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Rasool F, Klein AA, Leheste JR. Managing Addiction and Overdose Deaths: The Debate Over America's Safe Injection Spaces. Cureus 2023; 15:e50406. [PMID: 38213341 PMCID: PMC10783936 DOI: 10.7759/cureus.50406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2023] [Indexed: 01/13/2024] Open
Abstract
In the decade between 2010 and 2020, the number of people killed by opioid overdoses more than tripled, reaching 68,630. Among drug users in their second and third decades of life, hepatitis B and C are also on the rise. New York City's two new supervised drug injection sites (SDISs) reversed 114 overdoses within two months, and 585 people injecting drugs visited the facility 4,974 times. By providing medical professionals and a sterile and safe environment, supervised injection sites reduce overdose risk and save lives. This suggests that SDISs could be an important adjunct to currently failing strategies to combat the nation's raging opioid crisis, particularly in the aftermath of the COVID-19 pandemic. Here, we examine the perception and impact of SDISs as well as efforts by the United States Congress (H.R. 7029 and H.R. 6159) toward their prevention. We look into the perspectives of major stakeholders, such as residents, business owners, drug users, legislators, taxpayers, and the general public, and investigate the short- and long-term consequences of SDISs based on crime statistics and published data on opioid use, overdose deaths, and blood-borne disease transmission rates.
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Affiliation(s)
- Farhaad Rasool
- Biomedical Sciences, New York Institute of Technology (NYIT) College of Osteopathic Medicine, Old Westbury, USA
| | - Arthur A Klein
- Osteopathic Medicine, New York Institute of Technology (NYIT) College of Osteopathic Medicine, Old Westbury, USA
| | - Joerg R Leheste
- Biomedical Sciences, New York Institute of Technology (NYIT) College of Osteopathic Medicine, Old Westbury, USA
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Anjum A, Rehman AU, Siddique H, Rabaan AA, Alhumaid S, Garout M, Almuthree SA, Halwani MA, Turkistani SA, Qutob H, Albayat H, Aljeldah M, Shammari BRA, Alshahrani FS, Alghamdi AS, Alduwaihi SM, Alibraheem AA, Zeb S, Zeshan B. Evaluation of Hematological, Biochemical Profiles and Molecular Detection of Envelope Gene (gp-41) in Human Immunodeficiency Virus (HIV) among Newly Diagnosed Patients. Medicina (Kaunas) 2022; 59:medicina59010093. [PMID: 36676716 PMCID: PMC9860646 DOI: 10.3390/medicina59010093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/26/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023]
Abstract
The Human Immunodeficiency Virus (HIV) is a highly morphic, retrovirus that rapidly evolves through mutation as well as recombination. Because of the immunocompromised status in HIV patients, there is often a higher chance of acquiring different secondary infections followed by liver cirrhosis, hepatitis B & C, and HIV-associated nephropathy. The current study was conducted to see the prevalence of secondary infections, hematological and biochemical markers for liver and renal associated diseases, and to detect the envelope gene (GP41) in newly diagnosed HIV patients. A total of 37 samples were collected from HIV-positive patients registered in different hospital settings under the National AIDS control program. The collected samples were processed for hepatitis B, hepatitis C, hematological analysis, and biochemical analysis. To identify the envelope gene in newly diagnosed HIV patients, polymerase chain reaction (PCR) was performed using four gene-specific primers. The HIV infections were seen more in male as compared to females. A significant decrease in complete blood count was observed in HIV patients when compared to healthy individuals. There was a significant increase in aspartate aminotransferase (AST), alanine aminotransferase (ALT), urea, and creatinine observed in HIV patients. No significant difference was observed in alkaline phosphatase (ALP), total bilirubin, and albumin levels when compared to healthy control. Anemia was observed in 59.4% of HIV patients. A total of three (8.1%) patients were found to be co-infected with hepatitis B and one (2.7 %) was co-infected with hepatitis C. Out of these 37 tested samples, a total of four showed the successful amplification of the envelope gene. This study provides platform for the health care facilitators to regularly monitor the signs, symptoms and clinical biomarkers of HIV-associated infections to prevent toxicity at an early stage to improve the quality of life (QoL) and minimize the mortality rate in HIV patients. Envelope gene mutating frequently results in drug resistance, and thus future research on polymorphism analysis will reveal points of substitutions to improve drug designing.
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Affiliation(s)
- Asfa Anjum
- Department of Medical Education, University of Lahore, Lahore 54590, Pakistan
| | - Abaid ur Rehman
- Department of Medical Education, Sheikh Zayed Medical College, Rahim Yar Khan 06426, Pakistan
| | - Hina Siddique
- Department of Medical Education, Fatima Jinnah Medical University, Lahore 54000, Pakistan
| | - Ali A. Rabaan
- Department of Public Health and Nutrition, The University of Haripur, Haripur 22610, Pakistan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
- Correspondence: (A.A.R.); (B.Z.)
| | - Saad Alhumaid
- Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 31982, Saudi Arabia
| | - Mohammed Garout
- Department of Community Medicine and Health Care for Pilgrims, Faculty of Medicine, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Souad A. Almuthree
- Department of Infectious Disease, King Abdullah Medical City, Makkah 43442, Saudi Arabia
| | - Muhammad A. Halwani
- Department of Medical Microbiology, Faculty of Medicine, Al Baha University, Al Baha 4781, Saudi Arabia
| | | | - Haitham Qutob
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Rabigh 25732, Saudi Arabia
| | - Hawra Albayat
- Infectious Disease Department, King Saud Medical City, Riyadh 7790, Saudi Arabia
| | - Mohammed Aljeldah
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Hafr Al Batin, Hafr Al Batin 39831, Saudi Arabia
| | - Basim R. Al Shammari
- Department of Internal Medicine, College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia
| | - Fatimah S. Alshahrani
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University and King Saud University Medical City, Riyadh 11451, Saudi Arabia
- Diagnostic Laboratory, Prince Sultan Military Medical City, Riyadh 12477, Saudi Arabia
| | - Ali S. Alghamdi
- Diagnostic Laboratory, Prince Sultan Military Medical City, Riyadh 12477, Saudi Arabia
| | - Sami M. Alduwaihi
- Diagnostic Laboratory, Prince Sultan Military Medical City, Riyadh 12477, Saudi Arabia
| | - Adil A. Alibraheem
- ENT Department, Prince Sultan Military Medical City, Riyadh 12477, Saudi Arabia
| | - Shah Zeb
- Department of Microbiology, Faculty of Biomedical and Health Science, The University of Haripur, Haripur 22610, Pakistan
| | - Basit Zeshan
- Department of Microbiology, Faculty of Life Sciences, University of Central Punjab, Lahore 54000, Pakistan
- Faculty of Sustainable Agriculture, University Malaysia Sabah, Sandakan Campus, Locked Bag No. 3, Sandakan 90509, Sabah, Malaysia
- Correspondence: (A.A.R.); (B.Z.)
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Wang D, Ye Y, Zheng Q. Cost of Blood and Body Fluid Occupational Exposure Management in Beijing, China. Int J Environ Res Public Health 2020; 17:E4192. [PMID: 32545465 PMCID: PMC7345934 DOI: 10.3390/ijerph17124192] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 06/02/2020] [Accepted: 06/10/2020] [Indexed: 12/12/2022]
Abstract
(1) Objective: The aim of this study was to determine the cost of blood and body fluid (BBF) occupational exposure management in healthcare facilities in Beijing, China. (2) Methods: A survey was conducted from August to October 2018, seeking general information concerning the management of occupational exposure to BBF and the cost of the management process. In total, 216 healthcare facilities were surveyed, using a stratified-selection method. The collected information included BBF management protocols, direct costs such as laboratory testing fees, drug costs and medical service fees, as well as indirect costs, such as wages, lost working time, injury compensation, and psychological counseling time. (3) Results: The cost of post-BBF exposure management varied according to the infection status of the exposure source patients, the immune status of exposed employees, and the location and level of healthcare facilities. The mean values of management cost were determined to be hepatitis B (HBV)-positive source (RMB 5936/USD 897), hepatitis C (HCV)-positive source (RMB 5738/USD 867), Treponema pallidum (TP)-positive source (RMB 4508/USD 681), human immunodeficiency virus (HIV)-positive source (RMB 12,709/USD 1920), and unknown sources (RMB 7441/USD 1124). The survey also revealed that some healthcare facilities have insufficient post-exposure management. (4) Conclusions: A better post-exposure management system is needed in Beijing to reduce both infection risk after exposure and costs.
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Affiliation(s)
- Daifang Wang
- Department of Industrial Engineering and Management, Peking University, Beijing 100871, China;
- Center for Pharmaceutical Information and Engineering Research, Engineering School, Peking University, Beijing 100871, China
| | - Yan Ye
- Department of Occupational Health, Beijing Center for Diseases Prevention and Control, Beijing 100013, China
| | - Qiang Zheng
- Department of Industrial Engineering and Management, Peking University, Beijing 100871, China;
- Center for Pharmaceutical Information and Engineering Research, Engineering School, Peking University, Beijing 100871, China
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