Potential for repurposing oral hypertension/diabetes drugs to decrease asthma risk in obesity.

OBJECTIVE: Risk for asthma in the overweight/obese may be mediated by adiponectin and peroxisome proliferator activated receptor pathways and may be reduced by the use of oral drugs impacting these pathways, such as angiotensin converting enzyme inhibitors (ACE-I), thiazolidinediones (TZD), and angiotensin receptor blockers (ARB). Our study objective was to determine whether ACE-I, TZD, and/or ARB use in overweight/obese adults with diabetes mellitus and/or hypertension is associated with a lower risk for incident asthma. METHODS: Using an existing cohort of American veterans, we performed a longitudinal data analysis over 15 years. Exposure was defined by the prescription pickup of ACE-I, TZD, and/or ARB for at least 4 weeks. The outcome, time until new-onset of clinician-diagnosed asthma, was studied using survival analysis. The propensity scoring method controlled for treatment selection bias. RESULTS: 2.83 million eligible veterans, including 77,278 with incident asthma, were studied. As compared to those unexposed, the use of ACE-I alone, TZD alone, or their combinations were each associated with decreased risk for incident asthma (hazard ratios of 0.88, 0.74, and 0.20, respectively; p < 0.001 for all analyses in the fully adjusted statistical models). TZD lowered the risk among racial/ethnic minority subjects more than among White participants (p < 0.001). On the other hand, ARB use alone or in combination with TZD was associated with a higher risk for incident asthma. CONCLUSIONS: Use of ACE-I and/or TZD was associated with a lower risk for incident asthma in overweight/obese patients with diabetes mellitus and/or hypertension.

Methamphetamine Abuse Trends in Psychiatric Emergency Services: A Retrospective Analysis Using Big Data.

OBJECTIVE: This exploratory retrospective study assessed demographic and hospital utilization characteristics of patients presenting with methamphetamine use to an urban psychiatric emergency service in New Mexico. METHODS: De-identified data from patients presenting to PES from 2011 to 2015 were extracted from our health system. Descriptive statistics were used to characterize the study population. We employed bivariate analyses to assess the relationship between methamphetamine use and patient demographics. RESULTS: Methamphetamine use increased faster than any other drug tested during the study's time period. Compared to non-methamphetamine patients, methamphetamine use was associated with a shorter PES stay when the patient was in the PES more than 12 h. CONCLUSIONS: Patients with methamphetamine use are increasingly seeking emergency psychiatric evaluations. Methamphetamine use may impact certain racial, ethnic, and socioeconomic classes disproportionately. Further health service delivery studies are needed to develop clear, evidence-based interventions and policy recommendations to address the methamphetamine crisis in the United States.