Revista de informes de casos clínicos

Resin-Bonded Fixed Partial Dentures (RBFPD) was introduced to dentistry around 40 years ago. The typical design of resin-bonded fixed partial denture is characterized by conservation of tooth structure of abutment compared to fixed treatment. This article presents a case report of a patient who reported with missing maxillary central incisor. Multiple treatment options are available for replacement of missing tooth. Use of conventional fixed partial denture in such a situation is criticized because modern dental practice revolves around the principle of preservation of tooth structure. So in such cases resin bonded fixed partial denture is best treatment option.

Scar endometriosis is an infrequent type of extrapelvic endometriosis that is rather close together with obstetrical and gynecological surgeries. It is mostly confused with other dermatological or surgical conditions and delays the diagnosis. We report a case of a 50-year-old woman presenting with scar endometriosis 23 years after her last lower segment caesarean section. The epidemiology, diagnosis, pathogenesis, and treatment of the situation are discussed.

Endometrial cancer is the most common gynecological cancer and is a disease of postmenopausal women. The disease appears in 20 years or less extremely rare. Four case of endometrial cancer in 20 years old or less female, treated at Department of Gynecological Oncology, National Oncologic Hospital, Sofia, Bulgaria (1991-2009) are presented. The surgery mode and postoperative treatment was according the stage and histological type of the tumors. These patients were Stage IA, and one patient was Stage IIIC. A follow-up period till 31 December 2012 all the patients are free of disease.

We present a case of a 62 year old man with history of small cell lung cancer status post radiation and chemotherapy with cisplatin and etoposide who presented to the emergency room with complaints of generalized repetitive muscle contractions. His physical examination was notable for involuntary rhythmic muscle contractions of face, neck, upper arms, thigh and hyperreflexia. Laboratory data was significant for calcium 4.6 mg/dl (corrected 5.64 mg/dl), albumin 2.7 g/dl, and magnesium 0.7 mg/dl. He was treated aggressively with intravenous magnesium and calcium with resolution of symptoms. Hypomagnesemia with subsequent hypocalcemia is a common side effect of cisplatin therapy, an understanding of its pathophysiology is imperative for clinician.

An 80-year-old male was admitted to our institution with a complaint of chest pain. Electrocardiography revealed ST elevation in leads V1-V5, blood chemistry revealed elevated creatine kinase MB and troponin T levels, and transthoracic echocardiography revealed akinesis in the anterior wall of the left ventricle. Although chest radiography revealed no cardiac or respiratory abnormalities, multiple small nodules in both lungs were identified. A diagnosis of Acute Myocardial Infarction (AMI) was made and Cardioangiography (CAG) was performed, which revealed a severely stenotic lesion in the proximal left descending artery. After thrombectomy, drug-eluting stents were successfully placed. However, intramuscular hemorrhage in the right upper arm and hematuria occurred; moreover, the platelet count decreased to 7.5×104/μL, leading to a suspicion of Disseminated Intravascular Coagulation (DIC). Following treatment of the DIC, the chest nodules detected earlier were investigated further by whole-body computed tomography and magnetic resonance imaging, which revealed a tumor in the prostate gland with metastases to the first lumbar vertebra, ischial bone, and hyoid bone. Prostate cancer was thus detected during examination and diagnosis of AMI and DIC, suggesting an association between the underlying cancer and coagulation disorders such as DIC, venous thromboembolism, and acute coronary syndrome, similar to our patient. This case report suggests that physicians should be mindful of underlying disorders when encountering thrombotic diseases.

Transurethral Prostate Resection (TUR) opens large venous network and allows irrigation fluid to be absorbed into systemic circulation. The absorption of 2000 ml or more fluid causes a syndrome known as TUR-P syndrome and presents with head ache, restlessness, confusion, cyanosis, dyspnea, arrhythmia, hypotension and convulsions. The most important point in treatment is early diagnosis. When suspected, serum sodium levels of the patients should be measured. In cases with large prostate whose operation is estimated to last long, perioperative sodium measurement should be made routinely. Compared to general anesthesia, regional anesthesia decreases the incidence of postoperative venous thrombosis and the probability of symptoms being masked. Regional anesthesia enables earlier recognition and faster and more efficient treatment of TUR syndrome.

Purpose: Myocarditis is an inflammatory process of the myocardium that can have an assortment of different etiologies such as infection, systemic disease and/or exposure to medications and toxins. There can be a variety of clinical presentations ranging from mild dyspnea and chest pain that can be self-limiting to cardiogenic shock and death. Although myocarditis can have several causes, viral infection remains the leading cause of both acute and chronic myocarditis. Corticosteroids, Intravenous Immunoglobulin (IVIG) and ventricular assist devices are controversial treatment options with minimal evidence of efficacy in the adult population. Summary: A critically ill patient presented to a large academic healthcare facility with flu-like symptoms and severe left ventricular dysfunction. The patient was given broad spectrum antimicrobials, corticosteroids and intravenous immunoglobulin as part of their treatment regimen. Due to severe left ventricular dysfunction, the patient required the use of a left ventricular assist device and extracorporeal membrane oxygenation for cardiac and hemodynamic support. After improvement in left ventricular function, the patient experience neuropathies requiring physical therapy and rehabilitation. Conclusion: This case report presents a patient with severe left ventricular dysfunction due to myocarditis. After administration of broad antimicrobial coverage, corticosteroids and IVIG, our patient experienced recovery of left ventricular function and overall improvement in his condition.