ABSTRACT
Nocardiosis is a rare opportunistic disease that primarily affects patients with deficient immune systems. Nocardia otitidiscaviarum is one of the rare species of Nocardia and it represents less than 3% of all Nocardia cases. Clinical presentation can be varied according to the affected organ. This study describes a case of a breast cancer patient who is immunocompromised due to the chemotherapy. This patient presented with a feature of febrile neutropenia. Investigations of this case led to the diagnosis of Nocardia otitidiscaviarum . Treatment of this underlying infection required to hold the chemotherapy for good time and to adapt patient-specific cancer treatment according to the balance between both need of cancer control and infection treatment according to the susceptibility test as in our case.
ABSTRACT
Purpose Early detection of thyroid cancer has reduced mortality and improved survival of patients. Increased detection has raised the incidence of early stage disease. Some physicians underestimate the suffering of these patients due to the concept of "good cancer." The unmet needs of the survivors still need to be addressed. The objective of this paper was to evaluate the long-term quality of life (QOL) of thyroid cancer survivors. Methods A cross-sectional telephone survey of 211 thyroid cancer survivors who underwent thyroidectomy performed between 2006 and 2016 in two academic tertiary care hospitals was conducted using a validated Arabic version of the European Organization for Research and Treatment of Cancer head and neck cancer specific quality of life questionnaire (EROTC QLQ) - H&N43 questionnaire using a scale of 1-4, with 4 being most severe. Results On almost half (48.5%) of patients, thyroidectomy was performed in 2013 or earlier. Patients' perceptions of problems were very low, with a mean score of 1.56 ± 0.7). Worry about the test results (2.37 ± 1.19), future health (2.36 ± 1.22), tingling or numbness in hands or feet (2.32 ± 1.22), pain in the shoulder (2.04 ± 1.18), and dry, itchy skin (2.04 ± 1.18) were the only items that received a mean score of more than 2. No statistically significant differences in patients' problems were observed according to either tumor histopathology or type of thyroidectomy. Conclusion The overall QOL score for the patients was very good. The persistent problems identified need to be addressed in the long-term follow-up. Survivorship care plans need to be developed incorporating proper interventions.
