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Author: Michael Krausz (130)



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Oct
2017

The number of homeless people in Germany is increasing. Studies from multiple countries have shown that most homeless people suffer from mental illnesses that require treatment. Accurate figures on the prevalence of mental illness among the homeless in Germany can help improve care structures for this vulnerable group.

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Jan
2018

Evidence supports the effectiveness of Housing First (HF) programmes for people who are experiencing homelessness and mental illness; however, questions remain about its use in people with comorbid substance use disorders (SUD). The aim of this project was to test whether SUD modifies the effectiveness of an HF intervention.
Secondary analysis of data from a randomized controlled trial of HF versus treatment-as-usual (TAU) with 24-month follow-up, comparing those with and without SUD at trial entry.

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Jan
2018

To determine the effectiveness of injectable hydromorphone and dicaetylmorphine for Indigenous participants in the Study to Assess Longer-term Opioid Medication Effectiveness (SALOME) clinical trial. The study additionally aims to explore the prevalence and frequency of crack cocaine use among subgroups of participants (by gender and ethnicity). This secondary analysis is particularly relevant given the current need for expanded medication assisted treatments for opioid dependence across North America.

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Mar
2017

The indications and methods of parathyroid autotransplantation in children and adults are reviewed, with special emphasis on the methods of immediate transplantation and delayed autotransplantation after cryopreservation. Parathyroid autotransplantation is performed during surgery when all four parathyroid glands have been intentionally resected in parathyroid hyperplasia, or when all four glands were inadvertently damaged during total thyroidectomy, or recurrent neck surgery. When parathyroid damage is suspected during thyroid or extensive neck surgery, cryopreservation of a parathyroid gland is performed.

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Jan
2017

Minimally Invasive Parathyroidectomy (MIP) has become the treatment of choice of Primary Hyperparathyroidism (PHPT) caused by an adenoma. In the present investigation we describe our experience with MIP performed under local anesthesia.
MIP was performed on 454 of 496 patients (91.

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May
2017

To test whether there are gender differences in treatment outcomes among patients receiving injectable opioids for the treatment of long-term opioid-dependence. The study additionally explores whether men and women have different perceptions of treatment effectiveness.
This study is a secondary analysis from SALOME, a double-blind, phase III, randomized controlled trial testing the non-inferiorirty of injectable hydromorphone to injectable diacetylmorphine among 202 long-term street opioid injectors in Vancouver (Canada).

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Jul
2017

To review the safety profile of injectable hydromorphone and diacetylmorphine and explore if adverse events (AEs) or serious adverse events (SAEs) were associated with dose and patterns of attendance.
This was a non-inferiority randomized double-blind controlled trial (Vancouver, Canada) testing hydromorphone (n=100) and diacetylmorphine (n=102) for the treatment of severe opioid use disorder. Medications were delivered under the supervision of trained Registered Nurses up to three times daily.

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Jul
2017

To examine the factors associated with incident traumatic brain injury (TBI) among homeless and vulnerably housed persons over a 3-year follow-up period.
Data were obtained from the Health and Housing in Transition study, which tracked the health and housing status of 1190 homeless or vulnerably housed individuals in 3 Canadian cities for 3 years.
Main measure was self-reported incident TBI during the follow-up period.

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Apr
2017

Four-dimensional parathyroid computed tomography (4DCT) is a relatively new parathyroid imaging technique that provides functional and highly detailed anatomic information about parathyroid tumors.
To assess the accuracy of 4DCT for the preoperative localization of parathyroid adenomas (PTAs) in patients with biochemically confirmed primary hyperparathyroidism (PHPT) and a history of failed surgery or unsuccessful localization using 99mTc-sestamibi scanning and ultrasonography.
Between January 2013 and January 2015, 55 patients with PHPT underwent 4DCT at Hillel Yaffe Medical Center, Hadera, Israel.

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Dec
1969

Substance use treatment is often performed inside locked wards. We investigate the effects of adopting a policy of open-door treatment for a substance use treatment and dual diagnosis ward.
This is a prospective open-label study investigating 3-month study periods before opening (P1), immediately after (P2), and 1 year after the first period (P3).

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Dec
1969

Links between Bipolar Disorder (BD) and medical conditions are increasingly reported. Traumatic Brain Injury (TBI) is a prevalent medical condition found in homeless populations. urdens associated with BD in the homeless population.

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Jul
2017

The Hotel Study was initiated in Vancouver's Downtown East Side (DTES) neighborhood to investigate multimorbidity in homeless or marginally housed people. We evaluated the clinical effectiveness of existing, illness-specific treatment strategies and assessed the effectiveness of health care delivery for multimorbid illnesses.
For context, we mapped the housing locations of patients presenting for 552,062 visits to the catchment hospital emergency department (2005-2013).

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Dec
2017

Chronic pain is an important public health issue. However, characteristics and needs of marginalized populations have received limited attention. Studies on prevalence and correlates of chronic pain among homeless persons are lacking.

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Mar
2017

Recently, there has been a growing interest in using opium tincture (OT) for treating opioid dependence in certain regions. We aimed to assess the evidence on its safety and efficacy for this indication.
We searched several databases (CENTRAL, Medline, EMBASE, Web of Science, PsychINFO, ProQuest Dissertation and Theses Database, Iran Medex, clinicaltrials.

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Oct
2016

Introduction Trauma patients in the extremes of age may require a specialized approach during a multiple-casualty incident (MCI). Problem The aim of this study was to examine the type of injuries encountered in children and elderly patients and the implications of these injuries for treatment and organization.
A review of medical record files of patients admitted in MCIs in one Level II trauma center was conducted.

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Oct
2016

Although youth homelessness presents a significant public health problem, the needs of homeless youths with mental illness, as distinct from adults, are not well understood. This study examined the unique demographic, clinical, and service use characteristics of homeless youths.
At Home/Chez Soi was a large randomized controlled trial of the Housing First model in five cities in Canada.

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Dec
1969

There is controversy about which outcome parameters should be employed to assess substance use treatment. Subjective measures of medication-assisted treatment (MAT) of opioid dependence are increasingly important. However, while patients' perspectives have been examined, the caregivers' views remain largely unknown.

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May
2016

Diacetylmorphine hydrochloride (the active ingredient in heroin), delivered under supervision, is effective for the treatment of severe opioid use disorder. However, owing to political and regulatory barriers, it is not available in many settings around the world, which limits the options for many long-term street opioid injectors not attracted into or retained in available treatments.
To test if injectable hydromorphone hydrochloride is noninferior to injectable diacetylmorphine in reducing illicit heroin use for chronic injection opioid users after 6 months of intervention.

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Mar
2017

Mental illness and substance use are overrepresented within urban homeless populations. This paper compared substance use patterns between homeless individuals diagnosed with schizophrenia spectrum (SS) and bipolar disorders (BD) using the Mini-International Neuropsychiatric Interview. From a sample of 497 subjects drawn from Vancouver, Canada who participated in the At Home/Chez Soi study, 146 and 94 homeless individuals were identified as BD and SS, respectively.

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Mar
2015

Lessons from the creation of Canada's poorest postal code.

Lancet Psychiatry 2015 Mar 25;2(3):e5. Epub 2015 Feb 25.
Michael Krausz, Kerry Jang

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Jan
2016

Epidemiologic studies demonstrated higher incidence of thyroid cancer in patients with multinodular goiters compared to the general population. The aim of this study was to evaluate the risk of finding significant thyroid cancer in patients undergoing thyroidectomy for presumed benign disease.
The records of 273 patients operated for indications other than cancer or indeterminate cytology were reviewed and analyzed.

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Aug
2015

Socially disadvantaged people experience greater risk for illnesses that may contribute to premature death. This study aimed to evaluate the impact of treatable illnesses on mortality among adults living in precarious housing.
A prospective cohort based in a community sample.

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Aug
2015

Homelessness, substance use, and mental disorders each have been associated with higher rates of emergency department (ED) use and hospitalization. We sought to understand the correlation between ED use, hospital admission, and substance dependence among homeless individuals with concurrent mental illness who participated in a 'Housing First' (HF) intervention trial.
The Vancouver At Home study consisted of two randomized controlled trials addressing homeless individuals with mental disorders who have "high" or "moderate" levels of need.

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Dec
1969

Severe maxillofacial and neck trauma exposes patients to life threatening complications such as airway compromise and hemorrhagic shock. These conditions require rapid actions (diagnosis and management) and a strong interplay between surgeons and anesthesiologists. Effective airway management often makes the difference between life and death in severe maxillofacial and neck trauma and takes initial precedence over all other clinical considerations.

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Jan
2015

Women living in poor and vulnerable neighbourhoods like Vancouver's Downtown Eastside (DTES) face multiple burdens related to the social determinants of health. Many of them struggle with addiction, are involved in the sex trade and experience homelessness and gender-based violence. Such evidence suggests that psychological trauma is also a common experience for these women.

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Jan
2015

Women living in poor and vulnerable neighbourhoods like Vancouver's Downtown Eastside (DTES) face multiple burdens related to the social determinants of health. Many of them struggle with addiction, are involved in the sex trade and experience homelessness and gender-based violence. Such evidence suggests that psychological trauma is also a common experience for these women.

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Sep
2016

We examined the hypothesis that exposure to childhood maltreatment increases the vulnerability to Adult Victimization (AV) in a homeless population (N = 500). We also investigated the effects of specific types (emotional, physical, and sexual) and cumulative experience of childhood maltreatment on AV, and whether gender moderates these relationships. All three groups with AV experience (emotional, physical, and sexual) indicated higher exposure to childhood abuse and cumulative maltreatment, and those who were sexually victimized as an adult showed higher exposure to childhood neglect.

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May
2015

Homeless individuals are an extremely vulnerable and underserved population characterized by overlapping problems of mental illness and substance use. Given the fact that mood disorders are frequently associated with substance use disorders, we wanted to further highlight the role of excitement in substance abuse. Patterns of substance abuse among homeless suffering from unipolar and bipolar depression were compared.

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Dec
2014

Due to the high prevalence of psychological disorders and the lack of access to care among Canadian youth, the development of accessible services is increasingly important. eMental Health is an expanding field that may help to meet this need through the provision of mental health care using technology.
The primary goals of the study are to explore youth experiences with traditional and online mental health resources, and to investigate youth expectations for mental health websites.

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Dec
1969

Individuals living in single-room occupancy (SRO) hotels constitute a socially marginalized group with exposure to multiple factors with adverse effects on neurocognition, including substance use, viral infection, psychiatric illness, and brain injury. Consequently, marked heterogeneity in neurocognitive functioning is observed. This study aimed to identify and describe distinct neurocognitive profiles within a marginally housed sample.

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Sep
2014

Youth homelessness is on the rise in North America, yet this vulnerable population is rarely studied and compared with adults. This paper aimed to study the homeless youth and identify specific vulnerabilities, which rendered them different from the adult homeless population. It also aimed to describe the youth homeless population and their significant co-morbidities.

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Dec
2015

High rates of substance use, especially cannabis and stimulant use, have been associated with homelessness, exposure to trauma, and involvement with the criminal justice system. This study explored differences in substance use (cannabis vs. stimulants) and associations with trauma and incarceration among a homeless population.

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Sep
2014

Ventriculoperitoneal shunts (VPS) are a common treatment for hydrocephalus. Placement of the distal abdominal catheter can be difficult in the setting of advanced age, previous abdominal surgeries, obesity, or chronic illnesses. At our institute, complex patients are treated using a multidisciplinary team of a neurosurgeon and a laparoscopic surgeon.

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Aug
2014

Childhood maltreatment may lead to development of future substance use; however the contributions of a family history of substance use is unclear.
To better understand the relationship between childhood abuse, family history of alcohol and drug abuse, and injecting drug use initiation in a cohort of chronic opioid users.
A cross-sectional survey of long-term and difficult to treat intravenous opiate users of the North American Opiate Medication Initiative (NAOMI) cohort was conducted in two Canadian cities (Vancouver and Montreal).

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Mar
2014

It is well known that homeless individuals are at risk for a variety of health problems, including sexually transmissible infections. Optimisation of health services for the homeless requires knowledge of their sexual health. The sexual health and sexual vulnerability factors of 500 homeless adults (196 women) were assessed in a cross-sectional survey in three Canadian cities.

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Dec
2014

Incarceration and homelessness are closely related yet studied rarely. This article aimed to study the incarcerated homeless and identify specific vulnerabilities, which rendered them different from the nonincarcerated homeless. It also aimed to describe the homeless population and its significant involvement with the criminal justice and enforcement system.

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Oct
2014

This study examined religious behaviors in 380 homeless individuals. We hypothesized that higher frequency of religious attendance is associated with lower rates of use of all substances, lower rates of drug and alcohol dependence, and lower psychological distress. Individuals attending religious ceremonies at least weekly ("frequent attendees") were compared to infrequent attendees.

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Dec
1969

This work aimed to evaluate gender differences among the street-entrenched youth in British Columbia in terms of their demographics, experiences of childhood maltreatment, mental health issues, and substance use behaviors.
Data were derived from the BC Health of the Homeless Study (BCHOHS), carried out in three cities in British Columbia, Canada. Measures included socio-demographic information, the Maudsley Addiction Profile (MAP), the Childhood Trauma Questionnaire (CTQ), the Mini International Neuropsychiatric Interview (MINI) Plus and the National Survey of Homeless Assistance Providers and Clients (NSHAPC)-Health Chapter.

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Dec
1969

This study investigates 500 homeless adults and the associations between childhood maltreatment types and the age of first reported homelessness episode. Those first experiencing homelessness in youth (age 24 years or younger; 46%) were compared with those first experiencing homelessness at a later age (older than age 24 years). In individual models, physical abuse, emotional abuse, and emotional neglect were associated with first experiencing homelessness during youth (p < .

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Jan
2014

: Access to mental health care is limited. Internet-based interventions (IBIs) may help bridge that gap by improving access especially for those who are unable to receive expert care.: This review explores current research on the effectiveness of IBIs for depression and anxiety.

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Apr
2014

Single adenoma is the cause of 80 % of primary hyperparathyroidism (PHPT) resulting in wide acceptance of minimally invasive parathyroidectomy (MIP). The incidence of PHPT increases with age. Little information is available regarding the prevalence of multiglandular disease (MGD) in older patients.

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Dec
1969

The Independent Scientific Committee on Drugs (ISCD) assigned quantitative scores for harm to 20 drugs. We hypothesized that a personalized, ISCD-based Composite Harm Score (CHS) would be associated with poor health outcomes in polysubstance users.
A prospective community sample (n=293) of adults living in marginal housing was assessed for substance use.

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Dec
2013

The health of people living in marginal housing is not well characterized, particularly from the perspective of multimorbid illness. The authors investigated this population in a community sample.
A prospective community sample (N=293) of adults living in single-room occupancy hotels was followed for a median of 23.

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Jun
2014

Substance use disorders (SUDs) are highly prevalent in homeless populations, and rates are typically greater among males. Posttraumatic stress disorder (PTSD) is a common co-occurring condition among individuals with SUDs; however, little attention has been directed to examining this comorbidity in homeless populations. Although some studies indicate considerable sex differences among individuals with PTSD, it has also been suggested that sex differences in PTSD rates diminish in populations with severe SUDs.

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Jul
2013

Patients with addictions and concurrent disorders constitute the most underserved population in the system of care. There are numerous reasons why this population has so much difficulty accessing services, including behavioural issues, criminal engagement, and non-compliance with outpatient services. To improve services to this population which is marked by multiple morbidities, high mortality and insufficient access to health care, the government of British Columbia, Canada developed a program for people with both substance use disorder and one or more mental disorders who have not benefited from previous therapies.

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Aug
2013

This study used an experimental design to examine longitudinal changes in subjective quality of life (QoL) among homeless adults with mental illness after assignment to different types of supported housing or to treatment as usual (TAU, no housing or supports through the study). We hypothesized that subjective QoL would improve over time among participants assigned to supported housing as compared to TAU, regardless of the type of supported housing received or participants' level of need.
Participants (n = 497) were stratified by level of need ("high" or "moderate") and randomly assigned to Housing First (HF) in scattered-site apartments, HF in a congregate setting (high needs only), or TAU.

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