Well-differentiated thyroid carcinoma rarely spreads to soft tissues. Thyroid carcinoma arising within a mature cystic teratoma is even rarer. We report an extremely rare case of synchronous follicular thyroid carcinoma arising within a mature cystic ovarian teratoma and stage IV differentiated thyroid carcinoma. A 62-year-old woman who lived in an iodine-deficient area was accidentally diagnosed with an ovarian cyst during a radiological metastatic work-up for thyroid cancer. Following laparoscopic left salpingo-oophorectomy, histopathological examination revealed a follicular thyroid carcinoma arising within a mature cystic teratoma. After that, total thyroidectomy and surgical resection of the soft tissue lesion in the supraclavicular fossa were performed, and the patient received subsequent 131I ablation therapy, but the disease progression was recorded 3 months later. We believe that iodine deficiency plays a role in the malignant transformation of thyroid tissues within a mature cystic teratoma. In elderly individuals with significant metastases, radioactive iodine therapy is ineffective.
Safety and health management is a critical point in business management, especially in hazardous industries. The point of view and management methods of each entrepreneur depend much on safety culture, including awareness, competence, and behavior of each employee in the company, considering prevention is the priority. The article reviews the safety culture in companies with its components and categories, both in national and international concepts. Influenced factors are also mentioned, and appropriate safety culture models of the Vietnamese coal mining industry are suggested.
Objective: Klebsiella pneumoniae (K. pneumoniae) is one of the most prevalent human pathogens. Carbapenemaseproducing klebsiella pneumoniae (CPKP) has recently developed significant antibiotic resistance, not just to carbapenem antibiotics but also to the majority of other currently available antibiotics. Prior to this point, there have been few international studies or publications on the situation of CPKP in Vietnam. Hence, this study was conducted to determine the antibiotic resistance of K. pneumoniae and CPKP strains in Can Tho, Vietnam. Material and Methods: In total, 345 K. pneumoniae strains were isolated. Antibiotic susceptibility was assessed via an automated microbiological system. A modified carbapenem inactivation assay was applied to identify CPKP strains, followed by the use of the MASTDISCS combi Carba plus disc system to classify certain carbapenemases. Results: Of the 345 K. pneumoniae strains, 110 represented an isolation rate of 31.9%. There was a significant correlation (p-value<0.05) between the specimen type, hospital unit and CPKP ratio. All the examined CPKP strains exhibited complete resistance to penicillin and cefazolin. The CPKP strains were also significantly more resistant to PTZ, cefepime, ciprofloxacin and imipenem than the non-CPKP strains (p-value<0.05). Amikacin, gentamicin and TMP/SMX have been shown to be effective in treating patients infected with CPKP strains. Conclusion: CPKP accounts for 31.9% of all K. pneumoniae infections. K. pneumoniae and CPKP exhibited the highest levels of resistance to ampicillin, cefazoline, ciprofloxacin, ceftriaxone and ceftazidime. Amikacin, gentamicin and TMP/ SMX were the least resistant antibiotics tested.
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