Diagnoses, treatment, and oncologic outcomes in patients with calcaneal malignances: Case series, systematic literature review, and pooled cohort analysis

Abstract Background Nocardia bacteremia is a rare but important phenomenon, with previous studies describing a 50% mortality rate. We undertake a single-center review and the largest systematic review of Nocardia bacteremia performed over the past 20 years. Methods A single-center review of cases of Nocardia bacteremia was performed using hospital microbiology records from January 1, 2010 to December 31, 2017. A systematic literature review was also performed to identify cases of Nocardia bacteremia described in the English language literature between January 1, 1999 and December 31, 2018 using the NCBI PubMed database and snowballing from citations of relevant publications. Results Single-center case series: Four cases of Nocardia bacteremia are described. Three patients had an intravascular device in situ prior to the onset of Nocardia bacteremia and three patients were immunocompromised; one patient had both risk factors. Systematic literature review: A systematic review identified 50 publications that described 85 cases with sufficient patient data to be reviewed in detail. Including the 4 cases described in our institution, 89 cases of Nocardia bacteremia were included in the analysis. The median age was 57 years [interquartile range (IQR) 42–68] and 69% were male. Eighty-two percent of cases were immunocompromised and 38% had endovascular devices. Pulmonary infection was the most common concurrent site of clinical disease (66%), followed by central nervous system (25%), pleural (17%) disease, and endocarditis (11%). Blood cultures were the only positive microbiological specimen that isolated Nocardia in 45% of cases. Median incubation time to blood culture positivity was 4 days [IQR 3–6]. Thirty-day all-cause mortality was 24% and overall all-cause mortality was 42%. Conclusion Four new cases of Nocardia bacteremia are described. Isolation of Nocardia from blood cultures is rare but represents serious infection with high associated overall mortality. Nocardia bacteremia is most frequently identified in immunocompromised patients and those with intravascular devices. Disclosures All authors: No reported disclosures.

Download Full-text

Open necrosectomy is feasible as a last resort in selected cases with infected pancreatic necrosis: a case series and systematic literature review

World Journal of Emergency Surgery ◽

10.1186/s13017-020-00326-z ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Lucia Ilaria Sgaramella ◽

Angela Gurrado ◽

Alessandro Pasculli ◽

Francesco Paolo Prete ◽

Fausto Catena ◽

...

Keyword(s):

Literature Review ◽

Systematic Literature Review ◽

Pancreatic Necrosis ◽

Case Series ◽

Infected Pancreatic Necrosis ◽

Open Necrosectomy

Download Full-text

Polypharmacy in Middle-European Rheumatoid Arthritis-Patients: A Retrospective Longitudinal Cohort Analysis With Systematic Literature Review

Frontiers in Medicine ◽

10.3389/fmed.2020.573542 ◽

2020 ◽

Vol 7 ◽

Author(s):

Jacqueline Désirée Jack ◽

Rick McCutchan ◽

Sarah Maier ◽

Michael Schirmer

Keyword(s):

Rheumatoid Arthritis ◽

Literature Review ◽

Systematic Literature Review ◽

Anatomical Therapeutic Chemical ◽

Cohort Analysis ◽

World Health ◽

Management Guidelines ◽

The Mean ◽

Health Organization

Objective: To assess polypharmacy and related medication aspects in Middle-European rheumatoid arthritis (RA) patients, and to discuss the results in view of a systematic literature review.Methods: In this retrospective cohort study, charts were reviewed from RA-patients consecutively recruited between September 27, 2017 and April 29, 2019. Drugs were assigned to the Anatomical Therapeutic Chemical (ATC) groups as proposed by the World Health Organization (WHO). Results were compared to those of a systematic literature review.Results: One hundred seventy-five consecutive RA-patients were included. The mean number of drugs was 6.6 ± 3.5, with 2.4 ± 1.2 drugs taken specifically for RA—compared to 2.6 in the literature. 33.7% of patients experienced polypharmacy defined by ≥5 drugs, compared to 61.6% in the literature–with women affected more frequently than men. After 7 years of follow-up, the number of drugs increased in all ATC-groups by an average of 12.7 %, correlating with age (Corrcoeff = 0.46) and comorbidities (Corrcoeff = 0.599). In the literature, polypharmacy is not always defined precisely, and has not been considered in management guidelines so far.Conclusion: Polypharmacy is a frequent issue in RA-management. With an increasing number of comorbidities during the course of the disease, polypharmacy becomes even more relevant.

Download Full-text