No abstract

Buprenorphine abuse is common worldwide. Rates of abuse and diversion of three sublingual buprenorphine formulations (single ingredient tablets; naloxone combination tablets and film) were compared. Data were obtained from the Researched Abuse, Diversion, and Addiction-Related Surveillance (RADARS) System Poison Center, Drug Diversion, Opioid Treatment (OTP), Survey of Key Informants' Patients (SKIP), and College Survey Programs through December 2012. To control for drug availability, event ratios (rates) were calculated quarterly, based on the number of patients filling prescriptions for each formulation ("unique recipients of a dispensed drug," URDD) and averaged and compared using negative binomial regression. Abuse rates in the OTP, SKIP, and College Survey Programs were greatest for single ingredient tablets, and abuse rates in the Poison Center Program and illicit diversion rates were greatest for the combination tablets. Combination film rates were significantly less than rates for either tablet formulation in all programs. No geographic pattern could be discerned.

Pruritus (itching) is a common and distressing complaint after injury. The purpose of this study was to investigate self-reported postburn pruritus in a large, multisite cohort study of adult burn survivors. Descriptive statistics, general linear regression, and mixed model repeated measures analyses were employed to test statistical significance. Two cohorts of adult burn survivors were studied. Group 1 participants (n = 637) were injured from 2006 to 2010 and were followed up prospectively for 2 years from the time of injury. Prevalence and severity of pruritus were compared across multiple subgroups. Prevalence of pruritus at discharge, 6, 12, and 24 months following injury were 93, 86, 83, and 73%, respectively. Regression results established that %TBSA-burn and %TBSA-grafted were correlated to itch intensity values. Group 2 participants (n = 336) were injured 4 to 10 years before an assessment using the validated 5-D Itch Scale. Many patients (44.4%) reported itching in the area of the burn, graft, or donor site. Within this group, 76% reported itching for <6 hours/day, and 52 and 29% considered itch intensity to be mild or moderate, respectively. This study confirms that the prevalence of burn pruritus is high, initially affecting >90% and persisting for >40% of long-term burn survivors. New predictors for postburn itch were identified to include younger age, dry skin, and raised/thick scars. Characterization of the impact of postburn pruritus on leisure, vocation, and sleep are quantified for those long-term survivors suffering from postburn pruritus.

As coronavirus disease 2019 (COVID-19) spreads in communities across America, local, state, and federal agencies are working to reduce the impact of food insecurity. The US Department of Agriculture (USDA) defines food insecurity as inadequate access to affordable and nutritious food. In 2018, 11% of US households were considered food insecure, meaning they had difficulty at some time during the year obtaining enough food for all members of their household, due to lack of resources. 1 Pandemics adversely affect food supply chains and as COVID-19 impacts the lives of millions of Americans, the greatest burden will be felt by low-income families. 2 Although drastic measures are being taken to reduce the impact of COVID-19, food-insecure families with food allergies (FAs) and other food-related conditions remain vulnerable. FA is a potentially life-threatening condition, affecting 10.6% of adults 3 and 7.6% of children in the United States. 4 Patients with FA must eliminate allergens from their diet, resulting in costly grocery bills and an impaired quality of life. 5 Although 170 foods have been reported to cause allergic reactions, the 9 most common food allergens are peanut, milk, egg, soy, tree nut, wheat, fish, shellfish , and sesame. Elimination of a common allergen, especially milk or wheat, can have a major impact on the nutritional needs of a child, 6 negatively affecting short-and