ABSTRACT
Little is known about mental health problems among newly arrived Syrian refugees in the US. It is important to determine the prevalence of common consequences of exposure to trauma and high stress, and provide needed interventions, as these conditions if untreated, can be detrimental to mental and physical health. Adult Syrian refugees (n = 157, 47.1% women, 52.9% men) were screened at one-month mandatory primary care health visit for Posttraumatic Stress Disorder (PTSD), anxiety and depression using PTSD Checklist, and Hopkins Symptoms Checklist. Prevalence of possible diagnoses was high for PTSD (32.2%), anxiety (40.3%), and depression (47.7%). Possible prevalence of depression and anxiety were higher among women, but there was no gender difference for possible PTSD. We found a high prevalence of possible psychiatric disorders related to trauma and stress among Syrian refugees newly resettled in the US. Due to the high prevalence and feasibility of brief screening tools in primary care facilities, we recommend mental health screening during primary care health visits for resettled Syrian refugees.
Subject(s)
Mental Disorders/ethnology , Mental Health/ethnology , Primary Health Care/statistics & numerical data , Refugees/psychology , Adolescent , Adult , Aged , Anxiety/ethnology , Comorbidity , Cross-Sectional Studies , Depression/ethnology , Female , Humans , Male , Medical Savings Accounts , Middle Aged , Prevalence , Socioeconomic Factors , Stress Disorders, Post-Traumatic/ethnology , Syria/ethnology , United States/epidemiology , Warfare , Young AdultSubject(s)
Blood Platelets/drug effects , Diabetes Mellitus, Type 2/blood , Platelet Aggregation Inhibitors/pharmacology , Purinergic P2Y Receptor Antagonists/pharmacology , Receptors, Purinergic P2Y12/blood , Renal Insufficiency, Chronic/blood , Ticlopidine/analogs & derivatives , Biomarkers/blood , Blood Platelets/metabolism , Cell Adhesion Molecules/blood , Clopidogrel , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/diagnosis , Dose-Response Relationship, Drug , Drug Resistance , Humans , Microfilament Proteins/blood , Phosphoproteins/blood , Prospective Studies , Renal Insufficiency, Chronic/complications , Renal Insufficiency, Chronic/diagnosis , Signal Transduction/drug effects , Ticlopidine/pharmacologyABSTRACT
Several platelet function tests (PFT) are available to assess the pharmacodynamic (PD) effects of P2Y12 inhibitors. However, there are technical variances between PFT, and P2Y12 inhibitors differ in pharmacological properties. Manufactures of PFT recommend a time-frame within which assessments needs to be executed. However, if the timing from blood sampling to processing affects PD results is unknown. We conducted a prospective study assessing the impact of timing from blood sampling to processing on PD measures using three different PFT. We studied 60 aspirin-treated patients with coronary artery disease (CAD) on maintenance P2Y12 inhibiting therapy [clopidogrel 75 mg/day (n=20), prasugrel 10 mg/day (n=20) and ticagrelor 90 mg bid (n=20)]. PD assessments (trough levels) were performed by VerifyNow P2Y12 (VN), light transmittance aggregometry (LTA) and vasodilator-stimulated phosphoprotein (VASP) at 30 minutes, 2 and 4 hours post-sampling; VASP was also performed at 24 hours. P2Y12 reaction units (PRU) by VN significantly decreased over time with all P2Y12 inhibitors (clopidogrel p<0.001; prasugrel p=0.016; ticagrelor p<0.001). PRU at 30 minutes and 2 hours were similar, but decreased at 4 hours. LTA showed consistent findings with VN. Conversely, PD measures as assessed by VASP were stable over time (p>0.1 for all P2Y12 inhibitors). In conclusion, in CAD patients on maintenance therapy with P2Y12 inhibitors, timing from blood sampling to processing significantly influences PD measures as assessed by VN and LTA, but not by VASP.