Case Report with Systematic Literature Review on Vascular Complications of BCG Intravesical Therapy for Bladder Cancer.

(1) Background: Intravesical instillation of therapeutic Bacillus Calmette-Guerin (BCG) is the standard of treatment for non-muscular invasive bladder cancer. Although the exact immunomodulatory effects of BCG therapy in non-muscular invasive bladder cancer (NMIBC) are still unclear, it has been considered a safe and effective treatment with the largest to-date report of complications citing minimal side effects, none of which included arterial involvement; (2) Methods: A systematic literature review was performed using PubMed, Cochrane, Medline, and Google Scholar from database inception to March 2021. Only eligible studies reporting aneurysm formation in adult patients with a history of BCG immunotherapy and no previous vascular pathology were included; (3) Results: A systematic literature review was conducted, highlighting 17 reports suggestive of BCG-induced mycotic aneurysm development.

West Nile virus in a patient with Good's syndrome.

We describe the association between thymoma and hypogammaglobulinemia (Good's Syndrome) and a fulminant, seronegative West Nile Virus neuroinvasive infection confirmed by nucleic acid amplification. Diagnostic difficulties are emphasized and historical minutiae are highlighted.

The nerve of legal entrapment.

Chordomas are a rare type of bone tumor that arises from the embryological remnant of the notochord. They originate at any point along the axial spine with the sacrum and the skull based region being the most commonly affected sites. Chordomas are slowly growing, indolent tumors, presenting insidiously, but also carry a high recurrence rate with a tendency to invade contiguous structure making their treatment challenging.

Multiple coronary aneurysms in a young adult with acquired immunodeficiency syndrome.

HIV infection can cause multiple deleterious effects on the cardiovascular system. Emerging evidence has supported a direct association between HIV infection and accelerated atherosclerosis. The mechanism for atherosclerosis in HIV-positive patients is multifactorial, an interplay between conventional risk factors, HIV itself and highly active antiretroviral therapy.

The immune response to surgery and trauma: Implications for treatment.

Background: Infection after surgery and trauma is a major cause of increased morbidity, mortality, and cost. Alterations of the hosts immune system following these insults is believed to be responsible for the increased risk of infection. The hosts' immune response to tissue injury is widely believed to follow a bimodal response, with the systemic inflammatory response syndrome (SIRS) followed by the compensated anti-inflammatory response syndrome (CARS).

The risk of catheter-related bloodstream infection with femoral venous catheters as compared to subclavian and internal jugular venous catheters: a systematic review of the literature and meta-analysis.

Background: Catheter-related bloodstream infections are an important cause of morbidity and mortality in hospitalized patients. Current guidelines recommend that femoral venous access should be avoided to reduce this complication (1A recommendation). However, the risk of catheter-related bloodstream infections from femoral as compared to subclavian and internal jugular venous catheterization has not been systematically reviewed.

Chronic acetaminophen ingestion resulting in severe anion gap metabolic acidosis secondary to 5-oxoproline accumulation: an under diagnosed phenomenon.

Anion gap metabolic acidosis is commonly caused by lactic acidosis, ketoacidosis, and ingestion of methanol, salicylates, ethylene glycol or accumulation of organic/inorganic acids. However, rare causes of metabolic acidosis from enzyme defects, such as disturbances in the γ-glutamyl cycle, are being reported in higher frequencies in the adult population. Such disturbances cause an accumulation of 5-oxoproline and ultimately an anion gap metabolic acidosis.

Do dietary supplements have beneficial health effects in industrialized nations: what is the evidence?

Background: Dietary supplements are regularly used by at least half of the American population, yet the health benefits of these agents are unclear.

Objective: A systematic review to determine the benefits and risks of dietary supplements in Westernized societies.

Data Sources: MEDLINE, Embase, Cochrane Register of Controlled Trials and citation review of relevant articles.

Narrative review: the management of acute decompensated heart failure.

Acute decompensated heart failure (ADHF) is the most common reason for hospitalization in Western nations. The prognosis of patients admitted to hospital with ADHF is poor, with up to 64% being readmitted within the first 90 days after discharge and with a 1-year mortality approximating 20%. Epidemiological studies suggest that the majority of patients hospitalized with ADHF receive treatment that is inadequate and which is not based on scientific evidence.

Blood B-type natriuretic peptide and dialysis: present assessment and future analyses.

Brain natriuretic peptide (BNP) is elevated in hemodialysis (HD) patients and predicts increased mortality. Intra- and interdialytic changes in BNP have not been fully described. End-stage renal disease (ESRD) patients were prospectively recruited at three dialysis centers.

The agony and the ecstasy.

The authors, who are from the Vessel Sanitation Program of the Centers for Disease Control and Prevention (CDC), summarize the recent outbreaks of acute gastroenteritis (AGE), which occurred on five different cruise ships. Attack rates among passengers ranged from 4% to 13% and among crew members from 0.2% to 3.

Current Insights in Whipple's Disease.

Therapy for Whipple's disease should be continued for a minimum of 1 year, and the regimen should include an agent or agents that achieve acceptable concentrations in the central nervous system, given the likelihood of recurrence at this site. Clinical follow-up of proven cases of Whipple's disease should be conducted for a minimum of 10 years after discontinuation of therapy, given the potential for late relapses. Polymerase chain reaction analysis is preferred rather than endoscopy when evaluating for disease recurrence.

Diabetes and macrovascular disease.

Cardiovascular disease (CVD) is the major cause of morbidity and mortality in patients with diabetes. Macrovascular events, including stroke, myocardial infarction (MI), and peripheral arterial disease (PAD), occur earlier than in nondiabetics and the underlying pathologies are often more diffuse and severe. Diabetic arteriopathy, which encompasses endothelial dysfunction, hypercoagulability, changes in blood flow, and platelet abnormalities, contributes to the early evolution of these events.