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© Borgis - Postępy Nauk Medycznych 12/2015, s. 878
Wojciech Zgliczyński
Comment
In this issue of “Progress in Medicine” dedicated to endocrinology readers will find three original articles, two interesting case reports and seven review articles.
Kasperlik-Załuska in the original article on Addison’s disease, through long-term observation has shown that in some patients it comes to seroconversion of positive to negative result of antiadrenal antibodies. This is an important observation which may explain the absence of anti-adrenal 21-hydroxylase antibodies in the proportion of individuals with this disease.
Misiorowska, basing on her research conducted on the supply of vitamin D in pregnant women in the Warsaw agglomeration stated that the majority of pregnant women do not adhere to the recommendation of Polish Gynecological Society regarding vitamin D supplementation or apply too law dose of this vitamin, which in consequence have various adverse effects on pregnancy. The recommended dose of 1500-2000 IU/d should be ordered by obstetrician at the first control visit.
Majos and Zgliczyński comparing the efficiency of short-acting somatostatin analogues demonstrated the superiority of the new analog pasireotide over the previously used octreotide. So, it can be expected that in the future pharmacotherapy of acromegaly, especially in cases resistant to currently used analogs, such treatment should be more effective with the use of newly developed pasireotide.
Papierska in a review article writes how to treat adrenal insufficiency effectively and safely. In addition she discusses the possible impact of used medication on metabolic and cardiovascular outcomes and informs about new hydrocortisone formulations.
Jastrzębska in the next review article discusses various aspects of the treatment of hypothyroidism, including cases of malabsorption or lack of patient compliance. This article has sought to answer the question posed in the title, whether the treatment of this disease is easy and simple or, perhaps in some cases, is a difficult challenge.
Gietka-Czernel in a review article discusses the issue of iodine deficiency in the world, its consequences and ways of iodine deficiency prevention. A new opportunity of enrichment the diet with iodine through the fortification of vegetables is mentioned.
Baranowska-Bik in a review article in a detailed manner describes, a rarely discussed in the literature subject of pineal tumors. These tumors characterize by a variety of symptoms and their diagnosis and treatment requires modern radiological, laboratory and surgical techniques.
Kozakowski in an illustrative work discusses the role of bariatric surgery in the treatment of extremely obese patients with diabetes. This method of treatment can lead to complete remission of diabetes (with total withdrawal from insulin and oral antidiabetic drugs), and cause a significant decrease in insulin resistance and improvement of dyslipidemia. Patients who had such operation must however be followed to pay special attention to identify and supplement nutritional deficiencies, vitamins and microelements.
Kruszyńska and Słowińska-Srzednicka in a review article present current informations about adverse effects on cardio-vascular system of elevated serum aldosterone and parathormone levels, and indicate on a correlation between these two hormones. It appears that the pharmacological inhibition of renin-angiotensin-aldosterone system lowers the serum levels of both aldosterone and PTH. Thus, the drugs which decrease the serum concentrations of aldosterone and PTH can significantly reduce the risk of cardio-vascular complications in part by their impact on vascular calcification.
Kochman in the last review article shows the spectrum of modern methods of imaging techniques useful in the diagnosis of medullary thyroid carcinoma and during further monitoring of the treated patients for recurrence or spreading of the disease process.
Łebek-Szatańska and Misiorowski present two interesting rare cases of iatrogenic hypoparathyroidism resulting from major surgery within the neck – in one case, and after radiotherapy in the same region in the second case, both for oncologic reasons. Potentially bad prognosis and short survival time in some such cases may mask the hidden problem of hypoparathyroidism but in patients cured of the cancer an undiagnosed hypoparathyroidism may in long term have marked impact on overall health and impair quality of life.
Gietka-Czernel presents a case report of fetal goiter discovered on screening USG investigation performed at the 20th week of pregnancy, which together with the results of TSH and FT4 measured in umbilical cord blood, let settle the diagnosis of hypothyroidism. The ordered treatment with L-thyroxine applied initially intraamniotic and then to the umbilical cord appeared effective.
I hope that the articles selected for this issue “Progress in Medicine” readers will find didactic.
Prof. Wojciech Zgliczyński, MD, PhD
Postępy Nauk Medycznych 12/2015
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