The trace elements studied in this work (Se, Cu, Zn) are the essential constituents or cofactors required to activate numerous enzymes and proteins, playing crucial role in various physiological processes. The disturbed levels of abovementioned elements may adversely affect the endocrine system, resulting in various thyroid disorders among other upsets. The aim of this study was to investigate possible associations between them and parameters of redox balance, thyroid function indices as well as clinical records (duration of disease and therapy, lag time between thyroid surgery and this study examination, LT4 dosage) in patients with different thyroid disorders, including malignant diseases of the gland. In the group of patients with papillary carcinoma, we found a statistically significant higher Cu concentration compared with controls and patients with Hashimoto disease. In the same groups, the parameter of Zn/Cu ratio demonstrated reciprocally arranged statistically significant differences. For the group of papillary cancer patients, there was a negative correlation between lag time since thyroid operation and GPX3 activity. Our data support hypothesis of indirect involvement of Zn and Cu in thyroid regulation. For selenium, lack of simple correlation between its serum level and thyroid indices implies the need for further research on other selenium status parameters more adequately depicting changes in endocrine system.

Purpose Ectopic Cushing Syndrome (EAS) is a rare condition responsible for about 5–20% of all Cushing syndrome cases. It increases the mortality of affected patients thus finding and removal of the ACTH-producing source allows for curing or reduction of symptoms and serum cortisol levels. The aim of this study is to present a 20-year experience in the diagnosis and clinical course of patients with EAS in a single Clinical Centre in Southern Poland as well as a comparison of clinical course and outcomes depending on the source of ectopic ACTH production–especially neuroendocrine tumors with other neoplasms. Methods Twenty-four patients were involved in the clinical study with EAS diagnosed at the Department of Endocrinology between years 2000 and 2018. The diagnosis of EAS was based on the clinical presentation, hypercortisolemia with high ACTH levels, high dose dexamethasone suppression test and/or corticotropin-releasing hormone tests. To find the source of ACTH various imaging studies were performed. Results Half of the patients were diagnosed with neuroendocrine tumors, whereby muscle weakness was the leading symptom. Typical cushingoid appearance was seen in merely a few patients, and weight loss was more common than weight gain. Patients with neuroendocrine tumors had significantly higher midnight cortisol levels than the rest of the group. Among patients with infections, we observed a significantly higher concentrations of cortisol 2400 levels in gastroenteropancreatic neuroendocrine tumors. Chromogranin A correlated significantly with potassium in patients with neuroendocrine tumors and there was a significant correlation between ACTH level and severity of hypokalemia. Conclusion EAS is not common, but if it occurs it increases the mortality of patients; therefore, it should be taken into consideration in the case of coexistence of severe hypokalemia with hypertension and muscle weakness, especially when weight loss occurs. Because the diagnosis of gastroenteropancreatic neuroendocrine tumor worsens the prognosis-special attention should be paid to these patients.

Observed association between improved iodine supply and decrease of incidence of stomach cancer could indicate the protective role against stomach cancer of iodine prophylaxis in iodine deficient areas--further studies are necessary.

Background: Iodine prophylaxis in Poland started in 1935 and has been interrupted twice: by World War II and in 1980 for economic reasons. Epidemiological surveys carried out after the Chernobyl accident in 1989 as well as in 1992/1993 and in 1994 as a`ThyroMobil' study, revealed increased prevalence of goitre in children and adults. Ninety per cent of Poland was classified as an area of moderate iodine deficiency, and 10%, in the seaside area, as mild iodine deficiency territory. Iodine prophylaxis based on iodisation of household salt was introduced again in 1986 as a voluntary model and in 1997 as a mandatory model with 30^10 mg KIakg salt. Objective: The evaluation of the obligatory model of iodine prophylaxis in schoolchildren from the same schools in 1994 and 1999. Methods: Thyroid volume was determined by ultrasonography. Ioduria in casual morning urine samples was measured using Sandell±Kolthoff 's method, within the framework of the ThyroMobil study. Results: Goitre prevalence decreased from 38.4 to 7% and urinary iodine concentration increased from 60.4 to 96.2 mg/l mean values between 1994 and 1999. In four schools the prevalence of goitre diminished below 5%. In 1999, 70% of children excreted over 60 mg I/l, and 36% over 100 mg I/l, whereas in 1994 the values were 44 and 13% respectively. Conclusion: The present findings indicate that iodine prophylaxis based only on iodised household salt is highly effective.

The results of these studies imply that estrogens may at least modify the proliferation of thyroid cancer cells. The sex hormones probably intensify the actions of other carcinogens as well.