There are clinically significant differences between endocrine surgeons and endocrinologists in the management of multinodular goitre.

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Introduction Mortality from sepsis is decreasing in recent years owing to improved quality of care, targeted programs, and the implementation of sepsis bundles. This has led to an increased pool of sepsis survivors at risk of readmissions. Studies have shown that these sepsis readmissions are common and expensive. The factors associated with these readmissions remain elusive and have incited a lot of research in recent years. The 30-day sepsis readmission rate is increasingly being used as a quality metric for hospitals. A conducted a retrospective chart review analysis of patients admitted with sepsis to find factors affecting the 30-day readmissions of sepsis survivors. Methods Patients admitted to our hospital either on the medical-surgical floor or in the intensive care unit (ICU) with an administrative coding for sepsis between January 2014 to November 2015 were identified. A literature search, as well as expert opinion, was considered for the list of factors to be studied, including age, sex, residence on admission, length of stay, getting hemodialysis, hospitalization in the prior year, presence of acute kidney injury (AKI), source of sepsis, discharge disposition, receipt of red blood cell (RBC) products, and route of antibiotics on discharge. A univariate binary logistic regression analysis was performed to test the association between the above-mentioned variables and sepsis readmission. Variables with statistical significance in the univariate analysis were used to compute the multivariate regression analysis along, with adjusted OR and their 95% CI.

We present a case report of a 61-year-old patient with acute pulmonary and cerebral infections with Aspergillus and Rhizopus. The only risk factor for invasive fungal disease was high-dose corticosteroids used to treat her chronic obstructive pulmonary disease exacerbation. She had rapid progression and succumbed to her infections within 2 weeks of diagnosis in spite of aggressive antifungal therapy and surgery. To the best of our knowledge, this is the first reported case of rapidly fatal dual infection with Aspergillus and Rhizopus Our case highlights the role of high-dose corticosteroids as a risk factor for invasive fungal disease in patients without traditional risk factors like haematological malignancies, solid organ transplantation or uncontrolled diabetes.