No description available.

No description available.

Elizabethkingia Meningoseptica (E. Meningoseptica) an oxidase-positive gram-negative aerobic rod.1-2 Although ubiquitous in nature and widely distributed in soil and water, it is not a part of normal human flora. Cases of outbreaks of meningitis in premature neonates or infants have been reported, however, very few cases have been reported in adults.3 Infection is primarily nosocomial, or hospital acquired and has been implicated in bacteremia, meningitis, pneumonia, endocarditis especially in immunocompromised individuals.2-4 We report a 29-year-old male with past medical history significant for intravenous drug abuse, hepatitis C, oxymorphone induced hemolytic uremic syndrome, who presented to hospital with altered mental status. On admission, patient was unresponsive to vocal commands, febrile (102.3 F), tachycardic and tachypneic. He had pinpoint pupils and diffuse petechiae. In addition, he had erythematous flat macular lesions on his palms and dorsum of hands as well as injection marks in left cubital fossa. Cardiac examination was significant for a grade III systolic murmur at apical region and diastolic murmur at left second intercostal space. Laboratory studies revealed thrombocytopenia (43,000m/microL), lactic acidosis (4.9mmol/L), serum creatinine (Cr) of 6.6 mg/dL, glomerular filtration rate (GFR) of 10 ml/min. Transthoracic echocardiogram (TTE) revealed large mobile vegetation on aortic valve measuring 3.6 x 0.72 cm. Patient’s presentation was consistent with infective endocarditis with the vegetation seen on TTE and patient’s physical findings. Magnetic Resonance Imaging of the brain showed numerous small hemorrhagic infarcts, likely secondary to emboli from aortic valve vegetation. Patient required intubation for airway protection and started on hemodialysis. He was initially started on Meropenem and Vancomycin for infective endocarditis and later switched to Ciprofloxacin based on blood cultures and sensitivities which revealed methicillin sensitive staphylococcus aureus and multi-drug resistant E. Meningoseptica. Patient was transferred to long term care facility after acute care at the hospital. The increasing incidence of polymicrobial infective endocarditis and increasing resistance to antibiotic therapy pose challenges to the rapid assessment and treatment to mitigate the multi-organ involvement with septic emboli. Reports of pathogenicity associated with native valve endocarditis with this organism is scarce and exist primarily in a very few case reports and is resistant to many traditional antibiotics.5,6 E. Meningoseptica has shown antimicrobial susceptibility to the newer quinolones, rifampin, trimethoprim/sulfamethoxazole and ciprofloxacin with reasonable activity.7 Due to the unusual pattern of antibiotic resistance, early switching to appropriate antibiotics based on sensitivities is crucial for survival in patients with E. Meningoseptica. References 1..Kim KK, Kim MK, Lim JH, Park HY, Lee ST. Transfer of Chryseobacterium meningosepticum and Chryseobacterium miricola to Elizabethkingia gen. nov. as Elizabethkingia meningoseptica comb. nov. and Elizabethkingia miricola comb. nov. Int J Syst Evol Microbiol.2005 May;55(Pt 3):1287-93. 2:Shinha T, Ahuja R. Bacteremia due to Elizabethkingia meningoseptica. IDCases. 2015 Jan 17;2(1):13-5. doi: 10.1016/j.idcr.2015.01.002. eCollection 2015. 3..Jung SH, Lee B, Mirrakhimov AE, Hussain N. Septic shock caused by Elizabethkingia meningoseptica: a case report and review of literature. BMJ Case Rep. 2013 Apr 3;2013. pii: bcr2013009066. doi: 10.1136/bcr-2013-009066. 4.Ratnamani MS, Rao R. Elizabethkingia meningoseptica: Emerging nosocomial pathogen in bedside hemodialysis patients. Indian J Crit Care Med. 2013 Sep;17(5):304-7. 5.Bomb K, Arora A, Trehan N. Endocarditis due to Chryseobacterium meningosepticum. Indian J Med Microbiol. 2007 Apr;25(2):161-2. 6.Yang J, Xue W, Yu X. Elizabethkingia meningosepticum endocarditis: A rare case and special therapy. Anatol J Cardiol. 2015 May;15(5):427-8. 7. Hsu MS, Liao CH, Huang YT, Liu CY, Yang CJ, Kao KL, Hsueh PR. Clinical features, antimicrobial susceptibilities, and outcomes of Elizabethkingia meningoseptica (Chryseobacterium meningosepticum) bacteremia at a medical center in Taiwan,1999-2006. Eur J Clin Microbiol Infect Dis. 2011 Oct;30(10):1271-8.

Southern Illinois University Carbondale

Entre le milieu des années 1960 marqué par l’apparition d’une nouvelle toxicomanie juvénile inquiétant les pouvoirs publics (1966 : première campagne de presse contre le LSD) et débouchant sur la loi de 1970 et le milieu des années 1990 marqué par la généralisation des stratégies de réduction des risques (1996 : institutionnalisation des traitements de substitution), il s’agit d’étudier la constitution de la toxicomanie comme problème social, sanitaire et politique, à travers les politiques dont elle a fait l’objet, souvent influencées par le cadre international de « guerre à la drogue ». La thèse vise à cerner les évolutions des usages, trafics et politiques publiques. Sa problématique réside dans une interrogation sur la notion de prohibition : comment est construit socialement et médiatiquement le scandale qui légitime l’interdiction ? Qui sont les acteurs qui la définissent « d’en haut » (politiciens, législateur, experts médicaux), et ceux qui l’appliquent sur le terrain (policiers, magistrats, médecins) ? Quelles sont les conséquences sociales de son application (criminalisation accentué du trafic, stigmatisation des usages) ? Comment se contredit-elle entre son volet répressif et son volet sanitaire ? Cette recherche s’appuie sur le dépouillement de matériaux divers : archives ministérielles (Intérieur, Justice, Santé, Jeunesse et Sports, Education Nationale, Services du Premier Ministre, Mission Interministérielle de Lutte contre la Drogue et la Toxicomanie-MILDT), archives parlementaires, archives privées, sources imprimées, presse, audiovisuel (archives INA)…. / Between the mid-1960s characterized by the sudden upsurge of new patterns of drug addiction within the Youth (1966: first media frenzy about LSD) resulting in the new prohibitionist Act of 1970, et the mid-1990s pointing out the generalization of harm reduction strategies (1996: institutionalization of opiates substitution treatments), the dissertation highlights the making the social, health and political problem of drug abuse, through the public policies, often influenced by the international frame of the “war on drugs”. The thesis focuses on the evolutions of uses, trafficking and public policies. It addresses the issue of prohibition: how is socially and publicly constructed the scandal that legitimizes THE prohibition ? Who are the stakeholders who defined it “from the top” (politicians, parliamentary committees, medical experts) and those who enforce the law “on the bottom” (police officers, judges, physicians)? What are the social consequences of this enforcement (increased criminalization of drug smuggling, stigmatization of drug users) ? How the system is contradicting itself between its repressive and care aspects ? This research is based on various archival materials: ministerial archives (Interior, Justice, Heath, Youth and Sports, National Education, Prime Minister’s administration, Inter-ministerial mission for the fight against drug and drug abuse – MILDT), parliamentary archives, private archives, contemporary printed sources, medias, INA archives…

No description available.

To evaluate the effectiveness of the West Virginia Prescription Drug Abuse Quitline (WVPDAQ). Descriptive data and inferential analyses are provided for the period of operations from 9/11/2008 to 3/1/2010. Chi-square tests for Independence compared differences between callers completing at least one follow-up survey against callers completing only the baseline intake survey were observed. A Wilcoxon signed rank sum test tested differences between the scores of intake callers and follow-up callers at the one-week (n = 177) and one-month (n = 89) intervals. A total of 1,056 calls were received, including 670 intakes, 177 1st follow-ups, 89 2nd follow-ups, and 36 3rd follow ups, and 84 caller satisfaction surveys. Chi-square analyses determined that callers who only completed the intake survey tended to have initiated drug use at a younger age (< or = 39 years of age, chi2 = 7.63, p = .02). Longitudinal findings indicated significant self-reported declines in daily drug use (p < .0001), increased intentions to quit in the next 30 days (p < .0001), and declines in requesting a referral for treatment (p < .0001) at the one-month follow-up. Finally, approximately 19% (n = 17) of callers reported obtaining a counseling/ treatment appointment as a result of calling the WVPDAQ at the one-month follow up. Preliminary results suggest the WVPDAQ has established itself as a meaningful resource to combat prescription drug abuse in West Virginia. Sustainable funding and greater integration of the WVPDAQ into existing and developing treatment infrastructure could provide more affordable options for the state of West Virginia and its citizens.

No description available.

No description available.

The West Virginia Prescription Drug Abuse Quitline (WVPDAQ) is a resource that offers education and support to individuals and families affected by prescription drug abuse. The WVPDAQ began functioning September 11, 2008, through the use of mobile phone and laptop technology. Although some helplines and quitlines use some aspects of remote technology, most function through traditional call center and landline technology, making the WVPDAQ unique. This article describes the process evaluation of the WVPDAQ and outlines both the positive findings and challenges faced by the WVPDAQ. Lessons learned and future recommendations for remote quitline endeavors are also presented. It is hoped that the experiences and information regarding the WVPDAQ presented can provide best-practice insight for public health practitioners and evaluation personnel who are considering using alternative technologies to deliver quitline services.