Questioning the “Ease” in disease: Was living with HIV a burden or boost during the first wave of Covid-19 in France? A qualitative study (COVIDHIV)

Introduction Clinical research has focused on risk factors and treatment for severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), particularly in people with a comorbidity including the human immunodeficiency virus (HIV), but little attention has been paid to the care pathway. This article aims to show how living with HIV may have been a biopsychosocial burden or boost in care pathways for Covid-19. Method People living with HIV (PLHIV) from 9 clinical centers were invited to participate in this qualitative study. The sampling was purposive with a maximum variation in their sociodemographic profiles. Semi-structured interviews were conducted until data saturation, then coded for thematic analysis, using an inductive general approach. Results We interviewed 34 PLHIV of which 20 had SARS-COV-2 once. They were 24 males, 26 born in France; median age: 55. Twenty had a CD4 number above 500, and all were on antiretroviral therapy (ART). HIV appeared as a burden when Covid-19 symptoms reminded HIV seroconversion, fear of contamination, and triggered questions about ART effectiveness. HIV was not considered relevant when diagnosing Covid-19, caused fear of disclosure when participants sought SARS-COV-2 testing, and its care in hospitals was disrupted by the pandemic. ART-pill fatigue caused avoidance for Covid-19 treatment. As a boost, living with HIV led participants to observe symptoms, to get advice from healthcare professionals, and screening access through them. Some participants could accept the result of screening or a clinical diagnosis out of resilience. Some could consider ART or another drug prescribed by their HIV specialist help them to recover from Covid-19. Conclusion Living with HIV could function as a burden and/or a boost in the care pathways for Covid-19, according to patients’ relationship to their HIV history, comorbidities and representation of ART. Covid-19 in PLHIV needs further qualitative study to gain a more comprehensive assessment of the pandemic’s consequences on their lives and coping strategies

Complication sévère après injection de produit de contraste par voie intraosseuse

La voie intraosseuse pour l’administration de solutions de remplissage est utilisée depuis la Seconde Guerre mondiale après le développement de la technique au début du XX e siècle. Beaucoup de publications ont remis cette technique en lumière durant la dernière décennie, particulièrement dans le domaine de l’urgence pédiatrique. Actuellement, cette technique est validée tant chez l’enfant que chez l’adulte. Cette voie d’accès est principalement utilisée chez le patient critique après l’échec des tentatives de placement de voies d’accès intravasculaires classiques. Dans certaines conditions, comme lors de la prise en charge du patient traumatisé hémodynamiquement instable, la voie d’accès intraosseuse est souvent placée sur le terrain pour permettre une perfusion rapide de solutés de remplissage ou l’administration de médicaments. Après restauration d’un équilibre hémodynamique, la question se pose de savoir si cette voie d’accès peut être utilisée pour injecter un produit de contraste avant la réalisation d’un scanner d’évaluation des lésions traumatiques. Nous décrivons ici une complication sérieuse survenue après l’usage d’un dispositif intraosseux dans ces conditions

[Financial study of the bovine embryos production by untrasound-guided ovum pick-up and in vitro fertilization in Wallonia (South Belgium): preliminary results]

From the end of 1996, two legally authorized centres realize in vitro production of bovine embryos in Wallonia. Ultrasound-guided ovum pick-up and in vitro fertilization (OPU-IVF) is mostly applied on cows from the Belgian Blue breed. During the first sixteen months of OPU-IVF activities (initial period), the production results in each center were lower than the ones obtained in other laboratories using that biotechnology, the average international production level being of 1.30 embryos per session and per cow. Since embryos were concomitantly sold to breeders at an incentive price, this led to a financial deficit in each center at the end of the initial period. However, that negative situation should normally disappear within the two following years, owing to the expected improvement of the technical results. To conclude, the financial balance of each center will be attained provided that almost 10 cows may be punctured per week and also that from 0.85 to 1.25 embryos may be produced per session and per cow