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1.
Article in English | MEDLINE | ID: mdl-35788467

ABSTRACT

OBJECTIVE: In the USA, the increase in state-sanctioned medical and recreational cannabis consumption means more young adults (YA) with cancer are using cannabis. Data and information are needed to characterise this use and frame much needed discussions about the role of cannabis in cancer care. To that end, this study's objective was to describe consumption of cannabis in YA with cancer. METHODS: Four hundred seventy-six patients with cancer ages 18-39 years at a large comprehensive cancer centre responded to a survey about their cannabis consumption. The survey was administered online between July 2019 and June 2020, and respondents were anonymous. RESULTS: Fifty-two per cent (n=247) of respondents endorsed use within the last year; of these, half reported using cannabis prior to their diagnosis. Consumption was about equally distributed between smoking/inhalation and eating/drinking cannabis products. Seventy-five per cent of consumers used cannabis at least weekly. Top five primary reasons for use were pain, anxiety, nausea, sleep and recreation. More frequent consumption was associated with greater perceived improvement in certain symptoms. Cannabis products tended to be sourced from friends and family and information from non-medical sources. Most YA reported being comfortable discussing their consumption with providers. CONCLUSIONS: Many YA are using cannabis frequently to manage their cancer-related and treatment-related symptoms. Findings support the need for providers to consider cannabis use in treatment planning and symptom management with YA. Findings should help frame patient and provider discussions and herald much needed research on the effect of cannabis consumption on patient outcomes.

2.
Am J Emerg Med ; 54: 253-256, 2022 Apr.
Article in English | MEDLINE | ID: mdl-35190304

ABSTRACT

INTRODUCTION: Acute bacterial skin and skin structure infections (ABSSI) are frequently encountered in the emergency department and compromise more than 700,000 hospital admissions annually. Dalbavancin is a single dose long acting semi-synthetic lipogylcopepitde antibiotic with coverage against gram-positive organisms including methicillin resistant Staphylococcus aureus. Recent data from large tertiary care centers have shown a decrease in hospital admissions and repeat emergency department visits for ABSSI's but little data is available for those who practice in a rural community setting. The primary objective of this study was to describe the use of dalbavancin at a single rural emergency department. METHODS: A retrospective cohort study of all adult patients who received dalbavancin between 2019 and 2021 while in the emergency department was completed. Abstracted data included patient demographics, infection location by body region, emergency department return visits, hospital admissions, and length of stay. Analysis was conducted using descriptive statistics, the Mann-Whitney test for continuous data, and the chi-squared analysis for nominal data. RESULTS: A total of 125 patients were included in the final analysis with 35.2% being female. The median age of those treated with dalbavancin was 54 years (42.0-64.0) and the most common infection site was the lower extremities. A total of 35 patients re-presented to the emergency department following treatment with dalbavancin within 30 days and 16 were admitted to the hospital. Of those who re-presented to the emergency department, the median age was 56 (40.0-66.0) and the median re-presentation was 9 days (3-17) after dalbavancin administration. A total of 16 patients (12.8%) were subsequently admitted to the hospital with a median length of stay of 5.5 days (3.0-8.0). 30-day readmission rates were 23.9% in those who had an abnormal WBC count at initial presentation, 26.1% for those with congestive heart failure, 20.3% for those with hypertension, and 26.0% in those who had diabetes mellitus. CONCLUSION: Following the administration of dalbavancin for ABSSI at a rural emergency department, few patients are subsequently admitted within the following 30 days. To further decrease this number and alleviate the burden on emergency departments and hospitals, local treatment algorithms should be developed to minimize the risk of representation and hospitalization following administration.


Subject(s)
Methicillin-Resistant Staphylococcus aureus , Adult , Anti-Bacterial Agents/therapeutic use , Emergency Service, Hospital , Female , Humans , Male , Middle Aged , Retrospective Studies , Rural Population , Teicoplanin/analogs & derivatives
3.
South Med J ; 114(6): 361-367, 2021 06.
Article in English | MEDLINE | ID: mdl-34075429

ABSTRACT

OBJECTIVE: This study describes the prevalence of negative healthcare experiences, depression, and anxiety in the Tampa Bay transgender and gender non-conforming population. METHODS: Participants completed a survey encompassing healthcare interactions and validated mental health questionnaires. RESULTS: In total, 61% of participants experienced conversion therapy and 54% have been denied care. Depression and anxiety are prevalent, with higher levels statistically associated with denial of care; 60.5% and 43% fear seeking mental health or medical care, respectively. CONCLUSIONS: Self-reported negative experiences are prevalent in this population, with a potential association with avoidance of care. Further research is necessary to clarify these potential relationships.


Subject(s)
Delivery of Health Care/standards , Help-Seeking Behavior , Mental Health Services/standards , Sexual and Gender Minorities/psychology , Adult , Delivery of Health Care/statistics & numerical data , Female , Florida , Humans , Male , Mental Health Services/statistics & numerical data , Patient Satisfaction , Psychometrics/instrumentation , Psychometrics/methods , Self Report , Sexual and Gender Minorities/statistics & numerical data , Surveys and Questionnaires
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