Anxiety Levels among Healthcare Workers during the COVID-19 Pandemic and Attitudes towards COVID-19 Vaccines.

Background: The pandemic has proven to be a particular challenge for healthcare workers, not only in the professional but also individual sense. The COVID-19 pandemic negatively influenced their well-being and caused psychological distress. Undoubtedly, direct contact with sick patients, the fight against the pandemic, and observing the epidemiological situation influenced the attitudes of this group towards COVID-19 and vaccinations. The aim of the study was to analyse the level of anxiety among healthcare workers during the COVID-19 pandemic and to assess attitudes towards vaccinations against COVID-19. Methods: The cross-sectional study followed the recommendations of STROBE (Strengthening the Reporting of Observational Studies in Epidemiology). A convenience purposive sampling method was used and the study was led among nurses and doctors employed in healthcare facilities. The study used a survey and the Trait Anxiety Scale SL-C. Results: The study included 385 participants, with an average age of 48.41 ± 6.76 years. The nurses constituted 55% of the study group and the doctors 45%. A total of 70% of healthcare workers had over 10 years of work experience. Over half of the subjects (57%) became infected with COVID-19. A total of 85% of respondents have received vaccination. A total of 71% of respondents believe vaccinations are harmless. Frequently, the participants assessed their level of anxiety as moderate. Conclusions: Almost all surveyed doctors chose to be vaccinated, while the percentage of vaccinated nurses was significantly lower. As a result, it is possible to conclude that the employment position has a significant influence on the decision to get vaccinated against COVID-19. In self-assessment during the COVID-19 pandemic, most healthcare professionals experienced a moderate level of anxiety. Receiving the COVID-19 vaccination reduced the level of anxiety.

The Risk of Melanoma due to Exposure to Sun and Solarium Use in Poland: A Large-Scale, Hospital Based Case - Control Study.

OBJECTIVE: The incidence of skin cancer is constantly growing, it is considered a serious problem of public health. Most cases of skin cancer are caused by a combination of non-modifiable genetic, and modifiable environmental risk factors. The study objective was to analyse the correlation between pigmentation traits, excessive sunlight exposure, solarium use and the risk of melanoma development. METHODS: The study included 480 patients diagnosed with melanoma and 400 within the control group. Subjects diagnosed with the melanoma confirmed by histopathology were invited to take part in the study. The research was based on a clinical, direct, individual, structured, in-depth and focused interview. RESULTS: The mean age of the study subjects was 44.3 ± 7.86, while in the control group 59.5 (7.93) Most frequently, melanoma was located on the upper extremities (64%). A family history of neoplastic diseases was found in 55% of the patients. The assessment of sunburns showed that only 15%  of the respondents never experienced sunburn, 49% of the study subjects never used solarium. Among patients with multiple sunburns, the risk of developing skin cancer was 1.27 (AOR = 1,27; 95% CI, 1.07-1.55) compared with non-sunburns subjects. CONCLUSIONS: Risky behaviours including excessive exposure to UV radiation, both natural and artificial, are of special significance in women with fair complexion and fair hair. Indoor tanning is a probable factor of increased skin cancer incidence in younger women, as compared to men.

Genotypes and Variants of BKPyV in Organ Donors after Brain Death.

Kidney transplantation from a donor with latent BKPyV might be the cause of serious complications, such as BK virus-associated nephropathy. The aim of the study was to determine the prevalence of BKPyV infection in donors after brain death (DBDs), to analyse the molecular variation of BKPyV and to compare clinical and inflammation parameters of DBDs infected with various genotypes of BKPyV. BKPyV was investigated in blood and urine samples of 103 DBDs using PCR followed by sequencing and bioinformatic analysis, and the viral load was assessed by qPCR. Clinical parameters, including cellular markers of inflammation were assessed. The results confirm high prevalence of BKPyV (48%),and genotype IV (49%) over genotype I (43%) and the co-infection with genotypes I and IV in 8.2%. Viral load ranged from 102 to 107 copies/mL, with an average of 1.92 × 106 copies/mL. No specific markers for BKPyV infection were detected among the parameters tested. Infection with genotype I may be associated with the adverse impact on thekidney function, while infection with genotype IV was associated with the anemia Not only the viral load but also the genotype of BKPyV may have an impact on the course of infection.

Molecular Epidemiology and Variation of the BK Polyomavirus in the Population of Central and Eastern Europe Based on the Example of Poland.

The BK polyomavirus (BKPyV) is a widespread pathogen in humans. Polymorphism of the region encoding the VP1 protein of BKPyV provides the basis for classifying the virus into types and subtypes, whose frequency varies depending on geographic location. The aim of our study was to determine the frequency of BKPyV in the Polish population and to assess its variation by analysing polymorphism in the typing region. The study was conducted on 168 healthy, Polish volunteers, whose blood (plasma) and urine were sampled. The virus was detected using PCR, products, sequenced and subjected to bioinformatic analysis. In addition, viral load was assessed by qPCR. The presence of the genetic material of the BK virus was noted in 61/168 urine samples but in none of the plasma sample. Sequencing and phylogenetic analysis confirmed that the BKPyV isolates were of types I and IV, dominant in Europe (63.93% and 36.07%, respectively). All isolates from genotype I belonged to subtype Ib-2, showing polymorphism at position 1809 with a frequency of 61.54% (G1809A) and 38.46% (G1809C). To the best of our knowledge, this is the first study of this magnitude on the genetic variation of BKPyV among healthy volunteers in Poland.

Risk Factors for the Diagnosis of Colorectal Cancer.

BACKGROUND: Colorectal cancer defined as cancer of the colon or rectum, is the third most frequently diagnosed cancer in men and the second in women, and, according to the World Health Organization database GLOBOCAN, it accounts for nearly 1.4 million new cases annually worldwide. The occurrence of colorectal cancer is associated with nonmodifiable risk factors, including age and hereditary factors, as well as with modifiable environmental and lifestyle factors. METHODS: The study included 800 patients, 400 diagnosed with colorectal cancer and 400 within the control group, who gave their written informed consent to participate in the study. Patients with cancer other than colorectal cancer were randomly selected for control group I, and patients with no cancer diagnosis were selected for control group II. The method used was a case-control study - an observational and analytical study with a control group, conducted among patients of the Clinical Oncology Centre and the Provincial Hospital in the years 2019-2020. The study comparing the exposure was carried out in a group of people who developed the endpoint, that is colorectal cancer, with the exposure in a well-matched group of controls who did not reach the endpoint. Assessment of activity and BMI was used according to WHO recommendations, as well as the expert system. The data were tested for the distribution and the homogeneity of variance was validated before applying the parameter tests. Comparison of quantitative variables between groups was performed using ANOVA. RESULTS: The mean age of the patients was 64.53 ± 8.86 years, of the control group I - 59.64 ± 9.33 and the control group II - 57.5 (7.83). There was a strong positive association between the incidence of ulcerative colitis and the risk of colorectal cancer (P < .01). Among obese subjects, the risk of developing colorectal cancer was 1.27 (95% CI, 1.06-1.53) compared with nonobese subjects. A strong positive relationship was found between low physical activity converted to metabolic equivalent of MET effort per week and the risk of colorectal cancer (P < .001). The relative risk for current smokers was 2.17 (95% CI 1.79-2.66). There was an association between higher fat consumption and higher red meat consumption and the risk of developing colorectal cancer (P < .01). CONCLUSIONS: Obesity, low physical activity, active and passive smoking and high salt and red meat consumption have been associated with an increased risk of colorectal cancer. These findings provide further evidence of the importance of maintaining a healthy lifestyle.

Cancer prevention - review paper.

INTRODUCTION: Every year there is an increase in the number of cases and deaths due to the majority of cancers. Currently, these diseases constitute the second cause of death in Poland and the USA. The number of cases of malignant neoplasms in Poland has more than doubled over the last three decades. According to the National Cancer Registry, in Poland about 95.5 people per thousand die every year from malignant neoplasms. Current epidemiological data on cancer is worrying because the World Health Organization predicts a significant increase in the incidence of cancer in the general population. This problem, which is significant on the global scale, demands the search for more effective prevention methods so that more and more attention is paid to both primary and secondary prevention. Prevention and early detection of cancer have become a priority for the national health policy of many European countries. Numerous studies around the world prove that reducing the risk of cancer is most effective through adopting a healthy lifestyle, avoiding exposure to carcinogens, combined with regular screening. OBJECTIVE: The aim of the study was to review knowledge on cancer prevention, including the latest research results. CONCLUSIONS: Due to the systematic increase in the incidence of cancer, a strong emphasis should be placed on prevention. Preventive actions bring benefits not only to the individual, but are an important aspect of health policy. The importance of primary prevention in relation to healthy people has been demonstrated, including secondary prevention aimed at controlling risk factors in relation to persons exposed to them. The combination of these activities becomes an important element in maintaining the health of the individual, as well as society.

The Problems and Needs of Patients Diagnosed with Cancer and Their Caregivers.

(1) Background: As the literature analysis shows, cancer patients experience a variety of different needs. Each patient reacts differently to the hardships of the illness. Assessment of needs allows providing more effective support, relevant to every person's individual experience, and is necessary for setting priorities for resource allocation, for planning and conducting holistic care, i.e., care designed to improve a patient's quality of life in a significant way. (2) Patients and Methods: A population survey was conducted between 2018 and 2020. Cancer patients, as well as their caregivers, received an invitation to take part in the research, so their problems and needs could be assessed. (3) Results: The study involved 800 patients, 78% women and 22% men. 66% of the subjects were village residents, while 34%-city residents. The mean age of patients was 62 years, SD = 11.8. The patients received proper treatment within the public healthcare. The surveyed group of caregivers was 88% women and 12% men, 36% village residents and 64% city residents. Subjects were averagely 57 years old, SD 7.8. At the time of diagnosis, the subjects most often felt anxiety, despair, depression, feelings of helplessness (46%, 95% CI: 40-48). During illness and treatment, the subjects most often felt fatigued (79%, 95% CI: 70-80). Analysis of needs showed that 93% (95% CI: 89-97) of patients experienced a certain level of need for help in one or more aspects. (4) Conclusions: Patients diagnosed with cancer have a high level of unmet needs, especially in terms of psychological support and medical information. Their caregivers also experience needs and concerns regarding the disease. Caregivers should be made aware of the health consequences of cancer and consider appropriate supportive care for their loved ones.

Quality of Life of Cancer Patients Treated with Chemotherapy.

Background: Life-quality tests are the basis for assessing the condition of oncological patients. They allow for obtaining valuable information from the patients regarding not only the symptoms of disease and adverse effects of the treatment but also assessment of the psychological, social and spiritual aspects. Taking into account assessment of the quality of life made by the patient in the course of disease has a positive effect on the well-being of patients, their families and their caregivers as well as on satisfaction with the interdisciplinary and holistic oncological care. Methods: A population-based, multi-area cross-sectional study was conducted among patients with cancer in the study in order to assess their life quality. The method used in the study was a clinical interview. Quality of life was measured using the EQ-5D-5L Quality of Life Questionnaire, the Karnofsky Performance Status, our own symptom checklist, Edmonton Symptom Assessment and Visual Analogue Scale. Results: In the subjective assessment of fitness, after using the Karnofsky fitness index, it was shown that 28% (95% CI (confidence interval): 27-30) of patients declared the ability to perform normal physical activity. In the assessment the profile, quality of life and psychometric properties of EQ-5D-5L, it was shown that patients had the most severe problems in terms of self-care (81%, 95% CI: 76-89) and feeling anxious and depressed (63%, 95% CI: 60-68). Conclusions: Cancer undoubtedly has a negative impact on the quality of life of patients, which is related to the disease process itself, the treatment used and the duration of the disease.

Opinions and Knowledge of Parents Regarding Preventive Vaccinations of Children and Causes of Reluctance toward Preventive Vaccinations.

Background: Despite the stability of global vaccination coverage, over 19 million children worldwide do not currently receive basic vaccines. Over the past several years, there has been a dramatic drop in the number of vaccinated children worldwide. The implementation of the vaccination program and the scope of protection depend on the parents or legal guardians, who decide whether to vaccinate their child or not. Studies were conducted to assess parents' knowledge, attitudes, and beliefs about vaccines, as well as the role of healthcare providers in parents' decisions. Methods: A population survey was conducted in 2018-2019. Parents or legal guardians of the children were invited to participate in the study during their visits to the clinic for healthy or sick children. The method used in the research was a diagnostic survey. Results: According to the conducted research, men and women constituted 45% and 55% of participants, respectively. The average age of men was 44, while, for women, it was 41. Internal research showed that as much as 71% of parents declared the need for vaccination, although 41% of parents vaccinated their children according to the vaccination calendar. The most frequently mentioned concerns included the possibility of adverse vaccination reactions (22%), the occurrence of autism (7%), and child death (6%). General practitioners had, by far, the greatest impact on the use of protective vaccination in children (73% women and 80% men), although there were cases of discouraging the performance of compulsory vaccinations (41%), and mentioning a doctor (38%) or nurse (3%). Conclusions: Modifiable determinants of the negative attitude toward vaccinations are caused mainly by the lack of knowledge. These obstacles in vaccinations can be overcome by improving health education in terms of the vaccination program.

The improvement of QRS-T angle as a manifestation of reverse electrical remodeling following renal transplantation in end-stage kidney disease patients on haemodialysis.

BACKGROUND: Successful renal transplantation (RT) reverses some of the cardiac changes and reduces cardiac mortality in hemodialysis (HD) patients. Widened QRS-T angle reflects both ventricular repolarization and depolarization. It is considered a sensitive and strong predictor of heart ventricular remodeling as well as a powerful and independent risk stratifier suitable in predicting cardiac events in various clinical settings. The study aimed to assess the influence of the RT on QRS-T angle and to evaluate factors influencing QRS-T changes in renal transplanted recipients (RTRs). METHODS: Fifty-four selected HD patients who have undergone RT were included. Blood chemistry, echocardiography, and QRS-T angle were evaluated 5 times: about 1 week, 3 months, 6 months, 1 year and 3 years after RT. RESULTS: An improvement of echocardiographic parameters was observed. The dynamics of changes in individual parameters were, however, variable. QRS-T angle correlated with echocardiographic parameters. The biphasic pattern of the decreases of QRS-T angle was observed. The first decrease took place in the third month of follow-up. The second decrease of QRS-T angle was observed after 1 year of follow-up. The QRS-T angle was higher in RTRs compared with controls during each evaluation. Multivariable analysis demonstrated that the decrease of left ventricle enddiastolic volume was an independent predictor of early QRS-T angle improvement. The increase of left ventricle ejection fraction was found to be the independent predictor of the late QRS-T angle improvement. CONCLUSIONS: RT induces biphasic reverse electrical remodeling as assessed by the narrowing of QRS-T angle. Early decrease of QRS-T angle is mainly due to the normalization of volume status, whereas late decrease is associated predominantly with the improvement of cardiac contractile function.

Intraoperative decision to change the course of management based on an ultrasonographic image of urinary bladder paraganglioma - a case study.

This case study concerns a 69-year-old woman qualified for transurethral resection of a primary tumor in a urinary bladder. Since a cystoscopic image did not correspond with typical urothelial carcinoma, an intraoperative ultrasonographic transrectal imaging was carried out, on the basis of which it was believed to be urinary bladder paraganglioma. Endoscopic treatment was abandoned. The patient was directed for further examination and next, on suspicion of extra-bladder phaeochromocytoma, scheduled for open surgery. Due to the location and range of the tumor, and systemic conditions, a radical cystectomy and Bricker's supravesical ureteroileal conduit were carried out. A postoperative histopathological examination confirmed the phaeochromocytoma character of the urinary bladder tumor.This case study concerns a 69-year-old woman qualified for transurethral resection of a primary tumor in a urinary bladder. Since a cystoscopic image did not correspond with typical urothelial carcinoma, an intraoperative ultrasonographic transrectal imaging was carried out, on the basis of which it was believed to be urinary bladder paraganglioma. Endoscopic treatment was abandoned. The patient was directed for further examination and next, on suspicion of extra-bladder phaeochromocytoma, scheduled for open surgery. Due to the location and range of the tumor, and systemic conditions, a radical cystectomy and Bricker's supravesical ureteroileal conduit were carried out. A postoperative histopathological examination confirmed the phaeochromocytoma character of the urinary bladder tumor.

The atrial uremic cardiomyopathy regression in patients after kidney transplantation - the prospective echocardiographic study.

BACKGROUND: In patients with end stage renal disease (ESRD), left ventricular (LV) hypertrophy with impaired LV function, which is called uremic cardiomyopathy (UC) is often observed. The UC historically has been considered a contraindication for kidney transplantation (KTx). Currently, moderate LV dysfunction does not exclude the possibility of KTx. The amelioration of uremia after KTx improved cardiac function in patients with LV dysfunction. There is a little information on the function of the left atrium (LA) after the KTx procedure. There are no studies evaluating (LA) changes in patients with UC after KTx and determining the possibility of inhibiting the occurrence of LA unfavourable changes (remodelling) and even a possible LA recovery process (reverse remodelling) as a result of a successful KTx. The aim of the study was to assess the LA reverse remodelling in patients with ESRD undergoing KTx. METHODS: The study group consisted of 42 patients, aged 43.3 ± 12.6 followed for 36 months after a deceased donor KTx. The patients were studied at five time points: 1, 3, 6, 12 and 36 months after KTx. In all patients transthoracic echocardiography was performed in order to assess the following LA planimetric parameters: LAmax, LAmin, LAwaveP. LAshortmax, LAshortmin, LAshortwaveP, LAlongmax, LAlongmin, LAlongwaveP, LAcircmax and LAareamax, volumentric parameters: LA volume (LAV), LA volume index (LAVI), and hemodynamic indices: LA ejection fraction (LAEF), LA active emptying fraction (LAAE), LA passive emptying fraction (LAPE), LA index of expansion (LAIE) and LA fractional shortening (LAFS). RESULTS: The LAVI values were 34.63 ± 10.34 ml/m2, 32.24 ± 9.59 ml/m2 (p < 0,001), 31.36 ± 9.20 ml/m2 (p < 0,001), 28.29 ± 8.32 ml/m2 (p < 0,001) and 27.57 ± 8.40 ml/m2 (p < 0,001), after: 1, 3, 6, 12 and 36 months after KTx, respectively. The reduction of the LA size was accompanied by gradual LA contractility improvement, which was manifested as an increase of the LA hemodynamic indices such as LAEF, LAAE, LAIE, LAFS and a decrease of LAPE. CONCLUSIONS: LA remodelling secondary to atrial uraemic cardiomyopathy is an example of complex cardiomyopathy with elements characteristic of both congestive and infiltrative cardiomyopathy. Early LAVI reduction post KTx mostly depends on changed haemodynamic conditions, whereas the main reason for further decrease of LAVI values is related to resolution of uraemic toxaemia.

Environmental risk factors for cancer - review paper.

The cancerous process is result of disturbed cell function. This is due to the accumulation of many genetic and epigenetic changes within the cell, expressed in the accumulation of chromosomal or molecular aberrations, which leads to genetic instability. It is difficult to assess the validity of individual aetiological factors, but it can be concluded that interaction of various risk factors has the largest contribution to the cancer development. Environmental, exogenous and endogenous factors as well as individual factors, including genetic predisposition contribute to the development of cancer. Epidemiological research on the development of malignant tumors has focused over the years on the determinants of environmental and genetic factors of cancer incidence and mortality rate. According to current state of knowledge, 80-90% of malignant tumors are caused by external environmental factors (carcinogens). Epidemiological studies have proved that the main factors responsible for the development of malignant neoplasia among humans are environmental factors arising from human behaviour. It has been confirmed that smoking, excessive alcohol consumption, diet, and reproductive behaviour are important for the development of malignant neoplasia in the human population. According to the World Health Organization, in 2020 we may expect about 10 million deaths, including 7-8 million in the developing countries, while this number in the developed countries will not change and will be 2-3 million. The aim this study was systematization of knowledge concerning the risk factors of malignant tumours and supplementing them with the latest research results.

TRUS-guided drainage of the ectopic ureter entering the prostatic urethra and TRUS-guided transurethral neo-orifice formation using holmium laser.

A fifty-nine year-old male was hospitalized for exacerbation of chronic pancreatitis. As a gigantic cyst of the pancreatic tail was identified, it was fused with the jejunal loop. Due to persistent fever and severe symptoms in the storage and voiding phases, the patient was referred to a urologist. Because transrectal ultrasound examination revealed a fluid collection resembling the left seminal vesicle filled with purulent material, a transrectal puncture procedure was performed. The analysis of computed tomography scans led to the diagnosis of duplicated collecting system of the left kidney with the enormous ureter of the upper moiety that entered the prostate gland. In order to permanently decompress the hydronephrosed upper moiety of the left kidney, the patient was deemed eligible for endoscopic treatment. A transurethral incision through the bladder wall and the adjacent segment of the ectopic ureter was made with holmium laser under transrectal ultrasonography guidance, thus creating a neo-orifice of this ureter.

Parastomal hernia - current knowledge and treatment.

Intestinal stoma creation is one of the most common surgical procedures. The most common long-term complication following stoma creation is parastomal hernia, which according to some authors is practically unavoidable. Statistical differences of its occurrence are mainly due to patient observation time and evaluation criteria. Consequently, primary prevention methods such as placement of prosthetic mesh and newly developed minimally invasive methods of stoma creation are used. It seems that in the light of evidence-based medicine, the best way to treat parastomal hernia is the one that the surgeon undertaking therapy is the most experienced in and is suited to the individuality of each patient, his condition and comorbidities. As a general rule, reinforcing the abdominal wall with a prosthetic mesh is the treatment of choice, with a low rate of complications and relapses over a long period of time. The current trend is to use lightweight, large pore meshes.

A new way of presenting diagnostic imaging studies in surgical planning.

Technological advancement, availability and common use of diagnostic imaging slowly but consistently leads to a change in its nature from being additional studies to becoming the basis for diagnostic process and treatment planning especially in complex cases that require surgical treatment. CT angiography study presentation using the illusion called "Pepper's Ghost" in comparison to a three-dimensional printout and regular CT scan has been made to point out the relevance of research and implementation of new technologies in the diagnosis and surgical planning. Our image, despite being far from ideal and being just an illusion of a hologram, was more appealing and detailed to surgeons in comparison to a printed 3D model and standard CT angiography displayed with Osirix software. In order to change the existing methods of presenting imaging studies, it is advisable to use latest technologies, and among those currently available, ones based on virtual or mixed reality deserve special attention.

The reverse remodeling of the aorta in patients after renal transplantation - the value of aortic stiffness index: prospective echocardiographic study.

BACKGROUND: Atherosclerosis is regarded as a combination of two major separate diseases: atherosis and sclerosis. Sclerotic component depends on deterioration of elastic properties of the aortic wall and is called aortic stiffness. The most valuable, non-invasive method of aortic stiffness assessment is echocardiography, which allows to calculate the aortic stiffness index (ASI). ASI is an independent predictor of all-cause and cardiovascular mortality in different groups of patients. The main aim of study was the assessment of the aortic reverse remodeling in patients with end-stage renal disease (ESRD) after renal transplantation (RT). METHODS: Study group involved 42 patients aged 43.3 ± 12.6 years, including 19 women aged 49.9 ± 10.9 years and 23 men aged 41.5 ± 12.91 years, who have undergone RT from non-related renal transplant donors, The study protocol has been consisted of 5 stages: 1 week after RT, 3 months after RT, 6 months after RT, 1 year after RT and 3 years after RT. The echocardiographic examination was performed and measurements of Aomax, Aomin were done. On the base of obtained parameters ASI, aortic distensibility (AD) and aortic strain (AS) were calculated according to adequate formulas. RESULTS: The improvement of indices characterizing the elastic properties of aorta were noted. These changes attained the statistically significant level only at the end of the observation. ASI just after RT was equal - 4.65 ± 1.58, three months after RT - 4.54 ± 1.49, six months after RT - 4.59 ± 1.61, one year after RT - 4.35 ± 1.21 and three years after RT - 3.35 ± 1.29, while AD reached respectively - 6.55 ± 3.76 cm2/dyn-110-6 just after RT, - 6.38 ± 3.42 cm2/dyn-110-6 three months after RT, - 6.53 ± 3.60 cm2/dyn-110-6 six months after RT, - 6.48 ± 2.79 cm2/dyn-110-6 one year after RT and - 8.03 ± 3.95 cm2/dyn-110-6 three years after RT. Noted AS values were equal - 6.61 ± 4.05%, just after RT, - 6.40 ± 3.58% three months after RT, - 6.56 ± 3.76%, six months after RT, - 6.45 ± 2.80% one year after RT, - 8.01 ± 3.97%. and three years after RT. The exact analysis of parameters concerning aortic function showed that to achieve ASI, AD and AS improvement, long time was needed, because the most significant changes of these indices were observed only between 1 year and 3 years after RT. CONCLUSIONS: There is a relationship between renal transplantation and improvement of the aortic elastic properties. The recovery of the renal function allows to initiate the reparative processes leading to at least partial restitution of the structure and features of the aorta, which is called reverse remodelling. Improvement of aortic wall elastic properties after renal transplantation is a continuous and prolonged process.

Capillary hemangioma of the testis. A case report of a rare benign tumor.

This paper presents the case of a very rare capillary hemangioma of the testis in a 23-year-old patient. Physical examination revealed a tumor located in the upper pole of the left testis, which was suspected of being malignant due to its significantly increased density and irregular contours. Blood levels of the following tumor markers were determined: alpha-fetoprotein, human chorionic gonadotropin and lactate dehydrogenase. No abnormalities were found in any of these tests. A gray-scale ultrasound scan of the scrotum revealed a lesion located in the upper pole of the left testis, 24 mm in diameter with slightly decreased echogenicity and irregular contours, which suggested infiltration of the tunica albuginea of the testis. Color and power Doppler scans demonstrated a dense network of blood vessels and increased blood flow in the lesion described. In addition, 3D ultrasound scan images were obtained, which allowed for a thorough determination of the topography of the lesion. No abnormalities were found in the patient's medical history, physical examination or ultrasound scan of the right testis. Taking into account the suspected malignancy with signs of infiltration of the tunica albuginea of the upper pole of the testis a decision was made to remove the left testis together with the spermatic cord using the inguinal approach. A histopathological examination of the whole specimen revealed a multifocal capillary hemangioma of the testis, signs of testicular fibrosis and significant atrophy of the spermatogenic epithelium of the seminiferous tubules. Immunohistochemistry: CD31 (+), CD34 (+), FVIII (-), vimentin (+), CK MNF116 (-), mesothelial cells (-), calretinin (-), MIB-1 = 8.4%. The tumor described is one of the few benign lesions originating from the tissues of the testis for which partial resection of the organ may be considered. Intraoperative histopathological examination and resection of the lesion with the preservation of a healthy tissue margin may be considered in patients with a single testis in whom the tumor is found to have a very rich vascular network and the levels of tumor markers are normal.

Granulomatous prostatitis after intravesical immunotherapy mimicking prostate cancer.

Intravesical immunotherapy with attenuated strains of Mycobacterium bovis is a widely used therapeutic option in patients with non-muscle-invasive transitional cell carcinoma of the bladder. A rare complication of intravesical therapy with the Bacillus Calmette-Guérin vaccine is granulomatous prostatitis, which due to increasing levels of prostate-specific antigen and abnormalities found in transrectal examination of the prostate may suggest concomitant prostate cancer. A case of extensive granulomatous prostatitis in a 61-year-old patient which occurred after the first course of a well-tolerated Bacillus Calmette-Guérin therapy is presented. Due to abnormalities found in rectal examination and an abnormal transrectal ultrasound image of the prostate with extensive infiltration mimicking neoplastic hyperplasia a core biopsy of the prostate was performed. Histopathological examination revealed inflammatory infiltration sites of tuberculosis origin.