Introduction and purpose: Management of polycystic ovary syndrome (PCOS) is difficult since the exact pathogenic mechanism has not been established yet. Due to that fact, the substances registered to treat PCOS are still lacking efficacy and are associated with a number of adverse effects. The aim of this study is to review new possible treatment approaches.   State of knowledge: Inositol administered alone or combined with oral contraceptive drugs improves patients’ hormonal status and alleviates the weight increase in comparison to oral contraceptive drugs on their own. Berberine reduces insulin resistance, improves lipid metabolism, and reduces inflammatory reactions. Glucagon-like peptide-1 receptor agonists have a better weight loss effect and less severe adverse reactions than metformin. Thiazolidinediones combined with metformin improve ovulation rate, acne and increase SHGB levels. Thiazolidinediones have also less severe adverse reactions than metformin and can be useful in patients who are not able to tolerate metformin.   Summary: The review has shown that inositol, berberine, glucagon-like peptide-1 receptor agonists andthiazolidinediones have promising therapeutic effects in terms of PCOS treatment, however, more research is needed to establish safety and efficacy of those agents. Nonetheless, results of this study may be utilized in the education of health specialists in endocrinology departments.

Introduction: Academic burnout is emerging as an essential obstacle in education process. Students of the most challenging fields of study with high degrees of stress are thought to be at the highest risk. Medical studies are considered one of them. The aim of the study was to measure the levels of academic burnout, stress and gratitude among Polish medical students of Medical University of Lublin, and determine their styles of coping with stress. Materials and methods: A cross-sectional study was conducted using a questionnaire comprised of the following: Maslach Burnout Inventory – Student Survey (MBI-SS), Rosenberg Self-Esteem Scale (SES), a Coping Inventory for Stressful Situations (CISS) and a Gratitude Questionnaire Six-Item form (GQ-6). The data was obtained from 773 medical students. Results: Total number of 169 students (21.86%) met criteria for academic burnout. When it comes to 354 participants, they displayed signs of low self-esteem (45.8%). The number of 18 students showed low level of gratitude, while gratitude level of the majority of them – 496 (64.17%) was high. The most common style of coping with stress was emotions-oriented style – 354 students (48.29%), followed by task-oriented style – 345 students (47.07%). Burnout subscales turned out to be associated with age, year of study, self-esteem, gratitude and different styles of coping with stress to the various extent. Conclusions: The prevalence of academic burnout among Polish medical students is high compared with general population across various occupations. Utilisation of protective characteristics of high self-esteem, gratitude and healthy coping methods can result in development of efficient anti-burnout prevention strategies and intervention tools.

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: 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.