This case series suggests that neurologic assessment-based prognosis of patients after cardiac arrest undergoing therapeutic mild hypothermia should be considered unreliable for at least the first 72 hours. Use of additional assessments such as brain injury markers or evoked potentials, in addition to clinical examination, should be strongly considered to help determine an estimated prognosis. Functional reversibility after a global insult could be an intrinsic potential of the brain, similar to myocardial stunning, and deserves investigation.

Parenchymal lung infections occasionally present with clinical symptoms and radiological findings similar to lung malignancy. Pulmonary actinomycosis is a rare condition of its own right, let alone in coexistence with tuberculosis. We report a case of a man presenting with hemoptysis alongside a chest computed tomography compatible with lung cancer. The diagnosis, after removal of a large endobronchial mass with flexible bronchoscopy and cryon, was a concomitant infection with Mycobacterium tuberculosis and Actinomyces odontoliticus. In the literature, there are few reported cases with concomitant tuberculosis and actinomycosis. To our knowledge, such radical treatment without surgical intervention has not been reported in the past.

Visceral leishmaniasis is characterized by fever, cachexia, hepatosplenomegaly, pancytopenia, and hypergammaglobulinemia. Cough may be a presenting symptom as well. However, pulmonary involvement is considered rare and mainly described in immunocompromised patients. We describe a case of an immunocompetent adult whose clinical presentation was dominated by cough and hemoptysis. Bronchoscopy revealed a discreet polypoid mucosal endobronchial lesion whose biopsy yielded Leishmania amastigotes within histiocytes. Transbronchial needle biopsy of a right paratracheal lymph node was also positive. Leishmania amastigotes were also found on bone marrow and liver biopsies. Treatment with IV Amphotericin B was successful. In conclusion, cough should not be overlooked as a presenting symptom of visceral leishmaniasis and may be a sign of pulmonary involvement.

The efficacy and safety of once-daily beclomethasone dipropionate (BDP; 200 microg), in combination with the propellant hydrofluoroalkane-134a (HFA) was compared with that of budesonide turbuhaler (BUD-TH) 400 microg twice daily and fluticasone propionate inhaler (FP-IH) 250 microg twice daily in 40 patients with bronchial asthma or chronic obstructive pulmonary disease. All patients had used inhaled corticosteroids for at least 1 month. On randomization, 20 patients were switched to HFA-BDP and 20 patients remained on their existing BUD-TH or FP-IH treatment. After 8 weeks, HFA-BDP demonstrated a greater improvement in spirometric values, respiratory symptoms and beta2-agonist use. No significant local adverse effects were observed. Blood cortisol levels remained in the normal range in both groups. We conclude that HFA-BDP (200 microg once-daily) offered more benefit in terms of clinical and spirometry indices than BUD-TH (400 microg twice daily) or FP-IH (250 microg twice daily) in patients with moderate asthma and chronic obstructive pulmonary disease.