No abstract

IntroductionDrug abuse and overdoses are on the rise in West Virginia. Multiple socioeconomic and prescription-prescribing practices influenced this shift. The shifting burden of intravenous drug use to more rural areas has created unique challenges for patient access (medical attention, addiction education, rehabilitation), as well as created an avalanche of additional costs for hospital networks.MethodsWe analyzed sepsis cases from 2006 to 2015 to investigate whether different types of drug use have increased the odds of developing sepsis as compared to other forms of drug use. To investigate this aspect, the authors examined this relationship by using a logistical regression and a time series analysis of the total cases of drug use and infections.ResultsThe initial analysis investigated the association between drug use and the number of sepsis cases at Charleston Area Medical Center from 2006 to 2015 using a time series analysis. Results suggest that there are similar relationships between sepsis and sedative usage (p=0.016) and sepsis by mixed/other drug (p= 0.020) use. For logistic regression (n=2284), the infection models of sepsis/skin, endocarditis/skin infection, and osteomyelitis/skin infection showed several exposures significantly increased the risk of different infections. A drug user with a positive urine test for opiates is 80.8 percent more likely to develop sepsis as compared to skin infections (p=0.001). The use of sedatives also significantly increased the odds of developing sepsis by 83.2 percent (p=0.002).ConclusionSepsis left untreated will result in a high mortality rate. As illicit drug use increases, sepsis cases will increase. Further research is needed to understand the continued relationship between drug use and the incidence of sepsis. Based on the current evidence, sepsis appears to be slightly affected by drug use and seems to be influenced by sedatives and opiates but only at a marginal level.

IntroductionThe effect of insurance coverage on the health of at-risk populations is poorly understood in the Appalachian region of the United States. The goal of this study is to examine how different types of insurance coverage (Private Insurance, Medicare under 65, Medicare 65 or over, Medicaid and Self Pay) may influence cancer survival over time. This study analyzes colon, bladder, as well as combines anal, rectal, and esophageal cancers.MethodsWe systematically analyzed all West Virginia Cancer Registry patients between the years of 2000 and 2013 who was diagnosed with colon, bladder, anal, rectal, and esophageal cancers. Separate analysis examined colon (n = 927), bladder (n = 269), and combined anal, rectum, and esophageal cancers (n = 398). Cox proportional hazards models investigated the effect of insurance types on survival while controlling for age, sex, tobacco use, alcohol use, and cancer stage.ResultsOverall, tobacco use marginally significantly decreased colon cancer survival. Tobacco use had a suggestive relationship at hazards ratio at 1.150, 95% confidence interval: 0.9990-1.235, p = 0.052. The type of payer group did not alter survival. Older individuals tend to have a lower survival rate compared to those that are younger at the time of diagnosis. Also, late-stage cancer faced lower survival compared to those with early-stage cancer. Other results within stage groups corresponded to existing literature.ConclusionFor the three differing cancer groupings, there was no significant survival difference for patients by insurance type. The effect of tobacco usage on colon cancer survival merits further research. The study design could be improved by considering more risk factors such as patient comorbidities that might affect patient care and survival.

Objective: The effect of low birth weight as a result of dioxin-based exposure has been investigated through the existing literature, but the debate on exact point source and production is still debated. The Monsanto factory located in Nitro, West Virginia produced Agent Orange from 1948 to 1969. Methods: The vital statistics registry from the state of West Virginia of Kanawha county and Putnam county West Virginia. The production of dioxin and 2-4-5T was obtained from the legal files from (Civil Action No. 04-C-465) and the expert witness of Dr. Bruce Bell. In order to understand this relationship a time series analysis was conducted to compare 245T and dioxin and low-birthweight in Kanawha County and Putnam County, West Virginia. Results: The results suggest dioxin within Kanawha county had a suggestive relationship associated with dioxin production and low birthweight from 1948 to 1969 had a suggestive relationship of (p = 0.042). The comparison county of Putnam had no statistically significant relationship between low birthweight and dioxin production (p = 0.203). Agent Orange (2-4-5t) was also considered and measured within the counties of Kanawha and Putnam Counties, within these two counties no statistically significant relationship was observed. Conclusions: In conclusion the association between dioxin and low birthweight still requires more research but this analysis illustrates that there appears to be a suggestive relationship that exists within Kanawha County, West Virginia as related to the production of and effect of the by-product of dioxin.

No abstract