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The isolation of Candida may be related to comorbidity, prolonged mechanical ventilation, and survival during intensive care unit (ICU) stay, especially with non-albicans Candida (NAC). To examine the frequency of Candida isolation, associated comorbidities and outcomes in the surgical ICU in Osijek University Hospital, Croatia, the data from the electronic database from May 2016 to 30 June 2023 were analyzed. In a cross-sectional study examining 15,790 microbiological samples, different strains of Candida were observed in 581 samples from 236 patients. The control group (N = 261) was 130 consecutive patients from March to May 2019 and 131 in the same months in 2020 (pre- and post-COVID-19). Comorbidities, duration of mechanical ventilation, and survival were compared. Patients with isolated Candida were more often non-elective and had significantly more heart, kidney, and liver diseases and sepsis than the control group (p < 0.001). The duration of mechanical ventilation was 9.2 [2.2–9.24], 96 [24–146], 160 [19.5–343], and 224 [73.5–510] hours in the controls, in patients with Candida albicans, in patients with NAC, and in patients with ≥2 Candida species isolated, respectively. The mortality was significantly higher (42%) in patients with isolated Candida than in the control group (19%, p < 0.001). In a multivariate analysis adjusted for patients’ age, the Simplified Acute Physiology Score II, days of ICU, and type of admission, only sepsis on admission was an independent predictor of mortality (odds ratio = 2.27).

The recent outbreak of corona virus and coronavirus disease (COVID-19) caused by the SARS-CoV-2 virus is a global concern. Despite efforts to clarify the physiology and potential therapy, specific guidelines for the treatment of COVID-19 disease have yet to be established, and many therapeutic options are under investigation. Accumulating evidence suggests that dysregulation of iron homeostasis contributes significantly to the pathogenesis of COVID-19 through its toxic effects by the formation of reactive oxygen species (ROS). This review focuses on summarizing the available literature and relevant studies conducted to date on the possible therapeutic effects of iron chelation therapy in the treatment of COVID-19 disease. Scientific databases (PubMed, Scopus, Google Scholar) were searched for relevant articles using the following keywords: COVID-19, SARS-CoV-2, coronavirus, clinical management, iron chelators/chelation. Research articles, reviews, research letters, case reports, and commentaries were considered. Although there is ample evidence of the potential beneficial effects of using iron chelators as adjuvant treatment in COVID-19, further research on this topic is needed.

Abstract A patient taking opioid maintenance therapy unintentionally injected dissolved zolpidem pills into the femoral artery and suffered acute limb ischemia. High amounts of opioids with supplemental therapies were inefficient for intractable ischemic pain, suggesting the presence of opioid‐induced hyperalgesia (OIH). Epidural analgesia efficiently relieved pain and symptoms of OIH.