Middle East respiratory syndrome coronavirus in Al-Madinah City, Saudi Arabia: Demographic, clinical and survival data

Background: Middle East respiratory syndrome coronavirus [MERS-CoV], is an emerging virus respiratory infection. It has a high mortality rate and a wide spectrum of clinical features. This study describes the clinical characteristics and outcome of MERS infected patients

Methods: A retrospective study was conducted of all confirmed MERS-CoV infections from March 2014 to May 2014 at two tertiary care hospitals in Al-Madinah region [Saudi Arabia]. We gathered data about demographic, clinical presentation, and factors associated with severity and mortality

Results: A total of 29 cases were identified; 20 males [69%] and nine females [31%], age 45 +/- 12 years. The death rate was higher for men [52%] than for women [23%]. Initial presentation was fever in 22 [75%] cases, cough in 20 [69%] cases, and shortness of breath in 20 [69%] cases. Associated comorbidities were diabetes mellitus in nine [31%] patients and chronic kidney disease [CKD] in eight [27%] patients. Duration of symptoms before hospitalization ranged from 2.9 days to 5 days. Elevated liver enzymes were present in 14 [50%] patients and impaired renal profile present in eight [27%] patients. We also describe in this study radiological patterns and factors associated with mortality

Conclusion: MERS-CoV infection transmission continues to occur as clusters in healthcare facilities. The frequency of cases and deaths is higher among men than women and among patients with comorbidities

Present trends in the tareatment of advanced non-small-cell lung cancer

Lung cancer is the leading cause of cancer deaths all over the world. As most patients present with advanced disease, major efforts have been made in the treatment of such disease with systemic chemotherapy. Several new agents and new combinations of chemotherapy have been developed recently. This article reviews the randomized clinical trials investigating chemotherapy for advanced non'small-cell lung cancer [NSCLC] in relapse or progressive disease while being treated and in elderly patients. Therapies that incorporate new biological agents to target specific defects in lung cancer are also discussed. Several clinical trials have demonstrated improvement in overall survival as well as quality of life with presently available chemotherapy treatment of advanced NSCLC. Better options are available for the elderly as well as those having relapse after first-line chemotherapy. Despite all this progress the 5-year survival rate still remains at a dismal 14%. New therapies with good results are still desired