A case of a long course of Osler–Weber–Rendu disease in a 65-year-old patient

Carbapenem-resistant Acinetobacter baumannii (CRAB) is one of the most commonly reported nosocomial infections in cancer patients and could be fatal because of suboptimal immune defenses in these patients. We aimed to compare clinical response, microbiological response, nephrotoxicity, and 30-day mortality between cancer patients who received short (<14 days) and long (≥14 days) courses of colistin for treatment of CRAB infection. A retrospective cohort study was conducted in cancer patients with CRAB infection who received short or long courses of colistin between 2015 to 2017 at Chiang Mai University Hospital (CMUH). A total of 128 patients met the inclusion criteria. The results of this study show that patients who received long course of colistin therapy had a higher rate of clinical response; adjusted odds ratio (OR) was 3.16 times in patients receiving long-course colistin therapy (95%CI, 1.37–7.28; p value = 0.007). Microbiological response in patients with long course was 4.65 times (adjusted OR) higher than short course therapy (95%CI, 1.72–12.54; p value = 0.002). Moreover, there was no significant difference in nephrotoxicity (adjusted OR, 0.91, 95%CI, 0.39–2.11; p value = 0.826) between the two durations of therapy. Thirty-day mortality in the long-course therapy group was 0.11 times (adjusted OR) compared to the short-course therapy group (95%CI, 0.03–0.38; p value = 0.001). Propensity score analyses also demonstrated similar results. In conclusion, cancer patients who received a long course of colistin therapy presented greater clinical and microbiological responses and lower 30-day mortality but similar nephrotoxicity as compared with those who a received short course. Therefore, a long course of colistin therapy should be considered for management of CRAB infection in cancer patients.

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Pacing Strategies of 1500 m Freestyle Swimmers in the World Championships According to Their Final Position

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18147559 ◽

2021 ◽

Vol 18 (14) ◽

pp. 7559

Author(s):

Beatriz Lara ◽

Juan Del Coso

Keyword(s):

Swimming Velocity ◽

Final Position ◽

Men And Women ◽

Elite Swimmers ◽

Pacing Strategies ◽

The World ◽

Total Data ◽

Fast Start ◽

Long Course ◽

Competitive Swimmers

In 1500 m freestyle swimming races, pacing is generally represented by a parabolic or U-shaped curve indicating that swimming velocity is greatest at the start and the last laps of the race while swimmers maintain an even pace through the middle section of the race. However, there is no information to determine if 1500 m race winners select pacing different to other, less successful swimmers within the same competition. Therefore, this investigation aimed to describe the pacing strategies adopted by 1500 m freestyle competitive swimmers in World Championships (long course), from 2003 to 2019 to determine the most effective pacing to obtain victory or a medal. The official overall and split times for 1500 m freestyle races of the Fédération Internationale de Natation (FINA) were obtained from the website of this organization. In total, data of 143 swimming performances (71 male and 72 female) were extracted. With the split times, lap times, and position were calculated across the race. To determine differences in the pacing between best- and worst-ranked finalist, swimmers in each race were divided into four groups based on the final position (1st vs. 2nd vs. 3rd vs. 4–8th). All the lap times of the winners of the race were faster than those of participants classified as 4–8th position for men and women races (p < 0.05). However, there were no differences in lap velocity among the different positions achieved at the end of the race when it was normalized by average race velocity. Additionally, there were no differences in the lap-to-lap variability among swimmers with different positions at the end of the race. In summary, both men and women elite swimmers selected parabolic pacing consisting of a fast start in the first lap, an even pace close to their average race velocity in the mid-section of the race (from 50 to 1400 m), followed by an end spurt in the final lap(s). This pattern was very similar in all finalists irrespective of the final position in the race. Hence, the obtaining of a medal in the World Championships was associated to possessing a faster average race velocity rather than a specific pacing profile through the race.

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LONG-COURSE ORAL CORTICOSTEROID TOXICITY IN CHILDREN

Archives of Disease in Childhood ◽

10.1136/archdischild-2016-311535.57 ◽

2016 ◽

Vol 101 (9) ◽

pp. e2.53-e2 ◽

Cited By ~ 1

Author(s):

Fahad Aljebab ◽

Imti Choonara ◽

Sharon Conroy

Keyword(s):

Weight Gain ◽

Growth Retardation ◽

Oral Prednisolone ◽

Incidence Rates ◽

Cochrane Library ◽

Varicella Zoster ◽

Susceptibility To Infection ◽

Oral Corticosteroids ◽

Long Course ◽

Increased Susceptibility

BackgroundLong courses of oral corticosteroids are commonly used in children in the management of conditions such as nephrotic syndrome, leukaemia, asthma and others. Various adverse drug reactions (ADRs) are known to occur with their use. This systematic review aimed to identify the most common and serious ADRs and to determine their relative risk levels.MethodsA literature search of several databases; Embase, Medline, International Pharmaceutical Abstracts, CINAHL, the Cochrane Library and PubMed was performed to identify all studies where corticosteroids had been administered to paediatric patients ranging from 28 days to 18 years of age for at least 15 days of treatment. Each database was searched from their earliest dates to March 2014. All types of studies that provided clear information on ADRs were included.Results91 relevant studies were found from 27 countries. These studies represented a total of 6653 children and contained reports of 4124 ADRs, the majority in patients with leukaemia, haemangioma and asthma. Oral prednisolone was the most commonly prescribed corticosteroid (74% of patients). The three most frequent ADRs were weight gain, Cushingoid features and growth retardation. The incidence rates of patients with these three ADRs were 22.4%, 20.6% and 18.9%, respectively. Increased susceptibility to infection was the most serious ADR. 24 children died from infections, ten from varicella zoster and the others from different microorganisms.ConclusionsWeight gain, Cushingoid features and growth retardation were the most frequent ADRs seen when long-course oral corticosteroids were given to children. In addition, increased susceptibility to infection was the most common cause of mortality.

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SPLIT ENDS? LITERATURE AND POLITICS AT THEFIN DE SIECLE

Victorian Literature and Culture ◽

10.1017/s1060150307051728 ◽

2007 ◽

Vol 35 (2) ◽

pp. 697-709

Author(s):

Jock Macleod

Keyword(s):

Victorian Literature ◽

Cultural Landscape ◽

Modern Literature ◽

The Political ◽

Literature And Politics ◽

The Real ◽

Avant Garde ◽

Split Ends ◽

Bourgeois Culture ◽

Long Course

AS AN UNDERGRADUATE IN THE1970s, my introduction to the 1890s was perfunctory. Squeezed into a couple of weeks in the middle of a year-long course on “Victorian and Modern Literature,” the literature of the decade was reduced to aestheticism and decadence and presented as something of a preliminary to the real business of modernism. Such a focus reflected the scholarship of the time, in which thefin de sièclewas constructed as a moment of transition, one in which the political and socio-ethical dimensions so central to high Victorian literature were evacuated, as arguments for the autonomy of art came to dominate the literary cultural landscape. The organising principle was one of bifurcation: the separating out ofavant gardefrom bourgeois culture, the high from the low and, of particular relevance to this essay, literature from politics.

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