Liver Hemorrhage Following Mechanical CPR With the Lund University Cardiopulmonary Assist System (LUCAS) Device: A Focused Case Report.

Cardiac arrest is a leading cause of mortality globally, and mechanical CPR devices like the LUCAS system are designed to improve outcomes by enhancing consistency and reducing rescuer fatigue. However, this case report of a 76-year-old female who suffered cardiac arrest post-flight reveals significant complications associated with mechanical CPR. Despite achieving initial resuscitation, she developed extensive liver damage and additional complications, which ultimately led to her death. This case underscores the importance of precise training and strict adherence to guidelines when using mechanical CPR devices. It highlights that while these devices offer potential benefits, they also pose risks, especially for vulnerable patients, necessitating careful consideration and ongoing evaluation to optimize safety and effectiveness.

Successful Management of Pasteurella multocida Pneumonia in a Chronic Obstructive Pulmonary Disease Patient: A Case Report Highlighting the Importance of Tailored Antibiotic Therapy.

This report describes a patient with Pasteurella multocida pneumonia. The patient was a man in his 70s with significant comorbid conditions, including chronic obstructive pulmonary disease (COPD), and is an example of the diverse presentations of P. multocida infections increasingly found in the literature. The novelty of this case lies in the manifestation of P. multocida pneumonia in a patient with underlying respiratory conditions and its successful management, outlining a unique clinical scenario and a tailored therapeutic approach. A 71-year-old male with a medical history of COPD, asthma, tremors, hypertension, and arthritis presented to the emergency department with progressive shortness of breath, productive cough, and chest tightness. The initial diagnosis was COPD exacerbation and left lower lobe pneumonia, for which a regimen of ceftriaxone and azithromycin was initiated. The patient's condition was further complicated by the persistence of symptoms. Following sputum culture analysis, P. multocida infection was identified. Consequently, the antibiotic regimen was tailored, transitioning the patient to doxycycline, which led to substantial clinical improvement, enabling discharge with a 10-day course of oral doxycycline. This case elucidates the importance of precise microbiological diagnosis in patients with complex respiratory conditions, as it guides more targeted antibiotic therapy. It highlights the need for clinical vigilance for atypical pathogens like P. multocida in patients with COPD exacerbations, especially when conventional treatment strategies yield suboptimal responses. The successful resolution of the pneumonia underscores the effectiveness of antibiotic stewardship guided by sputum culture findings.

A Unique Case of Moraxella catarrhalis Meningitis Following Neurosurgical Intervention.

We present a rare case of Moraxella catarrhalis meningitis in a 51-year-old immunocompetent woman after surgical resection of a fourth ventricle ganglioma. Notably, the patient had no history of sinusitis or otitis media, which are typical predisposing factors for Moraxella infection. She developed symptoms including headache, altered mental status, and neurological deficits three days post discharge, leading to her diagnosis confirmed by cerebrospinal fluid culture. This case highlights the diagnostic challenges and management complexities of atypical meningitis post neurosurgery. The occurrence emphasizes the necessity of considering Moraxella catarrhalis in differential diagnoses, particularly following neurosurgical procedures. This instance contributes to the scarce documentation of such infections in immunocompetent adults, underscoring the importance of vigilant microbiological evaluation and tailored antimicrobial therapy in postoperative settings.

Cecal and ilial intubation rates in colonoscopy: Comparative study.

BACKGROUND: Colonoscopy is the procedure of choice for both the diagnosis and treatment of large intestine and distal ilium in patients complaining of bowel symptoms, anemia resulting from malabsorption, radiographic colon abnormalities, screening for colorectal carcinoma, after polypectomy and cancer resection surveillance, ulcerative colitis surveillance, and those with suspicion of neoplastic masses. Inspection of the whole colonic and distal portion of terminal ilial mucosa is usually feasible during colonoscopy. Quality examination of the large bowel includes intubation of the complete colon and mucosal visualization. The investigators demonstrate that terminal ilium intubation is possible in endoscopy practice and yields additional clinical details. Furthermore, it may be used as an indicator of colonoscopy completion. OBJECTIVES: This study estimated the rate of cecal and ilial intubation by a single well-trained endoscopist and compared it with the results of a heterogeneous group of endoscopists. PATIENTS AND METHODS: This retrospective comparative study estimates the rate of cecal and ilial intubation in a private endoscopy center in which all the endoscopic procedures were conducted by a single consultant gastroenterologist, and compared it with the rates of a governmental center with by five colonoscopy endoscopists (general surgeons, general physicians, trained endoscopists, and gastroenterologists). The study population included 442 patients (245 males [55.42%] and 197 females [44.58%], ranging from 14 to 85 years of age. RESULTS: Overall cecal and ilial intubation rates were 88% and 47.5%, respectively. The adjusted rates for cecal and ilial intubations were 94.2% and 50.8%, respectively, after considering cases of anatomic colonic obstruction and when the clinical indications do not justify total colonic intubation. These figures were superior in comparison to the results of a multi-operator study in which the cecal- and the ilial intubation rates were 51.81% and 30.69%, respectively. CONCLUSION: Cecal and ilial intubation are important quality indicators for colonoscopy, and in this study, they were found to be superior in qualified gastroenterologists than in general surgeons and physicians. This outcome points to the importance of providing endoscopy units in Iraq, with qualified well-trained endoscopy personnel.

Calculation of the Lémann index at initial presentation of Crohn's disease in a sample of Iraqi patients attending gastroenterology and hepatology teaching hospital.

INTRODUCTION: Crohn's disease (CD) is a chronic inflammatory disorder that may involve any part of the alimentary tract from mouth to anus and is characterized by periods of clinical remission alternating with periods of recurrence. Current clinical and endoscopic indices only measure disease activity at a specific time point. The recently published Lémann index (LI) is the first tool that aims to measure cumulative structural bowel damage and thus evaluates long-term disability. AIM OF STUDY: To measure the LI at initial presentation of CD in a sample of Iraqi patients attending the gastroenterology and hepatology teaching hospital (Baghdad). PATIENTS AND METHODS: This is a descriptive single-center study conducted in gastroenterology and hepatology teaching hospital and enrolled 30 patients with CD diagnosed from 2013 to 2015. They all underwent complete physical examination, abdominopelvic CT scan, upper endoscopy, and colonoscopy upon diagnosis for the purpose of assessing bowel damage by the LI. RESULTS: For the 30 patients included, median LI was 1.3 (range 0.2-12.6). CONCLUSIONS: The LI is now available and it enables, for the first time, assessment of bowel damage in CD.