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Background: Naltrexone, a medication for addiction treatment (MAT), is an FDA-approved medication recommended for the treatment of alcohol use disorder (AUD). Despite the high prevalence of AUD and efficacy of naltrexone, only a small percentage of individuals with AUD receive treatment. Objectives: To identify trends for the prescription of naltrexone in AUD admissions in substance use treatment centers across the U.S. Methods: Data from the 2000–2018 U.S. Treatment Episode Data Set: Admissions (TEDS-A) were used in temporal trend analysis of naltrexone prescription in admissions that only used alcohol. Data from the 2019 National Survey of Substance Abuse Treatment Services (N-SSATS) were also used to characterize medication use among AUD clients across different treatment service settings. Results: Treatment of AUD with naltrexone was 0.49% in 2000 and tripled from 0.53% in 2015 to 1.64% in 2018 in AUD admissions (p< 0.0001 for the Cochran–Armitage trend test). Women, middle-aged adults, and admissions for clients living in the Northeast U.S. were more likely to be prescribed naltrexone than their respective counterparts, as were admissions with prior treatment episodes and referrals through alcohol/drug use care providers, who paid for treatment primarily through private insurance, used alcohol daily in the month prior to admission, and waited 1–7 days to enter treatment. Naltrexone was more commonly prescribed by AUD admissions compared to acamprosate and disulfiram and was more frequently prescribed in residential and outpatient services as opposed to hospital inpatient services. Conclusions: Naltrexone remains underutilized for AUD, and factors that influence prescription of medication are multifaceted. This study may contribute to the creation of effective interventions aimed at reducing naltrexone disparities for AUD.
Fares Qeadan; Nana A. Mensah; Lily Y. Gu; Erin F. Madden; Kamilla L. Venner; Kevin English. Trends in the Use of Naltrexone for Addiction Treatment among Alcohol Use Disorder Admissions in U.S. Substance Use Treatment Facilities. International Journal of Environmental Research and Public Health 2021, 18, 8884 .
AMA StyleFares Qeadan, Nana A. Mensah, Lily Y. Gu, Erin F. Madden, Kamilla L. Venner, Kevin English. Trends in the Use of Naltrexone for Addiction Treatment among Alcohol Use Disorder Admissions in U.S. Substance Use Treatment Facilities. International Journal of Environmental Research and Public Health. 2021; 18 (16):8884.
Chicago/Turabian StyleFares Qeadan; Nana A. Mensah; Lily Y. Gu; Erin F. Madden; Kamilla L. Venner; Kevin English. 2021. "Trends in the Use of Naltrexone for Addiction Treatment among Alcohol Use Disorder Admissions in U.S. Substance Use Treatment Facilities." International Journal of Environmental Research and Public Health 18, no. 16: 8884.
Cytokine storm syndrome in patients with COVID-19 is mediated by pro-inflammatory cytokines resulting in acute lung injury and multiorgan failure. Elevation in serum ferritin and D-dimer is observed in COVID-19 patients. To determine prognostic values of optimal serum cutoff with trajectory plots for both serum ferritin and D-dimer in COVID-19 patients with invasive ventilator dependence and in-hospital mortality. We used retrospective longitudinal data from the Cerner COVID-19 de-identified cohort. COVID-19 infected patients with valid repeated values of serum ferritin and D-dimer during hospitalization were used in mixed-effects logistic-regression models. Among 52,411 patients, 28.5% (14,958) had valid serum ferritin and 28.6% (15,005) D-dimer laboratory results. Optimal cutoffs of ferritin (714 ng/mL) and D-dimer (2.1 mg/L) revealed AUCs ≥ 0.99 for in-hospital mortality. Optimal cutoffs for ferritin (502 ng/mL) and D-dimer (2.0 mg/L) revealed AUCs ≥ 0.99 for invasive ventilator dependence. Optimal cutoffs for in-house mortality, among females, were lower in serum ferritin (433 ng/mL) and D-dimer (1.9 mg/L) compared to males (740 ng/mL and 2.5 mg/L, respectively). Optimal cutoffs for invasive ventilator dependence, among females, were lower in ferritin (270 ng/mL) and D-dimer (1.3 mg/L) compared to males (860 ng/mL and 2.3 mg/L, respectively). Optimal prognostic cutoffs for serum ferritin and D-dimer require considering the entire trajectory of laboratory values during the disease course. Females have an overall lower optimal cutoff for both serum ferritin and D-dimer. The presented research allows health professionals to predict clinical outcomes and appropriate allocation of resources during the COVID-19 pandemic, especially early recognition of COVID-19 patients needing higher levels of care.
Fares Qeadan; Benjamin Tingey; Lily Gu; Ashley Packard; Esther Erdei; Ali Saeed. Prognostic Values of Serum Ferritin and D-Dimer Trajectory in Patients with COVID-19. Viruses 2021, 13, 419 .
AMA StyleFares Qeadan, Benjamin Tingey, Lily Gu, Ashley Packard, Esther Erdei, Ali Saeed. Prognostic Values of Serum Ferritin and D-Dimer Trajectory in Patients with COVID-19. Viruses. 2021; 13 (3):419.
Chicago/Turabian StyleFares Qeadan; Benjamin Tingey; Lily Gu; Ashley Packard; Esther Erdei; Ali Saeed. 2021. "Prognostic Values of Serum Ferritin and D-Dimer Trajectory in Patients with COVID-19." Viruses 13, no. 3: 419.
In Ghana, the HIV prevalence among MSM is more than 10 times greater than the general population of adults, and rates of engagement in HIV medical care are low among MSM diagnosed with HIV. Using structured surveys, we investigated the impact of HIV-related stigma, same-sex behavior stigma, and gender nonconformity stigma on linkage to HIV care (LTC) in MSM ( N = 225) living with HIV in Ghana. Autonomy-supportive healthcare climate ( OR = 1.63, p < .01), vicarious HIV stigma ( OR = 2.73, p < .01), and age ( OR = 1.06, p < .004) predicted LTC. Conversely, felt normative HIV stigma negatively predicted LTC ( OR = 0.65, p < .05). Finally, we identified regional disparities, with MSM from Takoradi being 4 times and 5 times more likely to be LTC compared to Kumasi and Accra, respectively. Our findings highlight the nuanced roles of stigmas in shaping the HIV care continuum among MSM living with HIV, while revealing potential gaps in current measures of HIV-related stigma.
Lily Y. Gu; Nanhua Zhang; Kenneth H. Mayer; James M. McMahon; Soohyun Nam; Donaldson F. Conserve; Marian Moskow; Judith Brasch; Yaw Adu-Sarkodie; Thomas Agyarko-Poku; Francis Boakye; LaRon E. Nelson. Autonomy-Supportive Healthcare Climate and HIV-Related Stigma Predict Linkage to HIV Care in Men Who Have Sex With Men in Ghana, West Africa. Journal of the International Association of Providers of AIDS Care (JIAPAC) 2021, 20, 1 .
AMA StyleLily Y. Gu, Nanhua Zhang, Kenneth H. Mayer, James M. McMahon, Soohyun Nam, Donaldson F. Conserve, Marian Moskow, Judith Brasch, Yaw Adu-Sarkodie, Thomas Agyarko-Poku, Francis Boakye, LaRon E. Nelson. Autonomy-Supportive Healthcare Climate and HIV-Related Stigma Predict Linkage to HIV Care in Men Who Have Sex With Men in Ghana, West Africa. Journal of the International Association of Providers of AIDS Care (JIAPAC). 2021; 20 ():1.
Chicago/Turabian StyleLily Y. Gu; Nanhua Zhang; Kenneth H. Mayer; James M. McMahon; Soohyun Nam; Donaldson F. Conserve; Marian Moskow; Judith Brasch; Yaw Adu-Sarkodie; Thomas Agyarko-Poku; Francis Boakye; LaRon E. Nelson. 2021. "Autonomy-Supportive Healthcare Climate and HIV-Related Stigma Predict Linkage to HIV Care in Men Who Have Sex With Men in Ghana, West Africa." Journal of the International Association of Providers of AIDS Care (JIAPAC) 20, no. : 1.