Clinical Pharmacist’s Role in an Alcohol Detox Unit in a Correctional Setting

2019 ◽  
pp. 089719001988807
Author(s):  
Ibrahim K. Muradian ◽  
Arastou Aminzadeh ◽  
Cindy H. Lin ◽  
Ngocdung T. Tran ◽  
Nguyen N. Do ◽  
...  
Keyword(s):  
Substance Use ◽  
High Risk ◽  
Los Angeles ◽  
Descriptive Analysis ◽  
Care Facility ◽  
Medication History ◽  
Correctional Setting ◽  
Severe Withdrawal ◽  
History Of

Introduction: Newly incarcerated inmates with chronic alcohol use are at high risk for alcohol withdrawal. This descriptive study aims to describe the role of a clinical pharmacist within an alcohol detoxification unit (ADU) in the Los Angeles County jail that serves nearly 18 000 inmates facility-wide daily. Methods: This descriptive analysis was conducted from August 2, 2018 through October 31, 2018 within the jail ADU. The pharmacist attended daily assessments on all alcohol detox patients; identified and assessed patients at high risk of severe withdrawal; and initiated, modified, and discontinued withdrawal medication for selected patients. Patients were determined to be high risk of severe withdrawal if they had history of severe withdrawal, any Clinical Institute Withdrawal Assessment for Alcohol-revised (CIWA-Ar) score ≥15, or polysubstance withdrawal. Results: A total of 1263 patients were admitted to the ADU during the study (average 97 per week). A total of 282 patients were assessed by the pharmacist. Patient assessments included substance use and medication history, CIWA-Ar score, response to pharmacotherapy, and referral to a substance use counselor. Medications were initiated, modified, or discontinued in 148 patients after discussion with a physician. Transfer to an acute care facility occurred in 48 patients. Zero alcohol detox patient deaths occurred during the study. Conclusion: This is a novel role of a pharmacist in a correctional setting. A pharmacist can aid in an ADU by identifying and assessing patients at high risk of severe withdrawal and managing pharmacotherapy. Future studies can examine pharmacist withdrawal management of additional substances.

scholarly journals The role of pubertal timing in the link between family history of alcohol use disorder and late adolescent substance use

2020 ◽  
Vol 210 ◽  
pp. 107955
Author(s):  
Alexander S. Weigard ◽  
Jillian E. Hardee ◽  
Robert A. Zucker ◽  
Mary M. Heitzeg ◽  
Adriene M. Beltz
Keyword(s):  
Substance Use ◽  
Family History ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Pubertal Timing ◽  
Adolescent Substance Use ◽  
Late Adolescent ◽  
Adolescent Substance ◽  
History Of

scholarly journals Clinical Assessment of Endothelial Function in Convalescent COVID-19 Patients Undergoing Multidisciplinary Pulmonary Rehabilitation

Biomedicines ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 614
Author(s):  
Pasquale Ambrosino ◽  
Antonio Molino ◽  
Ilenia Calcaterra ◽  
Roberto Formisano ◽  
Silvia Stufano ◽  
...  
Keyword(s):  
Endothelial Function ◽  
Pulmonary Rehabilitation ◽  
Pulmonary Function Tests ◽  
Care Facility ◽  
Forced Expiratory Volume ◽  
Vascular Events ◽  
Inclusion Study ◽  
History Of ◽  
Dependent Flow

Background: Growing evidence points to a key role of endothelial dysfunction in the pathogenesis of COVID-19. In this study, we evaluated changes in endothelium-dependent flow-mediated dilation (FMD) in a cohort of convalescent COVID-19 patients undergoing pulmonary rehabilitation (PR). Methods: After swab test negativization, convalescent COVID-19 patients referring to a post-acute care facility for PR were consecutively screened for inclusion. Study procedures were performed at the time of hospitalization and discharge. Results: We enrolled 82 convalescent COVID-19 patients (85.4% males, mean age 60.4 years). After PR, a significant improvement in most pulmonary function tests and exercise capacity was documented. FMD changed from 2.48% ± 2.01 to 4.24% ± 2.81 (p < 0.001), corresponding to a 70.9% increase. Significantly higher changes in FMD were found in patients without a history of vascular events as compared to those with (+2.04% ± 2.30 vs. +0.61% ± 1.83, p = 0.013). Values of forced expiratory volume in 1 s (FEV1%), forced vital capacity (FVC%) and diffusion capacity for carbon monoxide (DLCO%) significantly and directly correlated with FMD both at baseline and after PR. Patients with normal FEV1% (≥80% predicted) during the overall study period or those normalizing FEV1% after PR showed a more significant FMD change as compared to patients with persistently impaired FEV1% (<80% predicted) (p for trend = 0.029). This finding was confirmed in a multivariate analysis. Conclusions: Clinically evaluated endothelial function improves after PR in convalescent COVID-19 patients. A direct and persistent association between the severity of pulmonary and vascular disease can be hypothesized. Endothelial function testing may be useful in the follow-up of convalescent COVID-19 patients.

Thailand’s “77th Province”

2017 ◽  
Author(s):  
Mark Padoongpatt
Keyword(s):  
Los Angeles ◽  
Community Development ◽  
Urban Redevelopment ◽  
Global City ◽  
Community Leaders ◽  
Slave Labor ◽  
Culinary Tourism ◽  
History Of ◽  
Development Center

Chapter 5 explores "Thai Town" in East Hollywood (established in 1999) to highlight the role of culinary tourism in Thai American struggles for a right to the global city. It charts the history of Thai Town's development as a product of Thai community leaders, specifically the Thai Community Development Center, and Los Angeles city officials’ attempt to parlay Thai cuisine's popularity into political visibility, civic engagement, social justice activism, and urban redevelopment. While playing on cuisine-driven multiculturalism allowed Thais to use food, specifically culinary tourism, to root identity and community in a physical place, the chapter argues that heritage commodification in Thai Town also constricted a right to the global city, because it was geared toward a neoliberal vision of multiculturalism that sought to highlight the position of Los Angeles in the global capitalist economy. The chapter also includes a discussion of the 1995 El Monte slave-labor case.

The Development of the Underclass

2016 ◽  
Author(s):  
Marne L. Campbell
Keyword(s):  
Native American ◽  
Los Angeles ◽  
People Of Color ◽  
Federal State ◽  
Local Media ◽  
History Of ◽  
State And Local ◽  
The Impact ◽  
History Of Race

Chapter 4, “The Development of the Underclass,” contextualizes the history of race in Los Angeles within the history of the American West (1870 – 1900). It explores how local white Angelenos combated notions of criminality and attempted to portray Los Angeles as atypical compared to other western American centers, hoping to pin its social ills on the small racialized communities (black Latino/a, and Chinese) that they were actively trying to segregate and minimize. It also explores California’s legal history, and examines the impact of federal, state, and local legislation on the communities of racialized minorities, particularly African American, Native American, and Chinese people. This chapter also examines the role of the local media in shaping mainstream attitudes towards local people of color.

Rabies encephalitis

2021 ◽  
Vol 14 (4) ◽  
pp. e239249
Author(s):  
Shyam Chand Chaudhary ◽  
Akash Khandelwal ◽  
Ruchika Tandon ◽  
Kamal Kumar Sawlani
Keyword(s):  
Point Of Care ◽  
Treatment Options ◽  
Diagnostic Testing ◽  
Care Facility ◽  
Solid Organ ◽  
Mri Findings ◽  
Dismal Prognosis ◽  
Corneal Transplants ◽  
History Of

Rabies is an almost always fatal disease that physicians and patients dread due to its dismal prognosis and limited treatment options. Transmission of this disease occurs through the bite of dogs and wild animals (like jackal in our case). Other rare forms of transmission may be through inhalation in bat-infested caves and human-to-human transmission by infected corneal transplants, solid organ and tissue transplantation, and sometimes in laboratory settings. Its diagnosis is usually clinical in the absence of availability of special laboratory investigations at the point-of-care facility. Few people have described the role of imaging in diagnosis. We hereby report a patient with rabies encephalitis, having a history of jackal bite and classical MRI findings that we can use for early diagnosis in the absence of typical clinical features and specialised diagnostic testing.

Hippocampal and anterior cingulate morphology in subjects at ultra-high-risk for psychosis: the role of family history of psychotic illness

2005 ◽  
Vol 75 (2-3) ◽  
pp. 295-301 ◽  
Author(s):  
Stephen J. Wood ◽  
Murat Yücel ◽  
Dennis Velakoulis ◽  
Lisa J. Phillips ◽  
Alison R. Yung ◽  
...  
Keyword(s):  
Family History ◽  
High Risk ◽  
Anterior Cingulate ◽  
Psychotic Illness ◽  
Ultra High Risk ◽  
History Of

scholarly journals Substance Use Patterns among High-Risk American Indians/Alaska Natives in Los Angeles County

2012 ◽  
Vol 21 (5) ◽  
pp. 445-452 ◽  
Author(s):  
Daniel L. Dickerson ◽  
Dennis G. Fisher ◽  
Grace L. Reynolds ◽  
Safia Baig ◽  
Lucy E. Napper ◽  
...  
Keyword(s):  
Substance Use ◽  
High Risk ◽  
Los Angeles ◽  
American Indians ◽  
Los Angeles County ◽  
Alaska Natives ◽  
Use Patterns

LIFETIME HISTORY OF SUBSTANCE USE PREDICTS TRANSITION TO PSYCHOSIS IN ULTRA-HIGH RISK INDIVIDUALS

2008 ◽  
Vol 102 (1-3) ◽  
pp. 51
Author(s):  
Miriam Schäfer ◽  
Konstantinos Papageorgiou ◽  
Jana Becker ◽  
Patrick McGorry ◽  
Paul Amminger
Keyword(s):  
Substance Use ◽  
High Risk ◽  
Lifetime History ◽  
Ultra High Risk ◽  
History Of

Role of alcohol use in suicidal behavior in public places

2017 ◽  
Vol 41 (S1) ◽  
pp. s884-s884
Author(s):  
E. Baca-Garcia ◽  
M. Barrigon ◽  
F. Cegla Schvartzman ◽  
A. Sedano-Capdevila ◽  
L. Villoria-Borrego ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Descriptive Analysis ◽  
Suicidal Risk ◽  
Public Places ◽  
History Of ◽  
Self Harm ◽  
Assistance Service ◽  
Competing Interest ◽  
Alcohol Users

IntroductionSuicide in public places is a relatively common emergency in which alcohol use could be a factor involved.MethodsA total of 169 patients were attended for SB in Madrid public places by SAMUR (Municipal assistance service for emergency and rescue) and transferred to FJD emergency room where all of them were assessed by the psychiatrist on duty. For all (but 47 of them), blood alcohol level was measured and other variables were collected: age, sex, history of suicide attempt and characteristic of the attempt. A descriptive analysis was made and then differences between those using alcohol and those not was made.ResultsOur sample comprises 169 patients, 40.2% woman and 59.8% man (median age = 39.36 years). Alcohol was measured in 122 patients, being positive in 52.4% (median alcohol level = 95.09 mg/dL). We found that 64.6% of man had consumed alcohol against the 30.2% of women (P = 0.000). 64.8% of alcohol users were discharged, against the 35.2% that not users. We admitted 28.1% of the alcohol users and 56.8% of the non-users (P = 0.007). We did not found statistically significance differences when compared patients that consumed against patients who did not regarding previous attempts, behavior (ideation, intent, non suicidal self-harm) and method.ConclusionsWhen assessed SB, we found that most of the patients were man under the alcohol influence and most of them were discharged after being evaluated. The data does not reflect the seriousness of the SB, which opens the possibility of correlating the levels of alcohol with suicidal risk.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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