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>All study participants completed a self-administered follow-up health status survey that elicited detailed information about past and current dental and medical conditions. Physician examiners performed comprehensive physical examinations of the participants and recorded their findings for each body system. Oral health assessments (number of missing teeth, condition of oral mucosa and presence of dentures) were augmented by blood pressure, heart rate, height, weight, hematologic and biochemical measurements. The examiners recorded lesions or irregularities of the oral mucosa as “abnormal mouth condition” and summarized obvious dental caries as “abnormal dental condition.” In addition, trained interviewers conducted face-to-face assessments of substance-use behaviors with study participants. They used the Addiction Severity Index23 to elicit the frequency and patterns of use of various illegal drugs that participants may have used in the 30 days preceding the interview. Primary route of drug administration was determined as the “usual or most recent” route; for patients who reported using more than one route, the most severe route (in descending order, IV, intranasal and smoking) was abstracted from their records. Finally, the interviewers used the Life Experience Timeline interview24 to quantify MA use in the period after the initial MTP study.
> Physician examiners performed comprehensive physical examinations of the participants and recorded their findings for each body system.
>The most frequent physical examination findings were elevated body mass index (BMI > 25, 65.7 percent, n = 195), abnormal dental or oral findings (41.3 percent, n = 213), hypertension (21.6 percent, n = 64) and mental status abnormalities (16.3 percent, n = 49). A small subset of the sample had abnormal neurological findings; 6.7 percent (n = 20) evidenced disorders of movement (that is, tremor, tic, akathesia or choreoathetosis), 11 percent (n = 33) had abnormalities on sensory examination and 13.6 percent (n = 41) had other neurological problems (that is, cranial nerve disorders, abnormal deep-tendon reflexes or problems with gait, coordination, motor strength or tone). The prevalence rates of self-reported medical conditions and clinical laboratory abnormalities generally were unremarkable. However, we found elevated rates of hepatitis C antibody and hepatitis B core antibody, indicating prior exposure to or current infection with these viruses, in 16.3 percent (n = 45) and 12.9 percent (n = 24) of participants, respectively. Participants who injected MA were more likely to report having hepatitis (odds ratio [OR] = 15.3; 95 percent confidence interval [CI], 6.4–36.8) and sexually transmitted diseases (OR = 2.1; 95 percent CI, 1.2–3.9) than were participants who smoked MA. Other medical conditions were not related significantly to route of administration.
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>Self-rated oral health in MA users.
>At the time of the oral assessment, a substantial proportion of the participants reported experiencing one or more dental problems (Table 2⇓). Problems with dental appearance (28.6 percent, n = 86), broken or loose teeth (23.3 percent, n = 70) and tooth grinding or erosion (22.3 percent, n = 67) were the most commonly reported dental conditions. About 8 percent of the participants reported having TMJ problems. Study participants who reported having dental problems also manifested unmet oral care needs for extended periods (Table 2⇓). The average period during which participants experienced a dental problem ranged from nearly 18 months (for swollen or bleeding gingiva) to nearly 77 months (for TMJ disorders).
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