Daptomycin-induced eosinophilic pneumonia - a systematic review

Abstract Purpose Eosinophilic pneumonia comprises a group of lung diseases in which eosinophils appear in increased numbers in the lungs and sometimes in the bloodstream. Several case reports link daptomycin use to this phenomenon. Summary We performed a systematic literature review to identify cases of eosinophilic pneumonia associated with daptomycin use. Relevant studies were identified by searching Pubmed/Medline, EMBASE, Google Scholar, Cochrane Database of Systematic Reviews, and Clin-Alert from inception to May 2016, and manual searches of reference lists. All case reports that include information regarding patient age, indication, clinical and objective findings, treatment and outcome were evaluated. Abstracts from conference proceedings as well as case reports not in English were excluded. Descriptive statistics were used to analyze the data. Thirty-five patient-cases were included in the final analysis. Patients most likely to be identified with daptomycin-induced eosinophilic pneumonia were male (83%) and elderly (mean age 65.4 ± 15 years). The dose for daptomycin ranged from 4 to 10 mg/kg/day, but included a large number of patients with renal dysfunction. The average duration of daptomycin therapy upon onset of EP symptoms was 2.8 ± 1.6 weeks. Majority of patients presented with dyspnea (94%), fever (57%) and were also found to have peripheral eosinophilia (77%) and infiltrates/opacities of CT/CXR (86%). Symptom improvement was seen after daptomycin discontinuation (24 h to 1 week). The majority of patients were also prescribed treatment with corticosteroids (66%). Conclusion Clinicians should be aware of daptomycin-induced eosinophilic pneumonia and its symptoms along with its presentation and treatment

Discursive constructions of MMOGs and some implications for policy and regulation

This paper examines how the production of interactive, co-creative softwares such as multiplayer online games differs from conventional media production, and how stakeholders employ different discursive constructions to understand those environments. The convergence of forms and functions and the emergence of new structures that cross pre-existent regulatory and policy boundaries mean that the discourses adopted to describe these environments and enact regulation and control need to be examined for the particular interests they represent. The paper canvasses six different discourses about online social softwares such as games, and briefly discusses the implications of each for areas such as intellectual property, classification, governance, data privacy, creative industries and global cross-jurisdictional infrastructures