Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 7 de 7
Filtrar
Más filtros












Base de datos
Intervalo de año de publicación
1.
J Stud Alcohol Drugs ; 85(3): 381-388, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38206669

RESUMEN

OBJECTIVE: This project aimed to characterize the relationship between physical pain experienced at time of entry to residential treatment for substance use disorders (SUDs) and the frequency of treatment dropout. We hypothesized that both endorsement of recent pain and higher magnitude of endorsed pain intensity would be associated with higher dropout rates. We further hypothesized that these effects would be exacerbated among patients with opioid use disorder (OUD). METHOD: Participants included 1,095 individuals in residential treatment for SUD. Data were collected within 24 hours of treatment entry. Analyses were conducted using logistic regression with dropout as the dependent variable. Dropout was operationally defined as leaving treatment against medical advice or being discharged from treatment because of use of substances. Pain (including endorsement and intensity) was the primary independent variable in all analyses. Analyses included demographic and affective covariates and included both main effects of OUD and interaction terms between OUD and pain. RESULTS: Pain endorsement was associated with greater frequency of dropout (odds ratio [OR] = 1.49, p = .04). Higher levels of pain intensity predicted increased rates of dropout (OR = 1.13, p < .01). In contrast with our hypothesis, no interactions between OUD and pain were observed. CONCLUSIONS: These results underscore the import of integrating pain monitoring and pain interventions as core components of treatment for SUD. Our findings are highly consistent with a growing literature recognizing the impact of pain across a constellation of important treatment outcomes and provide novel data strongly suggesting that pain predicts early cessation of treatment.


Asunto(s)
Trastornos Relacionados con Opioides , Dolor , Pacientes Desistentes del Tratamiento , Trastornos Relacionados con Sustancias , Humanos , Masculino , Femenino , Pacientes Desistentes del Tratamiento/estadística & datos numéricos , Adulto , Trastornos Relacionados con Opioides/epidemiología , Trastornos Relacionados con Opioides/terapia , Trastornos Relacionados con Opioides/rehabilitación , Dolor/epidemiología , Trastornos Relacionados con Sustancias/terapia , Trastornos Relacionados con Sustancias/epidemiología , Persona de Mediana Edad , Tratamiento Domiciliario/métodos
2.
J Addict Dis ; : 1-10, 2023 Jun 28.
Artículo en Inglés | MEDLINE | ID: mdl-37380371

RESUMEN

Objectives: Chronic pain is both an important antecedent and consequence of substance use. Although evidence suggests healthcare professionals may be uniquely vulnerable to chronic pain, this vulnerability remains largely unexamined in the context of recovery from substance use disorders (SUDs). We characterized pain in a sample of treatment-seeking individuals, examined potential differences in pain trajectories between healthcare professionals and non-healthcare patients, and interrogated potential pain-related vulnerabilities in treatment outcomes between these groups. Methods: Patients with SUDs (n = 663; 251 women) completed questionnaires indexing pain intensity, craving, and abstinence self-efficacy (including self-efficacy in pain-related contexts). Assessments were conducted at treatment entry, 30 days, and discharge. Analyses included chi-square and longitudinal mixed models. Results: The proportion of healthcare and non-healthcare patients endorsing recent pain was equivalent (χ2=1.78, p=.18). Healthcare professionals reported lower pain intensity (p = 0.02) and higher abstinence self-efficacy (p < 0.001). Profession by pain interactions (ps <.040) revealed that among medical professionals, associations between pain and all three treatment outcomes of interest were more robust relative to the non-healthcare group. Conclusions: Results suggest that although healthcare professionals endorse similar rates of pain and lower average pain intensity, they may be uniquely vulnerable to pain-related disruptions in craving and abstinence self-efficacy.

3.
BMJ Case Rep ; 20142014 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-24717583

RESUMEN

Vitamin D deficiency is common. It causes osteomalacia, may contribute to osteoporosis and is an independent risk factor for cancer, diabetes, multiple sclerosis, cardiovascular disease and all-cause mortality. We describe patients with a history of sarcoidosis who developed acute kidney injury due to hypercalcaemia following treatment with colecalciferol.


Asunto(s)
Lesión Renal Aguda/inducido químicamente , Colecalciferol/efectos adversos , Hipercalcemia/inducido químicamente , Sarcoidosis/complicaciones , Deficiencia de Vitamina D/tratamiento farmacológico , Vitaminas/efectos adversos , Adulto , Humanos , Masculino , Deficiencia de Vitamina D/complicaciones
4.
Ann Clin Biochem ; 49(Pt 3): 295-9, 2012 May.
Artículo en Inglés | MEDLINE | ID: mdl-22362085

RESUMEN

The transformation of the antineutrophil cytoplasmic antibody (ANCA) specificity in the absence of specific drug treatment has not been reported in the literature. A few studies have suggested changes in the epitopes recognized by the ANCAs. We describe two patients who switched from myeloperoxidase-positive to PR3 (proteinase 3)-positive ANCA during the course of their disease process and subsequently remained unchanged. One patient developed ulcerative colitis following the appearance of PR3-ANCA while the other remains quiescent. Regular follow-up and close monitoring of ANCA specificity are essential. A change of specificity may indicate the development of a new ANCA-related disease.


Asunto(s)
Anticuerpos Anticitoplasma de Neutrófilos/sangre , Colitis Ulcerosa/sangre , Vasculitis/sangre , Anticuerpos Anticitoplasma de Neutrófilos/inmunología , Colitis Ulcerosa/etiología , Colitis Ulcerosa/inmunología , Epítopos , Técnica del Anticuerpo Fluorescente Indirecta , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Mieloblastina/sangre , Mieloblastina/inmunología , Peroxidasa/sangre , Peroxidasa/inmunología , Vasculitis/etiología , Vasculitis/inmunología
5.
Semin Dial ; 25(2): 233-8, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-21916999

RESUMEN

Catheter-related blood stream infections may be reduced by interdialytic locking with Taurolidine, a nontoxic antimicrobial agent. A formulation of 1.35% Taurolidine in 4% citrate (TC) is associated with a greater need for thrombolysis to maintain catheter patency than 5000 U/ml heparin. Our aim was to determine whether addition of 500 Units/ml of heparin to TC reduces the need for thrombolysis. TCH (1.35% taurolidine, 4% citrate and 500 U/ml heparin) was compared to TC and Heparin 5000 U/ml using retrospective data. Hundred and six adult hemodialysis patients with internal jugular tunnelled intravascular catheters using TCH were compared with 34 patients using TC and 34 patients using heparin 5000 U/ml respectively. Outcomes were time to first use of thrombolysis and bacteremia rates.TCH reduced the need for thrombolysis compared to TC (hazard ratio, 0.2; 95%CI: 0.06, 0.5; p < 0.001) and was not significantly different from heparin 5000 U/ml (hazard ratio, 1.4; 95%CI: 0.5, 3.9; p = 0.5). The bacteremia rates from all causes were 1.33, 1.22 and 3.25 per 1000 catheter- days (p < 0.001) in the TCH, TC and heparin groups respectively. Addition of 500 U/ml heparin to TC reduces the need for thrombolysis without increasing bacteremia and may achieve patency comparable to heparin 5000 U/ml.


Asunto(s)
Bacteriemia/tratamiento farmacológico , Infecciones Relacionadas con Catéteres/tratamiento farmacológico , Heparina/uso terapéutico , Diálisis Renal/métodos , Taurina/análogos & derivados , Tiadiazinas/uso terapéutico , Terapia Trombolítica/métodos , Adulto , Anciano , Antiinfecciosos/uso terapéutico , Anticoagulantes/uso terapéutico , Bacteriemia/etiología , Infecciones Relacionadas con Catéteres/epidemiología , Infecciones Relacionadas con Catéteres/prevención & control , Catéteres de Permanencia/efectos adversos , Catéteres de Permanencia/microbiología , Ácido Cítrico/uso terapéutico , Método Doble Ciego , Quimioterapia Combinada , Contaminación de Equipos/prevención & control , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Estimación de Kaplan-Meier , Fallo Renal Crónico/diagnóstico , Fallo Renal Crónico/terapia , Modelos Lineales , Masculino , Persona de Mediana Edad , Evaluación de Necesidades , Modelos de Riesgos Proporcionales , Diálisis Renal/efectos adversos , Medición de Riesgo , Taurina/uso terapéutico , Resultado del Tratamiento , Grado de Desobstrucción Vascular/fisiología
6.
Am J Kidney Dis ; 55(6): 1060-8, 2010 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-20207458

RESUMEN

BACKGROUND: Bacteremia is a major cause of morbidity in patients using intravascular catheters. Interdialytic locking with antibiotics decreases the incidence of bacteremia, but risks antibiotic resistance. Taurolidine is a nontoxic broad-spectrum antimicrobial agent that has not been associated with resistance. Preliminary evidence suggests that taurolidine-citrate locks decrease bacteremia, but cause flow problems in established catheters. STUDY DESIGN: Double-blind randomized controlled trial. INTERVENTION: Interdialytic locking with taurolidine and citrate (1.35% taurolidine and 4% citrate) compared with heparin (5,000 U/mL) started at catheter insertion. SETTING & PARTICIPANTS: 110 adult hemodialysis patients with tunneled cuffed intravascular catheters inserted at 3 centers in Northwest England. OUTCOMES & MEASUREMENTS: Primary end points were time to first bacteremia episode from any cause and time to first use of thrombolytic therapy. RESULTS: There were 11 bacteremic episodes in the taurolidine-citrate group and 23 in the heparin group (1.4 and 2.4 episodes/1,000 patient-days, respectively; P = 0.1). There was no significant benefit of taurolidine-citrate versus heparin for time to first bacteremia (hazard ratio, 0.66; 95% CI, 0.2-1.6: P = 0.4). Taurolidine-citrate was associated with fewer infections caused by Gram-negative organisms than heparin (0.2 vs 1.1 infections/1,000 patient-days; P = 0.02); however, there was no difference for Gram-positive organisms (1.1 vs 1.2 infections/1,000 patient-days; P = 0.8). There was a greater need for thrombolytic therapy in the taurolidine-citrate versus heparin group (hazard ratio, 2.5; 95% CI, 1.3-5.2; P = 0.008). LIMITATIONS: Small sample size. The study included bacteremia from all causes and was not specific for catheter-related bacteremia. CONCLUSIONS: Taurolidine-citrate use did not decrease all-cause bacteremia and was associated with a greater need for thrombolytic treatment. There was a decrease in infections caused by Gram-negative organisms and a trend to a lower frequency of bacteremia, which warrants further study.


Asunto(s)
Bacteriemia/etiología , Bacteriemia/prevención & control , Catéteres de Permanencia/microbiología , Ácido Cítrico/uso terapéutico , Fallo Renal Crónico/terapia , Diálisis Renal/efectos adversos , Taurina/análogos & derivados , Tiadiazinas/uso terapéutico , Adulto , Anciano , Antiinfecciosos/uso terapéutico , Anticoagulantes/uso terapéutico , Bacteriemia/epidemiología , Método Doble Ciego , Femenino , Infecciones por Bacterias Grampositivas/epidemiología , Infecciones por Bacterias Grampositivas/etiología , Infecciones por Bacterias Grampositivas/prevención & control , Heparina/uso terapéutico , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Diálisis Renal/instrumentación , Diálisis Renal/métodos , Taurina/uso terapéutico
7.
NDT Plus ; 2(1): 59-62, 2009 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25949289
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...