Vaso-occlusive Pain Crisis Mimicking Mandibular Abscess in an Adolescent with Sickle Cell Disease.

In people with sickle cell disease (SCD), oral abscesses are concerning clinical conditions and carry a high risk of postoperative sickle cell complications. We present an unusual case of a 14-year-old girl with SCD whose initial presentation of facial swelling, headaches, jaw pain, and paresthesia mimicked an odontogenic abscess. She was diagnosed with vaso-occlusive crisis in the mandibular bone and successfully managed noninvasively. This is among the youngest cases of paresthesia in the lower lip in SCD, which provided a clue that postponing invasive aspiration or biopsy was possible under empiric antibiotics and close observation.

Patient Toward Physician Occupational Stigma Scale: Development of the Chinese Version.

Background/Objective: Physicians' occupational stigma could eradicate physician-patient trust, threatening physicians' social status and occupational reputation. Hitherto, there has been no scale obtaining good psychometric properties to assess patients' stigma toward physicians. The present study aimed to develop the Patient toward Physician Occupational Stigma Scale (PPOSS) and examine its reliability and validity. Methods: The questionnaire comprising sociodemographic information and the PPOSS were employed to survey 645 Chinese patients in two phases. In Sample 2, the Wake Forest Physician Trust Scale (WFOTS), the Intolerance of Uncertainty Scale-12 (IUS-12), and the Brief Illness Perception Questionnaire (BIPQ) were tested. Results: The PPOSS includes 19 items subsumed into three dimensions of stereotype, discrimination, and prejudice. According to the results of confirmatory factor analysis (CFA), the three-factor model fitted well (χ2/df=2.065, RMSEA=0.057, SRMR=0.045, RFI=0.904, CFI=0.956, IFI=0.956, PNFI=0.779, PCFI=0.811). The PPOSS was significantly negatively correlated with the WFOTS, and significantly positively correlated with the IUS-12 and the BIPQ. The Cronbach's alpha coefficients for the total scale and each dimension were between 0.87 and 0.94, and the split-half reliability coefficients were between 0.84 and 0.93. Besides, the PPOSS had the measurement invariance across gender. Conclusion: With its satisfactory psychometric properties, the PPOSS can be used as an effective instrument to assess patients' stigma toward physicians.