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Editorial: Is TIPSS implantation effective in patients with portal hypertensive gastropathy?
No full textDetection of phosphatidylethanol after ethanol intake with targeted blood alcohol concentrations of 0.6 g/kg and 0.75 g/kg
No full textAlcohol consumption is widespread in most western countries such as Germany and a relevant risk factor for morbidity and mortality. Sensitive detection of alcohol consumption using suitable markers is therefore of central importance for clinical and forensic diagnostics. Direct alcohol markers are non-oxidative products of ethanol, which are produced in the body during the degradation of ethanol and provide high sensitivity and specificity. Phosphatidylethanol (PEth) is a promising marker for detecting alcohol consumption in the past days to weeks. The aim of this study was to determine the minimum amount of ethanol for a single alcohol consumption that leads to a detectable increase in blood PEth concentration. Therefore, 12 participants were recruited and, after four weeks of abstinence, drinking tests were carried out with target blood alcohol concentrations (BAC) of 0.6 g/kg and 0.75 g/kg. The PEth samples were obtained as dried-blood spots on the test day and the three following days and analyzed using LC-MS/MS. The result of the study were a detectable increase of PEth in the blood above limit of detection after both drinking events in all participants and an increase in PEth above the cutoff concentration for abstinence of 20 ng/mL in 9/12 (75%) and 7/12 (58%) participants, respectively, from a minimum BAC of 0.48 g/kg. These results make PEth appear promising as a marker for controlled moderate alcohol consumption
Advancing toxicovigilance of recreational drugs, including new psychoactive substances, by using data from four European poison centres
No full textIntroductionCommon recreational drugs and new psychoactive substances pose challenges to public health. This study investigated the feasibility of merging cases of recreational drug poisoning reported to European poison centres.MethodsFour European poison centres (Freiburg, Germany; the Netherlands; Sweden and Switzerland) collaborated in a retrospective, observational study. We collected aggregated data on poisonings with 11 common recreational drugs and case-by-case data on poisonings with new psychoactive substances in 2021 by using anonymized data from electronic case reports.ResultsIn 2021, 2.0% of the poison centre calls involved poisonings with recreational drugs. The poison centres were contacted about 3,705 patients, involving 4,380 drug exposures, of which 3,708 were common recreational drugs, and 672 were new psychoactive substances. Per million inhabitants, the poisoning rate with common recreational drugs varied between 48 (Freiburg) and 145 (Sweden). Poisonings with amfetamine (22%), cocaine (20%), all delta-9-tetrahydrocannabinol-containing preparations (20%), and 3,4-methylenedioxymetamfetamine (13%) exposures were most frequent. The poisoning rate per million inhabitants with new psychoactive substances varied between two (Switzerland) and 29 (Netherlands). Cathinones (43%), designer benzodiazepines (28%), and phenethylamines (13%) were the most commonly involved new psychoactive substance classes. Symptoms following cathinone poisoning were tachycardia (35%) and hypertension (13%), while following designer benzodiazepines, somnolence was most prominent (38%). The majority of users of new psychoactive substances were male (67%), 55% were between 18 and 30 years, and 8% involved minors (DiscussionThis study showed the feasibility of merging data on recreational drug poisoning collected by poison centres in four countries. Despite underestimating the overall incidence of drug-related health incidents, poison centre data offers national coverage, unlike other data sources, such as drug-related emergency department visits.ConclusionThis multi-centre, multi-national study reported a substantial annual number of recreational drug poisonings, with a variable proportion of new psychoactive substances. It shows that poison centre data offers detailed insights into exposures to common recreational drugs and new psychoactive substances, user characteristics, and symptoms. It can be used for comprehensive monitoring of drug-related health incidents on a multi-national level
Assessing dermatologists-venereologists' awareness, vigilance and attitude towards LGBT individuals: a cross‐sectional study in Greece
No full textEmpire and imagination in Roman Sardis: the Wadi B Temple of the imperial cult as mnemonic cluster
No full textThis chapter studies the entanglement of local imperial history and imperial worship in the Roman-period city of Sardis, modern-day Türkiye. In constructing its historical narrative and civic identity Sardis differentiated itself from surrounding cities, which mostly took Greek (mythological) figures and events for promotional strategies and the formation of collective memory. Sardis’ strategies of identity formation and its uses of imperial and mythological pasts were responses to the competition that arose between the cities of the province of Asia in the context of the imperial framework of the Roman empire. Looking at archaeological, epigraphic, and numismatic evidence from the period, this chapter discusses to what extent a post-imperial Lydian memoryscape was constructed in the provincially- organised temple of the imperial cult at Sardis. I will argue that the sanctuary dedicated for the veneration of the emperors in the very centre of the city not only served as a focal point of imperial allegiance, but also of the juxtaposition of contemporary imperial power with civic, post-imperial history and memory
Extractivist valorization in industrial forestry in the Global North – elements of an analytical framework and illustration for the cases of Finland and Alberta, Canada
No full textThis paper contributes to the political economic analysis of industrial forestry in the Global North (GN) by introducing and applying elements of an analytical framework for extractivist valorization. The proposed framework serves as a complement, systematization, and extension of the concepts of valorization and (post-fossil) extractivism. It scrutinizes the political-economic constellation and social as well as ecological sustainability challenges of current dominant practices in industrial forestry in the GN. The (potential) contribution and role of industrial forestry in social-ecological transformation processes is contested, although forestry is often perceived as a sustainable sector per se, and its services and products are crucial for many sustainability, bioeconomy, and decarbonization strategies. With the proposed analytical framework, the paper investigates forestry as an industry that socially and economically mediates relationships between individuals, society, and nature. The paper illustrates the analytical potential of the proposed framework by applying it to two exemplary cases of industrial forestry: Finland and the Canadian province of Alberta. The paper concludes that such a framework can provide relevant insights into the sustainability challenges in industrial forestry in both cases examined. New pathways of valuing and using forests need to be actively pursued to integrate the forest sector into the broader project of social-ecological transformations
A cross‐sectional survey exploring knowledge, beliefs and barriers to whole food plant‐based diets amongst registered dietitians in the United Kingdom and Ireland
No full textBackgroundPlant-based diets (PBDs) have gained popularity in recent years due to their co-benefits for human and planetary health. Although clinical guidelines now recommend well-balanced PBDs, it remains unclear how dietitians in the United Kingdom (UK) and Republic of Ireland (ROI) view such diets and their implementation in practice. This study aimed to evaluate the perspectives of registered dietitians (RDs) on the role of a whole food plant-based diet (WFPBD) in clinical practice.MethodsA cross-sectional online survey was conducted amongst RDs in the UK and ROI between September and November 2023.ResultsA total of 335 RDs participated in the survey. Most RDs (76%) agree that a well-planned WFPBD is suitable for all stages of life, with some (48%) expressing concerns over the risk of malnutrition and micronutrient deficiencies. Three-quarters of RDs (75%) incorrectly thought that plant protein is incomplete, necessitating protein combining. A WFPBD was on average ranked fourth out of 14 dietary strategies for managing some of the leading non-communicable diseases. Excluding dairy and eggs was the primary reason preventing RDs from personally adopting a WFPBD, whereas meal preparation and cost were the main barriers for their clients. The majority of RDs (79%) feel they did not receive sufficient education on WFPBDs, with 58% agreeing there are insufficient evidence-based resources available in their field. Only 33% feel supported when advocating for a WFPBD in their workplace.ConclusionsAlthough many RDs view WFPBDs as viable and clinically relevant, significant barriers to their implementation exist, underscoring the need for enhanced education and support
Therapeutic drug monitoring in children and adolescents with schizophrenia-spectrum, affective, behavioural, tic and other psychiatric disorders treated with aripiprazole: results of the TDM-VIGIL pharmacovigilance study
No full textAripiprazole is approved for various severe mental disorders in adults and adolescents. However, off-label prescribing is common, especially in children and adolescents (youth) in whom aripiprazole therapeutic serum level reference ranges are lacking for any disorders. The aim of the study was to evaluate the relationship between aripiprazole dose and serum concentrations and provide further knowledge on the use of aripiprazole in order to improve drug safety and effectiveness in the treatment of minors. The clinical course of youth treated with aripiprazole in the multicentre pharmacovigilance study TDM-VIGIL was systematically followed and serum concentrations measured. Sex, age, weight and comedications were analysed to identify possible effect modifiers. A preliminary therapeutic reference range was estimated for youth with schizophrenia-spectrum disorders, affective disorders and behavioural/emotional/tic disorders coded as treatment responders based on a Clinical-Global Impressions-Improvement (CGI-I) score of much or very much improved. In 93 youth (mean age = 15.2 ± 2.6, range = 7.4–18.2 years, females = 53%, CGI-Severity = 4.4 ± 1.1, responders = 64%), a positive, moderate correlation between the weight-normalized daily dose (WNDD) and aripiprazole serum concentration (=0.791, p < 0.0001) was found. The WNDD and co-medications that interact with CYP2D6 and CYP3A4 affected aripiprazole serum levels, explaining 64% of the variance. In patients within the preliminary therapeutic ranges determined by interquartile ranges (IQRs), slightly better outcomes and fewer adverse drug reactions were found versus patients within preliminary therapeutic ranges determined by the mean ± SD. The preliminary reference range for paediatric patients with schizophrenia-spectrum disorders calculated by the IQR showed an identical lower threshold (100–230 ng/ml) compared to adult schizophrenia-spectrum disorders patients (100–350 ng/ml). The preliminary therapeutic ranges for patients with affective disorders was: 60–160 ng/ml and for patients with behavioural/tic disorders 60–140 ng/ml. The therapeutic reference ranges for aripiprazole in youth estimated via the 25th and 75th IQRs may result in more clinically relevant therapeutic windows. Further studies need to confirm these results, especially in patients with affective and behavioural/tic disorder diagnoses
