Lung adenocarcinoma presenting as acute hypoxemic respiratory failure.

Lung adenocarcinoma usually presents with cough, hemoptysis, and weight loss with radiologic findings of suspicious nodules and masses. It rarely mimics other diseases such as pneumonia. We here present a case of a female patient who presented with acute hypoxemic respiratory failure and radiologic findings of multi-lobar consolidation and was found to have lung adenocarcinoma.

Cardiac Arrest as First Presentation of Thyroid Storm.

Thyroid storm is a life-threatening condition characterized by a high level of circulating thyroid hormones and harbors high mortality and morbidity, even if diagnosed and treated early. The condition is frequently overlooked and under-recognized in emergency departments owing to its rarity. Here, we present a case of a 24-year-old male patient, previously healthy, who presented with cardiac arrest and was found to have heart failure and high thyroid hormone levels after investigations. Consequently, the presentation was attributed to thyroid storm. His clinical status and cardiac function improved after treatment of the hyperthyroidism.

Case series of endoscopic treatment of post-intubation tracheal stenosis.

INTRODUCTION: Benign tracheal stenosis is a common problem encountered after tracheal intubation or tracheostomy. It can be managed by surgical or nonsurgical techniques. This case series describes the outcome of 11 cases of endobronchial treatment for complex tracheal stenoses. METHODS: A retrospective study was carried out in two hospitals in Lebanon. Patients were contacted on a regular basis for 6 months and asked about the presence of dyspnea and its characteristics. RESULTS: The most common presenting symptom was inspiratory stridor. Five patients (45.45%) were not satisfied after the bronchoscopic intervention. Six patients (54.55%) were satisfied with the outcome. All were initially treated with argon plasma coagulation and dilation. If any persistent symptoms were present, stenting was done. Three patients had a stent placement. Failure of stenting occurred with two patients. None of the satisfied patients had any early symptoms. CONCLUSION: Bronchoscopic interventions yielded acceptable results when treating complex stenoses. More data is still needed to guide physicians for better approaches. When confronting complex tracheal stenosis, a multidisciplinary approach between surgical and nonsurgical doctors is preferred to choose the best medical care.

Bacterial resistance to antibiotics and associated factors in two hospital centers in Lebanon from January 2017 to June 2017.

GENERAL PRESENTATION: Resistance of bacteria to antibiotics is a universal problem. With the increase in the rate of resistance, knowledge of susceptibility patterns is essential to guide antimicrobial therapy. In Lebanon, many studies investigated this subject. OBJECTIVES: Determine the rate of multidrug and extremely drug-resistant bacteria as well as the patterns of resistance and the factors associated with this resistance. MATERIALS AND METHODS: A cross-sectional study was performed using the cultures from the labs of two university hospitals in Lebanon. Bacteria were divided into four groups: sensitive, multidrug-, extremely- and pan-drug resistant. Patient information was obtained from the medical records. Using the SPSS software for Windows, version 20 (IBM, Armonk, USA), the frequency of the bacteria, their susceptibilities and the association of resistance with seven potential factors (age, gender, diabetes mellitus, cancer, chronic kidney disease, dialysis, previous hospitalization) were studied. RESULTS: The frequency of resistance was 53.7% (39.9% multidrug-resistant and 13.8% extremely drug-resistant). Escherichia coli strains were mostly susceptible to carbapenems and tigecycline; and nitrofurantoine and fosfomycin in urine. Pseudomonas and Acinetobacter species were mostly sensitive to colistin. Klebsiella species were mostly susceptible to amikacin and carbapenems. MRSA rates were 34.8%. Association was seen between the resistant bacteria and older age, chronic kidney disease, dialysis, and previous hospitalization. CONCLUSION: Resistance of bacteria to drugs in Lebanon is increasing. Significant association is seen between these bacteria and older age, chronic kidney disease, dialysis, and previous hospitalization.