Veronika Tóth

Developing an international Pseudomonas aeruginosa reference panel

Pseudomonas aeruginosa is a major opportunistic pathogen in cystic fibrosis (CF) patients and causes a wide range of infections among other susceptible populations. Its inherent resistance to many antimicrobials also makes it difficult to treat infections with this pathogen. Recent evidence has highlighted the diversity of this species, yet despite this, the majority of studies on virulence and pathogenesis focus on a small number of strains. There is a pressing need for a P. aeruginosa reference panel to harmonize and coordinate the collective efforts of the P. aeruginosa research community. We have collated a panel of 43 P. aeruginosa strains that reflects the organisms diversity. In addition to the commonly studied clones, this panel includes transmissible strains, sequential CF isolates, strains with specific virulence characteristics, and strains that represent serotype, genotype or geographic diversity. This focussed panel of P. aeruginosa isolates will help accelerate and consolidate the discovery of virulence determinants, improve our understanding of the pathogenesis of infections caused by this pathogen, and provide the community with a valuable resource for the testing of novel therapeutic agents.

Study on SSAO enzyme activity and anti-inflammatory effect of SSAO inhibitors in animal model of inflammation

SSAO/VAP-1 participates in the accumulation of leukocytes at the site of inflammation. A new SSAO inhibitor, SzV-1287 was demonstrated to inhibit both acute and chronic inflammation in rats more effectively than the known enzyme inhibitor, LJP-1207. Surprisingly, the SSAO activity was not increased, but decreased both in acute and chronic inflammation. Though experiments are in progress to clarify these findings, the enzyme might play a role in the very early phase of inflammation and be inactivated during leukocyte extravasation.

Grayish discoloration of the face – argyria

The 54 year-old vegetarian patient has taken oral colloidal silver for two years to stimulate his immune system. The silver intake resulted in diffuse grayish discoloration on the face. His laboratory values were in the normal range, and no internal organ disease was detected. The histology of the forehead skin confirmed the diagnosis of argyria. Argyria is a condition associated with chronic local or systemic exposure to silver-containing products. The silver is typically deposited in skin, fingernails, oral mucosa and conjunctival membranes. There is no effective treatment for this condition. With the availability of pharmacologic alternatives, physician-directed use of silver-containing products had significantly declined. We review the literature and call attention to the adverse effects and dangers of the widely used paramedicinal colloidal silver products.Az argyria ezustvegyuletek tartos lokalis vagy szisztemas alkalmazasa nyoman kialakulo korkep. A tunetek leggyakrabban a bőron, kormokon, conjunctivan, szajnyalkahartyan jelentkeznek, kezelesuk mind a mai napig kihivast jelent. Bar napjainkban ezusttartalmu gyogyszerek, gyogyaszati eszkozok hasznalatara mersekelt gyakorisaggal kerul sor, az argyria előfordulasaval megis szamolnunk kell. A korkep leggyakoribb okava mara a paramedicinalis gyogyaszatban szeles korben alkalmazott ezustkolloid tartos fogyasztasa valt. Kozlemenyunkben 54 eves ferfi beteg esetet ismertetjuk, aki evek ota vegetarianus eletmodot folytatott. A beteg immunrendszere erősitese celjabol fogyasztott ezustkolloidot kozel ket even at, amelynek hatasara kialakult az arc diffuz, szurke elszineződese. Az anamnezis es a klinikai kep alapjan az argyria diagnozisa merult fel. A beteg kivizsgalasa soran laboratoriumi es kepalkoto diagnosztikus vizsgalatokkal belső szervi elterest nem talaltunk. Az argyria diagnozisat a tunetes bőrből vegzett hisztologiai vizsgalat alatamasztotta. A szerzők az irodalmi adatok tukreben felhivjak a fi gyelmet a paramedicinaban az ezustkolloid napjainkban tapasztalt terhoditasara, mellekhatasaira, a szerrel kapcsolatos teves informaciokra, az ezustkolloid-fogyasztas veszelyeire. Kulcsszavak: ezustkolloid, paramedicina, szurke bőrszin, argyria Grayish discoloration of the face – argyria The 54 year-old vegetarian patient has taken oral colloidal silver for two years to stimulate his immune system. The silver intake resulted in diffuse grayish discoloration on the face. His laboratory values were in the normal range, and no internal organ disease was detected. The histology of the forehead skin confi rmed the diagnosis of argyria. Argyria is a condition associated with chronic local or systemic exposure to silver-containing products. The silver is typically deposited in skin, fi ngernails, oral mucosa and conjunctival membranes. There is no effective treatment for this condition. With the availability of pharmacologic alternatives, physician-directed use of silver-containing products had signifi cantly declined. We review the literature and call attention to the adverse effects and dangers of the widely used paramedicinal colloidal silver products.

Genotype analysis in Hungarian patients with multiple primary melanoma.

Multiple primary melanoma patients (MPMps) have better prognosis and are more prone to genetic predisposition than single melanoma patients. We aimed to compare genetic background (CDKN2A, CDK4, MITF, MC1R) of 43 Hungarian MPMps with their clinicopathological data. We observed a higher rate of synchronous first and second melanoma (MM) (49%) and a higher frequency of non‐melanoma tumor co‐occurrence (42%) than reported previously. CDKN2A mutation frequency was 4.7% (E69G, R99P). We identified a new human MC1R variant (D117G) and reported MC1R variant distributions in Hungarian MMs for the first time. The rare R163Q was exceptionally common among Hungarian MPMps, a variant otherwise frequent in Asia, but not in Europe. MC1R ‘R’ carriers showed histopathological signs of a more progressive disease than ‘r’ carriers did; however, tumor‐infiltrating lymphocytes (TILs) in their second melanomas occurred significantly more frequently. Calculating 5‐year overall survival, ‘R’ carriers showed more unfavourable prognosis (87%) than ‘r’ carriers did (95%).

Stage distribution of malignant melanomas in a Hungarian centre

INTRODUCTION Survival of patients with malignant melanoma primarily depends on tumor stage. Hungarian National Cancer Registry does not specify tumors according to TNM stages. AIM The authors aimed to survey the stage distribution of melanomas at the Department of Dermatology, Dermatooncology and Venerology, Semmelweis University. METHOD 1160 patients (558 males and 602 females, aged 60.5±16 and 57±17 years, respectively) diagnosed with cutaneous melanoma between 2004-2009 were included. RESULTS In comparison with international studies, the case distribution was favorable in stages IA and IV, i.e. the proportion of early melanomas was relatively high (IA: 43.8%), while the incidence in stage IV was low (0.4%). In stages IB-IIA the incidence was significantly lower, while in IIC, IIIA, IIIB it was higher as compared to published data from Western-Europe, Australia and the United States. CONCLUSIONS The study underlines the necessity of prevention and awareness campaigns that may result in increase of early diagnosis of melanomas.

Meningovascular neurosyphilis as the cause of ischemic cerebrovascular disease in a young man

Authors report a case of a 35-year-old male with right-sided mild paresis, incontinence, dysexecutive syndrome, short-term memory loss and behavioral changes. Bilateral cerebral infarcts in the region of the caudate nuclei and the adjacent white matter were proved by brain MRI and multiple stenoses of the branches of Willis-circle were confirmed by MR angiography. Elevated protein level and pleocytosis were found in the cerebrospinal fluid with intrathecal IgG synthesis. Serum rapid plasma reagin, Treponema pallidum Particle Agglutination test, Treponema pallidum ELISA, liquor Venereal Disease Research Laboratory tests were positive. Meningovascular neurosyphilis was diagnosed. 24M U/day intravenous penicillin-G treatment was given for 14 days. The patient has vascular dementia due to the bilateral strategic infarcts disconnecting the prefrontal circuits; his symptoms are similar to general paresis. Laboratory and radiologic improvement was observed. Still, the patient have severe residual cognitive decline.

Neisseria gonorrhoeae törzsek rezisztenciaadatai Magyarországon@@@Antimicrobal resistance of Neisseria gonorrhoeae strains in Hungary

INTRODUCTION European guidelines on the treatment of Neisseria gonorrhoeae are based mostly on Western European data, although these recommendations may not be optimised for the circumstances in Hungary. AIM The aim of the authors was to assess current antimicrobial resistance of Neisseria gonorrhoeae strains in order to enhance gonococcal antimicrobial surveillance in Hungary. Neisseria gonorrhoeae strains were isolated at the National Center of Sexually Transmitted Infections at the Department of Dermatology, Venerology and Dermatooncology of Semmelweis University in the period between January 2011 and June 2014. METHOD Antimicrobial resistance was determined with minimum inhibitory concentration measurement. Neisseria gonorrhoeae Multiantigen Sequence typing was used as molecular typing method. RESULTS Resistance to the currently recommended extended spectrum cephalosporins is rare in Hungary, but there is an emerging azithromycin resistance among the Neisseria gonorrhoeae strains. CONCLUSIONS Revision of the national treatment guideline must consider that the most frequent sequence types of Neisseria gonorrhoeae strains causing infections in Hungary are mainly resistant to azithromycin.

Neisseria gonorrhoeae törzsek rezisztenciaadatai Magyarországon

INTRODUCTION European guidelines on the treatment of Neisseria gonorrhoeae are based mostly on Western European data, although these recommendations may not be optimised for the circumstances in Hungary. AIM The aim of the authors was to assess current antimicrobial resistance of Neisseria gonorrhoeae strains in order to enhance gonococcal antimicrobial surveillance in Hungary. Neisseria gonorrhoeae strains were isolated at the National Center of Sexually Transmitted Infections at the Department of Dermatology, Venerology and Dermatooncology of Semmelweis University in the period between January 2011 and June 2014. METHOD Antimicrobial resistance was determined with minimum inhibitory concentration measurement. Neisseria gonorrhoeae Multiantigen Sequence typing was used as molecular typing method. RESULTS Resistance to the currently recommended extended spectrum cephalosporins is rare in Hungary, but there is an emerging azithromycin resistance among the Neisseria gonorrhoeae strains. CONCLUSIONS Revision of the national treatment guideline must consider that the most frequent sequence types of Neisseria gonorrhoeae strains causing infections in Hungary are mainly resistant to azithromycin.

Antimicrobal resistance of Neisseria gonorrhoeae strains in Hungary

INTRODUCTION European guidelines on the treatment of Neisseria gonorrhoeae are based mostly on Western European data, although these recommendations may not be optimised for the circumstances in Hungary. AIM The aim of the authors was to assess current antimicrobial resistance of Neisseria gonorrhoeae strains in order to enhance gonococcal antimicrobial surveillance in Hungary. Neisseria gonorrhoeae strains were isolated at the National Center of Sexually Transmitted Infections at the Department of Dermatology, Venerology and Dermatooncology of Semmelweis University in the period between January 2011 and June 2014. METHOD Antimicrobial resistance was determined with minimum inhibitory concentration measurement. Neisseria gonorrhoeae Multiantigen Sequence typing was used as molecular typing method. RESULTS Resistance to the currently recommended extended spectrum cephalosporins is rare in Hungary, but there is an emerging azithromycin resistance among the Neisseria gonorrhoeae strains. CONCLUSIONS Revision of the national treatment guideline must consider that the most frequent sequence types of Neisseria gonorrhoeae strains causing infections in Hungary are mainly resistant to azithromycin.

Epidemiological survey of patients with melanoma diagnosed at the Department of Dermatology, Dermatooncology and Venerology, Semmelweis University

A melanoma túlélése elsôsorban a TNM-stádium függvénye, azonban a Nemzeti Rákregiszter a daganatokat stádiumok alapján nem részletezi. Vizsgálatunk során felmértük a Semmelweis Egyetem Bôr-, Nemikórtani és Bôronkológiai Klinikán 2004–2009 között diagnosztizált 1160 cutan melanomás beteg (558 férfi és 602 nô, átlagéletkoruk 59±16 év) stádiumait. Nagy esetszámú nemzetközi vizsgálatokkal összehasonlítva az IA és IV-es stádiumban a klinika betegeinek aránya kedvezônek bizonyult, viszonylag magas százalékban fordultak elô a korai melanomák (IA: 43,8%) és alacsony volt a késôi, IV-es stádiumú daganatok aránya (0,4%). A vizsgálat felhívja a figyelmet arra, hogy a korai diagnózis további javítása érdekében a lakosság folyamatos felvilágosítása, primer és szekunder prevenciós programok szükségesek.