scholarly journals Changes in depression in a cohort of Danish HIV-positive individuals: time for routine screening

Sexual Health ◽  
2011 ◽  
Vol 8 (2) ◽  
pp. 214 ◽  
Author(s):  
Lotte Rodkjaer ◽  
Tinne Laursen ◽  
Nils B. Christensen ◽  
Kirsten Lomborg ◽  
Lars Ostergaard ◽  
...  
Keyword(s):  
At Risk ◽  
Major Depression ◽  
Psychiatric Treatment ◽  
Routine Screening ◽  
Hiv Positive ◽  
Unsafe Sex ◽  
Patients At Risk ◽  
Emotional Strain ◽  
Living With Hiv ◽  
Not At Risk

Background: The aim of this study was to follow a cohort of HIV-positive individuals for 3 years in order to assess changes in depression, adherence, unsafe sex and emotional strains from living with HIV. Methods: Participants were assessed for depression, adherence, emotional strain and unsafe sex via a questionnaire. The Beck Depression Inventory II (BDI) was used to assess the prevalence and severity of depressive symptoms. Patients with a BDI score of 20 or above (moderate to major depression) were offered a clinical evaluation by a consultant psychiatrist. Results: In 2005, 205 HIV-positive individuals participated in the study. Symptoms of depression (BDI >14) were observed in 77 (38%) and major depression (BDI ≥20) in 53 (26%) individuals. In 2008, 148 participants were retested (72% of original sample). Depression (BDI >14) was observed in 38 (26%) and symptoms of major depression (BDI ≥20) in 24 (16%) individuals. Patients at risk of moderate to major depression were more likely to be non-adherent to medications, to practice unsafe sex and to suffer from emotional strains compared with patients not at risk of depression, both at baseline (2005) and follow-up (2008). Conclusion: This study demonstrated a decline in depression scores over time and an association between the risk of depression and low medication adherence, stress and unsafe sex. We recommend routine screening for depression to be conducted regularly to provide full evaluations and relevant psychiatric treatment.

scholarly journals Sarcopenia and Malnutrition Screening in Female Osteoporosis Patients—A Cross-Sectional Study

2021 ◽  
Vol 10 (11) ◽  
pp. 2344
Author(s):  
Franca Genest ◽  
Dominik Rak ◽  
Elisa Bätz ◽  
Kerstin Ott ◽  
Lothar Seefried
Keyword(s):  
At Risk ◽  
Risk Groups ◽  
Cross Sectional Study ◽  
Mineral Density ◽  
Cross Sectional ◽  
Functional Deficits ◽  
Complementary Approach ◽  
Study Results ◽  
Patients At Risk ◽  
Not At Risk

Sarcopenia and malnutrition are important determinants of increased fracture risk in osteoporosis. SARC-F and MNA-SF are well-established questionnaires for identifying patients at risk for these conditions. We sought to evaluate the feasibility and potential added benefit of such assessments as well as the actual prevalence of these conditions in osteoporosis patients. We conducted a cross-sectional, single-center study in female osteoporosis patients ≥ 65 years (SaNSiBaR-study). Results of the sarcopenia (SARC-F) and malnutrition (MNA-SF) screening questionnaires were matched with a functional assessment for sarcopenia and data from patients’ medical records. Out of 107 patients included in the analysis, a risk for sarcopenia (SARC-F ≥ 4 points) and a risk for malnutrition (MNA-SF ≤ 11 points) was found in 33 (30.8%) and 38 (35.5%) patients, respectively. Diagnostic overlap with coincident indicative findings in both questionnaires was observed in 17 patients (16%). As compared to the respective not-at-risk groups, the mean short physical performance battery (SPPB) score was significantly reduced in both patients at risk for sarcopenia (7.0 vs. 10.9 points, p < 0.001) and patients at risk for malnutrition (8.7 vs. 10.5 points, p = 0.005). Still, confirmed sarcopenia according to EWGSOP2 criteria was present in only 6 (6%) of all 107 patients, with only 3 of them having an indicative SARC-F score. Bone mineral density was not significantly different in any of the at-risk groups at any site. In summary, applying SARC-F and MNA-SF in osteoporosis patients appears to be a complementary approach to identify individuals with functional deficits.

scholarly journals Evolving Toward Shared HIV Care Using the Champlain BASE eConsult Service

2019 ◽  
Vol 4 (2) ◽  
pp. 238146831986821
Author(s):  
Claire E. Kendall ◽  
Janessa E. Porter ◽  
Esther S. Shoemaker ◽  
Rachel Seoyeon Kang ◽  
Michael Fitzgerald ◽  
...  
Keyword(s):  
At Risk ◽  
Primary Care Providers ◽  
Question Type ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Local Health ◽  
Care Providers ◽  
Patients At Risk ◽  
Survey Responses ◽  
Living With Hiv

Background. Electronic consultation (eConsultation) is a potential strategy to improve access to specialist expertise and facilitate collaborative care models. The Champlain BASE eConsult service allows for asynchronous communication between primary care providers (PCP) and specialists on a secure, web-based system. HIV experts accessible include HIV physician specialists, HIV pharmacists, and social workers with expertise in HIV. Objective. This study aims to describe the use, value, and utility of this eConsultation service in the care of people living with HIV and to characterize the common question types and clinical topics asked by PCPs. Methods. We analyzed the data from eConsults sent to the HIV specialty group in Ontario’s Champlain Local Health Integration Network between February 2015 and December 2017. Usage data and close-out survey responses were analyzed using descriptive statistics, eConsults were classified using a predefined list of validated taxonomy, and a thematic analysis was performed on the consultation logs to identify common clinical themes. Results. Among the 46 eConsults, the most common question type related to drug treatment (58.7%, n = 27) and management (19.6%, n = 9). The main clinical themes involved the care of significant complexities in people living with HIV, such as comorbidities and drug interactions, and suggestions of coordinated patient care. As well, eConsult was used for advice regarding pre-exposure prophylaxis for HIV-negative patients at risk of HIV infection. PCPs highly valued the eConsult service (average rating 4.8/5). Conclusion. Overall, this study demonstrates that eConsult provides an efficient and valuable service to PCPs caring for patients living with or at risk for HIV by improving access to HIV specialists and facilitating the delivery of team-based comprehensive care.

Psychiatric Treatment Strategies for Patients at Risk of Dying Suddenly

1991 ◽  
Vol 56 (4) ◽  
pp. 242-246
Author(s):  
Brian Baker ◽  
Paul Dorian ◽  
Nadia Woloshyn ◽  
Shahe Kazarian ◽  
Caroline Lanphier
Keyword(s):  
At Risk ◽  
Psychiatric Treatment ◽  
Treatment Strategies ◽  
Patients At Risk

scholarly journals Reversible Thrombocytopenia after Gabapentin in an HIV-Positive Patient

2018 ◽  
Vol 2018 ◽  
pp. 1-2
Author(s):  
Mohammed Basith ◽  
Andrew Francis ◽  
Alfredo Bellon
Keyword(s):  
At Risk ◽  
Human Immunodeficiency Virus ◽  
Psychiatric Care ◽  
Hiv Positive ◽  
Inpatient Psychiatric Care ◽  
Immunodeficiency Virus ◽  
The Us ◽  
Patients At Risk ◽  
History Of ◽  
Severe Anxiety

Gabapentin has become increasingly used in psychiatric practice specifically for anxiety disorders. Even though gabapentin is not approved by the US Food and Drug Administration to treat anxiety, physicians sometimes use it as an alternative to benzodiazepines in patients with a history of substance abuse. Gabapentin is also prescribed when individuals are at risk of thrombocytopenia which is not considered a side effect. Among patients at risk of thrombocytopenia are those positive for human immunodeficiency virus (HIV). Here we present a case of an HIV-positive man who presented for inpatient psychiatric care with severe anxiety and a history of alcohol and benzodiazepine abuse. In this patient, gabapentin worsened thrombocytopenia after repeated exposure to this medication. We suggest caution when considering gabapentin for patients with preexisting low platelet counts, as there seems to be a risk for worsening thrombocytopenia with this antiepileptic in the presence of HIV infection.

Early and Late Hypocalcaemia After Total Thyroidectomy Prospective Study

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Emad EL-Deen Farid Ibrahim ◽  
Osama Mohamed Abdo Abo Gazya ◽  
Hesham Mohamed Ali Omran ◽  
Amr Hamed Afifi Ali ◽  
Mina Gad Shenouda
Keyword(s):  
At Risk ◽  
Total Thyroidectomy ◽  
Calcium Level ◽  
Ionized Calcium ◽  
Thyroid Resection ◽  
Patients At Risk ◽  
The Mean ◽  
Not At Risk ◽  
Symptoms And Signs ◽  
Postoperative Hypocalcaemia

Abstract Background Hypocalcaemia post total thyroidectomy, is one of the most common complication observed in patients who undergo bilateral thyroid resection. Although hypocalcaemia is self-limiting in most patients and does not require treatment, symptomatic hypocalcaemia is of particular concern. We aimed to evaluate the incidence of hypocalcaemia post total thyroidectomy with evaluation of serum calcium levels as a cheap and available method so we can identify patients at risk of postoperative hypocalcaemia who require supplementation treatment, and those not at risk who can be safely discharged without any supplementation treatment. Objective To assess the incidence of postoperative hypocalcaemia post total thyroidectomy wither it’s temporary or permanent. Methods prospective analysis of 100 patients undergoing total thyroidectomy. Preservation of parathyroid glands and their blood supply was attempted in all cases. The patients were assessed for manifestations of hypocalcaemia after thyroidectomy. The assessment was done through: (1) monitoring the total and ionized calcium level 24 hours postoperatively, (2) Total and ionized calcium level was measured in the third week postoperative, (3) clinical examination and detection of symptoms and signs of hypocalcaemia, (4) In resistant cases assessment of total and ionized calcium and PTH at 3 and 6 months. Results The study included 87 females and 13 males, 37 was the mean age; 15 patients developed symptoms of hypocalcaemia (15%), 8 of them were asymptomatic but 7 of them developed symptoms, 85 patients did not develop any clinically manifested symptoms of hypocalcaemia (85%). all of them recovered from hypocalcaemia except 2 patients, one of them recovered at 3 months postoperative and the other one didn’t recover from hypocalcaemia so we diagnose it’s case as a permanent hypocalcaemia post total thyroidectomy. Conclusion Results of this study indicate that measuring calcium postoperative is a cheap and available lab investigation to indicate hypocalcaemia post total thyroidectomy, and as we mentioned before that we don’t need to prescribe calcium or vitamin D to all the patients underwent total thyroidectomy as an empirical treatment to prevent hypocalcaemia but we prescribe it just to patients developed symptoms of hypocalcaemia as it will be costly to the patient.

The effect of 12-wk ω-3 fatty acid supplementation on in vivo thalamus glutathione concentration in patients “at risk” for major depression

Nutrition ◽  
2015 ◽  
Vol 31 (10) ◽  
pp. 1247-1254 ◽  
Author(s):  
Shantel L. Duffy ◽  
Jim Lagopoulos ◽  
Nicole Cockayne ◽  
Simon J.G. Lewis ◽  
Ian B. Hickie ◽  
...  
Keyword(s):  
At Risk ◽  
Fatty Acid ◽  
Major Depression ◽  
Fatty Acid Supplementation ◽  
Acid Supplementation ◽  
Glutathione Concentration ◽  
Patients At Risk

scholarly journals Cognitive Reserve as a Protective Factor in Older HIV-Positive Patients at Risk for Cognitive Decline

2012 ◽  
Vol 19 (1) ◽  
pp. 16-25 ◽  
Author(s):  
Jessica M. Foley ◽  
Mark L. Ettenhofer ◽  
Michelle S. Kim ◽  
Nina Behdin ◽  
Steven A. Castellon ◽  
...  
Keyword(s):  
At Risk ◽  
Cognitive Decline ◽  
Cognitive Reserve ◽  
Protective Factor ◽  
Hiv Positive ◽  
Patients At Risk

Identifying Destination Health: Developing the Concepts of Market Indifference and Destination Dependence / Market Irrelevance

2019 ◽  
Vol 59 (5) ◽  
pp. 879-892 ◽  
Author(s):  
Bob McKercher ◽  
Barry Mak
Keyword(s):  
At Risk ◽  
Early Intervention ◽  
Diagnostic Tool ◽  
Small Island ◽  
Tourism Sector ◽  
Patients At Risk ◽  
Not At Risk

This article develops a diagnostic tool to identify destinations “at risk” as a result of markets’ interest or lack thereof in a place. “At risk” is used in a similar manner to the medical profession’s use of the term “patients at risk” to identify those patients at risk of deterioration in order to trigger early intervention. Two situations are identified: market indifference, where markets as a whole show little interest in a destination, and destination dependence/market irrelevance, where destinations are overly reliant on markets that in the larger scheme of outbound travel show little interest in the destination. The study analyzed 162 destinations using UNWTO data. Almost 80 are affected potentially by one of these conditions. Most at-risk destinations are either small island countries, micro states, or countries with an underdeveloped tourism sector. Interestingly, no differences were found in the contribution tourism makes to GDP between seemingly at risk and not at risk places.

scholarly journals 1651. Describing the Tuberculosis Infection Cascade of Care Based on Electronic Health Record Data

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S813-S814
Author(s):  
Laura A Vonnahme ◽  
Jonathan Todd ◽  
Jon Puro ◽  
Jee Oakley ◽  
Matthew Jones ◽  
...  
Keyword(s):  
At Risk ◽  
Electronic Health Record ◽  
Tuberculosis Infection ◽  
Health Record ◽  
Populations At Risk ◽  
Cascade Of Care ◽  
Patients At Risk ◽  
Electronic Health ◽  
Not At Risk ◽  
Positive Results

Abstract Background Appropriate screening of individuals to detect latent tuberculosis infection (LTBI) is a critical step for achieving tuberculosis (TB) elimination in the US; &gt;80% of TB cases are attributed to LTBI reactivation. TB infection testing and treatment must engage community health clinics where populations at risk seek care. However, there are significant data knowledge gaps in the current LTBI cascade of care (CoC) in this setting. We used an electronic health record (EHR) database from OCHIN, Inc., to characterize the LTBI CoC and identify potential future interventions. Methods We extracted a cohort of patients from 2012–2016 EHR data; we stratified by whether patients were at risk for TB based on meeting at least one of the following criteria: non-US born or non-English language preference, homelessness, encounter at correctional facility, history of close contact with a TB case, or being immunocompromised. Along each step of the LTBI CoC, we determined the proportions with a test for TB infection, with available test results, with a positive test, with an LTBI diagnosis, and with LTBI treatment prescribed. We used Χ 2 tests to compare the LTBI CoCs among patients at risk with those classified as not at risk. Results Of nearly 2.2 million patient records, 701,467 (32.0%) met criteria for being at risk for TB; 84,422 at risk (12.0%) were tested; 65,562 (77.7%) had available results, of whom 9,624 (14.7%) were positive. Among those with positive results, 6,958 (72.3%) had an LTBI diagnosis, of whom 1,732 (24.9%) were prescribed treatment. Among those classified as not at risk, fewer were tested (66,773 [4.5%], p&lt; 0.001) and had positive results (2,500 [3.7%], p&lt; 0.0001). Among those with positive results, 1,998 (80.0%) had an LTBI diagnosis, of whom 395 (19.8%) initiated treatment. Conclusion This study highlights gaps in the LTBI CoC, and where interventions are most needed. The largest gaps were in testing patients at risk, as 88% were not tested, and treatment, as 75% diagnosed with LTBI were not treated. Just under half (44%) of all TB tests appeared to be performed in persons with little risk for TB; this is a substantial amount of testing given very few begin treatment. Resources could be redirected to increase screening and treatment among populations at risk. Disclosures All Authors: No reported disclosures

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