Trends in Substance Use Disorder-Related Emergency Department Visits in California: An Analysis of 46 Million Visits From 2006 to 2011.

INTRODUCTION: To better understand the development of the growing opioid crisis in the early 21st century, the authors studied trends in substance use disorder among 46,132,211 emergency department (ED) visit discharges in California between 2006 and 2011. METHODS: Utilizing the California State Emergency Department Database, the authors identified substance use based on International Classification of Diseases, Ninth Revision codes. Tabular and multivariable analysis methods were applied. ED visits were considered clustered at the level of patient. RESULTS: The authors observed a notable increase in substance use prevalence from 7.32 ± 6.07 to 12.21 ± 9.35 per 1000 ED visits. Nonopioid substance use was more prevalent among individuals aged ≤ 50 years old. Opioid use disorder (OUD) was associated with a higher mortality rate in the ED. In 2011, OUD was significantly higher among American Indians visiting the ED. A multivariable analysis revealed that OUD was an independent predictor for increased ED visits after controlling for demographic factors. DISCUSSION: Despite an overall decrease in mortality rate, opioid-related ED visits showed a higher mortality rate, underscoring the grave consequences of OUD. Nonopioid substance use was prevalent among younger age groups, suggesting a need for age-specific interventions. A major finding was the elevated OUD among American Indians, indicating persistent health disparities impacting this demographic. OUD was an independent risk factor for excess ED visits, which could strain health care systems. The authors suggest strategies like nonopioid pain management, community-level programs, and bridging ED with outpatient treatment facilities to mitigate the opioid crisis and ED overutilization. CONCLUSION: These findings advocate for tailored public health strategies, addressing the underlying disparities to combat the opioid epidemic effectively.

Alcohol Use and the Risk of Colorectal Liver Metastasis: A Systematic Mapping Review.

The consumption of alcohol has long been associated with the development of liver disease as well as cancers including colorectal cancer (CRC). Leading healthcare concerns include the prevalent use of alcohol and the high burden of CRC mortality. Many CRC deaths are attributed to the development of colorectal liver metastasis (CRLM) as the liver is the foremost site of CRC spread. However, an association has not been defined for the role of alcohol intake and related liver injury with the development of CRLM. Here, a mapping review of recent research was undertaken to evaluate the relationship between alcohol consumption and the risk of CRLM. The literature search revealed 14 articles meeting the inclusion criteria that included patient database analyses and preclinical studies. Most of the human data analyses found alcohol use independently associates with worse CRC outcomes. The preclinical evaluations identified several pathways involved in the alcohol-mediated promotion of CRLM burden and CRC cell metastatic behavior. The limited number of studies identified exposes a significant need for more prospective analyses to define the role of alcohol intake and advanced CRC as well as the translation of preclinical research to fully characterize targetable mechanisms for the generation of new therapeutic options.

The abundance of the potential pathogen Staphylococcus hominis in the air microbiome in a dental clinic and its susceptibility to far-UVC light.

The dental clinic air microbiome incorporates microbes from the oral cavity and upper respiratory tract (URT). This study aimed to establish a reliable methodology for air sampling in a dental clinic setting and quantify the abundance of culturable mesophilic aerobic bacteria present in these samples using regression modeling. Staphylococcus hominis, a potentially pathogenic bacterium typically found in the human oropharynx and URT, was consistently isolated. S. hominis was the most abundant species of aerobic bacteria (22%-24%) and comprised 60%-80% of all Staphylococcus spp. The study also assessed the susceptibility of S. hominis to 222 nm-far-UVC light in laboratory experiments, which showed an exponential surface inactivation constant of k = 0.475 cm2 /mJ. This constant is a critical parameter for future on-site use of far-UVC light as a technique for reducing pathogenic bacterial load in dental clinics.