Chest wall metastasis of endometrial cancer: case report and review of the literature

Introduction: Endometrial cancer is the fourth most common female cancer and also distant metastases to the chest wall associated with these tumors are seen less common. Surgical treatment options for metastases of endometrial cancer are limited.

Case: A 57-year-old patient who underwent total abdominal hysterectomy?+?bilateral salpingo oophorectomy and received adjuvant chemotherapy for endometrioid-type adenocarcinoma of the endometrium and tuba is presented. The patient initially presented with pleural effusion 8 years ago and the tumor was detected while during etiologic screening. The patient had no problems after adjuvant chemotherapy and had been living in another city when she presented with a mass on the chest wall measuring 20?×?15?×?12?cm 8 years after the initial diagnosis and distant organ metastasis due to the first surgery was detected. The mass was first thought to be a sarcoma and the tru-cut biopsy revealed a metastatic lesion that was immunohistochemically similar to the first surgical specimen. The mass was resected with a wide radical excision and ‘no touch’ technique. The patient was then discharged with no postoperative complications.

Conclusion: Here in, a case with a distant organ metastasis due to an endometrioid-type adenocarcinoma is presented accompanied by literature data.     

Culture-Proven Candida Albicans Endogenous Endophthalmitis in a Patient with Onychomycosis

ABSTRACT

Purpose: To report a case of Candida albicans endogenous endophthalmitis in an immunocompetent patient with onychomycosis.

Methods: Retrospective case report.

Results: A 40-year-old man with onychomycosis presented with C. albicans subretinal abscess in the left eye. Systemic and intravitreal injections did not prevent further progression of the infection. The patient underwent pars plana vitrectomy. One month after surgery, the intraocular inflammation gradually subsided. However, his visual acuity stayed at counting fingers as a result of macular scarring.

Conclusion: The aim of this case presentation is to emphasize that endogenous fungal endophthalmitis can be seen in an immunocompetent patient. The use of systemic steroids in the past was the main reason for the progression of the disease in this case. In these situations, when the clinical findings suggest a fungal etiology, it should keep in mind that endogenous candida endophthalmitis can be a result of fungal infections from distant sites such as the toenails and systemic steroids should not be started before definite diagnosis.     

Poor outcomes among elderly patients hospitalized for influenza-like illness

Background and objective: Global Influenza Hospital Surveillance Network is a worldwide initiative that aims to document the burden of influenza infections among acute admissions and vaccine effectiveness in particular countries. As a partner of this platform, we aimed to determine the frequency of influenza infections among acute admissions with influenza-like illness and the outcomes of enrolled patients during the 2015–2016 influenza season in selected hospitals in Turkey.

Patients and methods: The investigators screened the hospital admission registries, chart review or available records, and screened all patients hospitalized in the previous 24–48?hours or overnight in the predefined wards or emergency room. A total of 1351 patients were screened for enrollment in five tertiary care referral hospitals in Ankara and 774 patients (57.3% of the initial screened population) were eligible for swabbing. All of the eligible patients who consented were swabbed and tested for influenza with real-time polymerase chain reaction (PCR) based methods.

Results: Overall, influenza positivity was detected in 142 patients (18.4%). The predominant influenza strain was A H1N1pdm09. Outcomes were worse among elderly patients, regardless of the presence of the influenza virus. Half of the patients over 65 years of age were admitted to the intensive care unit, while one third required any mode of mechanical ventilation and one fourth died in the hospital in that particular episode.

Conclusion: These findings can guide hospitals to plan and prepare for the influenza season. Effective influenza vaccination strategies, particularly aimed at the elderly and adults with chronic diseases, can provide an opportunity for prevention of deaths due to influenza-like illness.     

Influence of fiber-reinforced composites on the resistance to fracture of vertically fractured and reattached fragments

Introduction

The aim of this in vitro study was to evaluate the fracture type and test the effects of 2 different fibers on fracture strength of roots with reattached fragments. The null hypothesis was that adding suitable fibers to the content of dual-cure adhesive resin cement increases the fracture resistance of reattached fragments under vertical forces.

Methods

Root canals of 45 teeth were prepared, and the teeth were intentionally fractured into 2 separate fragments. Control groups (n = 7 each) consisted of unfractured teeth with instrumented and obturated or only instrumented root canals. The fractured teeth were divided into 3 groups (n = 15 each), and separated fragments were reattached by using (1) dual-cured resin cement (Clearfil SA), (2) dual-cured resin cement + polyethylene fiber (Construct), or (3) dual-cured resin cement + glass fiber (Stick-Net). Force was applied at a constant speed of 0.5 mm/min to the root until fracture. Mean load was recorded and analyzed statistically by using Kruskal-Wallis and Dunn tests (P = .05). Fracture types were analyzed by using χ² analysis with Yates correction.

Results

Stick-Net demonstrated the lowest fracture resistance (P < .05), whereas Construct and Clearfil SA had similar fracture strengths (P > .05). The roots in the control group showed the highest fracture resistance. However, there was no statistically significant difference between the Construct, Clearfil SA, and control groups (P > .05).

Conclusions

Separated fragments of vertically fractured teeth can be reattached by using a dual-cured resin or by adding polyethylene fiber (Construct).     

Effect of bleaching on microhardness of esthetic restorative materials

This study evaluated the effect of a high-concentration carbamide peroxide–containing home bleaching system (Opalescence PF) and a hydrogen peroxide–containing over-the-counter bleaching system (Treswhite Supreme) on the microhardness of two nanocomposites (Filtek Supreme XT and Premise) and leucite-reinforced glass ceramic (Empress Esthetic), glass ceramic (Empress 2 layering), and feldspathic porcelain (Matchmaker MC). A total of 100 specimens, 20 of each kind of the restorative materials, 2 mm in thickness and 10 mm in diameter, were fabricated. Then the specimens were polished with SiC paper and 1 μm alumina polishing paste. After polishing, porcelain specimens were glazed in accordance with the manufacturer's instructions. Each type of restorative material was then randomly divided into two groups (n=10), and the specimens were treated with either Opalescence PF or Treswhite Supreme. The microhardness of the specimens before bleaching (baseline) and after bleaching was determined using a digital microhardness tester. Data were analyzed using the Mann-Whitney U-test and the Wilcoxon test. Opalescence PF significantly influenced the hardness of all the restorative materials. Statistically significant decreases with respect to before bleaching were found for Premise (p=0.005), Empress Esthetic (p=0.003), Empress 2 layering (p=0.005), and Matchmaker-MC (p=0.003), whereas a statistically significant increase was observed in Filtek Supreme XT (p=0.028). The difference in the microhardness values between before and after bleaching using Treswhite Supreme was statistically significant only for Premise (p=0.022). High-concentration carbamide peroxide–containing home bleaching may affect the microhardness of restorative materials.     

External laryngopyocele: a rare cause of upper airway obstruction

Laryngocele is generally defined as abnormal dilatations of the laryngeal saccule. Its etiology is not well known but probably caused by congenital and acquired causes. It is uncommon and usually asymptomatic. It may be seen at any age but is most commonly presented at fifth and sixth decades. They are defined as internal, external, and mixed (combined) types according to their relationship with the thyrohyoid membrane. External laryngocele extends upward and protrudes through the thyrohyoid membrane to the neck. Infection of the laryngocele can cause acute symptoms or worsens existing symptoms. An infected laryngocele is known as laryngopyocele. It is an extremely rare disease and needs urgent diagnosis and treatment. We report a rare case of an external laryngopyocele that presented as upper airway obstruction. We also discussed the effect of needle aspiration in the emergency treatment of external laryngopyocele.