Durvalumab-associated vasculitis presenting as 'the blue toe syndrome'.

Durvalumab is a selective, high-affinity human immunoglobulin monoclonal antibody in a class called check point inhibitors, that blocks PD-L1 on tumour cells. Despite clinical success in increasing progression-free survival rates in patients with stage III non-small-cell lung cancer, durvalumab has been associated with immune-related side effects such as pneumonitis and colitis. We present a case of an 84-year-old woman with acral vasculitis presenting as blue toe syndrome, associated with prolonged use of durvalumab.

Determining best outcomes from community-acquired pneumonia and how to achieve them.

Community-acquired pneumonia (CAP) is a common acute medical illness with a standard, effective treatment that was introduced before the evidenced-based medicine era. Mortality rates have improved in recent decades but improvements have been minimal when compared to other conditions such as acute coronary syndromes. The standardized approach to treatment makes CAP a target for comparative performance and outcome measures.

The role of modern matrons in infection control.

This article discusses the effect of the role of the modern matron on healthcare-associated infection (HCAI) and hospital cleanliness. The way the modern matron's role is developing is examined in relation to HCAI in a large acute NHS trust. As set out in Implementing the NHS Plan: Modern Matrons (Department of Health (DH) 2001), the role of modern matron includes a responsibility to lead clinical teams in the prevention of HCAI.