How probation affects treatment of opioid use disorders: Comparison of early remission rates between opioid use disorder patients admitted to medical clinic voluntarily and by probation

© 2019, Pacini Editore S.p.A.. All rights reserved.Background: Probation is a well-intentioned approach that aims to bring substance abusers back into the community. In the literature there is a lack of studies dedicated to showing how probation affects the treatment outcomes of opioid use disorders. Aim: This study aims to explore the probation’s impact on treatment outcomes of opioid use disorders by comparing the early remission rates of patients admitted voluntarily and by probation. Methods: 158 convicts on probation and 303 patients with opioid use disorder who applied voluntarily were included in the study. The sociodemographic characteristics and the early remission rates of the patients were compared. Based on DSM-5 criteria, early remission refers to the failure to meet any of the criteria of substance use disorder, other than craving or a strong desire, and the compulsion to use such substances for at least 3 months, but for a time period shorter than 12 months. Results: Early remission rate among patients who applied voluntarily (38.9%) was significantly higher than patients who were referred to us as convicts on probation (26.6%). Independent factors raising the probability of early remission were found to be voluntary referral to outpatient clinics (1.791-fold), being male (4.855-fold) and old age (1.090-fold), while being single (0.508-fold) and a long duration of substance use (0.981-fold) were found to be independent factors lowering the probability of early remission. Conclusion: The findings of the present study demonstrate that in patients suffering from opioid use disorder, the willingness and motivation of the individual to undergo treatment were more effective than motivations based on the threat of legal sanctions

Management of Chronic Hepatitis C Virus Infection: A Consensus Report of the Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases

Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases convened a meeting to develop a consensus report on management of chronic hepatitis C virus (HCV) infection, a global public health problem, affecting nearly 170 million people worldwide. Relevant literature and international guidelines were reviewed, and recommendations agreed are presented at the end of each section such as epidemiology and natural history of HCV infection, economic burden of chronic hepatitis C (CHC), diagnosis of acute hepatitis C (AHC) and CHC, treatment of AHC, goals, endpoints, stopping rules and pre-therapeutic assessment of CHC therapy, indications for treatment, treatment of CHC, monitoring and managing treatment safety and side effects, measures to improve treatment adherence, posttreatment follow-up of patients who achieve a sustained virological response, contraindications to therapy, retreatment of non-sustained virological responders, follow-up of untreated patients and of patients with treatment failure, and prevention of HCV infection. Examples of some selected recommendations are as follows: [1] It should be kept in mind that approximately 75-85% of people who become infected will develop chronic HCV infection, up to 20% of them develop cirrhosis within 20 years, and the average annual risk of hepatocellular carcinoma among them is 1-4%. [2] In addition to the HCV RNA quantification, the HCV genotype should be assessed to provide relevant information with respect to treatment duration and different response rates prior to treatment initiation. [3] If predicted response rate is not appropriate to any of the existing regimens, the patient should be kept waited until alternative therapeutic options become available

The Relationship between COVID-19 Severity and Bacillus Calmette-Guerin (BCG)/ Mycobacterium tuberculosis exposure history in healthcare workers: a multi-center study

The COVID-19 pandemic has brought countries' health services into sharp focus. It was drawn to our group's attention that healthcare workers (HCWs) had a lower mortality rate against higher COVID-19 incidence compared to the general population in Turkey. Since risk of exposure to tuberculosis bacillus among healthcare workers are higher than the population, we aimed to investigate if there is a relationship between BCG and Mycobacterium tuberculosis exposure history with COVID-19 severity in infected HCWs. This study was conducted with 465 infected HCWs from thirty-three hospitals to assess the relationship between COVID-19 severity (according to their hospitalization status and the presence of radiological pneumonia) and BCG and Mycobacterium tuberculosis exposure history. HCWs who required hospital admission had significantly higher rates of chronic diseases, radiological pneumonia, and longer working hours in the clinics. Higher rates of history of contact and care to tuberculosis patients, history of tuberculosis, and BCG vaccine were observed in hospitalized HCWs. HCWs who had radiological pneumonia had a significantly increased ratio of history of care to tuberculosis patients and a higher family history of tuberculosis. The findings from our study suggest that the lower mortality rate despite the more severe disease course seen in infected HCWs might be due to frequent exposure to tuberculosis bacillus and the mortality-reducing effects of the BCG vaccine