Congenital adrenal hyperplasia (CAH) represents a group of autosomal recessive disorders characterized by enzyme deficiencies thatimpair adrenal steroidogenesis, most commonly due to 21-hydroxylase deficiency. The biochemical defects in CAH translate to a spectrumof clinical consequences, which include adrenal insufficiency, genital ambiguity or disordered sex development, infertility, short stature,and an increased risk of metabolic syndrome during adolescence and adulthood. The severity and clinical features of CAH vary dependingon the enzymatic defect, residual enzymatic activity, the age of presentation, and genotype. This review comprehensively covers the genetic background, classification, and clinical spectrum of CAH, including classical and non-classical forms. We discuss the importance and implementation of neonatal screening programs for early diagnosis and intervention. Specialattention is given to differences in treatment approaches between children and adolescents, highlighting the challenges of optimizingglucocorticoid and mineralocorticoid therapy across developmental stages. Furthermore, we present emerging novel pharmacologicalagents currently in clinical trials aimed at improving disease management. The review also addresses potential complications associatedwith CAH, such as metabolic syndrome, cardiovascular risks, and bone health issues. Emphasizing a patient-centered approach, wehighlight the critical role of experienced endocrinologists in delivering individualized care to improve long-term outcomes. Our review summarizes the current knowledge, aims to guide clinicians in evidence-based management and highlights ongoing research into innovativetherapies for CAH.
The current update of the “Recommendations for the Management of Thyroid Cancer in Adult Patients” is based on a critical appraisalof whether the recommendations published in 2022 by the Polish Scientific Societies and the National Oncology Strategy remain valid,and which statements require modification or updating in light of the American Thyroid Association (ATA) Guidelines published in 2025. We have also taken into account the most recent National Comprehensive Cancer Network (NCCN) recommendations, as well as guidelines from other international and European scientific societies addressing thyroid cancer, adapting them to the specific epidemiologicaland legal conditions in Poland. We decided that the current Recommendations would not include management of medullary thyroid cancer, as, in our opinion, the Polish Guidelines published in 2022 and 2024 remain up to date. The Recommendations are divided into two sections: “General Principles” and “Clinical Management”. The “General Principles” sectionoutlines the key principles of thyroid cancer management, whereas the “Clinical Management” section specifies these principlesaccording to the risk of recurrence, incorporating the well-established and highly accurate ATA 2025 risk stratification system. Thus,the reader will find specific management recommendations depending on whether the patient has low-risk or high-risk thyroid cancer. The “Clinical Management” section includes a dedicated subsection outlining the recommended clinical approach to thyroid noduleswith indeterminate cytology. In these Recommendations, the management of anaplastic thyroid carcinoma and thyroid lymphomas is addressed in a separate subsection. In addition, brief information on other rare histological subtypes of thyroid cancer is also provided.
Introduction: Osteoporosis is a significant health concern among postmenopausal women owing to its association with increased fracture risk and morbidity. Although traditional risk factors such as hormonal changes, dietary intake, and physical activity have been extensively investigated, the role of muscle mass, particularly abdominal muscle mass, in bone health remains incompletely understood. This study aimed to investigate the association between abdominal muscle mass, as measured by computed tomography (CT), and osteoporosis in postmenopausal Korean women. Material and methods: This retrospective cross-sectional study included 1,723 postmenopausal women who underwent both abdominal CT and dual-energy X-ray absorptiometry (DXA) for bone mineral density (BMD) assessment. Abdominal muscle mass was quantified using total abdominal muscle area (TAMA) at the L3 vertebral level on CT. Osteoporosis was defined as a T-score <= -2.5 at the lumbar spine or hip. Multivariable logistic regression analyses were conducted to examine the association between TAMA and osteoporosis, adjusting for age, body mass index, lifestyle factors, and biochemical markers. Results: Participants in the highest TAMA quartile exhibited significantly higher BMD in both the lumbar spine and hip than those in the lowest quartile (p < 0.05). Higher TAMA was independently associated with a lower risk of osteoporosis (adjusted OR, 0.365; 95% CI, 0.199-0.669; p = 0.001), even after adjusting for confounding variables. Conclusions: Greater abdominal muscle mass was significantly associated with a lower risk of osteoporosis in postmenopausal Korean women. These findings suggest that maintaining muscle mass may play a protective role in bone health.
Introduction: Iodine is a crucial element for thyroid hormone synthesis and plays an important role in regulating the body’s basal metabolism. The aim of our study was to evaluate iodine status, thyroid volume, and thyroid function in pregnant women during the firsttrimester of pregnancy. Material and methods: This study included 130 healthy pregnant women in their first trimester between November 2022 and May 2024. However, urinary iodine concentration (UIC) data could not be obtained for two participants, and urinary iodine/creatinine ratio datawere missing for four participants because of insufficient sample volume. Laboratory tests, including free triiodothyronine (fT3), freethyroxine (fT4), thyroid-stimulating hormone (TSH), and thyroglobulin (Tg), were performed. First-morning single-spot urine samples were collected, and urinary iodine and creatinine concentrations were determined. The urine iodine/creatinine ratio (μg/g) was calculatedusing the following equation: urine iodine (μg/L)/urine creatinine (mg/dL) × 100. The thyroid gland, including thyroid volume, wasevaluated using ultrasonography. Results: The median UIC was 107.00 μg/L, indicating mild iodine insufficiency at the population level according to the World Health Organization criteria for pregnancy. Analysis of the spot urine samples revealed that 90 samples had a UIC below 150 μg/L. When the relationshipbetween the urine iodine/creatinine ratio and the measured parameters was investigated, Tg levels (p = 0.006) and thyroidvolume (p = 0.039) were significantly higher in the group with a urine iodine/creatinine ratio below 50 μg I/g Cr. Conclusions: The statistically significant associations between the urine iodine/creatinine ratio and both Tg and total thyroid volume suggest a potential relationship between these parameters and lower urinary iodine/creatinine ratios.
