The Impact of the War in Ukraine on the Epidemiological Situation of Tuberculosis in Europe.

Ukraine is at the forefront of one of the largest outbreaks of tuberculosis (TB) in Europe, including multidrug-resistant tuberculosis. Due to the ongoing armed conflict in this area, there is a significant number of refugees from Ukraine to other European countries. The aim of the study is to emphasize the essence of the problem of the increased incidence of tuberculosis, taking into account the impact of the armed conflict in Ukraine, resulting in the intensification of migration movements. A descriptive epidemiological method was used as the research method. The material was collected by analyzing source statistical data from WHO and statistical yearbooks of selected European countries. Particularly, Ukrainian refugees in Poland, Germany, the Czech Republic, and Slovakia are at higher risk of contracting tuberculosis due to factors like migration stress, poor nutrition, and comorbidities. Epidemiological data from these countries show a rise in tuberculosis cases among foreigners, emphasizing the need for European specialists to be more vigilant in this unique situation, focusing on refugees and other vulnerable populations. More research and collaborative efforts are essential to closely monitor and prevent the severe outcomes of tuberculosis transmission.

Trace Elements Levels in Major Depressive Disorder-Evaluation of Potential Threats and Possible Therapeutic Approaches.

The multifactorial etiology of major depressive disorder (MDD) includes biological, environmental, genetic, and psychological aspects. Recently, there has been an increasing interest in metallomic studies in psychiatry, aiming to evaluate the role of chosen trace elements in the MDD etiology as well as the progression of symptoms. This narrative review aims to summarize the available literature on the relationship between the concentration of chosen elements in the serum of patients with MDD and the onset and progression of this psychiatric condition. The authors reviewed PubMed, Web of Science, and Scopus databases searching for elements that had been investigated so far and further evaluated them in this paper. Ultimately, 15 elements were evaluated, namely, zinc, magnesium, selenium, iron, copper, aluminium, cadmium, lead, mercury, arsenic, calcium, manganese, chromium, nickel, and phosphorus. The association between metallomic studies and psychiatry has been developing dynamically recently. According to the results of current research, metallomics might act as a potential screening tool for patients with MDD while at the same time providing an assessment of the severity of symptoms. Either deficiencies or excessive amounts of chosen elements might be associated with the progression of depressive symptoms or even the onset of the disease among people predisposed to MDD.

Extracorporeal Rewarming Is Associated With Increased Survival Rate in Severely Hypothermic Patients With Preserved Spontaneous Circulation.

Treatment recommendations for rewarming patients in severe accidental hypothermia with preserved spontaneous circulation have a weak evidence due to the absence of randomized clinical trials. We aimed to compare the outcomes of extracorporeal versus less-invasive rewarming of severely hypothermic patients with preserved spontaneous circulation. We conducted a multicenter retrospective study. The patient population was compiled based on data from the HELP Registry, the International Hypothermia Registry, and a literature review. Adult patients with a core temperature <28°C and preserved spontaneous circulation were included. Patients who underwent extracorporeal rewarming were compared with patients rewarmed with less-invasive methods, using a matched-pair analysis. The study population consisted of 50 patients rewarmed extracorporeally and 85 patients rewarmed with other, less-invasive methods. Variables significantly associated with survival included: lower age; outdoor cooling circumstances; higher blood pressure; higher PaCO 2 ; higher BE; higher HCO 3 ; and the absence of comorbidities. The survival rate was higher in patients rewarmed extracorporeally ( p = 0.049). The relative risk of death was twice as high in patients rewarmed less invasively. Based on our data, we conclude that patients in severe accidental hypothermia with circulatory instability can benefit from extracorporeal rewarming without an increased risk of complications.

Performance of IOTA Simple Rules Risks, ADNEX Model, Subjective Assessment Compared to CA125 and HE4 with ROMA Algorithm in Discriminating between Benign, Borderline and Stage I Malignant Adnexal Lesions.

BACKGROUND: Borderline ovarian tumors (BOTs) and early clinical stage malignant adnexal masses can make sonographic diagnosis challenging, while the clinical utility of tumor markers, e.g., CA125 and HE4, or the ROMA algorithm, remains controversial in such cases. OBJECTIVE: To compare the IOTA group Simple Rules Risk (SRR), the ADNEX model and the subjective assessment (SA) with serum CA125, HE4 and the ROMA algorithm in the preoperative discrimination between benign tumors, BOTs and stage I malignant ovarian lesions (MOLs). METHODS: A multicenter retrospective study was conducted with lesions classified prospectively using subjective assessment and tumor markers with the ROMA. The SRR assessment and ADNEX risk estimation were applied retrospectively. The sensitivity, specificity, positive and negative likelihood ratios (LR+ and LR-) were calculated for all tests. RESULTS: In total, 108 patients (the median age: 48 yrs, 44 postmenopausal) with 62 (79.6%) benign masses, 26 (24.1%) BOTs and 20 (18.5%) stage I MOLs were included. When comparing benign masses with combined BOTs and stage I MOLs, SA correctly identified 76% of benign masses, 69% of BOTs and 80% of stage I MOLs. Significant differences were found for the presence and size of the largest solid component (p = 0.0006), the number of papillary projections (p = 0.01), papillation contour (p = 0.008) and IOTA color score (p = 0.0009). The SRR and ADNEX models were characterized by the highest sensitivity (80% and 70%, respectively), whereas the highest specificity was found for SA (94%). The corresponding likelihood ratios were as follows: LR+ = 3.59 and LR- = 0.43 for the ADNEX; LR+ = 6.40 and LR- = 0.63 for SA and LR+ = 1.85 with LR- = 0.35 for the SRR. The sensitivity and specificity of the ROMA test were 50% and 85%, respectively, with LR+ = 3.44 and LR- = 0.58. Of all the tests, the ADNEX model had the highest diagnostic accuracy of 76%. CONCLUSIONS: This study demonstrates the limited value of diagnostics based on CA125 and HE4 serum tumor markers and the ROMA algorithm as independent modalities for the detection of BOTs and early stage adnexal malignant tumors in women. SA and IOTA methods based on ultrasound examination may present superior value over tumor marker assessment.

Application of bioelectrical impedance analysis in monitoring patients with head and neck cancer after surgical intervention.

INTRODUCTION: It is estimated that about 60% of patients with head and neck cancer (HNC) show poor nutritional status, and approximately 80% lose weight during treatment. The impact of surgical procedures on the risk of further weight loss, severe malnutrition and cachexia is a significant clinical problem that determines the higher incidence of postoperative complications, reduced effectiveness of the treatment used, longer hospitalization time, poor quality of life and higher mortality among patients. Bioelectrical impedance analysis (BIA) is currently recognized as a useful method of assessing the body composition and therefore the nutritional status of cancer patients. The aim of this study is to investigate whether measured and calculated parameters of BIA change shortly after surgery and could reflect the health of cells and body composition changes. MATERIALS AND METHODS: We enrolled 54 patients (males) with advanced HNC in this observational study. We collected detailed anthropometric and BIA derived data. The Subjective Global Assessment (SGA) was used to assess the nutrition. RESULTS: In the assessment performed one week after the surgery, compared to the condition on the day of surgery, the patients had significantly lower values of nutritional status (weight; body mass index - BMI; SGA), body composition (free fat mass - FFM; intracellular fluid - ICF; total body water - TBW). Other changes include a significant increase in fat mass (FM) or extracellular fluid (ECF). Moreover, a significant reduction of phase angle (PA, one of the most important BIA derived prognostic factors) was also noted. CONCLUSIONS: Apart from the baseline assessment of the body composition and diagnosing nutritional disorders, it seems, that BIA should be considered also in the monitoring of HNC patients undergoing surgery.

Citrobacter freundii and Acinetobacter baumanii infection in a patient with neoplastic lung disease - Case report.

An 85-year-old male with a tumour in his right lung was admitted to Internal Diseases Ward to continue treatment after suffering a sudden cardiac arrest. An empiric antibiotic therapy with amoxycillin was introduced due to increased inflammation markers. Blood and sputum were collected. An abundant growth of AmpC ß-lactamase-producing Citrobacter freundii was observed in culture grown from the sputum. The antibiogram showed retained sensitivity to fluoroquinolones. The therapy was modified by replacing ß-lactam with ciprofloxacin. Neither clinical nor laboratory improvement were observed. Blood culture indicated sepsis of Acinetobacter baumannii etiology. The strain was suspected of producing OXA carbapenemase (CARBA test positive), KPC (-), MBL (-). Antibiogram illustrated retained sensitivity to gentamicin and colistin with complete resistance to ciprofloxacin. Another modification in treatment was implemented and ciprofloxacin was replaced with colistin.

Effect of Spirulina Supplementation on Systolic and Diastolic Blood Pressure: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Spirulina is a microalga that presents various important pro-health properties, for instance lowering blood pressure in the research. The study aims to appraise the efficacy of Spirulina administration on systolic (SBP) and diastolic blood pressure (DBP). Randomized controlled trials (RCTs) were retrieved by a systematic search of PubMed, Web of Science, and the Cochrane Library databases from inception to June 2021 according to a standardized protocol. The effect size of each study was counted from mean and standard deviation before and after the intervention and shown as Un-standardized mean difference and 95% confidence interval. Sensitivity analyses were performed. Meta-analysis on 5 RCTs with 230 subjects was eligible. The amount of Spirulina ranged from 1 to 8 g per day, and intervention durations ranged from 2 to 12 weeks. Data analysis indicated that Spirulina supplementation led to a significant lowering of SBP (Mean Difference (MD): -4.59 mmHg, 95% Confidence Interval (CI): -8.20 to -0.99, I square statistic (I2) = 65%) and significant lowering of DBP (MD: -7.02 mmHg, CI: -8.86 to -5.18, I2 = 11%), particularly in a subgroup of hypertensive patients. Spirulina administration might have a supportive effect on the prevention and treatment of hypertension. More exact randomized controlled trials are needed to clarify the effect of Spirulina supplementation on blood pressure.

Risk Assessment of Endometrial Hyperplasia or Endometrial Cancer with Simplified Ultrasound-Based Scoring Systems.

BACKGROUND: Abnormal uterine bleeding (AUB) represents a common diagnostic challenge, as it might be related to both benign and malignant conditions. Endometrial cancer may not be detected with blind uterine cavity sampling by dilatation and curettage or suction devices. Several scoring systems using different ultrasound image characteristics were recently proposed to estimate the risk of endometrial cancer (EC) in women with AUB. AIM: The aim of the present study was to externally validate the predictive value of the recently proposed scoring systems including the Risk of Endometrial Cancer scoring model (REC) for EC risk stratification. MATERIAL AND METHODS: It was a retrospective cohort study of women with postmenopausal bleeding. From June 2012 to June 2020 we studied a group of 394 women who underwent standard transvaginal ultrasound examination followed by power Doppler intrauterine vascularity assessment. Selected ultrasound features of endometrial lesions were assessed in each patient. RESULTS: The median age was 60.3 years (range ± 10.7). The median body mass index (BMI) was 30.4 (range ± 6.0). Histological examination revealed 158 cases of endometrial hyperplasia (EH) and 236 cases of EC. Of the studied ultrasound endometrial features, the highest areas under the curve (AUCs) were found for endometrial thickness (ET) (AUC = 0.76; 95% CI: 0.71-0.81) and for interrupted endomyometrial junction (AUC = 0.70, 95% CI: 0.65-0.75). Selected scoring systems presented moderate to good predictive performance in differentiating EC and EH. The highest AUC was found for REC model (AUC = 0.75, 95% CI: 0.70-0.79) and for the basic model that included ET, Doppler score and interrupted endometrial junction (AUC = 0.77, 95% CI: 0.73-0.82). REC model was more accurate than other scoring systems and selected single features for differentiating benign hyperplasia from EC at early stages, regardless of menopausal status. CONCLUSIONS: New scoring systems, including the REC model may be used in women with AUB for more efficient differentiation between benign and malignant conditions.

Impact of rescue collapse on mortality rate in severe accidental hypothermia: A matched-pair analysis.

AIM: To assess the impact of the occurrence of cardiac arrest associated with initial management on the outcome of severely hypothermic patients who were rewarmed with Extracorporeal Life Support (ECLS). METHODS: We collected the individual data of patients in a state of severe accidental hypothermia who were found with spontaneous circulation and rewarmed with ECLS, from cardiac surgery departments. Patients were divided into two groups: those with a subsequent cardiac arrest (RC group); and those with the retained circulation (HT3 group), and compared by using a matched-pair analysis. The mortality rates and the neurological status in survivors were compared as the main outcomes. The difference in the risk of death between the HT3 and RC groups was calculated. RESULTS: A total of 124 patients were included into the study: 45 in the HT3 group and 79 in the RC group. The matched cohorts consisted of 45 HT3 patients and 45 RC patients. The mortality rate in both groups was 24% and 49% (p = 0.02) respectively; the relative risk of death was 2.0 (p = 0.02). ICU length of stay was significantly longer in the RC group (p < 0.001). Factors associated with survival in the HT3 group included patient age, rewarming rate, and blood BE; while in the RC group, patient age and lactate concentration. CONCLUSIONS: The occurrence of rescue collapse is linked to a doubling of the risk of death in severely hypothermic patients. Procedures which are known as potential triggers of rescue collapse should be performed with special attention, including in conscious patients.

Sonographic Assessment of Complex Ultrasound Morphology Adnexal Tumors in Pregnant Women with the Use of IOTA Simple Rules Risk and ADNEX Scoring Systems

BACKGROUND: To evaluate the accuracy of subjective assessment (SA), the International Ovarian Tumor Analysis (IOTA) group Simple Rules Risk (SRR) and the Assessment of Different NEoplasias in the adneXa (ADNEX) model for the preoperative differentiation of adnexal masses in pregnant women. METHODS: The study population comprised 36 pregnant women (median age: 28.5 years old, range: 20-42 years old) with a mean gestation age of 13.5 (range: 8-31) weeks at diagnosis. Tumors were prospectively classified by local sonographers as probably benign or probably malignant using SA. Final tumor histological diagnosis was used as the reference standard in all cases. Logistic regression SRR and ADNEX models were used to obtain a risk score for every case. Serum CA125 and human epidydimis protein 4 (HE4) concentrations were also retrieved and the Risk of Ovarian Malignancy Algorithm (ROMA) value was calculated. The calculated predictive values included positive and negative likelihood ratios of ultrasound and biochemical tests. RESULTS: Final histology confirmed 27 benign and 9 malignant (including 2 borderline) masses. The highest sensitivity (89%) and specificity (70%) were found for the subjective tumor assessment. Although no malignancy was classified as benign using the SRR criteria (sensitivity = 100%), the specificity of this scoring system was only 37%. At the cut-off risk level of >20%, the ADNEX model had a sensitivity of 78% and a specificity of 70%. Serum levels of CA125, HE4 and the ROMA risk model correctly identified adnexal malignant tumors with a sensitivity of 67%, 25% and 25%, respectively. Corresponding specificities were 72%, 100% and 100%, respectively. The highest positive and negative likelihood ratios were found for SA (LR+ = 3.0 and LR- = 0.16, respectively). Overall diagnostic accuracy of all predictive methods used in this study were similar (range: 70-75%) except for SRR (53%). CONCLUSION: Subjective assessment remains the best predictive method in complex adnexal masses found at prenatal ultrasound in pregnant women. For less experienced sonographers, both the SRR and ADNEX scoring systems may be also used for the characterization of such tumors, while serum tumor markers CA125 and HE4, along with the ROMA algorithm appear to be less accurate.

Does the Epstein-Barr Virus Play a Role in the Pathogenesis of Graves' Disease?

Graves' disease (GD) it the most common chronic organ-specific thyroid disorder without a fully recognized etiology. The pathogenesis of the disease accounts for an interaction between genetic, environmental, and immunological factors. The most important environmental factors include viral and bacterial infections. The Epstein-Barr virus (EBV) is one of the most common latent human viruses. Literature has suggested its role in the development of certain allergic and autoimmune diseases. EBV also exhibits oncogenic properties. The aim of the study was to analyze and compare the presence of EBV DNA in peripheral blood mononuclear cells (PBMCs) in patients with newly recognized GD and to find a correlation between EBV infection and the clinical picture of GD. The study included 39 untreated patients with newly diagnosed GD and a control group of 20 healthy volunteers who were gender and age matched. EBV DNA was detected with reverse transcription polymerase chain reaction (RT PCR) assay. The studies showed a significantly higher incidence of EBV copies in PBMCs among GD patients compared to the control group. Whereas, no significant correlations were found between the incidence of EBV copies and the evaluated clinical parameters. Our results suggest a probable role of EBV in GD development. EBV infection does not affect the clinical picture of Graves' disease.

[Breasts self examination - everything we want you to know about it - survey study].

OBJECTIVE: Introduction: Breasts self examination is first line prevention in case of breast cancer. It is cheap, it is easy and it can save your life. That is why it is so important that every woman and even man know how to do it. The aim: To estimate the level of knowledge about breasts self examination among women and also among people connected with medicine. PATIENTS AND METHODS: Materials and methods: The data were gathered through the internet questionnaire, which contained of 14 questions. There were 204 respondents : 53% women and 47% men. Among them there were 93% people related with medicine. Average age was 23,5 years. The participation was voluntary and annonymous. RESULTS: Results: Among female respondents 57% admit doing breasts self examination, however only 23% of them do that regularly every month. Also only 36% of the respondents know how to do proper examination. When asked if they ever had their breasts examined by the doctor, only 20% replied positively. We also prepared questions for people connected with medical field: we asked them if doing breasts examination for the patient they would feel confident (61% replied negatively.) and also if they had a chance to do breasts examination during studies most of them replied negatively. CONCLUSION: Conclusions: To conclude, even among women connected with medical field the knowledge is not enough, which is the most concerning since they should educate others and diagnose concerning symptoms. We should put more afford to break the tabu and pay more attention to breast examination.

Subclinical hyperthyroidism in the course of autonomous nodules - clinical evaluation.

INTRODUCTION: Subclinical hyperthyroidism (SCH), also known as mildly symptomatic hyperthyroidism, has recently been diagnosed more frequently. One of the main endogenous causes of this disorder is autonomously functioning thyroid nodule (AFTN). Despite the fact that it is usually asymptomatic, SCH entails repercussions on the cardiovascular system and bone, and it carries a risk of progression to overt hyperthyroidism with a typical clinical picture. Treatment is still controversial, and its benefits are widely debated in literature. MATERIAL AND METHODS: From 459 patients authors selected a group of 49 patients (10.6% of all subjects with hyperthyroidism), 41 women (83.7%) with AFTN at the stage SCH treated in the Outpatient Endocrinological Clinic and the Department of Endocrinology of the Medical University of Lublin over a three-year period. The method applied in the study was a retrospective analysis of medical records with a particular account of medical history, physical examination, and additional tests obtained during the process of diagnostic and therapeutic procedures. RESULTS: Forty-one patients (83.7%) suffered from typical symptoms of hyperthyroidism; only eight patients (16.3%) were asymptomatic. The most frequently reported symptoms were tachycardia in women (51.2%) and anxiety in men (50%). The type of thyrostatic drugs and the length of therapy did not affect the outcome of iodine-131 therapy. In the vast majority of the patients (87.8%) radioidodine therapy was effective; 30 patients (61.2%) reached euthyreosis and 13 patients (22.5%) developed hypothyroidism. CONCLUSIONS: Most patients with SCH in the course of AFTN suffered from typical symptoms of overt hyperthyroidism; only every sixth patient was asymptomatic. The volume of autonomous adenomas did not affect the result of 131I therapy; however, the impact of AFTN volume as well as the thyroid volume on RIT efficacy requires futher investigation. In the vast majority of patients 131I therapy was an effective method of treatment, and an earlier therapeutic effect was observed more often in the patients with focal lesions located in the right lobe.

[Public knowledge of the infertility and legal aspects of infertility treatment in Poland].

OBJECTIVE: Introduction: The awareness of infertility is limited in Polish society despite the fact that this problem affects around one million couples in our country. Some of them decide to undergo specialistic treatment. Issues pertaining techniques of contributed reproduction are strictly regulated by Polish law. PATIENTS AND METHODS: Material and methods: The study was conducted among the residents of Lublin in the period from October 1, 2017 to May 1, 2018. The research tool was an original, anonymous questionnaire containing 24 questions. The study group consisted of 164 people. Statistical analysis was performed using T-student test for non-parametric variables. RESULTS: Results: The majority of the examined group were people who worked the medical profession (71%). It is significant that as much as 79.3% of respondents are religious. Only 8,5% of respondents know that the Polish law on infertility treatment is regulated in Act on the treatment of infertility of 25 June 2015. Almost half of the respondents (44.2%) answered correctly to the question regarding the treatment of infertility according to the binding Act. Only 28,5% of respondents were able to give the definition of embryo included in the Act. Moreover, almost all respondents (92.1%) never met with lectures about legal aspects in the treatment of infertility. Half of the respondents (47.3%) correctly indicated the most common cause of female infertility, the reason of men infertility was correctly indicated more respondents (65.5%). CONCLUSION: Conclusions: The respondents knowledge of infertility is more extensive than their knowledge of the legal regulations about infertility treatment. Respondents asked about regulations included in the Act on the treatment of infertility of June 25, 2015 mostly did not answer questions or gave wrong answers. The respondents whose field of study was related to medicine gave more correct answers compared to people who study non-medical fields. Practicing Catholic (45%) more often gave wrong answers.

Prevalence of neoplasms in patients with acromegaly - the need for a national registry.

INTRODUCTION: Acromegaly is an endocrine disorder caused predominantly by pituitary adenoma leading to autonomic oversecretion of growth hormone and secondary elevation of insulin-like growth factor 1 (IGF-1). Consequently, there are both theoretical and experimental grounds for establishing a correlation between this disorder and the higher incidence of neoplasms. OBJECTIVE: The aim of the study is to evaluate the incidence and types of neoplasms among patients with acromegaly. MATERIAL AND METHODS: The study included 67 patients with acromegaly, aged between 24 and 75±18.8 years, 46 women (68.7%) and 21 men (31.3%), BMI: 30.7±5.7 kg/m2, age at diagnosis 49.1±12.5 years, with the medians of GH and IGF-1 levels at diagnosis of 11.3 ng/ml and 663.8 ng/ml, respectively. A retrospective analysis of medical records with particular regard to physical examination, medical history, laboratory and imaging tests was performed. RESULTS: Fifty-one patients (76.1%) suffered from at least one neoplasm, among whom 48 patients (71.6%) had benign proliferations, whereas malignant neoplasms (larynx, endometrial and colon cancers) were found in only three patients (4.5%). CONCLUSIONS: Benign neoplasms were found in majority of patients with acromegaly (71.6%) most notably: nodular goiter and colon polyps; malignant lesions were rare (4.5%). Only every fifth patient suffered from no neoplastic proliferations. No correlations between the studied parameters and the incidence of neoplasms were found, most likely due to the small number of patients. This is the reason for proposing the creating of the first national register of incidences of neoplasms among acromegalic patients.

Impact of experimental diabetes and chronic hypoxia on rat fetal body weight.

OBJECTIVES: The aim of the study is to determine the impact of the experimental diabetes and the chronic hypoxia on pregnancy development and rat fetal body weight. MATERIAL AND METHODS: The experiment was performed on female Wistar rats. Animals were divided into the experimen-tal groups. I - Controls, II - Untreated diabetes, III - Insulin-treated diabetes, IV - No diabetes with chronic hypoxia, V - Untreated diabetes and chronic hypoxia, VI - Insulin- treated diabetes and chronic hypoxia. Diabetes was induced in groups II, III, V and VI with intraperitoneal injection of streptozocin (STZ) at a dose of 40 mg/kg. Chronic hypoxia was induced by placing dams (groups IV, V and VI) in conditions of 10.5% oxygen and 89.5%. Insulin was administered subcutaneously at the dose of 9 IU/kg. Starting from the 6th day after STZ injection and chronic hypoxia conditions animals were caged together for 12 hours for 3 consecutive days to ensure fertilization. On day 21 of gestation the animals were decapitated, the fetuses were removed and weighted. RESULTS: Mean fetal body weight in separate groups were: I - 5.38 g, II - 6.04g, III - 5.32g, IV- 5.56 g, V - 3.45 g, VI - 6.23 g. CONCLUSIONS: Pre-existing type 1 diabetes does not affect fetal body weight compared to healthy newborn control rats. Pro-longed hypoxia does not impact on fetal body weight. Chronic hypoxia during pregnancy complicated with untreated type 1 diabetes mellitus leads to significant reduction of fetal body weight. Insulin treatment reversed the detrimental effect of chronic hypoxia on fetal development.

[testicles self examination - knowledge and abilities - survey study].

OBJECTIVE: Introduction: Testicle cancer is a common malignant cancer among young men (20 to 44 years). In 90% of cases we can feel nodule or change of consistency, which means during testicles self examination we can quickly discover cancer. The aim: To estimate the level of knowledge about testicles self examination among men and also medical stuff and students. PATIENTS AND METHODS: Materials and methods: We gathered the data through the internet questionnaire, which contained of 13 questions. There were 204 respondents (53% women and 47% men). 93% were related with medicine. Average age was 23,5 years old. The participation in the study was voluntary and annonymous. RESULTS: Results: Only 41% of our respondents perform self examination. When asked if They every had Their testicles checked by a doctor only 33% responded positively. Most of the respondents almost correctly point out symtpoms and risk factors of testicles cancer. Only 22% of medical related respondents feel confident while performing testicles examination with the patient and just 12% of them had a chance to do it during studies. We also asked our respondents if They have ever seen a social campaign about priopriate testicles self exmiantion and 80% of them respondet negatively. CONCLUSION: Conclusions: The level of education about testicles examination is on low level. Men are usually aware of the risk, but They neglect it. In most cases doctors do not examine testicles and are not confident about it. We have to put more concern to that case.

Frequencies of PD-1- positive T CD3+CD4+, T CD3+CD8+ and B CD19+ lymphocytes in female patients with Graves' disease and healthy controls- preliminary study.

PD-1 maintains tolerance and inhibits autoimmune responses. Graves' disease (GD) is one of the most frequent autoimmune diseases of unclear etiology. The aim of this study was to evaluate the percentage and absolute counts of PD-1 positive T and B cells in newly diagnosed, untreated patients with hyperthyroidism due to GD. The study group included 30 patients and the control group comprised of 20 age- and sex-matched healthy individuals. Results showed significantly higher frequencies and absolute counts of PD-1 positive CD3+CD4+ T cells, CD3+CD8+ T cells and CD19+B cells in patients with GD in comparison to the healthy volunteers. Moreover, higher mean fluorescence intensity of PD-1 was found on CD3+CD4+ T cells, CD3+CD8+ T cells and CD19+B cells in the study group than in the control group. These results suggest that PD-1 protein might involved in the pathogenesis of GD.

Diagnostics of intestinal parasites in light microscopy among the population of children in eastern Afghanistan.

OBJECTIVES: The Afghans, living in poor socioeconomic conditions, are estimated to be a community with a high rate of intestinal parasitic infections. The aim of the study was to estimate the prevalence and species of intestinal parasites among children's population in eastern Afghanistan and to present the methods of optimizing the techniques for identification of pathogens in light microscopy. The research was carried out as a part of humanitarian project Capacity building of health care system in Ghazni Province. MATERIALS AND METHOD: The study involved 500 children aged 7-18 attending the Share Kona and the Khuija Ali High Schools in Ghazni, eastern Afghanistan in the period November 2013-April 2014. Three stool samples were collected from each patient at 2-day intervals, the samples were fixed in 10% formalin, transported to the Military Institute of Medicine in Poland, where they were pooled and examined using five different diagnostic methods in light microscopy (direct smear in Lugol's solution, Fülleborne's flotation, decantation in distilled water, Kato-Miura thick smear, and DiaSys/PARASYS sedimentation system). RESULTS: Pathogenic intestinal parasites were detected in 217 patients (43.4%), with the most common Ascaris lumbricoides (35.3%), Giardia intestinalis (31.1%), and Hymenolepis nana (15.7%). The use of direct smear method allowed for the detection of intestinal parasites in 161 individuals. The application of four following testing methods has improved the detection rates of infected patients by 11.2%. CONCLUSIONS: The variety of detected intestinal pathogens in examined children's population has required the use of combination of multiple diagnostic methods in light microscopy, and finally improved the detection rates of intestinal parasites and helped eliminate infections with nematodes, cestodes, trematodes, and protozoa using appropriate treatment in the study population.

Capacitance of Membrane As a Prognostic Indicator of Survival in Head and Neck Cancer.

BACKGROUND: Evaluation of prognostic value of capacitance of membrane (Cm), parameter measured by bioelectrical impedance (BIA) as an alternative to known clinical factors in patients with Head and Neck Cancer (HNC). METHODS: A cohort of 75 stage IIIB and IV HNC patients treated in Department of Otolaryngology, Head and Neck Surgery, Medical University of Lublin, Poland were prospectively evaluated. Cm measurements were performed in all patients using a bioelectrical impedance analyzer that was set on a frequency of 50 kHz. Results of Cm measurements were presented in nF. Survival differences were estimated using Kaplan-Meier method. RESULTS: Significantly higher Cm median was noted in well-nourished(n = 45) compared to malnourished (n = 30) patients (1.41 vs 1.01 respectively; p = 0.0009). Established in ROC curves analysis cut-off value (0.743) was characterized by 98% specificity and 37% sensitivity in the detection of malnutrition. Median overall survival (mOS) in the cohort was 32months. At the time of analysis deaths were recorded in 47 cases (62.7%). In patients who had Cm below the level of 0.743 risk of OS shortening was significantly higher than in other patients (12.1 and 43.4 months respectively; HR = 8.47, 95%CI: 2.91-24.66; χ2 = 15.38, p = 0.0001). CONCLUSION: Cm is a strong, independent prognostic factor in head and neck cancer.