scholarly journals Liaison Psychiatry During the Peak of the Coronavirus Pandemic: A Description of Referrals and Interventions

2021 ◽  
Vol 12 ◽  
Author(s):  
Mayte López-Atanes ◽  
Juan Pablo González-Briceño ◽  
Adrián Abeal-Adham ◽  
Sara Fuertes-Soriano ◽  
Janire Cabezas-Garduño ◽  
...  
Keyword(s):  
Respiratory Infections ◽  
Basque Country ◽  
Neuropsychiatric Symptoms ◽  
Severe Disease ◽  
Asymptomatic Infection ◽  
University Hospital ◽  
Psychiatric Evaluation ◽  
Patient Anxiety ◽  
Liaison Psychiatry ◽  
Cross Sectional

Introduction: The novel coronavirus SARS-CoV-2 belongs to the coronavirus family, a group of viruses that can cause upper respiratory infections in humans. Among other symptoms, it can present as an asymptomatic infection or as a more severe disease requiring hospitalization. Neuropsychiatric symptoms have been described in the acute phase of the illness and as long-term repercussions. We describe the characteristics and interventions in those COVID-19 patients referred to our liaison psychiatry service.Materials and Methods: This is a cross-sectional descriptive study. This study was carried out within the Department of Psychiatry of Cruces University Hospital (Basque Country, Spain). Data from each psychiatric consultation within our consultation-liaison service were consecutively obtained for 1 month from March 17 to April 17, 2020. We recruited data regarding clinical and referral characteristics and psychiatric interventions.Results: Of a total of 721 SARS-CoV-2 hospitalizations, 43 (5.6%) patients were referred to our psychiatry liaison service. The median age was 61 years old, and 62.8% were women. The infectious disease department was the most frequent petitioner (37.2%), and the most common reason for referral was patient anxiety (25.6%). A total of 67.4% of patients received psychological counseling and 55.8% received some pharmacological approach, with a median of 3.7 visits/calls per patient. In addition, 20.3% needed a medication switch due to potential interactions between psychotropics and drugs used to treat SARS-CoV-2.Discussion: In our study, up to 5.6% of SARS-CoV-2 hospitalized patients needed a psychiatric evaluation, especially for anxiety and mood symptoms. Psychosocial factors associated with the pandemic, drugs used to treat the infection, or a direct causative effect of the virus may explain our findings.

scholarly journals Social contacts and other risk factors for respiratory infections among internally displaced people in Somaliland

2021 ◽  
Author(s):  
Kevin van Zandvoort ◽  
Mohamed Omer Bobe ◽  
Abdirahman Ibrahim Hassan ◽  
Mohamed Ismail Abdi ◽  
Mohamed Saed Ahmed ◽  
...  
Keyword(s):  
Risk Factors ◽  
Respiratory Infections ◽  
Severe Disease ◽  
Social Contact ◽  
Physical Contact ◽  
Cross Sectional ◽  
Internally Displaced ◽  
Internally Displaced People ◽  
Social Mixing ◽  
Displaced People

Background Populations affected by humanitarian crises experience high burdens of acute respiratory infections (ARI), potentially driven by risk factors for severe disease such as poor nutrition and underlying conditions, and risk factors that may increase transmission such as overcrowding and the possibility of high social mixing. However, little is known about social mixing patterns in these populations. Methods We conducted a cross-sectional social contact survey among internally displaced people (IDP) living in Digaale, a permanent IDP camp in Somaliland. We included questions on household demographics, shelter quality, crowding, travel frequency, health status, and recent diagnosis of pneumonia, and assessed anthropometric status in children. We calculated age-standardised social contact matrices to assess population mixing, and conducted regression analysis on risk factors for recent self-reported pneumonia. Results We found crowded households with high proportions of recent self-reported pneumonia (46% in children). 20% of children younger than five are stunted, and crude death rates are high in all age groups. ARI risk factors are common, but we did not find any significant associations with self-reported pneumonia. Participants reported around 10 direct contacts per day. Social contact patterns are assortative by age, and physical contact rates are very high (78%). Conclusions ARI risk factors are very common in this population, while the large degree of contacts that involve physical touch could further increase transmission. Such IDP settings potentially present a perfect storm of risk factors for ARIs and their transmission, and innovative approaches to address such risks are urgently needed.

scholarly journals The role of body temperature on respiratory rate in children with acute respiratory infections

2021 ◽  
Vol 21 (2) ◽  
pp. 640-646
Author(s):  
Beril Ozdemır ◽  
Sıddıka Songül Yalçın
Keyword(s):  
Body Temperature ◽  
Respiratory Rate ◽  
Respiratory Infections ◽  
Severe Pneumonia ◽  
University Hospital ◽  
World Health ◽  
Acute Respiratory Infections ◽  
Low Oxygen ◽  
Cross Sectional ◽  
The Relationship

Background: The World Health Organization (WHO) recommends the use of tachypnea as a proxy to the diagnosis of pneumonia. Objective: The purpose of this study was to examine the relationship between body temperature alterations and respiratory rate (RR) difference (RRD) in children with acute respiratory infections(ARI). Methods:This cross-sectional study included 297 children with age 2-60 months who presented with cough and fever at the pediatric emergency and outpatient clinics in the Department of Pediatrics, Baskent University Hospital, from January 2016 through June 2018. Each parent completed a structured questionnaire to collect background data. Weight and height were taken. Body temperature, respiratory rate, presence of the chest indrawing, rales, wheezing and laryngeal stridor were also recorded. RRD was defined as the differences in RR at admission and after 3 days of treatment. Results: Both respiratory rate and RRD were moderately correlated with body temperature (r=0.71, p<0.001 and r=0.65, p<0.001; respectively). For every 1°C increase in temperature, RRD increased by 5.7/minutes in overall, 7.2/minute in the patients under 12 months of age, 6.4/minute in the female. The relationship between body temperature and RRD wasn’t statistically significant in patients with rhonchi, chest indrawing, and low oxygen saturation. Conclusion: Respiratory rate should be evaluated according to the degree of body temperature in children with ARI. How- ever, the interaction between body temperature and respiratory rate could not be observed in cases with rhonchi and severe pneumonia. Keywords: Fever; tachypnea; pneumonia; respiratory rate difference; children.

scholarly journals COVID-19 Infection among Older People Admitted to Hospital: A Cross-Sectional Analysis

Geriatrics ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 25
Author(s):  
Chiann Ni Thiam ◽  
Kejal Hasmukharay ◽  
Wan Chieh Lim ◽  
Chai Chen Ng ◽  
Gordon Hwa Mang Pang ◽  
...  
Keyword(s):  
Older People ◽  
Severe Disease ◽  
Severe Infection ◽  
University Hospital ◽  
Hospital Treatment ◽  
Comorbid Condition ◽  
Complication Rates ◽  
Inpatient Mortality ◽  
Local Data ◽  
Cross Sectional

(1) Background: Older people with COVID-19 infection report worse clinical outcomes. There is a paucity of local data and this study aimed to describe the clinical progression of older people admitted to a university hospital in Malaysia with COVID-19 infection. (2) Methods: Older people (≥60 years) admitted with COVID-19 infection confirmed with RT-PCR from 27 February 2020–25 May 2020 were included in this study. Data on patient characteristics, hospital treatment, and inpatient outcomes were collected via hospital-held electronic medical records. Analysis was done to describe the cohort and identify factors associated with inpatient mortality. (3) Results: 26 participants were included (mean age 76.2 years, female 57.7%). All had at least one comorbid condition and half were frail. About 19.2% had non-respiratory (atypical) symptoms; 23.1% had a severe disease that required intensive care unit monitoring; 46.2% were given COVID-19 targeted therapy. Inpatient mortality and overall complication rates were 23.1% and 42.3%, respectively. Delirium on presentation and lower Ct-value were associated with mortality. (4) Conclusions: Older people with COVID-19 infection have severe infection and poor hospital outcomes. Vigilant hospital care is necessary to address their multimorbidity and frailty, along with appropriate treatment for their infection.

Prevalence of depressive symptoms among inpatients at the university hospital of Sergipe, Brazil

2017 ◽  
Vol 41 (S1) ◽  
pp. s499-s500
Author(s):  
J. Oliveira ◽  
M. Machado ◽  
E. Cunha ◽  
K.M. Mansilla ◽  
E. Vieira Melo ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Depressive Symptoms ◽  
Early Identification ◽  
Medical Training ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Liaison Psychiatry ◽  
Cross Sectional ◽  
Medical Specialties ◽  
The University

IntroductionDepressive Symptoms (DS) generate a public and economic health problem, with decreasing productivity, labour market withdrawal and increased demand for health services. Studies show that in hospitalized patients, DS rates are higher than in the general population, in medical practice, however, they are under diagnosed or under-treated. Consultation Liaison Psychiatry (LP) can prevent aggravation of the psychic symptoms by early identification of them and by integration of psychiatry with the other medical specialties.ObjectivesTo estimate the prevalence of DS and associated factors in inpatients and the frequency of consultation LP.MethodsA cross-sectional study was carried out in March 2016, with 87 patients hospitalized in the clinical and surgical wards at the University Hospital (Sergipe/BR), through two instruments: (1) Structured Questionnaire prepared by the authors, (2) Beck Depression Inventory (BDI). Data analysis through descriptive and analytical statistics with final step of logistic regression.ResultsThe prevalence of DS were 54%, of which 24% correspond to moderate and severe symptoms, and only 3.4% of the patients had a LP. In Logistic Regression, the only factor associated with DS was the reason for hospitalization. Clinical causes (87.2%) were 9.24 times more likely to develop DS than surgical causes.ConclusionsResults suggest a high prevalence of inpatients with some psychic symptom. Physicians did not detect these symptoms and, therefore, LP request was low. These data reinforce the importance of LP for early identification of DS that should be stimulated during medical training.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Neuropsychiatric symptoms in patients with thymoma-associated and non-thymoma myasthenia gravis

2014 ◽  
Vol 20 (2) ◽  
pp. 4
Author(s):  
Carla Freeman ◽  
I Lewis ◽  
J M Heckmann
Keyword(s):  
Myasthenia Gravis ◽  
Rating Scale ◽  
Neuropsychiatric Symptoms ◽  
Severe Disease ◽  
Severe Depression ◽  
Cross Sectional Study ◽  
Depression Symptoms ◽  
Young Mania ◽  
Cross Sectional ◽  
Psychiatric Rating Scale

<p><strong>Background. </strong>Around 10 - 15% of patients with myasthenia gravis (MG) have a thymoma, and non-motor symptoms are more frequent in these patients. We hypothesised that neuropsychiatric symptoms would also be more frequent. </p><p><strong>Methods. </strong>A cross-sectional study of 30 consecutive MG patients attending a clinic at Groote Schuur Hospital, Cape Town, South Africa, was done over a 6-month period in 2010. Each patient underwent a series of single-blinded neuropsychiatric assessments, including the 16-item, self-reported Flanagan Quality of Life (QOL) scale, the Beck Depression Inventory second version, the Young Mania Rating Scale, the Hamilton Anxiety Rating Scale and the Brief Psychiatric Rating Scale (BPRS).  </p><p><strong>Results. </strong>The frequency and nature of neuropsychiatric symptoms were similar between thymoma (<em>n</em>=9) and non-thymoma (<em>n</em>=21) MG patients. Symptoms of moderate or severe depression and anxiety were present in around 30%. The severity of depression symptoms correlated with MG severity. Prednisone dosing was not associated with neuropsychiatric symptoms or QOL scores. Those with longer duration of MG were more likely to have higher scores on the BPRS and anxiety scales. Those with younger-onset MG had higher BPRS scores and a tendency to suicidal behaviour. </p><p><strong>Conclusion. </strong>Although no association with thyoma was found, this study shows that neuropsychiatric conditions may be underdiagnosed in patients with MG. Systematic depression screening should be done at outpatient clinics, particularly for those who developed symptoms at a young age, those with severe disease and those with a long duration of illness.</p>

scholarly journals Clinical and laboratory profile of COVID-19 in children below 15 years

2021 ◽  
Vol 8 (9) ◽  
pp. 1489
Author(s):  
Indumathi Chellappan ◽  
Venkateshwaran Palanisamy ◽  
Bharathi Elangovan
Keyword(s):  
Inflammatory Markers ◽  
Severe Disease ◽  
Tertiary Care ◽  
Severe Pneumonia ◽  
Cross Sectional Study ◽  
Asymptomatic Infection ◽  
Total Leucocyte Count ◽  
Care Hospital ◽  
Indian Children ◽  
Cross Sectional

Background: Coronavirus disease 2019 (COVID-19), in children has varied clinical presentations from asymptomatic infection to severe pneumonia, multi system inflammatory syndrome in children (MIS-C) and rarely death. To date, limited data has been published on the profile of COVID-19 infection among Indian children. The objective of this study was to analyze the clinical spectrum, laboratory parameters, treatment and it’s outcome in children less than 15 years admitted with COVID-19 infection.Methods: This was a cross sectional study done in a tertiary care hospital. Children with COVID-19 infection detected by Reverse transcriptase polymerase chain reaction (RT-PCR) were included.  Results: Out of 167 children, 93 were males (55.6%) and median (Interquartile range- IQR) age of children admitted were 9 (4-13) years. Family cluster (71%) was the dominant source of infection. Majority were asymptomatic (60%, N=100). The predominant symptoms were fever (29%), cough (16%) and rhinorrhea (4.1%). Seven (4.1%) children had comorbidities and two (28%) among them had moderate to severe disease. Median (IQR) total leucocyte count was 7 (4-10) ×103 µl and platelet count was 390 (275-500) ×103 µl. Leukopenia was observed in 58% (N=81), lymphocytosis in 32.8% (N=46) and thrombocytopenia in 3.5% (N=5). Inflammatory markers were raised in 10-15% of children. Peri-bronchial cuffing was the common abnormality (N=14, 17.5%) in chest X-ray (CXR) and peripheral heterogeneous opacities were noted in severe disease. Children with moderate to severe symptoms were treated with remdesivir and steroids.Conclusions: COVID-19 infection in children was often benign and increased severity was noted among those with comorbidities. Leukopenia, lymphocytosis were commonly observed. High inflammatory markers were noted in severe disease. Nil fatality among our study group.

scholarly journals High Frequency of Undiagnosed Psychiatric Disorders in Inflammatory Bowel Diseases

2020 ◽  
Vol 9 (5) ◽  
pp. 1387
Author(s):  
Irene Marafini ◽  
Lucia Longo ◽  
Damun Miri Lavasani ◽  
Rodolfo Rossi ◽  
Silvia Salvatori ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Inflammatory Bowel Diseases ◽  
Severe Disease ◽  
Significant Proportion ◽  
Structured Interview ◽  
University Hospital ◽  
Psychiatric Evaluation ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
First Time

Inflammatory bowel diseases (IBD) are associated with comorbid depressive and anxiety disorders, but a significant proportion of IBD patients with psychiatric disorders (PsychD) remain undiagnosed and untreated. The aim of this study was to assess the frequency and type of undiagnosed PsychD in IBD patients. Two hundred and thirty-seven adult IBD (136 Crohn’s disease (CD) and 101 ulcerative colitis (UC)) outpatients were consecutively recruited at a single university hospital centre between January 2018 and June 2019. After a scheduled follow-up visit for IBD clinical evaluation, participants underwent a semi-structured interview with a trained psychiatrist. One hundred and fourteen (48%) IBD patients had at least one PsychD, and in 67 (59%) of them, a diagnosis was made for the first time during the study. The remaining 47 (41%) patients had received a previous psychiatric diagnosis, but in only six cases was it consistent with the diagnosis made during the study. PsychD were equally distributed in CD (72/136, 53%) and UC (42/101, 42%), and mostly represented by mood disorders (54/114, 47%) and anxiety (27/114, 24%) disorders. PsychD were not related to the disease severity, phenotype or localisation of IBD, even though having three or more concomitant PsychD was associated with more severe disease in CD. Our data indicate that undiagnosed PsychD are common in IBD and highlight the importance of considering psychiatric evaluation in the management of IBD patients.

A STUDY ON THE CORRELATION BETWEEN MORPHOLOGIC ANORMALIES AND LEFT VENTRICULAR DIASTOLIC FUNCTION IN DILATED CARDIO-MYOPATHY

2011 ◽  
pp. 137-144
Author(s):  
Thi Ngoc Ha Hoang ◽  
Anh Vu Nguyen ◽  
Minh Loi Hoang ◽  
Cuu Long Nguyen ◽  
Thi Thuy Hang Nguyen
Keyword(s):  
Pulmonary Artery ◽  
Dilated Cardiomyopathy ◽  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Pulmonary Arteries ◽  
Left Ventricular ◽  
University Hospital ◽  
Cross Sectional ◽  
X Ray ◽  
Key Words Dilated Cardiomyopathy

Purposes: Describe the morphological and diastolic function of left ventricular changes in the patients with dilated cardiomyopathy (DCM) on US, X-ray findings, and Evaluate the correlation between morphology and diastolic function of left ventricular. Materials and method: Cross sectional study from Dec 2009 to Aug 2010, on 39 patients with dilated cardiomyopathy were evaluated at the University Hospital of Hue College of Medical and Pharmaceutical. Results: 1. X-ray and US findings characteristics of DCM is significantly increased in diameter of L, H and mG; LVM, LVMI, LVDd and LAD. 2. The pression of pulmonary artery has been significantly increased with redistribution pulmonary arteries in 61.5% cases and 23.1% have reversed pulmonary artery distribution. 3. DCM have diastolic dysfunction in 100% patients, including severe disorders to 61.5%; the restrictive dysfunction has ratio E/A>2 and E/Em average was 23.89± 17.23. 4.The correlation between the morphology and function in DCM: the diameter of H and L on the X-ray, LAD and ratio LA/AO on US correlated with the level of diastolic dysfunction (p< 0.05). All three radiographic parameters on the radio standard (H, L, the index Cardio/Thoracic) and LVDd on US have negative correlated with EF and FS with p <0.05. Key words: dilated cardiomyopathy, diastolic dysfunction, cardiac tissue Doppler, reversed pulmonary artery distribution

STUDY OF HISTOPATHOLOGY IN PATIENTS WITH HODGKIN AND NON - HODGKIN LYMPHOMA

2016 ◽  
pp. 59-65 ◽  
Author(s):  
Van Mao Nguyen
Keyword(s):  
Lymph Node ◽  
Hodgkin Lymphoma ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Cross Sectional ◽  
Histopathological Classification ◽  
Non Hodgkin Lymphoma ◽  
Key Words Lymphoma ◽  
Malignant Grade

Background: Lymphoma is one of the most ten common cancers in the world as well as in Vietnam which has been ever increasing. It was divided into 2 main groups Hodgkin and non – Hodgkin lymphoma in which non-Hodgkin lymphoma appeared more frequency, worse prognosis and different therapy. Objectives: - To describe some common characteristics in patients with non – Hodgkin lymphoma; - To determine the proportion between Hodgkin and non- Hodgkin lymphoma, histopathological classification of classical Hodgkin by modified Rye 1966 and non-Hodgkin lymphoma by Working Formulation (WF) of US national oncology institute 1982. Materials and Method: This cross-sectional study was conducted on 65 patients with Hodgkin and non- Hodgkin lymphoma diagnosed definitely by histopathology at Hue Central Hospital and Hue University Hospital. Results:. The ratio of male/female for the non-Hodgkin lymphoma was 1.14/1, the most frequent range of age was 51-60 accounting for 35%, not common under 40 years. Non - Hodgkin lymphoma appeared at lymph node was the most common (51.7%), at the extranodal site was rather high 48.3%. The non - Hodgkin lymphoma proportion was predominant 92.3% comparing to the Hodgkin lymphoma only 7.7%; The most WF type was WF7 (53.3%), following the WF6 18,3% and WF5 11,7%; The intermediate malignancy grade of non- Hodgkin lymphoma was the highest proportion accouting for 85%, then the low and the high one 8.3% and 6.7% respectively. Conclusion: The histopathological classification and the malignant grade of lymphoma for Hodgkin and non - Hodgkin lymphoma played a practical role for the prognosis and the treatment orientation, also a fundamental one for the modern classification of non - Hodgkin lymphoma nowadays. Key words: lymphoma, Hodgkin lymphoma, non-Hodgkin lymphoma, classication, grade, histopathology, lymph node

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