IMPORTANCEOpioid prescriptions for treatment of pain in emergency departments (EDs) are associated with long-term opioid use. The temporal pattern of opioid prescribing in the context of the opioid epidemic remains unknown. OBJECTIVE To examine the temporal pattern of opioid prescribing within an ED for varying pain conditions between 2009 and 2018. DESIGN, SETTING, AND PARTICIPANTS A population-based, cross-sectional study was conducted at the ED of an urban academic medical center. All patients treated within that ED between January 1, 2009, and December 31, 2018, were included.
MAIN OUTCOMES AND MEASURESThe proportion of patients prescribed an opioid for treatment of pain in the ED temporally by condition, condition type, patient demographics, and physician prescriber.
Background: The rate of suicide attempts among people with substance abuse disorders in the U.S. is six times higher than in the general population. The prevalence of suicidal ideations and attempts continues to increase in Puerto Rico, with a signi cant incidence in substance-abusing populations.Methods: This retrospective cohort study evaluate the suicide pro le of 4,347 opioid-dependent participants in ASSMCA's methadone center in San Juan, PR, from 2015 to 2018 using questions related to suicidal ideation and attempts included in the admission questionnaire.Results: Participants reporting suicide ideation increase from 8.5% in 2015 to 17.0% in 2018. In 2015 only 7.0% claimed to have had a history of a suicide attempt, increasing to 12.4% in 2018.Discussion: Our data support the need for screening for suicide risk among substance-abusing populations to identify targeted interventions. The identi cation of high-risk populations for suicide can help during rehabilitation and nding the adequate resources needed.
La formación académica de estudiantes de medicina implica interacción con pacientes y superficies del entorno hospitalario, los microorganismos presentes allí pueden ser adquiridos y transmitidos con los riesgos consecuentes para la comunidad hospitalaria. El presente es un estudio descriptivo cuantitativo donde se analizan muestras provenientes de estudiantes de medicina (n= 155) en rotaciones de 3 semanas, tomando hisopados de nariz, boca, manos y fonendoscopio, gram y cultivo en agar sangre, incubación 24 horas a 37°C y 5% de CO2. Se hizo la identificación mediante gram y pruebas de biotipificación convencionales y susceptibilidad antibiótica según técnica de kirby-bauer.Los hallazgos aquí presentados evidencian alta frecuencia de bacterias patógenas en las fuentes de aislamiento, siendo relevante la presencia del Staphylococcus aureus en un 41,7% y la resistencia a antibióticos tanto por gram positivos como por gram negativos; por tanto, es de considerar la implementación de estrategias que minimicen la circulación de estos microorganismos en el ambiente hospitalario. El objetivo de este estudio es establecer la frecuencia de los microorganismos aislados en estudiantes de una Facultad de Medicina.
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