Benign Acute Childhood Myositis (BACM) is rare clinical entity with an incidence of 2.69 cases per 100,000 that is caused by a range of viral, bacterial and rarely fungal pathogens. Recurrent BACM is even more rare with unknown incidence. Despite BACM being an unusual condition, it is widely reported in the literature, however a lack of knowledge results in missed, or delayed diagnosis. This case report discusses a rare presentation of recurrent BACM in an 11 year old female who presented to the authors’ rural emergency department with her mother. She had an 3 day history of difficulty walking following an upper respiratory tract infection that began 5 days prior to onset of symptoms. Examination revealed bilateral tender calves, sacroiliac joints and reluctance to weightbear with an abnormal gait. An incidental finding of generalised joint hypermobility (GJH) was noted. CK level was 2324 U/L. The patient’s mother disclosed a complex rheumatologic history on her side of the family and 2 identical episodes of BACM occurring within a 12 month timeframe. A discussion on current understanding of the pathophysiology of BACM and gaps in current literature is provided. BACM carries a small risk of rhabdomyolysis and renal failure and patients should be referred for assessment in the Emergency Department. No literature has explored the relationship between GJH and BACM and the relationship between recurrent BACM and other rheumatic diseases such as autoimmune juvenile myositis, or systemic myopathies is not known.
{"title":"Recurrent Benign Acute Childhood Myositis (BACM) and Incidental Generalised Joint Hypermobility (GJH); A Case Study and Discussion","authors":"","doi":"10.33140/mcr.9.07.01","DOIUrl":"https://doi.org/10.33140/mcr.9.07.01","url":null,"abstract":"Benign Acute Childhood Myositis (BACM) is rare clinical entity with an incidence of 2.69 cases per 100,000 that is caused by a range of viral, bacterial and rarely fungal pathogens. Recurrent BACM is even more rare with unknown incidence. Despite BACM being an unusual condition, it is widely reported in the literature, however a lack of knowledge results in missed, or delayed diagnosis. This case report discusses a rare presentation of recurrent BACM in an 11 year old female who presented to the authors’ rural emergency department with her mother. She had an 3 day history of difficulty walking following an upper respiratory tract infection that began 5 days prior to onset of symptoms. Examination revealed bilateral tender calves, sacroiliac joints and reluctance to weightbear with an abnormal gait. An incidental finding of generalised joint hypermobility (GJH) was noted. CK level was 2324 U/L. The patient’s mother disclosed a complex rheumatologic history on her side of the family and 2 identical episodes of BACM occurring within a 12 month timeframe. A discussion on current understanding of the pathophysiology of BACM and gaps in current literature is provided. BACM carries a small risk of rhabdomyolysis and renal failure and patients should be referred for assessment in the Emergency Department. No literature has explored the relationship between GJH and BACM and the relationship between recurrent BACM and other rheumatic diseases such as autoimmune juvenile myositis, or systemic myopathies is not known.","PeriodicalId":503698,"journal":{"name":"Medical & Clinical Research","volume":" 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141833351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 68-year-old Caucasian male presented to the emergency department for administration of IV ceftriaxone post discharge for Enterococcus faecalis Cardiac Device Infective Endocarditis (CDIE). The patient reported a rash on his legs which had been present for many weeks. On examination the rash a revealed non-blanching purpuric rash resembling leukocytoclastic vasculitis. Biopsy and serology performed in our rural emergency department confirmed IgA vasculitis (IgAV). The patient had no systemic features to suggest IgA nephritis, or other systemic disease and the rash resolved with no additional treatment. A discussion of the differential diagnoses in this case highlights the importance of opportunistic biopsy and vasculitis serology in the rural emergency department setting and recommends screening for underlying cancer given the close association of IgAV with malignancy. The importance of emergency department protocols for assessment of skin lesions suggestive of an underlying systemic disease is also discussed.
一名 68 岁的白种男性因患粪肠球菌性心脏装置感染性心内膜炎 (CDIE) 出院后到急诊科接受头孢曲松静脉注射。患者称其腿部出现皮疹已有数周。对皮疹进行检查后发现，皮疹为非淤斑性紫癜，类似白细胞凝集性血管炎。我们在农村急诊科进行的活检和血清学检查证实了 IgA 血管炎（IgAV）。该患者没有任何全身特征，表明其患有 IgA 肾炎或其他全身性疾病，而且无需额外治疗，皮疹即可消退。对该病例鉴别诊断的讨论强调了在农村急诊科环境中进行机会性活检和血管炎血清学检查的重要性，并建议筛查潜在的癌症，因为 IgAV 与恶性肿瘤密切相关。此外，还讨论了急诊科对提示潜在系统性疾病的皮肤病变进行评估的重要性。
{"title":"IgA Vasculitis Secondary to Enterococcus Faecalis Cardiac Device Infective Endocarditis; A Case Report, Discussion of the Literature and Protocol for Assessment of Inflammatory Skin Lesions in Emergency Medicine","authors":"","doi":"10.33140/mcr.09.06.01","DOIUrl":"https://doi.org/10.33140/mcr.09.06.01","url":null,"abstract":"A 68-year-old Caucasian male presented to the emergency department for administration of IV ceftriaxone post discharge for Enterococcus faecalis Cardiac Device Infective Endocarditis (CDIE). The patient reported a rash on his legs which had been present for many weeks. On examination the rash a revealed non-blanching purpuric rash resembling leukocytoclastic vasculitis. Biopsy and serology performed in our rural emergency department confirmed IgA vasculitis (IgAV). The patient had no systemic features to suggest IgA nephritis, or other systemic disease and the rash resolved with no additional treatment. A discussion of the differential diagnoses in this case highlights the importance of opportunistic biopsy and vasculitis serology in the rural emergency department setting and recommends screening for underlying cancer given the close association of IgAV with malignancy. The importance of emergency department protocols for assessment of skin lesions suggestive of an underlying systemic disease is also discussed.","PeriodicalId":503698,"journal":{"name":"Medical & Clinical Research","volume":"80 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141338146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
It had been four years since COVID-19 first appeared in Arizona on January 22, 2020. The state is about the same size as Italy. Since Arizona Governor Doug Ducey had declared a State of Emergency to combat COVID-19 on March 11, 2020, the state had gone through three Reopening Phases. ABC and NBC News reported that the state had the highest new cases per capital in the world during Arizona’s Reopening Phase 2 winter surge in 2020. The state had been in Reopening Phase 3 (final phase) since March 5, 2021. Arizona had the highest death rate per capital of all the 50 states in 2021-22 reported by the Centers for Disease Control and Prevention (CDC). The study examined four years of the state’s COVID-19 pandemic. On December 27, 2023, the four-year totals were 2,540,562 COVID-19 cases, 149,121 hospitalizations, and 33,900 deaths. During the first three years, the case numbers rose (590,745 in 2020, 827,573 in 2021, and 988,649 in 2022), but in the fourth year, the case number had dropped significantly (168,918 in 2023). There were seven case surges during the four years. Arizona had been in the endemic phase of the virus for the past six months. The new normal was not zero cases, but a low number of severe cases, manageable hospitalization numbers, and low number of deaths.
{"title":"Arizona and COVID-19: Four-Year Experience 2020-23","authors":"","doi":"10.33140/mcr.09.054","DOIUrl":"https://doi.org/10.33140/mcr.09.054","url":null,"abstract":"It had been four years since COVID-19 first appeared in Arizona on January 22, 2020. The state is about the same size as Italy. Since Arizona Governor Doug Ducey had declared a State of Emergency to combat COVID-19 on March 11, 2020, the state had gone through three Reopening Phases. ABC and NBC News reported that the state had the highest new cases per capital in the world during Arizona’s Reopening Phase 2 winter surge in 2020. The state had been in Reopening Phase 3 (final phase) since March 5, 2021. Arizona had the highest death rate per capital of all the 50 states in 2021-22 reported by the Centers for Disease Control and Prevention (CDC). The study examined four years of the state’s COVID-19 pandemic. On December 27, 2023, the four-year totals were 2,540,562 COVID-19 cases, 149,121 hospitalizations, and 33,900 deaths. During the first three years, the case numbers rose (590,745 in 2020, 827,573 in 2021, and 988,649 in 2022), but in the fourth year, the case number had dropped significantly (168,918 in 2023). There were seven case surges during the four years. Arizona had been in the endemic phase of the virus for the past six months. The new normal was not zero cases, but a low number of severe cases, manageable hospitalization numbers, and low number of deaths.","PeriodicalId":503698,"journal":{"name":"Medical & Clinical Research","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140411856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Macro-data during the COVID-19 pandemic in the United Kingdom (UK) are shown to have significant data anomalies and inconsistencies with existing explanations. This paper shows that the UK spike in deaths, wrongly attributed to COVID-19 in April 2020, was not due to SARS-CoV-2 virus, which was largely absent, but was due to the widespread use of Midazolam injections which were statistically very highly correlated (coefficient over 90 percent) with excess deaths in all regions of England during 2020. Importantly, excess deaths remained elevated following mass vaccination in 2021, but were statistically uncorrelated to COVID vaccination, while remaining significantly correlated to Midazolam injections. The widespread and persistent use of Midazolam in UK suggests a possible policy of systemic euthanasia. Unlike Australia, where assessing the statistical impact of COVID vaccination on excess deaths is relatively straightforward, UK excess deaths were closely associated with the use of Midazolam and other medical intervention. The iatrogenic pandemic in the UK was caused by euthanasia deaths from Midazolam and also, likely caused by COVID vaccination, but their relative impacts are difficult to measure from the data, due to causal proximity of euthanasia. Global investigations of COVID-19 epidemiology, based only on the relative impacts of COVID disease and vaccination, may be inaccurate, due to the neglect of significant confounding factors in some countries.
{"title":"Excess Deaths in the United Kingdom: Midazolam and Euthanasia in the COVID-19 Pandemic","authors":"","doi":"10.33140/mcr.09.053","DOIUrl":"https://doi.org/10.33140/mcr.09.053","url":null,"abstract":"Macro-data during the COVID-19 pandemic in the United Kingdom (UK) are shown to have significant data anomalies and inconsistencies with existing explanations. This paper shows that the UK spike in deaths, wrongly attributed to COVID-19 in April 2020, was not due to SARS-CoV-2 virus, which was largely absent, but was due to the widespread use of Midazolam injections which were statistically very highly correlated (coefficient over 90 percent) with excess deaths in all regions of England during 2020. Importantly, excess deaths remained elevated following mass vaccination in 2021, but were statistically uncorrelated to COVID vaccination, while remaining significantly correlated to Midazolam injections. The widespread and persistent use of Midazolam in UK suggests a possible policy of systemic euthanasia. Unlike Australia, where assessing the statistical impact of COVID vaccination on excess deaths is relatively straightforward, UK excess deaths were closely associated with the use of Midazolam and other medical intervention. The iatrogenic pandemic in the UK was caused by euthanasia deaths from Midazolam and also, likely caused by COVID vaccination, but their relative impacts are difficult to measure from the data, due to causal proximity of euthanasia. Global investigations of COVID-19 epidemiology, based only on the relative impacts of COVID disease and vaccination, may be inaccurate, due to the neglect of significant confounding factors in some countries.","PeriodicalId":503698,"journal":{"name":"Medical & Clinical Research","volume":"128 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140456193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Birhange Bukanja Sosthène, Bahati Badarhi Chance, Chiza Buhendwa Rock, T. B. Kabesha, Pr Théophile, MD Mph Barhwamire Kabesha
Introduction: Fractures of the humeral paddle in children are one of the most frequent causes of emergency trauma. The aim of this study is to describe the epidemiological, clinical and therapeutic aspects of humeral paddle fractures in children followed in our department for 3 years. Patients and Methods: Prospective study involving 15 consecutive patients followed for fracture of the humeral paddle in our department from January 1, 2020 to December 31, 2022. The sampling was exhaustive, the data were collected on a preestablished form. Sociodemographic, clinical and therapeutic parameters were studied. Lesions were classified according to the Rigault and Lagrange classification. All these patients were operated on and followed by the same surgeon with a one-year follow-up. Results: The 5-8 year old age group predominated (66.7%); the sex ratio was 2.5 in favor of boys. Gaming accidents were the most dominant in 60%, the indirect mechanism was the most represented. All patients presented with a painful and impotent elbow. Supra-condylar fractures were the most common (60% of cases) and type II fractures were the most frequent in 53.3% of cases. The immediate complications were predominated by the absence of the radial pulse. The treatment was orthopedic in 73.3% of cases, and according to the Blount method in 72.7%. The results were satisfactory in 93.3% of cases. Elbow stiffness was the main complication (6.7%). Conclusion: Fractures of the humeral paddle are common in children, and often occur during play. The prognosis depends on the precocity and effectiveness of treatment. Early rehabilitation helps prevent elbow stiffness. Supervision of children's games by adults remains essential to prevent these fractures.
{"title":"Fractures of the Humeral Paddle in Children: About 15 Cases Followed At The Celpa-Bukavu Hospital Center From 01.01.2020-31.12.2023","authors":"Birhange Bukanja Sosthène, Bahati Badarhi Chance, Chiza Buhendwa Rock, T. B. Kabesha, Pr Théophile, MD Mph Barhwamire Kabesha","doi":"10.33140/mcr.09.02.04","DOIUrl":"https://doi.org/10.33140/mcr.09.02.04","url":null,"abstract":"Introduction: Fractures of the humeral paddle in children are one of the most frequent causes of emergency trauma. The aim of this study is to describe the epidemiological, clinical and therapeutic aspects of humeral paddle fractures in children followed in our department for 3 years. Patients and Methods: Prospective study involving 15 consecutive patients followed for fracture of the humeral paddle in our department from January 1, 2020 to December 31, 2022. The sampling was exhaustive, the data were collected on a preestablished form. Sociodemographic, clinical and therapeutic parameters were studied. Lesions were classified according to the Rigault and Lagrange classification. All these patients were operated on and followed by the same surgeon with a one-year follow-up. Results: The 5-8 year old age group predominated (66.7%); the sex ratio was 2.5 in favor of boys. Gaming accidents were the most dominant in 60%, the indirect mechanism was the most represented. All patients presented with a painful and impotent elbow. Supra-condylar fractures were the most common (60% of cases) and type II fractures were the most frequent in 53.3% of cases. The immediate complications were predominated by the absence of the radial pulse. The treatment was orthopedic in 73.3% of cases, and according to the Blount method in 72.7%. The results were satisfactory in 93.3% of cases. Elbow stiffness was the main complication (6.7%). Conclusion: Fractures of the humeral paddle are common in children, and often occur during play. The prognosis depends on the precocity and effectiveness of treatment. Early rehabilitation helps prevent elbow stiffness. Supervision of children's games by adults remains essential to prevent these fractures.","PeriodicalId":503698,"journal":{"name":"Medical & Clinical Research","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140456140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cultural values among young population are focused on the concept of skin tanning as a perception of health and attractiveness. This has populated the development of using synthetic tanning agents especially with the advertisement coming from the social media. Synthetic tanning agents in forms of nasal spray or injections have gained publicity of use within society through the web and other uncontrolled sourcing routes. Warnings have been issued by UK Medicines and Healthcare products Regulatory Agency, and Irish Medicines Board against the use of subcutaneous injections labelled as Melanotan, after the upsurge in consuming tanning injections that has noticed in recent years [1].
{"title":"Tanning Melanotan Jabs and Nasal Spray: Safe or Not?","authors":"","doi":"10.33140/mcr.09.02.05","DOIUrl":"https://doi.org/10.33140/mcr.09.02.05","url":null,"abstract":"Cultural values among young population are focused on the concept of skin tanning as a perception of health and attractiveness. This has populated the development of using synthetic tanning agents especially with the advertisement coming from the social media. Synthetic tanning agents in forms of nasal spray or injections have gained publicity of use within society through the web and other uncontrolled sourcing routes. Warnings have been issued by UK Medicines and Healthcare products Regulatory Agency, and Irish Medicines Board against the use of subcutaneous injections labelled as Melanotan, after the upsurge in consuming tanning injections that has noticed in recent years [1].","PeriodicalId":503698,"journal":{"name":"Medical & Clinical Research","volume":"149 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140455606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A New Biodynamic Enzyme Therapy. First of all, without Enzymes There is no Life! • When the term "enzymes" is used, the first thing that comes to mind is digestion. However, there are two types of enzymes: those for digestion, which break down carbohydrates, proteins and fats. These are not the focus here. It is about the intracellular enzymes in all cells of the body, which are more important.
{"title":"Enzyme Therapy - A Revolution in Medicine?","authors":"","doi":"10.33140/mcr.09.03.03","DOIUrl":"https://doi.org/10.33140/mcr.09.03.03","url":null,"abstract":"A New Biodynamic Enzyme Therapy. First of all, without Enzymes There is no Life! • When the term \"enzymes\" is used, the first thing that comes to mind is digestion. However, there are two types of enzymes: those for digestion, which break down carbohydrates, proteins and fats. These are not the focus here. It is about the intracellular enzymes in all cells of the body, which are more important.","PeriodicalId":503698,"journal":{"name":"Medical & Clinical Research","volume":"44 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140455969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Steven Johnson Syndrome (SJS) and Toxic Epidermal necrolysis are rare dermatological emergencies that are associated with a high degree of morbidity and mortality [1]. They are considered to be severe blistering conditions that portray an image of diffuse epidermal necrolysis in association with sloughing of the skin. SJS and TEN are effectively the same disease with the main difference being the percentage of body surface area involved. It is widely accepted that SJS belongs to the below 10% body surface area category and TEN to the more than 30% category. A Steven Johnson syndrome and Toxic Epidermal Necrolysis overlap exists when the body surface area affected is between 10 percent and 30 percent [2]. The causes of both conditions within this spectrum are most likely drug related, however certain infections can also trigger SJS/TEN but this is less likely. In a substantial number of cases the cause is idiopathic [3]. The main grading system is the SCORTEN criteria, which can also provide more information regarding prognosis and mortality [4]. Management of this condition is highly controversial with no clear guidelines but there is a wide agreement that patients should be managed in a burns unit with intravenous fluids and protection from secondary infections. Stopping all medications and investigating for the cause is important unless there is clear benefit from any single medication.
{"title":"Pathogenesis and A Practical Guide to the Management of Steven-Johnson Syndrome & Toxic Epidermal Necrolysis","authors":"","doi":"10.33140/mcr.09.02.06","DOIUrl":"https://doi.org/10.33140/mcr.09.02.06","url":null,"abstract":"Steven Johnson Syndrome (SJS) and Toxic Epidermal necrolysis are rare dermatological emergencies that are associated with a high degree of morbidity and mortality [1]. They are considered to be severe blistering conditions that portray an image of diffuse epidermal necrolysis in association with sloughing of the skin. SJS and TEN are effectively the same disease with the main difference being the percentage of body surface area involved. It is widely accepted that SJS belongs to the below 10% body surface area category and TEN to the more than 30% category. A Steven Johnson syndrome and Toxic Epidermal Necrolysis overlap exists when the body surface area affected is between 10 percent and 30 percent [2]. The causes of both conditions within this spectrum are most likely drug related, however certain infections can also trigger SJS/TEN but this is less likely. In a substantial number of cases the cause is idiopathic [3]. The main grading system is the SCORTEN criteria, which can also provide more information regarding prognosis and mortality [4]. Management of this condition is highly controversial with no clear guidelines but there is a wide agreement that patients should be managed in a burns unit with intravenous fluids and protection from secondary infections. Stopping all medications and investigating for the cause is important unless there is clear benefit from any single medication.","PeriodicalId":503698,"journal":{"name":"Medical & Clinical Research","volume":"142 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140459531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vaccination have been critical for reducing death rates, severe illness, and severe long-term health risks; however, vaccine hesitancy has emerged as a key challenge. Understanding survivors’ perspectives on vaccination, given their direct virus experience and elevated risks, is critical. This study explores COVID-19 vaccination decision-making among Romanian adult survivors to gain a deeper understanding of the factors influencing vaccine acceptance and hesitancy within this societal context. Semi-structured interviews were conducted from November 2022-April 2023 with 30 participants (ages 35-76) previously hospitalized for severe COVID-19. Before contacting COVID-19, 26.6% of participants accepted vaccine, and an additional 50% chose to accept following their discharge. Thematic analysis identified four main themes: Severe Illness as a Catalyst for Vaccine Acceptancce, Vaccine Adverse Reactions Fueling Hesitancy, Accepting influence from trustworthy relationship and, General disbelief and Conspiracy Theories. This study’s findings indicate that many participants were deeply affected by their own severe experiences with COVID-19. For these participants, their traumatic experience was ultimately the main factor that motivated them to proactively seek out reliable information, ignore conspiracy theories, and engage diligently in recommended safety behaviours. Nevertheless, many survivors still opted against vaccination after hospital discharge. This qualitative study advances understanding of the intricacies underlying COVID-19 vaccination decision-making amongst survivors.
{"title":"Vaccine Decision-Making Influences - Insights from Severe COVID-19 Survivors: A Qualitative Study","authors":"","doi":"10.33140/mcr.09.052","DOIUrl":"https://doi.org/10.33140/mcr.09.052","url":null,"abstract":"Vaccination have been critical for reducing death rates, severe illness, and severe long-term health risks; however, vaccine hesitancy has emerged as a key challenge. Understanding survivors’ perspectives on vaccination, given their direct virus experience and elevated risks, is critical. This study explores COVID-19 vaccination decision-making among Romanian adult survivors to gain a deeper understanding of the factors influencing vaccine acceptance and hesitancy within this societal context. Semi-structured interviews were conducted from November 2022-April 2023 with 30 participants (ages 35-76) previously hospitalized for severe COVID-19. Before contacting COVID-19, 26.6% of participants accepted vaccine, and an additional 50% chose to accept following their discharge. Thematic analysis identified four main themes: Severe Illness as a Catalyst for Vaccine Acceptancce, Vaccine Adverse Reactions Fueling Hesitancy, Accepting influence from trustworthy relationship and, General disbelief and Conspiracy Theories. This study’s findings indicate that many participants were deeply affected by their own severe experiences with COVID-19. For these participants, their traumatic experience was ultimately the main factor that motivated them to proactively seek out reliable information, ignore conspiracy theories, and engage diligently in recommended safety behaviours. Nevertheless, many survivors still opted against vaccination after hospital discharge. This qualitative study advances understanding of the intricacies underlying COVID-19 vaccination decision-making amongst survivors.","PeriodicalId":503698,"journal":{"name":"Medical & Clinical Research","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140495000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We present two clinical cases in young patients with the rare pathohistological diagnosis of giant cell bone tumor (GCT) and aneurysmal bone cyst (ABC). Against this background, we discuss the rare indications for intensity modulated radiotherapy (IMRT). We focus on the imaging and pathohistological differences, as well as in terms of biological development in these two osteoclastic tumors with a high risk of recurrence after the inability to perform radical operations due to their localization.
{"title":"Intensity Modulated Radiotherapy in Giant Cell Bone Tumor and Aneurysmal Bone Cyst-Imaging and Pathohistological Differential Diagnosis and Achieved Long-Term Healing Results after Radiation Therapy","authors":"","doi":"10.33140/mcr.09.01.06","DOIUrl":"https://doi.org/10.33140/mcr.09.01.06","url":null,"abstract":"We present two clinical cases in young patients with the rare pathohistological diagnosis of giant cell bone tumor (GCT) and aneurysmal bone cyst (ABC). Against this background, we discuss the rare indications for intensity modulated radiotherapy (IMRT). We focus on the imaging and pathohistological differences, as well as in terms of biological development in these two osteoclastic tumors with a high risk of recurrence after the inability to perform radical operations due to their localization.","PeriodicalId":503698,"journal":{"name":"Medical & Clinical Research","volume":"13 1-2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140496388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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