Abstract WMP49: White Matter Hyperintensities in a High Risk Population Living in Marginal Housing (HOTEL study)

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Lily W Zhou ◽  
William J Panenka ◽  
Allen Thornton ◽  
Geoffrey Smith ◽  
Alasdair Barr ◽  
...  
Keyword(s):  
Risk Factors ◽  
White Matter ◽  
Drug Use ◽  
Injection Drug Use ◽  
White Matter Hyperintensities ◽  
Univariate Analysis ◽  
Injection Drug ◽  
High Risk Population ◽  
Young Cohort ◽  
Perivascular Spaces

Background: White Matter Hyperintensities (WMH) are features of cerebral small vessel disease (cSVD) along with lacunes, cerebral microbleeds and perivascular spaces. Vascular risk factors account for only a small proportion of the variability of the presence of WMH, and the role of additional risk factors including drug use/dependence or infections is not well defined. Objective: Examine prevalence and risk factors associated with WMH of presumed vascular origin within the HOTEL cohort, a population living in marginal housing with a high prevalence of prior homelessness, substance dependence, head trauma, mental illness and infectious diseases. Methods: Baseline imaging on 3T MRI included T1, T2-FLAIR and SWI sequences. WMH not consistent with vascular origins were excluded. Two raters assessed WMH using the Fazekas scale. Participants were divided into those with or without moderate-severe WMH (periventricular Fazekas score >2 or deep score >1). Potential cSVD risk factors which were significant on univariate analysis were entered into a multivariable stepwise binomial logistic regression to identify independent risk factors for moderate-severe WMH. Results: Intraclass coefficient for inter-rater reliability was 0.948 (95% CI, 0.924 to 0.965) for periventricular WMH and 0.848 (95% CI, 0.782 to 0.895) for deep WMH. Baseline prevalence of moderate-severe WMH (mean age 43.6 ± 9.5 years, 78% male) was 24.5%, much higher than in other, older healthy aging cohorts (Table). Age (OR 1.085, 95%CI 1.042-1.130), systolic blood pressure (OR 1.033, 95%CI 1.008-1.058) and regular injection drug use (OR 3.655, 95%CI 1.284-10.403) together explained 23.5% of variance in the presence of moderate-severe WMH within this population, with injection drug use having the largest effect. Conclusions: This young cohort appears to have an accelerated burden of cSVD, with injected drug use as a major risk factor. Further research is needed to elucidate potential mechanisms.

scholarly journals The Cedar Project: risk factors for transition to injection drug use among young, urban Aboriginal people

2011 ◽  
Vol 183 (10) ◽  
pp. 1147-1154 ◽  
Author(s):  
C. L. Miller ◽  
M. E. Pearce ◽  
A. Moniruzzaman ◽  
V. Thomas ◽  
C. W. Christian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Drug Use ◽  
Injection Drug Use ◽  
Aboriginal People ◽  
Injection Drug ◽  
Project Risk

scholarly journals A Vulnerability Assessment for a Future HIV Outbreak Associated With Injection Drug Use in Illinois, 2017–2018

2021 ◽  
Vol 6 ◽  
Author(s):  
Cara Jane Bergo ◽  
Jennifer R. Epstein ◽  
Stacey Hoferka ◽  
Marynia Aniela Kolak ◽  
Mai T. Pho
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Drug Use ◽  
Injection Drug Use ◽  
Negative Binomial ◽  
Cook County ◽  
Injection Drug ◽  
County Level ◽  
Opioid Use ◽  
Zip Code

The current opioid crisis and the increase in injection drug use (IDU) have led to outbreaks of HIV in communities across the country. These outbreaks have prompted country and statewide examination into identifying factors to determine areas at risk of a future HIV outbreak. Based on methodology used in a prior nationwide county-level analysis by the US Centers for Disease Control and Prevention (CDC), we examined Illinois at the ZIP code level (n = 1,383). Combined acute and chronic hepatitis C virus (HCV) infection among persons <40 years of age was used as an outcome proxy measure for IDU. Local and statewide data sources were used to identify variables that are potentially predictive of high risk for HIV/HCV transmission that fell within three main groups: health outcomes, access/resources, and the social/economic/physical environment. A multivariable negative binomial regression was performed with population as an offset. The vulnerability score for each ZIP code was created using the final regression model that consisted of 11 factors, six risk factors, and five protective factors. ZIP codes identified with the highest vulnerability ranking (top 10%) were distributed across the state yet focused in the rural southern region. The most populous county, Cook County, had only one vulnerable ZIP code. This analysis reveals more areas vulnerable to future outbreaks compared to past national analyses and provides more precise indications of vulnerability at the ZIP code level. The ability to assess the risk at sub-county level allows local jurisdictions to more finely tune surveillance and preventive measures and target activities in these high-risk areas. The final model contained a mix of protective and risk factors revealing a heightened level of complexity underlying the relationship between characteristics that impact HCV risk. Following this analysis, Illinois prioritized recommendations to include increasing access to harm reduction services, specifically sterile syringe services, naloxone access, infectious disease screening and increased linkage to care for HCV and opioid use disorder.

scholarly journals Injection Drug Use and Hepatitis C as Risk Factors for Mortality in HIV-Infected Individuals

2015 ◽  
Vol 69 (3) ◽  
pp. 348-354 ◽  
Author(s):  
Margaret T. May ◽  
Amy C. Justice ◽  
Kate Birnie ◽  
Suzanne M. Ingle ◽  
Colette Smit ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatitis C ◽  
Drug Use ◽  
Injection Drug Use ◽  
Injection Drug

scholarly journals Risk factors associated with infection of blood-borne virus among people who used methamphetamine

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yilin Cai ◽  
Zheng Dai ◽  
Sijin Wen ◽  
Ruchi Bhandari
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Drug Use ◽  
Injection Drug Use ◽  
Injection Drug ◽  
High School Education ◽  
Poverty Index ◽  
Methamphetamine Use ◽  
Factors Associated ◽  
The U.S

Abstract Background The surge of methamphetamine use has been a complicating factor compounding the steeply increasing number of drug overdose deaths in the U.S. Infection from blood-borne viruses including hepatitis B virus (HBV), hepatitis C virus (HCV) and HIV, related to methamphetamine use continue to grow. This study aims to examine the risk factors associated with HBV, HCV and HIV among people who used methamphetamine. Methods People who ever used methamphetamine were identified from five National Health and Nutrition Examination Survey (NHANES) cohorts, 2007 to 2016. The outcome was either positive or negative for blood-borne viruses as identified from laboratory tests. Weighted statistics for the combined ten years of data were calculated by multiplying the weighted variable for laboratory measurements by 0.2. We examined the association of sexual activities (sexual partners, sexual identity), drug use behaviors (poly-drug use, injection drug use, frequency of drug use, age started using methamphetamine), demographics, and socio-economic status with blood-borne viruses using bivariate and multivariable logistic regression models. Results There were 1132 participants representing approximately 11,996,319 persons who ever used methamphetamine in the U.S. Blood-borne viruses’ positive rate was 13.0 per 100,000. Multivariable logistic regression analyses showed significant associations of blood-borne infections with age 40–49 years (vs. age 20–29 years, adjusted odds ratio 4.77, 95% CI 1.11–20.55), age 50–59 years (vs. age 20–29 years, 10.25, 2.40–43.82), living within poverty index 1–1.9 (vs. poverty index > = 2, 2.55; 1.19–5.49), living below the poverty threshold (vs. poverty index > = 2, 2.55; 1.11–5.86), having lower than high school education (vs. equal or higher than high school education, 3.13; 1.51–6.46), sexual identity as other than heterosexual (vs. heterosexual, 5.60; 1.72–18.28), using methamphetamine and heroin and cocaine (vs. using methamphetamine alone, 4.24; 1.06–16.92), injection drug use (vs. no injection drug use, 3.15; 1.61–6.16), and started using methamphetamine at age above 25 (vs. started using methamphetamine at age between 10 and 17, 2.09; 1.01–4.35). Conclusions Among people who use methamphetamine, those who use polysubstance, or who inject substances, are in urgent need for vaccination and interventions to avoid further harm from blood borne infections.

scholarly journals Risk factors for progression to regular injection drug use among street-involved youth in a Canadian setting

2013 ◽  
Vol 133 (2) ◽  
pp. 468-472 ◽  
Author(s):  
Kora DeBeck ◽  
Thomas Kerr ◽  
Brandon D.L. Marshall ◽  
Annick Simo ◽  
Julio Montaner ◽  
...  
Keyword(s):  
Risk Factors ◽  
Drug Use ◽  
Injection Drug Use ◽  
Injection Drug ◽  
Canadian Setting

scholarly journals Prevalence of HIV infection in inmates with history of injection drug use and evaluation of risk factors, in Isfahan, Iran

2013 ◽  
Vol 29 (1(Suppl)) ◽  
Author(s):  
Ramin Dibaj ◽  
Behrooz Ataei ◽  
Majid Yaran ◽  
Zary Nokhodian ◽  
Katayoon Tayeri ◽  
...  
Keyword(s):  
Risk Factors ◽  
Drug Use ◽  
Hiv Infection ◽  
Injection Drug Use ◽  
Injection Drug ◽  
History Of

scholarly journals Risk Factors Associated With Infection of Blood-Borne Virus among People Who Used Methamphetamine

2020 ◽  
Author(s):  
Yilin Cai ◽  
Zheng Dai ◽  
Sijin Wen ◽  
Ruchi Bhandari
Keyword(s):  
Risk Factors ◽  
Drug Use ◽  
Injection Drug Use ◽  
Economic Status ◽  
Injection Drug ◽  
Methamphetamine Use ◽  
Factors Associated ◽  
Polysubstance Use ◽  
Increased Risk ◽  
The U.S

Abstract Background The surge of methamphetamine use has been a complicating factor compounding the U.S. poly-drug use landscape. Infections of blood-borne virus including hepatitis B virus (HBV), hepatitis C virus (HCV) and HIV, arising from methamphetamine use continue to grow. This study aimed to examine the risk factors associated with blood-borne infections from HBV, HCV and HIV among people who used methamphetamine. Methods Methamphetamine users were identified from five National Health and Nutrition Examination Survey (NHANES) cohorts from 2007 to 2016. We examined the association of sexual activities (sexual partners, sexual identity), drug use behaviors (poly-drug use, injection drug use, number of times drug use, age started using methamphetamine), demographics and socio-economic status with blood-borne infections using bivariate and multivariable logistic regressions. Results There were 1,075 participants representing approximately 11,319,270 methamphetamine users in the U.S. with prevalence of blood-borne infections 13.4 per 100,000. Multivariable logistic regression analyses showed significant associations of blood-borne infections with age 50-59 years (adjusted odds ratio 6.32, 95% CI 1.35-29.69), living within poverty index 1-1.9 (2.80; 1.33 – 5.88), living below the poverty threshold (2.46; 1.14 – 5.28), having lower than high school education (3.57; 1.74 – 7.33), identified as men who have sex with men (MSM) (54.24; 13.80 – 213.24), using methamphetamine with other substances (5.86; 1.50 – 22.87), injection drug use (3.77; 1.93 – 7.36), and started using methamphetamine at age above 25 (2.18; 1.05 – 4.54). Conclusions Polysubstance use, injection drug use, and MSM were strongly associated with increased risk of blood-borne infections among methamphetamine users.

scholarly journals Risk Factors, Screening and Treatment Challenges in Staphylococcus aureus Native Septic Arthritis

2020 ◽  
Author(s):  
Valerie C Gobao ◽  
Mostafa Alfishawy ◽  
Clair Smith ◽  
Karin E Byers ◽  
Mohamed Yassin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Drug Use ◽  
Septic Arthritis ◽  
Injection Drug Use ◽  
Predictive Value ◽  
Injection Drug ◽  
Opioid Epidemic ◽  
Demographic Shift ◽  
Predictive Values

Abstract Background Staphylococcus aureus is the most common cause of native septic arthritis. Few studies have characterized this disease during the U.S. opioid epidemic. The role of MRSA nasal screening in this disease has not been elucidated. We sought to identify risk factors and outcomes for S. aureus native septic arthritis and to evaluate MRSA screening in this disease. Methods A retrospective cohort study of native septic arthritis patients (2012-2016) was performed. Demographics, risk factors, and outcomes were compared between Staphylococcus aureus and other native septic arthritis infections. Sensitivity, specificity, and predictive values of MRSA screening were assessed. Results 215 cases of native septic arthritis were included. S. aureus was cultured in 64% (138/215). MRSA was cultured in 23% (50/215). S. aureus was associated with injection drug use (OR: 4.33, CI: 1.74 to 10.81, p=0.002) and switching antibiotics (OR: 3.92, CI: 1.01 to 21.38, p=0.032). For every ten-year increase in age, odds of S. aureus decreased (OR: 0.72, CI: 0.60 to 0.87, p=0.001). For one unit increases in CCMI, odds of S. aureus decreased (OR: 0.82 CI: 0.73 to 0.91, p=0.0004). MRSA screening during admission demonstrated sensitivity of 0.59, specificity of 0.96, positive predictive value of 0.85, and negative predictive value of 0.84 for MRSA native septic arthritis. Conclusions The opioid epidemic may be contributing to a demographic shift in native septic arthritis to younger, healthier individuals. S. aureus native septic arthritis has unique risks, including injection drug use. MRSA screening may be useful to rule in MRSA native septic arthritis.

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