Items in AFP with MESH term: Emigration and Immigration
ABSTRACT: Echinococcus tapeworms are parasites that infect dog species worldwide and occasionally are transmitted to humans. Infection occurs most commonly in persons who raise sheep or cattle, and who have contact with dogs. The tapeworm eggs are typically ingested during play with dogs or through consumption of garden vegetables or water contaminated by dog feces. The most common sites of tapeworm cyst formation within the body are the liver and lungs, although any internal organ or bone can be infected. The tapeworm infection is generally asymptomatic for 10 to 20 years, until the cyst grows large enough to cause problems. Untreated infection can be fatal. The possibility of this uncommon infection is most often considered when cysts are found on imaging studies of affected organs. Serologic testing has variable sensitivity, but it can be helpful. Surgical removal of cysts is the usual treatment, often with perioperative use of anthelmintic medication to prevent recurrence of disease caused by later growth of undetected daughter cysts.
Medical Care for Immigrants and Refugees - Article
ABSTRACT: Refugees and other immigrants often present with clinical problems that are as varied as their previous experiences. Clinical presentations may range from unusual infectious diseases to problems with transition. This article describes medical conditions associated with immigrants, as well as specific screening recommendations, including history, physical examination and laboratory tests, and some of the challenges encountered by family physicians caring for refugees.
Case Studies in International Medicine - Article
ABSTRACT: Family physicians in the United States are increasingly called on to manage the complex clinical problems of newly arrived immigrants and refugees. Case studies and discussions are provided in this article to update physicians on the diagnosis and management of potentially unfamiliar ailments, including strongyloidiasis, hookworm infection, cysticercosis, clonorchiasis and tropical pancreatitis. Albendazole and ivermectin, two important drugs in the treatment of some worm infections, are now available in the United States.
The A to Z of Cross-Cultural Medicine - Improving Patient Care
Primary Care for Refugees - Article
ABSTRACT: Over the past decade, at least 600,000 refugees from more than 60 different countries have been resettled in the United States. The personal history of a refugee is often marked by physical and emotional trauma. Although refugees come from many different countries and cultures, their shared pattern of experiences allows for some generalizations to be made about their health care needs and challenges. Before being accepted for resettlement in the United States, all refugees must pass an overseas medical screening examination, the purpose of which is to identify conditions that could result in ineligibility for admission to the United States. Primary care physicians have the opportunity to care for members of this unique population once they resettle. Refugees present to primary care physicians with a variety of health problems, including musculoskeletal and pain issues, mental and social health problems, infectious diseases, and longstanding undiagnosed chronic illnesses. Important infectious diseases to consider in the symptomatic patient include tuberculosis, parasites, and malaria. Health maintenance and immunizations should also be addressed. Language barriers, cross-cultural medicine issues, and low levels of health literacy provide additional challenges to caring for this population. The purpose of this article is to provide primary care physicians with a guide to some of the common issues that arise when caring for refugee patients.