Frequency Of Drug Use Research Articles

Experiences of harm and mental ill-health among gay, bisexual and other men-who-have-sex-with-men who use methamphetamine or GHB/GBL in different combinations: findings from the COMeT study in Taiwan

IntroductionPolydrug use in the context of chemsex is commonplace among gay, bisexual, and other men-who-have-sex-with-men (GBMSM). This study aimed to examine the differences in experiences of physical, social, and psychological harms, as well as mental ill-health among GBMSM who use different combinations of methamphetamine and gamma-hydroxybutyric acid/gamma-butyrolactone (GHB/GBL) during chemsex.MethodAdult GBMSM participants who had experience of chemsex in the past 12 months participated in a cross-sectional online survey in Taiwan and self-reported their sociodemographic background, sexual behaviours, mental health, and experiences of harm following a chemsex session. We used univariable and multivariable logistic regression to assess the different experiences of harm and mental ill-health among GBMSM who engaged in chemsex without using methamphetamine, used methamphetamine but not GHB/GBL, and who used both drugs.ResultsOut of 510 participants who completed all items included in the analysis, 24.1% engaged in chemsex without using methamphetamine, 36.9% used methamphetamine but not GHB/GBL, and 39.0% used both drugs. Eighty five percent of men who used both methamphetamine and GHB/GBL reported at least one kind of social harm after a chemsex session, such as missing dates or appointments, or appearing “high” at work, followed by used methamphetamine but not GHB/GBL (69.7%) and those without using methamphetamine (37.4%). After controlling for polydrug and frequency of drug use in the multivariable logistic regression, those who used methamphetamine but not GHB/GBL and those who used both drugs were more likely to report experiencing physical and psychological harms compared to those who did not use methamphetamine (p < 0.003).ConclusionGBMSM who used both methamphetamine and GHB/GBL in a chemsex context were more likely to report experience of harms than those who only used a single chemsex drug or engaged in chemsex without methamphetamine or GHB/GBL. Harm reduction should focus on both preventing HIV and STI transmission and on minimising psychosocial harm to GBMSM, with varying impacts depending on drug use.

Chemsex and its impact on gay and bisexual men who have sex with men: Findings from an online survey in Belgium.

The study aimed to estimate the prevalence of sexualized drug use, or chemsex, in a wide group of gay, bisexual and other men who have sex with men (gbMSM) in Belgium. It examined which drugs gbMSM used before and during sex, the frequency with which they used it, whether they experienced non-consensual sex, and evaluated the impact of chemsex on the health and professional and social lives of respondents. We conducted an online survey among Belgian gbMSM. Five specific questions on chemsex were included in the survey. These questions assessed whether gbMSM engaged in chemsex. If they did, they were asked to provide information on which drugs they had used and how often. We asked whether their and their partners' boundaries had been respected and whether and how engaging in chemsex had affected a range of life domains. Of 836 respondents, 258 (30.9%) self-reported having had sex under the influence of substances ("chemsex") in the previous 6 months. Of these, 227 (88%) were considered chemsex users according to the definition used for the analysis. Poppers (73%), gamma-hydroxybutyrate/gamma-butyrolactone (GHB/GBL; 69%) and cathinones (68%) were the most commonly reported substances. Almost half of respondents (45%) engaging in chemsex were high on drugs during at least half of their sexual encounters. Nearly 1 in 10 (9%) reported that boundaries had not been respected, suggesting non-consensual sexual activities. The 82 respondents experiencing negative impacts from their chemsex use reported that mental health (65%), physical health (40%) and sexual health (38%) were most impacted. Our findings provide a snapshot of the current chemsex situation in Belgium. The frequency of chemsex is concerning because several health, professional and social aspects are impacted. Almost 1 in 10 respondents using chemsex reported that chemsex impacted consent around sex, requiring additional efforts to eradicate these non-consensual sexual experiences. Therefore, larger scale research focusing on respected boundaries and consent during chemsex and the frequency of drug use for sex seems required. Additionally, sensitisation, as well as care and support programmes are critical.

Intelligent Generating Controller a Desflurane Concentration Value Which Helps to Decrease Blood Pressure.

The aim of the article is to determine the appropriate concentration of desflurane to effectively counteract the increase in blood pressure resulting from surgical stress. In medical practice, this increase is often limited by using additional doses of opioid drugs. Additional medications or higher doses of those already used may adversely affect your health. During anesthesia, physician must note the use of drugs and remember them, especially those that he has recently administered, which affect his concentration. For this purpose, the authors decided to propose support for the selection of desflurane concentration so that frequent use of opioid drugs is not necessary. The authors used a system based on AI issues to accomplish this task. The learned system supports the anesthesiologist's work by imitating him. The proposed method for selecting the desflurane concentration is based on a fuzzy controller. This system includes a learning mechanism that allows for minimizing the operating error. The main advantage of this system is the ability to build a function allowing the selection of anesthesia parameters without knowledge of the mathematical description of the process. To accomplish this task, you need an expert who will provide information in the construction of logical if-then sentences (points in space). The fuzzy controller connects the points in the consideration space appropriately, generating a hypersurface. The algorithm test was performed only by computer without the participation of patients. The operation of the proposed algorithm was verified by computer simulation. The authors of the article analyzed the compliance of the obtained results with the table provided by the expert. The desflurane concentration values obtained by computer simulation are similar to those given in the table Minimal driver error does not affect the patient's clinical response. This error results from the functions used in the fuzzy system and its settings. The results of the performance test of the proposed algorithm are presented in a time course, and it has the shape of a step function. The work proposes a function that allows you to enter the time needed for the body's reaction to reach the desired Etdes level. In this study, a controller was created to support the selection of the concentration of desflurane allowing for a reduction in blood pressure (resulting from surgical stress). The results obtained by computer simulation provide valuable insights for optimizing anesthesia. This system can also be used as an important simulation program for teaching purposes.

Effective measures to control eimeriosis in poultry in the Republic of Dagestan

The most common disease of young poultry in commercial farms of the Russian Caspian region is eimeriosis. In most cases, after convalescence from coccidiosis caused by one of Eimeria species poultry remains susceptible to other species. This parasite has a very short life cycle and immense reproductive capacity that is why it can cause large-scale outbreaks of the disease in commercial poultry houses. To control avian eimeriosis, various coccidiostats are used in combination with probiotics and vitamins. Frequent and long-term use of the same drugs against this infection can potentially result in the emergence of resistant Eimeria populations. This suggests that this coccidiosis control requires rotation of eimeriocidal drugs. Studies on eimeriosis prevalence were performed in the laboratory of the Caspian Regional Research Veterinary Institute and in different poultry farms of the Republic of Dagestan. Swabs of the floor, litter, equipment, droppings, feedstuffs, cecum smears from dead poultry were used for testing. High infection rate with eimerias was established in floor-housed poultry in the plain and piedmont zones of the Republic (Khasavyurtovsky and Karabudakhkentsky raions), where the infection rates were 81.6 and 82.4%, respectively. In batter-cage system poultry farms of the mountain and mountain valley zones (Khunzakhsky and Gergebilsky raions) the infection rates were significantly lower – 61.2 and 58.0%, respectively. The comparative efficacy study of two eimeriocidal drugs showed that “Robenidine”, used daily from the first day of life during the entire rearing period at a dose of 33 g per 1 ton of feedstuffs controls coccidiosis in poultry. At the same time, the survival rate of the experimental young poultry during the observation period was 98.0% compared with “Sarucoxum 12%” group (96.7%).

Prevalence of substance use among inpatients in two tertiary care hospitals in Tehran

ABSTRACT Background Non-medical use of substances among hospitalized patients is a significant medical challenge, disrupting effective patient care particularly in chronic disease conditions. Therefore, this study looked at how often patients admitted to two hospitals in Tehran might use substances. Methods The present study is a descriptive, cross-sectional research. 286 patients admitted to 12 departments of Rasoul Akram and Firoozgar hospitals in Tehran, were selected by simple random sampling. The WHO ASSIST tool was utilized to quantify the frequency of substance use across different categories. Results Our data revealed a lifetime, and recent (past three months) substance use frequency of 87.4% and 83.6% respectively. The most common substances among men were tobacco (81%), opioids (58%), and alcohol (48%), while sedatives (66%), tobacco (48%), and opioids (46%) were the most common substances among women. Young patients (18–39 years) had a history of substance use across all measured drug categories. The highest frequency of drug use was observed in psychiatry, neurology, orthopedics, and surgery departments. Conclusion Our research revealed a relatively high prevalence of drug use among hospitalized patients. These findings underscore the importance of integrating assessments for non-medical drug use and addiction disorders alongside patients’ existing illnesses to ensure comprehensive patient care.

Heterogeneous Trajectories in Post-Disaster Drug Use Across Different Race/Ethnicity and Income Strata: Focus on Natural Hazards During COVID-19.

During the COVID-19 pandemic, climate-related natural hazards, such as wildfires, storms/hurricanes, and others (e.g., earthquakes, tornadoes), further disrupted the normal functioning of US residents. The co-occurrence of natural disasters and COVID-19 created unprecedentedly elevated levels of stress, especially to the racial/ethnic minorities and lower-income households. This study examines how natural disasters related to recreational drug use during COVID-19 and whether the relation is heterogeneous across different subgroups categorized by race/ethnicity and household income. This study used the data from the biweekly online surveys of the Understanding America Study (UAS) and analyzed the drug use behaviors of 966 US adults between April 29 and December 31, 2020. This study found that middle-income adults (household income ranging from $50,000 to $149,999), serving as the reference group, generally exhibited a significant reduction in drug consumption during or after disaster events. However, compared to the middle-income group, White and Black adults with household income lower than $50,000 showed 142% and 88% more frequent drug use when experiencing storms/hurricanes. This disparity widened in the following weeks. Additionally, lower-income Hispanics showed 74% more frequent drug use compared to the middle-income group in the weeks following wildfire incidents. The study's findings shed light on the risk of drug misuse during the co-occurrence of climate and public health crises, emphasizing the disproportionate risk among lower-income racial/ethnic minorities amid the pandemic and natural disasters.

Efficacy and Mechanism of Core Traditional Chinese Medicines for Treating Malignant Lymphoma based on Efficacy Studies: A Study Supported by Network Pharmacology and Molecular Docking.

The burden of malignant lymphoma in China is greater than the global equivalent. The randomized controlled trials provide medical evidence that TCM can improve the response and survival in patients with lymphoma. However, the mechanisms underlying remain undefined. Evidence-based data mining for traditional Chinese medicine (TCM) on improving response and survival in malignant lymphoma treatment was performed in this study. In addition, the mechanisms of TCM through network pharmacology and molecular docking were explored. The China national knowledge infrastructure, Wanfang Data, China Science and Technology Journal Database, PubMed, and Web of Science databases were searched to select TCM formulas with response and survival benefits in the treatment of malignant lymphomas. We then analyzed and visualized the tropism of taste, frequency of drug use, dosage, clustering, association rules mining (minimum support threshold as 0.20, the minimum confidence threshold as 0.80 and lift >1), and complex networks for potential core herb compositions using Excel, IBM SPSS Statistics 26, and IBM SPSS Modeler 18. TCM systems pharmacology, GeneCards, Online Mendelian Inheritance in Man, and other databases were used to screen potential core active ingredients and malignant lymphoma-related targets. The intersection targets were used to construct a protein interaction network using Cytoscape to obtain the key targets. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment were used to analyze the core target, and molecular docking of key components and targets was performed using CB-Dock2. Twenty-four Chinese herbal formulae were included, encompassing 107 herbs with mainly cold and warm properties and bitter and sweet flavors. They were associated with the yin meridians of the liver, spleen, and lungs. The TCMs underwent association rule analysis, identified 27 association rules, including 12 herb pairs and 13 angle medicine, and clustered into eight classes by clustering analysis. Combined with the results from mining analysis, Pinelliae (Ban-xia), Poria (Fu-ling), Atractylodis macrocephalae (Bai-zhu), Curcumae (E-zhu), and Sparganii (San-leng) were the potential core herbs According to network pharmacology and molecular docking, the main core components of the potential core drugs are hederagenin, cerevisterol, 14- acetyl-12-senecioyl-2E,8E,10E-atractylentriol, 12,13-epoxy-9-hydroxynonadeca-7,10-dienoic acid, cavidine, and baicalein. These core drugs are mainly involved in the pathways of EGFR tyrosine kinase inhibitor resistance, PD-1/L1, natural killer cell-mediated cytotoxicity, NF-κB, epithelial cell signaling in H. pylori infections, and Th17 cell differentiation. They aid in regulating the transmembrane receptor protein tyrosine kinase signaling pathway, ERBB signaling pathway, PI3K signaling pathway, and phosphorylation process. Ten key components and eight key targets, including baicalein and hederagenin, demonstrated strong binding activity. Collectively, some core herbs exerted anti-tumor effects through immune and inflammatory pathway modulation, inhibition of immune escape, and induction of cell apoptosis. These findings support future evidence-based research on malignant lymphoma treatment using TCM.

Worsening trends in the frequency of methamphetamine and other stimulant use between treatment admission and discharge

BackgroundTreatment for methamphetamine and other stimulants can be effective but treatment attrition and continued use are very high. Abstinence is the conventional outcome used to evaluate treatment success, but defining treatment success in this way misses opportunities to promote improved health even when abstinence is not achieved. Reducing methamphetamine and stimulant use without abstinence is associated with many positive outcomes. However, little is known about drug use patterns during treatment or trends in use over time. MethodsWe used the Treatment Episode Dataset-Discharges (TEDS-D) to identify treatment episodes that had a stimulant drug indicated as the primary substance of use (2017–2021; N=251,841; methamphetamine, cocaine, other amphetamines, or other stimulants). Our outcome was the change in the frequency of drug use between admission and discharge (decreased use with abstinence, decreased use without abstinence, increased use). We used multiple logistic regression to model a change in drug use frequency, predicted by year, stimulant type, and their interaction. ResultsNearly two-thirds of the sample (60 %) had methamphetamine indicated as the primary stimulant of use. There was a decrease in the predicted rate of abstinence over time and worsening trends were strongest among those using methamphetamine. Daily and periodic drug use at both admission and discharge (no change in use) became worse over time, particularly for those using methamphetamine. ConclusionTreatment outcomes worsened over time and declined fastest among those reporting methamphetamine. Abstinence was rare and most treatment clients did not change their drug use behavior. We recommend a renewed focus on evidence-based harm reduction while the nation’s treatment systems continue grappling with the stimulant crises.

Assessment of pain intensity and analgesic requirements in patients with diabetes mellitus after STEMI

Abstract Introduction Patients with diabetes encounter a significantly higher risk of myocardial infarction, heart failure, and mortality following acute cardiac events. Examining pain intensity and analgesic needs in patients with diabetes can provide a comprehensive understanding of the pain experienced and individual analgesic needs in patients with diabetes. Aim of the study The aim was to assess pain intensity and analgesic requirements in patients with diabetes mellitus after STEMI. Material and Methods The study involved 104 participants (58 female and 46 male, with a mean age of approximately 72 years, M±SD= 11 yeas). The study was conducted at the Heart Institute, in the Intensive Cardiology Unit, and data were collected from patients following STEMI Participants were divided into two groups: 54 people with diabetes and 50 people without diabetes. The influence of factors such as gender, age, existing diseases, haemoglobin levels and the presence of diabetes on pain intensity was analysed. In the diabetes group, the effects of treatment method, duration of illness and diabetes compliance on pain intensity were also considered. A visual analogue scale (VAS) was used to assess pain, and analgesia requirement was assessed using an analgesic ladder. The level of significance wasp &amp;lt; 0.05. Results The analysis indicated the effect of diabetes on pain intensity in patients with myocardial infarction. Those with diabetes experienced significantly less pain, however glycated HbA1c levels above 7.0 mg/dl predisposed to experiencing more pain. The b standardized regression coefficient indicated for diabetes ,a strong negative correlation (β=-0.77 ,p = 0,008), and for HbA1c level ,a strong positive correlation (β=0.88 ,p =0,889). Comparative analysis of analgesics revealed lower usage in the diabetes group(p=0.002). Diabetes Patients, the most frequent use of first-line drugs while the group of patients without diabetes needed second-level analgesic treatment. Those with diabetes rated their pain level as low ,while the non-diabetic group was dominated by respondents with an intermediate pain level. Non-adherence to diabetic recommendations correlated with higher pain intensity , with a strong positive correlation (β coefficient=0.90, p = 0,010 ). No significant impact was observed based on gender, age, the presence of comorbidities, or the influence of diabetes treatment methods and duration on the intensity of perceived pain. Conclusions The analysis indicated the effect of diabetes on pain intensity in patients with myocardial infarction. Those with diabetes experienced significantly less pain than non-diabetes patients. Diabetes patients required a lower level of the analgesics ladder.

The practice of using antibacterial drugs for respiratory infections

Acute respiratory infections, being the leading ones in the structure of infectious morbidity of the population, require the use of antimicrobial drugs, along with symptomatic therapy. The purpose of the work was to assess the frequency and structure of the use of antibacterial drugs for acute respiratory infections before the pandemic and during the spread of Sars-CoV-2. A cross-sectional sampling study was conducted using a questionnaire using a specially designed questionnaire in a Google form. According to the eligibility criteria, 260 respondents aged 18–65 years, average age 25.14±11.13 years, took part in the study. Statistical processing of the results was carried out using the Microsoft Office Excel 2016 program, the significance of the differences was determined using the Student’s test, the results were considered significant at p&lt;0.05. The study showed that the majority of respondents use antibiotics to treat acute respiratory infections, the frequency of their prescription both before the pandemic and in the period 2020–2021. did not change — 60.8 % and 60.0 %, respectively. Antibacterial drugs were prescribed by a medical professional in 71.1 % of cases, and independently in 21.1 % of cases. Self-prescription of drugs was significantly more common in the group aged 30 years and older. In the structure of the drugs used, protected penicillins, macrolides and cephalosporins were in the lead. Age-related differences in the use of antibiotics in the pre-pandemic period were revealed: young people under 30 years of age, compared with the age group of 30 years of age and older, not only significantly more often used these drugs to treat respiratory infections (p = 0.012), but also could use them 2 or more times per year (p=0.0038). During the pandemic, men more often did without the use of antibacterial drugs compared to women (p = 0.035), however, in the structure of antibiotic use in men, the frequency of more frequent use of drugs increased 4 times (2 or more times a year, p = 0.047).

Trajectories of craving in the course of pharmacotherapy trials for methamphetamine use disorder.

The aim of this study was to measure trajectories of craving for methamphetamine during the course of pharmacotherapy trials for methamphetamine use disorder. Craving trajectories were identified using Group-Based Trajectory Modeling. The association of craving trajectories with drug use trajectories was examined using a dual trajectory model. Association of craving trajectories with other health and social outcomes was also examined. The study used pooled data from five randomized controlled pharmacotherapy trials for methamphetamine use disorder. A total of 866 adults with methamphetamine use disorder participated in randomized controlled pharmacotherapy trials. Craving was assessed weekly using the Brief Substance Craving Scale. Drug use was assessed using urine toxicology. Alcohol- and drug-related problems, as well as psychiatric, medical, legal, employment and relationship problems, were measured using the Addiction Severity Index. A three-trajectory model with high, medium and low craving trajectories was selected as the most parsimonious model. Craving trajectories were associated with methamphetamine use trajectories in the course of trial; 88.4% of those in the high craving trajectory group had a consistently high frequency of methamphetamine use compared with 18.7% of those in the low craving group. High craving was also associated with less improvement in most other outcomes and higher rate of dropout from treatment. In turn, low craving was associated with a rapidly decreasing frequency of methamphetamine use, greater improvement in most other outcomes and a lower rate of dropout. Participants on modafinil daily and ondansetron 1 mg twice daily were less likely to be in the high craving group compared with those on placebo. Trajectories of methamphetamine craving in the course of clinical trials for methamphetamine use disorder appear to be both highly variable and strongly associated with greater frequency of drug use, other drug-related outcomes and dropout from trials. Two medications, modafinil daily and ondansetron at a dose of 1 mg two times daily, appear to be associated with greater reduction in craving in the course of treatment compared with placebo. A decrease in methamphetamine craving shows promise as an early indicator of recovery from methamphetamine use disorder.

Synthesis, molecular dynamics simulation, and evaluation of biological activity of novel flurbiprofen and ibuprofen-like compounds.

The frequent use of anti-inflammatory drugs and the side effects of existing drugs keep the need for new compounds constant. For this purpose, flurbiprofen and ibuprofen-like compounds, which are frequently used anti-inflammatory compounds in this study, were synthesized and their structures were elucidated. Like ibuprofen and flurbiprofen, the compounds contain a residue of phenylacetic acid. On the other hand, it contains a secondary amine residue. Thus, it is planned to reduce the acidity, which is the biggest side effect of NSAI drugs, even a little bit. The estimated ADME parameters of the compounds were evaluated. Apart from internal use, local use of anti-inflammatory compounds is also very important. For this reason, the skin permeability values of the compounds were also calculated. And it has been found to be compatible with reference drugs. The COX enzyme inhibitory effects of the obtained compounds were tested by in vitro experiments. Compound 2a showed significant activity against COX-1 enzyme with an IC50 = 0.123 + 0.005 μM. The interaction of the compound with the enzyme active site was clarified by molecular dynamics studies.

Illicit drug use at licensed premises and the potential for prevention: A qualitative interview study of stakeholders.

Background: The aim of this study was to explore how stakeholders perceive illicit drugs at licensed premises, existing and potential prevention interventions, and to identify facilitators and barriers to reduce illicit drugs at these locations. Methods: Semi-structured interviews with police officers, licensed premises owners, security staff and municipality officials (n = 28) in seven counties in middle Sweden were conducted and analysed using qualitative content analysis. Results: The informants reported frequent illicit drug use and dealing at licensed premises, causing a negative influence on the restaurant environment. Efforts to prevent illicit drugs varied with respect to type and intensity but included environmental and situational changes as well as education and training, policy implementation and law enforcement. Facilitators for the reduction of illicit drugs are confidence that sufficient resources are allocated, motivated and skilled stakeholders who see benefits of prevention and collaborate closely, along with visible results. General societal prevention was also seen as important. Identified barriers were perceived drug-positive norms and high availability and use in the society, perceived lack of prioritisation and resources, difficulties to collaborate due to e.g., secrecy between organisations, lack of action among stakeholders due to financial considerations, perceived confusion about roles and mandate, and owner's and staff's fear of threats and violence from criminals or own involvement in crime. Conclusion: To maximise the potential of successful prevention, authorities should support owners of licensed premises to act firmly against illicit drugs by providing training, ensure that they apply a strict policy, work for increased stakeholder collaboration and provide appropriate police resources. Authorities should also investigate criminal activities among owners and staff as well as combat organised crime and availability of illicit drugs in the society.

Effects of hemodynamic support on arrhythmia-free survival following catheter ablation of ventricular arrhythmias

Abstract Background Radiofrequency-guided catheter ablation is an established therapy for ventricular tachycardia (VA). Hemodynamic support (HS) is often required for patients suffering from incessant VA to guide ablation. Data on the outcome of patients receiving HS during VA ablation procedures are lacking. Purpose The aim of this observational study was to analyze the acute procedural success as well as long-term 36-month-VA-recurrence rates and mortality in patients requiring HS during VA ablation procedures. Methods Data from consecutive patients receiving HS during VA ablation procedures between 2015-2023 were analyzed. HS was defined as the use of an Impella, an extracorporeal membrane oxygenation (ECMO) or a left ventricular assist device (LVAD). HS-group patients were compared to patients that underwent VA ablation procedures without HS. All patients were continuously followed up in our outpatient clinic. Data on procedural parameters, acute success and complications as well as long-term VA-free survival and mortality were analyzed. Results A total of 95 consecutive patients (mean age 60.9 ± 11.0 years, 15% female) were included. 62 patients (65%, mean age 60.4±9.4 years, 16% female) receiving HS (ECMO or Impella: n=26, 42%; ECMO+Impella: n=7, 11%; LVAD: n=29, 47%) were compared to those without (mean age 61.7±13.5 years, 12 % female). In the HS-cohort a significantly lower left ventricular ejection fraction (LVEF) (p&amp;lt;0.001), a higher New York Heart Association (NYHA) functional class (p=0.013) and a more frequent antiarrhythmic drug use (p=0.045) was documented. Fluoroscopy times were significantly longer in the HS-group (HS: 10:22 ± 07:04 vs. no HS: 05:52 ± 02:50 minutes, p&amp;lt;0.001). Acute procedural success (HS: n=59, 95% vs. no HS: n=33, 100%, p=0.549) and major procedure complications (HS: n=4. 6% vs. no HS: n=4. 6%, p=1.000) were comparable between the two groups. Nevertheless, patients receiving HS had a significantly higher in-hospital mortality (HS: n=20, 32 % vs. no HS: n=2, 6%, p=0.004). The estimated 36-month-VA-free survival was comparable between the groups (Log-rank p=0.114). But Kaplan-Meier-plot analyses revealed a significantly higher estimated mortality in patients receiving HS (Log-rank p=0.002) (Figure 1). Between the subgroups (ECMO or Impella vs. LVAD) no statistically relevant differences were observed (Log-rank p=0.466). Multivariate analyses revealed HS as an independent predictor for mortality (Hazard ratio (HR) 3.259, Confidence Interval (CI) 1.060-10.015, p=0.039), but not for VA-recurrence. Conclusion In the specific cohort of patients receiving HS, VA ablation procedures seem to be safe and effective with comparable acute and long-term success- and complication-rates. The need for HS seems to be associated with an increased risk for mortality. Further studies are required to validate our initial observations.Kaplan-Meier-plot on 36-month survival

Investigation of frequency and factors related to drug use in male students living in dormitories

ABSTRACT Introduction Students living in dormitories are more exposed to social harms due to a variety of reasons, including distance from family and educational problems. In this study, the frequency of drug use and its related factors in male students living in dormitories was investigated. Materials and methods In a cross-sectional study, 270 male dormitory students of Hamadan University of Medical Sciences were selected, and they were interviewed in terms of their drug use. Results Hookah (41.5%), cigarettes (35.5%), alcohol (24.1%), sedatives (20%), hypnotics (13%) and marijuana (13) were the most commonly used drugs in students. In total, 49.6% of cigarettes and hookahs). Lack of amusement and entertainment (25.2%), stress (14.1%), depression (11.9%) and love failure (11.5%) were the most important reasons for students’ tendency to use drugs. There was a statistically significant relationship between drug use and marital status, education of parents and field of study. Conclusion Due to the nature of the study, the obtained statistics are less than the reality and therefore, we must seriously make policy and plan to solve this social problem and prevent its dire consequences.

Role of invasive hemodynamics monitoring in sepsis intensive care

The objective was to study the effect of early planned use of transpulmonary thermodilution (TPTD) and therapeutic measures to stabilize blood circulation on the clinical outcome of sepsis.Materials and methods. The cohort study involved 132 patients with abdominal sepsis with SOFA &gt;7 and blood lactate &gt;1.6 mmol/L. Septic shock was diagnosed in 56 % of patients. TPTD in the early periods of intensive care was began in 53.8 % of patients. Logistic regression and ROC-analysis were used to process the data.Results. Early use of invasive monitoring (OR 2,3715, 95 % CI 1,1107–5,0635, p=0,026, AUC 0.655) and infusion volume &gt;43 ml/kg per day (OR 1.0313, 95 % CI 1.0073–1.0558, p=0.01, AUC 0.677) were predictors of survival in patients with abdominal sepsis. The use of TPTD compared to patients of group II was accompanied by an increase in the daily infusion volume (53.7 [38.1–63.5] vs 38.2 [29.9–47.2], ml/kg per day, p = 0.0001), more frequent use of inotropic drugs (39.4 vs 16.4 %, p = 0.004), and higher level of the inotropic scale (0 [0–4.7] vs 0 [0–0], p = 0.01). There were no differences in the frequency of prescription (57.7 vs 65.5 %, p = 0.376) and dosages (0.2 [0.1–0.4] vs 0.3 [0.2–0.4] μg/kg/min, p = 0.554) of norepinephrine. Twenty-eight-day mortality in groups I and II was 31 and 50.8 % (p = 0.022), hospital mortality was 32.9 and 54.0 % (p = 0.014).Conclusion. When assessed by SOFA &gt; 7 points and lactatemia &gt; 1.6 mmol/L, the onset of TPTD and infusion volume &gt; 43 mL/kg/day increase the likelihood of survival of patients with abdominal sepsis, as a result, 28-day and hospital mortality decrease by 1.6 times. The use of invasive monitoring of central hemodynamics in this clinical situation is accompanied by an increase in the prescription of inotropes by 2.4 times with an unchanged intensity of norepinephrine use.

Efficient role of Herbs used in Ulcer Therapy

Peptic ulcers, commonly referred to as PUDs or peptic ulcer disease, are very painful ulcers that typically occur in an acidic portion of the gastrointestinal tract. Either increased aggression or decreased mucosal resistance might upset the natural equilibrium, leading to ulceration. It could be brought on by stress, erratic eating patterns, frequent drug use, and other factors. Peptic ulcers develop when there is a breakdown in the mucosal barrier along with acidity and peptic activity in the stomach liquid. Mucosal resistance to damage is significantly disrupted by two major factors: Helicobacter pylori (H. pylori) infection and nonsteroidal anti-inflammatory medications (NSAIDs). However, in comparison to traditional remedies, these pharmaceuticals are more costly and probably have more negative effects. Pain relief, ulcer healing, and delaying the recurrence of the ulcer are the optimal goals of peptic ulcer disease treatment. The traditional, ethnobotanical, and ethnopharmaceutical uses of Indian herbal plants are unique. A few plants that may be utilised to treat or prevent peptic ulcers have been the subject of informational attempts in this review. Pain relief, ulcer healing, and recurrence prevention are the main objectives of peptic ulcer disease treatment.

Patterns of Socioeconomic Marginalization among People Who Use Drugs: A Gender-Stratified Repeated Measures Latent Class Analysis.

Socioeconomic factors are important correlates of drug use behaviors and health-related outcomes in people who use drugs (PWUD) residing in urban areas. However, less is known about the complex overlapping nature of socioeconomic conditions and their association with a range of individual, drug use, and health-related factors in men and women who use drugs. Data were obtained from two community-recruited prospective cohorts of PWUD. Using a gender-stratified approach, we conducted repeated measures latent class analyses (RMLCA) to identify discrete latent socioeconomic subgroups. Multivariable generalized estimating equations were then used to identify correlates of class membership. Between June 2014 and December 2018, RMLCA of 9844 observations from 1654 participants revealed five distinct patterns of socioeconomic status for both men and women. These patterns were primarily distinguished by variations in income, material and housing security, income generation activity, exposure to violence, criminal justice involvement, and police contact. Across gender, progressive increases in exposure to multiple dimensions of socioeconomic disadvantage were found to be associated with frequent use of opioids and stimulants, accessing social services, and being hepatitis C virus antibody-positive. Similar but less congruent trends across gender were observed for age, binge drug use, engagement with opioid agonist therapy, and living with HIV. Gendered patterns of multiple and overlapping dimensions of socioeconomic adversity aligned with patterns of frequent drug use and health-related concerns, highlighting priority areas for gender-inclusive, multilevel responses to mitigate health disparities and meet the diverse socioeconomic needs of urban-dwelling men and women who use drugs.

PrEP for people who use opioids: A NIDA clinical trials network survey study in Southern U.S. cities where HIV incidence is high

BackgroundPeople who use opioids (PWUO) are at increased risk for HIV. Pre-exposure prophylaxis (PrEP) is effective but underutilized as HIV prevention among PWUO. This study examined predictors of willingness to take daily oral PrEP and long-acting injectable (LAI) PrEP among PWUO across eight Southern urban cities with high HIV incidence. MethodsHIV-negative PWUO (N = 308) seeking services in community-based programs participated in this cross-sectional survey study. Measures included demographics, sexual risk behavior, substance use frequency, and awareness of and willingness to take oral and injectable PrEP. Data were analyzed using mixed-effects models. ResultsWillingness to take daily oral and LAI PrEP was moderately high (69.16% and 62.02%, respectively). Half had heard of PrEP, but only 4% had ever taken it. Only education and condomless vaginal sex predicted willingness to take oral PrEP. Only education predicted willingness to take LAI PrEP. Polysubstance use was prevalent, with substantial proportions of PWUO reporting frequent use of injection drugs (opioids or stimulants, 79.5%), non-injection opioids (73.3%), non-injection stimulants (71.1%), cannabis (62.6%), and hazardous drinking (29.6%). About 20% reported past-year condomless anal sex, and one-third reported past-year condomless vaginal sex. ConclusionsPWUO in this study were amenable to PrEP, particularly in light of education and condomless vaginal sex. Careful consideration for matching PrEP messaging to the PWUO audience is needed. PrEP promotion should expand beyond men who have sex with men to include groups such as these predominantly heterosexual, polysubstance-using PWUO with HIV risk who were open to both formulations of PrEP.

Longitudinal examination of borderline personality disorder symptoms and drug use: The influence of negative and positive emotion dysregulation.

Borderline personality disorder (BPD) is associated with greater substance use. Emotion dysregulation has been implicated in both BPD and substance use, yet there is limited research examining the role of emotion dysregulation in the BPD-substance use relation. We examined the independent and interactive associations of BPD symptoms and emotion dysregulation in reported drug use over 1year. Participants (N = 143) were over-recruited for BPD, assessed via interview, and completed measures of negative and positive emotion dysregulation. Drug use frequency was assessed with monthly surveys over a 1-year period. Results demonstrated interrelations among BPD symptoms and both negative and positive emotion dysregulation. However, when modeling BPD and emotion dysregulation together, only higher BPD symptoms were associated with more frequent drug use. Findings support the relation of BPD symptoms and emotion dysregulation but suggest that emotion dysregulation may not account for drug use frequency above and beyond BPD in community-recruited populations.