Reactivation of Chagas disease in organ transplant recipients: Panniculitis as the only skin manifestation in a three case series Chagas disease, caused by Trypanosoma cruzi, is associated with high mortality and it is still endemic in Latin America. Solid organ transplant recipients can manifest Chagas disease mainly from reactivation of a chronic latent infection. 1 We report three cases of Chagas disease reactivation with skin manifestations in solid organ transplant recipients.A 61-year-old male presented with a 5-day history of dry cough, chest pain and painful, subcutaneous nodules on Funding Sources: None.
Epstein-Barr virus-positive mucocutaneous ulcer is a recent and unusual type of lymphoproliferation, mostly associated with various forms of immunosuppression. In most cases, they regress spontaneously, but an increasing number of reports describe a spectral behavior of the lesion, which ranges from a simple ulcer with eosinophilia to aggressive ulcers. In these cases, Epstein-Barr virus-related lymphomas are the main differential diagnosis. We report a unique observation of this rare disease with mandibular involvement. Due to bone erosion, the patient was treated with 6 cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) with complete healing of the ulcer on clinical examination and PET-scan control.
Background: Immigrants and refugees have specific mental health needs. Studies of immigrant/refugee psychiatric patients in Latin America are scarce. Aims: Present the profile of patients from an outpatient psychiatric service in Sao Paulo (Brazil) to better inform mental health service planning for immigrants and refugees in the Global South. Methods: Exploratory study to characterize the sociodemographic and mental health profile of refugees and immigrants attending outpatient psychiatric service from 2003 to 2018. Chi-square tests and logistic regressions were used to examine the association of demographic variables, exposure to violence, and immigrant status with psychiatric diagnosis. Cluster analysis was used to identify subgroups within the sample. Results: A total of 162 immigrants and refugees referred to the service obtained treatment. Of these patients, 57.4% were men, 59.8% were refugees/asylum seekers, 51.9% were Black, 48.8% were single, 64.2% had 10 years of education, and 57.4% were unemployed; the mean age of the sample was 35.9. Half of the sample (52.5%) was exposed to violence. The most common diagnosis was depression (54.2%), followed by PTSD (16.6%). Approximately 34% of the participants sought psychiatric care within 6 months of arrival. Logistic regressions showed that men had lower odds of presenting with depression (OR = 0.34). Patients with PTSD were more likely to be refugees (OR = 3.9) and not have a university degree (OR = 3.1). In the cluster analysis, a cluster of patients with PTSD included almost all Black refugee men exposed to violence. Most patients diagnosed with psychotic disorders were also Black refugee men. Conclusion: Immigrants and refugees represent a vulnerable group. The majority of the sample was Black, refugee men, who were also more likely to present with PTSD. Future studies are needed to better understand issues in treatment adherence in relation to socioeconomic characteristics.
Background Immigrants and refugees have specific mental health needs. Studies of immigrant psychiatric patients in Latin America are scarce. This article presents the profile of patients from an outpatient psychiatric service in Sao Paulo (Brazil) in order to better inform mental health service planning for immigrants and refugees.Methods Exploratory study to characterize demographic and mental health profile of refugees and immigrants attending service from 2003 to 2018. Chi-square tests and logistic regressions were used to examine the association of demographic variables, exposure to violence, and immigrant status with psychiatric diagnosis. Cluster Analysis was used to identify sub-groups within the sample. Results A total of 162 immigrants and refugees referred to the service obtained treatment, being 57·4% men, 59·8% refugees/asylum seekers, 51·9% black, 48·8% single, mean age of 35.9, 64·2% with ten years of education, 57·4% unemployed. Half of the sample (52·5%) were exposed to violence. The most common diagnosis was depression (54·2%) followed by PTSD (16·6%). Around 34% of the participants sought psychiatric care in six months upon arrival. Logistic regressions showed men were had decreased odds to present depression (OR= 0·34). Patients with PTSD were more likely to be refugees (OR= 3·9) and not having university degree (OR= 3·1). In cluster analysis, a cluster of patients with PTSD were almost all black refugee men exposed to violence. Most patients diagnosed with psychotic disorders were also black refugee men.Interpretation Data raises questions regarding sex differences and mental health care access. Refugees in Brazil are mainly black men, what might contribute to the profile found in the present study. Further investigation is needed to better understand treatment adherence and clarify the role of patient-health professional relationship in mental health outcomes.
Background Immigrants and refugees have specific mental health needs. Studies of immigrant/refugee psychiatric patients in Latin America are scarce. This article presents the profile of patients from an outpatient psychiatric service in Sao Paulo (Brazil) and aims to better inform mental health service planning for immigrants and refugees. Methods This was an exploratory study to characterize the sociodemographic and mental health profile of refugees and immigrants attending outpatient psychiatric service from 2003 to 2018. Chi-square tests and logistic regressions were used to examine the association of demographic variables, exposure to violence, and immigrant status with psychiatric diagnosis. Cluster analysis was used to identify subgroups within the sample. Results A total of 162 immigrants and refugees referred to the service obtained treatment. Of these patients, 57.4% were men, 59.8% were refugees/asylum seekers, 51.9% were Black, 48.8% were single, 64.2% had ten years of education, and 57.4% were unemployed; the mean age of the sample was 35.9. Half of the sample (52.5%) was exposed to violence. The most common diagnosis was depression (54.2%), followed by PTSD (16.6%). Approximately 34% of the participants sought psychiatric care within six months of arrival. Logistic regressions showed that men had lower odds of presenting with depression (OR= 0.34). Patients with PTSD were more likely to be refugees (OR= 3.9) and not have a university degree (OR= 3.1). In the cluster analysis, a cluster of patients with PTSD included almost all Black refugee men exposed to violence. Most patients diagnosed with psychotic disorders were also Black refugee men. Conclusion : Immigrants and refugees represent a vulnerable group. The majority of the sample was Black, refugee men, who were also more likely to present with PTSD. Future studies are needed to better understand issues in treatment adherence in relation to socioeconomic characteristics.
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