Refractory fungal infection: Three case reports highlighting good practice.

Refractory invasive fungal disease is a significant clinical problem, with high morbidity, mortality and costs. The complex causes of refractory infection include breakthrough infection due to antifungal resistance (both innate and acquired), suboptimal therapy and impaired immune responses in critically ill or immunocompromised patients. This case series details three reports on the identification and management of refractory fungal infections, two cases of azole resistance and one case of resistant candidiasis, highlighting the importance of accurate diagnosis, monitoring, implementation of biomarkers (serological markers, PCR), antifungal susceptibility testing and antifungal stewardship to optimise management and minimise risks of emergence of drug resistance.

Ambiguous Clinical Presentations and Imaging Findings in Genetic Dilated Cardiomyopathy.

This case series underscores the crucial role of genetic testing and a multidisciplinary approach to the management of genetic dilated cardiomyopathy. It also highlights the importance of distinguishing dilated cardiomyopathies from other cardiomyopathies to personalize patient care.

Alcohol consumption and mortality among Canadian drinkers: A national population-based survival analysis (2000-2017).

Introduction: Alcohol contributes significantly global disease burden. Over 50 countries, including Canada, have established low-risk drinking guidelines to reduce alcohol-related harm. Canada's Guidance on Alcohol and Health (CGAH) was released in 2023.

Greater preservation of SARS-CoV-2 neutralising antibody responses following the ChAdOx1-S (AZD1222) vaccine compared with mRNA vaccines in haematopoietic cell transplant recipients.

Whilst SARS-CoV-2 mRNA vaccines generate high neutralising antibodies (nAb) in most individuals, haematopoietic stem cell transplant (HSCT) and chimeric antigen receptor T-cell (CAR-T) recipients respond poorly. HSCT/CAR-T treatment ablates existing immune memory, with recipients requiring revaccination analogous to being vaccine naive. An optimal revaccination strategy for this cohort has not been defined.