Kingsbrook Jewish Medical Center

Methamphetamine use disorder (MUD) is becoming more of a public health issue in Georgia State, with health and social effects affecting both people and communities. This study aimed to investigate attributes that may affect the accessibility of treatment among the methamphetamine-use population in the state of Georgia. We utilized the Treatment Episode Data Set -Discharges (TEDS-D) for 2016-2020 in Georgia, comprising participants with MUD (175,270). We utilized descriptive statistics and inferential techniques to ascertain the relationship between variables. Multiple logistic regression was used to control for confounding variables at a 95% confidence interval. This study's findings showed individuals aged 25-49 years had 1.8 times higher odds of getting treatment for methamphetamine use compared to those aged 12-24 years (adjusted odds ratio (AOR) = 1.8; 95% CI: 1.50-2.16).Alaska Native individuals (Aleut, Eskimo, and Indian) had 7.07 times higher odds of receiving treatment than Asian or Pacific Islander individuals (AOR = 7.07; 95% CI: 2.02-24.67). Compared to Asian or Pacific Islander individuals, Black or African American individuals had 12.11 times higher odds of receiving treatment (AOR = 12.11; 95% CI: 9.37-15.66), while White individuals had 6.82 times higher odds of getting treatment (AOR = 1.09; 95% CI: 0.86-1.37). MUD treatment disparity challenges are revealed in our study, emphasizing the critical need for focused intervention programs.

Kim, Sally1; Mohrien, Kerry2; Harris, Kimberley3; Beard, Jessica2; Dauer, Elizabeth2; Goldberg, Amy2; Maher, Zoe2; Mason, Leonard2; Santora, Thomas2; Sjoholm, Lars Ola2; Pathak, Abhijit2 Author Information

INTRODUCTION: Inflammatory bowel disease is associated with increased risk of mesenteric ischemia, likely due to factors such as vascular atherosclerosis caused by long-term inflammation, vasculitis, coagulation abnormalities, and abnormal lipid metabolism. Limited data exists for hospitalizations associated with acute vascular insufficiency of the intestines (AVII) in patients with Crohn's disease. METHODS: We analyzed the National Inpatient Sample (NIS) database for the years 2005-2011 to identify hospitalizations with Crohn's disease (ICD-9 CM code 555.0, 555.1, 555.2, and 555.9). Hospitalizations complicated by AVII (ICD-9 CM code 557.0) in this cohort were then identified. NIS is the largest all-payer inpatient care database in the United States, containing data on more than seven million hospital stays each year. Its large sample size is ideal for developing national and regional estimates and enables analyses of rare conditions, uncommon treatments, and special populations. Temporal trends of AVII in this cohort, patient demographics, comorbidity measures, and outcomes during the study period were determined using Cochran-Armitage trend test. RESULTS: Between 2005 and 2011, hospitalization with CD increased from 56,739 to 65,281 (P-trend < 0.0001, Figure 1a). The proportion of hospitalizations complicated by AVII increased from 0.14% in 2005 to 0.28% in 2011 (P-trend < 0.0001, Figure 1b). AVII was more common in women (57.9%) (P-trend = 0.0007, Figure 1c) and in Caucasians (64.7%). All-cause inpatient mortality increased from 6.3% to 7.6% (P = 0.001, Figure 1d). Analysis of the Agency for Healthcare Research and Quality (AHRQ) comorbidity measures revealed that hypertension, renal failure and psychiatric disorders were some of the most commonly associated comorbidities (Figure 2). CONCLUSION: A significant increase in the number of hospitalizations for CD complicated by AVII was seen during the study period. Caucasians and women were more commonly affected than other groups. There was also an increase in the in-hospital mortality associated with these hospitalizations. Although hypertension, renal failure and psychiatric disorders were more commonly associated with AVII in Crohn's disease hospitalizations, there were several other comorbidities including diabetes mellitus, obesity and chronic pulmonary disease that showed increasing trends. Further studies are needed to identify predictors of these trends and factors responsible for such outcomes to better elucidate and perhaps support our findings.

Buruli ulcer is a necrotizing skin disease caused by Mycobacterium ulcerans and is usually associated with tropical climates and exposure to slow-moving or stagnant water. We report a case of Buruli ulcer that may have originated in an urban semiarid area of Senegal.

217 Background: Poly adenosine diphosphate ribose polymerase (PARP) inhibitors have shown to benefit in DNA repair-deficient tumors by enhancing synthetic lethality in cancer cells and are currently employed in many solid tumors. Nevertheless, the risk of hematological toxicities remains significant. We performed a systematic review and meta-analysis of randomized controlled trials (RCT) to determine the risk of hematological toxicities. Methods: We conducted a comprehensive literature search using MEDLINE, EMBASE databases and meeting abstracts from inception through June 2018. Phase III RCTs that mention hematological toxicities as adverse effects were incorporated in the analysis. Mantel-Haenszel (MH) method was used to calculate the estimated pooled risk ratio (RR) with 95% confidence interval (CI). Random effects model was applied. Results: Seven phase III RCTs with a total of 3,188 patients with breast, ovarian and gastric cancer were eligible. Studies compared olaparib or niraparib or rucaparib versus placebo, olaparib vs single agent chemotherapy, iniparib + gemcitabine / carboplatin (GC) versus GC, veliparib + C versus C and olaparib + paclitaxel vs paclitaxel. The RR of all-grade side effects were as follows: anemia, 2.38 (95% CI: 1.42 – 4.00, p = 0.001); thrombocytopenia, 2.96 (95% CI: 1.37 – 6.40, p = 0.006); neutropenia, 1.47 (95% CI: 1.06 – 2.05, p = 0.02); and leukopenia, 1.08 (95% CI: 0.77 – 1.50, p = 0.63). The RR of high-grade adverse effects were as follows: anemia, 3.63 (95% CI: 1.53 – 8.57, p = 0.003); thrombocytopenia, 2.65 (95% CI: 0.89 – 7.85, p = 0.07); neutropenia, 1.27 (95% CI: 0.87 – 1.86, p = 0.21); and leukopenia, 1.20 (95% CI: 0.90 – 1.58, p = 0.19). Conclusions: Our meta-analysis demonstrated that patients on PARP inhibitors experienced a significant increase in the risk of all grades of anemia with a relative risk of 3.63 for grade 3 and 4 anemia, along with any-grade thrombocytopenia and neutropenia. Proper supportive care is essential, and it will ultimately reduce drug dosing inconsistencies and financial burden among patients undergoing treatment.

Chilaiditi sign, a condition first described by Greek radiologist Demetrius Chilaiditi in 1910, is the radiological appearance of colonic interposition between the liver and the diaphragm. The incidence in chest/abdominal x-rays and CT scans is 0.025 – 0.28%. When there are symptoms, such as abdominal pain, nausea, constipation or respiratory distress, the condition is called Chilaiditi's syndrome. One of the key factors in the development of this anomaly is anatomic variation in the suspensory ligaments of the intestines. Other important etiological factors include aerophagia, constipation, liver cirrhosis and chronic lung disease with increased intrathoracic pressure. Below we discuss a case of Chilaiditi's syndrome in an elderly female, who presented with shortness of breath, constipation and abdominal distention. The diagnosis of Chilaiditi's syndrome was made by chest x-ray and CT scan.

Objective: To examine the concussion history through a questionnaire for female soccer players in order to formulate potential risk factors and discover characteristics unique to this population. Design: Administer a survey based questionnaire evaluating concussion history among the athletes in the NewYork Metropolitan Women's League.Results: Of 105 individuals, 65 (61.9%) reported concussions during their career.Of that 65, only 33 were medically diagnosed with a concussion and the majority of individuals suffered three or less concussions (63.1%).Five players reported that they suffered from 10 or more concussions.Only 41 of 105 individuals reported the presence of a medical team on site to aid with injuries.Further analysis revealed correlations between increasing age (p=0.0162),increasing experience (p<0.0053), and increasing number of headers (p=0.0107) with concussion rates.Those who played multiple positionswere more likely to suffer from concussions (p=0.03556). Conclusions:The lack of education about concussions is a major area of concern with the population studied.Only 52% of individuals surveyed reported ever receiving any education about concussions, highlighting a need for better concussion education for players and ancillary staff.Providing basic training to coaches and ancillary staff to evaluate for concussions might be a viable option to prevent early return to play and increased rates of concussions.