Abstract Body

Background

Covid-19 infection poses a serious challenge for immune-compromised patients with inflammatory autoimmune systemic diseases.We present a case which occurred during the covid-19 pandemic,in which an infection of Sars-Cov-2 has an impact on the diagnostic hypothesis.

Case Description

A 63 years old female patient with history of allergic rhinitis and asthma,began with dyspnoea,cough,nausea and fatigue in April 2020.Due to worsening of her clinical condition,she was admitted to the hospital.She presented lymphopenia.SarsCov2 swab with a negative result. The lung computed tomography(CT) described aspects of bronchopneumonic infectious process suggestive of sar-cov-2 infection. She started hydroxychloroquine therapy and she repeated the SarsCov2 swab with negative result. In May 2020 she went to the emergency department presenting with fever and musculoskeletal symptoms with migrant arthralgia associated with edema of hands and legs. She presented elevated serum creatine kinase(CK),aspartate aminotransferase(AST),alanine aminotransferase(ALT),and was discharged with diagnostic hypothesis of Arthritis/Reactive Myositis of unclear aetiology, and treated with anti-inflammatory therapy. Due to maintenance of the clinical situation with myalgia, arthralgia, persistent fatigue and dyspnoea for small efforts, she was admitted to the hospital a month later.She needed a supplementary supply of O2 during hospitalization. At the electromyography and magnetic resonance of the pelvis the result was compatible with an inflammatory myopathy.The lung CT described worsening of multifocal opacities configuring geographic areas of peribronovascular and subpleural ground glass. A muscle biopsy was performed and the diagnosis was definitive: Autoimmune polymyositis with positive antiJo1 and antiSSA with interstitial lung disease.The patient began corticotherapy with symptomatic improvement.

Results/Conclusions

This case alerts the physicians about autoimmune diseases which can mimic COVID-19 infection.

Abstract Body

Background

Spirituality is one of many cultural variables that has become increasingly recognized for its potential to impact health behaviors and healthcare decision-making.Currently the spiritual approach is used in palliative care,but spirituality can be a useful means of connecting with patients and playing an important role in primary care also.It may be useful to consider the role that spirituality plays across the life course, considering the importance of spirituality for some individuals and the ways in which it may be used to improve quality of life.Primary care physicians face a new paradigm in which the spiritual dimension should be incorporated into their practice.

Aim and learning objectives

1.Reflect upon advantages of spiritual care approach in family practice;

2.Discuss strategies to include and improve spiritual care approach in primary care;

3.Discuss clinical cases that allow communication strategies, empathy and validation of the patient's feelings and expectations to be put into practice according to their spiritual beliefs.

Methods and timetable

After an introduction regarding the spiritual dimension, participants will be divided into 3 groups to debate through clinical cases how can we approach spirituality in the context of consultation.

The activity will take 90 minutes:

-10’:presentations of the speaker and the topic

-45’:clinical case discussion in 3 groups separately

-20’:discuss the resolution of clinical cases all groups together

-15´:conclusion, doubts and questions

Estimate number of participants:40

(Proposed)Results/Conclusions

Workshop participants will have valuable recognition of the importance of spirituality approach for holistic care and its impact on health behaviors.They'll also be taking home some tools to incorporate spirituality in their primary care practice.