Background: The aim of this study is to determine which types of microorganisms influence the onset and development of colorectal cancer (CRC) in humans. Methods: In patients with CRC, three swabs were taken for microbiological analysis during surgical removal of the cancer: the first swab from the surface of the healthy intestinal mucosa, the second from the surface of the tumor, and the third from the middle of the tumor tissue. Results: In the healthy mucosa of the colon, the most prevalent microorganism was Escherichia coli at 70.5%, followed by Enterococcus spp. (47.7%) and Klebsiella/Enterobacter (20.5%). Microbiological analysis of the swabs from the surface of the tumor tissue showed that E. coli was the most prevalent at 72.7%, followed by Enterococcus spp. at 40.9%, Klebsiella/Enterobacter at 25%, and Pseudomonas aeruginosa at 20%. In the center of tumor tissue, E. coli was the most prevalent at 77.3%, followed by Enterococcus spp. at 47.7%, Klebsiella at 27%, and Pseudomonas aeruginosa at 18.2%. Conclusion: Certain types of bacteria can influence the emergence and development of cancer, while other types can suppress the development of tumor tissue. Microbiological analysis of human stool samples can prevent the development of CRC.

Introduction World Health Organization (WHO) has recommended widespread vaccination to prevent the coronavirus disease 2019 (COVID-19) pandemic. At the moment, vaccines from different manufacturers, with different composition and mechanism of action are available on the world market. Due to the urgency and necessity for the production of large quantities of vaccines, they have undergone short clinical trials, but it is still necessary to monitor the occurrence of side effects for at least five years (post-marketing surveillance). Case report Patient No. 1, a 47-year-old female, was vaccinated twice against COVID -19 with the AstraZeneca vaccine and her Anti-TPO antibodies increased 10-fold three months after receiving the second dose. Concentration of T4 was at the lower limit and TSH titer was elevated. One month after receiving the third dose, Pfizer -BioNtech vaccine, based on the clinical picture and laboratory tests, she was diagnosed with Hashimoto’s disease. Patient No. 2, a 47-year-old male, has received two doses of Sinopharm vaccine against COVID-19. On regular physical examination, ultrasound revealed micro-nodules in the thyroid gland. Laboratory tests showed an increased titer of Anti- TPO antibodies with a preserved hormonal status of the thyroid gland. After receiving the third dose of the same vaccine, the Anti -TPO titer remained at the previous level. Conclusion In some patients, vaccines against COVID-19 may increase the titer of Thyroid autoimmune antibodies leading to subclinical or clinical manifestations of Hashimoto's disease. The reasons are specific action of different types of vaccines, the overdose of vaccines in relation to body mass index as well as the place of vaccine application. It is recommended to monitor for a while the titer of anti-thyroid antibodies in persons vaccinated against COVID-19.

Background: The aim of this study is to determine which types of microorganisms influence on the onset and development of colorectal cancer (CRC) in humans. Methods: In patients with CRC, three swabs were taken for microbiological analysis during surgical removal of cancer: first swab from the surface of the healthy intestinal mucosa, the second from the surface of the tumor and the third from the middle of the tumor tissue. Results: In the healthy mucosa of the colon, the most prevalent was Escherichia coli at 70.5%, followed by Enterococcus spp. (47.7%) and Klebsiella/Enterobacter (20.5%). Microbiological analysis of the swabs from the surface of tumor tissue showed that E. coli was the most prevalent at 72.7%, followed by Enterococcus spp. 40.9%, Klebsiella/Enterobacter 25%, and Pseudomonas aeruginosa 20%. In the center of tumor tissue, E. coli was the most prevalent in 77.3% of samples, followed by Enterococcus spp. 47.7%, Klebsiella 27%, and Pseudomonas aeruginosa 18.2%. Conclusion: Certain types of bacteria can influence the emergence and development of cancer, while other types can suppress the development of tumor tissue. Microbiological analysis of human stool samples can be a prevention of the development of CRC.

Cirrhotic cardiomyopathy (CCM) is a diagnostic entity defined as cardiac dysfunction (diastolic and/or systolic) in patients with liver cirrhosis, in the absence of overt cardiac disorder. Pathogenically, CCM stems from a combination of systemic and local hepatic factors that, through hemodynamic and neurohormonal changes, affect the balance of cardiac function and lead to its remodeling. Vascular changes in cirrhosis, mostly driven by portal hypertension, splanchnic vasodilatation, and increased cardiac output alongside maladaptively upregulated feedback systems, lead to fluid accumulation, venostasis, and cardiac dysfunction. Autocrine and endocrine proinflammatory cytokines (TNF-alpha, IL-6), as well as systemic endotoxemia stemming from impaired intestinal permeability, contribute to myocardial remodeling and fibrosis, which further compromise the contractility and relaxation of the heart. Additionally, relative adrenal insufficiency is often present in cirrhosis, further potentiating cardiac dysfunction, ultimately leading to the development of CCM. Considering its subclinical course, CCM diagnosis remains challenging. It relies mostly on stress echocardiography or advanced imaging techniques such as speckle-tracking echocardiography. Currently, there is no specific treatment for CCM, as it vastly overlaps with the treatment of heart failure. Diuretics play a central role. The role of non-selective beta-blockers in treating portal hypertension is established; however, their role in CCM remains somewhat controversial as their effect on prognosis is unclear. However, our group still advocates them as essential tools in optimizing the neurohumoral pathologic axis that perpetuates CCM. Other targeted therapies with direct anti-inflammatory and antioxidative effects still lack sufficient evidence for wide approval. This is not only a review but also a comprehensive distillation of the insights from practicing clinical hepatologists and other specialties engaged in advanced approaches to treating liver disease and its sequelae.