Coronary microvascular dysfunction (CMD) is a clinical entity linked with various risk factors that significantly affect cardiac morbidity and mortality. Hypertension, one of the most important, causes both functional and structural alterations in the microvasculature, promoting the occurrence and progression of microvascular angina. Endothelial dysfunction and capillary rarefaction play the most significant role in the development of CMD among patients with hypertension. CMD is also related to several hypertension-induced morphological and functional changes in the myocardium in the subclinical and early clinical stages, including left ventricular hypertrophy, interstitial myocardial fibrosis, and diastolic dysfunction. This indicates the fact that CMD, especially if associated with hypertension, is a subclinical marker of end-organ damage and heart failure, particularly that with preserved ejection fraction. This is why it is important to search for microvascular angina in every patient with hypertension and chest pain not associated with obstructive coronary artery disease. Several highly sensitive and specific non-invasive and invasive diagnostic modalities have been developed to evaluate the presence and severity of CMD and also to investigate and guide the treatment of additional complications that can affect further prognosis. This comprehensive review provides insight into the main pathophysiological mechanisms of CMD in hypertensive patients, offering an integrated diagnostic approach as well as an overview of currently available therapeutical modalities.

The study aimed to test the hypothesis that homeostatic microbiome (HM) disorders lead to the increased indirect influence of certain microorganisms (MO) in the gastrointestinal tract, causing a disorder of insulin secretion, insulin resistance, and diabetes. We highlighted Candida and certain types of bacteria since previous in vitro research showed they significantly affect insulin secretion and can cause insulin resistance in obese patients with metabolic syndrome. After determining the type of MO present in the throat swab and the stool, the oral glucose tolerance test (OGTT) test, and analysis of glucose and insulin secretion were performed in patients (n = 38) who were positive for certain types of MO compared to negative patients. Finally, all patients were divided into two groups: overweight patients (body mass index [BMI] < 30) and obese patients (BMI > 30). These two groups were compared for the percentage of certain types of MO to determine which MO can affect an increase in obesity and BMI. The presence of Diphtheroids in the throat (60.5%) reduces insulin secretion in patients compared with the negative group (194.5: 332.4) and the difference was statistically significant (P = .030). The presence of Candida in the throat (10%) increases insulin secretion, but the difference was statistically insignificant. The presence of Candida in the stool (28.9%) also increases insulin secretion and the difference was statistically significant (P = .038). Cumulative results (throat + stool) were similar (180: 332, P = .022). Analysis of BMI showed that the percentage of Diphtheroids in the throat decreases with increased body weight (53.8: 75%) while the percentage of Candida (38.5: 8.3%) and Enterobacter (61.5: 25%) increases, but these differences were statistically insignificant (P > .05). Diphtheroids in the throat can reduce insulin secretion by synthesizing their metabolites. Candida albicans is a conditional pathogen and as a significant indirect factor induces increased insulin secretion and insulin resistance. There are indications that elevated levels of Candida in the intestinal system can cause increased body weight of patients. C albicans should be considered a new factor in the pathogenesis of diabetes.

Background: In the post-COVID-19 era, there is growing concern regarding its impact on cardiovascular health and the following effects on the overall quality of life of affected individuals. This research seeks to investigate cardiac magnetic resonance (CMR) findings following COVID-19 and their impact on the quality of life of affected individuals. Methods: An observational, cross-sectional study was conducted in consecutive patients with persistent cardiovascular symptoms after COVID-19 who were referred to CMR due to suspected myocardial injury. In addition, patients completed a questionnaire about symptoms and the quality of life during the post-COVID-19 period. Results: In this study, 85 patients were included. The study population consisted of patients with a mean age of 42.5 ± 13.4 years, predominantly women, who made up 69.4% of the study population, while men made up 30.6%. CMR findings showed non-ischemic myocardial injury in 78.8% of patients and myocardial edema in 14.1% of patients. Late pericardial enhancement was present in 40% of patients and pericardial effusion in 51.8% of patients. Pericardial effusion (p = 0.001) was more prevalent in patients who reported more pronounced symptoms in the post-COVID-19 period compared to the acute infection phase. Predictors of lower quality of life in the post-COVID-19 period were the presence of irregular heartbeat (p = 0.039), cardiovascular problems that last longer than 12 weeks (p = 0.018), and the presence of pericardial effusion (p = 0.037). Conclusion: Acute myocarditis was observed in a minority of patients after COVID-19, while non-ischemic LGE pattern and pericardial effusion were observed in the majority. Quality of life was worse during the post-COVID-19 period in patients with CMR abnormalities, primarily in patients with pericardial effusion. Also, irregular heartbeat, cardiovascular symptoms that last longer than 12 weeks, as well as pericardial effusion were independent predictors of lower quality of life during the post-COVID-19 period.

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.

Coronary microvascular dysfunction (CMD) is a clinical entity linked with various risk factors that significantly affect cardiac morbidity and mortality. Hypertension, one of the most important, causes both functional and structural alterations in the microvasculature, promoting the occurrence and progression of microvascular angina. Endothelial dysfunction and capillary rarefaction play the most significant role in the development of CMD among patients with hypertension. CMD is also related to several hypertension-related morphological and functional changes in the myocardium in the subclinical and early clinical stages, including left ventricular hypertrophy, interstitial myocardial fibrosis, and diastolic dysfunction. This indicates the fact that CMD, especially if associated with hypertension, is a subclinical marker of end-organ damage and heart failure, particularly the one with preserved ejection fraction. This is why it is important to search for microvascular angina in every patient with hypertension and chest pain not associated with obstructive coronary artery disease. Several highly sensitive and specific non-invasive and invasive diagnostic modalities have been developed to evaluate the presence and severity of CMD, but also to investigate additional complications that can affect further prognosis, especially among those with hypertensive heart disease. Although various pharmacological and interventional treatments demonstrated certain clinical effects, integrated diagnostic and therapeutic algorithms are necessary to reduce the burden of this emerging condition.

Introduction: Crohn's disease (CB) is idiopathic, chronic inflammatory disease that can affect any part of the gastrointestinal tract. Extraintestinal manifestations (EIM) of CD affect about 20-40% of patients. Endocrine aspect of CD can be observed through glycemic disregulation, dyslipidemia, metabolic bone disease, hypogonadism, low growth, delayed puberty and other. All endocrine manifestations are closely related to severe inflammatory response and corticosteroid therapy (CSt). The most common complications are diabetes (generally poorly regulated) and osteoporosis in the elderly and low growth (with late puberty) in the younger ones. Case Report: A 57-year-old patient, S. Z., was hospitalized at our Clinic due to unstable glycoregulation within long-term diabetes with microvascular complications (on bolus-basal insuli treatment) The CD in patient was poorly regulated with changing multiple therapeutic modalities. During hospitalization, the CD therapy was corrected and aminosalicylate therapy was replaced with CSt, the glycoregulation was further worsened and only a partial improvement in glycemia was achieved. Malabsorption was diagnosed and supstitutional therapy was introduced. Secondary osteoporosis in patient has been initially treated with intravenous bisphosphonate while monitoring the effect. Due to long-term use of CSt and poor life quality anxiety disorder has been evaluated and treated properly. Conclusion: Long-term poorly-regulated CD is predictor of extraintestinal complications. All EIMs result in poor quality of life and bad prognosis. CD therapy and chronic inflammation constitute vicious circle in which all the consequences and manifestations are inadequately regulated and require a multimodal-multidisciplinary approach.