):  
Terri Gullickson

2020 ◽  
Vol 25 (3) ◽  
pp. 17-25 ◽  
Author(s):  
G. R. Ramazanov ◽  
L. B. Zavaliy ◽  
L. L. Semenov ◽  
S. A. Abudeev ◽  
A. O. Ptitsyn ◽  
...  

Abstract. Early rehabilitation (ER) of patients with acute cerebrovascular accident (ACA) is one of the priority tasks of the vascular centers; the issue of increasing the volume of rehabilitation measures in the resuscitation and intensive care units (ICU) is relevant. Objective. To evaluate the safety and effectiveness of the progressive ER program in patients with ACA. Material and research methods. The study included 129 patients with ACA in ICU. Each patient of the main group (MGr, n = 61) underwent progressive ER: at least 4–5 vertical adjustments per day, passive mode Kinesiotherapy 49 ± 9.3 minutes, a double load of physiotherapy exercises, preventive physiotherapy; the total time of classes reached 240 minutes per day. In the comparison group (СGr, n = 68), standard ER was performed no more than 120 minutes per day. The groups are comparable by sex, age, severity of the disease and comorbidity. The severity of ACA, the gravity gradient, patient mobility, functional status, degree of dependence, and the presence of complications were evaluated. Results. During a month of work with the MGr, 102 ICU bed-days, 94 days of the artificial lung ventilation use, p < 0.05 were saved. Mortality in MGr decreased -— 8 patients (13.1%) versus 14 (20.6%) in CGr (p < 0.05). In patients within CGr, pulmonary thromboembolism developed in 8.8%, in MGr – in 3.3%. The severity of the apoplectic attack decreased ( by 28% in MGr, and by 20% in CGr ), mobility increased. Comparing the modalities of post resuscitationsyndrome in MGr, it was noted that the score decreased by 2 times from 6 [5; 6] to 3 [2.3; 3.3], but it has not changed in the CGr. Patients in the MGr were 2-–3 days earlier adapted to the vertical adjustment. Conclusions. The progressive ER program in ICU is safe, effective, realisable, and allows reducing the number of bed-days in ICU, the number of days of the artificial lung ventilation use, complications, and mortality in comparison with standard medical care.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S224-S224
Author(s):  
Aryn M Andrzejewski ◽  
J Alex Viehman

Abstract Background Skin and soft tissue infections (SSTIs) are among the most prevalent infectious complications of intravenous drug use (IVDU). Given its polymicrobial nature, studies focusing on SSTIs in the general population may not be generalizable this group. We completed a retrospective chart review to better characterize the safety and efficacy of oral versus intravenous (IV) antibiotics for the treatment SSTIs in IVDU. Methods We reviewed patients admitted with bacterial SSTIs and IVDU from January 01, 2012 to December 31, 2019 based on ICD-10 codes. SSTIs complicated by bacteremia, endocarditis, bone or joint involvement on index admission were excluded. Patients who received &lt; 48 hours of IV antibiotics were considered oral therapy, otherwise they were considered IV therapy. Patient comorbidities, incision and drainage (I&D) status, substance use, microbiology and antimicrobial data were reviewed. Results Of 231 eligible patients, 84 received oral therapy. There was no statistical difference in patient characteristics between the two therapy groups. Streptococcus anginosus group were the most common organisms found (33%) followed by Staphylococcus aureus (31%). There was no statistical difference between rates of readmission (p=0.87), recurrent primary site infection (p=1.00), repeat debridement (p=0.08) or occurrence of deep-seated infections within 90 days of treatment completion. No morality was observed. The oral group had shorter length of stay (3 vs. 5 days, p &lt; 0.001) and shorter total duration of antibiotics (10 vs. 13 days, p &lt; 0.001). Overall, 90% of those with abscess underwent I&D, which did not differ between therapy groups. Time to I&D was shorter (0 vs. 1 day, p=0.005) in the oral group. Patients who did not receive and I&D were more likely to be readmitted within 90 days (p=0.025). Conclusion In SSTIs related to IVDU, oral antibiotic therapy was noninferior to IV in terms of mortality, readmission, and deep-seated infection rates within 90 days of treatment completion and had a decreased length of stay and total treatment duration. A delay in I&D led to increased length of stay and lack of I&D increased readmission rate. Therefore, a prompt I&D may allow a safe and effective early transition to oral therapy in SSTIs related to IVDU. Disclosures All Authors: No reported disclosures


2021 ◽  
pp. 1-7
Author(s):  
Christopher H. D. Lawrence ◽  
James Cheaveau ◽  
Michalis Kavourides ◽  
David Chadwick ◽  
Brendan McCarron

1993 ◽  
Vol 73 (3) ◽  
pp. 391-422 ◽  
Author(s):  
KENNETH C. HAAS

Intravenous drug use is both a common aspect of the pre-imprisonment lifestyles of many American prisoners and a leading risk factor for contracting HIV—the virus that causes AIDS. Moreover, incarcerated inmates frequently engage in behavior that can spread the disease, particularly homosexual activity and intravenous drug use. Correctional officials face increasing pressure to protect inmates and staff from HIV infection, and some have responded by implementing policies requiring all inmates to undergo HIV testing and by housing HIV-positive inmates in separate units. Screening and segregation policies, however, have been challenged on constitutional grounds by HIV-positive prisoners. This article examines the leading constitutional developments in this emerging area of law and finds that most courts so far have been inclined to reject constitutional challenges to mandatory testing and segregation policies. There are enough unsettled issues, however, to warrant expanded appellate review and eventual U.S. Supreme Court resolution of the key constitutional questions.


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