Postpartum thyroiditis is a form of autoimmune thyroiditis developing during the first 12 months postpartum in 5-10% of women as a consequence of the immunologic flare following the immune suppression of pregnancy. Autoimmune polyendocrine syndromes are rarely diagnosed conditions characterized by the association of at least two organspecific autoimmune disorders, and on the basis of their clinical picture, they may be divided into four different types. The underestimation of their real frequency probable results from physicians’ inadequate knowledge of these clinical entities and sometimes their atypical clinical picture. Although autoimmune thyroid disease may be a component of both type 2 and 3 autoimmune polyendocrine syndromes, but the association between postpartum thyroiditis and autoimmune conditions of other endocrine organs has very rarely been described in literature. We report a case of a young woman, who after two subsequent pregnancies developed postpartum thyroiditis of different clinical pictures. After her second pregnancy, postpartum thyroiditis was followed by the development of autoimmune adrenal failure and premature ovarian failure, which allowed to diagnose type 2 autoimmune polyendocrine syndrome. Our case study suggests that every person with postpartum thyroiditis, particularly if this disorder is accompanied by atypical clinical manifestation, should be assessed for the possible presence of autoimmune polyendocrine syndrome.

Implantation of the embryo in the cesarean section scar is a rare form of ectopic pregnancy. Such condition poses significant threat to a woman’s health and live, therefore, requires accurate diagnosis and rapid implementation of treatment. The following article presents the case of a patient with a pregnancy located in the scar after cesarean section treated in the Department of Gynecology and Obstetrics, Medical University of Silesia in Katowice, Faculty of Medicine in Katowice.

Connective tissue diseases are a group of more than 300 separate diseases. It can affect every system of organs, including the cardiovascular system. This process is particularly highly expressed in rheumatoid arthritis, systemic lupus erythematosus and scleroderma. Rheumatoid arthritis (RA) affects 0.5-1.0% of Europeans. The most common cardiac manifestation of RA is pericarditis. Its main risk factor is the occurrence of rheumatic nodules in people with the presence of serum rheumatoid factor. An important health problem in RA is also an increased risk of atherosclerosis and ischemic myocardial disease, the intensity of which grows independently of traditional risk factors and mainly depends on the severity of inflammation and duration of the disease. In rheumatoid arthritis also endocarditis, heart valves damage and ventricular arrhythmias can occure. Systemic lupus erythematosus (SLE) is most common in women between age 16 to 55. Cardiovascular complications of this disease are the third biggest cause of death of patients. The most common cardiac manifestation of SLE is pericarditis occurring in approximately 20 to 50% of the ill. Libman-Sacks non-infectious endocarditis characterized by thickening of the heart valves and the presence of non-bacterial vegetation is characteristic for SLE. Systemic sclerosis is characterized by progressive fibrosis of skin and internal organs and disorders of the morphology and function of blood vessels. Cardiac manifestations of systemic sclerosis are mainly heart failure and arrhythmias. The European League Against Rheumatism (EULAR) has developed a number of recommendations related to the prevention and therapy of cardiovascular events in RA. Since an increased risk of cardiovascular complications applies to many rheumatic diseases, there is a need to extend these recommendations to other connective tissue diseases.

Vitamin D is known for almost 100 years. Since time of its discovery, numerous studies on vitamin D function in the human body were performed. Considered from the beginning as an important factor in rickets prevention, thanks to the continuous development of knowledge, vitamin D is regarded now as an important factor from the point of view of the whole body homeostasis. Newly-find features of vitamin D allow to use this substance concentration in serum as a biomarker of general health and create opportunities of vitamin D use in the prevention and treatment of many diseases. The aim of this article is to present basic function of vitamin D in human body, sources of this substance, its metabolism and molecular mechanism of action, taking into account the evolution of the state of knowledge about Vitamin D - from early researches leading to its discovery, through the finding of its basic functions to the present studies on vitamin D mechanisms of action at molecular and genomic level.

Anemia is the most common disorder of the blood with iron deficiency being the predominant cause. On the other hand, diabetes prevalence is increasing rapidly. Over time, diabetes can damage the heart, blood vessels, eyes, kidneys, and nerves. Diabetic kidney disease (DKD) may be present in both types 1 and type 2 diabetes mellitus. Anemia is one of the common feature of chronic kidney disease. The epidemiological data on anemia prevalence are limited. In this review data on epidemiology, pathogenesis, complication and treatment of anemia in diabetic kidney disease are presented.

Merkel cell carcinoma is an aggressive, malignant, neuroendocrine tumor of the skin. The aim of the study is to present the clinical pictures, methods and results of treatment of MCC in the Clinic of Maxillofacial Surgery in Rzeszow in years 2003-2010. Changes were located on the skin of the face of four patients. All patients were treated surgically, the primary change was removed. Recurrence after surgical treatment was observed in all patients. The observations confirmed the data from the literature about the incidence of MCC over 75 years of age, aggressiveness and difficulties in treatment of this disease.

Although the development of technologically advanced imaging techniques has progressively reduced the use of chest X-ray in clinical practice, it is still an invaluable tool to evaluate different diseases of the respiratory and cardiovascular systems. We are presenting a case of a 55-year-old male with arterial hypertension, severe mixed hearing loss who was referred to an internal medicine ward due to abnormal mediastinal and cardiac contours observed in a routine chest X-ray. The finding was linked to an anomalous aortic course what was confirmed within transthoracic echocardiography. The computed tomography angiography of the whole aorta revealed the right sided aortic arch (RSAA) with four large arteries arising from the aortic arch, including the aberrant left subclavian artery compressing the esophagus causing though no symptoms. Since RSAA might be associated with other cardiovascular diseases and genetic disorders including 22q11.2 deletion syndrome, we have conducted a complex diagnostics which showed additionally a decreased level of lymphocytes. The patient did not consent to genetic diagnostics and was qualified for conservative treatment of his disorders. In conclusion, a plain chest radiograph with the assessment of heart silhouette must not be neglected in cardiologic diagnostics. The identification of even asymptomatic aortic anatomic variant should be followed by the whole aorta angiography and a detailed assessment of the patient. RSAA bears potential risk of tracheostomy bleeding, unforeseen problems in transradial coronary procedures and potential problems during thyroid surgery, also because of abnormal recurrent laryngeal nerves’ course.

Aging is associated with important changes in thyroid hormone secretion, metabolism, and action. It remains unclear, however, whether altered activity of the hypothamic-pituitary- thyroid axis represents physiologic changes in thyroid function or whether they are secondary to thyroid dysfunction. The prevalence of thyroid disorders increases with age, but because some thyroid-associated symptoms are similar to symptoms of the aging process, these disorders are relatively rarely diagnosed. On the other hand, because of the possible presence of chronic, non-thyroidal illnesses or pharmacotherapy, diagnosis of thyroid disorders in older populations is often much more challenging than in young people. Progress made in better understanding of thyroid disorders in older people has thrown a new light on the management of patients with these disorders, the clinical picture of which is often atypical. Therefore, physicians need a high index of suspicion to detect thyroid dysfunction in an older person with multiple comorbidities and chronic polypharmacy. The purpose of this article is to review the present state of knowledge on the age-related changes in hypothalamicpituitary- thyroid axis activity and to discuss the clinical course, diagnosis and treatment of thyroid disorders in the elderly.