Polyorchidism is a rare male urogenital tract anomaly characterized by at least one supernumerary testis in the scrotum or ectopically. According to data based on our systematic review, 76% of the supernumerary testes (SNTs) were located in the scrotum, and 24% were extra-scrotal (p < 0.001). Among testes located outside the scrotum, 87% were found in the inguinal canal and 13% in the abdominal cavity. In 80% of cases, the diagnosis of SNT was made based on imaging tests, and the remaining 20% of cases were detected incidentally during surgery. The imaging tests performed (US or MRI) resulted in a significantly higher rate of patients who qualified for observation vs. surgical treatment (45% vs. 35%, p < 0.001). The most common conditions associated with SNT were ipsilateral inguinal hernia (15% of cases) and cryptorchidism (15% of cases). Surgery (orchidopexy/orchidectomy) was performed on 54% of patients with SNT, and the decision to observe the SNT was made in a total of 46% of patients (p = 0.001). The therapeutic approach depends on the location of the SNT and the presence of factors that raise suspicion of neoplastic proliferation.
In our recent article (Smędra et al.: Oral form of auto-brewery syndrome. J Forensic Leg Med. 2022; 87: 102333), we showed that alcohol production can occur in the oral cavity (oral auto-brewery syndrome) due to a disruption in the microbiota (dysbiosis). An intermediate step on the path leading to the formation of alcohol is acetaldehyde. Typically, acetic aldehyde is transformed into acetate particles inside the human body via acetaldehyde dehydrogenase. Unfortunately, acetaldehyde dehydrogenase activity is low in the oral cavity, and acetaldehyde remains there for a long time. Since acetaldehyde is a recognised risk factor for squamous cell carcinoma arising from the oral cavity, we decided to analyse the relationship linking the oral microbiome, alcohol, and oral cancer using the narrative review method, based on browsing articles in the PubMed database. In conclusion, enough evidence supports the speculation that oral alcohol metabolism must be assessed as an independent carcinogenic risk. We also hypothesise that dysbiosis and the production of acetaldehyde from non-alcoholic food and drinks should be treated as a new factor for the development of cancer.
Background: Geopolitical and climate changes form the background of the current migration crisis. It has many faces. One of them are the tragic cases of poisoning of refugees due to eating wild forest mushrooms for socioeconomic reasons in the Western and Northern European countries. The most serious food poisonings in Europe, but not only, are caused by lamellar mushrooms, the most dangerous being Amanita phalloides. Its poisonous properties can be attributed to α-amanitin, an RNA polymerase II inhibitor. Unfortunately, as it is characterized by a delayed onset of symptoms, A. phalloides poisoning has a high risk of complications. Case presentation: Our article presents a case of A. phalloides poisoning in a 28-year-old man, in which the responding medical emergency unit made errors in diagnosis and treatment. Since the correct diagnosis was made too late, the typical treatment of A. phalloides poisoning was ineffective. The patient suffered a life-threatening liver failure and needed liver transplant from a deceased donor. Conclusions: Mushroom poisoning is a particularly important problem not only in countries with a mushroom picking tradition, but also—due to the inflow of refugees—in countries where mushroom poisoning was very rare until recently. In such cases it is crucial to quickly implement the correct procedure, as this can prevent the need for liver transplant or even death. This is a particularly important consideration for the first medical professionals to contact the patient, especially in cases where the patient reports mushrooms consumption and presents alarming symptoms of the gastrointestinal tract. Such situations cannot be underestimated and ignored.