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The presence of the Philadelphia chromosome (Ph) in chronic myelogenous leukaemia (CML) is a specific cytogenetic change resulting from a reciprocal translocation between chromosomes 9 and 22. In 5–10% of newly diagnosed cases there are variant translocations (vPh) involving more chromosomes. This paper presents the case of a CML patient with a complex variant translocation involving chromosomes 1, 6, 9, 17 and 22. A molecular analysis did not reveal any mutation in the kinase domain of BCR-ABL1 gene or the mutation of TP53 gene. After the first-line treatment with imatinib no cytogenetic or molecular response was obtained. The change of treatment to dasatinib resulted in a minimal cytogenetic response (minCyR) followed by a minor cytogenetic response (mCyR). The application of nilotinib in the third-line treatment resulted in a complete molecular response (CMolR) and therapy success. The likely reason for the failure of the first- and second-line treatment was the loss of a fragment of the 17p13 region as a result of a variant translocation. The change can be a functional equivalent of the loss of one copy of TP53. The analysis of presented case confirms the significance of the detailed evaluation of the composition of vPh complex variant translocations as well as importance of combination cytogenetic and molecular diagnostics in CML treatment monitoring. It makes possible to adequate diagnose higher-risk patients and apply effective treatment strategies if an aberration is identified. [ABSTRACT FROM AUTHOR]

The incidence of candidiasis among immunocompromised patients and emergence of antimycotics resistant strains has increased significantly. The aims of this study were: to examine the in vitro activity of antimycotics and biocides against Candida clinical isolates; to detect cross-resistance of fungi to these preparations and to estimate whether disinfectants applied in hospital areas are active against clinical Candida isolates. In vitro susceptibility of 102 Candida isolates to eight antimycotics was examined by Etest and ATB Fungus. Sensitivity of these strains to four disinfectants and an antiseptic agent was tested according to EN 1275:2005. Amphotericin B, caspofungin and 5-fluorocytosine were the most effective antimycotics against all Candida isolates. Resistance to itraconazole and fluconazole was observed among C. krusei and C. glabrata. The MICs (Minimal Inhibitory Concentrations) for ketoconazole, voriconazole and posaconazole against Candida albicans ranged: 0.003 - >32 μg/ml and one strain was resistant to three agents tested. All analysed Candida strains were sensitive to biocides containing either chlorine, aldehyde, alcohol mixtures, glucoprotamin or chlorhexidine gluconate with isopropanol. Sensitivity to these agents was observed at concentrations lower than those concentrations recommended by manufacturers to achieve proper biocidal activity to those preparations. Our data suggest that these disinfectants can be effectively applied in clinical wards to prevent nosocomial Candida infections. [ABSTRACT FROM AUTHOR]

Textile medical products can be widely used as barrier materials and individual protection against biological threats. Rules of introducing such products to market are regulated by the Directive 93/42/ EEC. Detailed requirements and testing methods of textile medical products are presented in obligatory norms. The required level of protection of these products against the penetration of microbes depends on the risk connected with planned type surgical procedure, the duration of the surgical intervention, risks of bleeding or presences of other body liquids of the patient and susceptibilities of the patient to infection. The aim of the study was to establish resistance of medical textiles to wet bacterial penetration. Materials were examined by the apparatus dedicated to this type of testing and obtained results were rated with reference to obligatory contracted requirements. assured Textiles laminated with foils possessed best protective proprieties, whereas medical products made from the cotton do not provide the sufficient level of the protection against microbes.

Multiple myeloma is usually characterized by production of a single serum monoclonal protein of constant isotype and light chain restriction. Isotype switching in human lymphomas appears to be an uncommon event. It could be due to altered para-protein production by the malignant plasma cell clone, or oligoclonal Ig production during recovery of B-cell function after chemotherapy. We describe a case of clonal heavy chain isotype switching in a patient with lymphoplasmocytic lymphoma.