Assuntos
Antivirais/uso terapêutico , Ética Médica , Política de Saúde , Hepatite C/complicações , Hepatite C/tratamento farmacológico , Interferons/uso terapêutico , Abuso de Substâncias por Via Intravenosa/complicações , Suspensão de Tratamento , Antivirais/efeitos adversos , Hepatite C/epidemiologia , Humanos , Interferons/efeitos adversos , Futilidade Médica , Cooperação do Paciente , Seleção de Pacientes , Guias de Prática Clínica como Assunto , Preconceito , Recidiva , Risco , Abuso de Substâncias por Via Intravenosa/terapia , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/terapia , Estados Unidos/epidemiologiaRESUMO
Skin and soft-tissue abscesses, a common problem among injection drug users (IDUs), result in serious morbidity for the patient and costly hospitalizations for incision and drainage; however, there has been little etiologic or preventive epidemiologic research on this problem. We performed a case-control study that enrolled 151 IDUs who had been given a new diagnosis of abscess requiring incision and drainage (cases) and 267 IDUs who did not have abscess or other bacterial infection during the previous year and who were stratum-matched to cases according to age, sex, and race (controls). Subcutaneous or intramuscular, instead of intravenous, injection is a major risk factor for abscess among IDUs. The injection of a cocaine and heroin mixture, or "speedball," may predispose patients to develop abscess by inducing soft-tissue ischemia. Cleaning the skin with alcohol before injection was found to have a protective effect. Neither human immunodeficiency virus nor human T-lymphotropic virus type II seropositivity was significantly associated with abscess.
