Experiences of Family Caregivers’ Involvement in Treatment Related- Decision-Making in Triadic Health Encounters

Purpose: To explore the experiences of family caregiver in health decision-making for patients with chronic diseases. Study Design: Qualitative Descriptive Design. Subjects and Methods: A descriptive qualitative approach was used. A purposive sample of fifteen family caregiver for patients with chronic diseases were interviewed in Amman, Jordan; fifteen caregivers; males (n= 2), females (n= 13). Average of age = 40 years old. Data were generated through phone messages voice records over a period of two months (March & April 2020) in Amman, Jordan. Data were analyzed using a five–step technique proposed by Giorgi (1985). Results: The findings of the study revealed that three major themes related to family caregivers’ experiences in health decision-making for patients with chronic diseases: 1) The patient has the right to decide about his health, 2) Healthcare providers know better, and 3) Roles of family caregivers in the decision making process. Conclusion: The vital role of the family members in taking decisions for patients with chronic diseases is well-recognized by healthcare providers. Continuous systematic assessment of family members’ preferences and needs is crucial to provide the needed support for their patients in decision-making

Checkpoint Inhibitor Colitis With Superimposed Clostridioides difficile Infection

Immune checkpoint inhibitors (ICI) are commonly used for various malignancies. A particular checkpoint inhibitor is the anti-PD-1 antibody pembrolizumab. Immune-mediated diarrhea and colitis (IMDC) is the most frequently observed immune-related adverse event (irAE) involving the gastrointestinal system. Although immune-mediated colitis precipitated by pembrolizumab is rarely life-threatening, it often necessitates a detailed diagnostic workup, including stool studies, imaging, and colonoscopy, to establish an accurate diagnosis. The coexistence of IMDC and Clostridioides difficile infection is not well understood, but patients undergoing pembrolizumab treatment have comparable risk factors to those who develop C. difficile infection. We report a case of a 76-year-old female with nonmetastatic non-small cell lung cancer who was diagnosed with IMDC responsive to steroid treatment but later developed worsening diarrhea leading to a diagnosis of checkpoint inhibitor colitis with superimposed C. difficile infection

First report of clinical, functional, and molecular investigation of chronic granulomatous disease in nine Jordanian families.

International audienceINTRODUCTION: Chronic granulomatous disease is a rare inherited immunodeficiency syndrome caused by mutations in four genes encoding essential nicotinamide adenine dinucleotide phosphate (NADPH) oxidase complex components. MATERIAL AND METHODS: Clinical, functional, and molecular investigations were conducted in 15 Jordanian CGD patients from nine families. RESULTS AND DISCUSSION: Fourteen patients were children of consanguineous parents and suffered from autosomal recessive (AR) CGD forms with mutations in the CYBA, NCF1, and NCF2 genes encoding p22phox, p47phox, and p67phox proteins, except for one patient in whom the mutation's location was not found. One patient had an extremely rare X(+)CGD subtype resulting from a novel missense mutation (G1234C) in exon 10 of CYBB. We found a genetic heterogeneity in the Jordanian families with a high frequency of rare ARCGD, probably because consanguineous marriages are common in Jordan. No clear correlation between the severity of the clinical symptoms and the CGD types could be established