scholarly journals 143. Opioid Use and Hospitalizations for Endocarditis, Osteomyelitis, and Central Nervous System Abscess among Adults — New York City, 2001–2014

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S99-S99
Author(s):  
Chaorui Huang ◽  
David Lucero ◽  
Denise Paone ◽  
Ellenie Tuazon ◽  
Demetre Daskalakis
Keyword(s):  
New York ◽  
Central Nervous System ◽  
New York City ◽  
Nervous System ◽  
York City ◽  
Opioid Epidemic ◽  
Opioid Use ◽  
Increased Risk ◽  
Opioid Users ◽  
Discharge Record

Abstract Background Along with a growing opioid epidemic nationwide, opioid users often have an increased risk of severe infectious diseases including endocarditis, osteomyelitis, and central nervous system (CNS) abscess. As the largest city in the United States, New York City (NYC) may serve as a study model for opioid use and infectious diseases. We investigated the association between opioid use and hospitalizations for endocarditis, osteomyelitis, and CNS abscess in NYC. Methods Data for NYC residents aged ≥18 years discharged from New York State hospitals during 2001–2014 were analyzed using a hospital discharge dataset. We defined a hospitalization for endocarditis, osteomyelitis, and CNS abscess as one with a principal or secondary diagnosis for these conditions within the discharge record. We identified opioid users by examining principal or secondary diagnoses for opioid use within the discharge record at the time of hospitalization for endocarditis, osteomyelitis, and CNS abscess. Log-binomial model was applied among all hospitalized patients using endocarditis, osteomyelitis, and CNS abscess as the outcome, adjusting for age, sex, race, and borough. Results During 2001–2014, there were 139,392 hospitalizations in total for endocarditis, osteomyelitis, or CNS abscess, of which 8,823 (6.3%) were among opioid users. There was an increased risk of hospitalization for endocarditis [RR: 2.6 (95% CI: 2.5–2.7)], osteomyelitis [RR: 1.1 (95% CI: 1.1–1.1)], and CNS abscesses [RR: 1.9 (95% CI: 1.8–2.1)] among hospitalized opioid users compared with hospitalized nonopioid users, adjusted by age, sex, race, and borough. Hospitalized opioid users had four times the risk for endocarditis hospitalization compared with hospitalized nonopioid users in the 18–44 year age group (RR: 4.2 [95% CI: 3.9–4.5]) (Table 1). Conclusion These results provide further evidence that opioid use is associated with an increased risk of endocarditis, osteomyelitis, and CNS abscess. Efforts to combat the opioid epidemic might lower the overall incidence of endocarditis, osteomyelitis, and CNS abscess. Disclosures All authors: No reported disclosures.

scholarly journals Carbapenemase-producing Enterobacterales causing secondary infections during the COVID-19 crisis at a New York City hospital

2020 ◽  
Author(s):  
Angela Gomez-Simmonds ◽  
Medini K Annavajhala ◽  
Thomas H McConville ◽  
Donald E Dietz ◽  
Sherif M Shoucri ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Bacterial Infections ◽  
Antibiotic Resistance Gene ◽  
City Hospital ◽  
Nanopore Sequencing ◽  
Sequencing Data ◽  
Secondary Infections ◽  
Increased Risk

Abstract Background Patients with COVID-19 may be at increased risk for secondary bacterial infections with MDR pathogens, including carbapenemase-producing Enterobacterales (CPE). Objectives We sought to rapidly investigate the clinical characteristics, population structure and mechanisms of resistance of CPE causing secondary infections in patients with COVID-19. Methods We retrospectively identified CPE clinical isolates collected from patients testing positive for SARS-CoV-2 between March and April 2020 at our medical centre in New York City. Available isolates underwent nanopore sequencing for rapid genotyping, antibiotic resistance gene detection and phylogenetic analysis. Results We identified 31 CPE isolates from 13 patients, including 27 Klebsiella pneumoniae and 4 Enterobacter cloacae complex isolates. Most patients (11/13) had a positive respiratory culture and 7/13 developed bacteraemia; treatment failure was common. Twenty isolates were available for WGS. Most K. pneumoniae (16/17) belonged to ST258 and encoded KPC (15 KPC-2; 1 KPC-3); one ST70 isolate encoded KPC-2. E. cloacae isolates belonged to ST270 and encoded NDM-1. Nanopore sequencing enabled identification of at least four distinct ST258 lineages in COVID-19 patients, which were validated by Illumina sequencing data. Conclusions While CPE prevalence has declined substantially in New York City in recent years, increased detection in patients with COVID-19 may signal a re-emergence of these highly resistant pathogens in the wake of the global pandemic. Increased surveillance and antimicrobial stewardship efforts, as well as identification of optimal treatment approaches for CPE, will be needed to mitigate their future impact.

scholarly journals Awareness of, experience with, and attitudes toward buprenorphine among opioid users visiting a New York City syringe exchange program

2013 ◽  
Vol 9 (6) ◽  
pp. 407-413 ◽  
Author(s):  
Pooja A. Shah, BS ◽  
Nancy L. Sohler, PhD, MPH ◽  
Carolina López, BA ◽  
Aaron D. Fox, MD ◽  
Chinazo O. Cunningham, MD, MS
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Syringe Exchange ◽  
Syringe Exchange Program ◽  
Exchange Program ◽  
Opioid Users

scholarly journals Dynamic Management of Lung Cancer Care During Surging COVID-19

2021 ◽  
Vol 8 ◽  
Author(s):  
Annie Wang ◽  
Stephanie H. Chang ◽  
Eric J. Kim ◽  
Jamie L. Bessich ◽  
Joshua K. Sabari ◽  
...  
Keyword(s):  
Lung Cancer ◽  
New York ◽  
New York City ◽  
Cancer Patients ◽  
York City ◽  
Healthcare Workers ◽  
New York University ◽  
Lung Cancer Patients ◽  
Increased Risk ◽  
Review Current

Management of patients with lung cancer continues to be challenging during the COVID-19 pandemic, due to the increased risk of complications in this subset of patients. During the COVID-19 surge in New York City, New York University Langone Health adopted triage strategies to help with care for lung cancer patients, with good surgical outcomes and no transmission of COVID-19 to patients or healthcare workers. Here, we will review current recommendations regarding screening and management of lung cancer patients during both a non-surge phase and surge phase of COVID-19.

scholarly journals Hepatitis C Virus Incidence in a Cohort in Medication-Assisted Treatment for Opioid Use Disorder in New York City

2020 ◽  
Vol 222 (Supplement_5) ◽  
pp. S322-S334
Author(s):  
Ashly E Jordan ◽  
Charles M Cleland ◽  
Katarzyna Wyka ◽  
Bruce R Schackman ◽  
David C Perlman ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
York City ◽  
Antibody Test ◽  
Female Gender ◽  
Drug Injection ◽  
Opioid Use ◽  
Medication Assisted Treatment

Abstract Background Hepatitis C virus (HCV) incidence has increased in the worsening opioid epidemic. We examined the HCV preventive efficacy of medication-assisted treatment (MAT), and geographic variation in HCV community viral load (CVL) and its association with HCV incidence. Methods HCV incidence was directly measured in an open cohort of patients in a MAT program in New York City between 1 January 2013 and 31 December 2016. Area-level HCV CVL was calculated. Associations of individual-level factors, and of HCV CVL, with HCV incidence were examined in separate analyses. Results Among 8352 patients, HCV prevalence was 48.7%. Among 2535 patients seronegative at first antibody test, HCV incidence was 2.25/100 person-years of observation (PYO). Incidence was 6.70/100 PYO among those reporting main drug use by injection. Female gender, drug injection, and lower MAT retention were significantly associated with higher incidence rate ratios. Female gender, drug injection, and methadone doses <60 mg were independently associated with shorter time to HCV seroconversion. HCV CVLs varied significantly by geographic area. Conclusions HCV incidence was higher among those with lower MAT retention and was lower among those receiving higher methadone doses, suggesting the need to ensure high MAT retention, adequate doses, and increased HCV prevention and treatment engagement. HCV CVLs vary geographically and merit further study as predictors of HCV incidence.

scholarly journals High enhancer, downer, withdrawal helper: Multifunctional nonmedical benzodiazepine use among young adult opioid users in New York City

2017 ◽  
Vol 46 ◽  
pp. 17-27 ◽  
Author(s):  
Pedro Mateu-Gelabert ◽  
Lauren Jessell ◽  
Elizabeth Goodbody ◽  
Dongah Kim ◽  
Krista Gile ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Young Adult ◽  
York City ◽  
Benzodiazepine Use ◽  
Opioid Users

Prevalence of Adult Male Circumcision in the General Population and a Population at Increased Risk for HIV/AIDS in New York City

2008 ◽  
Vol 35 (9) ◽  
pp. 814-817 ◽  
Author(s):  
Christy M. McKinney ◽  
Ellen J. Klingler ◽  
Rachel Paneth-Pollak ◽  
Julia A. Schillinger ◽  
R Charon Gwynn ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
General Population ◽  
Adult Male ◽  
Male Circumcision ◽  
York City ◽  
Increased Risk ◽  
Adult Male Circumcision ◽  
Hiv Aids

scholarly journals Lynch Syndrome–Associated Variants and Cancer Rates in an Ancestrally Diverse Biobank

2020 ◽  
pp. 1429-1444
Author(s):  
Rachel E. Rosenblum ◽  
Celina Ang ◽  
Sabrina A. Suckiel ◽  
Emily R. Soper ◽  
Meenakshi R. Sigireddi ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Lynch Syndrome ◽  
York City ◽  
Sequence Data ◽  
African Ancestry ◽  
European Ancestry ◽  
Electronic Health Record Data ◽  
Increased Risk ◽  
Cancer Rates

PURPOSE Limited data are available on the prevalence and clinical impact of Lynch syndrome (LS)–associated genomic variants in non-European ancestry populations. We identified and characterized individuals harboring LS-associated variants in the ancestrally diverse Bio Me Biobank in New York City. PATIENTS AND METHODS Exome sequence data from 30,223 adult Bio Me participants were evaluated for pathogenic, likely pathogenic, and predicted loss-of-function variants in MLH1, MSH2, MSH6, and PMS2. Survey and electronic health record data from variant-positive individuals were reviewed for personal and family cancer histories. RESULTS We identified 70 individuals (0.2%) harboring LS-associated variants in MLH1 (n = 12; 17%), MSH2 (n = 13; 19%), MSH6 (n = 16; 23%), and PMS2 (n = 29; 41%). The overall prevalence was 1 in 432, with higher prevalence among individuals of self-reported African ancestry (1 in 299) than among Hispanic/Latinx (1 in 654) or European (1 in 518) ancestries. Thirteen variant-positive individuals (19%) had a personal history, and 19 (27%) had a family history of an LS-related cancer. LS-related cancer rates were highest in individuals with MSH6 variants (31%) and lowest in those with PMS2 variants (7%). LS-associated variants were associated with increased risk of colorectal (odds ratio [OR], 5.0; P = .02) and endometrial (OR, 30.1; P = 8.5 × 10−9) cancers in Bio Me. Only 2 variant-positive individuals (3%) had a documented diagnosis of LS. CONCLUSION We found a higher prevalence of LS-associated variants among individuals of African ancestry in New York City. Although cancer risk is significantly increased among variant-positive individuals, the majority do not harbor a clinical diagnosis of LS, suggesting underrecognition of this disease.

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