© Borgis - Postępy Nauk Medycznych 12/2016, s. 944-945
Jastrzębska discusses in the section “Recommendations” the guidelines developed in 2016 by the European Group on Graves’ Orbitopathy (EUGOGO), taking into consideration both the diagnostics and the treatment of thyroid-associated orbitopathy. It is worth emphasising the fact of introducing to the recommendations on treating mild/severe lesions, apart from the standard one, also an increased dose of methylprednisolone. Conditions of the risk of loss of sight are accompanied, apart from the optic nerve neuropathy and cornea ulceration, also by eyeball subluxation constituting an indication for immediate surgical decompression of the orbital cavities.
Godziejewska-Zawada and Szyfner tried to define in their paper “Rapid-onset type 1 diabetes mellitus in middle-aged and older persons”, whether in the case of patients over 40 with a recently diagnosed diabetes mellitus, there are factors which may forecast the occurrence of a rapidly showing type 1 diabetes. Such factors, which should draw the doctor’s attention, are: very high glycaemia at the beginning of the inpatient stay at disproportionately low concentration of glycated haemoglobin and rapid dependence on insulin, making it impossible to apply oral medication under hospital conditions.
Kruszyńska et al. show in their paper “High prevalence of autoimmune thyroiditis in Polish PCOS women and its association with insulin resistance” that in the case of women with polycystic ovary syndrome, Hashimoto’s thyroiditis is present in nearly 35%, while hypothyreosis in 23%. Moreover, women with concomitant polycystic ovary syndrome and autoimmune thyroiditis have an increased concentration of insulin and higher HOMA index. The authors conclude for patients with polycystic ovary syndrome to exclude Hashimoto’s thyroiditis and hypothyroidism.
The article by Nowak et al. concerning the usefulness of OGTT in finding carbohydrates metabolism disorders in patients chronically treated with glycocorticosteroids shows the results of preliminary tests concerning this issue. A fact was indicated that the binding guidelines based only on monitoring glucose concentration fasting are impractical and useless. It is recommended to perform an oral glucose tolerance test in all the patients treated chronically with glycocorticosteroids regardless of other risk factors of diabetes, since it is the most effective screening test.
Bornikowska et al. presented an interesting case of a late diagnosed Kallmann syndrome, one of the most frequent causes of congenital hypergonadotropic hypogonadism with concomitant smell disorders. The paper emphasises the fact of how difficult it is to diagnose the syndrome, especially in the early period of life in girls due to few symptoms in the course, and in youth due to the difficulty in differentiation with a constitutionally retarded growing and maturation.
Juszczyszyn et al. present in their paper a description of a case of a woman with adrenal incidentaloma. Tumour phenotype in imaging corresponded to a benign lesion. However, in the course of diagnostics it turned out that a large lipid content in the tumour excluded the presence of chromaffin texture. There are mixed tumours, “chimeric”, which apart from a significant lipid content, typical of adenomata, also contain chromaffin texture. They constitute a rare, yet significant diagnostic problem, an example of which is the presented case study.
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