What are the current factors that impact on health-related quality of life for women living with HIV?

Since the start of the HIV epidemic, care has often had a strong focus on quality of life. In the early days, this was in part due to the limited treatment options available for people living with HIV, alongside the strong humanistic desire of those working in the specialty to provide optimum care. Advances in HIV treatments have led to care having more of a medical focus, with national and international targets concentrating on the prevention of new infections. Despite medical progress, the impact of being diagnosed and living with HIV has a significant impact on many people, across all aspects of their life. Factors that impact on health-related quality of life for women living with HIV are often poorly understood and under-explored in healthcare settings.

AIDS Related Kaposi’s Sarcoma: A 20-Year Experience in a Clinic from the South-East of Romania

Kaposi’s sarcoma (KS) was peculiarly described in the first notified cases of the acquired immunodeficiency syndrome as an opportunistic condition. However, the medical progress and the development of active antiretroviral therapy allowed the control of the HIV/AIDS epidemic, although the features of KS have changed throughout the past decades. The purpose of our study is to assess the epidemiological and clinical features of AIDS related KS in Romanian patients. A retrospective follow-up study was achieved in a single infectious diseases’ clinic from Galati—Romania, between 2001 and 2021. Referring to 290 new HIV diagnosed cases from our clinic retained in care, the prevalence of KS was 3.4%. The main characteristics of patients with KS are a median age of 33, a predominance of males, prevalent severe systemic forms of diseases, frequent association of past or concomitant tuberculosis, and context of immune reconstruction syndrome. The mortality rate was 70%. KS has occurred in patients with delayed HIV diagnoses and inadequate adherence to therapy. Early recognition of both infections, the close monitoring of latent or symptomatic tuberculosis, improving the antiretroviral adherence and raising the access to oncologic procedures in Romanian HIV patients could improve their prognosis related to KS.

Digital Technology in Visceral Medicine: An Overview in Outpatient Care in Germany

<b><i>Background:</i></b> Digital technology has become an integral part of healthcare and will revolutionize the practice of medicine. Although previously the administrative tasks were captured by digital technologies, now the communication channels with the patients are also being focused. For example, taking medical histories is now made possible by this new technology, information and explanatory forms can be sent digitally, and even face-to-face consultations are increasingly made possible by video consultations. Especially in the COVID pandemic, this form of contactless encounter has become a valuable enrichment of medical care. But also telemedical tasks such as teleconsultation or artificial intelligence in the context of adenoma detection are techniques that are conquering outpatient and inpatient visceral medical care. <b><i>Summary:</i></b> This article gives an overview of digital communication and possible uses of digital technologies in medical practices in Germany. <b><i>Key Message:</i></b> Medicine is renewing itself through digital techniques. The pace of change is rapid and unstoppable. Today’s medical progress is no longer conceivable without these techniques.

Cotard Syndrome in recurrent depressive disorder: case report

The Cotard Syndrome, also known as delirium of negation or nihilistic delirium, was described by the French neurologist, Julius Cotard, on June 1880. From that time until the end of the 20th century, in scientific literature, approximately 100 cases were reported that presented symptoms of depression, anxiety, nihilist delusions concerning the body and existence, hypochondriacal and immortality delusions, as well as auditory and visual hallucinations. We present the case of a female patient, 73-years old, from Ayacucho, with a history of sexual assault at the age of 12 and suicidal attempts on 2 occasions, diagnosed with depression at 40 years of age, received treatment with quetiapine, trazadone and clonazepam. She remained with fluctuating medical progress, with symptoms worsening with stressors such as the death of her mother and husband and when she underwent surgeries. Currently, she presents sad and anxious mood, daily crying, ideas of guilt, disability and death, insomnia of conciliation, nihilistic delusive ideas concerning the body, referring that her stomach and bladder do not work, reason why she doesn’t want to eat or drink water. Due to the total refusal of food intake and persistent suicidal ideation, she was hospitalized to receive psychiatric treatment and nutritional support. It is concluded that there are few cases reported on the use of psychotherapy in Cotard's syndrome. Therefore, this case in which psychotherapy was indicated to reduce anxious-affective symptoms, to avoid isolation of the person and to redirect his personal and social life, is important.

Value of Newborn Screening Programs for Severe Combined Immunodeficiency

Severe Combined Immunodeficiency Disease (SCID) is life-threatening disease of infancy and childhood characterized by recurrent infections and failure to thrive. Given the modern medical progress made available for treating SCID, early identification of these children is paramount to their wellbeing and overall survival into adulthood. Newborn screening (NBS) programs provide the opportunity to identify SCID patients before life-threatening infections can manifest. The T-cell receptor excision circles (TRECs) assay currently used for SCID screening has been shown to satisfy all parameters of an effective screening test. Its widespread use is indicated by the time-sensitive nature of the disease, its efficacy in reducing morbidity and mortality in these patients, and the cost-effectiveness of prompt recognition versus long-term management. While immensely beneficial, screening tests still hold limitations that require analyzing. Follow-up measures for SCID identification programs have identified ambiguity and inconsistency among testing algorithms across facilities and technical errors that have causes inaccurate results. Considering fewer than 20% of SCID patients report a positive family history and the lethal consequences of disease if left untreated, a screening program is a highly valuable tool for early diagnosis and prompt intervention.

A Blueprint for Undergraduate Students to Work on Medical Cases (Preprint)

UNSTRUCTURED A case report is a detailed narrative that describes the symptoms, signs, diagnosis, treatment, and follow-up of a medical problem of an individual patient. They usually describe an unusual or novel occurrence and although they lie at the bottom of the hierarchy of the Evidence Based Medicine Pyramid, they still remain one of the cornerstones of medical progress and provide key additions to the existing medical literature. Unfortunately, abysmally few physicians-in-training receive a formal education regarding what constitutes a publishable case report. The article throws light on this aspect of medical education

Work disability and rheumatoid arthritis: Predictive factors

BACKGROUND: Rheumatoid arthritis is often associated with work disability, a term used to describe the inability to be or to remain employed. Work disability is a common implication of rheumatoid arthritis. OBJECTIVE: This review aims to identify and analyze the predictive factors of work disability among patients with rheumatoid arthritis, as well as to group these factors into broader categories, based on the most current studies in this field. METHODS: An electronic search was conducted using Google Scholar, MEDLINE and PsycINFO databases. Eighty-six international journal articles were finally selected. RESULTS: The results suggest that occupational, personal, medical and societal factors are the main predictive categories of work disability for people with rheumatoid arthritis. CONCLUSIONS: Medical progress has had a positive effect on the development and the rates of work disability among patients with RA. Work disability is, however, not only defined by medical factors. Occupational, personal and societal factors interact with each other and affect the development of work disability in RA. The results of this review emphasize the need for medical and vocational therapy interventions, social support and state policies that target the work status of patients with RA. Future holistic research approaches to the field are required for a complete picture and concrete solutions with the aim of keeping patients with RA employed.