Notes

Specialist palliative treatment squads as well as traits in connection with word of mouth fee: a nationwide cross-sectional study between medical centers from the Holland.
Bacterial and fungal superinfections may complicate the course of hospitalized patients with COVID-19.

To identify predictors of superinfections in COVID-19.

Prospective, observational study including patients with COVID-19 consecutively admitted to the University Hospital of Pisa, Italy, between 4 March and 30 April 2020. Clinical data and outcomes were registered. Superinfection was defined as a bacterial or fungal infection that occurred ≥48 h after hospital admission. A multivariate analysis was performed to identify factors independently associated with superinfections.

Overall, 315 patients with COVID-19 were hospitalized and 109 episodes of superinfections were documented in 69 (21.9%) patients. The median time from admission to superinfection was 19 days (range 11-29.75). Superinfections were caused by Enterobacterales (44.9%), non-fermenting Gram-negative bacilli (15.6%), Gram-positive bacteria (15.6%) and fungi (5.5%). Polymicrobial infections accounted for 18.3%. Predictors of superinfectiond immunomodulant drugs should be carefully selected. Infection control rules must be reinforced.Immune checkpoint inhibitors (CPIs) have recently become a cornerstone for the treatment of different advanced cancers. These drugs have the ability to reactivate the immune system against tumour cells but can also trigger a myriad of side effects, termed immune-related adverse events (irAEs). Although there are numerous reports of CPI-related endocrinopathies, hypercalcaemia as a suspected irAE is not well documented. The mechanisms of CPI hypercalcaemia are not clearly established. However, in our review, four distinct causes emerged endocrine disease-related, sarcoid-like granuloma, humoral hypercalcaemia due to parathyroid-related hormone and hyperprogressive disease following CPI initiation. Prompt recognition of hypercalcaemia and the institution of therapy can be lifesaving, affording the opportunity to address the underlying aetiology. MSL6 In this review we discuss the incidence, diagnosis and management of immune-related hypercalcaemia in oncological patients receiving CPI agents.Thyrolipoma and thymolipoma are rare neoplasms of the thyroid gland and thymus, respectively. Their simultaneous occurrence is exceptional. Up to now, only 2 cases have been reported in literature in 1966 and in 1997. For the first time, we report the occurrence of both neoplasms associated with myasthenia gravis in a 64-year-old woman. The value of this case report lies not only in the fact that it allows us to speculate on the presence of a syndrome but also because a complete radiological work-up (computed tomography scanner, magnetic resonance imaging, Positron emission tomography (PET) with fluorodeoxyglucose (FDG)) is reported.
Lung ultrasound (US) reliably estimates lung water and it is increasingly applied in clinical practice in dialysis patients. A semi-quantitative US score summing up the US-B lines (an equivalent of B lines in the standard chest X-ray) at 28 sites in the intercostal spaces (Jambrik et al. Usefulness of ultrasound lung comets as a non-radiologic sign of extravascular lung water. Am J Cardiol 2004; 93 1265-1270) is the most used score.

We compared the prognostic performance for death, and cardiovascular (CV) events of the 28-sites US score with a score restricted to eight sites in a cohort of 303 haemodialysis (HD) patients.

The 8- and the 28-sites scores were highly inter-related (Spearman's ρ = 0.93, P < 0.001), and their concordance index was fairly good (k = 0.79, 95% confidence interval 0.74-0.84). During a mean follow-up of 3 years, 112 patients died, and 129 experienced a CV event. At univariate and multivariate analysis, both scores were associated with mortality (P ≤ 0.01) and CV events (P ≤ 0. be completed just in ∼3 min, the 8-sites score requires only ∼1.30 min, and it is, therefore, better suited for application in everyday clinical practice in HD units.Worldwide, Drug-resistant Tuberculosis (DR-TB) remains a big problem; the diagnostic capacity has superseded the clinical management capacity thereby causing ethical challenges. In Sub-Saharan Africa, treatment is either inadequate or lacking and some diagnosed patients are on treatment waiting lists. In Uganda, various health system challenges impeded scale-up of DR-TB care in 2012; only three treatment initiation facilities existed, with only 41 of the estimated 1010 RR-TB/MDR-TB cases enrolled on treatment yet 300 were on the waiting list and there was no DR-TB treatment scale-up plan. To scale up care, the National TB and leprosy Program (NTLP) with partners rolled out a DR-TB mixed model of care. In this paper, we share achievements and outcomes resulting from the implementation of this mixed Model of DR-TB care. Routine NTLP DR-TB program data on treatment initiation site, number of patients enrolled, their demographic characteristics, patient category, disease classification (based on disease site and tion of continuous improvement approaches, enhanced cohort reviews and use of multi-disciplinary teams allowed for rapid DR-TB program expansion, rapid clearance of patient backlog, attainment of high cumulative enrollment and high treatment success rates. Sustainability of these achievements is needed to further reduce the DR-TB burden in the country. We highly recommend this mixed model of care in settings with similar challenges.
Numerous studies have shown the association between eosinophilia and clinical outcomes of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). But the evidences are lack of consensus.

The aim of this meta-analysis was to conduct a pooled analysis of outcome comparing eosinophilic (EOS) AECOPD and non-EOS AECOPD patients.

We included PubMed, EMBASE, Web of Science, and Cochrane databases up to 2020 to retrieve articles. Randomized controlled trials and quasi-experimental studies about patients with and without EOS AECOPD in terms of in-hospital mortality, length of hospital stay, comorbidities, forced expiratory volume in 1 s (FEV1), gender, and BMI were included preclinical studies, review articles, editorials, commentaries, conference abstracts, and book chapters were excluded. The methodologic assessment of studies was performed with the Newcastle-Ottawa Scale and Cochran scale. Comprehensive Rev Man 5 was used for the statistical analysis.

Twenty-one studies with 18,041 patients fulfilled the inclusion criteria and were used in this meta-analysis.
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