History Of Drug Use Research Articles

Updated Results from the Retrospective CREST Study on the Safety and Effectiveness of 8-Week Glecaprevir/Pibrentasvir in HCV-Infected Treatment-Naïve Patients with Compensated Cirrhosis.

This brief report presents updated findings from the previously published CREST study evaluating the safety and effectiveness of 8-week glecaprevir/pibrentasvir (GLE/PIB) in treatment-naïve patients with chronic hepatitisC virus (HCV) infection and compensated cirrhosis. The current study includes an additional 51 patients, presents effectiveness data stratified by additional comorbidities and comedications, and offers insights into healthcare resource utilization. Analysis of treatment-naïve patients with HCV infection and compensated cirrhosis enrolled in the CREST study, a real-world, observational multicenter study. All enrolled patients were included in the full analysis set (FAS); the modified analysis set (MAS) excluded patients with missing SVR12 data, or who discontinued GLE/PIB for nonvirologic failure. The primary endpoint was sustained virologic response at posttreatment week12 (SVR12) in the MAS. Safety and healthcare resource utilization were also assessed. The FAS included 437 patients, and the MAS 375. Overall, the results were consistent with the previously published study, with 98.9% of patients in the MAS achieving SVR12. Patients with comorbidities such as alcoholism, diabetes, and hyperlipidemia achieved SVR12 rates > 94%. High SVR12 rates were also achieved by patients receiving comedications such as anxiolytics, antidepressants, and opioid agonists. Of the 26.8% of patients with an adverse event, 1.1% had a serious adverse event, none of which were deemed related to GLE/PIB. Healthcare resource utilization varied by employment status and history of drug use. Active drug users had more physician and nurse visits than specialist visits compared with former drug users. This study provides further evidence on the safety and effectiveness of 8-week GLE/PIB, supporting the use of shorter treatment in treatment-naïve patients with Child-PughA cirrhosis including subgroups of interest, regardless of comorbidities and comedications observed in this population. The variable healthcare resource utilization in different patient types can help plan and resource linkage to care better, thus supporting HCV elimination efforts.

7504 A Case of Methicillin Sensitive Staphylococcus Aureus Thyroiditis

Abstract Disclosure: K. Patel: None. P. Kachhadia: None. S. Khan: None. F. Akanbi: None. A. Abu Limon: None. S.A. Aldasouqi: None. Introduction: Acute suppurative thyroiditis refers to bacterial infection of the thyroid gland. It is rare as the thyroid gland is typically protected from infection due to isolation of the gland from neighboring structures as well as its rich blood supply and adequate lymphatic drainage. It shares characteristics with subacute and autoimmune thyroiditis which make for difficult diagnosis. Here we present a case of acute suppurative thyroiditis in the setting of methicillin sensitive staphylococcus aureus (MSSA) bacteremia. Case Presentation: We have a 45 year old gentleman with a history of polysubstance abuse who was admitted after a drug overdose. He was being treated for rhabdomyolysis and approximately ten days after admission he became febrile with Tmax 103.3 Farenheit with a sore throat and dysphagia. Workup showed leukocytosis, ESR 86 mm/h [0-15], CRP 45.5 mg/dL [0-1], blood cultures with MSSA, negative viral upper respiratory panel, throat culture, Syphilis and HIV testing. He had a positive Hepatitis C antibody without a detectable viral load. Echocardiogram ruled out vegetations. He was treated with cefazolin. CT neck was obtained and showed thyroid enlargement. Subsequent ultrasound showed heterogeneous echotexture and increased color flow and a left inferior pole nodule 2.3 x 2.1 x 2.0 cm. Thyroid labs showed TSH 0.16 [0.35 - 4.01 u[IU]/mL,] Free T4 3.91 ng/dL [0.61 - 1.37], TPO <0.3. The nodule was biopsied and endocrinology was consulted. On exam thyroid was nontender. He was started on beta blockers and thyroid labs were monitored. TSI and TRAB were negative. TSH, Free T4 and Free T3 improved to normal range. Nodule biopsy results showed benign follicular cells with abundant acute inflammation suggestive of an abscess. Metronidazole was added after biopsy results. Post antibiotic therapy, CRP improved to 1.7 mg/dL. Discussion/Conclusion: Incidence of acute suppurative thyroiditis has been published as occurring <1% of all thyroid diseases. One systematic review found 200 cases reported from January 2000 to January 2020. Prior case reports have described acute suppurative thyroiditis in adult patients with prior thyroid gland pathology or an immunocompromised state and some demonstrated a correlation with intravenous drug users. The most common culprits include Staphylococcus spp, Streptococcus spp, Salmonella spp, Escherichia spp. Management includes antimicrobial therapy and/or needle aspiration. Non-responders can undergo incision and drainage of abscess or thyroidectomy. Mortality was reported in about 8% of the reported 200 cases. In our patient, his history of drug use and Hepatitis C likely made him prone to infection. Although there was no description of pus during biopsy, pathology suggested acute inflammation. This along with elevated inflammatory markers led to the diagnosis. This case highlights an uncommon but potential cause of thyroiditis. Presentation: 6/3/2024

Examining trends in the incidence of HIV infection among people with a history of drug use to inform an outbreak investigation and response: A retrospective cohort study.

In the context of an outbreak of HIV among people who inject drugs in Glasgow, Scotland, identified in 2015, our objectives were to: (1) develop epidemiological methods to estimate HIV incidence using data linkage, and (2) examine temporal changes in HIV incidence to inform public health responses. This was a retrospective cohort study involving data linkage of laboratory HIV testing data to identify individuals with a history of drug use. Person-years (PY) and Poisson regression were used to estimate incidence by time period (pre-outbreak: 2000-2010 and 2011-2013; early outbreak: 2014-2016; ongoing outbreak: 2017-2019). Among 13 484 individuals tested for HIV, 144 incident HIV infections were observed from 2000 to 2019. Incidence rates increased from pre-outbreak periods (1.00/1000 PY (95% confidence interval, CI: 0.60-1.65) in 2000-2010 and 1.70/1000 PY (95% CI: 1.14-2.54) in 2011-2013) to 3.02/1000 PY (95% CI: 2.36-3.86) early outbreak (2014-2016) and 2.35 (95% CI 1.74-3.18) during the ongoing outbreak period (2017-2019). Compared with the pre-outbreak period (2000-2010), the incidence rates were significantly elevated during both the early outbreak (2014-16) (adjusted incidence rate ratio (aIRR) = 2.87, 95% CI: 1.62-5.09, p < 0.001) and the ongoing outbreak periods (2017-19) (aIRR = 2.12, 95% CI: 1.16-3.90, p = 0.015). Public health responses helped to curb the rising incidence of HIV infection among people with a history of drug use in Glasgow, but further efforts are needed to reduce it to levels observed prior to the outbreak. Data linkage of routine diagnostic test data to assess and monitor incidence of HIV infection provided enhanced surveillance, which is important to inform outbreak investigations and guide national strategies on elimination of HIV transmission.

Microbes Causing Spinal Epidural Infection in Patients Who Use Drugs.

The incidence of spine infections has increased due to the surge in injection drug use driven by the opioid epidemic. Few recent studies have evaluated the microbiology of spinal epidural infections among people who inject drugs compared to the microbiology of such infections among the general population. We performed a retrospective chart review to identify patients with a spinal epidural abscess or phlegmon unrelated to recent spine surgery between 2015 and 2023. Of 346 initial records, 277 met inclusion criteria for demographic analyses. Of the 229 patients with microbiologic results, details regarding possible drug use were available in 227 patients. Patients with no documented history of drug use were categorized as non-PWUD, while patients who use drugs (PWUD) were separated based on whether drug use was active or not. Patients with prior histories of injection or noninjection drug use were categorized as nonactive PWUD, while those with injection or snorting drug use reported in the past 3 months were categorized as active PWUD. Thirty-nine percent of patients with spinal epidural infection had substance use disorder. Most patients with monomicrobial cultures were infected with gram-positive, aerobic bacteria (86%). Active PWUD were more likely to have methicillin-resistant Staphylococcus aureus compared to non-PWUD (36% vs 13%, respectively, P = .002). Nonactive PWUD were more likely to have non-Escherichia coli gram-negative bacterial infections than non-PWUD (18% and 4.4%, respectively, P = .01). More than 1 in 3 patients with a spinal epidural infection unrelated to recent surgery had substance use disorder. These patients are more likely to have infections due to MRSA and gram-negative bacteria other than E coli such as Serratia marcescens.

Abstract A013: Factors associated to tobacco smoking and electronic cigarette use among a Hispanic sample of persons living with HIV in Puerto Rico, Mexico, and San Francisco

Abstract Introduction: People living with HIV (PLWH) are at greater risk of developing conditions related to tobacco smoking, given their increased use of tobacco products. A higher prevalence of electronic cigarette use among PLWH than the general population has been also reported. This study assessed factors associated with tobacco smoking and electronic cigarette use among a Hispanic sample of PLWH in Puerto Rico (PR), Mexico, and San Francisco (SF). Methods: Data from an ongoing cross-sectional study (May 2023 – May 2024) of oral HPV infection among a sample of PLWH ≥21 years old in PR [n=211 (women: 26%, men: 74%)], Mexico [n=30 (women: 90%, men: 10%)], and SF [n=18 (women: 11%, men: 89%)] was analyzed. Eligibility criteria included being a participant in the CAMPO study (NCI#U54CA242646). People who agree to participate in the oral HPV study complete an interview that collects sociodemographic and clinical characteristics, and relevant clinical procedures. Chi-squared test, Fisher exact test, and logistic regression models were used to evaluate factors associated with current smoking and electronic cigarette use. Results: Mean age (years) was 51.0±12.7 SD in PR, 37.2±8.8 SD in Mexico, and 61.2±10.4 SD in SF. History of AIDS diagnosis was 18.1% in PR, 13.3% in Mexico and 37.5% in SF. In PR, 24.2% were current smokers, 8.6% were current users of electronic cigarettes, and 2.8% used both. In Mexico, 33.3% were current smokers, 3.3% were current users of electronic cigarettes, and 3.3% used both. In SF, 16.7% were current smokers, 22.2% were current users of electronic cigarettes, and 5.6% used both. Regarding other behavioral characteristics, 53.1% in PR, 26.7% in Mexico, and 44.4% in SF reported current alcohol intake and 19.0% in PR, 6.7% in Mexico, and 33.3% in SF reported current marihuana use. In PR, Mexico, and SF, the prevalence of lifetime non-injected drug use was 52.9%, 30.0%, and 66.7%, respectively, while the prevalence of injected drug use was 10.4%, 0.0%, and 16.7%, respectively. In the multivariable logistic regression model adjusted for tobacco consumption, persons with history of injection drug use (OR=1.23; 95% CI 1.04-1.50), and non-injection drug use (OR=1.14; 95% CI 1.03-1.27) had higher odds to be current smokers than their counterparts. Meanwhile, people who report current marihuana use had higher odds of electronic cigarettes use (OR=1.14, 95% CI: 1.04-1.26) in comparison to their counterparts. No significant differences were observed by sex-at-birth, age, and site of recruitment. Conclusion: Our results showed a high prevalence of tobacco consumption among Hispanics living with HIV in PR, Mexico, and San Francisco. Higher odds of tobacco consumption were observed among people with a history of drug use. Similarly, higher odds of electronic cigarette use were observed among people who reported marijuana consumption. These results highlight the need for smoking cessation interventions among high-risk population, such as PLWH with a history of drug use. Acknowledgment: NIDCR Grant #R56DE032668-01, NCI Grant #U54CA242646. Citation Format: Sandra I. Garcia-Camacho, Jeslie M. Ramos-Cartagena, Josue Perez-Santiago, Frances E. Vazquez-Sanchez, Michael A. Santiago-Marrero, Jorge Salmeron, Joel Palefsky, Ana P. Ortiz. Factors associated to tobacco smoking and electronic cigarette use among a Hispanic sample of persons living with HIV in Puerto Rico, Mexico, and San Francisco [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A013.

A study on the mediating-moderate effect of the types of illicit drugs on mental health in China.

In China, over 5 million people have been identified and registered by the public security institutions for using illicit drugs. The aim of this study is to compare the influence of different types of illicit drugs on the self-reported mental health of Chinese people. In particular, we want to assess the damage of Heroin, Methamphetamine and Ketamine to mental health in a social environment where drug use is strictly regulated. The study is based on survey with 6,906 people who use drugs in Guangdong province, China. Risk of mental health issue is measured using the Brief Symptoms Inventory 18 (BSI-18) Scale, and a higher BSI-18 score indicates more severe mental health problems. The data was analyzed through multilevel regression analysis, propensity score matching analysis and mediation analysis. The three major types of illicit drugs have both moderating and mediating effects on the length of drug-use history, that Heroin use leads to longer drug-use duration, while Ketamine use causes more damage on mental health per unit time of drug-use duration. Average duration of Methamphetamine use is 0.7 year shorter than average duration of Heroin use, and average duration of Ketamine use is 1.7 year shorter than average duration of Heroin use. For each year of increase of drug-use duration, Ketamine use leads to 1.2 times more of BSI score increase than Heroin use, and 2.3 times more of BSI score increase than Methamphetamine use. These three drugs are associated with severe mental health issue in a society with strict drug regulation. Attention should be paid to the mental health of people regardless of the type of drugs they use.

Effects of natural environments on drug contents in nails: comparison of drug residual rates between nails and hair to determine the drug-use history of corpses in unnatural death cases using micro-segmental analysis.

We previously developed evaluation methods using micro-segmental analysis (MSA) to examine the effects of external environments on drug content in hair and nails. In this study, the effects of the natural environmental factors (water, temperature, humidity, light, and soil) on drug contents in nails were examined and compared with our previous experimental data on hair. Four hay-fever medicines were used as model drugs (fexofenadine, epinastine, cetirizine, and desloratadine) to evaluate drug stability in the nails. Reference nails containing the four medicines were collected from patients with hay fever who ingested the medicines daily for four months. The nails were exposed to various natural environments for up to four months. The effects of temperature, humidity, and light on drug contents in the nails were comparatively small. Soil significantly decomposed the nail surfaces and decreased the drug content of the nails (up to 17%). Water also decreased the drug content (up to 12%), although no apparent changes in nail surfaces were observed. In comparison with hair data obtained under the same environmental conditions, light affected drugs in the hair rather than in nails, whereas water and soil greatly affected drugs in the nails rather than in hair. Although the disposition of drugs incorporated in the tissues differed between nails and hair, the analytes were detected in nails and hair strands left in severe natural environments. MSA could be useful for estimating drug-use histories and personal profiles using the nails and hair of a corpse.

Outcomes of a 1-Year Pilot Study Implementing Universal Hepatitis Delta Virus Testing Among Veterans With Chronic Hepatitis B.

Current US guidelines recommend risk-based testing for hepatitis delta virus (HDV) in persons with chronic hepatitis B (CHB). While there is debate as to whether a risk-based or universal testing approach is most effective, limited data exist on universal HDV testing programs in the United States. We performed a 1-year pilot study evaluating the outcomes of a universal HDV testing approach among US veterans with CHB. All consecutive adults with CHB receiving care at hepatology clinics at a single-centre Veterans Affairs Health System from 1 October 2022 to 30 September 2023 were prospectively tested for anti-HDV antibody (anti-HDV). Patients who were anti-HDV Ab-positive were subsequently tested for HDV RNA. Comparison of HDV testing between groups utilised chi-square testing. A total of 91 consecutive CHB patients (90.0% male, mean age 60.9 ± 14.1 years, 73.9% Asian, 26.1% non-Asia, 16.5% cirrhosis and 17.1% with active or past history of drug use) had anti-HDV ordered. Overall, 76.9% (n = 70) completed anti-HDV testing; 4.3% (n = 3) were positive. HDV RNA testing was ordered in all three patients; two patients completed HDV RNA testing and one had detectable HDV RNA. No significant differences in completion of anti-HDV testing was observed by age, sex, race/ethnicity, cirrhosis status or drug use history. Among a single-centre prospective cohort study piloting a universal HDV testing approach, one patient with viremic HDV was identified. Implementing true reflex testing of all CHB patients with anti-HDV, followed by automated HDV RNA testing for anti-HDV-positive patients would improve the HDV testing cascade and timely diagnosis of HDV.

Potential Implications of Multi-Drug Exposure with Synthetic Cannabinoids: A Scoping Review of Human Case Studies

Synthetic cannabinoids are a rapidly evolving, diverse class of new psychoactive substances. Synthetic cannabinoid use results in a higher likelihood of adverse events and hospitalization when compared to cannabis use. The mechanisms behind synthetic cannabinoid toxicity remain elusive. Furthermore, poly-substance use may be a significant contributing factor in many cases. This scoping review aimed to identify the key characteristics of synthetic cannabinoid co-exposure cases and discuss the potential implications of poly-substance use in humans. There were 278 human cases involving 64 different synthetic cannabinoids extracted from the databases. Cases involved a total of 840 individual co-exposures, with an average of four substances involved in each case. The most common co-exposures were alcohol (11.4%), opioids (11.2%), and cannabis (11.1%). When analyzed by case outcome, co-exposure to either antipsychotics/antidepressants, alcohol, or tobacco were significantly associated with mortality as an outcome (p &lt; 0.05). Drug-use history (63.4%), mental illness (23.7%), and hypertensive and atherosclerotic cardiovascular disease (20.1%) were prevalent patient histories in the case cohort. There are several potential pharmacodynamic and pharmacokinetic interactions between co-exposure drugs and synthetic cannabinoids that could worsen clinical presentation and toxicity in synthetic cannabinoid users. Individuals with substance-use disorders or psychiatric illness would be especially vulnerable to these multi-drug interactions. Further research into these complex exposures is needed for the successful prevention and treatment of synthetic cannabinoid-related harms.

Modeling impaired insight after drug use in rodents.

Impaired insight in substance use disorder has been argued to reflect a global deficit in using cognitive models to mentally simulate possible future outcomes. The process of mentally simulating outcomes allows us to understand our beliefs about their causes, that is, to have insight and thereby avoid potentially negative outcomes. However, work in humans cannot address whether impaired insight and its neural/neurochemical sequalae are present prior to the development of a substance use disorder, a consequence of substance use, or a combination of both. This is because baseline measurements prior to drug use are not possible in humans. However, if these changes can be directly caused by drug use, then in animal models, a history of drug use should cause impairments in behavioral tasks designed to assess such inferences. Focusing on cocaine use, here we will review several lines of research from our laboratory that have tested this question using learning-theory tasks designed to isolate insight. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Mirtazapine in Primary Insomnia: Case report and Literature review

Introduction: Insomnia is a prevalent sleep disorder characterized by difficulty in falling asleep, maintaining sleep, or achieving restorative sleep, despite adequate opportunities. This condition often results in significant daytime impairments, including fatigue, concentration difficulties, and irritability. Insomnia can be primary or comorbid with other disorders such as anxiety or depression. Case Presentation: A 27-year-old woman presented with severe and chronic insomnia, persisting for 14 years with recent exacerbation. Her symptoms included significant difficulty in initiating and maintaining sleep, resulting in an average of only 3-4 hours of sleep per night and complete sleep deprivation for periods exceeding half an hour over the past 5 days. This sleep deficit led to pronounced emotional instability, physical discomfort, and reduced appetite, although suicidal ideation was absent. She had a past history of drug use for different psychiatric illnesses. She was started on mirtazipine 30mg and showed abrupt improvement in her symptoms. She was discharged afterwards. Discussion: The patient's chronic insomnia and its secondary effects necessitate a comprehensive treatment approach. Mirtazapine, an antidepressant with potent histamine receptor antagonism, has shown efficacy in improving sleep quality across diverse patient profiles. However, side effects like weight gain and sedation require careful monitoring. Combining mirtazapine with prolonged-release melatonin has demonstrated enhanced outcomes, particularly in perimenopausal women. Cognitive Behavioral Therapy for Insomnia (CBT-I) remains the first-line treatment due to its efficacy and long-term benefits. Conclusion: Mirtazapine can be a valuable option in the therapeutic arsenal for primary insomnia, but ongoing research is needed to refine treatment strategies. Personalized treatment plans considering patient history and response are crucial for effectively managing primary insomnia and improving patient outcomes.

Effectiveness of a culturally tailored HIV intervention in promoting PrEP among black women who use drugs in community supervision programs in New York City: a randomized clinical trial

BackgroundIn the U.S. there are significant racial and gender disparities in the uptake of pre-exposure prophylaxis (PrEP). Black Americans represented 14% of PrEP users in 2022, but accounted for 42% of new HIV diagnoses in 2021 and in the South, Black people represented 48% of new HIV diagnoses in 2021 but only 21% of PrEP users in 2022. Women who use drugs may be even less likely than women who do not use drugs have initiated PrEP. Moreover, women involved in community supervision programs (CSP) are less likely to initiate or use PrEP, More PrEP interventions that focus on Black women with recent history of drug use in CSPs are needed to reduce inequities in PrEP uptake.MethodsWe conducted a secondary analysis from a randomized clinical trial with a sub-sample (n = 336) of the total (N = 352) participants from the parent study (E-WORTH), who tested HIV negative at baseline were considered PrEP-eligible. Black women were recruited from CSPs in New York City (NYC), with recent substance use. Participants were randomized to either E-WORTH (n = 172) an HIV testing plus, receive a 5-session, culturally-tailored, group-based HIV prevention intervention, versus an HIV testing control group (n = 180). The 5 sessions included an introduction to PrEP and access. This paper reports outcomes on improved awareness of PrEP, willingness to use PrEP, and PrEP uptake over the 12-month follow-up period. HIV outcomes are reported in a previous paper.ResultsCompared to control participants, participants in this study assigned to E-WORTH had significantly greater odds of being aware of PrEP as a biomedical HIV prevention strategy (OR = 3.25, 95% CI = 1.64–6.46, p = 0.001), and indicated a greater willingness to use PrEP as an HIV prevention method (b = 0.19, 95% CI = 0.06–0.32, p = 0.004) over the entire 12-month follow-up period.ConclusionsThese findings underscore the effectiveness of a culturally-tailored intervention for Black women in CSP settings in increasing awareness, and intention to initiate PrEP. Low uptake of PrEP in both arms highlight the need for providing more robust PrEP-on-demand strategies that are integrated into other services such as substance abuse treatment.Trial RegistrationClinicalTrials.gov Identifier: NCT02391233.

Gambaran Karakteristik Pasien Dispepsia di Rumah Sakit

Dyspepsia is a disease of the digestive tract that is not contagious but is common among people in the world. Dyspepsia can be experienced by various age ranges, gender. According to research, the risk factor for organic dyspepsia is age &gt; 50 years. This is thought to be related to the increasing prevalence of chronic diseases in old age. Dyspepsia has an impact on quality of life because the natural course of dyspepsia is chronic and often recurs. This research is a quantitative research using a descriptive analytic research design. The sample in this study were dyspepsia patients at Nurdin Hamzah General Hospital, East Tanjung Jabung Regency, totaling 80 people. The sampling technique used in this research is purposive sampling technique. This research was conducted at the Nurdin Hamzah General Hospital, East Tanjung Jabung Regency, in 26 June – 04 July 2023, then the data will be obtained by looking at the medical records of dyspepsia patients at the Nurdin Hamzah General Hospital, East Tanjung Jabung Regency. Data analysis was performed univariately. Based on the results of the study, it was found that patients aged &gt; 65 years (elderly) were 20 respondents (25%) with dyspepsia, some of the dyspepsia patients were female, namely 55 respondents (68.8%), with working status, namely 44 respondents (55.0%) ), patients had a history of co-morbidities, namely 47 respondents (58.8%) and most dyspepsia patients had a history of drug use, namely 43 respondents (53.8%). It is recommended as input to the hospital to find out the problem about the description of the characteristics of dyspepsia patients

STUDY THE EFFECT OF HYLOCEREUS POLYRHIZUS SOME ANTIOXIDANT FACTORS IN CHRONIC KIDNEY DISEASE PATIENTS

The current work was aimed to study the effect of Hylocereus polyrhizus some antioxidant factors in CKD patients and healthy persons. An overall total of (80) CKD patients were included in this study. The patients were between the ages of 20 and 60. Each patient's case information sheet was compiled with information on their name, age, sex, marital status, place of residence, history of chronic diseases, history of drug use, history of smoking, and type of operation. These patients were hospitalized to Kirkuk, Iraq's Kirkuk Teaching Hospital between April and July 2022. 50 healthy individuals served as the control group in this experiment. testing for a few biological elements. The analysis of the peel extract from H. polyrhizus revealed the presence of saponin, flavonoid, tannin, polyphenol, alkaloid, quinone, and terpenoid compounds. Total antioxidant capacity level in male and female were showed significant (P≤0.05) reduced in comparison to the heath group. After using dragon fruits extract, Total antioxidant capacity level were improved and there was non-significant (P≤0.05) changes in comparison to the heath group. Total oxidant status level in male and female were showed significant (P&lt;0.05) elevated in comparison to the heath group. After using dragon fruits extract, Total oxidant status level (951.8±57.4) were improved and there was non-significant (P≤0.05) changes in comparison to the heath group. Based on the results of the current study, it was found that dragon fruits extract has an effective role as an antioxidant.

Clinical profile of Spanish hepatitis C virus-infected treatment-naïve patients with compensated cirrhosis in the CREST study

Background and aim of the studyThere are still patients with hepatitis C in Spain who have yet to be diagnosed, but their clinical profile is unclear. In 2021, 21.93% of patients diagnosed had cirrhosis and were mostly treatment-naïve. MethodsThis sub-analysis describes the clinical profile of the 60 Spanish treatment-naïve patients with compensated cirrhosis who were included in the CREST study. Major resultsSixty percent of patients were male, median age 56 years, and 33% had a history of drug use. Almost three-quarters (71.3%) had more than one comorbidity and 78.3% took concomitant medication. At treatment initiation, median platelet count was 139 × 103/µL and FibroScan® 17 kPa. No virological failure was observed and no patient discontinued treatment due to adverse events. No clinically significant changes were noted during or after treatment in the median platelet, albumin, bilirubin, and transaminase levels. ConclusionsTreatment with glecaprevir/pibrentasvir for 8 weeks in this cohort of treatment-naïve patients with compensated cirrhosis in Spain was safe and effective. This information reinforces the use of this short antiviral regimen even when there is compensated cirrhosis, simplifying the approach to hepatitis C among those patients still to be diagnosed and treated in Spain.

A holistic evaluation of patients with chronic Hepatitis D virus (HDV) infection enrolled in the Italian PITER-B and delta cohort

Background and AimsWe aimed to characterize the epidemiologic and comorbidities profiles of patients with chronic Hepatitis D (CHD) followed in clinical practice in Italy and explored their interferon (IFN) eligibility. MethodsThis was a cross-sectional study of the PITER cohort consisting of consecutive HBsAg-positive patients from 59 centers over the period 2019-2023. Multivariable analysis was performed by logistic regression model. ResultsOf 5492 HBsAg-positive enrolled patients, 4152 (75.6%) were screened for HDV, 422 (10.2%) were anti-HDV positive. Compared with HBsAg mono-infected, anti-HDV positive patients were more often younger, non-Italians, with a history of drug use, had elevated alanine transaminase (ALT), cirrhosis, or hepatocellular carcinoma (HCC). Compared with Italians, anti-HDV positive non-Italians were younger (42.2% age ≤ 40 years vs. 2.1%; P < 0.001), more often females (males 43.0% vs. 68.6%; P < 0.001) with less frequent cirrhosis and HCC. HDV-RNA was detected in 63.2% of anti-HDV-positive patients, who were more likely to have elevated ALT, cirrhosis, and HCC. Extrahepatic comorbidities were present in 47.4% of anti-HDV positive patients and could affect the eligibility of IFN-containing therapies in at least 53.0% of patients in care. ConclusionsCHD affects young, foreign-born patients and older Italians, of whom two-thirds had cirrhosis or HCC. Comorbidities were frequent in both Italians and non-Italians and impacted eligibility for IFN.

Assessment of Clinical Pharmacy Service Standards Implementation at Bhayangkara Hospital Level III in Kendari

One crucial component influencing the successful implementation of healthcare efforts in hospitals is the pharmaceutical system. Pharmaceutical services play a pivotal role in supporting quality healthcare, as outlined in Permenkes Number 72 of 2016, which delineates Pharmaceutical Service Standards in Hospitals. However, preliminary survey results conducted by the author indicate suboptimal implementation of these standards in 2021. Consequently, the researchers embarked on a study aimed at analyzing the implementation of pharmaceutical service standards at the Pharmacy Installation of Bhayangkara TK III Kendari Hospital. This research is scheduled to be conducted in January - February 2024. This study employed an exploratory qualitative method involving 9 informants at the pharmaceutical installation of Bhayangkara Hospital TK III Kendari. Data collection was conducted using interview guidelines, followed by transcription, introduction to interviews, coding, analysis, interpretation, and data mapping into a matrix. The implementation of health minister regulation Number 72 of 2016 regarding clinical pharmaceutical service standards at the Pharmacy Installation of Bhayangkara TK III Kendari Hospital can be summarized as follows: assessment and prescription services were carried out effectively, tracing the history of drug use was partially implemented well, drug reconciliation was partially implemented, drug information services (PIO) were partially implemented well, but some items such as counseling, visitation, monitoring drug therapy (PTO), monitoring drug side effects (MESO), evaluating drug use (EPO), dispensing sterile preparations, and monitoring drug levels in the blood (PKOD) were not implemented optimally. Overall, the implementation of pharmaceutical service standards according to health minister regulation Number 72 of 2016 at the pharmaceutical installation of Bhayangkara Hospital TK III Kendari has not been optimal. Keywords: Pharmaceutical service standards, Health minister regulation, Pharmacist, Hospital

Patterns and Factors Associated With Alcohol Misuse Among Young Black Men Who Have Sex With Men in New York City.

Alcohol misuse is a significant health concern among gay, bisexual, same-gender-loving, and other men who have sex with men (MSM). Yet, little is known about the severity and predictors of alcohol misuse among self-reported young Black MSM. This study aimed to identify patterns of and factors associated with alcohol misuse in a sample of young Black MSM living in New York City. Baseline data from a randomized controlled trial aimed at improving the uptake of HIV testing among 250 MSM aged 18 to 29 were analyzed. Log-binominal regression analyses were conducted to assess the association of demographic and psychosocial factors with alcohol misuse in the past year and past 3 months among young Black MSM. Overall, 33.2% and 28.0% of young Black MSM in the study experienced alcohol misuse in the past year and past 3 months, respectively. In the adjusted model, factors positively associated with past-year alcohol misuse included marijuana use, a history of drug use, and having one-two or more than two male sex partners. Likewise, participants who used marijuana and those with one-two or more than two male partners were more likely to report past 3-month alcohol misuse. No significant association was found between positive screening for depressive symptoms, chemsex, internalized homophobia, and the likelihood of having alcohol misuse. The high prevalence of alcohol misuse underscores the importance of raising awareness of alcohol misuse and designing alcohol risk reduction programs that jointly address HIV risk among young Black MSM.

Stigma and mental health among people living with HIV across the COVID-19 pandemic: a cross-sectional study

BackgroundMental health (MH) is extremely relevant when referring to people living with a chronic disease, such as people living with HIV (PLWH). In fact – although life expectancy and quality have increased since the advent of antiretroviral therapy (ART) – PLWH carry a high incidence of mental disorders, and this burden has been exacerbated during the COVID-19 pandemic. In this scenario, UNAIDS has set new objectives for 2025, such as the linkage of at least 90% of PLWH to people-centered, context-specific MH services. Aim of this study was to determine the prevalence of MD in PLWH followed at the Clinic of Infectious Diseases of the University of Bari, Italy.MethodsFrom January 10th to September 10th, 2022, all PLWH patients accessing our outpatient clinic were offered the following standardized tools: HAM-A for anxiety, BDI-II for depression, PC-PTSD-5 for post-traumatic stress disorder, CAGE-AID for alcohol-drug abuse. Factors associated with testing positive to the four MD were explored with a multivariable logistic regression model.Results578 out of 1110 HIV-patients agreed to receive MH screening, with 141 (24.4%) people resulting positive to at least one MH disorder. HAM-A was positive in 15.8% (n = 91), BDI-II in 18% (n = 104), PC-PTSD-5 in 5% (n = 29) and CAGE in 6.1% (n = 35). The multivariable logistic regression showed a higher probability of being diagnosed with anxiety, depression and post-traumatic stress disorder for PLWH who reported severe stigma, social isolation, psychological deterioration during the COVID-19 pandemic and for those receiving a dolutegravir (DTG)-based regimen. Moreover, history of drug use (OR 1.13; [95% CE 1.06–4.35]), family stigma (2.42 [1.65–3.94]) and social isolation (2.72 [1.55;4.84]) were found to be associated to higher risk for substance use disorder.ConclusionsIn this study, stigma was a strong predictor for being diagnosed of a MH disorder among PLWH. Also, the possible role of dolutegravir as a risk factor for the onset of MH disorders should be considered in clinical practice, and MH of patients receiving DTG-containing regimens should be constantly monitored.

Estimating fetal weight in gastroschisis: A 10 year audit of outcomes at the National Maternity Hospital.

To identify whether conventional methods of estimating fetal growth (Hadlock's formula), which relies heavily on abdominal circumference measurements, are accurate in fetuses with gastroschisis. A retrospective cohort study was performed between the period January 1, 2011 and December 31, 2021 in a tertiary referral maternity hospital identifying all pregnancies with a diagnosis of gastroschisis. Projected fetal weight was obtained using the formula (EFW [Hadlock's formula] + 185 g × [X/7]) where X was the number of days to delivery. During the study period 41 cases were identified. The median maternal age was 25. The median BMI was 25 and 63% were primiparous women (n = 26). Median gestation at diagnosis was 21 weeks. Median gestation at delivery was 36 weeks. A total of 4.8% of mothers had a history of drug use (n = 2). The rate of maternal tobacco use was 21.9% (n = 9). A total of 4.8% of fetuses had additional congenital anomalies including amniotic band syndrome and myelomeningocele (n = 2). Estimated fetal weight (EFW) and birth weight data were available for 34 cases. A Wilcoxon signed-rank test showed projected EFW using Hadlock's formula did not result in a statistically significant different birth weight (Z = -1.3, P = 0.169). Median projected weight and actual birth weight were 2241.35 and 2415 g respectively. Median difference was 0.64 g (95% CI: -148 to -28.5). Our data showed accuracy using standard formulae for EFW in fetuses with gastroschisis.