China 
Africa 
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High-Dose Chemotherapy with Haematopoietic Stem Cell Transplantation in Primary Systemic Vasculitis, Behcet’s Disease and Sjogren’s Syndrome
Published in Richard K. Burt, Alberto M. Marmont, Stem Cell Therapy for Autoimmune Disease, 2019
Christoph Fiehn, Manfred Hensel
The first step of treatment either in PSV, Behcet’s disease or in severe organ involvement of Sjogren’s syndrome should be effective and result in rapid remission induction, in order to limit organ damage. Induction therapy is followed by mild, long-term maintenance therapy for prevention or relapse. This maintenance therapy may lead to chronic and severe drug toxicity. The National Institutes of Health experience with Wegener’s granulomatosis reported the contribution of treatment toxicity to permanent damage in over 50% of their patients.25 In a large, international randomized trial in patients with ANCA-positive systemic vasculitis, severe or life-threatening adverse effects have been observed in 26% of patients (maintenance therapy with oral cyclophosphamide or azathioprine).26
Psychopharmacology in Aviation
Published in Carrie H. Kennedy, Gary G. Kay, Aeromedical Psychology, 2013
Bradford C. Ashley, Gary G. Kay
An entire chapter could be written about these newer antidepressant medications. When considering a specific antidepressant medication for use in the maintenance treatment of pilots it is helpful to use the basic conceptual template presented in this chapter. Given the rapid development of SSRI and related medications it is clear that each one will need to be considered individually with regard to its suitability for use in the aviation environment. Key points include low potential for sedation, minimal side-effects when used in maintenance therapy, minimal withdrawal side-effects if doses are missed, minimal or no drug–drug interactions, no long-term medical dangers with prolonged use, no masking of underlying medical conditions, and finally a demonstrated track record of safety, tolerability, and effectiveness. This may seem like an impossible set of requirements. However, several medications meet most of these criteria. These include sertraline, citalopram, escitalopram, and fluoxetine which are now listed as being eligible for aeromedical waiver (for example, FAA Special Issuance) by aeromedical regulatory agencies.
Drug use and pattern of injuries sustained by drivers involved in road traffic crashes
Published in Traffic Injury Prevention, 2021
Parisa Divsalar, Mehrnoosh Mohammadi, Kouros Divsalar
Methadone Maintenance Therapy (MMT) is the treatment of choice for opioid addiction. Although, there are a number of options available for addiction treatment nonetheless, MMT remains the most common treatment and for this purpose special drug rehab centers in prisons, government welfare centers, and detoxification clinics were established in Iran, but it seems that despite this national project, only a small percentage of addicts are receiving MMT, and most of whom underwent this treatment, abandoned it frequently, disbelieving the long-term treatment with MMT (Banazadeh et al. 2009). While there are no differences in traffic-related functions between the patients receiving MMT and the healthy controls, the risk of crash increases when methadone is used as a sedative, non-maintenance treatment or additional to regular daily dose (Baewert et al. 2007; Engeland et al. 2007; Strand et al. 2013).
Psychotropic substance abuse and fitness to hold a driving license in Italy
Published in Traffic Injury Prevention, 2019
Jennifer P. Pascali, Fabio Vaiano, Diego Palumbo, Federica Umani Ronchi, Francesco Mari, Elisabetta Bertol
In case of polydrug consumption, opiates are the class most often associated with cocaine in urine (25%). On the basis of recent data on opioid misuse across the United States and Canada, these data are alarming (Volkow et al. 2018). However, our protocol for urine confirmation did not help to distinguish between codeine, morphine, or heroin use, but the concomitant analysis of hair, when available, aimed at 6-MAM detection, was helpful because in most cases (57%) a positive opiate result was due to heroin use. For the remaining cases (absence of 6-MAM), it was not possible to exclude heroin abuse. In 5% of cases, positive results for morphine and codeine were not associated with an medical prescription. Methadone, the major drug used for opioid maintenance therapy in Italy, was associated with cocaine in hair in 28% of cases. It was associated with a medical prescription in all but a few cases (4 cases) during the period of study. Thus, it may be concluded that the risk of opioid misuse is rather limited in Italy as well in Europe (van Amsterdam and van den Brink 2015), but vigilance is needed. As further confirmation of these data, the results from hair testing confirmed a stable percentage of opiates and opioids over the period 2011–2016.