scholarly journals Benzodiazepine Use in Opioid Maintenance Treatment Programme: Risks and Clinical Outcomes

2021 ◽  
Vol 34 (3) ◽  
pp. 209
Author(s):  
Catarina Oliveira ◽  
Rita Filipe ◽  
João Meira ◽  
Lara Sampaio ◽  
Leonor Teixeira ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Clinical Outcomes ◽  
Maintenance Treatment ◽  
Treatment Effectiveness ◽  
Multivariable Analysis ◽  
High Rate ◽  
Opioid Maintenance Treatment ◽  
Cross Sectional ◽  
Increased Risk ◽  
Benzodiazepine Use

Introduction: The co-association of benzodiazepines and opioids is associated with an increased risk of overdose, death, and poorer psychosocial prognosis. The aim of this study is to characterize the prevalence, pattern of use, and primary clinical outcomes in benzodiazepines users in a public opioid maintenance treatment unit.Material and Methods: We conducted a cross-sectional study involving 236 patients treated with opioid substitutes (methadone and buprenorphine). We conducted a descriptive, bivariable, and multivariable analysis to determine clinical differences between benzodiazepines users and non-users.Results: The prevalence of consumption of benzodiazepines was 25.4% (60). The benzodiazepines were obtained with a medical prescription (49.8%) or on the black market (42.6%). The most prescribed benzodiazepine was diazepam (29.1%), and the main reasons were to relieve insomnia (27.7%) or anxiety (26.9%) and to enhance the psychoactive effects of other drugs (19.7%). Regarding the clinical outcomes, we highlight: a very high prevalence of hepatitis C (51.7%); severe ongoing consumption of psychoactive drugs (73.7%); and a high rate of depression and anxiety (> 60%), significantly higher in the benzodiazepines-user group. In the multivariable analysis of benzodiazepine use, we found alcohol consumption (OR 0.482; IC 95% 0.247, 0.238) had a negative association and having hepatitis C (OR 2.544, IC 95% 1.273, 5.084) or anxiety symptoms (OR 5.591; IC 95% 2.345, 13.326) had positive associations.Discussion: Our results suggest the BZD users had a complex drug addiction problem and underline the importance of adequately addressing BZD use, contemplating psychological and psychiatric approach in this particular population.Conclusion: Past or current use of benzodiazepines is associated with poor clinical and psychiatric outcomes. A multidisciplinary approach with a focus on infectious diseases and mental health is critical in order to enhance the treatment effectiveness and overall prognosis.

scholarly journals Cross-sectional observational study of epidemiology of COVID-19 and clinical outcomes of hospitalised patients in North West London during March and April 2020

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e044384
Author(s):  
Guduru Gopal Rao ◽  
Alexander Allen ◽  
Padmasayee Papineni ◽  
Liyang Wang ◽  
Charlotte Anderson ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Clinical Outcomes ◽  
Severe Infection ◽  
Older Age ◽  
Cross Sectional ◽  
North West ◽  
Icu Admission ◽  
Risk Of Death ◽  
Hospitalised Patients ◽  
Increased Risk

ObjectiveThe aim of this paper is to describe evolution, epidemiology and clinical outcomes of COVID-19 in subjects tested at or admitted to hospitals in North West London.DesignObservational cohort study.SettingLondon North West Healthcare NHS Trust (LNWH).ParticipantsPatients tested and/or admitted for COVID-19 at LNWH during March and April 2020Main outcome measuresDescriptive and analytical epidemiology of demographic and clinical outcomes (intensive care unit (ICU) admission, mechanical ventilation and mortality) of those who tested positive for COVID-19.ResultsThe outbreak began in the first week of March 2020 and reached a peak by the end of March and first week of April. In the study period, 6183 tests were performed in on 4981 people. Of the 2086 laboratory confirmed COVID-19 cases, 1901 were admitted to hospital. Older age group, men and those of black or Asian minority ethnic (BAME) group were predominantly affected (p<0.05). These groups also had more severe infection resulting in ICU admission and need for mechanical ventilation (p<0.05). However, in a multivariate analysis, only increasing age was independently associated with increased risk of death (p<0.05). Mortality rate was 26.9% in hospitalised patients.ConclusionThe findings confirm that men, BAME and older population were most commonly and severely affected groups. Only older age was independently associated with mortality.

Prevalence and incidence of hepatitis C in injecting drug users attending genitourinary medicine clinics

2008 ◽  
Vol 137 (7) ◽  
pp. 980-987 ◽  
Author(s):  
M. A. BALOGUN ◽  
N. MURPHY ◽  
S. NUNN ◽  
A. GRANT ◽  
N. J. ANDREWS ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Drug Users ◽  
Multivariable Analysis ◽  
Injecting Drug Users ◽  
Hcv Rna ◽  
Cross Sectional ◽  
Prevalence Studies ◽  
Genitourinary Medicine ◽  
Cross Sectional Design ◽  
Type 3

SUMMARYSurveillance reports and prevalence studies have indicated that injecting drug users (IDUs) contribute more to the hepatitis C epidemic in the United Kingdom than any other risk group. Information on both the prevalence and incidence of hepatitis C in IDUs is therefore essential to understanding the epidemiology of this infection. The prevalence of hepatitis C in specimens from the Unlinked Anonymous Prevalence Monitoring Programme collected in 1995, 1996, 1998, 1999, 2000, and 2001 was determined using residual syphilis serology specimens from IDUs attending 15 genitourinary medicine (GUM) clinics in and outside London. These specimens were tested for antibodies to hepatitis C virus (anti-HCV). Using this cross-sectional design, anti-HCV-negative specimens were tested for HCV RNA to identify incident infections during the ‘window’ period of infection, and thus to estimate HCV incidence. Results of the multivariable analysis showed that there was marked variation in prevalence by clinic (P<0·0001) and age (P<0·0001). Overall the majority of infections were in males and the overall prevalence in injectors declined over the study period from 36·9% to 28·7%. The annual incidence in these injectors was estimated as being 3·01% (95% CI 1·25–6·73). Over the study period HCV incidence decreased by 1·2% per year. Genotyping of the incident infections identified the most common genotype as type 1 with type 3 being more frequently seen after 1998. Of the prevalent infections, genotype 1 was the most common. The study has confirmed a higher prevalence of anti-HCV in IDUs in the London area compared to those outside London. How representative of the current injecting drug user population are IDUs attending GUM clinics is unclear. Even so, such studies allow prevalence and incidence to be estimated in individuals who have ever injected drugs and inform ongoing public health surveillance.

ALCOHOL CONSUMPTION PATTERNS AMONGST HEPATITIS C POSITIVE PEOPLE RECEIVING OPIOID MAINTENANCE TREATMENT.

2004 ◽  
Vol 28 (Supplement) ◽  
pp. 52A
Author(s):  
B Watson ◽  
P S. Haber ◽  
K M. Conigrave ◽  
J B. Whitfield ◽  
C Wallace ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Alcohol Consumption ◽  
Maintenance Treatment ◽  
Consumption Patterns ◽  
Opioid Maintenance Treatment

scholarly journals Consumption of ultra-processed foods is associated with abdominal obesity in rotating shift workers

2021 ◽  
Author(s):  
Luiz Antônio Alves de Menezes Júnior ◽  
Virgínia Capistrano Fajardo ◽  
Jonathas Assis de Oliveira ◽  
George Luiz Lins Machado-Coelho ◽  
Fausto Aloísio Pedrosa Pimenta ◽  
...  
Keyword(s):  
Abdominal Obesity ◽  
Multivariable Analysis ◽  
Saturated Fat ◽  
Cross Sectional Study ◽  
Processed Foods ◽  
Cross Sectional ◽  
Shift Workers ◽  
Logistic Regression Models ◽  
Body Adiposity ◽  
Increased Risk

Abstract Background and aims: Higher intake of ultra-processed foods might be associated with an increased risk of obesity. Our objective was to evaluate the consumption of ultra-processed foods and their association with nutrient intake and excess body adiposity in shift workers.Design: Cross-sectional study conducted in 2016 with 238 male rotating shift workers. Dietary data is obtained by the 24-hour recall and classified according to processing by the NOVA classification system. Body adiposity indicators assessed were waist circumference and body mass index. Logistic regression models were built and adjusted for sociodemographic, lifestyle, and dietary variables.Results: Ultra-processed foods represented on average 22.3% of the total caloric value of the individuals' food consumption, with a maximum value of 66.9%. Participants with the highest tercile of ultra-processed foods consumed more carbohydrate (57%), protein (35%), total fat (96%), saturated fat (79%), cholesterol (68%), and sodium (44%) intake compared to the first tercile (p < 0.001). The most frequencies of ultra-processed foods consumed were bread (81.0%), followed by cookies (45.9%), sweetened beverages (45.7%), processed meats (46.8%), and margarine (46.8%). In multivariable analysis, the highest consumption of ultra-processed foods had 183% higher odds of abdominal obesity (OR = 2.83, 95%CI 1.29-6.22), compared with the lowest consumption. Conclusion: Ultra-processed foods are important contributors to the energy intake of these workers, and higher consumption of ultra-processed foods was associated with abdominal obesity.

scholarly journals A Survey on Knowledge, Prevention, and Occurrence of Sexually Transmitted Infections among Freshmen from Four Italian Universities

2022 ◽  
Vol 19 (2) ◽  
pp. 897
Author(s):  
Luca Cegolon ◽  
Melania Bortolotto ◽  
Saverio Bellizzi ◽  
Andrea Cegolon ◽  
Luciano Bubbico ◽  
...  
Keyword(s):  
Sexually Transmitted Infections ◽  
Sexual Behaviors ◽  
Nuclear Family ◽  
Multivariable Analysis ◽  
Educational Interventions ◽  
Relative Risk Ratio ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Increased Risk ◽  
The University

Background. The peak of sexually transmitted infections (STI) among adolescents/young adults suggests a low level of prevention. In order to assess whether the level of sexual health education (SHE), received by several channels, was effective at improving sexual behaviors, we conducted a survey among freshmen from four Italian universities. Methods. This observational cross-sectional study was conducted with an anonymous self-reported paper questionnaire, administered during teaching lectures to university freshmen of the northern (Padua, Bergamo, and Milan campuses) and southern (Palermo campus) parts of the country. Knowledge of STI (a linear numerical score), knowledge of STI prevention (dichotomous variable: yes vs. no) and previous STI occurrence (polytomous variable: “no”; “don’t know”; “yes”) were the outcomes in the statistical analysis. Results. The final number of freshmen surveyed was 4552 (97.9% response rate). The mean age of respondents was 21.4 ± 2.2 years and most of them (70.3%) were females. A total of 60% of students were in a stable romantic relationship. Only 28% respondents knew the most effective methods to prevent STI (i.e., condom and sexual abstinence), with a slightly higher prevalence of correct answers among females (31.3%) than males (25.8%). Students with history of STIs were 5.1%; they reported referring mostly to their general practitioner (GP) (38.1%) rather than discussing the problem with their partner (13.1%). At multivariable analysis, a significantly higher level of STI knowledge was observed in older students (25+ years of age), biomedical students, and those from a non-nuclear family; lower levels were found among students of the University of Palermo, and those who completed a vocational secondary school education. Those who had less knowledge about the most effective tools to prevent STIs included males, students from the University of Palermo, students registered with educational sciences, economics/political sciences, those of foreign nationality, and those whose fathers had lower educational levels. The risk of contracting STI was significantly lower only in students not in a stable relationship (relative risk ratio, RRR = 0.67; 95% confidence interval, 95%CI = 0.48; 0.94), whereas such risk was significantly higher in students with higher STI knowledge (RRR = 1.15; 95%CI = 1.08; 1.22). Discussion and Conclusions. University freshmen investigated in this study had poor knowledge of STIs and their prevention. Unexpectedly, those with higher levels of knowledge had an increased risk of STIs. There were no educational interventions—with good quality and long-term follow-ups—that increased the confidence that such SHE programs could have population level effects. A new high-quality study is therefore required to assess the effectiveness of an intervention generating behavioral changes; increasing only knowledge may not be sufficient.

scholarly journals Eating Behaviors Are Associated with Excessive Daytime Sleepiness among female adolescents

2021 ◽  
Author(s):  
sara beigrezaei ◽  
Mohsen Mazidi ◽  
Gordon A Ferns ◽  
Majid Ghayour-Mobarhan ◽  
Zumin Shi ◽  
...  
Keyword(s):  
Daytime Sleepiness ◽  
Eating Behaviors ◽  
Fluid Intake ◽  
Cross Sectional Study ◽  
High Rate ◽  
Second Hand Smoke ◽  
Cross Sectional ◽  
Validated Questionnaire ◽  
Increased Risk ◽  
Main Meal

Abstract BackgroundExcessive daytime sleepiness (EDS) is a common sleep abnormality among adolescents, and it’s associated with increased risk of morbidity and mortality. We aimed to explore the relationships between eating behaviors and EDS among female adolscents.MethodsIn this cross-sectional study 988 Iranian adolescent girls aged between 12-18 years old were recruited. Presence of EDS was determined by the Epworth Sleepiness Scale, and eating behaviors was assessed by a pre-validated questionnaire. To investigate the association between dietary behaviors and the prevalence of EDS, we applied logistic regression analysis in crude and adjusted models (adjustments for age, physical activity, menstruation and second hand smoke and general obesity).ResultsThe prevalence of esccesive daytime sleepiness was obtained 24.3. The participants who consumed a major meal three times daily had a 0.56 lower odds for EDS compared to those who consumed a single major meal (OR: 0.46, 95% CI: 0.21- 0.91). Individuals with a ‘high-rate of food chewing’ were less likely to have EDS (OR: 0.55, 95% CI: 0.29 -1.04) compared with low and moderate rate of food chewing. Compared with those who consumed fried or spicy foods daily, individuals who never consumed fried (OR: 1.8, 95% CI: 0.55- 5.86) or spicy foods (OR: 1.71, 95% CI: 0.55- 5.29) had a greater risk for EDS. In addition, there were direct associations between lower meal regularity (OR: 0.53, 95% CI: 0.29- 0.95) and intra-meal fluid intake (OR: 3.00, 95% CI: 1.2- 7.3) with EDS in adjusted models. Neither in the crude nor in the adjusted models, were there significant associations between breakfast intake and frequency of snack consumption with EDS.ConclusionThe lowest frequency of main meal frequency, irregular meal consumption, breakfast skipping, low rate of food chewing, intra-meal fluid intake, and consumption of spicy and fried foods were associated with increased odds of EDS. Further prospective studies are required to confirm this finding.

Alcohol consumption patterns amongst hepatitis C positive people receiving opioid maintenance treatment

2005 ◽  
Vol 38 (05) ◽  
Author(s):  
FM Wurst ◽  
B Watson ◽  
PS Haber ◽  
J Whitfield ◽  
C Wallace ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Alcohol Consumption ◽  
Maintenance Treatment ◽  
Consumption Patterns ◽  
Opioid Maintenance Treatment
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