Disease and treatment experiences of COVID-19 patients: A qualitative study

BACKGROUND/AIMS The study aimed to explore the perceptions of hospitalized COVID-19 patients' experiences regarding the disease and treatment process. MATERIAL and METHODS The study was carried out as qualitative research at a hospital in Turkey between June 17, 2020 and July 7, 2020. The sample consisted of eight COVID-19 patients hospitalized in service after intensive care treatment. The data were collected through an in-depth individual interview form. Each interview was transcribed verbatim, and a thematic analysis was performed. The Standards for Reporting Qualitative Research checklist was followed. RESULTS Three main themes were identified for patients' perceptions of the disease experiences and treatment process. The patients experienced negative emotions after being diagnosed with COVID-19, and they spent the isolation and treatment process communicating with their beloved ones over the phone, watching television, and praying. Having an infectious disease caused them to have anxiety and sadness, and they reported satisfaction with the physicians and nurses during the treatment process. CONCLUSION Psychological and sociocultural factors, religious values, and health policies can be effective in patients' perception of disease and treatment. It is recommended for healthcare professionals to be aware of the psychosocial problems of the hospitalized COVID-19 patients during the disease and treatment process, monitor them for post-traumatic stress disorder, and provide the necessary support

Growth, tolerance and safety outcomes with use of an extensively hydrolyzed casein-based formula in infants with cow’s milk protein allergy

ObjectiveTo evaluate growth, tolerance and safety outcomes with use of an extensively hydrolyzed casein-based formula (eHCF) in infants with cow’s milk protein allergy (CMPA).MethodsA total of 226 infants (mean ± SD age: 106.5 ± 39.5 days, 52.7% were girls) with CMPA who received eHCF comprising at least half of the daily dietary intake were included. Data on anthropometrics [weight for age (WFA), length for age (LFA) and weight for length (WFL) z-scores] were recorded at baseline (visit 1), while data on infant feeding and stool records, anthropometrics and Infant Feeding and Stool Patterns and Formula Satisfaction Questionnaires were recorded at visit 2 (on Days 15 ± 5) and visit 3 (on Days 30 ± 5).ResultsFrom baseline to visit 2 and visit 3, WFA z-scores (from −0.60 ± 1.13 to −0.54 ± 1.09 at visit 2, and to −0.44 ± 1.05 at visit 3, p < 0.001) and WFL z-scores (from −0.80 ± 1.30 to −0.71 ± 1.22 at visit 2, and to −0.64 ± 1.13 at visit 3, p = 0.002) were significantly increased. At least half of infants never experienced irritability or feeding refusal (55.7%) and spit-up after feeding (50.2%). The majority of mothers were satisfied with the study formula (93.2%), and wished to continue using it (92.2%).ConclusionsIn conclusion, eHCF was well-accepted and tolerated by an intended use population of infants  ≤ 6 months of age with CMPA and enabled adequate volume consumption and improved growth indices within 30 days of utilization alongside a favorable gastrointestinal tolerance and a high level of parental satisfaction

The frequency of Duchenne muscular dystrophy/Becker muscular dystrophy and Pompe disease in children with isolated transaminase elevation: results from the observational VICTORIA study

IntroductionElevated transaminases and/or creatine phosphokinase can indicate underlying muscle disease. Therefore, this study aims to determine the frequency of Duchenne muscular dystrophy/Becker muscular dystrophy (DMD/BMD) in male children and Pompe disease (PD) in male and female children with isolated hypertransaminasemia.MethodsThis multi-center, prospective study enrolled patients aged 3–216 months with serum alanine transaminase (ALT) and/or aspartate transaminase (AST) levels >2× the upper limit of normal (ULN) for ≥3 months. Patients with a known history of liver or muscle disease or physical examination findings suggestive of liver disease were excluded. Patients were screened for creatinine phosphokinase (CPK) levels, and molecular genetic tests for DMD/BMD in male patients and enzyme analysis for PD in male and female patients with elevated CPK levels were performed. Genetic analyses confirmed PD. Demographic, clinical, and laboratory characteristics of the patients were analyzed.ResultsOverall, 589 patients [66.8% male, mean age of 63.4 months (standard deviation: 60.5)] were included. In total, 251 patients (188 male and 63 female) had CPK levels above the ULN. Of the patients assessed, 47% (85/182) of male patients were diagnosed with DMD/BMD and 1% (3/228) of male and female patients were diagnosed with PD. The median ALT, AST, and CPK levels were statistically significantly higher, and the questioned neurological symptoms and previously unnoticed examination findings were more common in DMD/BMD patients than those without DMD/BMD or PD (p < 0.001).DiscussionQuestioning neurological symptoms, conducting a complete physical examination, and testing for CPK levels in patients with isolated hypertransaminasemia will prevent costly and time-consuming investigations for liver diseases and will lead to the diagnosis of occult neuromuscular diseases. Trial RegistrationClinicaltrials.gov NCT04120168

Experiences and psychosocial difficulties of frontline health care workers struggling with Covid-19 in Turkey: A qualitative study

AIM: This study was performed to explore the experiences and the psychosocial difficulties faced by nurses and physicians involved in the treatment and care for COVID-19 adult patients in the intensive care unit. METHOD: The interpretative phenomenological approach was used, and the data were gathered between June and July, 2020 in Rize using face-to-face interviews. The sample consisted of 10 nurses and 5 physicians. The thematic analysis was utilized to analyze the data. The Consolidated Criteria for Reporting Qualitative Research (COREQ) were followed in the study. RESULTS: The experiences of nurses and physicians were categorized under three themes and subcategories. The theme of "Going Through Psychosocial Changes" was divided into decreased emotional well-being and experiencing social changes, the theme of "Work-Related Challenges" was divided into losing the routines and economic concerns, and the theme of "Felt Gains" was divided into realizing one's worth and increased motivation. CONCLUSION: The study revealed that nurses and physicians are supported, respected, and described as heroes by Turkish society. However, they are psychologically and socially adversely affected, they display negative and positive emotions, and experience psychological growth. In addition, nurses complain about insufficient and unfair payment. Despite all these challenges, nurses and physicians continue to work with increasing emotional resistance. It is recommended to be aware of the problems that they experience during and after the COVID-19 pandemic, protect their mental health, provide adequate economic support, especially for nurses, and take necessary measures by collecting data that may be a guide for subsequent outbreaks

The Frequency of Lysosomal Acid Lipase Deficiency in Children With Unexplained Liver Disease

Objectives: Evidence suggests that lysosomal acid lipase deficiency (LAL-D) is often underdiagnosed because symptoms may be nonspecific. We aimed to investigate the prevalence of LAL-D in children with unexplained liver disease and to identify demographic and clinical features with a prospective, multicenter, cross-sectional study