Abstract:
OBJECTIVES:To explore temporal trends and geographic variations in mortality from prescription opioids from 1999 to 2016. METHODS:Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research Multiple Cause of Death files were used to calculate age-adjusted rates and 95% confidence intervals (CIs) and create spatial cluster maps. RESULTS:From 1999 to 2016, counties in West Virginia experienced the highest overall mortality rates in the United States from prescription opioids. Specifically, from 1999 to 2004, the highest rate in West Virginia of 24.87/100,000 (95% CI 17.84-33.73) was the fourth highest in the United States. From 2005 to 2009, West Virginia experienced the highest rate in the United States, 60.72/100,000 (95% CI 47.33-76.71). From 2010 to 2016, West Virginia also experienced the highest rate in the United States, which was 90.24/100,000 (95% CI 73.11-107.36). As such, overall, West Virginia experienced the highest rates in the United States and the largest increases overall of ~3.6-fold between 1999 and 2004 and 2010 and 2016. From 1999 to 2004, Florida had no "hot spots," but from 2006 to 2010 they did appear, and from 2011 to 2016, they disappeared. CONCLUSIONS:These data show markedly divergent temporal trends and geographic variations in mortality rates from prescription opioids, especially in the southern United States. Specifically, although initial rates were high and continued to increase alarmingly in West Virginia, they increased but then decreased in Florida. These descriptive data generate hypotheses requiring testing in analytic epidemiological studies. Understanding the divergent patterns of prescription opioid-related deaths, especially in West Virginia and Florida, may have important clinical and policy implications.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Palumbo SA,Hennekens CH,Robishaw JD,Levine RSdoi
10.14423/SMJ.0000000000001074subject
Has Abstractpub_date
2020-03-01 00:00:00pages
140-145issue
3eissn
0038-4348issn
1541-8243pii
SMJ19100journal_volume
113pub_type
杂志文章abstract:BACKGROUND:Patient comfort is an important part of laceration repair. METHODS:The study was a randomized single-blind cross-over trial in which each participant received 250 ml warmed and 250 ml room temperature saline irrigation in simple linear wounds after a local anesthetic was instilled. The solutions and the ord...
journal_title:Southern medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.SMJ.0000056657.63336.6C
更新日期:2003-05-01 00:00:00
abstract::The use of silver wire retention sutures requires added operating room time and expense, and it incurs the potential hazards of caught viscera, the possibility of more adhesions, leakage of intraperitoneal fluid through the exit wound, mild infection of exit wounds, and, on removal of the sutures, pain despite sedatio...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197905000-00013
更新日期:1979-05-01 00:00:00
abstract::Based upon the cases reported in this paper and upon a literature review encompassing 1,783 patients having received HAIC, it is our opinion that upper gastrointestinal tract ulceration is a potentially significant complication of hepatic artery infusion chemotherapy. In addition, we believe that the mechanism respons...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198606000-00026
更新日期:1986-06-01 00:00:00
abstract::Two patients with retained laparotomy pads after laparotomy had pain, abscess formation, and bleeding, with erosion of the pad into the small bowel and colon. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198604000-00026
更新日期:1986-04-01 00:00:00
abstract::We reviewed our experience with thyroid sonography of 60 patients with nonfunctioning (cold) solitary thyroid nodules proven by iodine 123 scan. Twenty-two patients had surgery; the remaining 38 had thyroid scan and ultrasound only. In the first group, the echograms did not demonstrate the surgically proven nodules in...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198409000-00024
更新日期:1984-09-01 00:00:00
abstract::Thoracic nerve root dysfunction (TNRD) manifested as abdominal pain is an infrequently reported condition. We present data on six patients who had chronic intermittent thoracoabdominal pain originating in the back. Diabetes and osteoarthritis of the spine were the chief causes of these symptoms. The electromyogram in ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198802000-00014
更新日期:1988-02-01 00:00:00
abstract::In most cases of congenital cyst of the extrahepatic biliary system, a single choledochal cyst is described. We have reported a patient with multiple intrahepatic and extrahepatic biliary cysts. Intraoperative cholangiograms demonstrated free reflux among the multiple choledochal cysts, with reflux into the intrahepat...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197805000-00036
更新日期:1978-05-01 00:00:00
abstract::In addition to assuring an adequate and safe blood supply, blood collection agencies are responsible for the well being of donors. Several aspects of the current blood donor experience may negatively impact donor health and require modification. Physicians need to be aware of health-related issues associated with bloo...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/SMJ.0b013e3181d3904f
更新日期:2010-04-01 00:00:00
abstract::This article summarizes the research base, probable mechanism of actions, and clinical applications of acupuncture. It offers the clinician a deeper understanding of appropriate conditions for which acupuncture may be useful, outlines how to integrate acupuncture into a clinical practice, and describes referral and tr...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/01.SMJ.0000140834.30654.0F
更新日期:2005-03-01 00:00:00
abstract::In an investigation of withdrawals and delays among students enrolled at the University of Tennessee College of Medicine over a four-year period, we found significantly higher rates of attrition among minority than nonminority students and among female than male enrollees. There were, however, no significant sex-relat...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198105000-00025
更新日期:1981-05-01 00:00:00
abstract::Family physicians and other medical care providers are beginning to realize the importance of a comprehensive assessment examination for elderly patients. The components of such an examination are well documented, and include not only the standard history and physical examination, but also evaluation of mental health,...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199108000-00005
更新日期:1991-08-01 00:00:00
abstract::A patient with thioridazine-hydrochloride-associated agranulocytosis is described and eight previously reported cases are reviewed. This complication is most likely due to a direct toxic effect on the bone marrow. As in our case, markers for an immunologically mediated mechanism have not been found. Thioridazine-hydro...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197701000-00051
更新日期:1977-01-01 00:00:00
abstract::An elderly man with previous tuberculosis exsanguinated from esophageal rupture of an atherosclerotic thoracic aneurysm. Because the patient refused angiography, the source of bleeding was discovered only at autopsy. Selected clinical and pathologic aspects of the case are discussed in relation to the different causes...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197907000-00042
更新日期:1979-07-01 00:00:00
abstract::We have described a case of chronic pancreatitis due to stenosing papillitis relieved by sphincteroplasty and removal of pancreatic duct stones, as opposed to a major pancreatic resection. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198310000-00033
更新日期:1983-10-01 00:00:00
abstract::Two patients receiving steroid therapy for sarcoidosis had a potentially fatal opportunistic infection that was difficult to differentiate from the underlying illness, but was successfully treated after the diagnosis was made. The effects of sarcoidosis on the immune system and the additional effects of steroid therap...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2001-01-01 00:00:00
abstract::Diagnosis and management of hand infections in the elderly can be challenging. The general principles of rest, elevation, compresses, and drainage when appropriate apply. Antibiotics are important to therapy. Review of data from elderly patients and comparison with a younger population having identical infections show...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198502000-00009
更新日期:1985-02-01 00:00:00
abstract::An 8 year-old girl had a large congenital nevus involving the posterior thigh, leg, and foot. The nevus on non-weight-bearing areas was resected, and the areas were resurfaced with artificial skin and ultra-thin split-thickness grafts. A good result was ultimately achieved. Our management of this case and the relative...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2001-03-01 00:00:00
abstract::Medical inpatients in inner-city hospitals have both potentially lead-related disorders and potential lead exposure. To see whether there is substantial unexpected lead intoxication in this population, we did a cross-sectional study of 117 consecutively admitted patients to a general medical ward of an inner-city univ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199605000-00003
更新日期:1996-05-01 00:00:00
abstract:BACKGROUND:The blood gas analyzer (BGA) has been considered the "gold standard" for pleural fluid pH determination. METHODS:We report the various methods used to measure pleural fluid pH by 277 acute care institutions who responded to a mailed questionnaire. The techniques used included the BGA (32%), dip stick or pH ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199902000-00010
更新日期:1999-02-01 00:00:00
abstract::I describe the case of a 25-year-old man who, after a scuba dive, had ocular barotrauma caused by mask squeeze. As in most cases, the condition occurred because the patient failed to exhale into the mask during descent to equalize the pressure within the mask. Although alarming in appearance, the condition is generall...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199407000-00015
更新日期:1994-07-01 00:00:00
abstract:OBJECTIVES:Obstructive sleep apnea (OSA) is a prevalent disorder that is associated with multiple medical consequences. Although in-laboratory polysomnography is the gold standard for the diagnosis of OSA, portable monitors have been developed and studied to help increase efficiency and ease of diagnosis. We aimed to a...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000543
更新日期:2016-10-01 00:00:00
abstract::We reviewed the first 100 consecutive patients treated with extracorporeal shock wave lithotripsy (ESWL) at one institution. A total of 115 treatments were delivered to 58 men and 42 women. Patients with calculi of various sizes were treated and compared for (1) length of hospitalization, (2) ancillary procedures, (3)...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198801000-00010
更新日期:1988-01-01 00:00:00
abstract::The accuracy of the noninvasive carotid system studies done in our laboratory during an 18-month period were reviewed. The usefulness of these procedures was found to be limited when used as a "blind" screen for extracranial vascular disease. The overall correlation with angiography was good, with few false-negatives ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198205000-00008
更新日期:1982-05-01 00:00:00
abstract:BACKGROUND:Oxybutynin is a tertiary amine and has chemical similarities like protamine sulfate. Protamine sulfate's effect on bacterial viability has been shown in some studies; however, there is scanty data regarding the effect of oxybutynin on bacterial viability. Accordingly, the aim of the present study was to inve...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.smj.0000305885.23903.71
更新日期:2008-03-01 00:00:00
abstract::Reported is the fifth known case of Addison's disease due to adrenal involvement by North American blastomycosis (Blastomyces dermatitidis infection). The fact that amphotericin B therapy precipitated an addisonian crisis suggests that patients with disseminated blastomycosis should have their adrenal function and res...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197707000-00028
更新日期:1977-07-01 00:00:00
abstract::Hepatitis C is a leading cause of liver failure and transplantation in the United States and a major public health issue. Studies have shown that patients with hepatitis C are at an increased risk of cardiovascular disease, which make statins of particular benefit in this patient population. However, the National Chol...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/SMJ.0b013e3181f0c6b4
更新日期:2010-10-01 00:00:00
abstract::Thoracic splenosis is rare, with fewer than two dozen reported cases. Patients uniformly have a history of splenectomy with combined abdominal and thoracic trauma. Clinical signs and symptoms are usually absent, and the condition is most often discovered on routine chest radiography. The interval between trauma and cl...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199811000-00013
更新日期:1998-11-01 00:00:00
abstract::This paper briefly reviews the available evidence for the influence of environmental and occupational factors in the development of cancer of the larynx. Although several occupational exposures have been suggested to play a role in the etiology of this disease, few have been convincingly confirmed. The strong associat...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-198307000-00020
更新日期:1983-07-01 00:00:00
abstract:OBJECTIVE:The literature shows that food insecurity (FI) can negatively affect the trajectory of many chronic illnesses. FI can be acutely severe for older adults, but screening for FI is not regularly performed in the hospital setting. Our goal was to develop a tool to screen for FI upon hospital discharge to identify...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000001007
更新日期:2019-08-01 00:00:00
abstract::Nitrogen, derived from breakdown of dietary amino acids as ammonia, is normally converted to urea and excreted. Impairment in the conversion process (called the urea cycle) can occur, either as a consequence of primary genetic defects or through secondary suppression of enzyme activity. Either process results in hyper...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199307000-00004
更新日期:1993-07-01 00:00:00