Injection drug use, HIV/HCV, and related services in nonurban areas of the United States: A systematic review

Background—Injection drug use (IDU) in nonurban areas of the United States is a growing public health concern, but there has been no comprehensive assessment of existing research on injection-related HIV and hepatitis C (HCV) in nonurban communities. We conducted a systematic review to assess the current literature and identify knowledge gaps. Methods—We systematically searched six databases for relevant articles published between January 1990 and June 2016 and screened, extracted, and analyzed the resulting data. Studies were included if they reported original findings from the nonurban U.S. related to 1) IDU and its role in HIV/HCV transmission, and/or 2) HIV/HCV services for people who inject drugs (PWID). Results—Of 2,330 studies, 34 from 24 unique research projects in 17 states met inclusion criteria. Despite increasing HCV and high vulnerability to injection-related HIV outbreaks in nonurban areas, only three studies since 2010 recruited and tested PWID for HIV/HCV. Twelve reported on sharing injection equipment but used varying definitions of sharing, and only eight examined correlates of injection risk. Nine studies on syringe access suggest limited access through syringe exchange programs and pharmacies. Only two studies addressed HCV testing, none addressed HIV testing, and three examined behavioral or other interventions. Conclusions—Despite growing concern regarding nonurban IDU there are few studies of HIV/HCV and related services for PWID, and the existing literature covers a very limited geographical area. Current research provides minimal insights into any unique factors that influence injection risk and HIV/HCV service provision and utilization among nonurban PWID

Pseudomonas aeruginosa infection in cystic fibrosis caused by an epidemic metallo-β-lactamase-producing clone with a heterogeneous carbapenem resistance phenotype

AbstractAn epidemic IMP-13 metallo-β-lactamase (MBL)-producing Pseudomonas aeruginosa clone, causing infections and even large outbreaks in Italian critical care settings, was detected in a young cystic fibrosis patient. In this patient, the chronic infection was sustained by distinct clonal sub-populations of the MBL-producing P. aeruginosa clone, either susceptible or resistant to carbapenems. These findings underscore the importance of infection prevention practices in cystic fibrosis settings and pose an important diagnostic and therapeutic challenge

Not sold here: limited access to legally available syringes at pharmacies in Tijuana, Mexico

<p>Abstract</p> <p>Background</p> <p>Sterile syringe access is a critical component of HIV prevention programs. Although retail pharmacies provide convenient outlets for syringe access, injection drug users (IDUs) may encounter barriers to syringe purchase even where purchase without a prescription is legal. We sought to obtain an objective measure of syringe access in Tijuana, Mexico, where IDUs report being denied or overcharged for syringes at pharmacies.</p> <p>Methods</p> <p>Trained "mystery shoppers" attempted to buy a 1 cc insulin syringe according to a predetermined script at all retail pharmacies in three Tijuana neighborhoods. The same pharmacies were surveyed by telephone regarding their syringe sales policies. Data on purchase attempts were analyzed using basic statistics to obtain an objective measure of syringe access and compared with data on stated sales policies to ascertain consistency.</p> <p>Results</p> <p>Only 46 (28.4%) of 162 syringe purchase attempts were successful. Leading reasons for unsuccessful attempts were being told that the pharmacy didn't sell syringes (35.3%), there were no syringes in stock (31.0%), or a prescription was required (20.7%). Of 136 pharmacies also surveyed by telephone, a majority (88.2%) reported selling syringes but only one-third (32.5%) had a successful mystery shopper purchase; the majority of unsuccessful purchases were attributed to being told the pharmacy didn't sell syringes. There was similar discordance regarding prescription policies: 74 pharmacies said in the telephone survey that they did not require a prescription for syringes, yet 10 of these pharmacies asked the mystery shopper for a prescription.</p> <p>Conclusions</p> <p>IDUs in Tijuana have limited access to syringes through retail pharmacies and policies and practices regarding syringe sales are inconsistent. Reasons for these restrictive and inconsistent practices must be identified and addressed to expand syringe access, reduce syringe sharing and prevent HIV transmission.</p

Cryptic diversity of the jewel beetles Agrilus viridis (Coleoptera: Buprestidae) hosted on hazelnut

The genus Agrilus (Coleoptera: Buprestidae) represents a taxonomic puzzle, since the boundaries between species, subspecies and morphotypes tied to different host plants are sometimes difficult to establish on morphological characteristics alone. Some Agrilus species can cause severe agricultural damage; this makes correct distinctions of the taxon and knowing whether the insects switch from one host plant to another important. This study of mtDNA examined the genetic characteristics of lineages of A. viridis, a jewel beetle recently found causing damage to the hazelnut Corylus avellana in NW Italy. Three mitochondrial markers (a portion of the 12S rDNA and a DNA-fragment including partial NADH dehydrogenase subunit I gene, the tRNA Leucine gene and partial 16S rDNA, and partial  Cytochrome c oxidase) were compared between individuals collected on birch Betula sp., beech Fagus sp., willow Salix sp., alder Alnus sp. and hazelnut. We found a high genetic distance between A. viridis sampled on different host plants, while individuals sampled on the same host plant were similar despite a considerable geographic gap between sampled areas. Our study supports the general pattern for strong ecological separation between populations living on different host plants

Aging and memory phenomena in magnetic and transport properties of vortex matter: a brief review

There is mounting experimental evidence that strong off-equilibrium phenomena, such as ``memory'' or ``aging'' effects, play a crucial role in the physics of vortices in type II superconductors. We give a short review, based on a recently introduced schematic vortex model, of current progresses in understanding out of equilibrium vortex behaviours. We develop a unified description of ``memory'' phenomena in magnetic and transport properties, such as magnetisation loops and their ``anomalous'' 2nd peak, logarithmic creep, ``anomalous'' finite creep rate in the limit of vanishing temperature, ``memory'' and ``irreversibility'' in I-V characteristics, time dependent critical currents, ``rejuvenation'' and ``aging'' of the system response.Comment: updated versio

CARATTERIZZAZIONE GENOMICA DI CEPPI DI HELICOBACTER PYLORI CON L'IMPIEGO DELLE TECNICHE ERIC-PCR E REP-PCR.

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Cochrane rehabilitation: 2020 Annual report

during its fourth year of existence, cochrane rehabilitation went on to promote evidence-informed health decision-making in rehabilitation. in 2020, the outbreak of the coVid-19 pandemic has made it necessary to alter priorities. in these challenging times, cochrane rehabilitation has firstly changed its internal organisation and established a new relevant project in line with pandemic needs: the REH-COVER (Rehabilitation – coVid-19 evidence-based response) action. the aim was to focus on the timely collection, review and dissemination of summarised and synthesised evidence relating to COVID-19 and rehabilitation. Cochrane Rehabilitation REH-COVER action has included in 2020 five main initiatives: 1) rapid living systematic reviews on rehabilitation and coVid-19; 2) interactive living evidence map on rehabilitation and coVid-19; 3) definition of the research topics on “rehabilitation and COVID-19” in collaboration with the World Health Organization (WHO) rehabilitation programme; 4) Cochrane Library special collection on Coronavirus (COVID-19) rehabilitation; and 5) collaboration with COVID-END for the topics “rehabilitation” and “disability.” Furthermore, we are still carrying on five different special projects: Be4rehab; RCTRACK; definition of rehabilitation for research purposes; ebook project; and a prioritization exercise for Cochrane Reviews production. The Review Working Area continued to identify and “tag” the rehabilitation-relevant reviews published in the cochrane library; the publication Working area went on to publish Cochrane Corners, working more closely with the Cochrane Review Groups (CRGs) and Cochrane Networks, particularly with Cochrane Musculoskeletal, oral, skin and sensory Network; the Education Working area, the most damaged in 2020, tried to continue performing educational activities such as workshops in different online meetings; the Methodology Working area organized the third and fourth cochrane Rehabilitation Methodological (CRM) meetings respectively in Milan and Orlando; the Communication Working Area spread rehabilitation evidences through different channels and translated the contents in different languages

The effect of HIV infection on overdose mortality

Objectives: To quantify the association of HIV infection with overdose mortality and explore the potential mechanisms. Design: A prospective cohort study. Methods: A total of 1927 actively injecting drug users who were HIV seronegative at baseline, of whom 308 later HIV seroconverted, were followed semi-annually for death from 1988 to 2001. Survival analyses using marginal structural and standard Cox models were used to evaluate the effect of HIV infection on the risk of overdose mortality. Results: Overdose death rates were higher in HIV-seropositive than HIV-seronegative drug users: 13.9 and 5.6 per 1000 person-years, respectively (P < 0.01). The hazard ratio (HR) was 2.54 [95% confidence interval (CI) 1.47, 4.38] for the marginal structural model and 2.06 (95% CI 1.25, 3.38) for the standard Cox model, both adjusted for demographics, drug injection characteristics, alcohol abuse, substance abuse treatment, and sexual orientation. Adjusting for possible time-varying mediators (i.e. drug use, medical conditions and healthcare access) in extended marginal structural models reduced the effect of HIV on overdose mortality by 30% (HR 1.82, 95% CI 1.01, 3.30). Abnormal liver function was associated with a higher risk of overdose mortality (HR 2.00, 95% CI 1.05, 3.84); adjustment for this further reduced the effect of HIV on overdose mortality. Conclusion: HIV infection was associated with a higher risk of overdose mortality. Drug use behavior, systematic disease and liver damage associated with HIV infection appeared to account for a substantial portion of this association. The data suggest a group to target with interventions to reduce overdose mortality rates.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/40279/2/Wang_The Effect of HIV Infection on Overdose_2005.pd