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Assessing Injection Drug Use-Related Infective Endocarditis

Assessing Injection Drug Use-Related Infective Endocarditis

In recent years, clinicians have seen an uptick in viruses like HIV and hepatitis C virus (HCV) being transmitted through the sharing of needles and other drug paraphernalia. Another infectious complication of injection drug use (IDU) is IDU-related infective endocarditis (IDU-IE), a condition resulting from bacteria introduced into the vein in the process of injection. After observing an increasing young patients being admitted to Boston-area hospitals with IDU-IE, my colleagues and I sought to determine if the prevalence of these infections seen in our region matched those throughout the country. We also wanted to determine the characteristics of patients infected with IDU-IE. Previous research indicates that rates of HCV are higher in younger populations, a finding that was also linked to an increased likelihood of transmitting the virus via injection drug use. Assessing National Trends in IDU-IE Published in Open Forum Infectious Diseases, our study utilized the publicly available Healthcare Cost and Utilization Project National Inpatient Sample (HCUP/NIS) database, which includes age, race, ICD-9 code, and other demographic data for inpatient discharges from community hospitals across the country. We used ICD-9 codes for endocarditis, illicit drug use, and HCV to identify cases of IDU-IE between 2000 and 2013. Our most important finding was that the epidemiology of IDU-IE has changed in recent years, with an increasing frequency among patients younger than 34, Caucasians, and females. During the study period, the proportion of patients hospitalized for infective endocarditis whose infections were related to injection drug use increased from 7% to 12%. The proportion of hospitalizations for heart infections that were linked to drug use among patients aged 15 to 34 increased...
Prevalence of Heroin Use Rises in Decade, Greatest Increase Among Whites

Prevalence of Heroin Use Rises in Decade, Greatest Increase Among Whites

The proportion of the population using heroin and having heroin use disorder increased over the decade from 2001 through 2013, with the greatest increases among whites, and nonmedical use of prescription opioids before heroin use increased among white users only, according to a new article published online by JAMA Psychiatry. Heroin use is a public health concern because the risks associated with it include addiction, death, infectious diseases and impaired psychological status. Among the 79,402 survey respondents, the prevalence (proportion of the population affected) of heroin use increased from 0.33 percent in 2001-2002 to 1.61 percent in 2012-2013 and the prevalence of heroin use disorder increased from 0.21 percent to 0.69 percent, according to the results. Related Articles Opioid Use Disorder, Heroin Use Up Among Young Adults Comparing Heroin-, Opioid-, and Marijuana-Related Overdoses Many Patients Get Opioid Rx While Receiving Buprenorphine CDC: Fatal Drug Overdoses More Than Doubled Since 1999 The authors also note: The increase in the prevalence of heroin use was higher among whites (0.34 percent in 2001-2002 vs. 1.90 percent in 2012-2013) compared with nonwhites (0.32 percent in 2001-2002 vs. 1.05 percent in 2012-2013). The proportion of people who reported initiating the nonmedical use of prescription opioids before starting heroin use increased across time among white users only (from 35.83 percent in 2001-2002 to 52.83 percent in 2012-2013. Click here to read the full press...
VIDEO: Infections Possible Cause for Falls

VIDEO: Infections Possible Cause for Falls

Farrin Manian, MD, discusses a retrospective study looking at patients presenting with a fall who also had a co-existing systemic infection. Obstacles and poor eyesight get blamed. The existing literature on infections and falls mostly focuses on the elderly, usually in institutions and often suffering from dementia. But the records of patients presenting with a fall at Dr. Manian’s institution from 2000 through 2014 suggest it’s much broader than that. Source: MedPage...
Each State’s Predicted Nursing Demand

Each State’s Predicted Nursing Demand

  NURSING@GEORGETOWN The demand for health care professionals — especially those who work in primary care — is predicted to increase through 2020. This is due in large part to an aging baby boomer generation along with overall population growth. As the single largest health profession in the nation, nurses play a vital role in meeting that demand. With their clinical knowledge and skills to provide direct patient care, nurse practitioners (NPs) are uniquely positioned to help fill the shortage of primary health care providers. According to a 2013 report from the U.S. Health Resources and Services Administration (HRSA), the number of primary care NPs is projected to increase by 30 percent, from 55,400 in 2010 to 72,100 in 2020. All advanced practice nurses, including NPs, must first receive the education and licensure to be a registered nurse (RN). Since this is the case, it is important understand the state-level demand and projected shortages for RNs. Since 2000, the United States has more than doubled the number of RNs educated annually. In some states this means that the number of RNs is expected to exceed demand. Other states are still expected to experience nursing shortages. The following  infographic — based on data from the 2014 HRSA report, “The Future of the Nursing Workforce: National- and State-Level Projections, 2012-2025 — details the states that may, and may not, need more nurses over the next 10 years. You can learn more from the infographic below that was created by Nursing@Georgetown’s online family nurse practitioner program. Nursing@Georgetown is the innovative online Master of Science degree in Nursing program from Georgetown University School...
Is Sexual Activity Safe After a Heart Attack?

Is Sexual Activity Safe After a Heart Attack?

According to recent data, about one in five acute myocardial infarctions (AMIs) occur among people aged 18 to 55, and one-third of these patients are women. Recently, the Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients (VIRGO) study was conducted to investigate differences between women and men in their trajectory of functional recovery, including sexual activity and function, in the year after an AMI. The study population included hospital patients from both the United States and Spain. VIRGO showed that most AMI survivors were sexually active in the year before their event and many resumed sexual activity in the following year. A Deeper Look Despite this recommendation, little is known about the patterns of sexual recovery or sexual problems after AMI, especially among younger patients. To address this research gap, Stacy Tessler Lindau, MD, MAPP, and colleagues had a study published in JAMA Cardiology that looked at how patients were informed about sexual recovery and efforts that were made to address their expectations. “Previous research suggests that women are less likely than men to receive counseling about sex after an AMI,” explains Dr. Lindau. “This counseling is important for all AMI survivors.” Key Trends According to the results, most patients had resumed sexual activity by 1 month. More than half of women and less than half of men reported having sexual function problems in the year after their AMI. In addition, one in 15 women and one in 20 men never resumed sex during the year after their AMI. The most commonly reported sexual problems were lack of interest and trouble lubricating for women. For...
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