Head injury and neuropsychiatric sequelae in asylum seekers

Neurology ◽  
2020 ◽  
Vol 95 (19) ◽  
pp. e2605-e2609 ◽  
Author(s):  
Hannah S. McMurry ◽  
Darren C. Tsang ◽  
Nicole Lin ◽  
Stephen N. Symes ◽  
Chuanhui Dong ◽  
...  
Keyword(s):  
Head Injury ◽  
Asylum Seekers ◽  
Clinical Characteristics ◽  
Psychological Trauma ◽  
Cross Sectional Study ◽  
Primary Study ◽  
Cross Sectional ◽  
Physical Trauma ◽  
History Of ◽  
Neuropsychiatric Comorbidities

ObjectiveAsylum seekers experience a high burden of physical and psychological trauma, yet there is a scarcity of literature regarding the epidemiology and sequelae of head injury (HI) in asylum seekers. We examined HI prevalence and association with neuropsychiatric comorbidities in asylum seekers.MethodsA retrospective cross-sectional study was performed through review of 139 medical affidavits from an affidavit database. Affidavits written from 2010 to 2018 were included. Demographic and case-related data were collected and classified based on the presence of HI. For neuropsychiatric sequelae, the primary study outcome was headache and the secondary outcomes were depression, posttraumatic stress disorder, and anxiety. Multivariable logistic regression was performed to examine the association between HI and neuropsychiatric sequelae, adjusted for demographic and clinical characteristics.ResultsA total of 139 medical affidavits of asylum seekers were included. The mean age was 27.4 ± 12.1 years, 56.8% were female, and 38.8% were <19 years. Almost half (42.5%) explicitly self-reported history of HI. Compared to clients who did not report HI, clients with HI were older and more likely to report a history of headache, physical abuse, physical trauma, concussion, and loss of consciousness. After adjustment for demographic and clinical characteristics, clients with HI had greater odds for neuropsychological sequelae such as headache (odds ratio [OR] 4.2, 95% confidence interval [CI] 2.0–8.7) and depression (OR 2.5, 95% CI 1.1–5.7).ConclusionsWe observed a high prevalence of HI in asylum seekers. Comprehensive screening for HI and neuropsychiatric comorbidities is encouraged when evaluating asylum seekers.

scholarly journals A New Features of SARS-CoV-2 Infection in Wenzhou, China

2020 ◽  
Author(s):  
Zhao Hongjun ◽  
Xiaoxiao Lu ◽  
Tiegang Li ◽  
Boqi Rao ◽  
Dedong Wang ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Clinical Characteristics ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Wuhan City ◽  
Intimate Contact ◽  
Cross Sectional ◽  
Epidemic Area ◽  
History Of ◽  
Epidemiological Characteristics

Abstract BACKGROUND: An outbreak of pneumonia associated with the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) was initially emerged in Wuhan city, and subsequently spread throughout China. Then the epidemic is rapidly circulating in a few other countries at present. So it is very urgent to delineate the clinical characteristics of these affected patients. METHODS: To investigate the epidemiological characteristics of this new Coronavirus Disease 2019 (COVID-19), a cross-sectional study was executed with 459 patients with confirmed COVID-19 in Wenzhou, China, from January 27 to February 12, 2020. RESULTS: The median age of all patients was 48.0 years, and 46.8% were females. 37.5% of patients had a history of residence in Wuhan. Fever (72.1%) and cough (43.6%) were the most frequent symptoms. We also found that there were three kinds of unconventional patients including 4.4% of total confirmed patients who were asymptomatic, 7.8% patients who had no link to Wuhan city but contact with individuals from Wuhan without any symptoms at the time of contact, and 10.7% who had no link to Wuhan city nor a history of intimate contact with patients or individuals from Wuhan without any symptoms, respectively. CONCLUSIONS: Our findings presented the possibility of asymptomatic carriers affected with SARS-CoV-2, and this phenomenon suggested that chances of uncontrollable transmission in the larger population might be higher than formerly estimated, and transmission by these three kinds of unconventional patients in Wenzhou may be one of the characteristics of infection in other Chinese cities outside the Wuhan epidemic area.

scholarly journals Head injury in asylum seekers and refugees referred with psychological trauma

2016 ◽  
Vol 3 ◽  
Author(s):  
S. M. Doherty ◽  
R. Craig ◽  
M. Gardani ◽  
T. M. McMillan
Keyword(s):  
Mental Health ◽  
Head Injury ◽  
Asylum Seekers ◽  
Mental Health Problems ◽  
Psychological Trauma ◽  
Mental Health Clinicians ◽  
Trauma Service ◽  
History Of ◽  
Preliminary Study ◽  
Asylum Seekers And Refugees

Objective.Individuals who seek asylum are frequently fleeing violent persecution and may experience head injury (HI). However, little is known about the prevalence of HI in asylum seekers and refugees (ASR) despite the potential for HI to significantly affect cognitive and emotional functioning and to compromise asylum outcomes. This preliminary study investigates the prevalence of HI in ASR referred to a complex psychological trauma service.Method.Participants were 115 adult ASR referred to a community psychological trauma service with moderate to severe mental health problems associated with psychological trauma. They were screened for a history of HI using a questionnaire developed for the study. Interpreters were used when required.Results.The overall prevalence of HI was 51%. At least 38% of those with HI had a moderate–severe HI that could cause persisting disability. In 53% of those with HI, the cause was torture, human trafficking or domestic violence. Repeat HI can have cumulative effects on function; it was common, and was reported in 68% of those with HI. An injury to the head was not known to mental health clinicians prior to screening in 64% of cases.Conclusion.The emotional and cognitive consequences of HI in ASR may increase the vulnerability of this disadvantaged group, and can be associated with neurobehavioural problems affecting daily life and may compromise asylum outcomes. Routine screening for HI in ASR is needed, as are links to neuropsychology and brain injury services for advice, assessment and intervention.

scholarly journals Clinical Characteristics and Burden of a Large Series with Cluster Headache From Turkey: A Cross-Sectional Study From Headache Centers

2021 ◽  
Author(s):  
PINAR YALINAY DIKMEN ◽  
CAGLA ARI ◽  
ERDI SAHIN ◽  
MUSTAFA ERTAS ◽  
FUSUN MAYDA DOMAC ◽  
...  
Keyword(s):  
Cluster Headache ◽  
Clinical Characteristics ◽  
Past History ◽  
Positive Family History ◽  
Disease Onset ◽  
Diagnostic Delay ◽  
Preventive Treatment ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
History Of

Abstract Background: Our purpose was to investigate the demographics, diagnosis patterns, clinical characteristics, triggers, treatment experiences, and personal burden of patients with Cluster headache (CH) in Turkey, a country located between Europe and Asia.Methods: The study is a cross-sectional investigation based on data from eight headache centers in Turkey. All patients completed the semi-structured survey either face to face or by phone interview with a neurologist.Results: A total of 209 individuals with a mean age of 39.8 (11.3) completed the survey (176 males; 188 episodic, 21 chronic). The mean age at disease onset was 28.6 (10.2) years. The diagnostic delay was 4.9 years and misdiagnosis before CH was 57.9%. Of participants, 9.1% reported a positive family history for CH. Male patients with CH showed higher rates for being current smokers in comparison to females (59.7% vs. 24.2%; p<0.0001) and they also had significantly more past history of smoking at the time of first diagnosis (60.8% vs. 21.2%; p<0.0001). Females with CH had a previous diagnosis of migraine more frequently (57.6% vs. 27.3; p=0.001). Attack duration without treatment was significantly longer in female patients with CH compared to males (112 min vs. 87 min; p=0.029). Female participants had more migrainous features (57.6 % vs. 36.9%; p=0.033) and nausea/vomiting (48.5% vs. 30.1%; p=0.045) during their attacks. Only 42.1% of all participants reported satisfying treatment experiences. Of the participants, 85.9 % reported that oxygen was efficient for abortive treatment of CH; however, only 22 % of them had an oxygen tube at home. Female participants, as well as chronic CH patients, reported a higher likelihood of preventive treatment experiences. In this study, 49.3% of all participants appeared to be disabled by their headaches. Over one-quarter percent of our cohort reported that CH caused job-related burden.Conclusion: Remarkable diagnostic delay is an ongoing problem for CH and migraine was the most common misdiagnosis. Nearly half of the patients suffered from a burden of CH regardless of chronicity. Both past abortive and preventive treatment experiences of the participants highlight the insufficient efficacy of available choices and the necessity of more specific treatments for CH.

scholarly journals Predictors for Depression, Sleep Disturbance, and Subjective Pain among Inpatients with Depressive Disorders during the COVID-19 Pandemic: A Cross-Sectional Study

2021 ◽  
Vol 18 (12) ◽  
pp. 6523
Author(s):  
Dian-Jeng Li ◽  
Su-Ting Hsu ◽  
Frank Huang-Chih Chou ◽  
Li-Shiu Chou ◽  
Kuan-Ying Hsieh ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Linear Regression ◽  
Sleep Disturbance ◽  
Psychological Trauma ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Drinking Alcohol ◽  
Cross Sectional ◽  
Subjective Pain ◽  
History Of

The coronavirus disease 2019 (COVID-19) pandemic can have a negative impact on patients with mood disorders. The aim of this study is to explore the societal influence of COVID-19 and associated impacts on levels of depression, sleep disturbance, and subjective pain among patients with mood disorders. This cross-sectional study recruited inpatients with depression and bipolar disorder. Levels of depression, sleep disturbance, subjective pain, and related demographic variables were collected through self-reported questionnaires. Potential factors associated with levels of depression, sleep disturbance, and subjective pain were identified using univariate linear regression and further entered into a stepwise multivariate linear regression model to identify the independent predictors. A total of 119 participants were included in the analysis, of whom 50.42% had bipolar disorder and 49.58% had unipolar depression. Multivariate analysis showed that a higher level of depression was associated with female subjects, subjects with partners, present history of psychological trauma, and drinking alcohol. Sleep disturbance was associated with subjects with partners and drinking alcohol. A higher level of subjective pain was associated with a higher level of social anxiety and a history of psychological trauma. The current study identified several predictors of psychological burden and subjective pain among inpatients with depression during the COVID-19 pandemic. Further investigations are warranted to extend the application and generalizability of our results.

A New Features of SARS-CoV-2 Infection in a City of China

2020 ◽  
Author(s):  
Zhao Hongjun ◽  
Xiaoxiao Lu ◽  
Tiegang Li ◽  
Boqi Rao ◽  
Dedong Wang ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Wuhan City ◽  
Intimate Contact ◽  
Cross Sectional ◽  
Epidemic Area ◽  
History Of ◽  
Epidemiological Characteristics ◽  
Virus Carrier

Abstract BACKGROUND: An outbreak of pneumonia associated with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan city and then to other city. It is very urgent to delineate the epidemiological and clinical characteristics of these affected patients. METHODS: To investigate the epidemiological characteristics of the COVID-19, a cross-sectional study was executed with 459 patients with confirmed COVID-19 in WZ of China from January 27 to February 12, 2020. RESULTS: The median age of all patients was 48.0 years, and 46.8% were females. 37.5% of patients had a history of residence in Wuhan. Fever (72.1%) and cough (43.6%) were the most frequent symptoms. In addition, three kinds of unconventional cases were observed, in which included 4.4% confirmed virus carrier who were asymptomatic, 7.8% confirmed patients who had no link to Wuhan city but contact with individuals from Wuhan without any symptoms at the time of contact, and 10.7% confirmed patients who had no link to Wuhan city nor a history of intimate contact with patients or individuals from Wuhan without any symptoms, respectively. CONCLUSIONS: Our findings presented the possibility of asymptomatic carriers affected with SARS-CoV-2, and this phenomenon suggested that chances of uncontrollable transmission in the larger population might be higher than formerly estimated, and transmission by these three kinds of unconventional patients in WZ may be one of the characteristics of infection in other Chinese cities outside the Wuhan epidemic area.

Suicidal Ideation Among Medical Students in Dammam, Saudi Arabia

Crisis ◽  
2020 ◽  
pp. 1-6
Author(s):  
Mohammed Madadin ◽  
Ritesh G. Menezes ◽  
Maha A. Alassaf ◽  
Abdulaziz M. Almulhim ◽  
Mahdi S. Abumadini ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Medical Students ◽  
Suicidal Ideation ◽  
General Health Questionnaire ◽  
Cross Sectional Study ◽  
Eastern Province ◽  
Cross Sectional ◽  
The Past ◽  
Depression Subscale ◽  
History Of

Abstract. Background: Medical students are at high risk of suicidal ideation. Aim: We aimed to obtain information on suicidal ideation among medical students in Dammam located in the Eastern Province of Saudi Arabia. Method: This cross-sectional study was conducted at the College of Medicine affiliated with Imam Abdulrahman Bin Faisal University in the Eastern Province of Saudi Arabia. Suicidal ideation in the past 12 months was assessed based on responses to four questions in the depression subscale of the General Health Questionnaire 28 (GHQ-28). In addition, data were collected to examine the association of suicidal ideation with various factors. Results: We found that 1 in 3 medical students in the study had suicidal ideation in the past 12 months, while around 40% had lifetime suicidal ideation. Suicidal ideation was associated with feelings of parental neglect, history of physical abuse, and dissatisfaction with academic performance. Limitations: The cross-sectional nature of this study limits its ability to determine causality regarding suicidal ideation. Conclusion: These rates are considerably high when compared with rates from studies in other countries around the world. This study provides a reference in the field of suicidology for this region of Saudi Arabia.

DYSLIPIDEMIA IN THYROID DISORDERS

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Kashish Narula ◽  
Narendra Kumar Dara ◽  
Shyam Lal Meena
Keyword(s):  
Lipid Metabolism ◽  
Thyroid Dysfunction ◽  
Cross Sectional Study ◽  
Control Group ◽  
Thyroid Disorders ◽  
Cross Sectional ◽  
Carbohydrate And Lipid Metabolism ◽  
History Of ◽  
Thyroid Profile ◽  
Basal Energy Expenditure

Background: Thyroid hormones influence nearly all major metabolic pathways. Their most obvious and well-known action is the increase in basal energy expenditure obtained by acting on protein, carbohydrate and lipid metabolism. The lipid metabolism is more influenced by the thyroid hormone. Methods: A cross-sectional study was conducted on 100 patients with suspicion of thyroid disorders were taken as cases. One hundred patients with normal thyroid profile and no history of other chronic diseases were taken as control group. Results: The serum TC, TG and LDL levels in hypothyroid individuals (both overt and subclinical) were significantly higher than euthyroid subjects but the levels were comparable between hyperthyroid and euthyroid group. Conclusion: Dyslipidemias are associated with thyroid disorders, so biochemical screening for thyroid dysfunction in all dyslipidemic patients. Therefore, patients presenting with dyslipidemia are recommended for investigation to explore thyroid dysfunction. Keywords: Thyroid profile, Total cholesterol, Triglycerides and LDL

Metabolic Syndrome in HIV-patients in Antiretroviral Therapy

2020 ◽  
Vol 18 (6) ◽  
pp. 388-395
Author(s):  
Daniel Vargas-Pacherrez ◽  
Helma P. Cotrim ◽  
Leonardo Pires ◽  
Vitor Cunha ◽  
Vitor Coelho ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Antiretroviral Therapy ◽  
International Diabetes Federation ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Anthropometric Data ◽  
Cross Sectional ◽  
History Of ◽  
Family History Of Hypertension ◽  
Living With Hiv

Introduction: The global prevalence of metabolic syndrome (MS) among people living with HIV/AIDS varies from 20% to 33%. Objective: to estimate the prevalence of metabolic syndrome and associated factors in a group of HIV-infected patients on antiretroviral therapy. Methods: This is a cross-sectional study with HIV-infected patients from a reference center in Bahia, Brazil. We evaluated clinical, socio-demographic and anthropometric data. MS was defined according to the guidelines of International Diabetes Federation. Results: We evaluated 152 patients with mean age of 47.3±11.6 years, 59.2% male. The main comorbidities detected were diabetes (3.3%) hypertriglyceridemia (9.3%) and metabolic syndrome (MS,38.2%). Patients with MS were predominantly women (55.2% vs 31.9%; p=0.005), older [52.1 (10.4) vs 44.3 (11.3); p<0.001], and had overweight (74.1% vs 23.4%; p<0.001). After multivariate analysis MS remained associated with age (OR = 1.076; 95% CI: 1.030 – 1.125), female sex (OR = 2.452; 95% CI: 1.114 – 5.374) and family history of hypertension (OR = 3.678; 95% CI: 1.431 – 9.395). Conclusion: Almost half of the HIV-infected patients in Bahia presents with MS which seems to be driven by classical risk factors.

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