Introduction and purpose: Acromegaly is a rare disease which occurs with the frequency of 0.2-1.1 cases per 100 000 patients per year. The main cause is the excess level of growth hormone (GH) which stimulates the liver to the insulin-like growth factor type 1 (IGF-1) secretion. IGF-1 leads to the tissues overgrowth. In addition, acromegalic patients suffer from many comorbidities, such as: cardiovascular, endocrinological, neoplastic and musculoskeletal complications. The main aim of this review is the update of the latest information concerning cardiovascular comorbidities in patients with acromegaly.State of knowledge: Studies revealed that 80% of acromegalic patients will develop cardiovascular comorbidities. Complications such as: hypertension, cardiomyopathy, arrhythmia, heart valve disease, atherosclerosis and coronary heart disease as well as myocardial infarction were the most widely described. They are responsible for 44% of deaths in the first decade of the acromegaly and 23% in the second one.Conclusions: Because of the delayed diagnosis of acromegaly in most patients, most comorbidities are discovered in advanced stages leading to the decrease in patients’ life span. Adequate knowledge about potential complications is necessary to increase patients’ quality of lives.
Introduction and purpose: The problem with infertility affects between 8 and 12% of reproductive-aged couples. Among the reasons, smoking, adulterated food, hormonal disorder are featured. Our purpose is to check how micronutrients impact fertility. Brief description of the state of knowledge: Micronutrients deficiency, specifically zinc and selenium deficiencies have also unpropitious impact on fertility. In this review, the potential role of these microelements in male and female reproductive health is considered. Zinc had been proved to regulate sperm motility, spermatogenesis and reduce oxidative stress. Lower delivery of selenium decrease testosterone level by causing changes in receptor of the luteinising hormone. It is also compared with lower spermatozoa concentration. In this review the role of iron, manganese, lead, nickel, copper, magnesium and cobalt is described as well. Summary: Deficiencies of some micronutrients may make worse the fertility. That's the reason why additional supplementation may be important in the treatment of infertility.
Introduction and purpose: Male hypogonadism is diagnosed in patients with total testosterone under 9-12nmol/L (250-350ng/dl) in serum which is associated with numerous symptoms which can severely lower the quality of patients life. Due to the cause and associated levels of gonadotropins it can be divided to hypergonadotropic and hypogonadotropic hypogonadism. Hypogonadotropic hypogonadism occurs far less often, but it’s considered to remain underdiagnosed. The purpose of this study is to review most of the inborn diseases that involve hypogonadotropic hypogonadism as one of their components.Current state of knowledge: Patients with Kallmann syndrome constitute the majority of confirmed hypogonadotropic hypogonadism cases, however due to variable epidemiological data and differing diagnosing processes the exact incidence cannot be estimated – it ranges from 1 in 85 000, to 1 in 5000 males and about 3-4 times less often in women. Other conditions that can occur with hypogonadotropic hypogonadism are Isolated Gonadotropin-Releasing Hormone deficiency, Gonadotropin disorders, Prader-Willi Syndrome, some pleiotropic syndromes like CHARGE syndrome, Patau syndrome, Pfeiffer syndrome, Hartsfield syndrome, Waardenburg syndrome, Bardet-Biedl syndrome, or other syndromes. The evaluation and treatment of some of these conditions does not involve hypogonadism or other gonadal disorders due to short lifespan, which cause the underestimations in hypogonadism morbidity.Conclusions: Regardless of lower incidence of hypogonadotropic hypogonadism compared to hypergonadotropic type, endocrinologists should stay aware of its under-diagnosis and actively search for signs of low gonadotropic hormones and gonadotropin-releasing hormone levels in hypogonadal patients.
Introduction and purpose: Total lack of testosterone or its level lower than 9-12 mmol/L (250-350 ng/dL) of serum in men is called hypogonadism. Due to the importance of testosterone in male body, hypogonadism usually causes a variety of symptoms, mostly of sexual naturelack of libido, erectile dysfunction, infertility and associated psychological problems, it can though be the cause of more dangerous changes in the male body. The purpose of this study is to review possible systemic complications of male hypogonadism (with the emphasis on hypogonadotropic hypogonadism) apart from those sex-related. State of knowledge: The lack of testosterone and gonadotropins was proven to cause a number of negative changes in different systems and various clinical situations. It can negatively impact the condition of skeletal system. Although testosterone is widely thought to increase cardiovascular risk some studies show that the hypogonadism has a negative impact on it as well. Some studies hypothesised the role of hypogonadism in anaemia development, but generally it isn't taken into account in investigation of this condition. Some studies show the impact of hypogonadism on higher risk of some metabolic and endocrine diseases. The most interesting conclusions were found in literature on oncological implications of testosterone and lack of it. It turns out that there is a number of studies showing the positive impact of relatively higher testosterone concentrations while androgen deprivation therapy is the main therapeutic option in advanced prostate cancer. Conclusions: Due to very unpleasant and possibly dangerous complications of hypogonadism endocrinologists should stay alert to signs of hypogonadism to be able to start testosterone replacement in the right moment.
INTRODUCTION AND PURPOSE Recent studies have shown that changes in the microbiome, probiotic and antibiotic supplementation, can significantly modulate various forms of neuropsychiatric disorders - such as depression, anxiety and stress-related disorders. There is growing body of evidence pointing to a bidirectional correlation along the brain-gut microbiota line. This axis is connected through endocrine, immune and neuronal pathways. The nerves that make up the enteric nervous system transmit modifications occurring in the gastrointestinal tract and through the vagus nerve to the central nervous system (1). The main purpose of this review is to update recent information on the correlation between the gut microbiota and mental health. STATE OF KNOWLEDGE Interactions between the gastrointestinal system and brain function have become an important field of psychiatric research in recent years. Probiotics are thought to be a potentially valuable player in the treatment of many neuropsychiatric disorders. However, the role of specific gut microbiota species in the development of these disorders remains unclear. CONCLUSIONS Increasing knowledge of the correlation between gut microbiota and mental health may improve the quality of treatment for patients with neuropsychiatric conditions. Further research on larger groups is needed to assess whether probiotics can modify altered psychological well-being and be integrated into current, conventional treatments.
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