Merkel cell carcinoma of skin-current controversies and recommendations

The review covers the current recommendations for Merkel cell carcinoma (MCC), with detailed discussion of many controversies. The 2010 AJCC staging system is more in-line with other skin malignancies although more complicated to use. The changes in staging system over time make comparison of studies difficult. A wide excision with margins of 2.5–3 cm is generally recommended. Even for primary </= 1 cm, there is a significant risk of nodal and distant metastases and hence sentinel node biopsy should be done if possible; otherwise adjuvant radiotherapy to the primary and nodal region should be given. Difficulties of setting up trials owing to the rarity of the disease and the mean age of the patient population result in infrequent reports of adjuvant or concurrent chemotherapy in the literature. The benefit, if any, is not great from published studies so far. However, there may be a subgroup of patients with high-risk features, e.g. node-positive and excellent performance status, for whom adjuvant or concurrent chemotherapy may be considered. Since local recurrence and metastases generally occur within 2 years of the initial diagnosis, patients should be followed more frequently in the first 2 years. However delayed recurrence can still occur in a small proportion of patients and long-term follow-up by a specialist is recommended provided that the general condition of the patient allows it. In summary, physician judgment in individual cases of MCC is advisable, to balance the risk of recurrence versus the complications of treatment

Potentially pathogenic yeasts from soil of children’s recreational areas in the city of Łódź (Poland)

Objectives: Yeasts may become potential human and animal pathogens, particularly for individuals with a depressed immune system. Their presence in the environment, especially in soil, may favour their spread into human ontocenoses. Materials and Methods: Eighty-four soil samples obtained from 21 children's recreational sites in Łódź in autumn 2010 and spring 2011 were evaluated. The yeasts were isolated by classical microbiological methods and identified on the basis of morphological and biochemical features. Results: The fungi were found in 73.8% and in 69.0% of the examined samples collected in autumn and spring, respectively. Among 97 isolates of yeasts, the species potentially pathogenic to humans and animals were Candida colliculosa, C. guilliermondii, C. humicola, C. inconspicua, C. lambica, C. lusitaniae, C. pelliculosa, C. tropicalis, Cryptococcus albidus, C. laurentii, C. neoformans, C. terreus, Kloeckera japonica, Geotrichum candidum, G. penicillatum, Rhodotorula mucilaginosa, R. glutinis, Saccharomyces cerevisiae, Sporobolomyces salmonicolor and Trichosporon cutaneum. The most frequently isolated fungi included the genus Cryptococcus (38 isolates) and two species: Rhodotorula glutinis (15), Trichosporon cutaneum (14). C. neoformans, an etiological factor of cryptococcal meningitis, was present in the sandpits of 3 kindergartens. The Candida species were identified from park playgrounds and school sports fields mainly in autumn 2010 (14 isolates), in spring 2011 - only 1 isolate. The concentration of fungal species in particular samples varied considerably, but in the majority of samples, fungi were present at concentration of up to 1×102 CFU/1 g of soil. Conclusions: Yeasts were present in the soil of parks, schools and kindergarten recreational areas; the fact may pose a health risk to humans, especially to children, and this type of biological pollution should be regarded as a potential public health concern

Charakterystyka cech fenotypowych gatunkowych i wewnątrzgatunkowych szczepów grzybów wyodrębnionych z wybranych ontocenoz narządowych osób po przeszczepach nerek

Characteristics or phenotypic specific and intraspecific reatures of fungal strains isolated from the organ ontocenoses in patients after renal transplantation. The aim of present study was to describe 60 specific and intraspecific features of fungal strains isolated from the organ ontocenoses: oral cavity, rectum and genital organs in 32 patients undergoing permanent immunosupression after renal transplantation. Fungal strains identified using API 20 C and API 20 C AUX (bioMérieux). The activity or 19 hydrolases was investigated using API ZYM. Among 41 strains of fungi the following were found: Candida albicans (31 strains), C. glabrata (5), C. guilliermondii (2), C. krusei (2) and Saccharomyces cerevisiae (1). The number of fungal strains isolated from the oral cavity was the highest (21), less numerous from rectum (12) and the least from the genital organs (8). The enzymograms were described for all strains and the highest activity was noted in case of: e₆ -leucine arylamidase, e₁₁-phosphatase acid, e₃-esterase (C4), e₁₂-naphtol-AS-BI-phosphohydrolase. The activity of these enzymes is connected with higher pathogenicity of C. albicans strains

Charakterystyka cech fenotypowych gatunkowych i wewnatrzgatunkowych szczepow grzybow wyodrebnionych z wybranych ontocenoz narzadowych osob po przeszczepach nerek

Characteristics or phenotypic specific and intraspecific reatures of fungal strains isolated from the organ ontocenoses in patients after renal transplantation. The aim of present study was to describe 60 specific and intraspecific features of fungal strains isolated from the organ ontocenoses: oral cavity, rectum and genital organs in 32 patients undergoing permanent immunosupression after renal transplantation. Fungal strains identified using API 20 C and API 20 C AUX (bioMérieux). The activity or 19 hydrolases was investigated using API ZYM. Among 41 strains of fungi the following were found: Candida albicans (31 strains), C. glabrata (5), C. guilliermondii (2), C. krusei (2) and Saccharomyces cerevisiae (1). The number of fungal strains isolated from the oral cavity was the highest (21), less numerous from rectum (12) and the least from the genital organs (8). The enzymograms were described for all strains and the highest activity was noted in case of: e₆ -leucine arylamidase, e₁₁-phosphatase acid, e₃-esterase (C4), e₁₂-naphtol-AS-BI-phosphohydrolase. The activity of these enzymes is connected with higher pathogenicity of C. albicans strains

Prewalencja wieloogniskowych zarazen grzybami u chorych z przeszczepami nerek poddawanych stalej immunosupresji

Prevalence of multifocal fungal infections in patients undergoing permanent immunosuppresion alter renal transplantation. The aim of the study was to estimate the prevalence of fungi in monofocal and multifocal infections in renal transplant recipients. 32 renal transplant recipients were examined for presence of fungi in genital organs, oral cavity and rectum. Fungal strains were recovered in 66 out of 96 samples (68.2% of all renal transplant recipients) in oral cavity (65.6%), rectum (37.5%) and genital organs (25.0%). Monofocal mycosis was found only in 21.9% of the patients. Multifocal infections occurred in 68.2% and contained ontocenoses of oral cavity and rectum (34.4%) the most frequently. Trifocal infection (genital organs - oral cavity - rectum) occurred in 12.5% of all examined renal transplant recipients. The following fungi were found: Candida albicans (31 strains), C. glabrata (5), C. guilliermondii (2), C. krusei (20, Saccharomyces cerevisiae (1)

Prewalencja wieloogniskowych zarazeń grzybami u chorych z przeszczepami nerek poddawanych stałej immunosupresji

Prevalence of multifocal fungal infections in patients undergoing permanent immunosuppresion alter renal transplantation. The aim of the study was to estimate the prevalence of fungi in monofocal and multifocal infections in renal transplant recipients. 32 renal transplant recipients were examined for presence of fungi in genital organs, oral cavity and rectum. Fungal strains were recovered in 66 out of 96 samples (68.2% of all renal transplant recipients) in oral cavity (65.6%), rectum (37.5%) and genital organs (25.0%). Monofocal mycosis was found only in 21.9% of the patients. Multifocal infections occurred in 68.2% and contained ontocenoses of oral cavity and rectum (34.4%) the most frequently. Trifocal infection (genital organs - oral cavity - rectum) occurred in 12.5% of all examined renal transplant recipients. The following fungi were found: Candida albicans (31 strains), C. glabrata (5), C. guilliermondii (2), C. krusei (20, Saccharomyces cerevisiae (1)