Metastatic endodermal sinus tumor: CT appearances

A one-week-old boy had undergone resection of a sacrococcygeal benign cystic teratoma. At the age of 12 months, he had a serum alpha-fetoprotein level of 139,000 IU/ml and a recurrent pelvic mass which was removed, and the microscopic examination revealed endodermal sinus tumor. Postoperatively, massively enlarged inguinal lymph nodes and abdominal distention developed. Computerized tomography displayed enlarged inguinal lymph nodes, metastatic lesions in the liver, and a pelvic recurrent mass. He received BEP (bleomycin, etoposide, cisplatin) chemotherapy regimen, and a complete remission was achieved with a normal serum alpha-fetoprotein. Close follow-up and serum alpha-fetoprotein monitoring are mandatory after the resection of a sacrococcygeal teratoma.     

Topical and systemic antifungals in dermatology practice

Introduction: Dermatophytosis is generally defined as an infection of the hair, nails, or glabrous skin. These infections are caused by the keratinophilic fungi Trichophyton spp., Microsporum spp., and Epidermophyton, which have been recovered from both symptomatic and asymptomatic individuals. Although dermatophytosis is generally not a life-threatening condition, these types of infections are among the most common infections worldwide, and their incidence has continued to increase consistently in recent years.

Area covered: This article provides an overview of the general characteristics of dermatophytes, including their taxonomy and epidemiology, as well as the different clinical forms and laboratory diagnostics of dermatophytosis. We further classify the topical and systemic antifungal compounds currently used to treat dermatophyte infections.

Expert commentary: Antifungal therapy is a central component of patient management for dermatophytosis, and depending on the strategy chosen, topical and/or systemic drugs can be used. However, for effective treatment, it is important to correctly determine the causal agents at the species level, which will enable administration of suitable therapeutics and initiation of appropriate management strategies.     

Structural Modeling the Relationship of Food Addiction and Eating Attitudes of Young Adults with Emotional Appetite and Self-Esteem

The aim of the study was to examine the relationships among food addiction, eating attitudes, emotional appetite, and self-esteem of young adults aged 18–30 years by using a structural model. This cross-sectional study was conducted with 1,058 volunteers (male = 307, female = 751). The hypothesis that self-esteem of young adults influences their eating attitudes was supported in the study (β = –0.081, p < .05). Another hypothesis was also supported, so self-esteem had a positive effect on food addiction (β = 0.280, p < .05). Furthermore, eating attitude has mediating effects on the relationships between self-esteem and food addiction and between emotional appetite and food addiction. Individuals’ eating attitude, food addiction, emotional appetite, and self-esteem scores were found to be related to each other. This article provides valuable data for studies of disordered eating attitudes, emotional state, and food addiction that are thought to be important for young adults in the future.     

Patients’ postures during migraine attacks

Abstract The aim of this study was to determine postures adopted by patients during migraine attack. A total of 199 migraine patients were questioned about their postures during the migraine attack. Of these, 92 patients did not choose a specific lying position, 22 could not lie down during the attack because of the increase in pain, while 6 avoided lying due to scalp tenderness. During the attack, 19 patients preferred holding their heads up (compared to painless period) with a few pillows and 41 applied pressure on the aching side; 15 lay with their necks extended and 15 lay face downward. Various combinations of these postures were also reported. Pain may arise from extracranial muscles as well as vessels during a migraine attack. The posture chosen during attack is a reflection of vascular and muscle pains that provoke symptoms. The postures that patients chose were aimed to lessen the severity of symptoms of their migraine attacks. Patients know the position they adopt and do not need to be told by a doctor, but they come to consultations to be understood, to learn that others behave in the same way, and in some, to obtain reasons for their posture. The existence of a specific lying posture can be an advantage for the physician in terms of approaching the patient and selecting an appropriate therapy.     

Acute dyspnea in an adolescent girl after physical exertion: a case report and review of the literature

Dyspnea is a common symptom of cardiac and pulmonary diseases. We present a 15-year-old girl with acute dyspnea, chest pain, cough, and difficulty in swallowing whose initial diagnosis was psychogenic dyspnea. The etiology of acute dyspnea is discussed and reported cases are reviewed in this case report.     

Evaluation of leukocyte esterase and nitrite strip tests to detect spontaneous bacterial peritonitis in cirrhotic patients

AIM： To investigate the diagnostic efficacy of leukocyte esterase and nitrite reagent strips for bedside diagnosis of spontaneous bacterial peritonitis （SBP）. METHODS： A total of 63 consecutive patients with cirrhotic ascites （38 male, 25 female） tested between April 2005 and July 2006 were included in the study. Bedside reagent strip testing was performed on ascitic fluid and the results compared to manual cell counting and ascitic fluid culture. SBP was defined as having a polymorphonuclear ascites count of ≥ 250/mm^3. RESULTS： Fifteen samples showed SBP. The sensitivity, specificity, positive and negative predictive values of the leukocyte esterase reagent strips were; 93%, 100%, 100%, and 98%, respectively. The sensitivity, specificity, positive and negative predictive value of the nitrite reagent strips were 13%, 93%, 40%, and 77%, respectively. The combination of leukocyte esterase and nitrite reagents strips did not yield statistically significant effects on diagnostic accuracy. CONCLUSION： Leukocyte esterase reagent strips may provide a rapid, bedside diagnostic test for SBP.     

Lipophilic components of different therapeutic mud species

OBJECTIVE: Mud, which contains organic and mineral ingredients, is used for the treatment of several degenerative diseases. It has been proposed that beneficial effects of mud are not only related to its local thermal effects, but also to its chemical components. Unlike hydrophilic components, the lipophilic components of the mud extract have not been described precisely thus far. Thus, we aimed to determine the lipophilic components of the different mud species. METHODS: Three different mud species (e.g., krenogen, tone, and fango) were analyzed by using gas chromatography-mass spectrometry (GC-MS). RESULTS: There were organic substances with fatty-acid structures found in the structure of mud. Torf mud species contain the most compounds. The compounds of three mud species differ from each other. CONCLUSIONS: The chemical structure of mud does not only contain hydrophilic organic substances, such as humic, fulmic, and ulmic acids, but also low-molecular-weighted organic substances composed of fatty acids in the majority. Moreover, it would not be appropriate to explain mud with a single term, since it has different chemical structures and a new classification of the mud species is required.     

Bilateral lower extremity arterial thromboembolism mimicking conversion disorder

Thromboembolic causes of acute limb ischemia are not frequent; however, an immediate true therapy is needed to save the extremity. Here we presented a case with bilateral lower extremity arterial thromboembolism mimicking conversion disorder. Conversion disorder and acute arterial embolism can be confronted in different patterns. This case proved us that anamnesis can be misleading and manipulating to evaluate patients. Furthermore, our report may potentially highlight the inadequacies in the guidelines for diagnosis.