position:professor of epidemiology

  • Long-Term Use of Antibiotics Tied to Heart Risks - The New York Times
    https://www.nytimes.com/2019/04/24/well/live/long-term-use-of-antibiotics-tied-to-heart-risks.html

    Using antibiotics for two months or longer may be linked to an increase in a woman’s risk for cardiovascular disease.

    The finding, published in the European Heart Journal, applied to women who used the drugs when they were 40 and older.

    Researchers used data on 36,429 women free of cardiovascular disease at the start of the study who were participating in a continuing long-term health study. Beginning in 2004, the women reported their use of antibiotics.

    Over seven years of follow-up, there were 1,056 cases of cardiovascular disease. Compared with women who never used them, women who used antibiotics for two months or longer during their 40s and 50s had a 28 percent increased risk for cardiovascular disease, and women over 60 who used them that long had a 32 percent increased risk.

    The study controlled for family history of heart attack, body mass index, hypertension, the use of other medications and other factors.

    “It’s difficult to distinguish the effect of the antibiotic on cardiovascular disease from the effect of the disease for which the antibiotic was taken, and that’s a potential limitation of the study,” said the lead author, Lu Qi, now a professor of epidemiology at Tulane University. “But that we are seeing the effect of the disease instead of the antibiotic is unlikely, because we see the effect in so many different diseases where antibiotics are used.”

    #antibiotique #risque_cardiovasculaire #femmes

  • Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017 - The New York Times
    https://www.nytimes.com/2018/08/15/upshot/opioids-overdose-deaths-rising-fentanyl.html

    Fentanyl is a big culprit, but there are also encouraging signs from states that have prioritized public health campaigns and addiction treatment.

    By Margot Sanger-Katz

    Aug. 15, 2018

    Drug overdoses killed about 72,000 Americans last year, a record number that reflects a rise of around 10 percent, according to new preliminary estimates from the Centers for Disease Control. The death toll is higher than the peak yearly death totals from H.I.V., car crashes or gun deaths.

    Analysts pointed to two major reasons for the increase: A growing number of Americans are using opioids, and drugs are becoming more deadly. It is the second factor that most likely explains the bulk of the increased number of overdoses last year.

    A large government telephone survey suggests that around 2.1 million Americans had opioid use disorders in 2016, but that number may be an undercount because not all drug users have telephones and some may not mention their drug use because of the stigma. Dr. Ciccarone said the real number could be as high as four million.

    The number of opioid users has been going up “in most places, but not at this exponential rate,” said Brandon Marshall, an associate professor of epidemiology at the Brown University School of Public Health. “The dominant factor is the changing drug supply.”

    Strong synthetic opioids like fentanyl and its analogues have become mixed into black-market supplies of heroin, cocaine, methamphetamine and the class of anti-anxiety medicines known as benzodiazepines. Unlike heroin, which is derived from poppy plants, fentanyl can be manufactured in a laboratory, and it is often easier to transport because it is more concentrated.

    Congress is debating a variety of bills to fight the epidemic. Many of the measures, which have passed the House but have not reached the Senate floor, are focused on reducing medical prescriptions of opioids, and are meant to reduce the number of new drug users. But the package also includes measures that could expand treatment for people who already use opioids.

    The epidemic could also intensify again. One worrying sign: Dr. Jones said there is some early evidence that drug distributors are finding ways to mix fentanyl with black tar heroin, which could increase death rates in the West. If that becomes more widespread, the overdose rates in the West could explode as they have in parts of the East.

    #Opioides

  • America’s opioid epidemic began more than a century ago – with the civil war | Science | The Guardian
    https://www.theguardian.com/science/2017/dec/30/americas-opioid-epidemic-began-more-than-a-century-ago-with-the-civil-w

    An estimated two million people abused opiates during the war, after using drugs disseminated by healthcare providers, doctors and nurses to stem pain

    For many Americans, it was the prescription of a well-meaning physician that sent them down the dark road.

    Aggressive marketing and over-prescribing of painkillers touched off a scourge of opiate addiction and Congress, pushed by the destruction it had wrought, introduced a new law to reform painkiller prescribing.

    It was 1915 and Congress was considering what would become the first law to criminalize drug use, the Harrison Narcotic Act. By this time, addiction had already touched middle-class housewives, immigrants, veterans and even physicians hoping to soothe their own aches and pains. Between the 1870s and 1880s, America’s per capita consumption of opiates had tripled.

    More than a century later, Americans are fighting some of the same demons.

    Since 1999, more than half a million Americans have died of drug overdoses. Recent data shows the trend accelerated in 2016, when 63,600 people were killed by overdoses and the rate of Americans dying increased by 21%.

    “There was a massive opioid epidemic after the civil war,” said Robert Heimer, a professor of epidemiology and pharmacology at Yale University School of Public Health. “Except is wasn’t a black market – it was a perfectly legal market filled with patent medicines that contained not just cocaine and opiates, morphine mostly, but also alcohol.”

    Laudanum, Heimer said, “was commonly taken as a relief of colds, coughs, and in stronger form was particularly good for lung diseases such as tuberculosis, which was common at the time, in addition to being widely used in combat situations to facilitate amputations”.

    Where Purdue Pharma marketed Oxycontin to doctors as a “continuous around-the-clock analgesic” formulation of semi-synthetic oxycodone great for chronic pain, Mrs Winslow’s Soothing Syrup marketed morphine and alcohol to parents as a “perfectly harmless and pleasant” way to produce “quiet sleep, by relieving the child from pain”.

    History, Courtwright said, offers some “grounds for optimism”. Beginning in the 1890s, physicians began to criticize colleagues who reached for the prescription pad when patients had aches and pains; pharmacists refused to sell heroin or cocaine (then both legal); and in 1906 muckraking journalists and campaigners successfully argued for reforms to end the sale of patent medicines.

    By 1915, Courtwright argues in the New England Journal of Medicine, “the Harrison Act closed the barn door after the horse was back in”. Problematically, the Harrison Act also became the first law to criminalize drug use and opiate maintenance therapies, such as methadone and buprenorphine.

    #Opioides #Histoire #Addiction #Laudanum

  • Tracking Malaria With Cell Phones - ABC News
    http://abcnews.go.com/blogs/health/2012/10/11/tracking-malaria-with-cell-phones

    Harvard researchers found they could track the spread of malaria in Kenya using phone calls and text messages from 15 million mobile phones.
    “Before mobile phones, we had proxies for human travel, like road networks, census data and small-scale GPS studies,” said study author Caroline Buckee, an assistant professor of epidemiology at the Harvard School of Public Health. “But now that mobile phones have spread throughout the world, we can start using these massive amounts of data to quantify human movements on a larger scale and couple this data with knowledge of infection risk.” (...) By studying networks of human and parasite movement, the team could then determine primary sources of #malaria and who was most likely to become infected.

    #téléphonie #mobile #santé #épidémiologie #kenya #paludisme via @confluences