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SummaryBackground: Gemcitabine is an antimetabolic drug for solid tumors. Altough its pharmacokinetics as well as its side-effects are well known, paroxysmal atrial fibrillation associated to the administration of this drug has not yet been described. Patients and methods:We describe the case of a 78-year-old man with pancreatic adenocarcinoma who presented repeated paroxysmal atrial fibrillation episodes 18-24 hours after every gemcitabine infusion which resolved with antiarrhythmic drugs. This clinical history was positive for a remote brief episode of atrial fibrillation, which resolved spontaneously, and the patient had no predisposing factors for supraventricular arrhythmias (systemic hypertension, diabetes or coronary artery disease).Results: Cardiac work-up revealed only a mild mitral-valve

Central venous catheterization was once extremely hazardous, but developments since the 1960s have rendered it relatively safe. With the advent of more aggressive treatment modalities requiring extended periods of central venous access, catheter-related local or systemic infections, including local site infection, catheter-related bloodstream infection (CRBSI), endocarditis, septic thrombophlebitis and other metastatic infections (e.g, lung or brain abscess, osteomyelitis and endophthalmitis) are becoming more common (1). In particular, CRBSIs rank among the most frequent hospital-acquired infections representing an important medical and economic issue. In the USA, in a recent meta-analysis of 2,573 CRBSIs, the case fatality rate was 14%, and 19% of these deaths were attributed to catheter infection (2), while the estimated cost per infection ranged from $3700 to $29000 (3, 4). Our understanding of the pathogenesis of these infections during the past decade should be the basis for appreciating new techniques and approaches involved in the prevention and the diagnosis of CRBSIs. Catheter-related infection pathogenesis is a complex interaction of several factors. The initial event is microorganism entry into the system, with subsequent colonization and multiplication. This can result in disease: local and/or systemic infection (1). Intravascular devices can be contaminated during either non-aseptic device insertion or during nonaseptic care of every part of the line, i.e. at the connectors or the infused solutions, at the cutaneous catheter exit site, and at the catheter hub. Any manipulation of an intravenous giving set can introduce microorganisms, i.e. air entering solid bottles

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