BACKGROUND: Over the last 21 years, drug overdose deaths have increased nationwide, particularly in Rhode Island (RI). The goal of this work is to identify populations that are disproportionately impacted by accidental drug overdose deaths to guide future intervention efforts. Methods: We obtained data on accidental and undetermined drug overdose deaths from the RI State Unintentional Drug Overdose Reporting System (SUDORS) database from 2016 to 2021. We compared basic demographic factors stratified by decedent race and ethnicity. Chi Square and Fisher's exact tests were used to determine differences in characteristics across racial groups. FINDINGS: Across all race and ethnic groups, cocaine-involved (64.5%) fatal overdoses were higher among Black non-Hispanics. White, non-Hispanics (31.4%) were more likely to receive treatment for substance use disorder (SUD) when compared to minority groups. CONCLUSION: To help address the gaps in treatment for SUD among minority groups, culturally responsive intervention efforts should prioritize connecting minority groups to treatment.
Drug Overdose , Substance-Related Disorders , Humans , Analgesics, Opioid , Drug Overdose/ethnology , Drug Overdose/mortality , Ethnicity , Hispanic or Latino , Rhode Island/epidemiology , Black or African American , White , Racial Groups
Dyslipidemias or dyslipoproteinemias are quantitative changes in total cholesterol concentration, respective fractions, or triglycerides in the plasma. Evidence supported that dyslipidemia in childhood is associated with atherosclerosis in adulthood, and early identification and treatment potentially reduce cardiovascular risk in adulthood, which is the principal cause of morbidity and mortality in developed countries. Dyslipidemias can result from primary lipoprotein metabolism changes due to different genetic causes (primary dyslipidemias) or as a consequence of exogenous factors or other pathologies (secondary dyslipidemias). Therefore, the combined dyslipidemias result from the association of important epigenetic and environmental influences with risk factors for cardiovascular disease. The criterion for lipid metabolism screening at young ages is not widely accepted and possibly follows a universal or directed screening strategy. Additionally, little is known about its long-term effects or possible risk-benefit despite the growing tendency to start pharmacological therapy. Therefore, this study aimed to review the available bibliography on dyslipidemia in pediatric age to present a practical and structured approach to dyslipidemia that focuses on screening, risk stratification for atherosclerotic disease, and therapeutic approach.
ABSTRACT Crohn's disease has an ever-increasing prevalence and incidence, with about 20% of patients developing perianal fistula with significant impact on their quality of life. Despite the medical and surgical treatments currently used, Crohn's-related fistula treatment continues to pose a challenge due to the low rates of efficacy associated with high recurrence rates. Recent clinical trials have shown promising results regarding safety and efficacy of local treatment of this condition with the use of adipose tissue-derived mesenchymal stem cells. Besides being pluripotent and poorly immunogenic, they have immunomodulatory and anti-inflammatory properties, which combined, may accelerate healing. Our main objective is to summarize the clinical trials we found, highlighting the efficacy rates of this therapy and the main limitations we found in the analysis of the results. We conclude that, in perianal fistulas refractory to conventional therapies, the treatment with adipose tissue-derived mesenchymal cells is safe with promising results that may change the current paradigm of Crohn's related fistula treatment.
RESUMO A incidência e a prevalência da doença de Crohn têm aumentado e, ao longo do decurso da doença, cerca de 20% dos doentes irão desenvolver fístulas perianais com impacto significativo na sua qualidade de vida. Apesar dos tratamentos médicos e cirúrgicos utilizados atualmente, o tratamento destas fístulas continua a constituir um desafio com baixas taxas de eficácia e com elevadas taxas de recorrência. Ensaios clínicos recentes têm demonstrado resultados promissores em termos de segurança e eficácia de tratamentos locais destas fístulas com o recurso a células estaminais mesenquimatosas derivadas do tecido adiposo que, além de pluripotentes e pouco imunogênicas, têm capacidades imunomoduladoras e anti-inflamatórias capazes de promover o processo de cicatrização. O objetivo desta revisão sistemática é sumarizar os ensaios clínicos encontrados, realçando as taxas de eficácia desta terapêutica e as principais limitações na análise dos resultados. Concluímos que, nas fístulas perianais refratárias ás terapias convencionais, o tratamento com com celulas estaminais mesenquimatosas derivadas do tecido adiposo é seguro e com resultados promissores que podem mudar o paradigma atual do tratamento das fistulas complexas associadas à Doença de Crohn.
Humans , Male , Female , Crohn Disease/pathology , Rectal Fistula/therapy , Mesenchymal Stem Cells/cytology , Adipose Tissue/cytology , Treatment Outcome
