The lived experience of HIV-infected patients in the face of a positive diagnosis of the disease: a phenomenological study

Background AIDS as a human crisis may lead to devastating psychological trauma and stress for patients. Therefore, it is necessary to study different aspects of their lives for better support and care. Accordingly, this study aimed to explain the lived experience of HIV-infected patients in the face of a positive diagnosis of the disease. Methods This qualitative study is a descriptive phenomenological study. Sampling was done purposefully and participants were selected based on the inclusion and exclusion criteria. Data collection was conducted, using semi-structured interviews. Data analysis was performed using Colaizzi’s method. Results 12 AIDS patients participated in this study. As a result of data analysis, 5 main themes and 12 sub-themes were identified, which include: emotional shock (loathing, motivation of social isolation), the fear of the consequences (fear of the death, fear of loneliness, fear of disgrace), the feeling of the guilt (feeling of regret, feeling guilty, feeling of conscience-stricken), the discouragement (suicidal ideation, disappointment), and the escape from reality (denial, trying to hide). Conclusion The results of this study showed that patients will experience unpleasant phenomenon in the face of the positive diagnosis of the disease and will be subjected to severe psychological pressures that require attention and support of medical and laboratory centers.

Staphylococcal Epidermolysis: A Case Report

Acute staphylococcal epidermolysis, also known as staphylococcal scalded skin syndrome (SSSS), in young children is caused by the release of exfoliative toxins A and B (ETA and/or ETB) from an initial outbreak which can be ear-nose-throat, conjunctival or cutaneous. Staphylococcal scalded skin syndrome is characterized by painful erythroderma, quickly followed by generalized detachment with respect to mucous surfaces, regressing in 2 to 4 days on antibiotics. The positive diagnosis is mainly based on clinical examination and sometimes on skin biopsy. The course of the disease is benign, favored by anti-staphylococcal treatment combined with local care. However, the risk of fatal course is estimated at around 4% in the event of delay in antibiotic treatment. We report the case of an infant with SSSS, diagnosed and treated early with good evolution.

HIPERTENSIUNE PORTALĂ STÂNGĂ PRIN CHIST HIDATIC LIENAL

Left portal hypertension, caused by hydatic cyst of spleen is a rare complication. We present the clinical case of a 41 years old patient, diagnosed and surgically managed in our clinic. Positive diagnosis was confirmed by imaging methods and intraoperatively. Splenectomy, associated in postoperative period with antiparasitic medication and β-blockers, had a positive influence over the disease evolution.

Identifying Inconclusive Data in the SARS-CoV-2 Molecular Diagnostic Using Nucleocapsid Phosphoprotein Gene as Target

ABSTRACT Context: The gold standard test to identify the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in coronavirus disease 2019 (COVID-19) patients is the real-time reverse transcription quantitative polymerase chain reaction (RT-qPCR), but the inconclusive data and presence of false positive diagnosis remain the major problem of this approach. Objective: To compare the fitness of two primers sets to the SARS-CoV-2 nucleocapsid phosphoprotein (NP) gene in the molecular diagnosis of COVID-19, we verify the inconclusive data and confidence of high cycle threshold (Ct) values in the SARS-CoV-2 detection. Design: The 970 patient samples were tested using United States Centers for Disease Control and Prevention protocol. We compared the fitness of two primers sets to two different regions of NP gene. In addition, we check the consistency of positive samples with high Ct values by retesting extracted SARS-CoV-2 RNA or by second testing of patients. Results: The N1 and N2 displayed similar fitness during testing with no differences between Ct values. Then, we verified security range Cts related to positive diagnostic with Ct above 34 failing in 21/32 (65.6%) after retesting of samples. The samples patients with Ct above 34.89 that were doubly positive revealed a low sensitivity (52.4%) and specificity (63.6%) of the test in samples with Ct above 34. Conclusions: It is secure to use one primer set to the NP gene to identify SARS-CoV-2 in samples. However, samples with high Ct values may be considered inconclusive and retested to avoid false positive diagnosis.

Rhinolithiasis: A Rare Clinical Case

Rhinolithiasis is a rare condition in our current practice. We report the case of a 19 year old woman, presenting with a double symptom marked by rhinorrhea and chronic unilateral nasal obstruction evolving since the age of 7 years, without any known foreign body. Rhinoscopy and nasal endoscopy coupled with CT scan were decisive examinations for the positive diagnosis. The therapeutic management consisted in the extraction of the rhinolithiasis resulting in the vacuity of the nasal cavity. The evolution was favorable with simple postoperative courses. Keywords: Rhinolithiasis; Woman; Rhinoscopy; Endoscopic Surgery

Torsion of the Ovary in Infancy, a Rare Emergency; A Case Report

Torsion of the ovary is a rare condition whose diagnosis remains difficult given the non-specificity of the clinical picture as well as the difficulty of clinical evaluation, especially in young girls. It is a surgical emergency because it involves the vital prognosis by the hemorrhagic risk, and functional prognosis by the risk of infertility. The clinical picture is dominated by acute abdominal pain. Our work reports the case of a 2-year-old girl in whom the diagnosis of ovarian torsion was made in front of an atypical clinical picture. Laparoscopy is the method of choice for making a positive diagnosis and performing a conservative procedure as described in this work.

Examining the potential benefits of the influenza vaccine against SARS-CoV-2: A retrospective cohort analysis of 74,754 patients

Introduction Recently, several single center studies have suggested a protective effect of the influenza vaccine against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). This study utilizes a continuously updated Electronic Medical Record (EMR) network to assess the possible benefits of influenza vaccination mitigating critical adverse outcomes in SARS-CoV-2 positive patients from 56 healthcare organizations (HCOs). Methods The de-identified records of 73,346,583 patients were retrospectively screened. Two cohorts of 37,377 patients, having either received or not received influenza vaccination six months–two weeks prior to SARS-CoV-2 positive diagnosis, were created using Common Procedural Terminology (CPT) and logical observation identifiers names and codes (LOINC) codes. Adverse outcomes within 30, 60, 90, and 120 days of positive SARS-CoV-2 diagnosis were compared between cohorts. Outcomes were assessed with stringent propensity score matching including age, race, ethnicity, gender, hypertension, diabetes, hyperlipidemia, chronic obstructive pulmonary disease (COPD), obesity, heart disease, and lifestyle habits such as smoking. Results SARS-CoV-2-positive patients who received the influenza vaccine experienced decreased sepsis (p<0.01, Risk Ratio: 1.361–1.450, 95% CI:1.123–1.699, NNT:286) and stroke (p<0.02, RR: 1.451–1.580, 95% CI:1.075–2.034, NNT:625) across all time points. ICU admissions were lower in SARS-CoV-2-positive patients receiving the influenza vaccine at 30, 90, and 120 days (p<0.03, RR: 1.174–1.200, 95% CI:1.003–1.385, NNT:435), while approaching significance at 60 days (p = 0.0509, RR: 1.156, 95% CI:0.999–1.338). Patients who received the influenza vaccine experienced fewer DVTs 60–120 days after positive SARS-CoV-2 diagnosis (p<0.02, RR:1.41–1.530, 95% CI:1.082–2.076, NNT:1000) and experienced fewer emergency department (ED) visits 90–120 days post SARS-CoV-2-positive diagnosis (p<0.01, RR:1.204–1.580, 95% CI: 1.050–1.476, NNT:176). Conclusion Our analysis outlines the potential protective effect of influenza vaccination in SARS-CoV-2-positive patients against adverse outcomes within 30, 60, 90, and 120 days of a positive diagnosis. Significant findings favoring influenza vaccination mitigating the risks of sepsis, stroke, deep vein thrombosis (DVT), emergency department (ED) & Intensive Care Unit (ICU) admissions suggest a potential protective effect that could benefit populations without readily available access to SARS-CoV-2 vaccination. Thus further investigation with future prospective studies is warranted.

The Lived Experience of HIV-Infected Patients in the Face of a Positive Diagnosis of the Disease: A Phenomenological Study

Background: AIDS as a human crisis may lead to devastating psychological trauma and stress for patients. Therefore, it is necessary to study different aspects of their lives for better support and care. Accordingly, this study aimed to explain the lived experience of HIV-infected patients in the face of a positive diagnosis of the disease.Methods: This qualitative study is a descriptive phenomenological study. Sampling was done purposefully and participants were selected based on the inclusion and exclusion criteria. Data collection was conducted, using semi-structured interviews. Data analysis was performed using Colaizzi’s method.Results: 12 AIDS patients participated in this study. As a result of data analysis, 5 main themes and 12 sub-themes were identified, which include: emotional shock (loathing, motivation of social isolation), the fear of the consequences (fear of the death, fear of loneliness, fear of disgrace), the feeling of the guilt (feeling of regret, feeling guilty, feeling of conscience-stricken), the discouragement (suicidal ideation, disappointment), and the escape from reality (denial, trying to hide).Conclusions: The results of this study showed that patients will experience unpleasant phenomenon in the face of the positive diagnosis of the disease and will be subjected to severe psychological pressures that require attention and support of medical and laboratory centers.